Message from Congress: World AIDS Day

Dear Friends,

 

Today, as we commemorate World AIDS Day, we must reflect both on the lives lost and on our moral obligation to provide necessary treatment and research dollars for those living with HIV/AIDS.  As a senior member of the House Energy and Commerce Committee's Health Subcommittee, I understand the urgency of this issue.  I pledge to continue my efforts to halt the spread of this terrible disease, and treat its victims.

I have continally fought for increased federal money for New York to treat the more than 135,000 New Yorkers who are living with HIV, and the over 87,000 others who are dealing with an AIDS diagnosis.

New York still remains the epicenter of HIV/AIDS in the U.S., with the AIDS case rate equaling more than 3 times the U.S. average. Through 2009, over 200,000 New Yorkers have been diagnosed with AIDS.  Sadly, HIV is the 3rd leading cause of death for New York City residents aged 35 to 54.  Worldwide, the epidemic is even more severe.  In South Africa, the Joint United Nations Programme on HIV/AIDS estimates that there are 5.6 million people living with the deadly disease, and that's just in one country in Africa.  The numbers are equally staggering throughout the continent.

I am proud of the work I have done on my bipartisan Early Treatment for HIV Act (ETHA).  While I was able to have it included in the House version of the Affordable Health Care Act (H.R. 3269), but it was omitted from the Senate version which eventually became law.  The legislation would reform Medicaid rules mandating that people be disabled by AIDS before receiving treatment.  National health guidelines recommend early and aggressive treatment for those with HIV - in order to keep illnesses from progressing to AIDS.  ETHA would allow states to treat low-income individuals with HIV under the Medicaid program  at an enhanced federal reimbursement.  HIV will no longer have to be a death sentence for many people, because of the new medical treatments available today.  Once the insurance exchanges and Medicaid expansion, created in the Affordable Care Act, are up and running, much of the focus of my legislation will be realized as patients will be able to gain access to insurance coverage for HIV/AIDS treatment through the exchanges.

Globally, we must always be mindful of the 33.4 million people currently living with HIV/AIDS.   Tuberculosis is the leading infectous killer among adults with HIV/AIDS, as it preys upon those with weakened immune systems.  I wrote the Stop Tuberculosis Now Act, which was included in the 2008 President's Emergency Plan for AIDS Relief (PEPFAR) reauthorization.  Worldwide, close to 2 million people were killed by tuberculosis in 2007, and my legislation will go a long way towards providing resources to those suffering from both diseases.
Some other alarming worldwide data:

• Young people aged 15-24 account for 40 percent of all new adult HIV cases.
• 2.1 million children are currently living with HIV, there were 430,000 new infections in 2008 and 280,000 deaths.
• There are approximately 17.5 million AIDS orphans - children who have lost one or both parents to AIDS - 81% of whom live in sub-Saharan Africa.
• Almost 1.2 million Americans were living with HIV or AIDS in 2008, with 55,000 new cases of HIV each year, according to the CDC.
• African-Americans make up 12% of the U.S. population but account for approximately 45% of those newly-infected with HIV, according to the CDC.  Gay and bisexual men make up about 2% of the population, but account for 61% of new HIV infections, and nearly half of all Americans living with HIV.
• Two million people died from AIDS in 2008, and more than 16,000 people die each year from AIDS in the U.S.
• AIDS has killed 30 million people worldwide - half as many people as were killed in World War II.  There are 34 million currently living with HIV, dwarfing the total amount of Americans who have been killed in armed conflict.  Ever.

Working together, we can address both prevention and early treatment options and hopefully one day find a cure for AIDS.  The fight against AIDS began in 1981, and will continue until a cure is found.  The current administration, and the two preceeding it, have made huge commitments to fighting the AIDS epidemic at home, and all over the world.  Together, we can make a difference.

I will continue tmy work in Congress, using the resources at hand in both committees on which I serve (House Energy and Commerce and House Foreign Affairs Committees), to make a difference in the lives of those living with HIV/AIDS and their family members who suffer along with them.

Sincerely,

Eliot L. Engel
MEMBER OF CONGRESS

A Message from Congressman Engel

Dear Friends,

 

I found it to be very puzzling that after the American people made it loud and clear that job creation and the economy were the most important issues facing our nation today, the new House Majority felt compelled to instead grandstand with their first major act of 2011.  Knowing full well that the Senate would never support it, and that President Obama would veto it, if it ever reached his desk, the Majority tried to score points by passing a repeal of last year's landmark Affordable Care Act.

Make no mistake about it -  the majority felt compelled to remove health care coverage from 30 million Americans rather than take up any jobs bill that their colleagues in the Senate managed to repeatedly block last year.  This was nothing but a charade and a terrible way to show the American people that they plan to work in a bipartisan nature this year to fix the many problems facing our nation.  If it became law, the repeal of the Affordable Care Act could cause some Americans to get so sick their lives could be in jeopardy, and it would certainly bankrupt others.  It is irresponsible governance and diverts the focus from putting Americans back to work, and instead would put millions of others out of work.

