Indians in Health Overhaul: And you think you have worry about health reform

As someone who worked in Indian Health Service as a Servicce Unit Director who fought the odds and won some major changes, it will be a long haul to see that First Americans receive the promises made in exchange for the land. 

Remember, you are walking on Indian land.
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American Indians Stand to Gain in Health Overhaul
PAM BELLUCK
Published: Wednesday, December 2, 2009
The meeting last month was a watershed: the leaders of 564 American Indian tribes were invited to Washington to talk with cabinet members and President Obama, who called it “the largest and most widely attended gathering of tribal leaders in our history.”

Laura Segall for The New York Times

Topping the list of their needs was better health care.

“Native Americans die of illnesses like tuberculosis, alcoholism, diabetes, pneumonia and influenza at far higher rates,” Mr. Obama said. “We’re going to have to do more to address disparities in health care delivery.”

The health care overhaul now being debated in Congress appears poised to bring the most significant improvements to the Indian health system in decades. After months of negotiations, provisions under consideration could, over time, direct streams of money to the Indian health care system and give Indians more treatment options.

Some proposals, like exempting Indians from penalties for not obtaining insurance, may meet resistance from lawmakers opposed to expanding benefits for Indians, many of whom receive free medical care.

But advocates say the changes recognize Indians’ unique status and could ease what Senator Byron L. Dorgan, Democrat of North Dakota, calls “full-scale health care rationing going on on Indian reservations.”

“We’ve got the ‘first Americans’ living in third world conditions,” Mr. Dorgan said.

Mr. Obama has emphasized Indian issues more than most presidents. He campaigned on reservations, created a senior policy adviser for Native American affairs and appointed Kimberly Teehee, a Cherokee, to the post, and gave Indians other high-ranking positions.

He has proposed a budget increase of 13 percent for the federal Indian Health Service, which provides free care to 1.9 million Indians who belong to federally recognized tribes, most of whom live on tribally owned land. The service, which had a budget this year of $3.3 billion, has also received $500 million in stimulus money for construction, repairs and equipment.

“This new administration has been much more positive,” said W. Ron Allen, chairman of the Jamestown S’Klallam tribe in Washington State and treasurer of the National Congress of American Indians, adding that the Congressional proposals provide “a very impressive opportunity to close the gap in Indian health care.”

On Thursday, the Senate Indian Affairs Committee is scheduled to discuss other Indian health issues that could end up in the overhaul bill.

Indians could benefit from broader overhaul programs for low-income and uninsured citizens, but they do not want to relinquish the health care they claim as a historical right.

“Indian people have given up a lot,” said Dr. Yvette Roubideaux, director of the Indian Health Service. “They really feel like they have, in a sense, prepaid for this health care with loss of land, natural resources, loss of culture.”

‘List Goes On and On’

In the vast, varied territory called Indian Country, health care is stung with struggle.

Too few doctors. Too little equipment. Hospitals and clinics miles of hardscrabble road away.

In cities, where over half of the country’s roughly 3 million Indians now live (and nearly 5 million including part-Indians), only 34 programs get Indian Health Service funding, providing mostly basic care and arranging more advanced care and coverage elsewhere.

While some Indians have private insurance, often through employers or tribal businesses like casinos, a third are uninsured and a quarter live in poverty. By all accounts, the Indian Health Service is substantially underfunded.

Money shortages, bureaucracy and distance can delay treatment of even serious conditions for months, even years.

Many Indians face multiple roadblocks.

Joanna Quotskuyva’s breast cancer did not require a mastectomy, but she chose to have surgery because radiation would mean months of driving five hours round-trip from her home on the Hopi reservation in Kykotsmovi, Ariz.

Many make similar choices, because “unfortunately, we don’t have the capability,” said Dr. Joachim Chino, chief of surgery at the nearest hospital, the Tuba City Regional Health Care Corporation. Treating large swaths of the Hopi and Navajo reservations — the Navajo alone is the size of West Virginia — is inherently difficult.

Despite its dedicated medical staff, the hospital struggles “to bring, right here, appropriate state-of-the-art, specialty, critical-care medicine,” said Joseph Engelken, the hospital’s chief executive.

While the Indian health system has improved nationally and Indians are living longer, Dr. Roubideaux acknowledged problems, not all from underfunding, saying, “The list goes on and on in terms of areas that need improvement.”

Sometimes urgent “life or limb” cases get attention, while others, some serious, must wait.

