A combination of unrelated events and changes in the last two
years is increasingly threatening the ability of thousands of
Americans with HIV to get medically necessary care. The
national economic slowdown, a crisis in state budgets, the
Federal focus on war, and the neglect of treatment-access
activism, have combined so that probably thousands of people
are being denied necessary treatment for economic reasons
alone, when they would have had access a year ago. The
problem is likely to get much worse before it gets better.
While most of the causes are beyond the control of readers of
AIDS Treatment News
, we can work on the activism.
Few patients are immune to these problems. Due to high prices
for drugs and tests, very few can pay the full cost of HIV
care entirely out of pocket. And private insurance has become
increasingly efficient at getting rid of people with
expensive illnesses -- especially HIV infection, since it is
not officially recognized as a medical specialty like cancer,
even though it is one in fact. Therefore HMOs can pay HIV
doctors the "healthy adult" rate, less than the cost of
providing care, in order to drive good doctors out of the
plan and keep patients away.
- As this issue goes to press, there may or may not be an
emergency mobilization on ADAP (the AIDS Drug Assistance
Program, funded by the Ryan White CARE Act), in the coming
days or weeks. The growing crisis in ADAP results from flat
Federal funding despite increasing needs, rising drug prices,
state budget shortfalls, and indirectly from increasing
Medicaid problems. Also, the traditional coalition of patient
advocates and industry to seek funding for ADAP has not been
very active in the last year.
- Medicaid is a huge program that has surprisingly little
advocacy for it, either in AIDS or otherwise. Many people
think of Medicaid as a program only for the poor -- not
realizing that it also pays for their own grandparent in a
nursing home. Medicaid provides for many more HIV patients
than ADAP, and pays for more of their medical care instead of
just drugs. After hearing from people who are having more and
more serious problems obtaining HIV care under Medicaid in
many states, activist Kate Krauss looked into the program and
wrote the background article for AIDS Treatment News. She is also researching the ADAP crisis -- and how people can help with both programs -- for a future article for this newsletter.
ISSN # 1052-4207
Copyright 2002 by John S. James. Permission granted for noncommercial reproduction, provided that our address and phone number are included if more than short quotations are used.