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What Qualifies a Leader? The Nominee Director for IHS with Nominal Experience

By

IHS Director Nominee, Robert Weaver

What qualifications are needed to manage (and possibly reform?) the Indian health Service?

This is Trahant Reports.

The Indian Health Service is Indian Country’s largest employer with more than 15,000 people on the payroll and many, many more people who work in health care for tribes, non-profits and other related agencies. The IHS budget is $6.1 billion. Yet it’s also the least funded national health care delivery system.

The Wall Street Journal published a story last week about the controversial nomination of  Robert Weaver, the Trump Administration’s pick to head the Indian Health Service. The Journal raised questions about Weaver’s role at St. John’s Regional Medical Center in Joplin, Mo.

Weaver is a member of the Quapaw Tribe of Oklahoma.

These are the facts. Weaver will be the least educated director of the Indian Health Service ever. If confirmed, Weaver will the tenth permanent director. All but one prior to Weaver have been physicians, most with multiple degrees in public health, science, and health administration. Weaver is not a college graduate. His background is insurance. In a September 2016 profile in Native Oklahoma magazine he said his business saved the Quapaw Tribe more than $5 million a year.

The problem here is one of scale. He was owns a business where he can hire and fire at will. But at the Indian Health Service most of the key personnel decisions are made by folks in the chain of command. Sometimes even as a favor to a United States Senator. And firing? Just one such action could take up more time than the three years left in this administration.

And that’s the easy stuff. The agency’s operations are complicated by Congress, law, regulation, tribal relations, the Veterans Administration, Medicare, Medicaid, and private insurance.

To his credit, Weaver has been outspoken about the underfunding of the Indian health system. (My question: Will he say so again in his confirmation testimony?)

Perhaps the Indian Health Service should be led by someone with an insurance background. It would surely help if the agency could come up with a better funding model, including a mix of insurance funds. But it’s a complex organization and he would be managing jobs that he himself could not be qualified to run, such as a hospital administrator.

Just what are the qualifications necessary to run the Indian health system? I have a bias. I met some of the great physicians who ran the agency. I remember Emery Johnson’s passion and thoughtfulness about what IHS could be. So the standard for me, at least, is high.

Then the Trump administration likes the idea of shaking up government. And, appointing someone to run the IHS with a very different background, does just that.

We would do well to remember a phrase that medical doctors learn early in their training, First, do no harm.

 

I am Mark Trahant.

Jordan First Native American Woman to Hit Campaign Trail for Governor

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Paulette Jordan is campaigning to be the Governor of Idaho.

This is Trahant Reports.

There have been very few Native Americans who have ever run for office at that level (I can think of three: Alaska’s Byron Mallott, Idaho’s Larry EchoHawk, and Peggy Flanagan in Minnesota).

Now add Jordan to that list. And she’s the first Native woman who has the audacity to ask citizens to run their state. Yay!

She also already has winning over conservative Idaho voters. Two years ago when Democrats were losing races across the country, she captured her second term as a state representative, winning by a margin of 290 votes. That might not sound like a lot, but she won during a Republican wave.

Jordan is a citizen of the Coeur d’Alene Tribe.

She grew up in a farming family, Jordan says her grandparents showed her that cultivating the land was a continuation of our ancestral traditions of caring for homelands. The Coeur d’Alene peoples have cared for Idaho homelands since time immemorial and Idahoans today practice the same combination of self-sufficiency and cooperation that her grandparents once did. She told her constituents: This is what connects us to each other.

At her announcement, Jordan said, “when asked, ‘what are you going to do next to improve this world?’” She answered: “I am going to run for governor.”

Idaho once regularly elected Democrats to state office, including former Interior Secretary Cecil Andrus (who won office a record four times). These days it’s a super-majority Republican state. But things change. Idaho is also a state where the legendary National Congress of American Indians President Joe Garry served in the state senate and was a candidate for the U.S. Senate. It’s where Jeannie Givens served in the legislature and she ran for the U.S. House of Representatives (in fact, likely the first Native woman to do so). Both Garry and Givens are Coeur d’Alene tribal members. It’s also a state that that elected Larry EchoHawk, a Pawnee, first to the legislature, and later as Idaho’s state’s Attorney General. EchoHawk did lose a bid for governor. And, so yes, it’s an uphill climb for Jordan. But it’s not impossible.

One telling story about Jordan is that she lost her first race for the legislature in 2012 by less than a hundred-fifty votes. She did not give up. She went right back to work — and won two years later.

Jordan said there is even an advantage to being a member of the minority party. She said being in the majority can be insular and keep their circle small. She said: “In my family, our circle can always get bigger, and that’s what I see for Idaho. A bigger circle is what achieving justice for all looks like.”

I am Mark Trahant

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