healthcare
Dr. says I need to use a #cane until further notice.
#snakes #phobia #handcrafted #woodcarving #healthcare #instahomo #instagay
Those that know me, know that I am terrified of snakes. My heart skipped a beat when I unwrapped this. I chose it purpose.
Obamacare vs. GOP replacement pic.twitter.com/N9zqj8uzTa
— Christian Ledan (@angelindiskies) March 7, 2017
A lot is happening these days that most of us are finding, frankly, pretty hard to believe. But it is not a dream. Donald Trump, who ran on repealing the Affordable Care Act, is now our president, and Republicans, who control the entire Congress, wasted no time and have already set in motion the process to repeal parts of health care reform. As someone who has advocated for years to ensure that people living with HIV have access to quality and affordable care and treatment, and worked with the Obama administration to make sure ACA implementation meets the needs of people with HIV, I am questioning how we are going to make America great for people with HIV without the ACA.
While the current law is not perfect and needs improvement, the ACA has provided health care coverage to more than 20 million Americans, including tens of thousands of people with HIV. Prior to the ACA, private insurance companies were allowed to exclude people with a preexisting condition. Now people living with HIV can purchase coverage and access health care and lifesaving medications to keep them healthy.
The ACA expanded access to Medicaid for low-income people with HIV. Prior to the ACA, low-income, childless adults with HIV (which is not considered a disability) had to progress to AIDS to become eligible for Medicaid. Now states are provided the option to expand their Medicaid program so that low-income individuals, no matter their health status, can receive health care. Today, Medicaid is the largest source of insurance coverage for people with HIV, covering 40 percent of people with HIV who are in care.
Under the ACA, important preventive services, including HIV screening, are covered by most private insurance plans and state Medicaid programs at no cost to the beneficiary. Repealing the ACA would prevent millions from receiving HIV tests that are critical to linking people with HIV to care and treatment, along with other preventive services, including STD, hepatitis B and C tests, hepatitis B vaccines, and alcohol and substance use counseling.
The ACA provides additional critical patient protections that directly impact people living with HIV. These include limits on annual out-of-pocket expenses, prohibiting lifetime caps on benefits, nondiscrimination provisions, prohibiting premiums based on health status, and access to essential health benefits, including prescription drugs and mental health and substance use services. These protections do not just apply to individuals buying insurance through their state marketplace, but for almost everyone in the country. As more people with HIV age into Medicare, the ACA also helps them by reducing patient cost-sharing for Medicare Part D drugs by gradually closing the “doughnut hole” (a temporary gap in coverage).
There is no question that in some markets the ACA is facing obstacles in its implementation. People with HIV are concerned with increased premiums, high deductibles, and high patient cost-sharing for prescription drugs. My organization even filed discrimination complaints against four insurance companies for charging people with HIV excessive costs for all HIV drugs and making them impossible to access without jumping through a prior authorization process. We were disappointed that the Obama administration did not do a better job of enforcing the ACA nondiscrimination provisions or limiting cost-sharing for medications. However, in many states the ACA is working for beneficiaries, insurers and providers. Instead of repealing the ACA, the focus should be on improving it to limit patient cost-sharing without compromising access to coverage.
If Congress repeals the ACA without simultaneously replacing it with programs that ensure comprehensive health coverage for the same if not more individuals, the private insurance market will become unstable, and people with HIV and others would lose access to the care and treatment that they rely on to remain healthy. People with HIV, who depend on a daily drug regimen, cannot risk losing access to their health coverage, not even for a single day.
President Trump has said that his replacement plan will be better and cheaper, and not reduce benefits. But we are still waiting to see his plan.
The legislation that eventually led to the ACA took years to develop, and implementing regulations and guidelines have taken additional years and continue even today. We in the HIV/AIDS communities, along with other patient groups, have worked diligently to ensure ACA beneficiaries have access to quality health care, including specialty providers and medications, at a price that beneficiaries can afford. While improvements can be made, we cannot afford to go backwards by eliminating or destabilizing the health care that the ACA provides.
