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by jeff sheehy

HIV policy is no joke

WOULD-BE assemblymember Mark Leno is trying to put an AIDS-phobic spin on a joke that his opponent Harry Britt supposedly made during a conversation between the two of them and former police chief Dick Hongisto. At first it seemed like typical preelection game-playing, but the buzz out of the Leno camp is that this will be the HIV/AIDS issue in the campaign.

This dubious attempt to trivialize a deadly serious issue raises grave questions that Leno needs to answer.

First of all, even making the charge against Britt demonstrates either ignorance of or obliviousness to history. Britt was supervisor in 1981 when the first cases of AIDS were reported and was in the thick of the war to save our lives until he left office in 1992. He played a vital role in shaping the city's response during some of the worst years of the epidemic.

Second, and most disturbing to me as a person living with HIV, is the transparent attempt to avoid a discussion about policy. Current assemblymember Carole Migden has used her office to do historic work such as obtaining funding for organ transplants for people with HIV. Key issues need to be addressed by the candidates, such as how funding will be maintained for the AIDS Drug Assistance Program. This program pays for lifesaving anti-HIV medications for people without insurance. Like all programs at the state level, its funding is threatened. Without Migden chairing the Appropriations Committee, what does her successor plan to do to ensure that ADAP continues to be fully funded?

I worry because ADAP saved my life when I didn't have health insurance. What about someone who needs it next year?

Another critical HIV issue for our future assemblymember: HMO reimbursements for doctors who treat people with HIV/AIDS. For instance, if you have cancer, you are referred to an oncologist who is then reimbursed at the higher specialist rate by the HMO. Not so if you have HIV – your doctor is reimbursed at a much lower general-practitioner rate and the practice of HIV medicine is not even recognized as a specialty.

The consequence is that some HIV doctors don't accept HMO patients (I had to change doctors when I was shifted into an HMO), and those who do have huge practices (my current doctor has 1,000 HIV patients), with the comparatively healthy patients often getting shortchanged by the doctor's need to spend most of his or her time with the sickest patients.

The further consequence is that HIV doctors do not make as much money as other specialists, and few or no doctors are starting new HIV practices.

These are just two of the many policy issues that will need to be addressed at the state level. I could list many more.

The point is that people with HIV/AIDS need to have heavy lifting done in Sacramento by a heavyweight assemblymember – not one carping about bad jokes. It is a disservice to those who've died and those who live with this disease to play political football with the issue.

If Leno is trying to convince people with HIV/AIDS to support him, he needs to explain how he plans to develop and implement real and substantial policy. We do not want, and we do not need, Leno raising an absolutely irrelevant issue against Britt that is contradicted by Britt's genuine record of achievement.

Is Leno's political consultant, Robert Barnes, going to blow hard and send him wafting over to execute the next trick, gimmick, or stunt? Or is Leno going to let us know what he stands for and what he intends to do as an assemblymember? We're waiting.

Jeff Sheehy is a member of the San Francisco Democratic County Central Committee.