Navigation Links
HIV-Treating Clinicians Support Health Care Reform, Express Caution
Date:8/10/2009

Increased caseloads, lack of proper reimbursement, possibility of rationing HIV care cited as concerns

WASHINGTON, Aug. 10 /PRNewswire-USNewswire/ -- The International Association of Physicians in AIDS Care (IAPAC), which represents approximately 4,000 HIV-treating clinicians in the United States [out of a global membership of over 13,000], today released results of a nationwide survey indicating that while supportive of ongoing health care reform efforts, a significant percentage of its U.S. membership is concerned about issues ranging from increased patient caseloads to the possibility of rationing HIV care.

The survey results come on the heels of President Barack Obama's recent national address underscoring the importance of health care reform. With mounting pressure from the White House, Congress is currently working to pass health care reform legislation that would create a more affordable and efficiently run health care system, as well as expanding coverage to the estimated 45-50 million Americans that are either uninsured or underinsured, among them people living with HIV/AIDS.

"Our clinician-members recognize HIV/AIDS is but one of the myriad health challenges posed in reforming the U.S. health care system so that it delivers care at a cost that is affordable, but in a manner that does not sacrifice quality or jeopardize access," said Jose M. Zuniga, Ph.D., IAPAC's President/CEO. "Their concerns, however, must be addressed in the health care reform legislation eventually enacted because the health and well-being of over 1 million Americans living with HIV/AIDS and those as yet undiagnosed are at stake."

HIV-Specific Views Related to Health Care Reform

Fifty-seven percent of respondents favored the inclusion of HIV-specific provisions in health care reform legislation citing the special needs of people living with HIV/AIDS. Forty-three percent disagreed, favoring an approach that would mainstream HIV and thus avoid "HIV exceptionalism."

Among those who disagree with the inclusion of HIV-specific provisions is Neal Rzepkowski, MD, an HIV-treating physician from Cassadaga, New York, who himself is HIV-positive. "HIV-specific implies 'special status,' 'special interest,' and by the same token, discrimination, or a tiered medical system," Rzepkowski wrote in response to the survey. "This type of 'special treatment' has backfired and hindered good HIV care."

When asked how health care reform would affect their practices, clinician-respondents claimed it would expand the numbers of HIV-positive patients they treat (23%), increase their paperwork (23%), decrease their reimbursement (13%), and require them to ration HIV care (10%). Positive affects included the integration of HIV care into primary care (17%), stabilizing their practices' finances (7%), and lowering drug and administrative costs (7%).

Health care reform "could potentially be better for those without insurance," wrote a Connecticut-based HIV-treating nurse who requested anonymity, "but personally, the elimination of choice for those insured and the possibility of the government telling those of us providing or receiving care what can and cannot be done is not right." For Barbara Yusko, RN, an HIV-treating nurse from Albany, New York, health care reform poses another challenge: "The health care environment is a busy one. Too many changes too quickly can create harm. I am opposed to sudden drastic changes that cannot be accommodated by an already overburdened system."

Still, for HIV-treating physicians such as J. Yusuf Erskine, DO, from Sebastapol, California, achieving health care reform "would deter the erosion of health care, and stabilize the health care financial situation so that I can afford to continue to provide HIV care." This sentiment is shared by Bary Siegel, MD, an HIV-treating physician from Sacramento, California, who added that with health care reform, "this would be the first time that all of my patients might be able to actually afford all of their medications, needed lab work, and follow-up care they need to manage their acute and chronic diseases."

Survey respondents were also asked to make specific recommendations related to health care reform legislation. Survey respondents prioritized incorporating prevention into HIV clinical management (21%), allowing for proper HIV clinician reimbursement (18%), prohibiting discrimination based upon HIV diagnosis (pre-existing condition) (14%), guaranteeing antiretroviral drug access (14%), and enhancing HIV treatment adherence (14%), among a series of other recommendations.

Views on Health Care Reform Overall

Sixty-three percent of respondents indicated they are "very informed" about current efforts to reform the U.S. health care system, while an equal percent (18%) said they are either "somewhat informed" or "somewhat uninformed."

When asked about the level of urgency to enact health care reform, 36% consider the matter "extremely urgent (reform legislation is needed immediately)," 31.8% "urgent (reform legislation is needed as soon as possible in 2009)," and 23% "somewhat urgent (reform is needed but can await further debate)." Seven percent said health care reform was "not urgent (reform legislation can wait, there are more pressing priorities)," and 2% were undecided.

With respect to a public health insurance option, the majority (73%) supported the option (which garnered more support from nurses than physicians, 83% to 72%, respectively), and 25% rejected the option. Two percent were undecided.

Among the specific positive factors that respondents said would influence their support of health care reform were: extending health care coverage (21%), eliminating pre-existing condition barriers to health care (7%), a focus on prevention (2%), and improved quality of care (2%). Sixty-five percent cited all four of these factors as influencing their decision-making on the matter. Two percent said none of these factors had an influence.