CARL SCHMID is the deputy executive director of the AIDS Institute.
Robin Beaton: This Is America And We Deserve Good Health Care (by NancyPelosi)
In the streets they gather
screaming for a future
Lacking jobs, insurance and hope
The other side claims everything is fineYou stole their houses
Their jobsLet them bail out your bank
Laid them off to thank them
Now you send in the cops
To shut them upThey have nowhere to go
No jobs exist to occupy their time anymore
And it’s because of youYou outsourced their jobs
For cheaper wages
What were they to doYou don’t care
It doesn’t effect you
You profit from our hardship
You smile your ass to the bank
We cut and downsize as best we canENOUGH IS ENOUGH
We can’t live on less
We can’t cut any more cornersI am a political junkie. I am also a media addict. I majored in journalism and being a total liberal how could I NOT fall in love with the Occupy Wall Street movement? I am the 99 percent. We are just floating along in the water with debt up to our necks.
History is written daily. Little things impact us that we see on the news that we did not expect. Things like Columbine and Katrina, 9/11, Virginia Tech. Well, Occupy found ME. These are MY people. This is MY cause. More than 50 percent of my income goes to rent. The last few weeks we have had rent and gas money and $100.00 for groceries for two weeks – that’s it.
I
was supposed to go to the doctor a few months ago and don’t even have the money for my co-pay to get into the doctor. What’s the point of medical insurance when you can’t afford to use it?
We are all affected by the economy. According to HIVPlusMag.com: “HIV-positive residents in 39 U.S. cities may soon be facing difficulty accessing some federally supported AIDS services because of program cuts to offset steep Ryan White funding reductions. The Department of Health and Human Services awarded $595 million nationwide in Ryan White AIDS funds in March; the amount is about $5 million less than distributed in 2003. Funding cuts ranged from 3 to nearly 14 percent …”
How can we logically cut funding? If you are HIV and on meds there has to be some financial help to keep you on meds to keep US out of hospitals. We went to Occupy Seattle, took Myles to his first protest; my dad would be proud. Walked among 500 people fed up with the system. Our generation has needed a movement like this for a long time. They had a sit-in in front of a Chase bank. I hadn’t felt so much unity since AIDS Walk. We need to stand up for each other more in America.
Watching the videos of Occupy Oakland where my brother lives made me sick: police beating nonviolent protesters. Where are we, Iran? Since when did America become against free speech?
Thursday December 1st, eight people were arrested at Occupy Wall Street in New York for protesting cuts to HIV/AIDS housing and services. The cuts in New York alone were $10 million. More than 110,000 people in New York have HIV/AIDS per NY1.com.
To make this issue hit home even more: I was talking to a woman who found me on TheBody.com. She lives in Mozambique and is married, pregnant and HIV . She gets FREE medical care. Free meds at an HIV clinic all sponsored by the U.S. and the UN. She was saying when she was diagnosed her husband wanted to move them to the U.S. for better health care for her and the baby. In talking we have both realized here is NOT better. Not by any means. She gets two months off maternity leave at full pay, free meds. When I was pregnant, my out-of-pocket cost for meds alone was $500 a month.
Sign the petition below to co-sign the letter from Sir Elton John and David Furnish calling on Florida Governor Rick Scott to not cut HIV med access to those in need.
The full text of the letter can be found here:
http://goo.gl/30MXO
I am #1575 Sun Jun 19 21:56:54 EDT 2011
Over the past 30 years, five U.S. Commanders in Chief have led the nation’s response to the HIV/AIDS epidemic. Who gets good marks? From 1981 to the present, we assess each president’s leadership.
Biggest Hits: Allowed Surgeon General C. Everett Koop to send a letter to all Americans about AIDS.
