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David Mixner, HuffPost: Reasoning, Not Rhetoric, Key to Charting a New Path Forward for HIV/AIDS Treatment

Reasoning, Not Rhetoric, Key to Charting a New Path Forward for HIV/AIDS Treatment
by David Mixner, September 30, 2011

Instead of coming together as Americans and finding common ground to solve our problems, the pendulum swings of the last two elections have only served to sharpen the differences between right and left. Add to this 9.1 percent unemployment, low consumer confidence, overseas conflict and uncertainty, and a never-ending feeling of division, all of which threaten to dismantle the progress and civility that have been the direct result of major national debates of the last 40 years.

As someone who was a leader during the Vietnam War, Civil Rights movement, and the endless struggle for marriage and societal equality, it’s clear that important ideas and areas for common ground are increasingly falling through the cracks.

It’s time to change and we must be the ones leading this effort.

The current battle being waged in Washington over Medicare, if carried out improperly, will have a major and harmful impact on millions of America’s most vulnerable citizens: people living with HIV/AIDS. By 2015, half of all US HIV patients will be aged 50 and older. But with Medicare spending skyrocketing out of control (2011 budget: $468 billion), there is a consensus among Democrats and Republicans that something needs to be done to reduce costs while ensuring overall quality of care. Simply repeating chants of “Save Our Medicare!” at full volume isn’t going to work. Just the opposite: we need to identify what’s most important and mobilize our forces into action. The worse option is just sitting on the sidelines waiting for someone else to decide our fate.

This begins with Medicare Part D: the most fundamental aspect of the Medicare program that helps millions of HIV/AIDS patients every day. Passed in 2003 and implemented in 2006, the program gives seniors access to affordable prescription drug coverage, with premiums actually decreasing despite skyrocketing healthcare costs. Despite the program’s success, President Obama’s latest plan would save $130 billion by forcing drug manufacturers to pay rebates to the government, but those “savings” will only lead to higher premiums being paid by Medicare patients, up to 40 percent according to one study. In light of the critical, life-saving value of HIV drug therapies, there are better areas to reduce the budget than one of the few government-run success stories for patients struggling with HIV/AIDS.

Back home they often said when things are going well, “let that sleeping dog lie”. Don’t mess with it.

Another idea that stands to harm millions is the Independent Payment Advisory Board (IPAB), created under the Affordable Care Act to help bring down Medicare costs. While any cost-reduction goals are noble, entrusting unprecedented power to a small, unelected and unaccountable group has large risks. People with HIV/AIDS have learned the hard way what happens when our institutions are not held accountable. HIV/AIDS patients need greater access to quality care, not less. And while many primary care doctors already limit the number of Medicare patients they see, the decisions of the IPAB will almost certainly lead to fewer patients being able to see the best doctors and receive the highest quality care. No one aspect of our nation’s health care system is perfect, but risking quality of care to promote an untested cost-savings idea is another significant threat to the HIV/AIDS community.

Last, but not least, we need to find ways to reinforce the amazing strides that have been made in HIV/AIDS research. The development of new drugs and antiretroviral combination therapies has had a massive impact on the quality of life for HIV patients. Our knowledge of diseases, and what causes them, has also increased exponentially thanks to breakthroughs in understanding the human genome, giving us new hope that we can one day eradicate a disease that has claimed more than 25 million lives worldwide.

But we’ve got to keep fighting to ensure research remains a top priority in both the private and public sectors. Implementing pro-research policies, while preventing the super committee from tapping into budgets of the CDC or NIH, is equally important to preserving the current programs that provide for millions of our citizens.

It’s time that the HIV/AIDS community join with supporters and adversaries alike by creating our own priorities in treating and curing this horrific disease. By substituting facts for rhetoric, engaging in the policy debates of the day and avoiding volume over reason, we can help elevate the level of discourse and ensure that America doesn’t come out of this debate and the next elections even more divided than it is now. In the end, this may be the best way to honor the legacy of those whose lives were extinguished before our country became educated enough about HIV/AIDS to start demanding a better path forward.

Stated simply, it’s time to demand it again.

David Mixner has been involved in public life creating policy and as an HIV/AIDS and LGBT activist and writer for over 40 years. He has had two bestselling books, “Stranger Among Friends” and “Brave Journeys,” both published by Bantam Books.

Follow David Mixner on Twitter: www.twitter.com/davidmixner

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