[Congressional Record (Bound Edition), Volume 145 (1999), Part 20]
[Extensions of Remarks]
[Page 29894]
[From the U.S. Government Publishing Office, www.gpo.gov]




   INTRODUCTION OF INDIAN HEALTH CARE IMPROVEMENT ACT REAUTHORIZATION

                                 ______
                                 

                           HON. GEORGE MILLER

                             of california

                    in the house of representatives

                       Tuesday, November 16, 1999

  Mr. GEORGE MILLER of California. Mr. Speaker, today I am joined by 26 
of our colleagues in introducing the Indian Health Care Improvement Act 
reauthorization legislation. The Indian Health Care Improvement Act 
which provides for the delivery of health services of American Indians 
and Alaska Natives throughout the nation will expire at the end of 
fiscal year 2000. Since its enactment in 1976, the act has resulted in 
a reduction in serious illnesses and healthier Native American births.
  The unmet health needs among American Indians and Alaska Natives 
continues to be staggering with their health status for below that of 
the rest of the United States population. When compared to all races in 
the United States, Indian people suffer a death rate that is: 627 
percent higher from alcoholism; 533 percent higher from tuberculosis; 
249 percent higher from diabetes; and 71 percent higher from pneumonia 
and influenza.
  The bill I introduce today represents, for the first time, Indian 
country's proposal, ``Speaking With One Voice.'' Throughout the past 
year the Indian Health Service held regional meetings across the United 
States gathering information and consulting with health care providers, 
Indian tribes, tribal organizations and urban Indian organizations on 
how best the unique needs faced by Indian health delivery systems could 
be addressed. Following these meetings a national steering committee 
made up of tribal leaders from each of the Indian Health Service (IHS) 
areas plus a representative of urban Indians was established. The 
national steering committee drafted legislation and held numerous 
meetings to receive additional tribal views and incorporate them into a 
consensus document.
  The legislation is focused on the national needs and includes very 
few tribal specific authorizations. Several of the programs normally 
administered by the Indian Health Service headquarters would be 
decentralized under this legislation with more funds distributed to IHS 
area offices to address local priorities. The bill also includes 
important health care training and recruitment provisions to assist 
with the chronic shortage of qualified health care providers. 
Additionally, the bill is designed to work cooperatively with 
contracting and compacting provisions under the Indian Self 
Determination and Education Assistance Act.
  I am introducing this important legislation at the request of the 
national steering committee on the Reauthorization of the Indian Health 
Care Improvement Act. All the important component of Indian health care 
delivery are addressed in this bill including access to, and care for, 
diabetes, prenatal care, ambulatory care, alcohol and substance abuse, 
mental health, coronary care, and child sexual abuse. Certainly, there 
will be changes made to the bill as it proceeds through the legislative 
process, but this bill provides a solid basis for us to work from.
  I commend the hard work and dedication of all the members of the 
national steering committee and those within the Indian Health Service 
who helped produce this legislation. For far too long Native Americans 
have put up with inferior health care. I will push for swift 
consideration of this bill and ask all my colleagues to join me in 
passing legislation to ensure that our first Americans are afforded 
only the best health care this nation can offer. We have the 
responsibility to accept nothing less.

                          ____________________