Biggest Misses: Ignored the disease for years. Failed to rally public awareness and support. Imposed mandatory HIV testing in numerous federal programs.
The AIDS epidemic arose during his first year in office, yet no U.S. president demonstrated less leadership about the disease or a greater lack of concern for its sufferers than Ronald Reagan. Strongly influenced by the so-called Moral Majority, which believed that AIDS was God’s punishment to gay men and IV drug users, the Reagan administration failed to mount a meaningful public health response at a time when aggressive action might have curbed what would become the greatest public health catastrophe of the 20th century. Ignoring the overwhelming opinion of medical and public health experts, Reagan pursued mandatory HIV testing in federal programs as the centerpiece of his AIDS policy.
While the Reagan administration allocated some funding for research, it wasn’t until 1986 that Reagan’s Surgeon General C. Everett Koop – aided by a small team that included Dr. Anthony Faucci, the head of AIDS research at the National Institutes of Health – effectively executed an end run around the rest of the administration. Dr. Koop published a Surgeon General’s report that not only explained AIDS, its risk factors and how to prevent the disease to the American public, but that also included information about condoms and sex education that differed from the administration’s more conservative approach. (In 1988 Dr. Koop also sent a mailing about AIDS to every household in the U.S.) Ironically President Reagan, nicknamed The Great Communicator, didn’t give his first speech on AIDS until 1987. By then over 36,000 Americans had been diagnosed with the disease and 20,000 people had died, including his dear friend Rock Hudson. Shortly after speaking out he established the President’s Commission on the HIV Epidemic, whose findings activists say, he largely ignored.
Grade: F
Biggest Hits: Signed Ryan White CARE Act and Americans with Disabilities, and met with the National Commission on AIDS.
Biggest Misses: Refused to support full funding for Ryan White. Largely ignored the recommendations of the National Commission on AIDS.
He was Vice President when the Reagan Administration failed to launch an effective approach to the burgeoning epidemic. And while he never implemented a comprehensive strategic response of his own, President Bush did take two very important steps that provided much-needed services to people living with HIV/AIDS (PLWHA). First, President Bush signed the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, providing $882 million in federal grants to the hardest-hit cities and all 50 states to care for people living with HIV/AIDS (PLWHA) and their families. Second, President Bush signed the Americans with Disabilities Act, prohibiting discrimination against people with disabilities, including PLWHA.
Grade: C
Biggest Hits: Supported robust funding increases for AIDS treatment and Ryan White services. Rallied public support for the fight against AIDS. Supported creation of the Minority AIDS Initiative as part of the Ryan White programs. Approved notable funding increases for global AIDS at the end of his second term.
Biggest Misses: Failed to approve federal funding for needle exchange. Failed in his effort to achieve comprehensive health care reform.
President Clinton failed in his 1994 attempt to achieve national health coverage through a universal health care plan. But he succeeded in bolstering the country’s response to the AIDS epidemic, elevating AIDS to the level of a White House office by establishing the Office of National AIDS Policy and creating the President’s Advisory Council on HIV/AIDS (PACHA). Funding for AIDS programs increased on his watch, including to the Minority AIDS Initiative directed towards communities of color. His administration also initiated outreach to educate Black leaders about AIDS’ disproportionate impact on their constituents.
The Clinton administration launched the national effort to discover an AIDS vaccine and reorganized the AIDS research program at NIH. As well, that reorganization improved coordination and strategic focus.In 1995 President Clinton signed the Family Medical Leave Act, allowing employees to take unpaid leave for a pregnancy or serious medical condition. And after killing the first version of the bill, he eventually signed the Children’s Health Insurance Program, providing health coverage to low-income children and pregnant women.
