$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 heterosexual -- "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.