HUM 221: Health care, cultural issues

A proposed spending cut in President Bush's budget proposal for the coming fiscal year reflects how cultural issues can be overlooked by the U.S. government. Whatever you think about Bush, this kind of thing has been going on since George Washington was president (and our next leader before him, King George III, wasn't too swift on Indian policy either, come to think of it). A story picked up today by The Guardian (U.K.) gives the details.

According to a story by Angie Wagner, a reporter in The Associated Press' bureau in Las Vegas, Bush wants to "zero out the $33 million allocation for urban Indian health clinics." In addition to the politics of the issue, which are (as always) debatable, Wagner touches on cultural issues when she quotes American Indians who say the clinics offer services that are culturally unique. It is this angle that is overlooked by the proposed budget cut. Wagner says:

In Bush's 2007 budget proposal, it is suggested that urban Indians can go to community health centers instead, since those centers are slated to receive a $181 million increase that would build or expand 300 sites.

Alex Conant, spokesman for the White House Office of Management and Budget, noted the increase and said: ``Urban Indians, like all Americans, continue to benefit from the president's initiatives to make health care more affordable and available.''

But Wagner also quotes health care providers who say many Native Americans need types of care that that their culture into account:

Community health centers are already ``stretched to the limit,'' said Amy Simmons, spokeswoman for the National Association for Community Health Centers. The proposed program expansion isn't designed to meet the needs of urban Indians, Daniel Hawkins, the association's vice president for federal, state and public affairs, said in a recent letter to Bush.

``My fear is losing our Indian identity,'' said [Susette] Schwartz, the Wichita [Hunter Health C]linic CEO. ``We would be able to stay open, but would lose our Native American programs.''

At the Wichita clinic, which also operates as a community health clinic, urban Indians receive free services and prescriptions. Some 2,700 Indians visited the clinic last year.

If the funding is dropped, urban Indians there could get health care from the community clinic. But they would miss the cultural connection they enjoy now because most Indian workers would lose their jobs, Schwartz said.

``We have so many people who don't know exactly why they're so messed up and out drinking and abusing until they talk to someone who understands Indian history. There's generations of anger that only someone who understands can connect the dots,'' Schwartz said.

Another perspective was provided by Cynthia Jurosek, a patient and temporary employee at the Indian Health Board in Billings, Mont., said:

``All these urban clinics, they belong to the Indians,'' said Jurosek, a Crow Indian. ``It's where they can go and feel good about themselves. They're treated with respect. And that's what I will lose here.

``I will lose people who are truly interested in helping me get well.''

Again, the politics of the issue are debatate. But it's another example the U.S. government hasn't ever known quite what to do about American Indians.