Criticism of Indian Health Service by Gov. Mike Rounds is inspiring some Native Americans served by the agency to defend it.

They're also questioning whether the Republican governor was expressing sincere concerns about failures in the IHS system or simply engaging in a partisan attack on the health care reform plans of President Barack Obama and congressional Democrats.

"There are absolutely some political motivations there," Robert Moore, a tribal council member for the Rosebud Sioux Tribe, said. "We know insurance companies, the governor's association, have great interest in what happens with health care reform in the United States."

Rounds, a former insurance executive who intends to return to the business after leaving office in 2011, labeled the IHS as a failed system that shows how badly government health systems can run. He made the comments while suggesting that less government involvement would make for better national health care reform.

Moore and others on South Dakota reservations took offense at the statements. They said the governor focused on the shortcoming of the IHS without fully acknowledging its challenges and successes.

Sharon Vogel of the Cheyenne River Tribe in Eagle Butte said she agrees with Rounds that money problems plague IHS and hurt service. But Vogel said that is because the agency doesn't receive the funds it needs to begin with.

"Obviously, IHS would provide excellent care if fully funded," Vogel said. "Even with woefully inadequate funding, not all individual experiences with IHS are bad. The quality of care is inconsistent, meaning that even at current funding levels, some people are perfectly happy with the care they receive."

Along with Medicaid and Medicare programs, the federal government provides or pays for health care or health insurance specific to other groups besides Natives, Vogel said. They include active military, veterans, federal employees and federal inmates. She wondered why Rounds picked out IHS as "a health care system run amok."

"Has the VA 'run amok?'" Vogel said. "Spending on these and other groups for health care varies wildly, sort of correlating to their ability and willingness to vote. But we know that Native Americans are at the bottom of the money pile."

Moore said federal prisoners receive more per capita in health care spending from the government than Native Americans. Yet even with the funding shortfalls, IHS works with tribes to provide important health care services, and not just on an emergency or critical-need basis as Rounds asserted, Moore said. A community health outreach program the Rosebud Tribe operates under contract with IHS to transport patients, help with prescriptions and provide health education is an example of cooperative projects that work, he said.

"For the governor to make that broad of a statement without having a richer knowledge base than just the complaint side of IHS is unfortunate," Moore said.

Non-Natives have their own health care problems, which in some cases might be worse than what Native people face in the cash-strapped IHS system, Vogel said. Increasingly costly premiums and deductibles, networks that can limit health care options and shortcoming in providing for dental or eye care, prescription coverage and mental health treatment are challenges to many non-Natives, Vogel said.

"People with money get over-treated, and people without money go without care," she said. "And you're worried about losing this marvelous plan? I'll take Indian Health Service."

Those who consider the federal dollars that go for Native health care are forgetting the legal obligations the nation has to Native people, Vogel said.

"Bottom line for Indian people, health care is a treaty right," she said. "And make no mistake: We gave up a lot for our government hospitals and government doctors and free prescription drugs."

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