Repeal would take away health care from over 30 million people, forcibly remove young adults, up to age 26, from their parents’ health plans, leaving them vulnerable to health crises, it would reopen the ‘donut’ hole to increase costs to seniors for prescription drugs, and empower insurance companies to discriminate against people with pre-existing conditions – which includes HALF of the American population.  If the Majority was serious about fixing the health care system, surely there are ways we could work together to improve the bill.  However, I wonder since there was no comprehensive reform which took place during the many years they controlled the House, Senate and Presidency.  This repeal was not governing, this was grandstanding.

Instead of throwing the baby out with the bathwater, we should get together and try to make the law better.  Every major piece of legislation has been tweaked over time - the Civil Rights laws were done in several stages, Social Security has been altered, Medicare has had changes, etc.  The Affordable Care Act is not perfect and certainly we can find middle ground on some changes.

The reality for Americans is that repealing the Affordable Care Act would:

• Deny insurance to 32 million Americans – once again placing the burden of care upon more expensive emergency rooms.
• Explode the deficit by $230 billion by 2021, according to the non-partisan Congressional Budget Office.
• Re-open the “donut” hole for Medicare Part D prescription drugs increasing costs for millions of seniors,
• Force young Americans up to 26 years old to be removed from their parents’ plans and be on their own should catastrophic health issues occur,
• Allow insurance companies to deny coverage to ailing Americans with pre-existing conditions, and to cap the coverage of others who are in great need of care,
• Increase the taxes on small businesses who provide health care for their employees,
• Halt the preventative cancer screenings and annual check-ups for seniors,
• Force high-risk Medicare patients who are hospitalized to be continually readmitted, rather than allow for comparable services in community care programs,
• Stop advances in health care technology rather than looking ahead at new and innovative ways to care for Americans in the 21st century and beyond.

For District 17 in New York (Bronx, Rockland, Westchester Counties), the consequences of repeal would mean (according to statistics provided by the House Energy and Commerce Committee):

• Up to 289,000 people would be vulnerable to coverage denials from insurance companies, including up to 42,000 children, due to pre-existing conditions,
• 400,000 people would lose consumer protections from their employer-based insurance or private insurance,
• Up to 15,000 small businesses and 136,000 families would lose health care tax credits,
• 7,000 seniors would pay more for prescription drugs from the re-opening of the “donut” hole in the Medicare Part D drug plan,
• 91,000 seniors would be denied preventative care benefits, halting treatments which could nip devastating diseases in the bud,
• 9,300 early retirees would have their health costs increased
• 2,700 young adults would have their new health coverage eliminated,
• 49,000 more people would be left without health insurance
• $312 million annually would be added to the costs of local hospitals to provide uncompensated care.

I call on the Majority to come forward with suggestions to make the law better, rather than totally scrap it.   If they have a plan to cover the 30 million people we are covering, and are able to do so with a Congressional Budget Office score better than ours, then I welcome the discussion.  I am certain the over-200 organizations opposed to the repeal would agree.

Sincerely,

Eliot L. Engel
MEMBER OF CONGRESS

Summary of Federal Health Care Reform

Federal health care reform

NPR: Why picking a doctor is harder than ever.

Michelle Andrews from NPR has written the following article about why it's difficult to find a doctor in today's world.  The article discusses several reasons and it's important to address these issues to improve the continuity of care as well as pursue the mission of accessible care for everybody.

In just a few weeks many people who get health insurance on the job will have to pick a health plan. Often the decision boils down to which one has your favorite doctors within the network.

Your choices might be even more limited this year than in previous ones, if your employer is looking, as most are, to slow the rise in health costs, So if you're in the market for a new doctor, how do you decide? It's not easy.

While U.S. News & World Report has "best hospital" rankings, they don’t necessarily always reflect where to go if you need a procedure. But they are, at least, compiled from hard data as well as broad surveys of specialists in the fields. But with few exceptions, there's not a lot of quality information out there on doctors.

You probably put more research into buying a new television than into picking a doctor. When consumers do shop for a physician, who they trust for advice varies a lot on the type of doctor they're looking for.

If it’s a primary care physician someone's after, about half of people turn to friends and relatives; and more than a quarter of those people look no further than people they know, according to a study by the Center for Studying Health System Change.

But when a specialist is needed, nearly 70 percent of people rely on a referral from their primary care doctor, and only 20 percent turn to friends and relatives.

Of course, most people with insurance already have a primary care physician or have visited one, so it’s easy to weigh in with suggestions. But when it comes to medical problems you need a specialist for, even if you’re willing to share private details with friends, it may be tough to find people who can make a personal recommendation for a doctor who does hip replacements or treats overactive bladders, for example.

In addition, “I think there’s still quite a lot of patient trust in their physician,” says Ha Tu, a senior health researcher at the Center for Studying Health System Change and the lead author of the study. “When they need a specialist or procedure, it’s hard for secondary data sources to replace that relationship.”

