Arizona Republic Examines State of Native American Health Care

The Arizona Republic on April 14 reported on the state of health care for Native Americans, who have a mortality rate up to seven times higher than that of other Americans, as well as higher rates of disease. In Arizona, the average life expectancy for Native Americans is 55 years, compared with 72 years for whites. Further, the rate of tuberculosis is five times worse for Native Americans than whites, and the rate of diabetes among Native Americans is the "worst ... in the world." Mortality rates from heart disease and cancer are increasing for Native Americans, while the rates for other Americans are improving. HHS' Indian Health Service provides health services for approximately 1.5 million Native Americans and has a budget of $3.2 billion. According to a study compiled by a group of tribal and Indian health leaders, IHS would need to spend more than $7 billion per year to provide care comparable to what other Americans receive and more than $15 billion per year to "add and improve facilities to make the system equal." IHS spends approximately $1,920 per Native American per year, compared with the more than $4,390 private health plans budget per beneficiary. The federal government spends about $3,859 per Medicaid beneficiary, $5,600 per Medicare beneficiary and more than $5,700 per veteran. Federal funding of IHS has "remained nearly flat" over the last few years, even while the Native American population grows by about 2% per year and medical costs rise "about 10% to 12% a year." Senate Majority Leader Tom Daschle (D-S.D.) intends to request an additional $4.4 billion for IHS this year. But Dr. Stephen Kunitz, a professor of community and preventive medicine at the University of Rochester School of Medicine, said, "If Congress in its wisdom or malevolence or thoughtlessness holds funding [for the IHS] constant or at a 1% to 2% increase, things will get worse" (Nichols, Arizona Republic, 4/14).