All seven of the Indian Health Service sanctioned hospitals of the Great Plains region have put patients in "immediate jeopardy" of harm, and failed to meet hospital requirements, according to an article published by the Wall Street Journal today.
This crisis exists even as the 2018 federal budget currently proposes an additional $300 million in cuts to IHS.
YPR's Brie Ripley spoke with Dan Frosch and Chris Weaver, co-authors of 'People Are Dying Here': Federal Hospitals Fail Native Americans.
Brie Ripley: According to your research, how did it get this bad?
Dan Frosch: A couple things. The level of healthcare at Indian Health Service facilities across the country, and particularly across the West, has been bad for years. But I think what we sort of discovered in our reporting is that it has been allowed to fester and worsen because of neglect at the highest levels in the Indian Health Service itself, and then within its parent agency, the Health and Human Services Department. So these top officials knew about problems, problems were continually reported to them, but nothing was done.
Chris Weaver: You know one, I think sensitive, you know, really complicated problem that the government has for a long time has really struggled with is that the operations of the IHS, by the very nature of the agency, are entwined with local tribal politics in complicated ways because – oh, for a lot of reasons. I mean for one thing they’re on their land; for another, this service hires preferentially based on whether or not candidates for jobs are Indians. And as a consequence of that, a lot of top officials, both in Washington and at the hospitals on these reservations, are themselves members of the tribes that they serve – often. Those kinds of relationships are not something that the rest of the federal government understands well, local politics are not something that they understand well. These situations where people are both pretty high ranking federal officials and members of the tribes that are complaining about the issues with these services is a vexing one for the government and for anybody from the outside looking in trying to figure out what the real leadership issues are here.
BR: So, is there a what next? Is there hope?
CW: There’s no reason you can’t run a good hospital in a rural place or a place, or an isolated place. I mean there’s just no reason it can’t work. There’s a lot of obstacles to getting there, for sure.
DF: Just to add to what Chris is saying, on the positive end, these issues have the attention of members of congress – some powerful members of congress – who represent Indian Country; who are well aware of them, have been talking to their constituents about them, and have proposed legislation that would overhaul IHS to varying degrees. At the same time, this issue has drawn congressional interest for years now. So, to Chris’ point, there’s no reason why a hospital in a rural area should be so negligent that people are dying there. One would think that those issues can be improved upon. It is going to take time. You can’t just throw money at the issue. It’s a matter of funding, staffing, attracting more qualified talent, making sure that IHS has strong leadership – sort of a multifaceted approach. There are many congressional committees taking a hard look at this right now. But, as Chris and I discovered, probably not surprisingly, I don’t think either one of us were surprised by this, that in the pantheon of federal healthcare policy, IHS is not a huge priority. And so, I think, clearly it remains to be seen whether we find ourselves writing about this same exact issue in five years and nothing has changed.
BR: Dan Frosch and Chris Weaver are reporters with the Wall Street Journal. I’m Brie Ripley, YPR News.
An extended version of this conversation is available below