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Monday, August 24, 2009

Governor Rounds Disingenuous on Indian Health Care

Insurance salesman and South Dakota Governor Mike Rounds offers disingenuous arguments about Indian Health Services to make the case against health care reform:

The rate of diabetes, obesity and tobacco use is high on Indian reservations across America. And due to a lack of federal funding, patients can't always get the treatments they need.

"Indian Health is an example of a government run system in the United States today," Rounds said.

Congress has a treaty obligation to provide quality health care on reservations, but Governor Mike Rounds says historically, it doesn't happen.

"Apparently they disagree, because if you take a look at the funding for Indian health, it's about half of what it is for other government paid for programs, which is Medicaid and Medicare," Rounds said.

Rounds says reform is needed but is afraid if Congress passes a government run health care system, all South Dakotans would suffer.

"I don't think you take a system in South Dakota that provides good high quality care for 91 percent of our population and throw it out and say, 'Guess what? We've decided on a lark that we're going to start over with a brand new system that has no evidence of success,' at least if you're comparing it to Indian health," Rounds said [Don Jorgenson, "Indian Health Care: Rounds' Concerns," KELOLand.com, 2009.08.21].

What Rounds gets wrong:
  1. H.R. 3200 and the big debate we're having this summer is about reforming health insurance, not having the government own and operate hospitals, hire doctors, buy medicine, etc., as it does with the Indian Health Service.
  2. Rounds contradicts his own argument: he says the fact that Uncle Sam doesn't give IHS enough funding shows Uncle Sam can't do health care, but then he acknowledges that government manages to fund other health care programs at double the IHS levels. Which is it, Governor Rounds: can government find the funding for health care or not?
  3. If IHS lacks funding, it's because its "customers," American Indians, comprise less than 2% of the population and have little political clout. The customers of Medicare comprise 13% of the population—that proportion could double as baby boomers retire—and they have disproportionate political clout (old folks vote!)
  4. "No evidence of success"?! Right: dozens of other indutrialized countries using some form of public health insurance and achieving cost savings and longer life spans are just left-wing propaganda. The public option in the city of San Francisco that has insured more people without knocking private insurers out of the market is a figment of our imagination (although the NYTimes op-ed touting San Francisco's success was written by William Dow, a former member of President George W. Bush's Council of Economic Advisors).
Governor Rounds is right that Indian Health Services struggles to provide care. We have a moral obligation to increase funding for IHS and live up to our promises. But we also have a moral obligation to recognize the difference between government-run health care (that's IHS) and reforming health insurance. That's what President Obama wants to do... and that's what insurance agents like our governor want to avoid at all costs... even the cost of twisting the truth.


  1. I'm not the only one to say this, but fury from Medicare members about the imaginary threat to their program shows just how successful a government health care can be. Republicans fought that and claimed it would bring socialism to the country, and now they wouldn't dream of touching it for fear of getting dominated in elections. The government isn't a bogeyman.

  2. In Monday's Argus Leader article on Indian Health, it gave figures comparing Indians and non-Indians that includes an alcoholism rate eight times higher (43.6%), Cervical Cancer rates almost twice as high, Diabetes three times higher, Homicide twice as high and several others. The core issue is alcoholism and diabetes on our reservations compounded with a lack of industry and jobs, and perhaps lack of initiative.

    While we need to address the understaffing of Indian Healthcare, that alone will not change the future of healthcare needs on the reservations.

    We're not going to solve those internal issues, we can only address them. The people themselves must decide they want to live healthier more productive lives and that factor will reduce healthcare needs on the reservations. There also has to be hope and opportunity fueled by desire and successful mentors from their own tribes.

    More money probably won't change anything other than provide faster treatment of issues that have festered for generations.

  3. Whatever the cause, do we just say, "Well, those darn Indians keep making bad choices, so let 'em die"? (Who sounds like the death panel around here?) I would think greater medical problems on the reservations warrant greater response by the federal government (and don't forget treaty obligations). Those greater medical problems shold also blunt arguments that government can't do health care right: the government is tackling health care in the hardest areas possible, where the private sector fears to tread.


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