One of the benefits of Self-Governance Compacting is that our healthcare system would be under Tribal control. This will allow our elected officials to install experienced people in the proper leadership roles to administer these funds and services. A health plan could then be developed by Osages that contains Osage specific priorities and not one developed by Indian Health Service (IHS) in Rockville, Maryland, that consists of “pan-Indian” priorities.
A Compacted Tribe may receive all money for operations on the first day of the fiscal year and is allowed to place those funds in an interest bearing account (which means more services for our Tribal citizens). A Tribe can bill for and receive “third party” insurance payments for services rendered and generate income to improve health services above and beyond those provided under a direct service relationship. Some of these improved services could take the form of an increase in the number and type of contract health services, more doctors and nurses, better access (less waiting time) to services with an improved drug formulary. And more MRI studies could be paid for with fewer denials for payment to see a specialist. New services tailored to and for our elders could be funded with the ability to expand those services beyond Osage county.
Many of our people tell me they go to Pawnee or even the Kaw clinic for their healthcare, as they perceive the service at the Pawhuska IHS clinic to be inadequate. The Pawhuska clinic has had unfilled provider positions, limited drug formulary, and long wait period for services. There is a fair amount of Osage allocated funds being used to provide services at the Pawnee Service Unit. Also, the Kaw tribe has an IHS Self-Governance Compact and has been running a very successful clinic since Compacting.
It is estimated that IHS funding for the Oklahoma tribes leaves an unmet need for services of 40 percent to 50 percent of that required for the full healthcare of the populations represented by those tribes. This is much of the root cause of the current limited healthcare that our Osage citizens endure from the IHS as a direct service tribe. Our edge for reducing this unmet need under a Self-Governance IHS compact are the financial advantages as described above with the expectation that with a “ramped-up” third party billing department the Osage Nation would increase collections by millions with which to provide improved healthcare.
Sounds like a no-brainer but our elected officials are wary and cautious, as they should be, as they make decisions for us but paralysis by analysis and politics threaten to leave Osages with the status quo and that should not be a viable option.