AMERICAN INDIAN LEADERS are looking to the Obama administration for support in passing the Health Care Improvement Act reauthorization
bill. The bill, approved by the Senate, would allocate $35 billion over the next 10 years for American Indian healthcare programs,
including screening services and mental health programs, and would improve access to healthcare.
Sources of Coverage, 2006-2007
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The bill also would increase tribal access to Medicare and Medicaid, prompt new construction and modernization of reservation
health clinics, and seek to recruit more American Indians into healthcare professions. President Obama campaigned heavily
in Indian Country. During the campaign he said he supports more funding for the Indian Health Service (IHS) and better services
at IHS clinics. He also promised to create the first White House position to oversee American Indian affairs.
ALCOHOL AS A CAUSE OF DEATH
Nearly 12% of American Indian and Alaska Native deaths over a four-year period from 2001 to 2005 were alcohol related, according
to a Centers for Disease Control and Prevention report. That compares with a national average of 3.3%. Researchers examined
the death certificates of American Indian and Alaska Natives during the time period and found that more than 1,500 deaths
were alcohol-related. The report found traffic accidents and liver disease are the two leading causes of alcohol-related deaths
among the groups. CANCER RATE HIGH
Alaska
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The incidence of cancer among American Indians and Native Alaskans varies tremendously based on geography, according to research
published in Cancer. Native Alaskans had some of the highest cancer rates in the nation while American Indians in the Northern Plains have the
highest rate of lung cancer among native communities.
The report called for implementing prevention and education programs and basing treatment on cultural differences within the
tribal subgroups.
In a separate study published last spring in Ethnicity & Disease, researchers surveyed 112 elders to assess their willingness to participate in a hypothetical cancer clinical trial. Factors
most influencing participation included having a lead researcher of native descent, a study physician with experience in treating
the groups, family support for participation and hope that the study would result in new treatments. Results indicate a "need
to establish partnerships with native communities and include American Indian/Alaska Native and culturally competent professionals
in research efforts."
NONPROFIT SECTOR
The Foraker Group and the Rasmuson Foundation are offering a health insurance program designed to promote a healthier nonprofit
sector in Alaska. The program offers two options that will help expand coverage to underinsured individuals and families or
those who currently have no insurance. Alaska's 18% uninsured rate exceeds the national average.
Under the Foraker insurance initiative, a high-deductible ($1,500) plan with a health savings account or a catastrophic indemnity
plan with a $2,500 deductible are available. Both plans offer options for preventive care and prescription benefits.
The high deductible/HSA plan requires the employer to contribute at least half the annual deductible level into an individual's
HSA. Both options also incorporate an individual and family wellness program that is intended to reduce the need for medical
care and keep down the cost of claims. The program is available through Premera Blue Cross Blue Shield of Alaska.
NURSING HOME VIOLATIONS
Every nursing home in Alaska, Idaho, Wyoming and Washington, D.C., was cited for federal health and safety violations in 2007,
according to a report by the Health and Human Services Office of the Inspector General last fall. Nationwide, 90% of U.S.
nursing homes were cited for violations. Nursing homes in Alaska had an average of 6.5 deficiencies in 2007, down from 9.5
in 2006.
According to the report, the most common deficiencies nationwide centered on quality-of-care measures, including treatment
and prevention of bedsores and urinary tract infections.
MHE Sources: Centers for Medicare & Medicaid Services; Urban Institute; Kaiser Family Foundation; U.S. Census Bureau; The
Commonwealth Fund.
