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Do insurance companies and employers discriminate against people after they are informed that a person has HIV/AIDS? This is an important question at issue because many people and their loved ones are affected with terminal diseases, such as HIV/AIDS. Also, it is important because they are treated with disrespectful and it is not how any human being should be treated or cared for. They are regular looking and acting humans that happen to be infected with this horrific disease and that is the sole reason that they are being discriminated against. The public is unaware that they will not get the disease by touching the victim or using the same products or utensils as them. The only way that they could catch the disease from anyone is if they have sexual relations with them or if the share needles by taking drugs with someone who is infected with the virus.
“Two decades after HIV first appeared an estimated 30 million people worldwide have contracted the virus; 11.7 million people have dies of AIDS” (Frankowski xi). This deadly virus has continually and rapidly spread to all different people. Around the world this virus is a major problem and is affecting more women and children then ever before. Although when this disease first appeared it was male dominated, but they have passed it on to the women and in which case they pass on to their children when they are in the womb.
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The question at issue brings to the fact that this is an unsolved problem. This issue needs to be addressed and their needs to be steps taken to help solve this problem. This problem is unresolved because it is a fairly new issue. Therefore, there is no cure. Many people are affected by this disease not only in the United States, but it is also a major problem in Africa and around the world as well. That is why the research and effort put forth into finding a cure is very important to many people’s lives. The last few years this disease has increased rapidly, and for that reason specialists do not want to fall behind and truly want the best for the future. They know if they do not get the number increased under control, then there would be no better and healthy future. In addition, if people are planning on living longer lives, then specialists need to find a cure for this deadly disease that has affected many people. In search for a cure and more information, researchers spend numerous hours of their time in the lab with millions of dollars that has been donated, raised or given to by the government in order to research, fight, provide the victims with adequate care and most importantly to find a cure for this horrific disease.
History of the HIV/AIDS Epidemic
In 1981, AIDS (Acquired Immune Deficiency Syndrome) was first diagnosed in this country. At that time, it was closely identified with GRIDS (Gay-related Immune Deficiency Syndrome), but now more people refer to it by the disease that it causes, HIV (Human Immunodeficiency Virus). This virus can cause two different diseases which both are fatal, AIDS and AIDS – related complex (ARC). Also, there are two forms to HIV, HIV 1 and HIV 2. HIV 1 is the more serious type, and has an estimated average of seven to ten years of life. Compared to HIV 2, which is the milder of the two, but still deadly, having an average of 20 – 25 years of life. If specialists prove that a person with HIV 1 may be more immune to the more serious HIV 2, then there is hope that the medical field may be able to create a vaccine for both forms of the virus, which could save or extend many peoples lives.
HIV is a disease in which attacks and destroys the immune system. This explains why people with HIV do not die from the actual virus. They die from a simple virus, like the common cold, because their immune system cannot simply fight it off the virus.
As of today, HIV is currently incurable and, therefore, these victims who need health coverage are being denied or poorly treated with non living standards. “It is a difficult task to calculate an additional risk of premature death for a person infected with HIV, but the annual premium required of an infected person would be so high as to make the purchase of the policy financially impractical” (Christensen 1-2). Insurance companies cannot afford to insure these people with HIV at standard or substandard rates, because they are already providing coverage for those people who were infected with the disease after they had established coverage with a company. Consequently, people searching for health insurance, after they have been informed they have HIV, is a very difficult process. The insurance companies do not want anything to do with these people. They want people who are healthy and living “normal” lives. The reasoning for this is that they want their patients to pay them regularly. They are paying the insurance companies so that they can provide coverage for their clients. What the companies do not want to do is actually pay continuous coverage for these terminally ill people. These companies feel like they would be wasting money, when their patient is going to die in the near future with or with out adequate health care and their medicine.
Laws and Regulations
When this disease first came to this country and people started finding out what it was all about and who it was affecting it also came to the attention of the American public health officials. The American public health officials brought the attention that their needed to be something done about this with the Legislation. Laws and other groups need to take action and try to solve this problem because people were beginning to lose hope and the rate at which this disease is spreading is unhealthy and not good for the economy just because when many people are getting terminal diseases they cannot perform to the highest potential. Therefore, numerous people are being affected.
