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The American health-care debate from an HIV patient’s perspective

Posted Mar 21 2010 12:00am

I do not understand all the ins and outs of the American health-care system, neither that which existed before today’s vote in the House of Representatives nor the one after.

Here’s what I do know.

Canada has a single-payer health system for hospitalizations, doctor’s visits and related expenses such as most diagnostic tests. Coverage of pharmaceuticals remains a gap with only private insurers, usually with co-pays, covering employee benefits and only provincial governments paying for drugs for those on social assistance or those in need of “catastrophic” coverage. (In most jurisdictions, the thousands of dollars for HIV/AIDS and related drugs each month fits the definition
of “catastrophic”.) These provincial plans only came about as the result of hard work by coalitions, led by AIDS activists, in the 1990s and they vary from province to province which is why a national pharmacare plans remains a dream.

Such a plan only makes sense with hospitals, where patient drug costs are absorbed, treating only the sickest of people. Most of us are able to stay out of hospitals thanks to medications.

This month my eleven prescription medications cost $2589.72, nearly all of which the government pays (to be clear). The most expensive, because they are new and freshly-patented, are the four HIV treatments. However, with buyers as large as the governments of Canadian provinces, bulk prices are negotiated to everyone’s benefit.

My single-payer health-care allows me to visit any hospital emergency room in Canada, as well as my taxpayer-financed family doctor, my HIV specialist, my psychiatrist and my dermatologist with nothing more than the swipe of a provincial government health card.

Are there ‘uninsured’? Sure but people such as the homeless are treated in emergency departments and in street clinics as necessary.

I’m curious to know how I might have fared, these past twenty-one years of living with HIV, had I lived in the United States. I am very optimistic that the system there will change – even if not all at once – in the next few years.

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