Indian Health Care Improvement Act Amendments of 2007

Floor Speech

INDIAN HEALTH CARE IMPROVEMENT ACT AMENDMENTS OF 2007--Continued -- (Senate - January 22, 2008)

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Mr. THUNE. Mr. President, I wish to speak to that legislation. The Indian Health Care Improvement Act is before the Senate today and tomorrow and hopefully will be completed, and we will be able to vote on some amendments and finally get this legislation reauthorized because it is very long overdue and the need for its completion cannot be underestimated.

I represent nine tribes in my State of South Dakota, and in any given year, depending on the year we are talking about, as many as five of those reservation counties in South Dakota will be in the top 10 poorest counties in America. These are areas in my State that are struggling in so many different ways where many of the basic services that those of us who live off the reservations expect on a daily basis are just not available.

One of the things that is desperately needed is access to health care, making sure there is quality health care available to people on the reservations.

The Indian Health Care Improvement Act reauthorization has really been in the works since 1999-2000. I think the 106th Congress was the last time this issue was debated. We have been trying since that time to get this bill on the floor and get it reauthorized. It is a critical piece of legislation that is so important to the people whom I represent and to tribes all across this country and to Native American people.

To give an example of what I am talking about, in South Dakota, between 2000 and 2005, Native American infants were more than twice as likely to die as White infants. Nationally, Native Americans are three times as likely to die from diabetes as compared to the rest of the population in the country.

In South Dakota, a recent survey found that 13 percent of Native Americans suffered from diabetes. This is twice the rate of the general population in which only 6 percent are suffering from diabetes.

An individual who is served by IHS is 6.5 times more likely to suffer an alcohol-related death than the general population. An individual served by an IHS facility is 50 percent more likely to commit suicide than the general population.

I appreciate the time the Senate is taking to debate this bill and the serious health issues this bill hopes to address and correct. I especially thank the Indian Affairs Committee for working with me to help the Yankton Sioux Tribe of South Dakota keep the Wagner emergency room open. Our delegation from South Dakota has been working for some time in making sure that members of the Yankton Sioux Tribe have access to emergency room service 24 hours a day, which is critically important.

The committee was very helpful in making sure that issue was addressed in this authorization. I thank them for that help and appreciate their work in working with us to that end.

I also thank them for the work they have done to ensure that the Urban Indian Health Program remains a viable and helpful program for Native Americans who live off the reservation.

I am also a cosponsor of an amendment that has been offered by Senator Vitter. I reiterate my support for extending the Hyde language of this bill in preventing Federal funds being spent on abortions, except in cases where the life of the mother is at stake or in case of incest or rape.

I also reiterate my support for Senator Bingaman's amendment. I am a cosponsor of that amendment which will extend Medicare payment rates to all Medicare providers who accept IHS contracting agreements.

This amendment hopefully will stretch IHS contracting dollars even further and help reduce, even if it is only in a small way, some of the shortfalls that currently exist.

This legislation goes a long way in attempting to improve health care throughout Indian country. However, we have to remember there is still more, lots more, that we need to do, especially in the area of tribal justice and law enforcement in order to help improve the lives of individuals who live on and near Indian reservations throughout the country.

Last year, I worked hard to improve tribal justice and law enforcement on Indian reservations, and I look forward to partnering with my colleagues in the Senate to continue that fight this year to make sure we have adequate law enforcement personnel, that we have an adequate number of prosecutors so that when crimes are committed, they can be prosecuted. But we have to address these very fundamental issues if we are going to improve the quality of life for people on the reservations.

As I travel the reservations in South Dakota--and I was at the Rosebud Indian Reservation just this last week--what strikes me is, people on the reservations, just as those I represent who live off the reservations, want the same thing: They want a better life for their children, for their grandchildren, for future generations. They want to make sure they have security and there is adequate law enforcement and they do not have to live in fear when it comes to the issues of crime. They want to make sure their children have access to quality education and a responsibility that many of us take very seriously, ensuring and seeing to it that young people, children on the reservation, have an opportunity to learn at the very fastest rate possible, to go through elementary and secondary school and then on to higher education if they choose to.

A number of the tribal colleges we support in many cases suffer, again, from a lack of funding. They also have to have basic health care services, which is what this bill attempts to address. Whether it is in the area of dental care, whether it is in the area of basic primary care, speciality care, the IHS facilities on the reservations suffer from being unable to recruit and retain health care providers. Whether it is physicians or dentists--and that is an issue we face as well--we need to make sure we have the right incentives in place to attract health care providers to serve in reservation areas.

This bill, as it is currently structured, I believe, will help to address that very basic expectation that all

people who live on reservations have, and that is, when they have a need, they will have access to quality health care to address those needs.

This bill will be debated again tomorrow in the Senate, probably, I hope, voted on sometime tomorrow so that we can finally get this reauthorization bill through. It has been teed up for some time.

I appreciate the work the chairman, Senator Dorgan from North Dakota, and Senator Murkowski from Alaska, the ranking Republican, have done to bring this bill to the floor and, as I said before, to work with us on issues important to South Dakota.

I am also happy to cosponsor a couple of amendments that I hope can be adopted--the Vitter amendment and, as I said earlier, the Bingaman amendment, which will help make health care more available and take the dollars of the IHS and stretch them further when it comes to contracting services.

I urge my colleagues in the Senate to vote for this bill. This should be a big bipartisan vote. If anybody cares seriously about improving the quality of life on reservations in this country and addressing what are deep economic needs, it starts with some of these very basic services. It starts with law enforcement security, it starts with education, and it starts with health care, and I think this bill takes us a long way in the direction of dealing with the health care issues that affect so many of our tribes in this country.

I hope my colleagues in a very big bipartisan way will vote for this legislation, support it, and hopefully get it signed into law before this year is out.

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