Native American tribes are turning their backs on government medical care to keep their communities from receiving inadequate treatment, but are quickly finding out it's a costly feat, the New York Times reports.

Why it matters: Some of the 24 hospitals overseen by the Indian Health Service are systemically failing, with one in the Great Plains responsible for patients' deaths and misdiagnoses, according to several federal investigations.

  • These groups that largely rely on Indian Health Service hospitals have death rates for preventable diseases 3 to 5 times higher than other races.

Millions of dollars are needed long-term for tribes to achieve better health care, and some regions are finding their casino money won't cut it. Leaders hope applying federal grants and more money from Medicaid and Medicare may help.

Still, a takeover of the Sioux San hospital’s operations by 18 tribal communities led to upgraded equipment, more qualified health care workers and the ability to reopen a disqualified inpatient hospital and ER.

Go deeper: Warren presents 2020 plan to protect tribal lands, support Native Americans

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