Broken Promises

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U.S. Commission on Civil Rights
The U.S. Commission on Civil Rights is an independent, bipartisan agency established by Congress in 1957.
It is directed to:
􀂃 Investigate complaints alleging that citizens are being deprived of their right to vote by reason of their race, color, religion, sex, age, disability, or national origin, or by reason of fraudulent practices.
􀂃 Study and collect information relating to discrimination or a denial of equal protection of the laws under the Constitution because of race, color, religion, sex, age, disability, or national origin, or in the administration of justice.
􀂃 Appraise federal laws and policies with respect to discrimination or denial of equal protection of the laws because of race, color, religion, sex, age, disability, or national origin, or in the administration of justice.
􀂃 Serve as a national clearinghouse for information in respect to discrimination or denial of equal protection of the laws because of race, color, religion, sex, age, disability, or national origin.
􀂃 Submit reports, findings, and recommendations to the President and Congress.
􀂃 Issue public service announcements to discourage discrimination or denial of equal protection of the laws.
Members of the Commission
Mary Frances Berry, Chairperson
Cruz Reynoso, Vice Chairperson
Jennifer C. Braceras
Christopher Edley, Jr.
Peter N. Kirsanow
Elsie M. Meeks
Russell G. Redenbaugh
Abigail Thernstrom
Les Jin, Staff Director
U.S. Commission on Civil Rights
624 Ninth Street, NW
Washington, DC 20425
(202) 376-8128 voice
(202) 376-8116 TTY
www.usccr.gov
This report is available on disk in ASCII and WordPerfect 5.1 for persons with visual impairments. Please call (202) 376-8110.
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Letter of Transmittal
The President
The President of the Senate
The Speaker of the House of Representatives
Sirs:
The United States Commission on Civil Rights transmits this report, Broken Promises: Evaluating the Native American Health Care System, pursuant to Public Law 103-419.
It has long been recognized that Native Americans are dying of diabetes, alcoholism, tuberculosis, suicide, and other health conditions at shocking rates. Beyond disturbingly high mortality rates, Native Americans also suffer a significantly lower health status and disproportionate rates of disease compared with all other Americans. Finding disparities in the health status and outcomes for Native Americans, the Commission explored the causes for those disparities. Consequently, the Commission report assesses whether the Indian Health Service (IHS), and the Centers for Medicare and Medicaid Services (CMS) are improving the delivery of health services and the overall health status of Native Americans. In essence, this report evaluates the Native American Health Care system.
Based on a Commission briefing, interviews, research, and a review of relevant literature, the report concludes that our nation’s lengthy history of failing to keep its promises to Native Americans includes the failure of Congress to provide the resources necessary to create and maintain an effective health care system for Native Americans. The Commission’s report documents the existence of cultural, social and structural barriers that continue to limit Native American access to health care. These barriers must be removed. Accordingly, the Commission makes numerous recommendations including educating and training health care providers on cultural differences that influence the effectiveness of disease prevention and treatment programs, recruiting more health care providers to reduce patient wait times and ensure that services are available when needed, increasing the retention rates for IHS health care providers to improve the continuity of health care and strengthen the doctor-patient relationship, improving program monitoring and evaluation, modernizing data collection, increasing appropriated funding levels, increasing enrollment in public insurance programs, and increasing collections from third party insurers. The recommendations also call for expedited passage of pending legislation intended to improve Native American access to health care.
The report also reveals that the Native American health care system created by the federal government has used only limited and incremental responses to the health care challenges faced by Native Americans. Specifically, the Commission has found that, although IHS has, in many cases, identified solutions to the health problems so common in Indian Country, Congress has failed to provide the resources necessary to implement those solutions. The Commission believes that the current Native American health care system requires the rapid implementation of the remedial measures identified in this report.
This report compels the federal government to acknowledge the dire health care situation facing Native Americans. A long history of treaties and broken promises urges the federal government
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to recognize that the concept of fulfilling treaty promises through proper funding and effective administration is a moral imperative. The federal government must take immediate action to improve the health status of Native Americans.
For the Commissioners,
Mary Frances Berry
Chairperson

See the full report @:   http://www.usccr.gov/pubs/nahealth/nabroken.pdf