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Know the West

President Bush would jettison Indian health for ideology


Is President Bush willing to sacrifice the health and welfare of Native Americans in order to pursue one of his administration’s pet peeves? It sounds as if he is.

The White House recently warned that the president may veto long-overdue legislation to improve health care for Native Americans if the bill includes a provision calling for paying workers hired to build new facilities prevailing wages and benefits. The bill in question is the Indian Health Care Improvement Act Amendments of 2008. The provision in dispute involves a 77-year-old labor law known as the Davis-Bacon Act.

This health-care bill rightly topped the Senate’s list of priorities when it returned to work Jan. 22. It is no secret that Indian Country is in the grip of a health-care crisis. It is one made worse by poor access to doctors and clinics, outdated facilities and services that are inadequate to deal with rates of disease, and death rates that far exceed those of the overall U.S. population.

Co-authored by Sen. Byron Dorgan, D-N.D., and the late Sen. Craig Thomas, R-Wyo., the bill enjoys bipartisan support for its comprehensive approach to a health care crisis throughout Indian Country. The measure authorizes $1 billion worth of desperately needed health care facilities, along with another $1 billion in projects to improve sanitation in tribal communities. The bill also aims to improve mental health services, tackles high rates of teen suicides, makes it easier for tribal members to enroll in Medicaid and Medicare, and encourages Native Americans to pursue careers in health care.

Although the White House Office of Management and Budget says it has some objections to various aspects of the bill, it’s the so-called Davis-Bacon provision that triggered Bush’s veto threat. That provision extends requirements of Davis-Bacon Act to the Indian Health Service. The White House isn’t objecting to the facilities themselves or disputing the urgent need for them. It simply doesn’t want to pay full price for the labor.

It’s worth noting that the Davis-Bacon Act already applies to nearly all government agencies and federal contracts. Why prevailing-wage requirements don’t already apply to Indian Health Service contracts is an interesting question that raises the issue of discrimination. However, extending the requirement is consistent with overall federal practice. Signing Davis-Bacon into law in 1931 was perhaps the most constructive thing President Herbert Hoover did during the Great Depression. By effectively setting minimum pay scales for workers on federal construction projects, Davis-Bacon was designed to ensure that skilled, local workers aren’t aced out of jobs by low-balling contractors bringing in unskilled workers at substandard wages.

It was Republicans in Congress who sponsored Davis-Bacon and a Republican president who signed it into law. In recent years, however, political conservatives have taken to attacking prevailing-wage requirements as an undeserved leg-up for organized labor. In a statement issued Jan. 22, the White House said that “expansion of Davis-Bacon Act prevailing wage requirements … would violate a longstanding administration policy.”

Fair enough. If the president and his administration want to fight for lower construction-worker wages, nothing’s stopping them. This is an election year. Let them argue for Davis-Bacon repeal, and see where that gets them.

Well, no. Instead comes the threatened veto casting Native Americans desperate for better health care as pawns in the administration’s ideological tussle over a long-settled aspect of federal law. Better health care for Native Americans isn’t a favor or just a good idea. It’s an explicit legal obligation. Health care for Native Americans is among the federal government’s clearest but least-fulfilled responsibilities. It’s been promised by treaties and guaranteed by law in exchange for lands ceded to the government.

Failing to live up to this responsibility is bad. What’s even worse is arguing that the promised care shouldn’t be provided if it means creating a level playing field.

Jennifer Perez Cole and Steve Woodruff are contributors to Writers on the Range, a service of High Country News (hcn.org). She is coordinator of Indian affairs for Montana Gov. Brian Schweitzer; he is deputy director of the northern region for Western Progress in Missoula, Montana.