Dr. David Yost, clinical director at the White Mountain Apache reservation in Arizona, cited “piles of care we have to put on the back burner,” including 150 cases this summer, some “waiting a year and a half.” This budget year, he said, 40 patients are still waiting, and about “10 people a month” are added to the list.

Ronnye Manuelito, 56, a Navajo in Naschitti, N.M., said he “almost felt like giving up” after waiting for brain surgery to quell blackouts, seizures and headaches experienced over three years from a shifting metal plate in his head from a childhood carousel injury.

One time he “left the stove on in the kitchen and passed out,” and another he had a seizure in a car, said his sister, Brenda. His Indian Health Service doctor “was trying to get him a referral to a specialist in Albuquerque, but they weren’t approving it because it wasn’t life-or-limb,” she said.

Ultimately, two surgical procedures helped him.

Dr. Roubideaux, speaking generally, said, “There are some places where funding is so short and there are so few health care providers, unfortunately people may have to wait quite a long time.”

A former reservation doctor herself, Dr. Roubideaux said she would see “someone who maybe had chronic knee pain and a little bit of surgery would help, yet the person was still walking,” making it non-life-threatening. “It’s really heartbreaking,” she said.

In cities, scarce Indian facilities and patchwork insurance can mean “a woman with a lump in her breast — we can’t guarantee we can get her into treatment in a reasonable period,” said Ralph Forquera, the executive director of the nonprofit Seattle Indian Health Board. “A cardiac problem? We can’t guarantee that person can get to see a specialist.”

Sometimes, Mr. Forquera said, when that woman is treated, “the lump has metastasized.” He added, “We’ve had people actually die on waiting lists.”

Jackie BirdChief, 46, a single mother with thyroid cancer, did not have to wait. She just had to move 200 miles from Phoenix to the Apache reservation she left in 1983, leaving her city, her job and, for months, her daughter, then 14. She moved because cost containment rules link coverage for care to establishing residency on reservations.

Ms. BirdChief, a secretary, was lucky because the Indian Health Service, her employer, “manipulated the system to make it work out for her,” Dr. Yost said. It found her jobs on the reservation, he said, “whereas someone working in a grocery store would have had to quit their job — or decide if they wanted to have the procedure.”

Still, Dr. Yost said, Ms. BirdChief “was a victim of our system, and ironically, she worked for the Indian health system.”

Living on a reservation, however, does not ensure accessible care.
Ruby Biakeddy’s six-sided hogan, a traditional Navajo home, without running water or a phone, is an hour’s drive on a dirt road from drinking water, and even farther from diabetes and blood pressure medication. Since her truck got swept away in a rain-swollen ditch five years ago, Ms. Biakeddy, 67, who tends sheep, must borrow her children’s vehicles.

“I recently ran out of the medicine I inject for a week,” she said in Navajo through a translator.

Serious cases, where getting care within the “golden hour” after problems start is critical, can also suffer. “For many of our patients,” said Dr. Anne Newland, acting clinical director of a clinic in Kayenta, Ariz., “that hour is gone by the time they get to us.”

Ciara Antone, 4, died on the Navajo reservation outside Tuba City from an apparent bowel obstruction. Her mother, Genita Yazzie, called 911, but said that with the distance and road conditions, the ambulance was two hours away.

“I kept telling the dispatcher, ‘My daughter’s coding, she’s not breathing,’ ” Ms. Yazzie said. Desperate, she drove to the closer Hopi reservation to get an ambulance, but by then, “they couldn’t bring her back.”

Whether a closer ambulance could have saved her daughter is unclear (the family has sued the non-Indian hospital that treated her). Henry Wallace, director of Navajo Emergency Medical Services, which Ms. Yazzie called first for an ambulance, declined to discuss the case, but said, “the geographic area is so large that the time factor is probably the biggest problem we have.”

“We really don’t have a golden hour,” he said. “Ours could be the golden three hours.”
Staffing shortages exacerbate things. Recently, Kayenta began closing its emergency room overnight, making Tuba City, at 90 minutes away, the closest hospital. At Indian hospitals and clinics nationally, a fifth of physician positions and a quarter of the nursing slots are unfilled.

Patients contribute to the frustrations. Nearly a third do not show up for scheduled surgery at Tuba City, often citing distance or cost.

Richard White, 61, acknowledged taking his medicine sporadically and drinking, aggravating his diabetes. He went blind, lost a toe and, during a Navajo medicine-man ceremony that he hoped would restore his vision, burned his other foot, which was then amputated.

