Managing HIV
Yesterday I posted on the disappointing strings attached to US assistance to international AIDS efforts. An article in the April 4, 2007 Los Angeles Times indicates that some state programs are also hamstrung by federal requirements. California is one of those states.
A widely touted law that was supposed to provide medical care for poor, uninsured Californians infected with HIV has yet to be put into practice by Gov. Arnold Schwarzenegger's administration, leaving thousands without the health coverage lawmakers promised more than four years ago.
The 2003 law was endorsed by newspapers across the state and championed by activists as the most significant piece of AIDS-related legislation in a decade. It was designed to allow low-income, uninsured people with HIV — but not full-blown AIDS — to get medical care through the state's Medi-Cal program, as they can now do after their illness fully develops. [Emphasis added]
The program sounded perfect. Treating HIV is less expensive than treating AIDS. Unfortunately, the legislation had a catch to it, and that catch is the reason the new law hasn't been implemented.
Healthcare for HIV patients was to be paid for by savings from AIDS patients voluntarily moving from expensive fee-for-service treatment to more cost-effective managed care. But the state Department of Health Services says that of the 18,000 Medi-Cal recipients with AIDS, only 200 have agreed to switch.
The stipulation that the program's costs be offset was required by the federal government, and the law said that the state could not launch the program until it had shown how it would do that. Lawmakers and advocates expected that the state would start enrolling people with HIV as the money became available. [Emphasis added]
Because Medi-Cal requires federal grants to sustain it, the state really had no choice but to include the stipulation. The problem is that patients with AIDS are reluctant to switch from doctors who have shown their expertise in treating this disease to the unknowns of managed care, and it's pretty hard to fault them for such a decision. However, that means that not enough "savings" have accumulated to institute the new program, and that means that the poor and uninsured with HIV are not getting the treatment they need to forestall the onset of the full-blown disease.
Unfortunately, Governor Schwartzenegger has shown little interest in promoting the program which urges AIDS patients to switch to managed care. Right now he's concentrating on ways to cut costs on the fees-for-service AIDS Medi-Cal program.
In other words, a pretty good idea which actually made it into legislation is dying on the vine.
And that's a shame.
A widely touted law that was supposed to provide medical care for poor, uninsured Californians infected with HIV has yet to be put into practice by Gov. Arnold Schwarzenegger's administration, leaving thousands without the health coverage lawmakers promised more than four years ago.
The 2003 law was endorsed by newspapers across the state and championed by activists as the most significant piece of AIDS-related legislation in a decade. It was designed to allow low-income, uninsured people with HIV — but not full-blown AIDS — to get medical care through the state's Medi-Cal program, as they can now do after their illness fully develops. [Emphasis added]
The program sounded perfect. Treating HIV is less expensive than treating AIDS. Unfortunately, the legislation had a catch to it, and that catch is the reason the new law hasn't been implemented.
Healthcare for HIV patients was to be paid for by savings from AIDS patients voluntarily moving from expensive fee-for-service treatment to more cost-effective managed care. But the state Department of Health Services says that of the 18,000 Medi-Cal recipients with AIDS, only 200 have agreed to switch.
The stipulation that the program's costs be offset was required by the federal government, and the law said that the state could not launch the program until it had shown how it would do that. Lawmakers and advocates expected that the state would start enrolling people with HIV as the money became available. [Emphasis added]
Because Medi-Cal requires federal grants to sustain it, the state really had no choice but to include the stipulation. The problem is that patients with AIDS are reluctant to switch from doctors who have shown their expertise in treating this disease to the unknowns of managed care, and it's pretty hard to fault them for such a decision. However, that means that not enough "savings" have accumulated to institute the new program, and that means that the poor and uninsured with HIV are not getting the treatment they need to forestall the onset of the full-blown disease.
Unfortunately, Governor Schwartzenegger has shown little interest in promoting the program which urges AIDS patients to switch to managed care. Right now he's concentrating on ways to cut costs on the fees-for-service AIDS Medi-Cal program.
In other words, a pretty good idea which actually made it into legislation is dying on the vine.
And that's a shame.
Labels: AIDS, California
posted by Diane at 3:34 AM
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