President Bush’s federal budget request for fiscal year 2005 includes $2.97 billion in funding for the Indian Health Service--an increase of $45 million over FY 2004. But the National Indian Health Board (NIHB), an organization that serves tribal governments in advocating for improved health care delivery to American Indian and Alaska Native (AI/AN) people, charges that this amount still “falls well short of the level of funding that would permit [AI/ANs] to achieve health and health system parity with the majority of other Americans.”
Testifying before the Senate Indian Affairs Committee in February, NIHB Chairman H. Sally Smith, a member of Alaska’s Yupik tribe, argued: “No other segment of the population is more negatively impacted by health disparities than AI/ANs, and tribal members suffer from disproportionately higher rates of chronic disease and other illnesses. [Yet] health care spending for AI/ANs lags far behind spending for other segments of society. It is unfortunate that despite two centuries of treaties and promises, American Indians are forced to endure health conditions and a level of health care funding that would be unacceptable to most other U.S. citizens.”
So if $2.97 billion is not enough to make a difference in improving what Smith calls “the deplorable health of American Indians,” how much money is really needed? The NIHB reports that tribal leaders have developed a Needs-Based Budget for IHS funding that reflects a more realistic assessment of the health needs of Indian Country. The result of several years of meetings between tribal governments and health providers throughout all areas of IHS, the Needs-Based Budget for FY 2005 documents the agency’s health care funding needs at $19.4 billion.
In her Senate testimony, Smith called attention to several areas of the President’s proposed IHS budget that NIHB feels are seriously underfunded when compared to the documented need. They include:
• Construction of sanitation facilities in AI/AN homes and communities.
• Contract Health Services funding and contract support costs.
• Preventive health resources aimed at reducing AI/ANs’ risk of developing serious chronic diseases like diabetes, cancer and cardiovascular disease.
• Public health funding to help tribal communities prepare for and respond to potential terrorist attacks.