<center>Letters to the Editor</center>

Editor,

The Navajo Health Care System Corporation (NHCSC) ‘638 contract should develop alongside the United States Public Health Service, Indian Health Service (USPHS/HIS). According to ‘638, the employees who work for the USPHS/HIS program may decide to remain with the new management of NHCSC or “move on.” The NHCSC will inevitably turn into another enterprise of the Navajo Nation. These enterprises can be profitable or as disastrous as the Navajo Agricultural Products, Incorporated (NAPI).

The concept of ‘638 contracting reminds me of another system that our Navajo government uses. This other system involves our law enforcement officers of the Navajo Nation. Our Navajo Nation police officers are also ‘638 contracted. Many times our officers are not timely paid for over-time work, are severely under-staffed, lack adequate funding for virtually non-existent programs that can be effective for law enforcement. Law enforcement officers must reduce long-range patrols to conserve fuel and maintenance costs. Finally, these officers face an uphill battle for retirement plans comparable to retirement plans provided by cities and states.

Ironically, the similarities between law enforcement and health management are synonymous, having a lot of land and not enough people to cover the large land base. In the case of health management, people like me agree that problems lie not with poorly trained medical doctors. Instead, problems lie with the number of medical doctors who are not available in relation to the population throughout the immense land base of the Navajo Nation.

The ‘638 contract system by NHCSC superficially identifies itself as another corporate system. Unless a substantial doubling increase of public funding of federal monies is diverted toward the current healthcare, the number of patient treatments will remain the same. Unless the other means by which the corporation acquires, its funding will inevitably derive from patients who provide third party insurance.

Our level of care within the reservation of the Navajo Nation will improve with a substantial increase in funding that overwhelmingly creates an immense development of more hospital facilities. NHCSC must develop a separate program of its own. Private practice will exemplify the term-Corporation-in NHCSC. It is another system instilling corporate philosophy and business concepts for efficiency bypassing the Navajo Nation’s council.

Americans other than Native American descent contribute to the local, Navajo Nation, and U.S. economy therefore must be entitled to public healthcare. Honoring every American will help by not providing a platform for discrimination that is characterized by the term-Navajo-in NHCSC. NHCSC must provide healthcare for everyone within the Navajo Nation. When the NHCSC delivers a level of care; higher in quality, increases its doctor-patient output, and provides reasonable, low, or no out-of-pocket costs to the patient, then the NHCSC will complete its mission for a public healthcare system.

Michael S. Bilagody

Tuba City, Arizona

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