“Stare at these incredible statistics, you become overwhelmed,” Dr. Yost said. “It’s like drinking out of a fire hydrant.”

Keeping a Promise

Congress’s goal, in using penalty and co-payment exemptions, is to encourage Indians to enroll in proposed programs like subsidized private insurance or expanded Medicaid, while respecting their sovereignty and the conviction that they are owed health care.
That conviction and bureaucratic hurdles have kept many eligible Indians from enrolling in Medicaid. But getting insurance allows Indians to receive care from more providers and allows the Indian system to get reimbursed from Medicaid or other insurers.

That would generate “an influx of capital,” said Jim Roberts, policy analyst for Northwest Portland Area Indian Health Board, that “you can use to improve Indian health care.”
Some disagree. Senator Tom Coburn, Republican of Oklahoma, said exemptions could discourage insurance enrollment, raise premiums for insured people and further stress the Indian health care system, which he called “poorly managed” and in need of billions of dollars to “keep the promise to Native Americans.”

Even if more Indians become insured, it will not end the problems, especially if providers and insurers, daunted by the alarming health problems, continue avoiding Indian Country.

Proposed legislation would not give Indians everything they want, but the overhaul does include grants for preventive care and research. And the Indian Health Care Improvement Act, which stands a good chance of being reauthorized by Congress for the first time since 2001, would enhance programs, physician recruitment and hospital construction. Although it approves no funding, advocates hope it will prompt additional money.

Representative Frank Pallone Jr., Democrat of New Jersey, said that with the current climate in Congress, and “particularly the president, it’s definitely going to be easier to get Indian provisions in the health care bills.”

Easier, but no sure thing.

With expansions in public coverage or subsidies to buy private coverage, some lawmakers may question whether Indian Country should “still be getting direct payments to run I.H.S. clinics,” said Stephen Zuckerman, a health economist at the Urban Institute, a research group.

“Some people are saying, ‘We can’t make all these adjustments for you guys,’ ” Mr. Allen said, adding that some Indians reply: “Make us pay for health care, then the deal is off. Give us the land back, and we’re good.”

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Learn the Benefits of Chi

Have you asked yourself how much your health is worth to you lately?

Is your health even something that you think about on a daily basis?

Are taking the most effective, purposeful actions to ensure that you achieve optimal health?

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Chi is the life-force energy. Awakening your chi allows your mind, body, and spirit to all be connected instead of operating in fragmented parts.

Practicing chi allows you to leave chronic illnesses behind, it allows you to go from an external-centered life to an internal-centered life. Chi must flow freely and openly within you.

Today I'm excited to announce the release of Study Chi by Master Hypnotist Steve G. Jones.

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Sexy Fitness Male Model Sean Faris

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Viral Infections: An Overactive Immune Response

The herb Nettle (Nettle, Urtica urens)

New culprit for viral infections among elderly -- an overactive immune response

ScienceDaily (2009-11-30) -- Researchers have found that exaggerated responses of the immune system explain why the elderly succumb to viral infections more readily than younger people. The study bucks the general belief that declining immune responses are to blame for susceptibility to viral infections. ... > read full article

from the leaflady: Nettle

"Anti-inflammatory
Stinging nettle demonstrates anti-inflammatory activity in experimental situations. The extract partially inhibits the activity of 5-lipoxygenase and shows a concentration dependent inhibition of the synthesis of cyclooxygenase derived reactions.(2) (Note: these are the same enzymes that aspirin inhibits). A new class of drugs (called Cox2 inhibitors) aimed specifically at modulating cyclooxygenase enzymes is one of the new darling in the pharmaceutical industry.

Stinging nettle (both the leaf and root) also appears to prevent the over stimulation of proinflammatory cytokines like tumor necrosis factor-alpha and interleukin-1 beta. Cytokines can be thought of in simple terms as immune system messengers. And while a discussion of these proinflammatory cytokines and immune system balance is beyond the scope of this column, cytokine balance is a growing area of interest in medicine.

In fact, virtually all immune disorders (from HIV, to cancer, to autoimmune diseases), allergic conditions (like asthma and allergies) and even obesity/insulin resistance have characteristic imbalances in cytokine levels as part of the functional derangement occurring at a metabolic level. Between the lipoxygenase, cyclooxygenase, and cytokine modulating activities of this plant, stinging nettle is literally a treasure chest of unexplored potential.


