Should we care or should we not?

[Cutedelicategay]

I know this maybe a touchy question for some but that's not the intention at all. 

My question is specifically for the western world where medical science has progressed and preventative medicines are now widely used.

Should we as a society still need to take the burden of providing HIV medications to new HIV infections? I am not talking about the ones already on medication. This is specifically for new infections when Prep and DoxyPep are widely available and prescribed to men at risk. Prevention is always better than cure then why encourage spread of infections by providing care post infection? It's a burden on tax payers for someone's risky behaviors and choosing not to use Prep. Most insurance companies pay for these nowadays. 

Please be respectful in your responses.

[BootmanLA]

1. You say "most insurance companies pay for these (ie PrEP) nowadays", but guess what: if they pay for PrEP, they're paying for HIV treatment meds, too. They may prefer PrEP over treatment because it saves money over the long haul, but that doesn't mean the same entity isn't paying for both. It's not like all the cost of HIV treatment gets shifted to the government - certainly not in the U.S., at least.

In fact, typically, whether it's an employer plan, an individual private insurance plan, Medicare/Medicaid/VA/other govt. plan, or what have you: the same entity that would cover your PrEP will cover your HIV treatment. The plan may prefer (as noted) that people get on PrEP rather than get infected and need treatment, but getting HIV doesn't mean that it's going to be a burden on taxpayers. For several years I had an individual insurance plan for which *I* paid, out of pocket, 100% of the premiums, and now I'm on my partner's company plan as a domestic partner, which they offer. Neither one of those options cost "the taxpayers" a fucking dime.

2. Here in the US, even with the Affordable Care Act, there's a tier of people who make too much for traditional Medicaid (govt health plans for the poor) but not enough to qualify for a subsidy on the ACA exchanges for a plan. Part of the ACA is an "Expanded Medicaid" plan to cover those people, but the courts here ruled that because Medicaid is a cost shared between the federal and state governments, the feds can't mandate that a state participate.

As a result, 13 states (at last count) still refuse to participate in Expanded Medicaid, meaning people in those states who make less than the poverty wage can't get a subsidy on the exchange nor can they qualify for traditional Medicaid. They have NO insurance, because when you make less than $15,000 as a single person, there isn't an individual plan out there you can afford.

So at least here in the US, while the uninsured rate is the lowest it's been in decades, it's still almost 8 percent, or more than 25 MILLION people with zero health insurance coverage.

3. Prevention sometimes fails. Some people brought up in restrictive circumstances don't know about prevention. Some people don't even know they might be at risk because sex education in this country largely sucks - it's left up to local school systems, many of which are run by highly conservative, religious people who don't want kids to be taught the facts. Some people are going to get infected no matter how much "prevention" is preached.

4. Lots of things are preventable. Heart disease is heavily influenced by factors like diet, exercise, and smoking. Are you prepared to tell people we won't treat them for a heart attack because we all know how to reduce the risks for that? Are you going to be making exceptions for people with a genetic disposition towards heart issues, and are you going to spend the millions of dollars it would take to screen every heart attack patient to determine whether they're one of the lucky "deserving" ones or one of the "too bad, hope all those hamburgers tasted good, you're on your own" unlucky ones?

This whole idea smacks of who "deserves" health care and who doesn't. That, to me, is a nasty way to look at the world.

[PozBearWI]

My Medicare Advantage plan does not cover either HIV meds nor PrEP.  My out of pocket should I decide to start ARV is a lovely $55,000 per year.  

[BlindRawFucker1]

Smoking, drinking, driving wrecklessly, skydiving, eating fatty foods  and a lot of other activities shouldn’t be covered by insurance if you don’t cover HIV treatments.

 

Is that what is wanted?

[hntnhole]

Well, my former Health Care Company just up and left the marketplace, and they paid for the PrEP 100%.  Maybe too many raw guys were on that plan, and we just ran them out of dough !!!  Fortunately, there are others that will cover the (bloated) costs; there's another medication* I (and tons of others) people) have to take, and it's far less expensive.  

Also, there are other providers that find ways to pay for PrEP from foundations, etc.  One example is the Mistr program.  I'm sure there are others too.  

*not associated with any sexual orientation or activities

[onlyraw]

Also you forget that not everyone has a medical provider they can be honest with about their sexual activities (and so get the preventative care that is available) 

And - not all sexual activity is planned or consensual 

And as was mentioned- do we stop paying for cancer treatment for previous smokers?

do we  not pay for blood pressure medication for people who are overweight?

If we want HIV ( or any future plague) covered- we can’t start down the path of saying “oh well this is preventable so you are out of luck”

[Incognito91]

On 2/2/2024 at 4:02 AM, Cutedelicategay said:

Should we as a society still need to take the burden of providing HIV medications to new HIV infections? I am not talking about the ones already on medication. This is specifically for new infections when Prep and DoxyPep are widely available and prescribed to men at risk. Prevention is always better than cure then why encourage spread of infections by providing care post infection? It's a burden on tax payers for someone's risky behaviors and choosing not to use Prep.

The same argument can be made for infections that occurred in the past. Why didn't they use condoms? Seems unfair if that is argument.

I assume this is a question to countries where medical costs for HIV is covered.

The main benefit to treat all HIV patients is that then the patient will be undetectable and therefore not infect others. They will continue with their treatment rather than let it fall away because they need the money to be spent on something else. Is that not a good enough societal benefit? 

[tallslenderguy]

Ditto those who would not segregate HIV from other forms of disease that we don't question the cost of treating.

Personally, i think healthcare should not be a for profit venture.  Beef up the NIH and research that result in new treatments can then be produced at cost, not for a profit. 