That’s unfortunate news for the health plans that are under pressure by state and federal government officials to keep costs down. They're nudging members to use physicians they rate highly for providing the best care for the least cost. People consult health plans for information less frequently than they do either friends or other doctors, according to the study.

Health insurance plans tend to evaluate doctors more on cost than on quality. Right now, most consumers still don't have much incentive to pay attention to costs, because they’re not paying much out of pocket for their care.

In fact, cost remains one of the least important factors consumers consider when choosing a physician, whether primary care or specialist, according to the study. Just under 30 percent of primary care physician shoppers considered cost; for specialists, the figure was even lower: a tad more than 12 percent.

Congress: Health Care Provisions for Young Adults

Dear Friends,

Each spring marks a time of new opportunities for our recent college and high school graduates entering the workforce. Earning your degree is no small feat, and those who have been given their diplomas this year deserve all of the praise and accolades which have come their way. However, this is not the end of the journey. In fact, it is really just the beginning. These young future leaders of our nation will be facing much uncertainty as they embark on their careers. Thankfully, for over 13 million of them, having health care will not be one of those challenges.

As families and small businesses continue the slow and steady climb out of the recession which reached its apex in December 2008, far too many people were forced into situations where they lost coverage, were denied care or forced to pay exorbitantly high premiums. In many cases, young adults without employer-based coverage were forced off their parents' plan until they were able to find a job that actually offered health coverage. Thanks to the new health insurance reform bill, young adults will now be able to retain health coverage while they work towards standing on their own two feet.

According to a report issued by the Commonwealth Fund, the Affordable Care Act will enable the vast majority of uninsured young adults - up to 13.7 million of them - to gain coverage. Young adults, the most uninsured age group, will be able to take care of their most important asset, their health. As a parent, I believe that knowing my children could be cared for when they are sick is a huge relief, and I am proud to have supported this legislation for this reason and many others.

The law's provision requiring health insurers to extend dependent coverage up to age 26 for young adults on their parents' plans will go into effect this September. This means that millions of our children can go to the doctor when sick, and not hold back because they fear the cost. Many insurers have elected to implement this provision early, filling in the coverage gap for many new college graduates. In the cases of those young adults with serious conditions, this could be life saving.

The newly-created insurance exchanges and lower premiums for lower- and moderate-income families - which begins in 2014 - will provide coverage for six million more uninsured young adults. In addition, new insurance regulations, an essential benefits package, and limits on cost-sharing will ensure young adults have comprehensive health insurance to protect them from high out-of-pocket costs. Expanding Medicaid eligibility will also provide coverage to millions more young adults. The Affordable Care Act eliminates lifetime limits on coverage - another provision to take effect in 2010 - which will protect young adults from devastating medical debt.

A lot of attention has been paid on many other groups in relation to the health care debate, but its our young adults who have the most to gain from this law. As a father, I have always tried to provide for my children and, of course, that does not end once they stand on stage in their cap and gown. Clearly, I am not alone in this thinking and I am extremely proud to have cast my vote for this law so that my children and yours will have a healthier future.

Sincerely,

Eliot L. Engel
MEMBER OF CONGRESS

CNN: Why do Latinas avoid the doctor?

Here's an interesting article off of the CNN website about Latina women and their fear of going to the doctor. One must question, though, if this is only about Latina women. This could be a trend in immigrant populations across the board. But it raises an interesting question about cultural sensitivity.

By: Sabriya Rice
CNN Medical Producer

Social and cultural factors may play just as big a role as economics in the poor health care outcomes of Latinas, a new study finds.

The small study, published in the journal Ethnicity and Disease, looked at Latinas in upstate New York found that 70 percent of the women reported delaying doctor appointments, even though nearly all had insurance and over half had diagnoses of chronic medical conditions including diabetes, heart disease and cancer.

"Diagnosis should typically motivate you to seek further attention," says Janie Jurkowski, an assistant professor at the University at Albany's School of Public Health and lead author of the study. "It's really quite scary and striking to see that even with a chronic disease people are delaying care.”

Among the reasons the women listed for avoiding their doctor appointments included opting for alternative therapies, previous experience with discrimination in a clinical setting and a preference for doctors of their own race who "speak their language." Jurkowski says the cultural competence of the provider is very relevant in today's society and efforts to diversify the work force, provide interpretation services and encourage cultural sensitivity benefits everyone in the long run.

"The longer the these patients delay, the worse the outcome and the more rigorous and costly the treatment,” Jurkowski notes. “Getting people in sooner would be better for the healthcare system as whole, especially in the era of rising costs. "

Most of the participants in this study were of Dominican and Puerto Rican heritage, however the trend has been viewed in other Hispanic groups in the U.S., and the number of Hispanic Americans continues to rise. According to census reports, the Hispanic population is increasing at more than three times the growth rate of the total U.S. population, and by the year 2020 Hispanics will represent nearly 18 percent of the U.S. population.

"There are lot of places in this country that are seeing fast growing Latino populations, and the health care system is not ready culture-wise to respond to the growth," Jurkowski says.