Elections Have Consequences

By: Marcus Hopkins, Blogger

Those of us in the healthcare advocacy, education, and provider community come from all political backgrounds, every set of economic circumstance, and every stripe of religious upbringing; what brings us together, as a community, is our shared belief that all people deserve access to education, information, and service, when it comes to their health. To suggest that all members of any one community feel the same or share the same opinions discounts the individuality represented by our multifaceted composition – even narrowing down a single, universally held belief would be little more than a fool’s errand.

Though we differ on many issues, most of us can agree that access to affordable, reliable healthcare services can help relieve much of the stress felt by everyone when they’re faced with issues regarding personal wellbeing. While we me disagree on how best to ensure that access is available, it is virtually impossible to find anyone who would argue that certain people should not have access to healthcare.

Even within the Democratic Party, whose campaign promises in 2008 included massive healthcare reform, there is much dissent over how that got implemented – the Affordable Care Act. Since its passage, the ACA has seen its fair share of bumps in the road – missed deadlines, Federal lawsuits, over 54 votes to repeal all or part of the legislation – despite several setbacks, the ACA has, to date, managed to withstand all attempts at unraveling.

C-SPAN image of the House voting to repeal Obamacare

Health Care Law Repeal

But, as our current president once reminded us, “Elections have consequences.”

For three consecutive election cycles, the Republican Party (whose membership have initiated all repeal votes, and whose candidates have consistently run on the repeal of Obamacare) has gained seats in both houses of Congress. Democratic candidates, whose political ideologies consistently trend center-right since the 1990s, have largely failed to either iterate or campaign upon the ACA’s successes, instead choosing to address the law only when pressed to do so.

This hesitation on the part of Democratic politicians to campaign on arguably the largest piece of healthcare-related legislation over the past thirty years, combined with Republican politicians’ and pundits’ vehemence that said legislation is akin to Fascism/Socialism/Communism/Nazism, and must be repealed immediately (with or without replacement legislation), has left many in the healthcare community largely unsure on many fronts.

There are many unanswered questions pertaining to the law as it’s currently implemented, further pending lawsuits regarding Constitutionality of certain provisions within the law, and now, the potential threat of a partial or total repeal at the start of the next legislative session have helped to foster an environment of uncertainty and a lack of confidence for both consumers and providers.

What does this mean for people living with HIV/AIDS and/or Hepatitis C? The honest answer is, “…Can we get back to you, on that?”

For better or worse, HIV/AIDS and HCV have consistently had champions on both sides of the aisle; pinning down which political party has been more beneficial to either or both communities is difficult to quantify, as with long-term, chronic illnesses, care is measured not only in sheer numbers (metrics that are verifiable, and help to guide policy), but in terms of the quality of the care provided (stories that can be largely anecdotal, and help to guide sentiment and sway votes). What we have consistently discovered is that, when it comes to healthcare, “stories” are better at getting legislation started, moving, and passed, while numbers are better at getting funding.

If this is the case, the outcome for HCV patients may be more in their favor. Current infection data indicates that a good majority of HCV infections (either new or existing) lie in lower income, yet heavily Republican-leaning districts and states. With numbers becoming more distinctly clear (as more data is collected and disseminated), advocates are in a better position to convince right-trending representatives that HCV is, in fact, an issue that affects their constituency, and that it will behoove them to act in the best interests of both their constituents and themselves.

For HIV/AIDS patients, even with the gradual decentralization of new HIV/AIDS diagnoses out of large metropolitan areas, the path can be less clear. In many states, HIV-related stigma still shapes much of the policy decisions, despite being outdated; in the minds of many non-infected people living in these lower-income, heavily Republican districts and states, HIV/AIDS may be seen as a personal failing, rather than a healthcare crisis.

That doesn’t mean, of course, that there are not HIV/AIDS allies on the right side of the aisle. Former Governor Tommy Thompson (R-WI) has long proven one of the most effective and staunch supporters within the HIV/AIDS legislative movement since the 1990s. Furthermore, HIV/AIDS funding saw its highest increase in funding under George W. Bush (much of which was allocated and appropriated for combating the illness overseas, rather than in the U.S.).

And so, I leave you with this advice:

Don’t worry; be cautious.

Close scrutiny must be paid in the coming years, if we are going to go about ensuring that all people living with HIV/AIDS and/or HCV have access to medical services and medications. But, we must remember that, if we want allies in Congress who will help us to reach the people most in need, we need to make certain that we don’t alienate them, right out of the gate.

Remember – some of our best-friends are Republicans.

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