Three specific negative factors were cited by respondents as influencing their support of health care reform, including overall cost (15%), detrimental affect on medical practices (15%), and the possibility of rationing care (13%). Twenty-eight percent said these three factors influenced their support for health care reform, while 30% said none of these reasons bore any significant influence.

About the Survey

Potential respondents were invited to participate in the 10-question online survey via two IAPAC email invitations transmitted July 22, 2009, and July 24, 2009, to HIV-treating clinicians in the United States. Of the 400 respondents, 70% were physicians, 23% were nurses, 5% were pharmacists, and 2% were physician-assistants. Among physician-respondents, 74% reported that less than 50% of their patients were uninsured, and 26% reported that more than 50% were uninsured. Following is a geographic breakdown of respondents' home states (plus the District of Columbia): New York (24%); California, Illinois, and Massachusetts (10% each); Texas (8%); Maryland (7%); Louisiana (6%); Arizona, District of Columbia, Georgia, and Pennsylvania (4% each); Florida and New Jersey (3%); Arkansas, North Carolina, and Tennessee (1% each).

The International Association of Physicians in AIDS Care (IAPAC) is a non-profit medical association representing more than 13,000 physicians and allied health care professionals in over 100 countries. Its mission is to expand access to and improve the quality of care, treatment, and support for men, women, and children living with HIV/AIDS. Visit www.iapac.org for more information.


'/>"/>
SOURCE International Association of Physicians in AIDS Care
Copyright©2009 PR Newswire.
All rights reserved

Related medicine news :

1. Therap Services Continues to Hire Experienced Developmental Disability Industry Clinicians for its Customer Support Team
2. Pain medicine meeting unites top researchers and clinicians
3. Does artificial intelligence help clinicians to recognize atrophic gastritis with thyroid disease?
4. Publication Provides a Wake-Up Call For Clinicians Treating Narcolepsy
5. New Evidence Provides Clinicians With Better Tools to Help Smokers Quit
6. CME Publication Gives Clinicians a Leg Up in Treating Disorders of the Lower Extremities
7. Streamline Healths Document Management Solution Integrated into Oacis, Allowing Clinicians to Access Patients Information - Either Scanned or Electronic
8. APCTODAY.com and Convera(R) Launch Vertical Search Site for Advanced Practice Clinicians
9. Report says clinicians should consider economic impact of new interventions
10. AHRQ Releases Two New Resources to Help Consumers and Clinicians Prevent Dangerous Blood Clots
11. Clinicians in Netherlands Treat Lung Cancer Patients Using New RapidArc Radiotherapy Technology from Varian Medical Systems
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/26/2017)... ... May 26, 2017 , ... Water damage to the flooring of several ... had left education officials with a number of critical issues to address before students ... to be accomplished with little or no disruption to class schedules. Second, the project ...
(Date:5/24/2017)... ... May 24, 2017 , ... In modern research, success depends ... instruments for research and understanding the basic principles that were designed to drive ... innovations in stereo microscopy for brightfield and fluorescence typically used in laboratories working ...
(Date:5/24/2017)... ... 24, 2017 , ... Altec Products, Inc., a leader in enterprise ... one-day technology conference in San Diego, CA. , At nVerge 2017, Altec will ... utilize and enhance their Sage ERP solutions by providing improved visibility and control to ...
(Date:5/24/2017)... ... May 24, 2017 , ... Drs. ... NY, who have now spent 10 years as clinical instructors for the reputable ... College of Dentistry. Through the program, private practitioners receive cutting-edge clinical training and ...
(Date:5/24/2017)... ... , ... Patients who want to receive cosmetic dentistry procedures such as Invisalign® ... for a consultation, with or without a referral. Dr. Bedich enjoys improving the appearance ... , Dr. Bedich offers a variety of cosmetic dentistry services at his practice that ...
Breaking Medicine News(10 mins):
(Date:5/10/2017)... MARLBOROUGH, Mass., May 10, 2017 Hologic, Inc. ... financial results for the fiscal second quarter ended April ... (EPS) of $1.84 increased 666.7% compared to the prior ... business resulted in a significant gain, while non-GAAP diluted ... increased 3.2%, or 3.8% in constant currency terms.  Excluding ...
(Date:5/10/2017)... Md. , May 10, 2017 CSSi, ... solutions for the clinical research industry, is proud to ... www.CSSiEnroll.com . The new website features both enriched content ... user experience and enhances the company,s already well-established position ... industry. "After many months of hard ...
(Date:5/9/2017)... 9, 2017  Semler Scientific, Inc. (OTCQB: SMLR), ... to improve the clinical effectiveness and efficiency of ... first quarter ended March 31, 2017. ... customers to identify when preventive care options are ... like heart attacks or strokes occur," said ...
Breaking Medicine Technology: