By Dave Baldridge
The Devil Is in the Budget Details
At its heart, healthcare for American Indians has been initiated and sustained by Congress as a nonnegotiable right, in exchange for tribal lands and loss of sovereignty. The federal Indian Health Service (IHS), an agency within HHS, has provided American Indians (AI) and Alaska Natives (AN) healthcare since 1955, following implementation of the Transfer Act of 1954 (P.L. No. 83-568).
The Census reports that the 5.2 million AIAN population is growing at three times the national rate, the number of AIANs ages 65 and older will triple by 2050 and the number of people ages 85 and older will increase by eight times, from 42,000 to 300,000, according to the National Academy of Social Insurance. Clearly, AIAN elders will be among the first affected and least able to recover from cuts to Medicaid and Social Security. Their loss of federal health coverage cannot be replaced by the purchase of private insurance.
Indian country’s responses to health disparities often reveal a longer view of the social contract— perhaps best expressed in the Seventh Generation credo of the Iroquois Confederacy—a centuries-old coalition of northeastern tribes. It says that each of us should consider every action we take in terms of its effects upon on our unborn children seven generations from now. It emphasizes respecting and preserving the safety and well-being of elders.