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Mich. gov. ignored HIV and AIDS in health message to legislature

When Gov. Rick Snyder issued his health and wellness message to the legislature last week, HIV activists were hoping to hear from Snyder about how he intended to address the HIV epidemic in the state. They were sorely disappointed.

A press release from his office listed the following items as other targets in addressing health issues in the state:

– Developing strategies to address Michigan’s current and anticipated shortages in the health care sectors. The state could face a shortage of anywhere between 16,000 and 24,000 physicians by 2020.

– Reviewing the 30-year-old statute under which Blue Cross and Blue Shield of Michigan operates to make sure it is up to date.

– Achieving better coordination between the federal Medicare and state Medicaid programs on behalf of the more than 205,000 residents who are dually eligible for both programs.

– Aggressively dealing with the challenges posed by autism, a pervasive developmental disorder that affects one out of every 110 children born today. To date, 27 states have changed their laws to require insurers to cover evidence-based therapies for autism that will save taxpayers billions of dollars.

– Pursuing additional Federally Qualified Health Centers (FQHCs) for Michigan. FQHCs are federally funded community organizations that offer care to people of all ages, regardless of their ability to pay. Only 29 of the total 1,048 FQHCs are in Michigan.

– Helping Michigan veterans access their benefits. Only 19 percent of Michigan veterans use their U.S. Department of Veterans Affairs health care benefits compared to their counterparts in other states who use theirs at rates closer to 25 percent.

– Giving the Michigan Department of Natural Resources the authority to require that all state-owned and operated beaches be smoke-free. Tobacco use is the leading cause of preventable death, killing 14,419 Michiganders in 2009. It also costs the state more than $3.4 billion a year in health care costs.

– Encouraging policymakers to include the expansion of the successful Healthy Kids Dental program as a priority item during the fiscal year 2013 budget cycle.

– Incorporating Body Mass Index (BMI) information in the Michigan Care Improvement Registry, which tracks childhood immunization records. This will increase obesity screening rates and improve treatment of childhood obesity.

– Working with Michigan’s farmers to alleviate the state’s obesity problem.

Snyder’s message dealt with addressing obesity in the state, which Snyder said costs the state $3 billion a year. He also said he wants to address infant mortality and teenage pregnancy. However, his message avoided discussions about issues such as condoms, birth control or even which educational curriculum the Republican governor would advocate, abstinence-only education or abstinence-plus. The former program teaches youth that abstinence is the only option, while abstinence-plus teaches that abstinence is the best choice, but if youth are going to engage in sexual behaviors, there are ways to prevent pregnancy and sexually transmitted infections.

But his message said nothing about HIV and AIDS, prompting criticism from activists in that area.

“The Governor has wrapped the entire health care issue into talking points that all have the same outcome: Blame the patient. It doesn’t matter what chronic health issue he’s talking about, in the end according to the arguments put forward in this statement, if patients just wouldn’t get sick, we wouldn’t have health care issues,” says Mark Peterson, spokesperson for Michigan Positive Action Coalition. “Since his argument is all about responsibility, I’m not surprised that HIV/AIDS was not mentioned at all in this announcement. This is especially noteworthy because it seems that the Snyder administration’s goals around HIV/AIDS consists of underfunding, underprioritizing and focusing on cost in the short term. This, of course, is completely shortsighted and in the next few years we’ll reap the outcomes of this ‘business minded’ approach to dealing with terminal illnesses.”

There are an estimated 18,000 people in Michigan living with HIV/AIDS. According to the Kaiser Family Foundation State Facts in June 2010, 2,321 people received assistance through the state’s AIDS Drug Assistance Program. That program pays co-pays or for the entire cost of drugs to treat HIV and opportunistic infections. The program cost $32,704,231 in 2010, a 35 percent increase over expenditures in 2009.

And it is not just HIV that was left unmentioned in the message. Sexually transmitted infections were also conspicuously missing from the message as well. This in spite of the fact the state saw 50,430 cases of chlamydia in 2010 (up from proceeding years), 13,919 cases of gonorrhea (down from proceeding years) and 607 cases of syphilis (down from proceeding years).

“The prevention and treatment of HIV and STDs are priorities for the administration and the MDCH,” said Geralyn Lasher, communications director for Snyder. “There were several topics we were not able to cover in the special message, including cancer, Alzheimer’s, diabetes, etc., but that in no way should imply they are not priorities.”

Lasher referred additional questions to the Michigan Department of Community Health, which did not respond to inquiries by press time.

But MIPOZ’s Peterson disagrees.

“Because of the Snyder administrations short term focus on costs and away from supporting any logical approach to comprehensive prevention and care services for HIV, we will have increases in new infections, increased demand for medical care from those without medical insurance and, due to shrinking the provider network, more negatively impacted health outcomes for people living with HIV,” says Peterson. “Forget what this says about basic human compassion, it doesn’t even make any fiscal sense. Health outcomes for people at-risk for and living with chronic terminal illnesses are not computer parts, but the governor’s plan fails to recognize this obvious distinction.”

Joshua Moore, who runs Detroit Legal Services specializing in cases involving HIV, was also disappointed by the lack of call to action from Snyder.

“It is troubling because it gives a false message that this epidemic is somehow not as bad as it once was. The truth is that more and more people, especially young people and minorities, disproportionately are being infected. I personally find it hard to believe that the governor would accidently forget to mention HIV in his message,” Moore said.

“The stigma surrounding HIV is enormous, especially in minority communities,” he continued. “The governor only reinforces those myths surrounding this disease by willfully ignoring the issue of HIV. The community looks to Governor Snyder to take the lead in combating the stigma surrounding HIV/AIDS, because the refusal to talk about it with our leaders in the community only can lead to more infections.”

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