Recently Kaiser Health News published a story about the concerns some people living with HIV/AIDS have about Obamacare. As the Affordable Care Act is implemented, many have questions about how current insurance coverage may be affected and whether funding streams like the Ryan White Care Act will survive.
These are all very appropriate concerns as the nation rolls out the most dramatic change in healthcare delivery since the 1980s’ introduction of a Medicare payment system that based reimbursement on algorithms by patient’s principal diagnosis, ICD diagnoses, gender, age, treatment procedure, discharge status and the presence of complications or co-morbidities. While the “Diagnostically Related Groups,” as this system was called, resulted in many positive outcomes, there were also cases where seriously ill stroke patients were sent home a day after admission, sometimes before they fully recovered, because the hospital could no longer get paid for a typical 4-5 day stay. Unintended kinks in new systems are not all that uncommon.
Since we have 31 years of experience working with low-income people living with HIV/AIDS, we have our own views on all of this. We strongly believe that as this revolution in healthcare unfolds, people living with HIV/AIDS and all other chronic illnesses need safety net services and advocacy that will ensure continued care access and positive health outcomes. As one man interviewed in the Kaiser article stated: “”My medical is very well-managed,” said Land, an insurance adjuster before he retired in 1993 because of his illness. “But I also need that wrap-around care that helps me live every day. In my 15 minutes with the doctor…I am not going to get that.”” We couldn’t agree more.
Comprehensive care including stable housing, mental health services, food and healthcare coordination are the foundation for surviving and thriving. Bailey House built this model in the early epidemic because it made sense. Now after 31 years we have lots of data to prove it. Let’s make sure that as the nation seeks to cut costs, it doesn’t disassemble what makes the rest work.
To read the full Kaiser News article, click here.