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Figure out some way to produce anti-retrovirals more efficiently.
Buy out the patents and either void them or licence them for a peppercorn.
If someone develops a vaccine for HIV, or a cure for it, that would have a sizeable effect.
In general, things of the form 'everyone is still expected to contribute, either equally or in proportion to their means, to the costs of prevention; however, we will try to bring the total price tag downward.'
Your proposals, and others of the form 'total price stays the same, but we move the costs to my outgroup', are unlikely to be effective. 'I-got-mine-AMF-YOYO' attitudes have a rather nasty tendency to backfire.
How about total price stays the same, because unlike the imaginary vaccine or the nonexistent more efficiently produced anti-retrovirals that's what we actually have, and the group that gets to pay for them is the group that actually benefits from them, or those who volunteer to foot the bill? As opposed to forcing everyone to cover for the few?
Letting the actual beneficiaries pay seems like the simple, fair and transparent thing to do.
A lot of them can't afford it. The cost of PrEP divided by the population is a smaller figure than the cost divided by the number of people who need it; removing from the denominator those who cannot afford the larger expense will place it beyond even more people. Iterate enough times, and we end up with PrEP being accessible only to the likes of Peter Thiel, which I think is a worse outcome than you having a higher tax bill.
We expect people who chose not to have children to contribute financially to the cost of primary and secondary education; the same principle applies here.
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How is the OP's proposal significantly different than "sin taxes" on cigarettes or sugary beverages?
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It's not "I got mine". I'm more than happy to chip in for the healthcare of someone who got mauled in a freak alligator attack, but my enthusiasm drops suddenly when I find out they're an amateur alligator-wrestler.
Yes but to an extent everyone is an amateur alligator wrestler. Some people overeat, some people smoke, some people drink, some do extreme sports, or sports in general, some drive too fast, or pilot light planes and so on and so forth.
There are very few people who are utterly viceless when it comes to activities that increase the risk of illness or injury.
They're not amateur alligator wrestlers, they actually minimize their burden on society. They're more like the old men that used to go out "to hunt" in the dead of winter, knowing they will never come back.
Yes, but that doesn't mean anything. Saying "everyone is an extreme outlier, to an extent" is just saying "everyone is". "To an extent" nullifies the "extreme outlier" descriptor, which was the defining feature of the group I was pointing to.
Right, but everyone wants to minimise their own risk factors. Which is why the deal is we won't deny medical treatment to anyone. No-one can be trusted to objectively measure their own risks (I only overeat a bit!) against those of the people they dislike (they jump out of planes like lunatics!).
We are well aware that groups cannot be trusted to tell extreme outliers apart from non-outliers when social distaste is involved (as it pretty much always is) so our institutions have evolved to minimise that issue. Trying to go back to "this group doesn't deserve x because they do y" is opening the can of worms we just escaped from. We do it this way for a reason.
And smoking may kill people but it still puts a lot people in hospital for long painful treatment and decline. Smokers are not doing it so they die early in 30 years time after smoking 2 packs a day as some kind of honorable suicide. Plus the study that showed it was cheaper for smokers is contested. It was funded by Phillip Morris after all.
"This critique analyzes the methodology used in a study of the economic burden imposed on public finances in the Czech Republic by the consumption of cigarettes. The study was prepared by a consulting firm on behalf of the Phillip Morris Company. This critique, by using economic theory and a cost-benefit methodology, refutes the conclusion of the Phillip Morris study that smoking represents an economic benefit to Czech state finances. In fact, the correction of only one among numerous errors in assumptions and calculations in the Phillip Morris study leads to the opposite conclusion: Instead of savings of $150 million per year, smoking drains at least $373 million from the state budget annually, nearly.8% of the Czech gross domestic product. The net loss to the society is even greater if all pertinent costs and benefits are calculated properly. The critique demonstrates how to craft a rigorous economic response to common industry attempts to influence public opinion in which the industry employs specious or erroneous assumptions and data."
https://pubmed.ncbi.nlm.nih.gov/14982702/
Consensus building. No I am not aware of that, and would appreciate it if you would argue for that explicitly. Even if it was true, I don't need to rely on my ability to discern extreme outliers, because the gay community readily admits they are one, so unless you want to argue they have a distaste for themselves, your argent seems baseless.
I appreciate the correction, the I reserve the right to skepticism until I look into it further.
Either way you'll notice that, if this is true, it is precisely why tobacco is covered by heavy vice taxes.
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