It has been over 30 years since the first cases of “Slim” started appearing in men and women from the villages dispersed near the border of Uganda and Tanzania. Since then, the world has made progress- “Slim” was recognized as the Human Immunodeficiency Virus, the progression of HIV to AIDS was more clearly understood, the science behind HIV transmission dispelled xenophobic notions (for the most part), antiretroviral therapy was discovered and is improving, researchers have demonstrated a functional cure via stem cell transplant, and the results of a recent multinational trial presented at the 2011 Intl. AIDS Society Conference have finally confirmed the highly effective duality of treatment as prevention. The statistics reflect these advances- nearly 50% of ARV eligible people now have access to treatment, in 2010 there were only 1.8 million AIDS-related deaths as compared to 2.2 million in 2005, and there has been a 15% reduction in new infections per year over the last decade, with 22 African countries now reporting incidence rates which are 25% lower than in 2001 (UNAIDS World AIDS Day Report 2011).
I just finished Healthcare, Guaranteed, Dr. Ezekiel Emanuel’s book about the failure of the American healthcare system to provide accessible, affordable, and effective healthcare. I think that in general, most people are aware that our total healthcare spending ($2.6 trillion in 2010- the most in the world absolutely and as a % of GDP) is exorbitantly high without the expected health outcomes that such high spending should procure (the World Health Report by the WHO ranked the U.S. 37th overall in health systems rankings). However, in the complicated mess that is American healthcare, I think it is important that we at least have a basic understanding of why our system is the way it is. In this post, I want to review some of Dr. Emanuel’s main points about our systematic failures and also present his alternative, the Guaranteed Healthcare Access Plan (GHAP), as well as my thoughts. Excuse the length of this post, but I do think these are all important points that everyone should understand. For the experts, I’d like to hear your thoughts on the GHAP. Continue reading