Who is Responsible for Your Healthcare?

by Guest Contributor Jessica Yee

One of the best kept secrets in American health administration is the existence of Indian Health Service.

Unbeknownst to many outside the Native community, our healthcare is actually delivered by the military.

Oh sure, they call themselves the “Public Health Service Commissioned Corps” which is just a nice way of saying they don’t carry guns, but you can bet that you will more than likely receive care from someone dressed in full-out camouflage gear who indeed works for the U.S. Uniformed Services.

How did this all get started? Well for lands seized (read: stolen) the government has a federal responsibility to provide healthcare to Native Americans. After assimilating us and annihilating our culture, the War Department had this duty in 1849. Which was then overseen by the Bureau of Indian Affairs who was responsible for the many abuses and mistreatments that occurred under their umbrella until 1955, when the government thought it would then be a good idea to turn it over to the Department of Health and Human Services.

I don’t know about you, but I’m not really comfortable going to see a doctor wearing army boots in a non-war torn country. Last time I checked, they haven’t exactly been our best friends in the Native community (forcible removal to attend Residential Schools, reproductive trauma from military testing anyone?) I’m also less than pleased being the only race whose healthcare comes like this.

Among the numerous other problems that you can already think of that exist with this kind of oppressive set-up, IHS lacks several necessary services and policies that exist in other clinics and hospitals because as sovereign peoples, we aren’t subject to receive the same things as everyone else.

Sovereignty is supposed to mean governing our own people, on our own land, the way we want to, but in reality it means doing what the United States allows us to do, when they want to. I saw a really good example of this recently in Oneida, Wisconsin when I was reading a posted U.S. government bulletin on minimum wage that basically read “as a federally recognized Indian tribe we don’t have to make sure you get equal pay since you are a separate entity”.

Oh, but how dare we ever try to assert our sovereignty and take care of our own people according to our own ancestral traditions!

Missing links at IHS include sexual assault procedures and some 50% of clinics who lack the trained personnel to administer rape kits, which is so very interesting when you consider our people have one of the highest rates of sexual abuse in the country.

This was all detailed in the latest Glamour article by journalist Marianne Pearl entitled “The Land Where Rapists Walk Free“. (I’d also like to add to that article that the Yankton Sioux reservation where the story takes place had their IHS emergency room shut down in the Spring of this year).

What is more, if you live in a major urban centre, or even away from your home territory, good luck trying to find an IHS you can go to. In California, Native Americans account for the largest “ethnic” poverty group, while there are virtually no IHS clinics in existence to service the more than 70% of people who live off reservation.

I was actually at a conference once where IHS personnel were wondering why some Native youth didn’t want to come in to get tested for sexually transmitted infections to which I grabbed the mic and yelled “Maybe it’s because we can’t trust you!” I mean, are we really supposed to have confidence in the same system that is still colonizing us, more than a hundred years later?

But don’t worry, if you belong to a tribe and work for IHS, you don’t have to wear the military garb.

They’ll just separate the “savages” from the “civilized”.

(Photo Credit: Glamour Magazine)