MyDD :: Reductions in Funding ....

Reductions in Funding ....

by DizzyQueen, Sat Jul 26, 2008 at 04:10:55 PM EST

Crossposted from Clintonsitas For Obama and Obama--Criticism and Support

When I went to the pharmacy yesterday, I noticed a petition to the Governor and the CA State legislature trying to prevent a 10% cut in funding of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. This enraged me, as California is only spending an average of 2 months medication costs per patient per year. Moreover, a large chunk of the funding goes to the hardest hit urban areas. In short, the LA and SF metros get over 50% of the funding, and the rest of the state is relegated to fight over the rest. While I'm all for money going where it's needed, the earmark needs to be expanded to truly serve the population living with HIV and AIDS.

Now I know that the Ryan White CARE Act has long been a target of the GOP and fiscal conservatives, but the current funding levels are shameful. While the total amount that is earmarked for the fund seems large at $255,305,160 (FY2006 as reported by the Kaiser Family Foundation in partnership with US Dept. of Health and Human Services, Health Resources and Services Administration), when you take into account there are 92,560 reported cases in the State of California (31 May, 2008, California Dept of Public Health, Office of AIDS), it boils down to an average $2758.27 per patient per year. An average month's medication cost for someone who is taking Anti-Retroviral Therapy (HIV Meds) is around $1400.00. With the proposed 10% cutback, the average amount spent per reported case would drop to an average of $2482.44 per year.

In 2005, there was a compromise measure enacted by Congress (when reauthorizing the Ryan White CARE Act) that limited how the monies are allocated. Title's I and II of the act are limited to spending 75% on a core set of medical services, including the AIDS Drug Assistance Program (ADAP), and places like the Center for AIDS Research, Education, and Services (CARES), and the other 25% used for "Wrap Around Services" such as housing assistance and food / meal assistance. Those levels are good for places like Sacramento, but don't work for places like San Francisco, where donors have taken the financial burden off the clinics and the San Francisco AIDS Foundation's medical outreach programs. In San Francisco, the SF AIDS Foundation reports that they only use an average of 60% out of the 75% medical allocation, but cannot reallocate those surplus monies to bolster their ailing non-medical assistance programs. Other agencies, such as CARES in Sacramento, are fighting to keep every dollar they get for medical care as they are severely under-funded, and are the only such agency in the California central valley.

So, in short, when I go to the Democratic Platform meeting next week, this is the issue I will bring. This is one of the many issues that need to be addressed by Congress under the Obama Administration, and one that will be kept silent as it's not a big newsmaker. But thankfully for myself (and the 92,559 other reported cases of HIV and AIDS in California), I've got a big mouth ... and am willing to use it to effect change.

Just my 2 Cents - comments and suggestions always welcome.

Dizzy

Tags: AIDS, HIV, health care, Ryan White CARE Act (all tags)

Permalink :: 21 Comments :: Post a Comment

Re: Reductions in Funding .... (2.00 / 3)

" the average amount spent per reported case would drop to an average of $2482.44 per year"

If you play that angle we all lose. One of the reasons why CA, NY, IL, TX, FL,etc actually received far less funding in the new RWTMA is that some states claimed the cost per patient treatment was far, far less than in other states, and that the poorer states were being discriminated against because of that. They didn't mention that their state legislatures wouldn't approve any money for HIV/AIDS services at all, so their Medicaid allocations were less from the feds. A few have actually caught on that treating people with an infectious disease was actually less costly that treating someone with an end stage infectious disease, and they could actually get federal funding to do so.

What they didn't mention, however, is that despite the increased amount of money that the non big 7 states received, they can't find medical staff who want to live in their states and serve poor people. They can't get their state legislatures to kick in more money to Medicaid - which is what covers most people with AIDS throughout the country - and a lot of these states will only even consider treating people with AIDS if they are paid well to do so.

