I have had tribal members ask on several occasions why the front desk at the Health Center keeps asking for things like; formal ID, insurance cards, VA cards, Medicare cards, and they ask for it each and every time you come in to see a provider.

The federal government requires us to have all that information up to date and current each time you visit. If you have insurance of any kind, we have to have it on file and by law – MUST bill the insurance program. Even further and more important, we have to make sure you have applied for all programs to which you are entitled. 

Now this might seem as if the government was trying to help, but it is a little more complicated than that. Health care, this is a deal the United States made, a promise that included sending doctors to the tribes that signed treaties in exchange for “peace and for titles to lands”. Along the way to providing the care needed, the Indian Health Service (IHS) fell further and further behind in having the funds to meet all they were obligated to, under the agreements.

Why do American Indians and Alaska Natives need insurance of any kind when there is a treaty right, a statutory call to health care, which transcends this latest national experiment or the Affordable Care Act? Then recall the long history of shortages. The Indian health system has never been adequately funded, probably less than half of the dollars that would be necessary have been provided.

The National Indian Health Board in 2017 noted that IHS spent approximately $3,337 dollars per Native American/Alaskan Native while Medicare spent $12,774 per person, which is a significant difference.

They also wrote that a 40 percent budget increase would be needed in 2019 to begin to decrease the long-term shortages. Even starting there, it would take more than 11 years to close the hole in funding.

So why do we in the Health Center ask you to apply for every insurance or government program possible? Because the alternate fix to the missing money by the government was to allow the AI/AN access to other funding sources to achieve the agreed to health care promise. Therefore, while they could not get the $32 Billion that IHS needed they could take advantage of other funds that were available to make more dollars available for AI/AN health care.

So when you refuse the Health Centers offer to apply for Medicaid, Medicare or Veterans Benefits, “because Indian Health Service owes me,” you are allowing the United States government to keep its money. Money that is rightfully due to the Native American for healthcare … as was promised.

So the next time the ladies at the Front Desk as you to apply for Medicaid or Medicaid or your VA benefits – don’t just say NO! Make an appointment, get it done. It’s your right to be cared for, your right to have access to the funds necessary. If you do not apply, you are leaving money on the table rightfully due you. Why would you do that? Why would you allow the historic agreement to go unfulfilled? Another agreement where the Government wins …  by default.