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Murray Speaks Out for Indian Health Bill that Provides First Major Health Care Improvements for Washington Tribes Since 1992

Jan 23 2008

As co-sponsor of legislation, Murray touts modernization of services and preventative care included in bill that aims to close the disparity between Indians and the general population.

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(Washington D.C.) – U.S. Senator Patty Murray (D-WA) today delivered a speech on the Senate floor that outlined her support for the Indian Health Care Improvement Act which is being considered by the U.S. Senate this week. The Indian Health Care Improvement Act hasn’t been reauthorized since 1992. 

"Our government has a legal responsibility to provide health care for American Indians, but we also have a moral responsibility to ensure we provide the best care possible," Senator Murray said. "This bill will allow Indian health clinics and hospitals to modernize their services and enable them to provide better preventive care. These services are vitally important to Indian Country, where tribal members suffer from high rates of diabetes and other chronic illnesses."   

Senator Murray is a co-sponsor of this important legislation that will:

  • Modernize and improve Indian health care services and delivery,
  • Address the behavioral and mental health challenges in Indian communities,
  • And allows for in-home care for the Indian elderly population.

In her speech, Senator Murray used the example of tragic deaths among Skokomish Tribe members in Western Washington to illustrate some of the dramatic health problems American Indians currently face. 

More in-depth information about this bill

Senator Murray's full remarks follow:

Mr. President, I rise today to urge my colleagues to support a bill that will make a critical difference to thousands of American Indians in Washington state, and across our country.

I’m proud to be an original co-sponsor of the Indian Health Care Improvement Act, which reauthorizes and updates the health care services our government provides to American Indians and Alaska Natives. 

This bill will allow Indian health clinics and hospitals to modernize their services and enable them to provide better preventive care.  These services are vitally important to Indian Country, where tribal members suffer from high rates of diabetes and other chronic illnesses.     

Mr. President, our government has a legal responsibility to provide health care for American Indians, but we have a moral responsibility to ensure we provide the best care possible.

The Indian Health Care Improvement Act hasn’t been reauthorized since 1992.  And in the years since it expired, in 2001, Congress has simply appropriated money for health programs without examining the Act to see how it could be improved.  This bill takes important steps toward ensuring we’re providing the best – and the most cost-effective – care.  It’s long past time to pass it.

The Health Disparity is Staggering

Mr. President, the health disparity between American Indians and the general population is too great.  The numbers show why this bill deserves our attention now:

  • The infant mortality rate among Indians is 150 percent greater than for Caucasians.   
  • Indians are 2.6 times more likely to be diagnosed with diabetes.  
  • Indians suffer from greater rates of Post Traumatic Stress Disorder, and the suicide rate among Indians is more than twice the national average. 
  • Life expectancy for American Indians is nearly six years less than the rest of the U.S. population.

Skokomish Example

Mr. President, an example from my home state of Washington helps illustrate the impact these numbers have on Indian communities.  Three years ago, in a six-month period, the Skokomish Tribe – which has a reservation near the Hood Canal – lost nine of its 1,000 members.  Among them were two children, two young adults, and five elders.  

One of the elders was Bruce Miller, a Vietnam veteran and a nationally known artist and spiritual leader.  Bruce helped restore ceremonies that were once banned by the U.S. government.  His work to prevent drug abuse and rebuild tribal customs will be sorely missed.  Bruce was only 60 years old when he passed.

Mr. President, many of the Skokomish tribal members died of conditions that are all too common on Indian reservations – including drug overdoses, heart disease, cancer, and diabetes.  These conditions are preventable, and many in Indian Country have been working hard to reverse the numbers I mentioned earlier.  But their work has been hindered because Indian health services are badly in need of updating.

Mr. President, the most important thing the Indian Health Care Improvement Act does is help modernize those services.  

It’s Time to Update Indian Health Services

In the last 16 years, we have revolutionized the way we approach chronic illnesses, such as diabetes.  Doctors’ offices and health clinics around the country emphasize the importance of eating right and staying healthy.

We’ve changed where we provide services, as well.  Instead of treating elderly and chronically ill patients in the hospital, more and more people get care at home or in community clinics.  And it’s now standard practice to coordinate mental health, substance abuse, and domestic violence prevention services.  But health care for Indians is badly out of date.  We’re still providing services as if it were 1992.  

The bill we’re considering today would help bring health care for Indians into the 21st Century.  It would enable clinics to do more than just treat symptoms, and instead focus on prevention and mental health. 

Rural Indian Health Services

Mr. President, it’s particularly important to ensure that Indian health clinics can provide up-to-date care because for many tribal members, those clinics are the only source of health care available.  

For tribal members in rural Washington state and across the West, visiting a doctor off the reservation often means driving for hours to get to the nearest big city.  In remote areas, some tribal members never see a doctor off the reservation.  They are born in Indian hospitals, see the doctor there for their entire lives, and die in the same hospital.

Urban Health Clinics

Mr. President, this bill also funds urban Indian health clinics.  Now, in recent years, President Bush and some of my colleagues have questioned the need to provide health services to Indians who live in and around major cities.

In fact, disappointingly, the President’s budget routinely eliminates funding for the 34 urban Indian health centers across this country.  And every year, Congress restores this funding because these centers serve thousands of Indians – many of whom are uninsured and wouldn’t get care elsewhere. 

The doctors and nurses who staff these urban clinics specialize in the conditions many Indians face, and – even more importantly – they’re sensitive to the cultural needs of their patients.  

That often makes all the difference when a patient is deciding whether to get care.  And it increases the chances that Indians will continue to get the treatment they need – particularly preventive and mental health care.  

am disappointed that Republican objections have limited how far the important improvements for urban Indians in the bill can go.  But this bill ensures these important health centers will stay open.  My state has two, and I’ve heard firsthand from a number of tribal members how important they are.

Both Urban and Rural Clinics Empower Tribes

Mr. President, both urban and rural Indian health clinics also give tribes more decision-making power over health programs, so they can determine how to best serve their people.

In Washington state, for example, the Nisqually Health Clinic – located near Olympia – offers a Community Health Representative program that trains tribal members about how to provide basic preventive care and education to help elders and members suffering from diabetes and substance abuse.

Mr. President, we need to give programs like those a boost so they can grow and succeed, and so other tribes can try similar programs.  Reauthorizing the Indian Health Care Improvement Act would help do that.

Veterans

Finally, Mr. President, this bill also makes important improvements to the medical benefits provided to tribal veterans.  Tribal veterans – as many of my colleagues know – have served throughout this nation’s history with great honor and valor.  In fact, American Indians have served in higher numbers than any other ethnic minority in this nation. 

Despite their extraordinary commitment to this nation, veterans’ services for American Indians often times fall short of what is available for non-Indians.  Fortunately, this bill changes current law to allow the Secretary to enter into or expand arrangements to share medical facilities and services with the Departments of Veterans Affairs.  The provision requires consultation with the affected Indian Tribes before entering the agreements.  And it requires reimbursement to the IHS, Tribes, or Tribal Organizations.

Now, Mr. President, I want to repeat something I said earlier because it’s important:  Providing health care to Indians is part of our government’s Trust responsibility, dating back to the 18th and 19th centuries.  Congress enacted the Indian Health Care Improvement Act in 1976 to better carry out this duty.  In President Ford’s signing statement, he said:

"Indian people still lag behind the American people as a whole in achieving and maintaining good health.  I am signing this bill because of my own conviction that our first Americans should not be last in opportunity.”

Mr. President, 32 years later, we still have a long way to go toward achieving that goal.  But we can take some important steps by reauthorizing this bill now.