Health care crisis hits South Dakota reservations

A crisis of heath care strikes South Dakota reservations, resulting in deaths. Deaths and crisis beget public outrage and political promises of solutions. Promises of solutions are followed by years of ambivalence, avoidance and neglect. A crisis of health care strikes South Dakota reservations, resulting in deaths…

The decades-long health care crisis in Indian Country, where underfunded and understaffed hospitals and emergency rooms struggle to provide adequate services, is back in the outrage and promises portion of the cycle, and hopefully this time we can make meaningful progress.

After the Centers for Medicare and Medicaid Services flagged hospitals on two South Dakota reservations last fall, conditions got so bad the federal government closed down the emergency room in Rosebud in December. That resulted in patients being diverted to emergency rooms some 50 miles away. Since then, six people have died in the back of ambulances on the way to treatment. Mary Smith, the now two-months-in head of Indian Health Services (IHS), has called these failings “unacceptable,” and has contracted with a private company to reopen the Rosebud emergency room, as well as run the same on Pine Ridge and Winnebago, Neb. South Dakota Rep. Kristi Noem says she intends to bring legislation aimed at “real solutions, not just a fix.” Her opponent in this fall’s upcoming election, Paula Hawks, echoes that sentiment, but questions what, if any, progress can be made without addressing the funding gap for Native health care.

So we have attention on the problem, and the collective intention to solve it. And again, this is not new. We have been here before. But with some stability of service provided by temporary privatization, and the political will on both sides of the aisle, now is the opportune time for progress, and to not lose sight of the unacceptable, deadly conditions of our fellow South Dakotans.

And this is not just a Rosebud problem, it’s not just an IHS problem, and it’s not just a Bureau of Indian Affairs problem.

We can’t waste this momentum with the insanity of doing the same thing over and over but expecting different results. And as Rep. Noem recently pointed out, to find a long-term solution, we’ll need partners with a strong connection to our state. And at some level, the answer is money. IHS successfully lobbied Congress for $2 million to upgrade the Rosebud facility and two others in the region. Money is also needed to help with recruitment of staff, another major problem on reservations.

It’s good these issues have our attention. Let’s not shirk our responsibility this time. Or we’ll be doomed to continue the death/promise/failure cycle.

— Argus Leader, Sioux Falls, May 21, 2016

More in Opinion

Gov. Mike Dunleavy (R-Alaska) speaks to reporters about his decision to veto an education funding bill at the Alaska State Capitol on Thursday, April 17, 2025. (Jasz Garrett / Juneau Empire file photo)
Opinion: The fight for Alaska’s future begins in the classroom

The fight I’ve been leading isn’t about politics — it’s about priorities.

Dick Maitland, a foley artist, works on the 46th season of “Sesame Street” at Kaufman Astoria Studios in New York, Dec. 15, 2025. (Ariana McLaughlin/The New York Times)
Opinion: Trump’s embarrassing immaturity Republicans won’t acknowledge

Sullivan should be embarrassed by the ignorance and immaturity the president is putting on display for the world to see.

Rep. Justin Ruffridge, R-Soldotna, speaks in support of debating an omnibus education bill in the Alaska House Chambers on Monday, Feb. 19, 2024 in Juneau, Alaska. (Ashlyn O’Hara/Peninsula Clarion)
Capitol Corner: Choosing our priorities wisely

Rep. Justin Ruffridge reports back from Juneau.

Sen. Jesse Bjorkman, R-Nikiski, speaks in support overriding Gov. Mike Dunleavy’s veto of House Bill 69 at the Alaska Capitol in Juneau, Alaska, on Tuesday, April 22, 2025. (Mark Sabbatini/Juneau Empire)
Capitol Corner: As session nears end, pace picks up in Juneau

Sen. Jesse Bjorkman reports back from Juneau.

Alaska Department of Education and Early Development Commissioner Deena Bishop and Gov. Mike Dunleavy discuss his veto of an education bill during a press conference March 15, 2024, at the Alaska State Capitol. (Mark Sabbatini/Juneau Empire file photo)
Opinion: Strong policy, proven results

Why policy and funding go hand in hand.

Former Gov. Frank Murkowski speaks on a range of subjects during an interview with the Juneau Empire in May 2019. (Michael Penn / Juneau Empire File)
Opinion: The Jones Act — crass protectionism, but for whom?

Alaska is dependent on the few U.S.-built ships carrying supplies from Washington state to Alaska.

Cook Inlet can be seen at low tide from North Kenai Beach on June 15, 2022, in Kenai, Alaska. (Photo by Erin Thompson/Peninsula Clarion)
Opinion: Solving the Cook Inlet gas crisis

While importing LNG is necessary in the short term, the Kenai Peninsula is in dire need of a stable long-term solution.

Sockeye salmon caught in a set gillnet are dragged up onto the beach at a test site for selective harvest setnet gear in Kenai, Alaska, on Tuesday, July 25, 2023. (Jake Dye/Peninsula Clarion)
Capitol Corner: Creating opportunities with better fishery management

Sen. Jesse Bjorkman reports back from Juneau.

The ranked choice outcome for Alaska’s U.S. Senate race is shown during an Alaska Public Media broadcast on Nov. 24, 2022. (Alaska Division of Elections)
Opinion: Alaska should keep ranked choice voting, but let’s make it easier

RCV has given Alaskans a better way to express their preferences.

The Alaska State Capitol on March 1. (Ashlyn O’Hara/Peninsula Clarion)
Opinion: Keep Alaska open for business

Our job as lawmakers is to ensure that laws passed at the ballot box work effectively on the ground.

Image provided by the Office of Mayor Peter Micciche.
Opinion: Taxes, adequate education funding and putting something back into your pocket

Kenai Peninsula Borough taxpayers simply can’t make a dent in the education funding deficit by themselves, nor should they be asked to do so.

Brooke Walters. (Courtesy photo)
Opinion: A student’s letter to the governor

Our education funding is falling short by exuberant amounts.