[Congressional Record (Bound Edition), Volume 150 (2004), Part 2]
[Senate]
[Pages 1992-1993]
[From the U.S. Government Publishing Office, www.gpo.gov]




                          INDIAN BUDGET ISSUES

  Mr. DASCHLE. Mr. President, 2 days ago I talked about the need to 
find a way to ensure that every American has access to health insurance 
and high-quality health care--and to counter the defeatism of some who 
suggest it isn't possible. As I said, the United States is the only 
industrialized country that has failed to achieve this goal. It is 
possible. It is a matter of political will, and we must show that we, 
as a Nation, have it.
  Today I want to talk a little about a group of people who are counted 
among the insured in this country--Native Americans. They are counted 
among the insured, but the Government has failed utterly to deliver 
even basic health care to the vast majority of them.
  Through treaty and statute, the Federal Government has promised 
health care to all Native Americans through the Indian Health Service. 
In fact, the Federal Government provides less than half what it would 
cost to provide basic clinical services to the current IHS user 
population.
  Incredibly, the Federal Government spends twice as much per capita on 
medical treatment for Federal prisoners than it spends on treatment for 
Native Americans. Twice as much on Federal prisoners as Native American 
children.
  Last year, and the year before that, I offered amendments to the 
budget resolution to make up the difference. During consideration of 
last year's budget resolution, we were two votes short of passing our 
amendment to add $2.9 billion in funding for IHS clinical services.
  Every Democratic Senator voted for the funding; every Republican 
Senator voted against it. Republican leaders then offered an amendment 
to provide one-tenth of those funds--$290 million to the IHS. As meager 
as that increase was, it was welcome. Unfortunately, that amendment 
never made it through the conference with the House. Furthermore, when 
the Interior Appropriations bill was considered, the Republican support 
for that $290 million--their own proposal--had dried up.
  This year, the President's budget does no better. The President's 
budget includes a $7 million increase for IHS clinical services--less 
than the cost of inflation, and about $3.4 billion short of what is 
needed to meet Native Americans' basic health care needs.
  I have spoken many times on this floor about the ``life or limb'' 
test at the Indian Health Service. When funding is low--and that is 
pretty much all the time--treatment is rationed using the ``life or 
limb'' test.
  If a Native American patient isn't at immediate risk of losing his or 
her life or a limb, then he or she is turned

[[Page 1993]]