You are absolutely correct that Ryan White needs at least 250 million more per year, and that places that have developed effective infrastructures and community resources should not be punished for doing so, but that cost per treatment per patient is just a way to get people fighting for a too small pot of money to fight amongst themselves. And unless you have groups of people in every state telling their Senators and Reps that AIDS is a priority, they just might not even vote for another RWTMA Act. Get some people from other states to make noise with you as well, Dizzy, you'll be helping out the entire country. You might also want to remind a few people there is neither a vaccine nor a cure for AIDS.

Barack Obama is my President

by Jeter on Sat Jul 26, 2008 at 06:39:44 PM EST

Re: Reductions in Funding .... (2.00 / 3)

Thank you, Jeter, for such great feedback ... your points were very valid, and something I forget all too often when making arguments such as that.

-- Dizzy
Proudly cross-posting everything to:
http://www.computerqueen.net/
http://clintonistasforobama.blogspot.com /

by DizzyQueen on Sat Jul 26, 2008 at 07:04:14 PM EST
[ Parent ]

True... (2.00 / 3)

There were states that were cheated out in past legislation... Even within states, certain counties were earmarked for more $$$$ than other counties. Here in California, for instance, Orange, San Bernardino, Riverside, & San Diego Counties had received far less Ryan White funding (including per person) than Los Angeles or San Francisco. In the last Ryan White HIV/AIDS renewal bill, those imbalances were corrected... BUT the bill also cut funds for San Francisco.

That's just unfair. While I get your point (and agree!) on past geographic discrimination, the cuts were just unfair... Especially to areas like SF where HIV's starting to look like an epidemic again.

I just hope that as President, Barack Obama won't forget all these HIV positive people right here in America who are in desperate need of help.

No way, no how, no McCain! :-)

by atdleft on Sat Jul 26, 2008 at 07:07:00 PM EST
[ Parent ]

Re: Reductions in Funding .... (2.00 / 4)

This is a great explanaton of this issue. I agree with Jeter. Keep it up. thanks.

by linfar on Sat Jul 26, 2008 at 06:43:40 PM EST

Trans fat (1.00 / 2)

was clearly a more serious issue, idiots. Since there is no vaccine nor cure, maybe CA needs to have an ad campaign for prevention and use some money wisely. Unprotected sex is bad and they need to stop sugercoating it. Sharing needles is also bad.

For a preventable disease(for the most part) I can see why people in CA, who from what I hear will have a 17B deficit this year are trying to cut funding.

"Is there no keeping with class in whom we mingle with anymore?"

by Brandon on Sat Jul 26, 2008 at 07:04:05 PM EST

Have you no shame? (2.00 / 5)

Or compassion, for that matter? You know, there are many HIV positive people who could not have prevented infection on their own. My best friend, for example, was infected by someone who RAPED him. I've also met kids who were born HIV positive because their mothers were positive. So really, the issue is far more complicated than just stupid people who have unprotected sex.

There actually ARE prevention campaigns underway. But thanks to these funding cuts, local agencies have to cut back. Maybe if the federal government stops giving so many chances for the ultrawealthy to avoid paying taxes, we'd have the money to prevent further infections AND treat everyone who already is HIV positive.

No way, no how, no McCain! :-)

by atdleft on Sat Jul 26, 2008 at 07:14:45 PM EST
[ Parent ]

Btw, I'm sorry... (2.00 / 4)

For this:

So really, the issue is far more complicated than just stupid people who have unprotected sex.

I'm stupid for calling other people stupid. I'm SO SORRY! We all make mistakes, and I'm in no position to judge others for past actions.

So for anyone who may be offended by my comment upthread, please accept my sincere apology.

No way, no how, no McCain! :-)

by atdleft on Sat Jul 26, 2008 at 07:19:01 PM EST
[ Parent ]

Re: Have you no shame? (1.00 / 1)

Excuse me, how dare you try to make me look like some kind of minster on this. What % of aids cases are from rape and being born with aids. And when I said, "for the most part" that would clearly allow for the tiny % that wasn't completely the fault of the person contracting the virus. Having family members with Aids, and knowing their story, along with knowing how teh virus is transmitted, you are kidding yourself if you believe most cases are not preventable.

