American Indian Health Care to improve, Sebelius says

WASHINGTON - Health and Human Services Secretary Kathleen Sebelius says she will launch a new multiyear effort to improve health care for American Indians, which she calls a "historic failure."

Sebelius said Tuesday she will challenge Congress to make the back-burner issue a priority. Part of that strategy would be to recruit more providers for reservations and to focus more on preventive care, which is often neglected in Indian health clinics as dollars run out.

"(We need to) begin to lay the groundwork with Congress right now to say here's where we need to be," she said. "I think often the tribal issues just fade away."

She said her department is also increasing the size of the U.S. Public Health Service Commissioned Corps, which dispatches doctors to reservations as part of its mission.

The U.S. has an obligation, based on a 1787 agreement between tribes and the government, to provide American Indians with free health care on reservations. But the troubled Indian Health Service only has about half of the money it needs, leaving poor tribes in remote areas with severely underfunded facilities and substandard care. Wealthier tribes are often able to supplement the federal budget with their own dollars.

"Some of the Indian health facilities are in great shape, some are really in terrible shape," Sebelius said.

President Barack Obama campaigned on Indian reservations during his Democratic primary last year and promised better health care there. His budget for 2010 includes an increase of $454 million, or about 13 percent, and the stimulus bill he signed earlier this year provided for construction and improvements to clinics.

Sebelius said that generous increase would still be far from what the agency needs.

"One of my challenges to the new head of the Indian Health Service is that we need a multiyear strategy, we need an end goal," she said.

She said health disparities between minority groups and whites are "unconscionable."

"The most severe disparity between quality care and what goes on with health outcomes is in the Native American population," she added.