Insurance Companies/Employers Discrimination
People with HIV/AIDS are losing jobs and insurance coverage because companies are always trying to cut back on their expenses. Many insurance companies and employers with in the companies discriminate against people who live with HIV/AIDS whether they notice or not. Companies are not willing to pay full coverage for these people with HIV/AIDS. They think that it is a waste of money and time for their company. Many companies are not set out to discriminate, but they find themselves in the middle of a no win situation. Meaning no one will come out happy and fully satisfied with the end result. It does make sense where the company is coming from because, if their patient does not make it after two years, they would have wasted valuable time and would have lost money out of the situation. Therefore, meaning that their company could go down in value compared to other companies. The employers and the insurance companies go hand in hand with the discrimination. Both of them do feel bad that this particular person has to go through this, although they can get over it real fast and think to themselves, “Glad it wasn’t me!” The reason that they work together is because the employers and the insurance company both want to maximize their profit. When they have someone that is not up to their best capability, they can lose money and therefore, will not be successful. The insurance companies lose money because they are paying an essential amount of money for this person’s medication and frequent doctor appointments. The employers are not satisfied because they cannot succeed and continue to do well if they don’t have a strong staff working for them. Although both, the insurance companies and the employers have strong arguments in their reasoning for their actions, and their need to succeed, it is still discrimination.
A patient from Project Angel Heart is a victim of all these health coverage controversies. Devin is a 42 year old man who has been living with AIDS sense August 8, 1990. His health has restrained him from the ability to work. So because of this he has been out of work sense 2000. When he worked he was a high profile individual and because of his health he lost his job on unfair circumstances. Under the FMLA, which is a Federal Law that protects people with terminally ill diseases with rights in the workplace, he was able to have 412 hours off a year. So after taking some time off, Devin’s responsibilities with work seemed to reduce day by day and he was left with non-valuable assignments to do at work. During this time period when Devin was first diagnosed, they were trying to get him to quit. They wanted him to quit because it would look poorly upon the company if they had to fire someone because of a person’s illness. Also, at that time he was opted for benefits for long term disability. Clearly, this major financial company is trying to save money. They realized that they are not getting the work and performance that they need from their employer because he simply cannot perform to the best of his ability. They are spending a lot of money for this employer to be healthy when he cannot even perform well. It clearly makes sense unethically, although, from Devin’s point of view it is a different story. He had relied on the major financial company that he had worked with for several years and was given the benefits that he deserves. Although, when he was in need of the money and adequate coverage for his illness, they broke down and were trying to find loopholes around and out of the situation.
As a result of this situation Devin took his employer to court and won. From now on the company has to pay him 70 percent of his income when employed until he is 65. This ended up costing the company more money then it would have if they would have just stuck to their long term disability plan. Although, he won the case he still receives help from other sources in order to live. He turned to the government for help as well. He used the Social Security Disability for two years then after that he had to change over to Medicare for adequate coverage. All of his medications cost around $37,000. With Social Security’s $8,000, he receives maximum about $23,000 a year for his income. That is not enough for his medication alone, and he has other living expenses that he has to pay and live with as well. Some ways in which Devin has been granted more money is by being sponsored by pharmaceutical companies and Medicaid, which can also help as well.
This type of life style made Devin realize what really is important in life and where his spending habits and time spent are better off. This is just one example in which an insurance company and employer work together in discriminating against these people with HIV/AIDS. They don’t directly discriminate them because they want to, it is more like they want what is best for their company and they want to be as successful and as profitable as they can be. Insurance companies cannot live up to these goals if they have people slowing them down and giving their best ability to the company. The company cannot have this happen because these people who are not giving their best work are the people that are costing them the most money in health care coverage. Although this is a business and they have to run it professionally, it is still discrimination and something needs to change.
ADA Discrimination Situations
Discrimination is not just a small problem that does not go noticed, it is a large problem that happens too often and the results are not favorable. As a result to all of these situations there is an act that supports these people who are being discriminating against. The “employees may sue health insurers under the American with Disabilities Act (ADA)” (Shoop 1). “The decision will give a boost to lawsuits brought by workers who claim they were discriminated against when their medical benefits were reduced because they suffer from expensive illnesses like AIDS” (Shoop 1). One case that raised question was brought by Ronald Senter, who was president of a New Hampshire auto parts distribution company. He diagnosed with HIV in 1986. Just four years later, “the company’s health plan was changed to limit lifetime benefits for AIDS-related illnesses to $25,000. Other illnesses were covered up to $1 million” (Shoop 1). That $75,000 can make a huge difference when struggling with providing for their family as well as keeping themselves healthy. From this case they made the decision that held the insurers liable under the ADA for discrimination in providing health benefits. Claims have failed because of the Employee Retirement Income Security Act (ERISA), therefore if they could for any reason change there plans. Senter ended up suing the Automotive Wholesales Association of New England. He felt that the cap on coverage for AIDS-related illnesses amounted to illegal discrimination because of his disability. The case was dismissed shortly after and there was nothing settled. This example shows how insurers may be liable for disability discrimination and how it is very hard to prove the situation is discrimination in court. Also, it is hard to prove that there is an amount of money and deciding how much is worth being discriminated against. It is apparent that there needs to be something done about the situation. That is what the ADA is trying to do but it still needs work because they found a way out of the Senter case.
