American Indian Health Care Coverage
The history of the American Indians after the European invasion of the New World is not a pleasant topic. Everyone wants to believe the stories that are told about Squanto, the Pilgrims and the harmony of the first Thanksgiving and then skip the next three hundred years of oppression and racism. Unfortunately, the next three hundred years happened and by the 20th century most Indian tribes as well as their traditional ways of life, had been extinguished. Despite the widespread destruction of the American Indian, many still survive. In an attempt to provide some sort of compensation the federal government of the United States has a special health care system set up for American Indian descendants. …show more content…
Stemming from the Constitution, to be considered eligible for this health care, a person must be a member of one of the 557 federally recognized tribes. In 2008 the budget for this program was 3.5 billion dollars. The Affordable Care Act (ACA) of 2008 created a special allowance for members of a federally recognized tribe, exempting them for the insurance mandate. Members who decide they would like to purchase health insurance through the Health Insurance Marketplace are also able to do so at any time, they are not limited the annual enrollment period (Newkirk, 2014). If a member of a federally recognized tribe does purchase health insurance through the Health Insurance Marketplace they are exempt from cost-sharing measures such as co-pays and deductibles as long as their income level does not equal more then 300 percent of the federal poverty level (Newkirk). In 1976 the Indian Healthcare Improvement Act was passed. This act was meant to improve the quality of medical care available to American Indians, as well as lessen the life expectant gap for American Indians and Alaskan Natives relative to the rest of the United States. At the time the act was established, that gap was over 20 years different between the two groups. In 2001 this act expired and was not reestablished until 2009 when it was “rolled into the Affordable Care Act and made permanent” (Trahant, 2012) Many politicians
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The continuous trauma that they endured has negatively affected the mental health and physical health of the population. Native Americans are at higher risk for depression, physical/sexual abuse, domestic violence, substance abuse, and mental health issues (McLeigh, 2010). Native American youth are three times more likely to commit suicide than the average population. Native Americans in general are twice as likely to be diagnosed with depression and five times more likely to have alcoholism. Colonization not damaged natives mentally, but also brought harm to their physical health as Europeans brought diseases (measles, chicken pox, smallpox, etc) to America (McLeigh, 2010). In order for this population to be served to treat their many medical and mental health issues brought on by years of trauma, policies must be implemented to help Native Americans specifically. However, the reality is that natives mental health needs are often ignored (Gone, 2004). There have been policies that have attempted to meet the needs, but much more is needed. In the most recent action towards improving mental health services for natives, the Affordable Care Act of 2010 permanently gave authorization to the Indian Health Care Improvement Act (Ross, Garfield, Brown, & Raghavan, 2015). This policy will be discussed and analyzed to examine further needs for services in this
By 1940, Native Americans had experienced many changes and counter-changes in their legal status in the United States. Over the course of the nineteenth century, most tribes lost part or all of their ancestral lands and were forced to live on reservations. Following the American Civil War, the federal government abrogated most of the tribes’ remaining sovereignty and required communal lands to be allotted to individuals. The twentieth century also saw great changes for Native Americans, such as the Citizenship Act and the Indian New Deal. Alison R. Bernstein examines how the Second World War affected the status and lives of Native Americans in American Indians and World War II: Toward a New Era in Indian Affairs. Bernstein argues
Though American Indians are enjoying an independent public health system with above $3 billion funds provided by Congress annually for delivering healthcare services to them, still figure and facts on health status of American Indians reveal that they are facing many difficulties and have to suffer from diverse type of illness and disease at a misappropriate level. Since long it was identified by medical communities that there are wide spread diseases diabetes, alcoholism, tuberculosis, suicide, unintentional injuries, and other health conditions among American Indian and they are dying of these diseases at shocking rates (American Heart Association [AHA], 2010). Through this essay I want to discuss the healthcare status of American Indians in the perspective of their culture as how it impacted and lead to develop mistrust between amongst the medical community and American Indians.
The Native American culture is the original culture of the United States. Members of Native American tribes live throughout the country. “There are an estimated 4.9 million persons, in 565 federally recognized tribes who are classified as American Indian or Alaska Native (AI/AI), alone or in combination with one or more other designated racial classifications. This demographic group compromises 1.6% of the U.S. population” (Horowitz, 2012). Wisconsin is home to the Ho-Chunk (Winnebago), Ojibwa (Chippewa), and the Potawatomi tribes (“American”, 2014). It is important for nurses within this state, as well as any other state, to understand the Native American belief system in order to provide a quality healthcare experience. Nurses are the primary point of contact in the healthcare setting. Client advocacy is one of the nurse’s major roles. Therefore, the nurse should have the highest level of diversity understanding for the cultures within the local region.
The American Indian Policy Review Commission's report on the health of Native Americans said it best when they stated,"the federal responsibility to provide health services to Indians has its roots in the unique moral, historical, and treaty obligations of the federal government, no court has ever ruled on the precise nature of that legal basis nor defined the specific legal rights for Indians created by those obligations" (DeFine 1997 p.4). Thus, the Indian Health Service has always worked in strange and ambiguous ways.
