By: Marcus Hopkins, HEAL blogger
We here at HEAL Blog have consistently hammered home our belief that testing for Hepatitis C become common practice in the course of medical examinations. This January, Florida State Representative Mia Jones (D – Jacksonville) filed legislation requiring doctors to offer patients an HCV test during check-ups.
This is an important step forward in the fight against HCV, particularly in a state like Florida, where the highest afflicted demographic (Baby Boomers born between 1945-1965) make up a significant portion of the population (18.2%).
What is important to note about this piece of legislation, HB 465 is that it requires only that doctors offer the test, not that the test be conducted. There are exemptions built into the bill for those who are facing a life-threatening emergency, are unable to consent, or have already been offered the test.
In addition to the obvious risk posed to Baby Boomers, another demographic should be considered, as well – people between the ages of 13-25, particularly Men who have Sex with Men (MSM).
While HCV’s most common manner of transmission remains injection drug use, the increase in popularity of injectable drugs within the MSM community increases the likelihood that HCV will be spread via sexual contact. Combined with an increased incidence of unprotected sex practices within this age demographic, there is little indication that the trend of sexual transmission will abate.
This demographic is one of the least served groups in America. People in this age range are less likely than their older peers to visit the doctor outside of an emergency, largely due to the perception that healthcare is out of their price range. As a result, they are also less likely to be made aware of any conditions for which they might not normally be screened.
Requiring that doctors at the very least offer testing to every patient is a small step, and means little more work for practitioners than simply asking the question. Whether or not the opportunity is taken advantage of is up to the patient.
This sort of common sense legislation is the type of advocacy we need to see in our state and Federal houses, but there are concerns on the part of Republican representatives and the Florida Association of Health Plans that the bill would “mandate” additional coverage.
In the wake of contentious battles over the Affordable Care Act, it would appear that insurers and the representatives who represent their interests in state and Federal governments have little appetite for legislation that requires coverage be offered for any additional medical conditions.
Both patients and insurers have consistently seen costs for HCV treatments as being “untenable,” both in terms of financial costs and in terms of reactions to treatment. The side effects of many of the traditional HCV therapies have kept many patients from seeing the regimen through to conclusion.
New treatment options are becoming available, two of which we’ve covered assiduously in previous posts, OLYSIO and Sovaldi. The costs of these two medications are, however, prohibitively high without Patient Assistance Programs. Both manufacturers for these drugs offer PAPs for their products, which greatly reduce the burden shouldered by individuals with lower incomes or little/no insurance coverage.
Insurers believe that mandating coverage for HCV treatment would require that they shoulder a greater financial burden, negatively impacting their bottom lines. This, of course, would result in patients being forced to ask for assistance when they mistakenly believe their insurance should cover the cost of treatment.
It is the opinion of this author that the crisis we face in terms of HCV far outweighs the financial interests of health insurance companies and their shareholders. The long-term costs of care associated with liver degradation and failure far outpace those of simply treating the illness when it’s first detected.
When insurance companies and legislators focus on near-term expenditures without taking into account the increased costs associated with failure to treat illnesses when they’re first detected, the primary victims of their shortsighted approach are patients.
HB 465 is an important first step to combating the spread and long-term consequences of HCV, and it is important our readers in Florida contact their local representatives to tell them to vote in favor of its passage. I feel it is incumbent upon our readers in other states to contact their representatives about crafting similar pieces of legislation.
Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.