Kristi Noem actually said...

The medical care that we receive at IHS in the Great Plains region is like getting health care in a third-world country.

I want everyone to know, and I want you to know that we're obviously aware that there are people scared of retaliation.

I believe that IHS should get out of the hospital business. I think they're terrible at it. I don't think they know what they're doing.

The mismanagement of fiscal stability that is lacking in the area and the agency have just completely eliminated my confidence in the agency...