Monday, April 03, 2006

Happy April

A little mental health break, and I'm back all nice and fluffy. Congress had a bit of a break for St. Paddy's Day (well, it must have been St. Paddy's Week, but who's counting?). Presumably they, at least those not yet indicted, are all nice and fluffy, too, and ready to hear from you.

Indeed, they need to hear from you. Today's news is all about how election year politics (not actual fiscal policy) is affecting the budget resolution for FY 2007, i.e., how much of our tax dollars will Congress spend next year? (All of 'em, of course. Duh!) Some folks (not naming names here) want to cut spending, since we're in such a hole with the deficit. Some folks (no names here either) whacked the stuffing out of "social programs" (as in "safety net," "most vulnerable populations," "people too sick to lobby and too poor to pay for lobbyists") in the last few budgets, so maybe they should worry that this might affect their re-election chances so maybe Congress should make the deficit a little bigger to help them out by making them look all compassionate (fill-in-the-blank).

Here's a tidbit (and I do mean tidbit, since there's a lot more where this came from) from a recent letter sent to Congress from the AIDS Institute (formatting applied, emphasis added):

Ryan White CARE Act
FY 2005: $2,073 million
FY 2006: $2,063 million
FY 2007 President’s Request: $2,158 million
FY 2007 Community Request: $2,648 million

The centerpiece of the federal government’s response to caring and treating low-income individuals with HIV/AIDS are those programs funded under the Ryan White CARE Act. CARE Act programs currently reach over 571,000 low-income, uninsured, and underinsured people each year, most of who are from a racial or ethnic minority group. The majority of CARE Act funds support primary medical care and essential support services.

Providing care and treatment for those who have HIV/AIDS is not only the compassionate thing to do, but it is cost-effective in the long run, and serves as a tool in prevention of HIV/AIDS.

In recent years, with the exception of minor increases for the AIDS Drug Assistance Program (ADAP), CARE Act funding has decreased. Because of across the board recessions, flat funding has actually resulted in budget cuts for the past several years. We urge you to provide these vitally important programs with the community requested level of funding. Consider the following:

1) The caseload is increasing. People are living longer with HIV/AIDS due to lifesaving medications; there are 40,000 new infections each year; and the federal government has initiated increased testing programs to identify positive people-all of which will necessitate the need for more medical services and medications.

2) There is a greater financial burden on CARE Act programs. The price of healthcare, including medications, is increasing; non-profit organizations are struggling; Medicaid benefits are being scaled-back at the state level and significant Medicaid reductions recently passed the Congress.

3) Level or decreased funding for the CARE Act is impacting state and local governments grant awards. Because of reduced funding levels, 34 out of the 51 largest cities affected by HIV/AIDS experienced cuts to their Title I awards this year. This is after 18 cities experienced cuts last year. Additionally, 41 states and territories received less money last year in their Title II base awards.

4) ADAP funding shortfalls are causing states to place clients on waiting lists, limiting drug formularies, and increasing eligibility requirements. In February 2006, nine states reported having waiting lists, totaling 791 people. Several ADAPs reported other cost containment measures, including formulary reductions (4), eligibility restrictions (2) and limiting annual client expenditures (2). Due to the small increase the ADAP program was given last year, additional severe restrictions are anticipated in many additional states across the country.

5) Two recent reports conclude there are a staggering number of people in the U.S. who are not receiving life-saving AIDS medications. The Institute of Medicine report “Public Financing and Delivery of HIV/AIDS Care, Securing the Legacy of Ryan White” concluded that 233,069 people in the U.S. who know their HIV status do not have continuous access to Highly Active Antiretroviral Therapy (HAART). A study by the CDC titled, “Estimated number of HIV-infected persons eligible for and receiving antiretroviral therapy, 2003-United States”, reached similar conclusions. According to CDC’s estimates, 212,000, or 44% of eligible people living with HIV/AIDS, aged 15–49 in the U.S., are not receiving antiretroviral therapy. The report concludes, “there is a substantial unmet health care need for antiretroviral therapy among HIV-infected persons in care”.

This is a travesty in our own country. As we seek to provide lifesaving medications to those abroad, we must ensure we are providing medications to our own here in the U.S.

Election year politics? Deficit? This is simple arithmetic, people. Y'know how much we need, y'know how much we have. The only thing you don't know is how much you need to get in order to meet the need. Can you spell s-u-b-t-r-a-c-t-i-o-n?

OK, so I'm not all nice and fluffy. I tried. April is gonna be like this.

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