THIS TIME ON CODE WACK!
What’s being done to help elder Native Americans receive culturally competent long term care? Would it surprise you to learn that relying on the Indian Health Service may not be enough to meet their needs? Why are some members of this highly vulnerable population buying health insurance too?
To find out, we spoke to Elder Billie Tohee, acting executive director of the Albuquerque-based National Indian Council on Aging (NICOA) and former chair of the board.
SHOW NOTES
WE DISCUSS
When it comes to health care, Indigenous people face many challenges. What could be done to improve health care for Native Americans?
“I hope I see more Indian Health Service facilities come up. If you can’t have a facility close to the Sisseton Reservation or the Navajo Nation out in the rural areas, at least find a way for transportation for these people so that it won’t be such a burden and such a life-threatening event that I can’t get to my dialysis today. What do they do? You’re putting that life at risk. How many lives are going through this throughout the nation?” – Billie Tohee
The Indian Health Service was created to provide health care in perpetuity for Native Americans in exchange for millions of acres of land. It provides care through its federally funded clinics and hospitals, but it’s not health insurance. How do you feel about your choice to carry separate health insurance?
“It’s frustrating. I’ll tell you, it’s like when I have to pay that premium, it’s like, I shouldn’t have to be doing this. I’m not supposed to be doing this. That’s what Indian Health Service is supposed to be covering.
“[But] I can’t risk, you know, constantly, depending on Indian Health Service, they may not cover [it]. Every time I go to a facility, they may not do it. So now I have a Blue Cross/Blue Shield premium – it kind of makes me feel I have a backup. I don’t like it. Like I said, it shouldn’t be occurring. But for my own wellbeing, I do have that.” – Billie Tohee
There’s a movement … toward single payer, Medicare for all, which would give everyone comprehensive health coverage for things like dental, vision, long-term care, mental health care. What are your thoughts on this?
“…to have a comprehensive health plan like that, that covers medical, vision and dental across the nation, or however far it can spread, and include Native Americans and Alaska Natives, I think it would be a wonderful, wonderful thing to see, to come about.
“And I’m hopeful…can we just stick together and keep advocating for things like that? That’s where I’m at today, I just want to take care of our elders.
“And like I said, these are the golden years. We shouldn’t have to be suffering. We shouldn’t have to be worrying, how am I going to get dialysis? How am I going to pay for my prescriptions? Just like any American, any United States citizen, we shouldn’t have to be deciding ‘do I go pay that hundred dollars for that bottle of pills, medication that I need to stay alive, or do I go over to the grocery store and buy my groceries?’ That should not be happening in the United States or anywhere, but it is.“ – Billie Tohee
Helpful Links
National Indian Council on Aging (NICOA)
Indian Health Service (IHS)
10 Important Facts About Indian Health Service and Health Insurance, HealthCare.gov
How Do Indian Health Services and Medicare Work Together?, Healthline
The Indian Health Service Is Insufficient. It’s Time for Medicare for All. Truthout
The Care Gap for Indigenous Seniors: Aging in Place and Long-Term Care on Native American Reservations, United South and Eastern Tribes
Supreme Court delivers win for Native American tribes in adoption case, NBC News
Indian Child Welfare Act (ICWA) Fact Sheet, Partnership with Native Americans
Episode Transcript
Read the full episode transcript.
Biography: Elder Billie Tohee
Elder Billie Tohee, of the Otoe-Missouria Tribe of Indians in Oklahoma and the Iowa Tribe of Oklahoma, is the acting executive director of the National Indian Council on Aging. She previously served as the chair of the board.
She remembers attending the NICOA 2016 conference in Niagara Falls. “The conference speakers were so dedicated, knowledgeable and passionate. It really impressed me. I sensed a real dedication and a concern for our elders and what laws and programs affect them,” she said.
She became a Southern Plains regional member at the following NICOA conference in 2018. Several months later she was asked to serve on NICOA’s board of directors.
“I wanted to represent rural tribes and bring awareness to that area and what’s available,” she said. “There are so many resources nationally that each tribe can benefit from.”
She enjoys spending time assisting the tribal members and elders who come to her with their grievances, advocating for them so they feel welcome outside their reservation as well as within. She often reaches out to local officials to encourage cultural competency in their tribal interactions.
Her goal is to bring regional tribes together so that they can network and utilize one another’s resources.
“Elders need to become more aware of resources. Especially in my region, I’d love to see more interaction. They don’t have as much communication as they could. Everyone should be able to help each other when it comes to tribal elders.”
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