Copyright © 2000 NLThomas
All Rights Reserved

TAHLEQUAH OK - On Tuesday, December 5, 2000 Chad Smith, Principal Chief of the Cherokee Nation of Oklahoma, said that the Cherokee Nation has been forced to ration its health care because federal funding had fallen far short of demand. Indian Health Service (IHS) hospitals located in Tahlequah and Claremore, and six tribally operated outpatient clinics, provide health care for members of the 200,000-member tribe.

Chief Smith stated, "Unquestionably! We are in a ration system." Smith added, "With a finite budget, we must make heart-breaking decisions as to who gets health care and who doesn't."

To illustrate the hardship the tribe is working under, Chief Smith pointed out state and national figures. Smith explained that in Oklahoma the average funding per year per Indian patient $856 and said, that the national average is $1,351.

Mike Miller, a tribal spokesperson added that the Oklahoma average is the lowest in the nation. Miller asked, "With an average of $856 to spend on a patient, what does it do to the next patient when $2,000 is spent on the patients before him?"

Chief Smith said that over the last year the Oklahoma delegation in Washington has gained more funding for Oklahoma tribes, "but that doesn't make up the difference."

According to Chief Smith the IHS hospitals had a combined $34 million budget for a workload of 240,000 patient days, compared to the IHS hospital in Phoenix, which has a larger $40 million budget based on 100,000 patient days. Smith said, "Obviously, that is a huge inequity and no one, has been able to adequately explain the inequities between IHS regions." Smith stated, "They still don't get enough money to meet their needs", but made it clear that he does not advocate taking away funds from other hospitals in order to get more for the Cherokee Nation.

In June, U.S. Senator Jim Inhofe, R-Okla., with the support of other members of the Oklahoma congressional delegation, asked the IHS to address the inequities in funding among the nation's IHS regions. Senator Inhofe said, "Oklahoma is being shortchanged."

Chief Smith explained that the health care in the Cherokee Nation of Oklahoma is based on a national system that ranks various procedures from one to 25. "We only have enough funding to go to level seven", Smith said, and noted that level eight is for cancer treatments.

The Cherokee Nation of Oklahoma also lacks funding for the treatment of such life threatening diseases such as tuberculosis and diabetes, in addition to cancer.

According to Chief Smith, the Cherokee Nation tribal council has appropriated funds from the tribe's motor fuels account in an effort to deal with the adverse situation. Smith explained that the CNO's health care is funded at 27 percent "of the national benchmark for all Americans."

The chief said that the tribe has three efforts under way as attempts to improve the situation. First, is the attempt to deliver better health care, second is keeping members of Congress informed on the shortage of funds, and third is to coordinate the tribe's health care delivery service with those in eastern Oklahoma.

Indian advocates have taken the position that the U.S. Federal Government has a legal obligation to provide American Indians health care on an equal basis with other Americans, because of lands taken away from tribes. Principal Chief Chad Smith said, "The legal obligation is probably dwarfed by the moral obligation."

According to Chief Smith, uninsured Indians do not get anything close to other Americans through employee health care plans or government plans, such as Medicare and Medicaid. Smith said that, citing national figures, the health care costs per capita per year for federal employees are $3,330 compared to the $856 in the Cherokee Nation.

Chief Smith said that health care in the Cherokee Nation is so underfunded, that stories are cropping up about the Indian medical system. One has it that a woman basket maker went to an Indian clinic to have her toes removed, then her feet and then her legs because no funds were available to treat the actual illness.

Principal Chief Smith pointed out that the W.W. Hastings hospital, located in Tahlequah, OK, opened in 1984 to handle 90,000 outpatient visits, but had over 220,000 last year.