The American health-care debate from an HIV patient’s perspective


I do not understand all the ins and outs of the American health-care system, neither that which existed before today’s vote in the House of Representatives nor the one after.

Here’s what I do know.

Canada has a single-payer health system for hospitalizations, doctor’s visits and related expenses such as most diagnostic tests. Coverage of pharmaceuticals remains a gap with only private insurers, usually with co-pays, covering employee benefits and only provincial governments paying for drugs for those on social assistance or those in need of “catastrophic” coverage. (In most jurisdictions, the thousands of dollars for HIV/AIDS and related drugs each month fits the definition
of “catastrophic”.) These provincial plans only came about as the result of hard work by coalitions, led by AIDS activists, in the 1990s and they vary from province to province which is why a national pharmacare plans remains a dream.

Such a plan only makes sense with hospitals, where patient drug costs are absorbed, treating only the sickest of people. Most of us are able to stay out of hospitals thanks to medications.

This month my eleven prescription medications cost $2589.72, nearly all of which the government pays (to be clear). The most expensive, because they are new and freshly-patented, are the four HIV treatments. However, with buyers as large as the governments of Canadian provinces, bulk prices are negotiated to everyone’s benefit.

My single-payer health-care allows me to visit any hospital emergency room in Canada, as well as my taxpayer-financed family doctor, my HIV specialist, my psychiatrist and my dermatologist with nothing more than the swipe of a provincial government health card.

Are there ‘uninsured’? Sure but people such as the homeless are treated in emergency departments and in street clinics as necessary.

I’m curious to know how I might have fared, these past twenty-one years of living with HIV, had I lived in the United States. I am very optimistic that the system there will change – even if not all at once – in the next few years.

4 thoughts on “The American health-care debate from an HIV patient’s perspective

  1. As I sit here listening to the debate on our health care reform here in the United States I keep asking myself each time someone stands up and says “Americans don’t want health care reform” I have to ask myself who they have asked, furthermore when they asked did they tell the truth.

    I am in the last stages of my blog on this issue as well as my vlog on my youtube channel. So give me a few hours and I will try to give me perspective on health care reform and share my experience of having and not having health care

  2. Americans with HIV or AIDS and no medical plan die a lot sooner than Canadians.
    When i watched the debate I kept thinking, if they say Americans don’t want government funded health care, what do people do who don’t have health care insurance. Did anyone ask them?
    If you can not afford to pay for medical services in the U.S.A. and no one will treat you without being paid, you die. i don’t think people want to die nor have their children die.
    when I saw Americans demonstrating before the vote, against government health care I wondered if anyone asked people with out health insurance if they wanted it or did they want to become very ill and die.

  3. Holy Shit $2589.72!!! That’s a lot of money. With my hiv meds here in Montreal, I pay no more than $78.00 for all of my medications/monthly. When I lived in the U.S. I was on medicare and that was a pain in the ass, the things they made me do to get coverage. In the U.S. people with AIDS are encouraged to die quickly. because staying alive having to jump through hops would make the weak fall quickly. I was paying hand over fist for medications. It got so bad in the end, that I had to choose to pay for food, pay rent or pay for medications. I could not pay for all three at the same time. Not with an under the table job. Thank God I am Canadian. I can’t imagine what it takes to stay healthy with HIV in some areas of the U.S.

    Jeremy in Montreal.

    • Thanks, Jeremy, let me clarify. The $2589.72 figure was retail. I only pay a deductible, based on income, amounting to about $160 quarterly plus $2 per prescription.

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