Western International University
ETH 123 - Cultural Diversity
December 16, 2005
One of the largest issues facing American Indian's today
One of the largest issues facing the American Indian's today is that health care. As tribes and urban Indian health centers struggle along with the rest of the country to address the growing numbers of Elders in their communities. There are key issues and special considerations that must be addressed to ensure American Indian Elders are not forgotten in any proposed reform or redesign proposals that the newly formed Medicaid Commission or Congress put forth. By 2030, it is estimated there will be 430,000 American Indian and Alaska Native Elders, constituting 12.2% of the American Indian population (Day, 1993). While the federal government has a legal trust responsibility to all federally-recognized Tribes, the Indian health care system has broad discretion in how it fulfills that responsibility as stated Lincoln v. Vigil (91-1833), 508 U.S. 182 (1993) (Supreme Court of the United States, 1993) . Unlike Medicare and Medicaid, the services provided by the Indian Health Service are not considered entitlements to those that receive them. The Indian Health Service operates as part of the Public Health Service and does not offer insurance or have an established benefits package. Instead, it relies on yearly Congressional appropriations and third party reimbursements from Medicare, Medicaid, and private insurance to provide direct, contracted, or compacted services to American Indians and Alaska Natives ("About Indian Health Services," 2005.) The National Indian Council on Aging in July of 2002 stated: Despite our nation's prosperity, times are still very hard for Indian elders. Their health status ranks among the poorest of any minority in the nation. They are disabled at rates 50% higher than other American elderly. Nearly three out of five...