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AIDS-ing Universal Health Care

AIDS-ing Universal Health Care

Protesters are cheeky in their opposition to Rangel’s inaction on single payer health care reform

With universal health care a real possibility this year, AIDS advocates are getting in the game, proposing, endorsing and protesting federal health care reform plans in the hopes that people with HIV/AIDS will finally get adequate health care.

“This is an opportunity to raise the bar,” said HIV Medicine Association Executive Director Andrea Weddle. “We have to make sure the reform system meets the needs of people with HIV and AIDS and that medical systems include coordinated, comprehensive care.”

Weddle is a member of the HIV Health Care Access Working Group (HHCAWG), which has endorsed ten principles any health care plan must contain, including increasing access to Medicaid coverage; facilitating routine, voluntary HIV screening and counseling; and increasing access to care by strengthening Ryan White community-based programs. The group, which includes members from AIDS Foundation of Chicago, Project Inform, and Housing Works, are judging national health care proposals based on how well they meet these ten criteria.

One of HHCAWG’s members, the Treatment Access Expansion Project (TAEP), published an analysis of the plans by Sen. Ron Wyden and Sen. Max Baucus (available at Baucus’s plan fared best, hitting six of the ten check marks, including eliminating barriers for access to Medicaid and Medicare. Wyden’s plan only hits three of the criteria, though does promote screening for HIV testing.

What about single payer?

While HHCAWG is open to public and private options, a coalition of activists say that a single-payer health care system is the only sensible option.

Wearing hospital gowns with exposed fake butt cheeks, about 30 activists from the Private Health Insurance Must Go coalition rallied outside Rep. Charles Rangel’s Harlem office in the rain Monday, demanding that Rangel, the chair of the House Ways and Means committee, hold testimony on a bill that would provide universal health care.

The group delivered a letter to Rangel demanding that he hold hearings for the United States National Health Care Act (H.R. 676), the only health care bill that would implement single-payer health care. Although Rangel is a co-sponsor of the bill, he hasn’t brought it to committee.

According to the Center for Responsive Politics, Rangel received $123,950 in campaign contributions from HMO/health care services, making him the top House recipient of funds from that group. He also received $81,500 from the pharmaceutical manufacturers.

Single-payer health care would be entirely government-run in the manner of health care systems in Canada and most of Western Europe. The activists argue that health insurance companies provide inadequate coverage and should not be included in a government response to health care. The protestors at Monday’s event jumped through hula hoops signifying the “hoops” that private health insurance plans require.

“My private health insurance is leaving my ass out in the cold,” said Eric Sawyer, an HIV-positive ACT UP New York member who is also a Rangel constituent and a member of the coalition. In addition, Sawyer said, single-payer health care would lessen the disparities in care that Americans with AIDS experience, depending on what state they live in. “The AIDS-specific safety net has not been an effective public health response,” he said.

According to Rangel staffer John Shiner, Rangel hasn’t held hearings on any particular bills. Shiner said while he thought in an ideal world Rangel would probably prefer a single-payer health care plan, he noted, “Representative Rangel is looking for a bill that’s going to pass.”

“Rangel’s job is to look at what is politically possible to do and also what the President wants to do and what members are willing to do,” Shiner said.

Looking at all sorts of options

Housing Works endorses a single-payer health care plan but supports, as an interim step, a progressive plan that provides universal coverage and broadens the public options.

Robert Greenwald, executive director of the Treatment Access Expansion Project, the group analyzing all of the government health care proposals, said that TAEP is open to the possibility of a single-payer health care plan.

“Most people would consider that dead-on-arrival. I don’t,” Greenwald said. “We’re looking at all proposals to see which one is going to propose the most meaningful health care reform.”

Access to AIDS care in the U.S. leaves much to be desired. Despite a mix of Medicaid, Medicare, private health insurance, the Ryan White Care Act, 30 percent of Americans with HIV/AIDS aged 18 to 49 eligible for antiretrovirals went without, according to a 2003 study. And Medicaid and Medicare both only cover people with AIDS when they get sick.

This huge flaw in the system, Greenwald said, is why it is extremely important for any health care plan to include the principles of the Early Treatment for HIV Act (ETHA), which allows states to expand Medicaid to people with HIV and offers substantial subsidies to encourage states to do so.

ETHA was first introduced in 2007, was reintroduced in the House last month, and is expected to be reintroduced in the Senate by Sens. Chuck Schumer and Olympia Snowe shortly.

Posted on April 8, 2009 at 11:26 pm