United States AIDS Laws – ADA
In 1983, discrimination began to surface against people with AIDS and for those who are associated with them as well. During this time, “the 1973 Vocational Rehabilitation Act (VRA) was in force” (Frankowski 11). It was an effort to protect the unjustified discrimination against these people that are living with HIV/AIDS. Also it helps to provide federal financial assistance. This was the old way in how to deal with this type of situation and now the laws have changed and therefore the help provided has changed as well. This new legislation was to address disability discrimination against the AIDS epidemic, which began “with amendments to the federal Fair Housing Act in 1988, adding protection against discrimination for persons with disabilities; and ultimately with passage of the ADA in 1990” (Frankowski 13). In this they established detailed definitions and confidentiality for employee medical records; because when AIDS was first becoming an issue in the United States, the victims were concerned that the insurance companies would not keep their results confidential. However, they proved that their medical records containing information about positive HIV test results are secure and protected. In addition, the help that they received from the federal government was through Medicare, which does require payment of premiums. Both the federal and the state governments share responsibility for health care for people who do not fall under the other categories and it is financed from general tax revenues.
“The ADA and the corpus of disability law are regarded as highly effective mechanisms to redress discrimination and remove physical barriers for people with disabilities” (Grubb 106). In the history of the legislator, the rehabilitation Act shows that Congress did not give this problem any time to research discuss and try to find a solution for. Finally, after receiving attention from congress and the government, they realized that what they needed to improve was already there, the ADA. So after research and discussion the ADA was improved to continue to help provide the best health care that they can to patients with HIV/AIDS, considering the circumstances.
“The American with Disabilities Act of 1990 (ADA) and the corpus of anti-discrimination legislation appear to be unlikely sources of law to fill the doctrinal void left be deferential constitutional standards” (Grubb 121). This act is supposed to work against discrimination and the solutions towards a non-discrimination world. The ADA prohibits three different types of discrimination: employment against otherwise qualified individuals, public services, and public accommodations. “Pure discrimination occurs when a public or private entity treats a person unfairly, not because she lacks adequate skill, qualifications, or experience, but because of her disability” (Grubb 122). Overall, for ADA the main goal “is to assure equality of opportunity, full participation, equality living and self-sufficiency to allow people with disabilities to compete on an equal basis” (Grubb 122).
Discrimination in the Real World
Another example of discrimination against people with HIV/AIDS was taken to court by John Collimore. The reasoning behind it was that he felt that he was discriminated under the American with Disabilities Act. Collimore, “an HIV-positive Connecticut man settled an Equal Employment Opportunity Commission complaint against his employer for decimating his health coverage” (Sargeant 1). “The employer, an oil distributor, agreed to pay Collimore emotional distress damages, reinstate HIV-related coverage for all its workers, and bring in a disability-awareness educator to train the staff on the ADA and AIDS awareness” (Sargeant 1). Collimore discovered that he was HIV-positive in October 1991. Just a short “four months later, the company retroactively reduced the lifetime cap in its self-insurance plan from $1 million to $10,000 for HIV-related health benefits” (Sargeant 1). He was absurdly upset that they chose AIDS and let all the other life threatening diseases remain the same. So therefore, he decided to make a point and to fight the company. The company approached him with an offer to reinstate his benefits, but he refused “because he wanted to publicize the point that cutting benefits for one illness, even one with a social stigma like AIDS, is illegal” (Sargeant 1). He wanted to send the message that ordinary people can fight it and can win if they work hard and strive to achieve. He also decided to go through with it because he wanted it to be a learning experience for everyone, especially for his co-workers to learn more about his disease for their sake in the future. He wanted them to be aware that they can use the same bathroom, same phone and same pen as him and every other person with HIV/AIDS. As of 1994, there have been about 60 complaints of AIDS discrimination in insurance that have made nationwide attention, including this one. This helps the problem because it sends awareness to people that are oblivious of the situation and also gives people more courage to speak out about their experiences and hopefully send the message that it is not ok to do this and it is discrimination.
