SCHURZ -- When Elveda Martinez tells fellow members of her Walker River Paiute Tribe they deserve health care that's at least as good as the care received by federal prisoners, they listen.
Most also promise to participate in the upcoming presidential caucuses. Those who aren't registered to vote generally fill out the forms she always carries with her.
"The issue of health care is getting Indians involved in the political process like never before," the 48-year-old says before a mock caucus held by the neighboring Yerington Paiute Tribe.
American Indians have access to federally paid health care based on hundreds of treaties the United States signed with Indian nations. What Martinez finds unacceptable is that according to a 2003 study by the U.S. Commission on Civil Rights, the federal government's rate of spending on health care for Indians is 50 percent less than it is for prisoners or Medicaid recipients.
"It makes no sense that we would be better off in prison," Martinez says.
The raw physical beauty of Indian reservations -- the Walker Lake Indian Reservation is about 530 square miles of stark, rolling cattle range -- can make people forget that the health care needs of the tribes are serious, Martinez says.
Studies show that compared with the U.S. population as a whole, Indians have a 189 percent higher incidence of diabetes and a 600 percent higher incidence of tuberculosis.
Since October, Martinez has registered 98 new voters, bringing the total on the Walker River reservation to 426. Most are Democrats. Only 850 people live on the reservation. Martinez thinks she can persuade the remaining 15 eligible voters to "do the right thing."
"The health situation has become so challenging that I think the vast majority of people are going to caucus and vote," she says. "I know they don't trust the government to do right by Indians, but they have to try to change the government."
After she was laid off from her job as a water resource coordinator on the reservation, Martinez got involved with the Native American Network, a national organization working to get Indians more involved in the political process.
She has been proud of how members of her tribe have taken principled stands. She says she was on hand when tribal elders turned down $100 million from the Department of Energy, which wanted the right to transport nuclear waste through the reservation by rail. "We're not for the dangers of Yucca Mountain," she says.
Martinez says the tribe has turned down out of concern for the environment huge offers from mining companies to probe for rich ores.
"Now I want our people to take a stand for health care change," Martinez says.
Mary Stevens, a 71-year-old Paiute who was on hand for the mock caucus, is ready.
"I'm going to caucus for Barack Obama," she says. "He reminds me of John Kennedy. He has new ideas. He's listening to people. He'll be good for Indians."