The claim that the vast majority of aids cases are not 100% preventable is a mockery and illusion. Prevention is the best way to fight a preventable disease. Just like the best answer for unwanted children is contraception, there are other options, but denying that is the best is denying reality.

We have to be honest with people, the best way to prevent aids is to not have unprotected sex and not share needles, of course every child born with HIV is a tragedy and the parent is responsible, and every case where someone gets it from being raped is reprehensible, but don't pretend prevention is not the answer for the overwhelming majority of cases.

People need to be educated.

"Is there no keeping with class in whom we mingle with anymore?"

by Brandon on Sat Jul 26, 2008 at 07:29:53 PM EST
[ Parent ]

Re: Have you no shame? (2.00 / 3)

I understand both of your feelings on this ... and yes, more money should be put into prevention efforts as well. But for those of us who are living with the virus, we've already made our mistake (for the vast majority of us). My issue was with the care that is needed on a daily basis to keep us healthy and contributing to society. I, myself, work 45 hours a week in an IT related field, and still cannot afford my medications without assistance.

so in short ... point taken from both of you ... now let's get back to getting along and focusing on the bigger issues than a small amount of rhetoric.

~Dizzy

-- Dizzy
Proudly cross-posting everything to:
http://www.computerqueen.net/
http://clintonistasforobama.blogspot.com /

by DizzyQueen on Sat Jul 26, 2008 at 07:39:35 PM EST
[ Parent ]

Re: Have you no shame? (2.00 / 3)

Please allow me to revise and extend my remarks -

While I agree that Harm Reduction is vital for stemming the spread of HIV, Harm Reduction is a separate earmark from Title I and II of Ryan White (which is what I was specifically speaking to).

And as to the stupidity comments . . . bad judgment aside, it is interesting that some would choose to continue to lambaste people for past mistakes which are so dramatically life changing as to already teach a completely harsh life lesson.

and with that, I yield the floor.

-- Dizzy
Proudly cross-posting everything to:
http://www.computerqueen.net/
http://clintonistasforobama.blogspot.com /

by DizzyQueen on Sat Jul 26, 2008 at 08:00:07 PM EST
[ Parent ]

Re: Have you no shame? (2.00 / 2)

Harm Reduction is actually sometimes funded through Part A or Part B (previously Title I or Title II) of the RWTMA. SAMSHA typically takes care of the rest. But there has been intense political resistance to funding needle exchange programs in this country, despite the fact they have been clearly demonstrated to work, because the objection was always that people already using drugs would just start injecting drugs. Could have cut the rate of IV drug use transmission of HIV (and the bigger crisis of hepatitis C) down really quickly. Except that would not have stopped the transmission of both HIV and Hepatitis and other transmissable diseases caused by health care providers who just decided that it was too much trouble to follow universal health care precautions, or who just reused needles to save a few bucks.

Barack Obama is my President

by Jeter on Sat Jul 26, 2008 at 09:12:51 PM EST
[ Parent ]

Re: Have you no shame? (2.00 / 2)

Good point - I hadn't seen where HR was funded from Titles I and II, but I've not gone over every earmark from each state ... so I delightfully stand corrected, as you have more knowledge about the nuance of the funding than I do. Thank you, kind Sir, for your clarification.

~Dizzy

-- Dizzy
Proudly cross-posting everything to:
http://www.computerqueen.net/
http://clintonistasforobama.blogspot.com /

by DizzyQueen on Sat Jul 26, 2008 at 09:28:38 PM EST
[ Parent ]

Re: Have you no shame? (2.00 / 3)

Brandon - Most cases of HIV are preventable when men, women and children have access to preventative care, which includes treatment of viruses like HSV-1, which grandma probably gave her with that last kiss, and vaccinations for things like HPV, a virus that can cause the children of zealous parents to develop cervical cancer but which they refuse to give them because they believe it will make those young things suddenly want to have unprotected sex with some cute guy. Nevermind it could prevent the development of cervical cancer, and even rectal cancer in men - a topic that you probably don't know much about either.