The U.S. health care system is a scrutinized issue that affects everyone: young, old, rich, and poor. The health care system is comprised of three major components. Since 1973, most Americans have turned to managed-care programs, known as HMOs. The second type of health care offered to Americans is Medicare, health care for the elderly. The third type of health care is Medicaid, a health care program for the poor.
Native Americans have felt distress from societal and governmental interactions for hundreds of years. American Indian protests against these pressures date back to the colonial period. Broken treaties, removal policies, acculturation, and assimilation have scarred the indigenous societies of the United States. These policies and the continued oppression of the native communities produced an atmosphere of heightened tension. Governmental pressure for assimilation and their apparent aim to destroy cultures, communities, and identities through policies gave the native people a reason to fight. The unanticipated consequence was the subsequent creation of a pan-American Indian identity
Health is known as a state where an individual is socially, mentally and emotionally stable without the presence of any illness, disease or infirmity (Carson, 2007). Jenny, an indigenous woman is 34 weeks pregnant, she has been complaining about her abdominal pains and after seeing the flying doctor, she was asked to fly back with him as she might be in an early labour. Jenny is concerned about her family; she wonders how they will manage without her. Her mother-in-law lives with her sister-in-law and she wonders if she will be able to come and help as her mother has a diabetic leg ulcer and needs treatment so cannot travel. This essay will discuss about the health issues before colonization and after colonization, Jenny’s
American Indians and Alaskan Natives have a relationship with the federal government that is unique due to the “trust relationship” between the US and American Indians/Alaskan Natives (AI/ANs) who are entitled to health care services provided by the US government by virtue of their membership in sovereign Indian nations. In order to contextualize the complex nature of Indian health programs it is necessary to become versed in the political and legal status of Indian tribes. Through numerous constitutional, legislative, judicial, executive rulings, and orders that were largely associated with the succession of land and subsequent treaty rights; the health care of AI/ANs has been one of many responsibilities guaranteed by the federal government. The foundations of which can be traced back to the year 1787. The ceded land has been interpreted in courts to mean that healthcare and services were in a sense prepaid by AI/AN tribes and 400 million acres of land. The misconception of “free healthcare” and a conservative political disdain from so called entitlement programs have also led to misconceptions regarding the federal government’s responsibility to provide health care and services to AI/ANs. Rhoades (2000) has argued that tribal sovereignty is the overarching principle guiding Indian health care on a daily basis.1 This paper will examine the history surrounding federally mandated healthcare to AI/ANs, pertinent issues of sovereignty, as well as case studies in tribal
To help aid, Indian Health Services is a federal service to meet the native health needs of those federally recognized, but what about those who are not recognized such as the Lumbee people? Do we allow them to drift in the tide of the devastating diseases present? No, we make a stand to explore, provide institutions, and offer aid to improve native health
To start off, the physical state of health of Native Americans is far below the rest of the American people. They face more disease and death than any other population in the United States. In an article written by Michelle Sarche, a professor at UC Denver, and Paul Spicer titled Poverty and Health Disparities for American Indian and Alaska Native Children: Current Knowledge and Future Prospects, they state,
It was one of few U.S. studies that concerned about the economic, health and living conditions of the Indians for centuries. By pointing out the failure of the federal government in protecting the Indians on various aspects, it played the foundation for the new legislation, the Indian Reorganization Act of 1934, and the succeeding policies in regards to health care, education,
In case studies that I have explored, there has been a more negatively connoted relationship between the IHS and Native Americans than positive. There are numerous causes to the dissatisfaction that Native Americans feel towards to IHS. In a study that looked at long-term care of Native American elders, some barriers to a positive relationship with the IHS included a basic distrust of non-tribal agencies due to the policy history between tribes and the federal government (Dwyer
American Indian/Alaskan Native health care scheme is unitary of its nations leading concerns. The health care system needs reform in society for economic resources to be allocated through foreign aid at the micro and macro levels. The Indian Health Service (IHS) has had its problems in being under-funded to meet the nation demands. The Indian Self-Determination and Education Assistance Act, enacted in 1975 was approved to administer the Indian country health care programs. This consists of funding, third-party revenue, concessions, and contract support costs. The internal government has implemented the use of Medicaid under the Patient Protection and Affordable Care Act (ACA) to take into account for easier eligibility for registration of residents at or under the poverty level, in hopes of increasing access to wellness services. However, the problem still stays as the AI/AN population surges, their finances are not capable to hold up with the medical rise. Inadequate funding over time has influenced health disparities. In order to help resolve this health care funding issue to parallel to analogous federal employee health benefits it would take an added $3 billion per year (Warne & Frizzell, 2014). This report will offer an overview of the underprivileged social group (American Indian/Alaskan Native) within a developed nation and provide a perspective on informal health care providers (IPs) in growing nations.