Anti-viral and Immune Balancing
UDA Superantigen Stinging nettle actually contains a "super lectin" called UDA superantigen (UDA for short). For those interested, UDA appears to be an N-acetylglucosamine specific lectin. Evidence indicates that this super lectin can inhibit a range of viruses including those responsible for HIV, colds, and influenza.(4)

UDA is also T-cell mitogen, distinguishable from classical T-cell lectin mitogens, by its ability to discriminate a particular population of CD4+ and CD8+ T-cells, as well as its capacity to induce an original pattern of T-cell activation and cytokine production.(5) Basically, what this means is that unlike most things that stimulate the immune system only toward greater activity, the super lectin in stinging nettles appears to stimulate the immune system to be in balance.(6)

While studies in humans are lacking (and would be extremely desirable), the UDA super lectin has been shown to prevent the progression of experimentally induced systemic lupus erythematosus-like pathology in mice. In the experiment, UDA-lectin treated animals did not develop overt clinical signs of lupus and nephritis (kidney disease). UDA was also shown to alter the production of autoantibodies in a sex-dependent manner.(14)"

excerpt above from Notes on Nettle at leaflady.org

http://naturalhealthnews.blogspot.com/2009/11/research-shows-antioxidants-beneficial.html

How to Spot Reduce and Burn ONLY the Fat Off Your Stomach...

By Nick Nilsson

I'll share with you my top-secret technique for burning ONLY the fat off your stomach. This is spot-reducing at its best...you can even apply this technique to ANY other specific areas you want to tone up!

Yep, it's exciting and I know you're curious so I'll get right into it!

To perform this technique, you're going to need a roll of duct tape, 3 double cheeseburgers, a set of jumper cables and a housecat...

Ok, you're going to hate me for this...

The truth is there IS no top-secret technique for spot reducing and burning only the fat from your stomach. I made that headline up in hopes that you would at least read far enough into this article to learn the TRUTH about how your body burns fat and WHERE it burns fat from (and I'll try to keep it entertaining so you actually want to read the whole thing :) ).

And honestly, this type of question is one of THE most frequently asked questions I've gotten in all the years I've been answering questions online...

"How do I get rid of fat from just my [insert area here]?"

Bottom line is, you can't. And even those stupid creams and lotions won't do it (one of these days I swear I'm going to get one of those creams and put it only on the left side of my abs and not the right and see what happens...I'm sure I'll have a ripped 3 pack within days).

To lose fat from any one specific place in your body, you're going to have to lose it from EVERYWHERE ELSE, too. There's really no getting around it.

I like to use the analogy of a swimming pool (I "borrowed" this one from fat-loss guru Tom Venuto)...

When you're filling up a swimming pool (the pool is your total amount of body fat), the deep end fills up first, right? Then the shallow end fills up as the water level rises.

Generally speaking, the deep end can be compared to the areas where you put on fat FIRST. The shallow end is where you put on fat LAST.

When you go to lose fat, look at the swimming pool again...when you drain the swimming pool, you can't drain water from just the deep end! It drains from the whole pool at once...the shallow end shows it first, THEN the deep end last.

So basically (and fairly depressingly!), the fat you want to get rid of FIRST is the fat that's going to come off pretty much LAST. To burn just stomach fat (or thigh fat or back fat), you'd have to figure out a way to defeat the entire system your body uses to store fat.

Sticking a vacuum into your belly with surgery is one way to do it - taking useless pills like Acai Berry definitely WON'T do it, no matter how many "simple rules" you follow (in that case, the simple rule is "give us all your money so you can't afford food anymore" - I guess that one actually WILL work).

And that's not even all your options for losing stomach fat...

1. Starvation dieting - this is THE best way to lose weight...of course, it'll be mostly muscle, which will send your metabolism into a nosedive, which will make it harder to continue to lose weight, which will make it easier to REGAIN weight, which will keep that lovely stomach fat firmly where you left it, even though the precious scale shows a smaller number...oops, somebody changed the calibration on it...you actually weigh more now...never mind.

2. Diet pills - pretty much all of these will work for you, especially the ones that say you can eat anything you want and still lose weight (just make sure you're never more than 15 feet from a bathroom). You know the manufacturers are only interested in your success and well-being, after all! And don't forget, the heart is a muscle and the faster it goes, the more calories you burn, right! Who wouldn't want to have their heart-rate up in the "training zone" while they're sleeping...talk about efficiency!