You might have had a valid point with regards to people just having safer sex or not using "bad" needles, if in the early eighties when the federal government was informed that there was some kind of unusual disease noted in homosexual men that then President Reagan didn't just say that God had a way of letting us know what is right and wrong. For a good ten years before even those initially reported cases of a rare cancer only previously seen in older Mediterranean men, tens of thousand s of people were dying across the country from what was incorrectly referred to as "junky's pneumonia". The fact is that most of these people were poor, and neither they, nor homosexuals, nor blood banks, nor those given mass inoculations using the same injection device or syringe had any idea what virus caused AIDS, nor how it was spread.

You'd have a better case if you just blamed increased access to transportation amongst Africans who happened to eat bush monkey meat 40 years ago and became the first humans to contract a disease that was previously confined to monkeys.Do I need to remind you that the leap of a pathogen from an animal vector to humans is a major ineternational event in the history of the world? But not knowing this lead to the seeding of thousands of people and countries with the virus, and it became an epidemic because long before AIDS people were having unprotected sex. If it weren't for the development of penicillin, bot you and I would most likely be dead anyway.

Having treated people with AIDS for over 2 decades now, I can assure you that had most of them known having unprotected sex or sharing needles or getting a tattoo in an unsterile manner (which can even mean reusing the same ink well) or having anal intercourse to prevent pregnancy the critical mass required to create an epidemic would never have been created. But instead we got a pandemic that still threatens the stability of whole countries, and robs our economy of trillions of dollars a year. Do you care about that, or should we have just not given money to developing countries to treat HIV, malaria and tuberculosis - all preventable diseases. You seem to think that is a solution. Maybe we should tell all those people who ate one too many pieces of mom's apple pie they should just get over their fatty selves and shut up about heart diease and obesity related diabetes.

It's kind of like saying that fat, not just trans fat, when consumed in excess are pretty likely to cause elevated blood lipids, obesity, elevated cholesterol all culminating in obesity related diseases like diabetes and heart attacks - so overweight people should just pay for their own mistake of eating one too many times twenty years ago. Or their moms should be prosecuted for feeding them comfort food one too many times.

Using the word " idiots" in your first post on this topic demonstrates how you treat every post. In fact, you go to every recommended diary, and you mark the thread with your bitterness. As your tagline says, you are definitely a victim. Monster would not be the first word that came to mind if I wanted to get into name calling. Same number of letter, though.

Barack Obama is my President

by Jeter on Sat Jul 26, 2008 at 09:03:09 PM EST
[ Parent ]

Re: Trans fat (2.00 / 3)

A group of clinics in Nevada just gave hundreds of people both HIV and/or hepatitis because they were trying to save some money. The people responsible were fired of course, but not the managers or owners. Too bad for those people who have to live their innocent lives with HIV and/or chronic hepatitis, right Brendon? They should have just never had unprotected sex or gone near "bad" needles. Neither should the thousands of other people in the US who got one or more of those disease the same way just last year alone.

Barack Obama is my President

by Jeter on Sat Jul 26, 2008 at 09:15:20 PM EST
[ Parent ]

Re: Trans fat (2.00 / 3)

Also, Brandon. Your tagline is a little incongruous with the person you claim to support. Hillary Clinton put a hold on the last RW bill until a compromise was made that wouldn't have let people who believe in the absolute preventability of HIV severely gut the program. Obama, Boxer, Lautenberg, Menendez and Feinstein also did the same. But Hillary held out until Kennedy was able to force a humane compromise that was better than nothing.

Hillary was also the first to call for an inquiry into why people going to doctors for routine procedures - even gynecological examinations or surgery - were getting HIV and/or HCV. Darn. It turned out once again that a doctor was trying to save money on syringes by reusing both syringes and vials - you know, kind of like the vials that multiple vaccinations are given from. But I'm sure one of those people had to be having unsafe sex or used a "bad" needle for Botox or something, so they must have been able to prevent it as well and should just be told not to eat trans fats.

