When compared to the U.S. population as a whole, Native Americans face serious healthcare issues in a disproportionate manner. The rate of diabetes for Native Americans is twice that of the general American population. Indeed, the Pima Indian Tribe located in Arizona, has the sad distinction of having highest rate of diabetes in the world. The suicide rate for Native Americans is approximately 74% higher than it is for the rest of the population. Regardless if the category is mental or physical health, there is virtually no health issue that is not over represented in the Native American population. In a stark example of how bad policy affects real lives, the sequester will result in a reduction of healthcare for much of the Native American population.
The Indian Health Service (IHS) is a federal agency within the Department of Health and Human Services. The IHS has the difficult task of trying to provide healthcare to approximately 2 million Native Americans. Most of those they serve live on reservations or in rural areas with few other healthcare options. Their budget for 2012 was 4.3 billion dollars. It is estimated that the sequester is going to remove 9% of the budget. This agency could have been exempted from the sequester. The Department of Veterans Affairs (VA) has been exempted from the sequester. The Office of Management and Budget has specifically exempted the VA from having to enact budget cuts as a result of the sequester. No one is suggesting that Veterans healthcare options be compromised as a result of the sequester. Why was this protection not provided to Native Americans?
It is estimated that as the budget cuts will result in a decrease of up to 3000 inpatient admissions and over 800,000 outpatient visits. Could the IHS be exempted from the sequester cuts? Of course but that would require direct intervention from President Obama. In February of this year Native American tribal leaders specifically requested that President Obama provide such an exemption. Charlie Galbraith, the Associate Director for Intergovernmental Affairs said,
“That’s just not going to happen. We have the entire military machine, every lobbyist, every contractor, trying to exempt the military provision—the president is not going to cut this off piecemeal. We need a comprehensive solution that is going to address the real problem here.”
So, the option existed, it was just not an option favored by the Obama Administration. Why? What possible rationale exists to not exempt Native American healthcare in the same manner as the healthcare for Veterans. Galbraith went on to say that exempting the Native American programs “weakens our argument as a whole.” In a statement that I believe can only be generously characterized as idiotic, he said, “We need the support of Indian country out there being public, writing op-eds, on Facebook, on Twitter, telling the American people how important it is that we come to a balanced solution that raises revenues and cuts spending in an appropriate, reasonable way.”
Did the White House just casually cut healthcare to Native Americans, something it could have chosen to exempt, and then say that those affected should take their concerns to Facebook and Twitter? The dismissive attitude is nearly as embarrassing as it is stupid. The lives of some of America’s poorest citizens are endangered for no other reason than to make a political point and the response is to tell those affected to get on Facebook. This is directly on President Obama. He could have exempted this agency, however, he chose not to do so because it would weaken his argument that the sequester is bad policy. I agree that the sequester is bad policy but I also believe that cutting healthcare for some of the poorest Americans make a point is bad policy. Cutting government spending during a period of slow economic growth is foolish.
Mitigating steps could have been taken to make the sequester less painful. President Obama had the option of giving agency heads the authority to make the cuts in a more targeted manner. Agencies could have had the option of cutting programs which would have minimized the damage caused by the mandated budget reductions. Workers did not have to be furloughed. Healthcare for Native Americans could have been exempted. President Obama chose not to do so because it would weaken his argument. A true profile in courage.