3. High Impact Aerobics For Beginners - the good news is, soft tissue injuries require a LOT of calories to heal up, so bust out those Step Tae Bosu Dance tapes and go nuts!

Okay, let's move on to some of the more "radical, unproven" stuff ;)...

1. Eating natural, wholesome foods - what a crock! The only thing anybody has ever lost from eating this garbage is fat. Oh wait...

2. Weight training - even more useless than good nutrition, weight training is something to stay away from. All it will do is build muscle and increase your metabolism. Total B.S. Same with interval training...it's the worst.

3. Supplementing with multivitamins, minerals, fish oil and protein - I know...I can't make this stuff up! Some people actually USE these things to support their nutrition while eating natural foods and training with weights for fat loss. I guess their quack doctors wouldn't write out a prescription for Orlistat or Xenical or Gottapoopital.

So bottom line, fat loss isn't rocket science...just don't eat anything, take a lot of pills and thrash around for hours on end until you hurt yourself.

------------------

Nick Nilsson is Vice-President of the online personal training company BetterU, Inc. He has a degree in Physical Education and Psychology and has been inventing new training techniques for more than 16 years. Nick is the author of a number of bodybuilding eBooks including "Metabolic Surge - Rapid Fat Loss," "The Best Exercises You've Never Heard Of," "Gluteus to the Maximus - Build a Bigger Butt NOW!" and "The Best Abdominal Exercises You've Never Heard Of" all available at http://fitness-ebooks.rxsportz.com. He can be contacted at betteru@fitstep.com.

World AIDS Day: activists and HIV-positive children and adults mark December 1

HIV/AIDS cure getting little publicity

WASHINGTON, Nov. 30 (UPI) -- Efforts of the Obama administration to address HIV/AIDS are the focus of remarks in Washington by officials Monday, the eve of World AIDS Day, officials said.

The event by the officials was to be delivered live and online at WhiteHouse.gov/live, the White House said.


Participants include Secretary of State Hillary Clinton, Health and Human Services Secretary Kathleen Sebelius, Ambassador and U.S. Global AIDS Coordinator Eric P. Goosby, and senior adviser Valerie Jarrett, assistant to the president for intergovernmental affairs and public engagement.


World AIDS Day, observed Dec. 1 each year, is dedicated to raising awareness of the AIDS pandemic caused by the spread of HIV infection, the virus that causes AIDS.

http://naturalhealthnews.blogspot.com/2008/12/different-approach-needed-for-aids.html

http://naturalhealthnews.blogspot.com/2008/11/politics-hivaids-and-gmo-drugs.html

http://naturalhealthnews.blogspot.com/2007/10/politics-and-hivaids-mos.html

http://naturalhealthnews.blogspot.com/2008/04/hivaids-drugs-and-monitoring-scheme.html

http://naturalhealthnews.blogspot.com/2009/03/coconut-oil-components-compound-hiv.html

12/1/09: World AIDS Day: AIDS faces funding drop

With funding an issue it seems as if a new approach to these troublesome health issues would be welcome.  There are natural treatment approaches for HIV/AIDS, drug resistan TB and Malaria. 

Try thinking outside the box for a while, it might do so much more than keep research-that-goes-nowhere going.

CONGERS, N.Y., Dec. 1 (UPI) -- On World AIDS Day Tuesday, a day devoted to raising awareness, U.S. researchers point out the world could face a funding shortfall for treatment.

The policy journal Health Affairs devoted much of its November/December edition to the cost and demand challenges of HIV/AIDS. Over the next several years, the world could face a funding shortfall that would prevent millions more with human immunodeficiency virus/AIDS from gaining access to antiretroviral drugs, the journal said.
However,over the long-term, the world could also take critical steps to slash the global burden of HIV-AIDS -- and the costs of battling the pandemic -- by half.
During the past six years, the world has poured $52 billion into fighting the HIV/AIDS pandemic and more than 4 million people with the disease worldwide are being treated. But the rapid growth in AIDS treatment has not kept pace with the rate of new infections.

A total of 11 million people are sick enough that they should be on anti-AIDS treatment, but aren't, and with an estimated 33 million infected, the number needing treatment will only grow in the years ahead, academic journal Health Affairs said.

The Global Fund to Fight AIDS, Tuberculosis and Malaria needs $3 billion to help run the programs it currently funds. Over the next year, however, the organization will be another $2 billion short of its goal for funding new programs.