Governor Bill AnoatubbyOctober 2012
U.S. health care system provides unique challenges, opportunities
A common situation among governments of all types today involves how to “do the most with the least.”
As tax receipts have declined, governments are continually seeking ways to cut expenses while also maintaining essential programs and services. There are a number of reasons for declines in federal, state, county and municipal revenues. Some have to do with erosion of tax bases, some with less than robust business climate, and some with actual reduction of tax rates assessed by the governments. A real challenge occurs when an essential program or service continues to experience cost increases even as the state’s ability to pay for that program or service declines.
In American health care, the squeeze is on – and it is often on in a big way. Regardless of who sits in the White House, the Governor’s Mansion or the mayor’s chair, health care costs are rising at a rate that could eventually become unsustainable. The demographics of the country have something to do with this, but regardless, costs could continue to rise.
Some government leaders have sought to reduce health care costs by shifting burdens to hospitals, clinics and physicians. Reimbursements from the Medicare and Medicaid funds are then reduced.
Others advocate reducing the health care cost to government by shifting the burden to the patients who utilize Medicare and Medicaid. Whatever the proposed solution, it presents a tough situation that enforces some hard-to-swallow medicine.
We can count ourselves – Chickasaws – as very, very fortunate when it comes to health care. We are in a unique situation that allows us to access high quality health care in a low-cost environment.
When we built the new Chickasaw Nation Medical Center in Ada, we accessed funds through the U.S. Indian Health Service joint venture program. This program provided our tribe substantial resources for medical practitioners in exchange for our construction of the medical center. Those resources are helping drive our health care excellence for Chickasaws and other Indian patients.
In addition to the joint venture funding, the Chickasaw Nation continues to receive federal IHS dollars for providing Indian health care in the service unit surrounding Ada. These dollars flow from our 1994 compact with the federal government in which our tribe agreed to provide Indian health care in this area.
Finally, the Chickasaw Nation provides Chickasaw-specific programs which supplement the above funding programs with tribal dollars. Chickasaw people can, among other programs, access the Medisaw and Medical Assistance Program (MAP) elements for treatment.
That, in a nutshell, is how our Chickasaw Nation health care system works. All dollars involved – both federal and tribal – are dedicated to Chickasaw and Indian health care.
Our tribe also has other health care entities, but these are entirely unique and separate from our medical center, clinics and general health care.
Our Division of Commerce is in the business of producing net income that is, in many cases, used to build programs and services for the Chickasaw people. Our tribal businesses range from hotels to manufacturing to gaming to data processing – and much more. All these businesses produce resources vital to our continued vitality and strength as a tribe, and as individual Chickasaws.
We have several operations that are engaged in the “business” of health care. One of those businesses is the Sovereign Clinic, located in the city of Ada.
Our Sovereign Clinic is open to anyone seeking health care services. The facility is staffed by physicians, nurses, physician assistants, technicians and other staff. At the Sovereign Clinic, we provide health care services, and for those services we receive payment by the patient, the patient’s insurance company, or both. Our dual goals at the Sovereign Clinic are to provide excellent health care, and to produce revenue.
That, basically, is how American health care works. At the Division of Commerce, it has been determined that a health care business provides a very good opportunity to deliver services that help people, and also pay dividends for the tribe.
Every penny that goes into the Sovereign Clinic, and other for-profit businesses, is tribal funding that has been designated for such investment. No federal funding is used to operate the Sovereign Clinic.
Health care today can be a very complicated business. Many entities are engaged – hospitals, clinics, physicians, insurance companies, patients, governments – and it can be a bit daunting. However, at the Chickasaw Nation we have a clear and firm mandate to provide the highest quality health care to Chickasaws and other Indian patients through our Division of Health. And we are totally committed to that mandate.
We are also committed to self-governance and tribal independence. Our plan, conceived more than two decades ago, was to build our tribal businesses up to the point that we would be masters of our own destiny. Of the many businesses we operate, some are engaged in health care-related fields.
At the Chickasaw Nation, we are respected because we do things the right way. We don’t cut corners or operate in gray areas. We understand our mission – to enhance the overall quality of life of Chickasaw people – and we take that mission very seriously.
My job is to be a good leader, to evaluate situations carefully and fully, and to make decisions that are good for the people I serve. We are living up to those expectations together.
I look forward to serving you far into our shared, exciting future. My goal is prosperity, happiness and success – for all Chickasaw people.
