Phuoc Le – Page 2 – The Health Care Blog

For American Indians, Health is a Human and Legal Right

Mar 29, 2019• 6

By PHUOC LE, MD and SAM APTEKAR

Most will be surprised to learn that American Indians and Alaska Natives represent the only populations in the United States with a legal birthright to health care.[1] Even though Article 25 of the UN’s Universal Declaration of Human Rights declares, “everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including…medical care and necessary social services,” U.S. federal policy only guarantees this human right to enrolled tribal members. The source of this juridical entitlement is what the United States Supreme Court has defined as the federal trust responsibility.

Between 1787 and 1871, the United States signed nearly 400 treaties with Indian tribes, in which, for the exchange of millions of acres of tribal land, the U.S. government promised in perpetuity to respect their sovereignty and provide benefits, including housing, education, and healthcare. Argued in March 1983, United States v. Mitchell is the most recent Supreme Court case establishing this principle as a matter of law. This week marks the 36-year-anniversary of that seminal case, providing us the opportunity to discuss the federal government’s failure to adequately fund the healthcare institutions that serve American Indians and Alaska Natives despite its legal responsibility to do so.

Supreme Court Justice Thurgood Marshall penned the majority opinion of United States v. Mitchell.

The current life expectancy for American Indians and Alaska Natives is 73 years, 5.5 years less than that of the general population. American Indians die at higher rates from heart disease, cancer, diabetes, stroke, and kidney disease. When we consider why Native communities suffer from preventable and treatable diseases at disproportionate frequencies, we must first evaluate the inequity in Congressional funding for Indian Health Services (IHS), the national agency within the Department of Health and Human Services that is responsible for providing comprehensive healthcare to the country’s enrolled American Indians and Alaska Natives.

Standing Rock Two Years Later: Public Health Lessons and the Physician’s Responsibility

Mar 7, 2019• 11

By PHUOC LE MD

A close look at disease and suffering would lead most of us to the same conclusion: our natural environment is inextricably linked to our health. When the Army Corps of Engineers approved the construction of the Dakota Access Pipeline (DAPL) in July 2016, thousands of water protectors from across the world gathered in protest. Through staunch, organized resistance, indigenous activists and their non-indigenous allies refuted the proposed pipeline, which now shuttles over 500,000 barrels of oil per day through the Standing Rock Sioux’s sole water supply and most coveted burial grounds.

In December 2016, I joined the thousands at Standing Rock to briefly bear witness to their commitment to protecting the health and well-being of future generations. Eager to assist, I provided medical care to these heroes, many of whom had given up their jobs, quit school, or come out of retirement in solidarity with the water protectors. Their determination and strength became even more inspirational when a blizzard brought -40° F in its wake, trapping everyone inside the camp for several days.

Photo Courtesy of Phuoc Le, MD

After battling corporate juggernauts, state governments, and fossil fuel lobbyists for months, the Standing Rock Sioux Tribe and their allies neared victory when the Obama administration denied a permit required for the pipeline’s completion. Just a couple of months later, however, President Trump authorized its advancement and on February 23^rd, 2017, the U.S. National Guard evicted the final Standing Rock protestors from the Oceti Sakowin camp. Last week marks the two-year anniversary of that eviction.

“Public Charge” is a Public Health Disaster in the Making

Mar 1, 2019• 5

By PHUOC LE MD

I was born in a rural village outside of Hue, Vietnam in 1976, a year after Saigon fell and the war ended. My family of four struggled to survive in the post-war shambles, and in 1981, my mother had no choice but to flee Vietnam by boat with my older sister and myself. Through the support of the refugee resettlement program, we began our lives in the United States in 1982, wearing all of our belongings on our backs and not knowing a word of English.

Though we struggled for years to make ends meet, we sustained ourselves through public benefit programs: food stamps, Medicaid, Section 8 Housing, and cash aid. These programs were lifelines that enabled me to focus on my education, and they allowed me to be the physician and public health expert that I am today. Looking back, I firmly believe that the more we invest in the lives and livelihoods of immigrants, the more we invest in the United States, its ideals, and its future.

So, when I first learned of the current administration’s plan to make it harder for immigrants with lower socioeconomic statuses to gain permanent U.S. residence, the so-called changes to the “Public Charge” rule, I felt outraged and baffled by its short-sightedness.
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