The global impact of what was rapidly becoming an HIV/AIDS pandemic began to be felt during the middle of his term. By then the president’s effectiveness was hampered and he failed to fund needle exchange programs to prevent new infections because he believed “politically the country wasn’t ready”. Since leaving office President Clinton has become one of the most effective HIV/AIDS ambassadors in the world. Through the William J. Clinton Foundation, he has played an integral role in convincing heads of state and industry leaders to focus on HIV/ADIS and negotiating price reductions in antiretroviral medications for millions of PLWHA worldwide.
Grade: B
Biggest Hits: Created the largest global health program in history to tackle a single disease, delivering life-saving antiretroviral therapy to millions of people in poor countries and transforming the global AIDS response.
Biggest Misses: Paid very little attention to domestic epidemic, watching while waiting lists for AIDS Drug Assistance Programs emerged and particularly shortchanging prevention programs. Limited the prevention impact of U.S. global AIDS programs by favoring unproven abstinence-only programs and by imposing restrictions on organizations serving sex workers.
While his father strengthened the domestic response after years of inaction under President Reagan, the second President Bush largely turned his back on the domestic epidemic. Not only did he barely convene PACHA, the Bush administration’s investment in the domestic epidemic was lackluster at best, barely keeping pace with inflation. For every dollar the Bush administration spent on AIDS domestically, it spent only 4 cents on prevention. He also failed to implement meaningful reform during the prescription drug plan, which many say turned into a give-away to pharmaceutical companies.
But while Bush II failed to carry out a vision at home, globally he showed significant leadership in the form of his landmark 2003 legislation the President’s Emergency Plan for AIDS Relief (PEPFAR), a $15 billion, 5-year strategy to fight the epidemic in 15 severely affected African nations. Renewed by the Obama administration, to date PEPFAR claims that nearly 33 million people have been counseled and tested, 3 million people have started on treatment and in 2010 alone 114,000 mother-to-child transmissions have been prevented, worldwide. Although PEPFAR has literally changed our world, some of the Bush administration’s policies limited its effectiveness. In particular, the administration prioritized abstinence-only funding over comprehensive prevention measures, an approach that critics contend allowed Uganda’s epidemic to rebound after years of success. In addition, the administration required recipients of PEPFAR support to pledge their opposition to sex work, undercutting the effectiveness of efforts to engage sex workers in prevention programs.
Meanwhile the virus devastated Black communities in the U.S. By 2009 Black America was suffering the equivalent of the world’s 16th largest AIDS epidemic, which would have qualified it for PEPFAR had that program existed at home. President Bush also vetoed two attempts to expand funding for the SCHIP program.
Grade: C-
Biggest Hits: Launched National HIV/AIDS Strategy. Achieved comprehensive health care reform. Lifted longstanding HIV immigration ban and previous bar on federal funding for needle exchange. Revitalized PACHA and Office of National AIDS Policy.
Biggest Misses: Failed to ensure that domestic AIDS funding keeps pace with need. Supported only modest funding increases for global AIDS spending.
Before he entered office our nation’s first Black president had already spoken at length about the need for personal and professional leadership on AIDS. He’d also walked the talk by getting tested publically. Once in office he moved fairly quickly on two fronts: repealing the ban against PLWHA traveling to the United States and ending the federal prohibition against needle exchange in Washington, D.C.
He also maneuvered through political landmines, orchestrating the passage of the Affordable Care Act (ACA), which majority whip James Clyburn, the most powerful Black member of the U.S. House of Representatives, called “the Civil Rights Act of the 21st century”. Although now being vigorously fought by its detractors, the ACA will ensure health insurance coverage for 32 million uninsured Americans, close the drug assistance donut hole, prevent insurance companies from denying coverage to those with “pre-existing conditions,” and prohibits lifetime caps on the amount of health care an insurance plan will provide.
But the publication of our country’s first National HIV/AIDS Strategy in the 30-year history of the epidemic ranks as perhaps the most notable HIV/AIDS-related accomplishment by any U.S. president in the 30-year history of the epidemic. With its goal of reducing new infections 25 percent by 2015, the NHAS sets forth aggressive goals and accountability for all departments in the federal government.
