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Washington, D.C. –Secretary of the U.S. Department of Health and Human Services (HHS), Tommy Thompson, assured U.S. Sen. Mike Enzi, R-Wyo., that the agency is taking steps to improve healthcare for Native Americans.

Thompson’s comments came at a Senate Budget Committee hearing today when Enzi told Thompson about problems Native Americans on the Wind River Indian Reservation in Wyoming are having gaining access to healthcare professionals.

Enzi said that in rural places like Wyoming, choices in health service providers are often limited. On Indian Reservations, health service selection is even more limited with many tribes relying entirely on Indian Health Services (IHS). In Wyoming many tribal members from the Northern Arapaho and Eastern Shoshone tribes must – for emergency purposes – go to the Lander or Riverton hospitals. However, despite this common use of contract health services at both hospitals, IHS does not always adequately or evenly supply doctors in both Riverton and Lander.

“It’s my understanding that the problem is both fiscal and administrative. I am pleased to see the HHS budget begin to address the fiscal problem by increasing the Contract Health Services budget by $18 million. However, I am also wondering whether or not IHS plans to review the management policies of doctors to ensure that Native Americans have equal access to quality care at hospitals serving large populations of Native Americans,” said Enzi.

Thompson said this was a high priority and that the agency was taking steps to make the situation better.

“We are reviewing all of the IHS programs and projects and one of the biggest problems we have is being able to get enough medical personnel to go to areas that are hard to get individuals to go into. Indian reservations in some areas of the country have a real serious problem of getting the proper medical people there. We are expanding the National Health Service Corps so that we can get more people to use the service portion and get more doctors and nurses to go to Indian reservations,” Thompson said. “I see the tremendous need.”

In addition to Enzi’s queries, Thompson faced a barrage of questions from other members of the Senate Budget Committee regarding HHS’s 2005 budget priorities. Funding for the new Medicare prescription drug plan was a central topic.

In addition to Enzi’s queries, Thompson faced a barrage of questions from other members of the Senate Budget Committee regarding HHS’s 2005 budget priorities. Funding for the new Medicare prescription drug plan was a central topic.

Enzi shares many of his views on the new Medicare modernization law in his opening statement which can be accessed at ( More information on the hearing can be found at (

U.S. Sen. Mike Enzi
Senate Budget Committee Hearing Statement
Feb. 12, 2004

This is the fourth time the Budget Committee has had the opportunity to discuss the President’s budget request with you, Secretary Thompson. Last year, we discussed how to pay for landmark Medicare legislation and modest increases to the Health and Human Services Budget. This year, we are still discussing how to pay for the landmark Medicare legislation and even more modest increases to the budget. The recurring theme of this hearing points to both the challenges and the opportunities we face in 2005.

I would like to preface my statement by saying that I am encouraged by the steps we are taking to address the risks to our nation’s health and well-being. While the budget only provides modest increases, which is prudent given our ballooning deficits, we are funding the research that will keep America advancing towards new medical breakthroughs and more effective treatments. We have renewed our efforts to fight HIV and AIDS across the world. Mr. Secretary, some of your agencies will play an important role in carrying out President Bush's Emergency Plan for AIDS Relief and I am interested in hearing your thoughts on this issue.

Of course I would be remiss in not mentioning the Medicare Modernization Act that my congressional colleagues and I passed last year. This law will give seniors more options for health care coverage and the ability to afford the prescription drugs they need. It has been obvious for a long time that seniors are in desperate need of prescription drug coverage. Unfortunately, under the old Medicare system, the flexibility to change with the needs of Medicare recipients just wasn’t there. With the new Medicare Act, seniors will start saving immediately with their Senior Discount Cards. When the voluntary prescription drug benefit begins in January, 2006, seniors will get an even better deal on their prescriptions. The typical senior who signs up for Medicare drug coverage will save 50 percent on their out-of-pocket costs, and that's not small change.

One of the most controversial provisions of this Act is the role that private companies will play in providing the medical insurance and drug coverage that seniors need. As a former businessman, I appreciate the ability of market-oriented solutions to spur innovation and drive down prices through competition. However, I also realize that the healthcare marketplace is not like any other market. Not every senior is going to have the same needs and no senior should be forced to have only one choice when it comes to health care providers. At the same time, flexibility comes at a price.

There has been a lot of discussion about whether Medicare should negotiate prices for drugs directly with pharmaceutical companies, or whether Medicare should leave these negotiations up to the plans that win the bidding to offer Medicare drug coverage to seniors. I understand that the federal government negotiates directly with drug manufacturers in the Veterans Affairs healthcare system. I also understand that in the Federal Employees health plan, the government leaves the negotiations up to the private plans to which you and I belong. I would appreciate you sharing your views on why you believe it makes more sense for Medicare to address drug prices the same way our Federal Employees health plan does.