$165 Million More Tax Dollars for AIDS
by Paul Philpott
President Clinton wants to spend an additional $165 million on "anti-HIV"
treatments for people regarded as otherwise unable to afford the therapies,
which "can cost $12,000 to $15,000" a year, The New York Times
reported on December 20, 1997.
The increase includes $100 million to purchase the drugs from pharmaceutical
companies. In 1996, American tax-payers spent $167 million on anti-HIV
drugs, and $285 million in 1997. The additional $100 million would mean
a total of $385 million in expenditures for HIV drugs as "part of a larger
sum provided under the Ryan White Care Act for treatment of people who
have AIDS or HIV." Ryan White was a young HIV-positive hemophiliac whom
HIV/AIDS lobbyists used as a poster boy to raise private contributions
and tax dollars for HIV researchers, government programs, and "support
groups." When White died in 1990 at the age of 18 -- not an unusual age
for a severe hemophiliac to die -- the press called his death "AIDS-related,"
when in fact he died of hemophilia. Congress responded by passing the Ryan
White Care Act, which Clinton now wants to expand.
The NYT article listed the 1997 Ryan White budget at $1.15 billion,
and stated that the additional $165 million would bring its 1998 total
to $1.3 billion. "The figures do not include money for research on AIDS
or for efforts to prevent transmission of [HIV]," the article stated. In
other words, the Ryan White Act represents just a small piece of the federal
AIDS cash pie.
The justification for increasing the drug spending results from the
increased popularity of prescribing toxic pharmaceuticals to HIV-positive
people who have neither clinical symptoms nor low T4 counts. Before the
popularity of "viral load" testing and protease inhibitor therapy, many
physicians and patients who thought that HIV caused AIDS initiated therapy
only if AIDS-defining symptoms or low T4 counts appeared. Now more healthy
HIV-positive people want AIDS drugs, and HIV lobbyists want tax payers
to pay pharmaceutical companies to increase production accordingly.
Clinton also wants to raise more money for other HIV programs. The
President's Advisory Council on HIV/AIDS issued a report suggesting that
Medicaid rules be expanded to cover medications for HIV-positive people
who do not have symptoms or low T4 counts. Currently, Medicaid only covers
AIDS drugs for HIV-positive people with AIDS-defining conditions.
"The Administration and Vice President Al Gore in particular were eager
to address the concerns of advocacy groups that focus on AIDS and gay rights,"
the NYT article said. Gore's concern may stem from his interest
in attracting gay voters for his bid to succeed Clinton in the 2000 presidential
election. Gay political leaders were very supportive of the Clinton-Gore
ticket in 1992 and 1996, and regard federal HIV funding as among their
most important concerns. But many are angry with Clinton and Gore for failing
to promote legislation that would guarantee the rights of gays to serve
in the military, marry each other, and adopt children. Additional HIV funding
may placate this anger.
Naturally, Clinton would not have been able to win cooperation from
Republicans for overtly pro-gay measures. But even Republicans back anti-AIDS
funding, since they buy into the myth that "everyone" -- every drug-free
"is at risk for AIDS," and thus don't view this topic purely in gay
terms. The article notes that the current federal budget surplus (the first
one in many years) provides a means for this initiative.
Agencies and pharmaceutical companies that receive federal HIV money
typically make contributions to the various organizations which lobby for
federal HIV money, including gay political groups. This money, which some
people regard as payola, is officially designated to help the recipient
organizations provide HIV "education" and "support" services.
The NYT article quotes Daniel Zingale, executive director of
AIDS Action -- "an advocacy group" -- asking for more than the proposed
extra $165 million. "The AIDS drug-assistance program... provides the drugs,
but not the basic health care and services that must accompany the drugs
to make them effective," he says. Presumably, Zingale's organization provides
some of those supposedly necessary services. The article does not say if
his group receives funding from the drug companies that benefit from the
Ryan White Act, or directly from federal HIV programs.
A month earlier, the article reminds us, Vice-President Gore indicated
unsubstantiated faith in the proposal to expand Medicaid. He stated, "Our
view is that getting these drugs to people earlier won't cost more in the
long run. It may even save money." Gore made this comment while revealing
that he had asked the Federal Health Care Financing Administration to "report
back to me" about the cost implications of the plan. "The answers were
not what Mr. Gore wanted to hear," the NYT reported. "Federal health
officials estimated that the proposed expansion of Medicaid would cost
the Government $1.5 billion to $4.5 billion."
It appears that the administration decided to push HIV spending increases
before gathering and evaluating the financial and scientific facts, and
will not permit the facts to affect its plans.