Still, the NHAS must be carried out in the worst economic climate since the Great Depression – one that has blown holes in state ADAP budgets. (The administration did provide $25M in emergency funding.) In our opinion the president’s FY2012 budget came up a little short, with no increases to the Minority AIDS Initiative and too few dollars allocated to drive the nation toward its 2015 prevention goal. Still, we’re cautiously optimistic.
Grade: Incomplete
Alabama: 12 individuals
Arkansas: 58 individuals
Florida: 3,825 individuals
Georgia: 1,515 individuals
Idaho: 14 individuals
Louisiana: 682 individuals**
Montana: 26 individuals
North Carolina: 235 individuals
Ohio: 397 individuals
South Carolina: 664 individuals
Utah: 0 individuals***
Virginia: 668 individuals
Wyoming: 4 individuals
Arizona: reduced formulary
Arkansas: reduced formulary, lowered financial eligibility to 200% FPL (disenrolled 99 clients in September 2009)
Colorado: reduced formulary
Florida: reduced formulary, transitioned 5,403 clients to Welvista from 2/15-3/31/11
Georgia: reduced formulary, implemented medical criteria, participating in the Alternative Method Demonstration Project (AMDP)
Idaho: capped enrollment
Illinois: reduced formulary, instituted monthly expenditure cap ($2,000 per client per month)
Kentucky: reduced formulary
Louisiana: discontinued reimbursement of laboratory assays
North Carolina: reduced formulary
North Dakota: capped enrollment, instituted annual expenditure cap, lowered financial eligibility to 300% FPL (grandfathered in current clients above 300% FPL)
Ohio: reduced formulary, lowered financial eligibility to 300% FPL (disenrolled 257 clients in July 2010)
Puerto Rico: reduced formulary
South Carolina: lowered financial eligibility to 300% FPL (grandfathered in current clients above 300% FPL)
Utah: reduced formulary, lowered financial eligibility to 250% FPL (disenrolled 89 clients in FY2010)
Virginia: reduced formulary, transitioned 207 clients onto waiting list and PAPs, only distribute 30-day prescription refills
Washington: instituted client cost sharing, reduced formulary (for uninsured clients only), only paying insurance premium for clients currently on antiretrovirals
Wyoming: reduced formulary, instituted client cost sharing
Alabama: reduce formulary
Colorado: institute client cost sharing, establish waiting list
Florida: lower financial eligibility
Hawaii: establish waiting list
Illinois: lower financial eligibility to 300% FPL (grandfather in current enrollees from 301 – 500% FPL), disenroll clients not accessing ADAP for 90 days
Kentucky: reduce formulary
Montana: reduce formulary
Oregon: reduce formulary
Puerto Rico: reduce formulary
South Carolina: disenroll 200 clients based on financial eligibility
Tennessee: establish waiting list (as of July 1, 2011)
Washington: cap enrollment, establish waiting list, reduce formulary
Wyoming: reduce formulary
* As a result of ADAP emergency funding, Hawaii, Idaho, Iowa, Kentucky, South Dakota and Utah eliminated their waiting lists; Idaho reinstituted a waiting list in February 2011.
** Louisiana has a capped enrollment on their program. This number represents their current unmet need.
*** Utah instituted a waiting list in May 2011. To date, no individuals have been added.
**** March 31, 2012 is the end of ADAP FY2011. ADAP fiscal years begin April 1 and end March 31.
If repairing your car cost 18 percent of your income, would you buy a new car? Of course you would.
Now imagine that your mechanic tried to persuade you to keep the jalopy with a clever tax argument: The costs of your annual car tax and registration would decline over time, saving you money. Keep the car long enough and you would save a third of a year’s income just in taxes.
That sounds appealing, unless you stop to think about how much more you would pay for repairs as your vehicle ages and breaks down ever more often. READ MORE
