As an American gay man, living in the UK, but with a vote in the New Hampshire primary, there is one thing that has become clear to me recently, especially since the Human Rights Campaign (HRC) endorsed Secretary Clinton: Bernie Sanders is the best candidate for the LGBT community, and specifically, LGBT-ers living with HIV.
But why go against the HRC? Let's start with a look at the history of the LGBT movement in the US. LGBT politicization centered around the AIDS epidemic of the 1980s, because, back then, Silence = Death. But that's over, right?
Wrong. A 2014 Gallup study found:
Americans who identify as [LGBT] are more likely than non-LGBT Americans to report that they lack health insurance. While the percentage of LGBT adults without health insurance has decreased significantly since the Affordable Care Act's provisions requiring Americans to have health insurance took effect at the beginning of 2014, they are still more likely to be uninsured than their non-LGBT counterparts.
So, what happens to these uninsured LGBT Americans, in The HRC and Clinton's America, if they are HIV+? Does the virus know it's not the '80s and that recent studies show patients on medication paradoxically live longer than their negative friends, because their overall health is more closely monitored? (Chris Sandford, Patient Advocate, in conversation at The Bloomsbury Clinic, Mortimer Market Centre, London, UK).
No, of course not -- it's a virus. Untreated, HIV still kills uninsured LGBT Americans. Unfortunately, according to Clinton, we must stick with Obamacare, where many fall through the cracks , and we can't save them with a universal, single-payer system, like almost every other Western country -- because Americans can't save money with nice things, or something.
But how does single-payer save money on HIV treatment, specifically?
According to The Bloomsbury Clinic, one of the leading treatment and research centers for HIV in the UK, a routine patient costs £1600 annually out of their tax-funded budget -- just under $2300, including all visits, all blood work, and, most importantly, all medication. (Sandford,) This is because under single-payer, a government has better bargaining abilities than individuals, who have none -- Martin Shkreli couldn't happen in single-payer.
But what does $2,300 buy a patient in the U.S. who doesn't have insurance?
Five weeks of pills. For the price of an entire year's worth of service at a tax-funded clinic in London, uninsured Americans receive five weeks of pills, despite scientific proof that continuous treatment is necessary. (Listed US retail price for a month's supply of the two most common antiretroviral drugs, isentress and truvada, that must be taken together, in order to be effective.)
Why is continuous medication important? Once a patient's viral load becomes "undetectable" (4% chance of transmission.
A leading physician at the Bloomsbury Clinic, believes though further study will reduce this number to 0% -- un-transmittable. (Dr. Sarah Pett, FRACP, FRCPE, Ph.D, Senior Clinical Lecturer in Infectious Diseases, UCL Research Department of Infection and Population Health and MRC Clinical Trials Unit at UCL)
This needs repeating. The BEST way to stop the epidemic that once galvanized our community is treatment. And continuous treatment is only possible for every patient under single-payer -- which only Bernie Sanders offers.
Dr. Sarah Pett had further comments on these issues, which remains contentious in the U.S., yet they are answered with a simple economically sound morality abroad.
...one of the great things that we negotiated and got the green light for in the UK, and one of the few countries to do this is, is to provide free treatment and care to anyone in the UK who is positive, you don't have to be a tax payer, you don't have to be here legally. Our feeling was that we should take the politics out of this, and just offer proper health care irrespective of any of that other stuff.
From an economist's point of view, of course you're going to treat all patients who present with HIV with medical treatment. Why? We come back to this point, again. Medication = Prevention. Just because they're in the country illegally does not mean they're not going to transmit the virus without treatment. There is no border crossing between our naughty bits to check passports.
But in the HRC/Clinton America, the only option to achieve this level of blanket treatment, single-payer, is off the table. And she continues to evade answering why it is off the table.
Yet again, Silence = Death. This time, it's not Reagan shutting down LGBT Americans, it's the HRC, and Secretary Clinton. An "AIDS-free generation," which Clinton herself has touted, actually is impossible without single-payer.
It's our duty to continue to act up and fight for these uninsured members of our community--because Clinton sure won't. And they fought hard to get us the right to marry.
So what's the best way we can act up and make sure they stay alive? Support Bernie.