Treatment access emergency: ADAP and Medicaid.A combination of unrelated events and changes in the last two years is increasingly threatening the ability of thousands of Americans with HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States. to get medically necessary care medically necessary care,
n the reasonable and appropriate diagnosis, treatment, and follow-up care (including supplies, appliances, and devices) as determined and prescribed by qualified appropriate health care providers in treating any condition, . The national economic slowdown For articles with similar titles, see Slow Down (disambiguation).
A slowdown is an industrial action in which employees perform their duties but seek to reduce productivity or efficiency in their performance of these duties. , a crisis in state budgets, the Federal focus on war, and the neglect of treatment-access activism, have combined so that probably thousands of people are being denied necessary treatment for economic reasons alone, when they would have had access a year ago. The problem is likely to get much worse before it gets better. While most of the causes are .beyond the control of readers of AIDS Treatment News, we can work on the activism.
Few patients are immune to these problems. Due to high prices for drugs and tests, very few can pay the full cost of HIV care entirely out of pocket. And private insurance has become increasingly efficient at getting rid of people with expensive illnesses -- especially HIV infection, since it is not officially recognized as a medical specialty medical specialty Any specialty that provides non-interventional Pt management, ie with drugs, or with minimum intervention–eg, balloon catheterization Examples Internal medicine–allergy and immunology, cardiology, gastroenterology, hematology/oncology, like cancer, even though it is one in fact. Therefore HMOs can pay HIV doctors the "healthy adult" rate, less than the cost of providing care, in order to drive good doctors out of the plan and keep patients away.
(1) As this issue goes to press, there may or may not be an emergency mobilization mobilization
Organization of a nation's armed forces for active military service in time of war or other national emergency. It includes recruiting and training, building military bases and training camps, and procuring and distributing weapons, ammunition, uniforms, on ADAP ADAP AIDS Drug Assistance Program
ADAP Alcohol and Drug Awareness Program
ADAP Agricultural Development in the American Pacific
ADAP Airport Development Aid Program
ADAP Advanced Digital Antenna Production (the AIDS Drug Assistance Program, funded by the Ryan White CARE Act The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act (Ryan White Care Act, Ryan White, Pub.L. 101-381, 104 Stat. 576, enacted 1990-08-18) was an Act of the U.S. ), in the coming days or weeks. The growing crisis in ADAP results from flat Federal funding despite increasing needs, rising drug prices, state budget shortfalls, and indirectly from increasing Medicaid problems. Also, the traditional coalition of patient advocates and industry to seek funding for ADAP has not been very active in the last year.
(2) Medicaid is a huge program that has surprisingly little advocacy for it, either in AIDS or otherwise. Many people think of Medicaid as a program only for the poor -- not realizing that it also pays for their own grandparent in a nursing home. Medicaid provides for many more HIV patients than ADAP, and pays for more of their medical care instead of just drugs. After hearing from people who are having more and more serious problems obtaining HIV care under Medicaid in many states, activist Kate Krauss looked into the program and wrote the background article below for AIDS Treatment News. She is also researching the ADAP crisis -- and how people can help with both programs -- for a future article for this newsletter.