The White House Blog
ONAP Commissions Institute of Medicine to Examine HIV Testing and Care Policies
Posted by on November 14, 2009 at 9:58 PM ESTAccording to the Centers for Disease Control and Prevention (CDC), over 56,000 Americans become infected with HIV each year. A lot needs to be done to halt the HIV epidemic in the U.S. and, thankfully, we have effective tools at our disposal.
Chief among these tools is HIV testing. CDC estimates that 21% of people living with HIV are unaware of their HIV status. You might ask how this is related to stopping the HIV epidemic. Well, many studies have found that HIV-positive individuals who know that they are HIV-positive change their behavior to reduce the chance of transmitting the virus to their HIV-negative partners. People who are infected with HIV but don’t know it are at high risk of unintentionally placing HIV-negative partners at risk for HIV infection. The result is that a greater number of new HIV transmissions in the U.S. each year stem from people who do not know that they are HIV-positive. If we scale up HIV testing, then we can reduce the number of individuals who are unaware of their HIV infection and possibly also reduce the number of annual HIV transmissions.
We can also do more to help people who are diagnosed with HIV to get connected to appropriate health care services. Besides prolonging the life of people living with HIV, HIV-positive individuals on antiretroviral therapy (ART) are less likely to transmit HIV to an HIV-negative partner. Increasing the number of people with HIV who receive regular care will help extend their lives, reduce the likelihood of late stage diagnoses (which is especially common among racial/ethnic minorities), and possibly reduce the number of new HIV transmissions.
So, why aren’t people getting tested regularly for HIV or accessing services once diagnosed? There are many complicated personal, financial, and other reasons that affect a person’s decision to get tested for HIV or to access HIV services after diagnosis. Federal, state and private health insurance policies can also deter people from seeking HIV-related preventive or treatment services.
The White House Office of National AIDS Policy (ONAP) has commissioned the Institute of Medicine -- the independent health arm of the National Academy of Sciences that provides unbiased and authoritative advice to decision makers and the public -- to examine federal, state, and private health insurance policies that 1) serve as barriers to HIV testing or 2) inhibit entry into clinical care or continuous and sustained care. We know that providing clinical care for HIV-positive persons is complicated by the fact that fewer providers are choosing to specialize in HIV care. Even if we get more people tested for HIV or into health care services, it is a problem if there are fewer health care providers available to provide these services for the long-term. We have also asked the Institute of Medicine to examine policies that may help increase the number of health professionals providing HIV care.
To get the process started, the IOM will select a panel of 15 subject matter experts who will plan a series of workshops that will address questions in each of the following 3 areas:
- HIV testing and federal, state, and private health insurance policies: Relevant questions include: What current federal and state laws or private health coverage policies impede HIV testing? What has been the impact of opt-out HIV testing? What effective HIV testing methods can be used to reach at-risk populations?
- Health care system capacity to administer a greater number of HIV tests and to accommodate new HIV diagnoses: Relevant questions include: Where do HIV-positive patients currently get care? What is the training of most HIV care providers? What capacity is there to absorb newly diagnosed HIV-positives as a result of expanded HIV testing services? What are the impediments for professionals entering into AIDS care and being retained? Are there ways to incentivize HIV/AIDS as a specialty among the health care professions?
- Federal and state policies that influence entry into clinical care and the provision of sustained care: Relevant questions include: How can federal and state agencies provide more integrated HIV care services? What policies promote clinical care services among agencies at the federal level, state level or between state and federal agencies? What are federal and state agency policies in funding HIV medication adherence programs?
A summary report from the each of the workshops on these three topics will be released in March 2010, May 2010 and September 2010, respectively. Information from the reports will help inform the implementation of the National HIV/AIDS Strategy and will complement ONAP’s other activities. Stay tuned...
Greg Millett is Senior Policy Advisor in the Office of National AIDS Policy
Working to Boost American Exports, Grow American Jobs Through Trade with the Asia-Pacific
Posted by on November 14, 2009 at 5:00 PM ESTOn Saturday in Singapore, I spoke to the Asia-Pacific Economic Cooperation (APEC) CEO Summit on behalf of President Obama. In my remarks to this gathering of more than 800 business leaders from across the Asia-Pacific region, I spoke of the robust and beneficial trade relationships that the United States enjoys with our 20 fellow APEC members – 61 percent of total American manufacturing exports are destined for APEC economies, and roughly 3.7 million American jobs are supported by those exports – and about the potential to gain even more job-creating opportunities for American workers, families, and businesses by increasing engagement with and exports to our partners in this fast-growing region.
