[Public Papers of the Presidents of the United States: George H. W. Bush (1992-1993, Book II)]
[October 29, 1992]
[Page 2074]
[From the U.S. Government Publishing Office www.gpo.gov]



[[Page 2074]]


Statement on Signing the Indian Health Amendments of 1992
October 29, 1992

    Today I am signing into law S. 2481, the ``Indian Health Amendments 
of 1992.'' S. 2481 reauthorizes appropriations for health services for 
American Indians and Alaska Natives.
    S. 2481 continues Indian scholarship and training programs, thereby 
assuring an available source of health care professionals to serve 
American Indian and Alaska Native communities. In addition, the bill 
expands primary and preventive health programs, emphasizing mental as 
well as physical health. The bill's other significant new or expanded 
activities include the encouragement of Native Americans to enroll in 
Medicare and Medicaid, continued services to urban Native Americans, and 
expansion of substance abuse programs.
    S. 2481 also contains specific health care objectives drawn from the 
U.S. Public Health Service's ``Healthy People 2000'' report and ties the 
allocation of resources to these objectives. This new approach will 
prove useful in measuring progress toward the goal of raising the health 
status of American Indians and Alaska Natives to the highest possible 
level.
    Although S. 2481 clearly contains a number of provisions to improve 
the health of Native Americans and Alaska Natives, it also includes 
provisions that are problematic. For example, the bill prohibits third-
party collections from self-insured health plans for services provided 
by the Indian Health Service (IHS). This prohibition actually reduces 
the number of Native Americans and Alaska Natives who can be served and 
sets an undesirable precedent. In addition, the establishment of yet 
more categorical authorities in S. 2481, especially grants for specified 
tribes or tribal organizations, is counterproductive to a rational 
allocation of limited resources.
    Finally, S. 2481 also includes a ``Buy American'' provision that 
directs the IHS to comply with the requirements of the Buy American Act 
with respect to its construction procurements. This provision will not 
apply to the extent that I determine it would violate the Nation's 
international obligations under the General Agreement on Tariffs and 
Trade or any other international agreement to which this country is a 
party.

                                                             George Bush

The White House,
October 29, 1992.

                    Note: H.R. 2481, approved October 29, was assigned 
                        Public Law No. 102-573.