Programs that Aid
For people with terminal diseases that have serious medical conditions, “the security of comprehensive health coverage is essential. In 1994, around 30 percent of the people who are living with HIV are uninsured. Along with that, 40 percent of the terminally ill people depend on the Medicare program for their personal coverage. “Many of the 30 percent with private health coverage live in day-to-day fear that their insurance will disappear or their coverage is inadequate to meet the very real needs of their health status” (Gebbie 1). The Health Security Act is for the security of all Americans and most importantly for the ones who have terminal diseases like HIV/AIDS. This act “will provide the peace of mind and financial protection of private health insurance that can never be taken away” (Gebbie 1). This act will cover many costs; doctor visits, hospitalization, laboratory test, and prescription drugs. Also, other areas that this act covers are counseling for metal health, substance abuse and also there is coverage in hospice care. “For those who move in and out of the work force, the Health Security Act provides portability of benefits that could be taken from job to job, from employment to unemployment or to self-employment” (Gebbie 1). The actual individual will be able to have the authority to choose plans that best fit their needs and to keep those plans even if they meet the needs. “People living with HIV/AIDS frequently prefer to receive medical care in their home or community. Yet current rules often force them into institutional care” (Gebbie 1). This act can support this issue by creating a new federal/state program. This program would provide assistance to the ruthlessly ill and disabled to stay at home where they want to be able to have the community-based long term care. “Finally, the Health Security Act will protect the vital network of HIV/AIDS service organizations that have so ably served people with HIV” (Gebbie 1). This has been just one way that the government has stepped in and taken action on a problematic issue. This act is also a sense of security for the people who do not have health care and feel helpless because they have no one and nothing to turn to. That is where the government should and did step in to try and comfort its citizens in trouble.
Start of AIDS Organizations
“The World Health Organization (WHO) has divided the AIDS epidemic’s history into three periods: ‘the silent period (ca. 1970-1981), the initial discovery (1981-1985), and worldwide mobilization (1985-1988)’” (Boehmer 12). This division of periods supports the argument that the organization of essential help to this AIDS crisis was put on hold because people were afraid and uneducated on the issues surrounding the deadly virus. After many people asking and searching for help, the public health officials gave no response back. “Their lack of action lasted until the mid-1980s, when the perception of AIDS shifted from being a ‘gay disease’ to being a threat for the ‘general population’ or ‘heterosexual community’” (Boehmer 12). After the public health officials finally responded to the call, service organizations for AIDS emerged in three major cities: New York, Los Angeles, and San Francisco. Shortly after these organizations were developed they branched out into other major cities as well: Boston, Chicago, Washington, Atlanta, and Huston. The purposes for these organizations are pretty clear through their goals. These goals were described as, “AIDS organizations provided services for people with AIDS and pressed for research dollars both to find a cure and through education to prevent the further spread of the disease” (Boehmer 17).
This discussion is relevant to the wider audience outside the circle of people who are infected with this disease because of many different aspects. First and most importantly it is a major problem in our society today and also in other third-world countries as well. It may not be in one’s life today, but it could affect one in the future. These people would not want to have to deal with the problems involving insurance companies and discrimination worse then it already is. Also, another reason why it is relevant to a wider audience is because people need to be educated on the disease and the situations around it. That is one of the possible solutions to this major problem. If other people are aware of the problems and complications that HIV/AIDS brings they would be less likely to discriminate and therefore, the problem could be reduced. It is only to their benefit that they are aware and educated about these problems that surround them involving HIV/AIDS. When they are educated, they can prevent themselves and loved ones from getting the disease, and also prevent others from spreading it to other people who are clean and healthy. Lastly, if people are educated and aware of the issue then they could help to reduce the spread of the disease and help to increase the results in finding a cure for this horrible disease that affects millions of people every year.
As proved, this problem of discrimination is important for these people to fix because it is an essential part to the infected people’s lives. The solutions for this problem have started to show a sign of hope and therefore, one day people have hope for a cure. All the effort and support from millions of people improves the chances greatly to finding a cure. Although, there may still be questions about this issue, people still have hope and are still supportive in this disease. Although, there is still the major problem in discrimination that each and everyone can work act to eliminate. Also, the complications that people will come across when trying to succeed in finding a cure or just simply surviving in life, but there still is support out there that people can strive for with a positive attitude.