away. Of course, denying early treatment often leads to a worsening 
condition. Sometimes by the time their condition is bad enough to meet 
the ``life or limb'' test, the funding is simply gone.
  People are suffering preventable long-term health effects, and even 
dying, because we--the U.S. Government--are failing to meet our 
responsibilities. Sometimes we grow numb to these realities.
  We do not want to face them. We hear ``life and limb test'' and 
simply don't believe it. But this is the reality in Indian country. We 
have the power to fix it.
  The Indian health care budget and the overall budget for Indian 
country were the subjects of discussion in several meetings I have had 
this week. Tuesday afternoon I met with, among others, John Yellow Bird 
Steele, president of the Oglala Sioux Tribe.
  President Steele talked about what an affront to Indian country 
President Bush's fiscal year 2005 budget is. Inadequate funding for 
Indian health. Inadequate funding for Indian education. Inadequate 
funding for law enforcement. Inadequate for housing. There is only one 
area of the budget that was increased--the Department of the Interior's 
proposed reorganization of the Bureau of Indian Affairs and the Office 
of the Special Trustee that will oversee the Interior Department trust 
reform efforts.
  This reorganization plan was given a 50 percent increase in the 
President's budget. One who hasn't heard much about the trust reform 
issue might think that should be welcome news. But the truth is that 
Indian tribes and trust account holders strongly oppose the 
reorganization plan. This plan has been pursued without proper 
consultation with Indian tribes and over the vehement objections of 
Indian tribes.
  So this administration has dedicated wholly inadequate resources to 
Indian country and, in distributing those scarce resources, has devoted 
its only increase to a proposal that Indian people vehemently oppose. 
In the process, the administration has ignored the needs of Indian 
health, education, law enforcement, and every other major priority 
facing Indian tribes and Indian people.
  Again, Indian country needs are not theoretical. They are real, 
everyday needs.
  Tuesday President Steele and other representatives of the Oglala 
Lakota people talked to me about a few of them. They reminded me that 
Pine Ridge has four judges and two prosecutors to serve the entire 
reservation. BIA law enforcement funds cover the salaries of those two 
prosecutors for only 6 months of the year. Because the tribe's general 
fund is limited, it cannot make up the entire difference. This year, 
the prosecutors volunteered their time for 3 months of the year.
  Pine Ridge has 2 troopers to cover its 1,800 miles of roads. When 
there is a car accident on one of those roads, more often than not, the 
troopers will not be able to respond. There are more unattended crashes 
on Pine Ridge than attended crashes. On Pine Ridge, the ``first 
responders'' are often the next people who happen to drive by.
  Waste water systems are inadequate--some underground pipes date back 
to the 1800s. Housing is inadequate--some homes have no electricity or 
running water. As Cora Whiting, a tribal council member, said to me, 
``How many people in America are still living that way?''
  Pine Ridge has an unemployment rate of 85 percent. Tribal leaders 
like President Steele and Cora Whiting know that the only way to 
improve that statistic is to bring economic development to the 
reservation. But it is impossible to attract businesses without the 
infrastructure necessary to support them. And we have a duty to help 
build it.
  Yesterday I met with Chairman Harold Frazier of the Cheyenne River 
Sioux Tribe. We discussed many of these same issues. We talked about 
their unmet needs, and their story is all too close to that of Pine 
Ridge.
  Their tribal court system is a perfect example. The Bureau of Indian 
Affairs' tribal priority allocations fund the Cheyenne River Tribal 
Court. This year, their funding is about $300,000 short of what they 
require to deliver the bare minimum of services. In essence, they have 
enough funds to pay salaries and benefits for an inadequate number of 
staff. They can pay for nothing else--no attorney fees, no supplies, no 
juror fees, nothing.
  The Cheyenne River Sioux Tribe also faces some of the same 
infrastructure problems that the Oglalas and so many other tribes face. 
Water systems cannot maintain water pressure or support building 
upgrades that are essential to the provision of basic tribal services. 
And, of course, Chairman Frazier and I also talked at length about 
health care and the system that has failed them.
  People tend to think of budgets as intellectual exercises--something 
that isn't binding or real. Even when we say we have balanced the 
budget--something we actually did in the 1990s--people tend not to 
believe it. And now that the failed fiscal policy of the last few years 
has turned projected surpluses into massive deficits, our credibility 
is even lower.
  But budgets are not just numbers. They reflect choices about our 
priorities and our political will. They have real consequences for real 
people.
  For several years, I have watched this administration and its allies 
defend tax cuts for the wealthy while they claim we ``can't afford'' to 
fund the Indian Health Service. We have borrowed money--from Social 
Security and other countries--to finance those tax cuts, but we have 
denied Indian children the health care that federal prisoners take for 
granted.
  The fact that we choose to afford huge tax cuts for the wealthiest 
among us, or the construction of hospitals in Iraq, but choose not to 
afford health care or education or housing for Indian families is lost 
on no one in Indian country.
  This budget isn't Indian country budget. It isn't America's budget. 
It is time to make our budget reflect America's true priorities, which 
are fair opportunities for every child in America, for their parents 
who work so hard to create a better life for them, and for their 
grandparents who deserve to retire with dignity.
  That is the budget I'm going to be talking about and fighting for as 
this year unfolds.
  I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant bill clerk proceeded to call the roll.
  Mr. REED. I ask unanimous consent that the order for the quorum call 
be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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