Barack Obama is my President

by Jeter on Sat Jul 26, 2008 at 09:26:32 PM EST
[ Parent ]

A better answer ... (2.00 / 1)

is to change laws in order to allow ALL folks to form loving, committed, LEGALLY recognized relationships that provide ALL folks the ability to live more monogamously if they so choose. I wonder what the level of HIV - AIDS would be now if there had been full marriage equality back in the 1970's?

Of course, you, and folks like you, would rather whine about the effects of promiscuity than allow for everyone to have a level playing field.

Hell's bells, even the GOP didn't have to crucify Eisenhower's record in order to make Reagan their 'saint'. We can have two great ones, you know?

by emsprater on Sat Jul 26, 2008 at 10:28:04 PM EST
[ Parent ]

Re: A better answer ... (2.00 / 1)

First, thank you for weighing in!

I agree with you to a point. Being a gay man, I am totally for marriage equality. And if marriage equality were to have been enacted in the 1970's, it very well might have helped stem the progression of the epidemic to a point.

However, I am a little reticent to concede that it's a better idea. It's a great idea in it's own right, and one that is WAY overdue - but I think that we need to have multi-target prevention AND care programs that try to as holistically as possible combat the epidemic from all sides.

Just my thoughts :-) again, thanks for commenting!

Dizzy

-- Dizzy
Proudly cross-posting everything to:
http://www.computerqueen.net/
http://clintonistasforobama.blogspot.com /

by DizzyQueen on Sat Jul 26, 2008 at 11:01:24 PM EST
[ Parent ]

Re: A better answer ... (2.00 / 1)

My reasoning is that allowing for full marriage equality for gay Americans is a much better answer than Brandon's continual show of dislike for gays, gay rights and his homophobia in general.

It always disturbs me to see folks like him weigh in and spout RW talking points about AIDS all while they work to keep gays in sexual limbo by denying tools that would achieve some level of monogamy.

Hell's bells, even the GOP didn't have to crucify Eisenhower's record in order to make Reagan their 'saint'. We can have two great ones, you know?

by emsprater on Sun Jul 27, 2008 at 12:02:38 PM EST
[ Parent ]

Re: A better answer ... (none / 0)

On these points, we are fully in agreement! Thank you for clarifying your rationale . . . I now see exactly where you are coming from - thanks for your feedback :-)

-- Dizzy
Proudly cross-posting everything to:
http://www.computerqueen.net/
http://clintonistasforobama.blogspot.com /

by DizzyQueen on Sun Jul 27, 2008 at 01:04:30 PM EST
[ Parent ]

Re: Reductions in Funding .... (2.00 / 1)

It is sad that the cost of life-saving drugs are out of the reach of many people. Unfortunately, there are a lot of diseases out there and a lot of people that need help. One of the drugs prescribed to extend the life of people with ALS cost $800 per month. That's one drug. My fiancee had a drug that cost $1400 per month. That was one of about a dozen she was on at one time.

I am not unsympathetic to the plight of people with HIV or AIDS. I only want to point out that there are a lot of other people that get no help whatsoever with the cost of drugs. There is only so much money to go around. Every dollar that goes towards one disease is a dollar that can't be spent on dozens of other equally fatal diseases.

"The true measure of a man is how he treats someone who can do him absolutely no good." Samuel Johnson

by MS01 Indie on Sat Jul 26, 2008 at 10:28:04 PM EST

Re: Reductions in Funding .... (none / 0)

Very valid point - thanks for weighing in :-)

~Dizzy

-- Dizzy
Proudly cross-posting everything to:
http://www.computerqueen.net/
http://clintonistasforobama.blogspot.com /

by DizzyQueen on Sat Jul 26, 2008 at 10:51:25 PM EST
[ Parent ]

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