Paying the medical cost of the HIV epidemic: a review of policy options.
The complex health care needs of people with HIV infection highlight inadequacies in our health care financing system and raise the question of how best to pay for care. AIDS requires a broad continuum of care to maintain high quality and reasonable costs. A simultaneous need is to assure access to care for patients with HIV infection who lack insurance or entitlement to health care benefits. We suggest new and practical payment mechanisms that can encourage the availability of comprehensive care for people with HIV infection. We suggest changes in state and federal payment policies that would make the cost of providing AIDS care more of a collective, community responsibility. We recommend mandated workplace insurance, extension of Medicaid eligibility to all with incomes below the federal poverty level, an opportunity for individuals with incomes to 200% of the poverty level to purchase Medicaid coverage, mechanisms to encourage public and private agencies to pay for continued health insurance after loss of employment, and a shortened waiting period for Medicare disability.
Makadon
H J
HJ
Harvard AIDS Institute, Harvard School of Public Health, Boston, Massachusetts.
Seage
G R
GR
Thorpe
K E
KE
Fineberg
H V
HV
D000163:Acquired Immunodeficiency Syndrome / Q000191:economics*; D003365:Costs and Cost Analysis; D004196:Disease Outbreaks / Q000191:economics*; D035082:Federal Government; D015658:HIV Infections / Q000191:economics*; D006296:Health Services / Q000191:economics*; D006699:Home Care Services; D006801:Humans; D007348:Insurance, Health; D008484:Medicaid; D006278:Medicare; D012935:Social Justice; D014481:United States