Caring for the estimated 1.1 million people infected with the AIDS virus will bolster the Clinton administration's argument for universal healthcare coverage and save money, the administration's AIDS czar said last week.
Kristine Gebbie, who has been on the job seven months as national AIDS policy coordinator, told MODERN HEALTHCARE that the Clinton managed-competition plan will bring those infected with HIV, the virus that causes AIDS, into the health system at the beginning stages. Thus, they can be treated earlier and avoid costly, long-term inpatient care.
"That's at the heart of the whole issue," Ms. Gebbie said during an interview at Cook County Hospital in Chicago, which is launching a study of women and HIV infection. "The administration won't discriminate in its universal coverage."
American taxpayers already are paying for people infected with HIV and AIDS, Ms. Gebbie said. Total federal spending for HIV and AIDS will increase to $7 billion in 1995 from $6.4 billion in 1994, according to the Office of National AIDS Policy.
"This administration is committed to fighting HIV," Ms. Gebbie said.
Of those with HIV and AIDS, more than 40% are on Medicare or Medicaid, she said.
"It won't cost more because we're already paying for them on a public payment system," Ms. Gebbie said. "We're paying badly now."
Those who are uninsured either never had private insurance or have lost the insurance altogether, Ms. Gebbie said. State and federal courts are ruling against health plans that attempt to deny coverage of people with HIV and AIDS under the Americans with Disabilities Act.
Health plans that deny coverage for people with HIV and AIDS are only adding to the high cost of healthcare for everyone, Ms. Gebbie said.
The lifetime cost of treating a person with HIV from the time of infection until death is about $119,000, said Fred Hellinger of the Agency for Health Care Policy and Research of Rockville, Md. Mr. Hellinger's study, completed last year, concluded that costs have fallen because there is less use of inpatient treatment.
"Early care and treatment of HIV and AIDS fits right into managed care," Ms. Gebbie said. "It doesn't have to be a specialized practice in a hospital. You need to get them into a care system early."
Systems that aren't thinking of investing more in HIV and AIDS care at the outpatient level should be, she said.
AIDS is now the leading killer of men between the ages 25 and 44. The disease has killed more than 180,000 Americans.
"The epidemic has not peaked," Ms. Gebbie said. "We are far from saying, `We've got that under control."'