Longstanding Underfunding of the Indian Health Service


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Donald Warne, the Associate Dean of Diversity, Equity and Inclusion, Director of the Indians Into Medicine and Public Health Programs, and Professor of Family and Community Medicine at the School of Medicine and Health Sciences at the University of North Dakota, discusses the ethical issues arising from the longstanding underfunding of the Indian Health Services.


Discussion Questions

  • What did you know about the rights of American Indians and Native Alaskans to health care before you watched this video? How has that changed?
  • Dr. Warne describes the underfunding of the Indian Health Service as impacting its ability to provide important specialty care as an ethical dilemma, a social justice issue, and a civil rights issue, as well as a legal and policy issue. How are ethics, social justice, and civil rights related? How does law and policy interact these them?
  • Dr. Warne shares a story about his grandmother and her challenges receiving necessary care for her lung cancer. What do you take away from this experience? What are some of the structural barriers she faced? Which of these are unique to the experience native populations? Which of these may be experienced by other marginalized populations?
  • American Indians and Native Alaskans are underrepresented in medicine, law, and other professions. What impact do you think this has on the underfunding of the Indian Health Service? What steps might be taken to remedy the disparities that Dr. Warne has highlighted?

Selected Resources

Donald Warne and Linda Bane Frizzell, American Indian Health Policy: Historical Trends and Contemporary Issues, American Journal of Public Health, 104(Suppl 3): S263-S267 (2014).

Indian Health Service, Disparities, https://www.ihs.gov/newsroom/factsheets/disparities/.

“If you knew the conditions . . .” Health Care to Native Americans, U.S. National Library of Medicine, https://www.nlm.nih.gov/exhibition/if_you_knew/ifyouknew_02.html

Mark N. Trahant, The Story of Indian Health is Complicated by History, Shortages & Bouts of Excellence, Daedalus, 147(2): 116-123 (2018).

English.srt (13 kB)

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