The big problem is that the IHS is incredibly underfunded. The agency basically gets a check each year, and only has that amount of money to spend on health care. Since it often runs out of money about six months into the year, you should really try to plan on getting sick exclusively in the springtime. In 2013, IHS spent an average of $2,849 on each patient -- a fraction of the national average of $7,717 per patient. Estimates place the IHS budget at around 45 percent adequate, which is a disappointing score for a Judd Apatow movie, let alone a health care program.
U.S. Department of Health & Human Services
You shouldn't get to tell two million people, "Eh, have you tried walking it off?"
This chronic underfunding becomes even more terrifying when you consider that Indian reservations can be massive. It's not uncommon for an ambulance to take hours to arrive at a medical emergency -- or in most cases, about 45 minutes after the medical emergency has become fatally less urgent. And those who do take the time to spend a hundred bucks on gas money to drive out to one of the dwindling facilities in the reservations are met with a lack of advanced equipment, and often turned away by the IHS because they only have resources for desperate circumstances, which means "people who will have an uneven amount of limbs tomorrow." Otherwise? Most of the time, you'll get sent home with an ice pack, an aspirin, and the knowledge that the United States has wiped its ass with yet another treaty.