HIV PREVENTION DRUG: BILLIONS IN CORPORATE PROFITS AFTER MILLIONS IN TAXPAYER INVESTMENTS

HEARING BEFORE THE COMMITTEE ON OVERSIGHT AND REFORM HOUSE OF REPRESENTATIVES ONE HUNDRED SIXTEENTH CONGRESS

"...this treatment was developed as a result of investments made by the American taxpayers through the National Institutes of Health and the Centers for Disease Control and Prevention. The problem is that Gilead, the company that now sells this drug, charges astronomical prices. When Truvada was first approved in 2004, Gilead charged about $800 per month, again, for this life- saving drug. Since then, Gilead raised the price of this drug over and over and over and over and over again. It now charges about $2,000 for just one month or about $70 per pill. Think about that, lifesaving drug.

In the same period, Gilead has made massive windfalls on this treatment, more than $36 billion in revenues. Let me say that one more time. They made more than $36 billion on this drug alone. How can Gilead do this? How can our system allow a company to take a drug treatment that was developed with taxpayer funds and abuse this monopoly to charge such astronomical prices? This life- saving treatment would not exist but for the research funded by the CDC and NIH. So how can our system let a company charge prices that are so outrageous, making $36 billion while there are literally hundreds of thousands of people who need this drug? "

[think before following links] [think before following links] https://docs.house.gov/meetings/GO/GO00/20190516/109486/HHRG-116-GO00-Transcript-20190516.pdf

{mosads}Truvada costs approximately $6 per month to make, but Gilead Sciences charges up to $2,000 per month to consumers. Unlike HIV treatment drugs, HIV prevention drugs are not covered by the Ryan White Care Act, so there are significant barriers that prevent vulnerable communities from taking the drug.

Edited February 3 by tallslenderguy

[hntnhole]

If we (meaning the U.S. taxpayer) are required to support all the Government functions - some of which we may not approve of - but must pay our share regardless, then of course we should be required to support health-care costs for all as well.  

In fiscal 2023, The US Government spent over 6 Trillion dollars on all kinds of things.  If we, the taxpayers, are unwilling to provide Health Care for our citizens (and everyone else who is in process of becoming a citizen) via our taxes, then how on Earth can we consider ourselves to have "good Government"?  Just because the Health Care industry isn't kicking back mountains of dough to the Government (and it's elected representatives) like the armaments industry, for instance, wouldn't caring for the health of it's citizens fall into a "must-do" category?  I say the Government should absolutely provide health-care to all it's citizens, and if that industry gets too greedy, enact legislation that will obviate that greed.

I notice that one political party in the US is trying to deny children a food-assistance program this coming summer.  Comprehensive health-care, regardless of whether some folks dislike the causes, is a foundational requirement of enlightened Governments.  Unless and until the citizens get to vote on these issues (and that will never happen), subsidizing Health Care for it's citizens is as crucially foundational as it gets, and far more than subsidizing the hand-gun/arm-cannon/machine-gun industry - and that's just one example.  

 

 

 

[hntnhole]

5 hours ago, tallslenderguy said:

Personally, i think healthcare should not be a for profit venture

I ask again:  Why are we limited to only one "upvote"?  tallslenderguy's comments deserve at least a dozen (per respondent).

[hntnhole]

5 hours ago, tallslenderguy said:

HIV PREVENTION DRUG

by the way ........ how did you change the color of the text ?????????

[NastyRawBottom]

Treatment IS prevention. Reaching undetectable levels, via treatment, makes it almost impossible to transmit the virus to those who are negative, thereby reducing the total amount of people with the virus. Even if we didn’t pay for HIV treatment, we would still end up paying for inevitable emergency services as untreated people develop AIDS and rare, opportunistic infections. HIV treatment for life is way cheaper than specialized care for AIDS-related complications. 

Treatments means people with HIV are healthy, able to work and pay taxes. On the other hand, people who are sick with AIDS can generally claim disability and other government benefits. Even ignoring the morally bankrupt implication of letting people die from lack of treatment, paying for HIV treatment makes fiscal sense and no serious political faction has ever suggested not paying for treatment as logical way to punish or deter “irresponsibility”.

[ellentonboy]

I will ask this question politely to the OP.  Do you know what site you are on?  I read your post a few times and I have to admit, based on the feelings of a large percentage of members of this Forum, you're question that you posed will get a response that is primarily negative.

Remember freedom of sexual expression is a big part of what is welcome and freely discussed here on this Forum.

You should post this on TruthSocial or even Facebook, you might get the response I think you are looking for.  Oh, and please, don't give me the "oh, I was just wondering how BZ members feel on this subject".  Because you know EXACTLY how they feel.  

That's as about as RESPECTFUL as I am going to be, I value my ability to post here and I don't want to piss off the moderators.    I'll have to remember to put you on "ignore".

[tallslenderguy]

45 minutes ago, hntnhole said:

by the way ........ how did you change the color of the text ?????????

When You are writing a reply, go up to the top of Your response frame and you will see a paint brush, click on that and it will give You a whole color pallet to paint with. Highlight the text You want to "paint" and then click on the color. 

[VersGuyAnon]

On 2/1/2024 at 5:02 PM, Cutedelicategay said:

I know this maybe a touchy question for some but that's not the intention at all. 

My question is specifically for the western world where medical science has progressed and preventative medicines are now widely used.

Should we as a society still need to take the burden of providing HIV medications to new HIV infections? I am not talking about the ones already on medication. This is specifically for new infections when Prep and DoxyPep are widely available and prescribed to men at risk. Prevention is always better than cure then why encourage spread of infections by providing care post infection? It's a burden on tax payers for someone's risky behaviors and choosing not to use Prep. Most insurance companies pay for these nowadays. 

Please be respectful in your responses.

The problem is many people don't have the benefit of education about HIV.