Recently, Massachusetts took a major progressive step in the care of people with HIV/AIDS: It became the first state to insure poor people with HIV infection, not just with fully developed AIDS. Before the program change, HIV-positive folks had to wait until they reached AIDS to qualify for drug coverage, hospitalization, lab tests, and doctor care. Now, about 1,000 indigent HIVers (income less than $17,000 per year) will be eligible for the state’s low-income health insurance system. It will cost about $10 million a year, of which the federal government will pay half.
While it’s true that HIV care – especially the drugs – is expensive, hospitalization is even more costly. By keeping infected people as well as possible, the lifetime care costs are reduced.
Three additional benefits – two practical and one humane – also accrue by keeping people healthy:
• A healthy person is able to continue in employment, even if it’s just a low-wage job, thus contributing something to the tax coffers and not requiring as much welfare assistance;
• HIV-infected people who are successful with the therapies can, generally speaking, achieve low viral levels, which reduces the risk of
transmission to others. This may be very helpful in slowing the further spread of the AIDS virus;
• Controlling a person’s infection, especially if reached early, contributes dramatically to higher quality of life.
Waiting until a person’s health has hit the skids before assisting with medical care has always been a short-sighted response, not only in human terms, but also financially. It’s good to see that at least one state’s decision-makers have awakened to reality. Is anybody in the Legislature or at the Texas Department of Health taking notice?
This article appears in May 18 • 2001.