HIV subsidies: On Waste, Taxation and Justice

I love diversity of views, whether or not I agree with them, so keep them comming!

Here, I respond to a comment made to my earlier post, that I really appreciate, because I think it represents the views of many people. To people with these views, I am not saying I disagree, but I would hope that you can further your views on these 3 points I am making in response.

To summarise, someone raised the points that:
1. HIV subsidies “would be a disproportionate use of resources for a small affected population. “
2. HIV subsidies will come from taxpayer money which might have to be raised
3. Charities should provide the subsidies, not the taxpayers

And my questions to everyone in response:

1. WHERE DO YOU DRAW THE LINE?
You said that “That would be a disproportionate use of resources for a small affected population.” So what proportion of the population has to be afflicted by an illness before we start subsidising? Where and HOW do you decide on this line? SARS affected only less than 100 people. Look at the resources poured in. Was that due to the fast-spreading nature of SARS? AIDS is also an infectious disease which spreads. The numbers looks small, but with half the cases only being detected a few years after infection, and with the rising rates if infection, you can be sure there are many many more undetected HIV cases.

According to MOH statistics the No.10 killer in Singapore “Nephritis, Nephrotic Syndrome & Nephrosis” (layman language : KIDNEY FAILURE)  had only 3500 deaths in Singapore in 2007. Shall we also stop all government treatment subsidies (through grants to NKF, through direct medication subsidies, through Medishield coverage) for Kidney patients? Or should the government have the apply the same subsidy model to HIV treatment?
(http://www.moh.gov.sg/mohcorp/statistics.aspx?id=5526)
2. WHERE IS JUSTICE?
AIDS patients have been contributing to society, same as everyone else, through taxes, through their work. Is it justice if some people have their treatments (eg smokers for lung cancer) subsidised, but not others? How do you decide who to subsidise, if justice is your principle criteria? 14,000 women a year abort their babies. They get high subsidies for their abortions, even tho’ it was their “mistake” having unsafe sex, and no one makes a sound about it. Why should 5000 people pay the price of death for the same mistake of unsafe sex? Remembr, drugs can keep them healthy for another 40 yrs. By denying them affordable drugs, you are killing them 40 yrs earlier than necessary.

By relegating the ENTIRE responsibility to Charities (charities are great, as a support structure, as with NKF), you are essentially saying that treatment for HIV patients is a form of underserved mercy to them, because it is the governments role to provide what citizens DESERVE (ie. human rights). Do HIV patients not deserve the treatment they need? Why?

By the way, each year there are only 2 – 4 babies getting HIV from their mother (http://www.moh.gov.sg/mohcorp/statistics.aspx?id=246), that’s like $5000 a month to provide full subsidies for these babies, so let’s not even talk about having to raise taxes yah?
3.  WOULD IT ALWAYS BE SUCH A SMALL PORTION, 5000 out of 5million?
Based on the current rising trends (http://www.moh.gov.sg/mohcorp/statistics.aspx?id=246)
the answer is a definate NO. When a family has to spend all its income on treatment because no subsidy is provided, everyone, including their children who need money for schoolm gets affected. How many people must be infected before we start providing treatment subsidies?

One reason that people do not test for HIV (or opting out of the auto-testing now) , is because there is absolutely no incentive for them to. If you are negative, then no point testing. If you are positive, you will lose your job, you screw up your family, you have to pay for treatments $1000 a month, no one helps you, you die. Why should anyone want to test? For most other diseases eg cancer screening, heart disease screening, you test because you CAN get treated (direct subsidies or Medishield coverage) when you test positive. Not so for HIV.

So with the high risk people not wanting tests, would the infection rates go up or down?

Yes we might have a law that convicts people of transmitting HIV, even unknowingly. But this law is REACTIVE, not PREVENTIVE. And seriously, when the death sentence that is AIDS does not even deter people, what makes you think they will be detered by a jail sentence?