Learn more about Foreign Policy"I am Here Because I'm a Daughter"
Posted by on November 14, 2009 at 4:28 PM EST"And when all is said and done, part of why I believe so strongly in reforming our health care system is because of the difference it will make for these women who gave us life -- so simple -- these women who raised us, these women who supported us through the years" -- so said the First Lady in explaining why she wanted to speak about how health insurance reform will affect older women in America. She followed several other women who were willing to share their difficult and even tragic stories dealing with the status quo, and thanked them for speaking out.
The First Lady has spoken before about the many ways in which reform will benefit women in particular. And as for the impact on all Americans as they become seniors and rely on Medicare, the Vice President gave the scare tactics propagated by defenders of the status quo the contempt they deserve. The First Lady made sure to cover all of that ground again, but also made the point that older woman have their own specific circumstances:
And I don’t think anyone here will be surprised to learn that a recent study found that one-third of all women have either used up savings, taken on debt, or given up basic necessities just to pay their medical bills. And as many of you know firsthand, these kinds of problems -- the problems of coverage and cost -- only grow worse when you get older, making quality, affordable coverage harder to come by just -- as we’ve seen today and heard today -- just when you need it the most.
In the individual market, people in their early 60s are more than twice as likely to be denied coverage than people in their late 30s. Older women are more likely than men to face a chronic illness, but they’re less likely to be able to afford the cost of treating that illness. And in recent years, studies have shown that women over the age of 65 spend about 17 percent of their income on health care. And that’s just not right.
Our mothers and grandmothers, they have taken care of us all their lives; they’ve made the sacrifices that it takes to get us where we need to be. And we have an obligation to make sure that we’re taking care of them. It’s as simple as that. America has a responsibility to give all seniors the golden years they deserve and the secure, dignified retirement that they worked so hard to achieve. (Applause.)
Learn more about Health Care, Seniors & Social SecurityHeading to Singapore
Posted by on November 14, 2009 at 3:22 PM ESTThough the local time was 3pm, as I walked down the main corridor aboard Air Force One, it may as well have been the middle of the night given row after row of sleeping people. This is officially day three of the President's trip to Asia, and if our colleagues who travel ahead of us to get things set up (called the advance team) are to be believed, this is when the jet lag catches up with you. It gets better from here.
Don't tell that to David Axelrod, Senior Advisor to the President. When I arrive to set-up this taping, I find David hard at work along with Robert Gibbs in the Air Force One conference room. "Maybe I should do the taping after dinner? Should I even be eating dinner? What time is it?"
What time is it actually? A glance at almost any wall on the plane gives you three time zones to choose from, the most unsatisfactory is 4:30am Eastern Standard Time.
David's eyes slide from the food tray to the beckoning computer, "We better do that taping now. Are you all set?"
is the official White House videographer
Learn more about Foreign PolicyReactions Following President Obama’s Speech in Tokyo
Posted by on November 14, 2009 at 2:10 PM ESTWhile getting ready to do this taping with Jon Favreau, the President’s Chief Speechwriter, my Blackberry was buzzing in my pocket, carrying new instructions for a motorcade movement, pushed up by over 2 hours. What was going to a leisurely stroll to find the perfect location for our Japan update, became a scramble to secure a suitable section of the lobby.
Learn more about Foreign PolicyIn Tokyo, Our Common Future
Posted by on November 14, 2009 at 1:51 PM ESTRead translations of the President's speech in Chinese, Indonesian, Japanese or Korean.
For some, our relationship with the nations of Asia may not always be at the forefront of their minds. The President's sweeping speech at Suntory Hall in Tokyo was a powerful argument for why that should not be so. Indeed the President noted that to the extent this attitude has been reflected in our government's neglect of the emerging multilateral organizations in the region, this mistake would not be made again: "I know that the United States has been disengaged from many of these organizations in recent years. So let me be clear: Those days have passed." The rapid pace of development on virtually every front in Asia creates an environment of almost endless opportunity for collaboration and innovation through our ties.
Learn more about Foreign PolicyPower for India, Jobs for the U.S.
Posted by on November 14, 2009 at 8:15 AM ESTEd. note: You can always keep up with Secretary Chu through his Facebook page.
Before joining President Obama in China on Monday, I am visiting India, another crucial partner for the United States as we meet the challenge of climate change and help speed the transition to a clean energy economy.
India has three times as many citizens as the United States but consumes just 15 percent as much electricity. But in the coming decades, India is likely to become the third largest energy consumer in the world, following China and the United States. In a "business as usual" future, India's demand of coal will be 60% higher than projected its domestic production. The demand for oil could be 10 times the domestic supply.
Learn more about Energy & Environment, Foreign Policy
