by: Dr. Joan Waitkevicz

I’m a Board member ofPalm BeachCountyNOW.  I have taught community health workers, treated people with AIDS in the early years of the epidemic, and currently I do home care for people at the end of life.

I’d like to share informaiton about what happens when a young person without insurance gets HIV, cancer or other serious illness.

For 2 years in a row, Florida has over 4000 people with HIV/AIDS on a waiting list for life saving drugs.  We’re number one. Georgiais second this year.  They have 1660 people on their waiting list. 

ADAP, the AIDS Drug Assistance Program, a federal-state-private partnership, has been providing medication to Americans with HIV since 1987.  It is extremely unusual for there to be such a shortfall.

Why is it happening?  Unemployment.  People losing their health insurance they had from work, and their COBRA running out. 

Who is affected?  African- American Latina women are the most rapidly growing group.  African- American and Latino men who have sex with men.  But, as young people know, anyone could have HIV.  They’re not shy to ask a partner to take the test, or to take one themselves.

So say you test positive and fall within treatment guidelines.  What’s wrong with waiting for medication?  Imagine the stress.  You know that with treatment you can look forward to 20 or more years of health, like Magic Johnson.  Just as important, when on treatment you are less likely to transmit the virus to your spouse.

You both can stay healthy while your kids are growing up.  With your guidance, they are more likely to make good choices about sex.  And drugs. That’s why I believe treatment prevents AIDS in the next generation. 

But if you see people dying around you, you lose hope.  This is America.  Why should my neighbors in downtownWest Palm Beach have to explain to their kids why Mom or Uncle Ray can’t get medicine?  Under the Affordable Healthcare Act you can be sure those 4000 Floridians would be getting treatment.

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Now let’s consider what happens when a young person gets cancer.

At my job, I sign death certificates and have to review the records of people I have not treated.  A couple of years ago I read the record of a woman who lived near here. She said when she got her breast cancer she had her surgery.  But then because she was uninsured she and her family decided she couldn’t afford chemo. 

The sad thing is that chemo for breast cancer is highly effective.  At least it would have bought this woman more time with her kids. Why did she make that choice?  Was she trying to save for their college?  After this experience, how will those kids feel about the healthcare system?  Will their grief and anger lead them to make bad choices for themselves, never see a doctor? 

The Federal Government has had programs to detect breast and cervical cancer for the past 20 years.  It was one of the greatest achievements of the Congressional Women’s Caucus. So from 1990 to 2011 federal money was earmarked to find women’s cancers but not to treat them.  For treatment you had to spend down to get Medicaid.

In 2011 the Affordable Care Act has changed all that.  Today, if you have a condition that makes you uninsurable, and have had no health insurance for 6 months or more, you can apply to the DHHS for the Pre- Existing Condition Insurance Plan.  It’s direct fromWashington to you.  You don’t have to ask Rick Scott’s permission.

So if you’re age 40, like this women was, you can now get insurance for about $250 a month with maximum out of pocket additional expense of $5950 a year.   You can find the application at www.pcip.gov.

Doug Ullman got cancer at age 19.  He is now the CEO of LIVESTRONG.

In 2009 he said, “Over the years, LIVESTRONG has heard countless heart-breaking stories of families driven into financial ruin trying to pay for a loved one’s care while the insurance company abandons them in their time of need due to a technical error…the bill is not perfect, but it’s a big step forward.”

The 2010 U. S. Census says as many as 45,000 Americans (3900 Floridians) die in a year as a direct result of being uninsured.  The Journal of the American Medical Association, Annals of Internal Medicine and other professional journals tell us why they die:

The uninsured die of injuries.  People of all ages but especially children.

The uninsured don’t get:  ▪ Childhood vaccines ▪ Followup after a heart attack ▪ Followup after a stroke, especially if we’re young. (And by the way, African-Americans are much more likely to get stroke and breast cancer at a young age.) ▪ Coloncancer screening ▪ Rural health care ▪ Prescription medicines ▪ Urgent care

Uninsured people do get more of one thing: hospitalizations. For late stage illness that has been neglected.

The right wing says “These people die because they have bad habits.”  Not because they’re uninsured.  They say, “These people don’t take care of themselves.”  

With respect, how can you learn how to take care of yourself if nobody in your family has had 21^st century healthcare?  

And I ask the right wingers: Do you think the government should help teach people how to take care of themselves?  I don’t really think they do.

The Affordable Care Act is a big step toward everyone getting the 21^st Century care and the teaching.  It is here.  It is ours.  And I believe it is worth fighting for.  I hope you agree.  Thank you.