The Indian Health Service Must Be Held Accountable
By Sen. John Thune
The Indian Health Service (IHS) is broken. It has been for a long time. And while it might shock some people to know that the federal agency whose sole mission is to raise the “physical, mental, social, and spiritual health” of Native Americans is so fundamentally flawed, it will, unfortunately, come as no surprise to the tribal members throughout South Dakota who depend on it for their health care needs. The IHS is in such dire straits that even a nominal improvement in health care delivery would be far less than what Native American men, women, and children deserve.
While there are many hard-working people who do good work for the IHS, too many systemic challenges remain. The status quo is unacceptable, and it has to change. Words are important, but we are far beyond the time for Congress to take meaningful action to correct these problems. I intend to be part of the solution.
Last year, I introduced comprehensive legislation that would reform the IHS and hold its leaders more accountable to Congress and the communities they serve. I drafted the bill with a colleague from a neighboring state who heard stories similar to the ones tribal members had shared with me. One story in particular stuck with me – a young mother who was in labor at an IHS facility was relegated to giving birth on a bathroom floor without a single medical professional there to help her. It was because of heartbreaking stories like this one that we put pen to paper on our IHS Accountability Act. Enough was enough.
After the i’s were dotted and the t’s were crossed, the Senate Committee on Indian Affairs (SCIA) traveled to South Dakota to hear directly, again, from the tribal members whose lives would be affected by our bill. SCIA field hearings aren’t common, so I knew we had a unique opportunity to gather feedback that the committee likely wouldn’t otherwise receive. I’m still thankful that the committee gave South Dakotans such a strong platform to share their stories.
This year, with a new Congress upon us, we’ve teamed up with more senators and representatives to introduce an improved version of our bill. The Restoring Accountability in the IHS Act would accomplish several core goals I’ve sought to implement, including giving the U.S. Department of Health and Human Services secretary greater flexibility to terminate poorly performing employees, streamlining the hiring process so IHS can get additional dedicated and talented medical professionals on the job faster, and creating and expanding incentives so those folks stay on the job longer.
None of this would be possible, though, without continued consultation with tribal leaders and members. Their feedback is critical. They know these issues better than anyone, especially D.C. bureaucrats who are disconnected from the day-to-day life in tribal communities throughout the Great Plains. Together we can accomplish the goal of bringing accountability back to the IHS, and I look forward to finally making it happen.
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Perhaps we should consider the fact that government just isn’t very good at delivering healthcare. A private hospital or healthcare organization is forced to react to market pressures and if a certain organization is providing poor health care, that organization would be forced to make some quick changes or risk being out of business.
In its current structure, IHS never has to worry about going out of business. That becomes problematic because there are no real consequences to providing poor healthcare. Perhaps instead of greater government oversight of IHS, there should be some thoughtful consideration to privatizing the care given to our our indigenous people. Maybe IHS should become more of a payor source rather than healthcare provider and allow patients to seek out and choose their own provider based on their own preferences. Let the free market sort it all out with the current government oversight in place for healthcare providers and organizations.
Bootstrapping onto the prior poster’s first sentence, perhaps Senator Thune should get Mitch McConnell to get to work on the health care for the rest of the country and get Obamacare repealed and a common-sense, market-driven system in place. I think McConnell should resign his position and the Senate needs to get someone with some guts in his place.
Anonymous 12:14,
This is a democracy and total repeal of Obamacare takes 60 votes in the Senate. Thus, we don’t have enough Republicans in the Senate.
Too bad the nut jobs nominated for the Senate McConnel (Delaware), Akin (Missouri), Angle (Nevada), and Mourdock (Indiana) or we’d have four more. And, with the one’s we could pick up in the next election, we’d have our 60.
But, we have to work with what we have since neither Trump, McConnell or Ryan are dictators (separately or together).