What's Wrong with Coburn's Legislation
Contact Tracing, 'Routine' Testing & Mandates
- "Routine testing" means testing without explicit consent. Anytime someone draws your blood, you can be tested for HIV without your knowledge.
- Voluntary testing means that a patient is already involved in his or her health care, and has options for counseling and treatment. Routine testing does not necessarily take into account the affected person's point of view.
- One of the main reasons for testing and notification is that early treatment can help. But many of those tested with out consent for example, prisoners, and many of the uninsured will not receive treatment.
- Mandatory reporting and contact tracing will force anonymous testing sites to close. But many people report that they would not have been tested if they could not have done so anonymously. And those who test in anonymous sites are more likely to be positive than those who test elsewhere. Many will simply avoid health care.
- Contact tracing isn't easy. Think about the government tracking down your sexual partners.
- And it's expensive. Is the money for this going to come from the tiny and already strained budget for AIDS prevention?
- No other disease is required to be reported by federal mandate.
- States are already free to require notification, and four states have done so: Arkansas, North Carolina, South Carolina, and Oregon. Note that these are not states noted for their care for HIV-positive people.
- Both names reporting and contact tracing have been subject to disturbing abuses around the country.
- The Coburn bill prevents states from tailoring prevention efforts to different communities. Contact tracing and partner notification do not mean the same thing in all contexts.
- It invites a return to the hysteria of the 1980s. Instead of offering resources to the affected people, it merely identifies the HIV positive for surveillance and discipline.
- Because the Cobern Bill withholds Medicaid funding for states that do not comply with its mandates, it could jeopardize health care for people with HIV. (For example, nearly two out of three New Yorkers with HIV depend on Medicaid.)
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