Trahant: The Pink Adobe Dictate: Judge the end of the delivery system

By Mark Trahant
Special to News From Indian Country 9-09


Recently I drove past the Pink Adobe in Santa Fe, New Mexico. The view evoked instant memories, starting with many wonderful meals. But it’s also where twenty summers ago I interviewed John Ehrlichman.

This was well after Watergate – make that, after his prison term – and Ehrlichman had moved to Santa Fe to reestablish himself.

Ehrlichman was officially Richard Nixon’s assistant to the president for domestic affairs. But what I didn’t know then – and few know now – is that Ehrlichman was essentially Nixon’s deputy president. On many domestic matters – including Indian affairs – the deputy president made the decision and began implementation before bothering to tell the president. His influence on Indian issues was substantial, ranging from the return of Blue Lake to the Taos Pueblo to the Nixon message on self-determination.

Ehrlichman hinted at this when I asked him why Nixon was interested in Indian issues. He repeated the oft-told story about the influence of Nixon’s football coach, Wally Newman from Whittier College in California.

But Ehrlichman told me it was more than that: He said there was a White House meeting when a small group of aides figured that the American Indian population was small enough to demonstrate that government programs could be effective. Indeed, the federal government could not then (nor now) solve all the problems in America. But what if the government could make a focused attempt to improve the lives of one group, American Indians?

After a year and a half in prison Ehrlichman moved to Santa Fe where he worked as a writer and an occasional consultant. One of his clients was a group of Indian parents working a problem at a school. Ehrlichman discovered that the bureaucracy of government was a “stone wall.”

In Washington, D.C., when a new program was launched everyone would tell you how well it’s working, even when it wasn’t, Ehrlichman said. The great mistake of government was “that we bring these bright young people into the White House who have never experienced the end of the federal delivery system.”

I thought of these words in the context of the health care reform debate.

 

The legislation will be thousands of pages written by bright young people who’ve never experienced the end of the federal delivery system. Some of them are congressional staffers – others are paid lobbyists. As The New York Times pointed out recently: “The strategic course the White House has chosen may have had the unintended effect of increasing the breadth and complexity of the battle involving special interests.”

I have a utopian idea: Too bad there’s not an easy way to turn this notion around. What if the legislation was drafted at the clinic level and then sent up instead of down? Or, written from the patients’ point of view? Imagine a budget that fully-funded clinics and then used the remaining funds to staff the regional and central offices? A memo might read: “We’d love to fund the important bureaucracy… if only we could afford it.”

The push for national health care reform is going in the opposite direction. Decisions are being made that will reshape the entire care system without considering how it will impact the government programs already in operation, such as the Indian Health Service. A recent letter by the National Indian Health Board and other Indian organizations supports the effort, but asks for consideration of an amendment to protect IHS.

“While H.R. 3200 takes important steps to improving access to health insurance and preventative health care services for all Americans, the bill does not take into account the unique position of Indian health care providers,” the letter said. “Moreover, the bill does not respect the fact that Indian people have already paid for their health care by ceding millions of acres of land.”

House Natural Resources Committee Chairman Nick Rahall has proposed amendments that will ensure some preservation of the IHS delivery system – perhaps with even added money from new insurance sources.

But the important measure here is a practical application of the Pink Adobe dictate, the idea that policy and law ought to include the experiences from the end of the federal delivery system. Over the next few weeks there will be town halls across the country as the members of Congress listen to their constituents about health care reform. This is an opportunity not to be missed because Indian people have much experience with the receiving end of the delivery system.

Mark Trahant is the former editor of the editorial page for the Seattle Post-Intelligencer. 

On The Net:
marktrahant.com

 

 

 

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