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But who does it make sense to have it? Especially when you can just sign up the following year. At 7k a year and cash discounts you need a significant injury to make it worth getting.
Yes, that's what I mean: it's literally insurance against catastrophic injury. I think that's one of the biggest flaws in the system, really: it conflates a health care plan with health insurance, when an awful lot of people would be perfectly fine with a bare-bones plan that only covers the latter, and then paying for the former out of pocket.
It’s a lot more than that. Obamacare requires Prep. Which I believe is $20k per year. I believe 4% of men are gay so if they all took it that alone adds like $1k/year to what insurance needs to charge to break even. And lots of other required coverages
One, I doubt that the cost of pre-exposure prophylaxis is greater than the cost of treatment for someone who has caught HIV.
Two, the more people become infected with HIV, the more opportunities it has to mutate, including mutations that would make it airborne or otherwise easily transmissible. If you ignore AIDS because "it's only killing gay people and drug users, and they don't matter", you run a not insubstantial risk of the first clause in that sentence no longer holding.
What would be effective policy to both maintain the current levels of HIV prevention and also reduce costs to taxpayers?
There's all kind of interesting lawfare going on these days. Could it be possible to follow the same kind of playbook that was used against Purdue Pharma?
Or perhaps dram shop laws?
Perhaps we should tax companies like Grindr (Tinder?) for facilitating HIV-transmission. Cities or other governments that publically glorify the homosexual and the drug-enthusiastic lifestyles (like Portland up until recently) should also be paying up on a federal level.
Once HIV infection is identified, we should be able to do some contact tracing, and make the most probable establishments that permitted the contamination (the last 3 bathhouses or bars visited by the infected within 3 days of probable infection) pay for the treatments.
If it appears that the infection occurred in a government-managed building or outdoors area, the government in question should be responsible for the treatments, unless they can prove that they have taken appropriate steps to mitigate possible infections.
In the spirit of the EEOC, HR departments, sexual harassment and discrimination trainings, I'm thinking of placards placed at regular intervals explicitly advising that anal masturbation and drug injections are formally prohibited in the area, the punishments associated with them, and the phone number to a confidential tip line to immediately address any possible incident.
Of course promotions, federal funds and contracts should be conditioned to how well these policies are applied.
We would need some new class of lawsuits similar to the ADA ones where any household or business harboring a rainbow or similar flag and symbols would be considered a supporter of the homosexual lifestyle and would have to contribute to a HIV-treatment fund, preferably through wage garnishment.
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.
No. You expect that, and most states do enforce the principle, but I do not share that expectation and I do not endorse the principle.
Well that's tragic then. Almost as bad as the scenario in which all of society is forced to labor for the creation of a pharmaceutical product that only a small minority of people need, who themselves are either unable or unwilling to bear that burden themselves and/or with the assistance of their well-wishers. Having states force everyone to contribute to the upkeep of an expensive minority, damn the costs and the fairness and the individual responsibility, is not in my view the better outcome.
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