Panel Assails AIDS Health Care System

The National Commission on AIDS, describing the nation’s health care system as “singularly unresponsive” to the needs of persons infected with the human immunodeficiency virus, called on the Bush Administration Wednesday to take a series of steps to “begin solving the problems of health care delivery” to these individuals.

“Recent years have seen considerable advances in the development of new HIV-related drugs . . . but scientific breakthroughs mean little unless the health care system can incorporate them and make them accessible to people in need,” the commission wrote, releasing its first report to the White House.

The commission, an independent panel made up of members appointed by Congress and the White House, was created by Congress to advise Congress and the President on the development of a “national consensus on policy” concerning the AIDS epidemic.

The commission is not required to send a report to the White House until August, but it said in a letter to President Bush that the information it has gathered regarding health care and financing “was so compelling we felt it is vital to write to you now.” There are expected to be further reports as the commission continues its work.

The commission urged that, first of all, the Administration recognize “that a crisis situation exists in many cities that will require extraordinary measures to overcome.

“There is a dangerous, perhaps even growing, complacency in our country toward an epidemic that many people want to believe is over,” the panel said.

The AIDS epidemic, the commission said, “is not just a New York City or San Francisco problem as some would like to believe.” By 1991, it said, an estimated 80% of new cases of AIDS will occur outside those two cities. More than 1 million people are estimated to be infected with the virus that causes AIDS.

The commission said that several factors have contributed to the AIDS health care problems in this country, including low reimbursement rates under Medicaid and variations among states in Medicaid eligibility.

The commission recommended that a comprehensive system be established that would coordinate hospital, ambulatory, residential and home care. Primary-care physicians, the commission said, “must be central” to such a system. The commission also said that comprehensive health care services should be provided “under one roof,” adding: “Fragmented services create additional barriers to needed health care.”

Further, the panel suggested the possible creation of regional centers to treat the HIV-related disease, modeled after a similar program for hemophilia. The centers would provide backup and consultation services for the primary-care physicians.

The panel also recommended that units be created to treat patients who have both HIV infection and drug addiction.