A U.S. Senate bill aimed at improving the Native American health-care system has the potential to save lives on South Dakota reservations, a tribal leader said Thursday.

Robert Moore, a member of the Rosebud Sioux Tribal Council, said the Indian Health Care Improvement Act includes essential provisions - including better medical screening and mental-health options - to better Indian Health Service services that could help fight exploding diabetes rates and other debilitating health problems among Native Americans. It could also reduce bureaucratic red tape and individual costs that make it difficult for Native people to receive proper care from the IHS, Moore said.

"We're on the edge of having something very significant happen for the tribes that hasn't happened in a long time," he said. "This could save lives."

During a speech Wednesday on the floor of the U.S. Senate - his first since suffering a near-fatal brain hemorrhage 13 months ago - Sen. Tim Johnson said passage of the bill is "truly a matter of life and death" to Native Americans struggling with inadequate health-care options.

"It is a sad fact that the six counties in America with the lowest life expectancy are tribal counties in South Dakota," Johnson said. "Poor health affects not only life expectancy but also the quality of life for American Indians. It is also preventable."

Diabetes is a good example of that, Moore said. The legislation includes provisions to help identify and treat early-onset type 2 diabetes in children. Early intervention and treatment of diabetes can prevent many harmful effects of the disease, he said.

The legislation also would reduce the burden of co-payments that can discourage some Native Americans from seeking medical care, Moore said. And it would end a requirement that tribal members prove U.S. citizenship in addition to their tribal membership to qualify for Medicaid and Medicare through an IHS facility, he said.

"That can be very difficult and time consuming for a lot of our participants, particularly those in the late 60s or older, because there were basically not any vital-statistic records at all," Moore said. "My own father was born in a tent, and his only documentation saying he was born was a baptismal certificate."

The Senate began consideration of the authorization act Tuesday and is expected to return to the bill next week. The Bush administration opposes certain labor provisions of the bill, and has issued a veto threat, something Moore hopes can be avoided.

Moore said the fact that Johnson chose the legislation as the focus of his first Senate speech since his own illness showed the senator considers it to be a priority.

"It's very important to him. And his own personal experience, I'm sure, probably opened his eyes a little wider," Moore said.

Moore also praised Sen. John Thune, R-S.D., for his support of the bill and for a recent visit to Rosebud to meet with tribal officials on health care and other issues. Thune worked with the Rosebud Tribal Council on an amendment to the act and spoke in favor of its reauthorization Tuesday night on the Senate floor.

Thune quoted stark statistics reflecting the serious health problems facing Native Americans. Nationally, Natives have twice the infant-mortality rate, three times the diabetes rate, six times the rate of alcohol-related vehicle deaths and 50 percent higher suicide rates, Thune said.

"I strongly support the objective of this bill, which is to provide quality health care to Native Americans, and I hope to improve it through the amendment process," he said.

Moore said having the state's two senators and U.S. Rep. Stephanie Herseth Sandlin, D-S.D., working in support of the bill could work for the reauthorization act, just as their unity helped keep Ellsworth Air Force Base from being closed.

"I think they're unified on this one," Moore said. "And there's power in that. Look what it did for Ellsworth."

Contact Kevin Woster at 394-8413 or kevin.woster@rapidcityjournal.com