martes, 23 de agosto de 2005

indian health care in tennessee

A lot of comments have been made about the lack of health care for Native Americans in Tennessee, and the need to do something about it. The problem is that all of the information we have about health care concerns have been anecdotal (stories about so-and-so being sick or getting kicked off of TennCare) and isolated (no groups of same-area individuals), ie, there's no state-wide information based on real information of any more than a very few individuals.

If we really want to do something about health care for indians in this state, then we have to understand the health care issues of Native Americans in Tennessee. To do that, some group or some body is going to have to start keeping track of indians in this state and their specific health care issues, including names, addresses, problems/issues, treatment (or lack thereof), resolution (or lack thereof), insurance (private, public, or lack thereof), tribal affiliation and status, etc., from individuals themselves and from county health departments and the state.

In keeping with their missions, the Commission of Indian Affairs (4-34-103. "Powers and duties. It is the duty of the commission to: ... (2) Investigate relief needs of Indians of Tennessee and to provide technical assistance in the preparation of plans for the alleviation of such needs;")
or the Advisory Council (ACTIA) ("ARTICLE 3. DUTIES It is the duty of the Advisory Council on Tennessee Indian Affairs to: ... (3) Investigate needs of Indians of Tennessee and to provide technical assistance in the preparation of plans for the alleviation of such needs;" and "3. The Health Care Committee"), or both,
ought to initiate a survey next year asking every person who self-identifies as indian to fill out some basic information about health care, specifically about health and health insurance status. These forms could be distributed at every indian event around the state, and the state Department of Health, and/or a university with a public health interest (like Vanderbilt or the Center for American Indian and Alaskan Native Health at Johns Hopkins University, School of Public Health), or a private organization (eg, www.tpha.info) could be used to process and interpret the data.

Health care needs, both short- and long-term, are met, for the most part, by medical insurance, usually obtained through employers or public health care plans like TennCare or Medicare or the Indian Health Service. If we want to figure out if these programs suffice for the indian population in the state, we first have to determine who in the indian community is being served and who isn't. It's time for the Commission and ACTIA to investigate these assumed health-care needs.

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The way one avoids making mistakes is
to do nothing or to do nothing new.

-DB

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