This report is an assessment of health care for American Indians and Alaska Natives who are eligible for medical and health-related services from the federal government. Chapters outline Federal-Indian relationships; provide demographic and economic information on the Indian population; trace current health status, changing health problems, and regional health differences; describe Indian Health Service (IHS) care and facilities construction programs; and discuss major issues such as eligibility, effects of self-determination on tribal health services management, equity of fund allocation among IHS service areas, and problems of purchasing high-cost care which IHS cannot provide. Among findings are that changing Federal policy has introduced great complexity into the Federal-Indian relationship, that there is controversy over IHS eligibility, and that Indian health continues to lag far behind that of the population of the United States as a whole. The report recommends that IHS programs be coordinated with needs-based planning, including cooperation with private providers, improvement of existing facilities, and continuation of sanitation projects. Numerous tables and graphs supplement the text; appendices include Indian population estimates by IHS service units and tribe, age-specific and age-adjusted death rates by leading causes, IHS allocations for 1972-85 by area and budget categories, and a glossary. A 223-item reference list concludes the document. (LFL)