Funding for HIV drugs is a “Pocket Problem”
Twenty-three states have or are considering how to cut the number of people who get benefits from the Ryan White Program, which helps low- and moderate income people living with HIV pay for medications and for health insurance.
This is what I call a Pocket Problem. Congress funds the pocket that in turn, funds the program. That pocket is getting turned inside out, so to speak. Unless they cut something elsewhere, the states will have to limit how many people get help and how much help they get.
Meanwhile, there are many pockets that save money when people living with HIV do NOT spread it to other people, when they are able to work, go to school, take care of their families, when they do not die young(er). The problem is the “saving” pockets are in different pairs of pants. They can’t front money to the “spending” pocket even if they could figure out how much they save. The ripple effect is perhaps small for each organization, but it adds up to a large wave.
Imagine one adult living with HIV who suddenly cannot afford medications. Now, as they try to face the $4,000 a month cost of their drugs,…
Their family becomes a new regular at the local food pantry;
They come to the community closet to get winter coats and boots;
Their child skips joining the school track team because they are ashamed to ask the coach to cover the fees. Besides, their teen wants to get a job so they can buy their own clothes, now that the family clothes budget is almost nothing.
They spend all of their spare time looking for ways to get their meds and to avoid running out of meds. (An interruption in meds can make the person prone to other things, such as pneumonia.)
And keep in mind – HIV is an infectious disease that, without treatment, still kills people. Though the numbers are at historic lows, 36,000 people a year get a new diagnosis of HIV; and around 4,000 people die of AIDS each year in the U.S (1.3 deaths per 100,000 population). Yes, this is decimal dust compared to heart disease (162.2 deaths per 100,000) as a killer, but the average age of a person dying from AIDS is 45, when a person has almost half of their career ahead of them, and is likely to have young at-home children. The social cost of people dying young is higher than people dying older.
What is the solution? When we cut funding, we need to look at the impact on more than just the program itself. We need to think of those other pairs of pants and their pockets. Cutting Ryan White funding will push costs into other pockets, and not in the end save money.
