Health Care Costs and Self-Hatred

Health Care Costs and Self-Hatred

When I was listening to the debate between Obama and McCain the other night, I heard a lot of pablum about cost containment from Obama, but I didn't hear anywhere near enough about one of the core problems of health care costs: self-inflicted health problems. The October 16, 2008 Idaho Statesman discusses the rising problem of AIDS in Idaho (which, having relatively few gay people, hasn't had a big problem with this in the past):

An upward spike in HIV cases is leading Idaho health officials to warn people at risk to get tested.
“HIV infections appear to be on the rise in young people in Idaho,” Dr. Christine Hahn, state epidemiologist, said in news release.
“Some people are putting themselves at risk for a preventable infection which is lifelong and can cause serious illness and death," Hahn said. "We are concerned that people think the risk of HIV is low since they have heard little about it in the news lately. This increase in new infections reminds all of us that the risk is real in Idaho.”
Idaho historically has among the lowest rates of HIV and AIDS infections in the nation. Five cases have been reported so far this year in the health district that includes Ada County, and another five in the district that takes in Canyon County.

As the article points out:

The 2008 reports are being seen in people putting themselves at risk in several ways, including:

People having unprotected sex with multiple sexual partners, sometimes finding anonymous partners through Internet sites.

Men having unprotected sex with other men.

People sharing injection drug paraphernalia, such as needles and syringes

Now, before I point out this ugly fact, let me explain that I am not defending casual heterosexual sex. But the fact is that the vast majority of the risk of getting, or giving AIDS is not from casual, non-commercial heterosexual sex. There is a risk there, and there are plenty of risks of getting other STDs (some of which may increase one's risk for contracting AIDS). But overwhelmingly, Americans get AIDS from sharing dirty needles, from sex with prostitutes, and homosexual sex.

The risk of sharing dirty needles is obvious. Homosexual sex is especially risky compared to heterosexual sex, not just because homosexuals are, on average, more promiscuous than heterosexuals (and STDs spread with the square of the increase in the number of sexual partners per time), but because there are aspects to homosexual sex that are intrinsically more risky.

1. Anal sex seems to be especially effective at transmitting AIDS--and for the same reason that anal suppositories are an effective method of getting drugs into your bloodstream.

2. Because homosexual men are seldom just recipients of anal sex, if A infects B, B will likely infect C. By comparison, vaginal sex seems to be relatively inefficient at transmitting AIDS from women to men. Women are penetrated, and infected, but they simply lack the right "parts" to be quite so effective at passing it on.

3. There has long been reason to suspect that substance abuse and STDs other than AIDS may diminish the body's immune system--and remember that AIDS is, after all, Acquired Immune Deficiency Syndrome. Homosexuals are disproportionately substance abusers, and those suffering from syphilis. Last year, 64% of syphilis cases were among gay men--who make up about 2% of the U.S. population.

In 1980, or 1981, or maybe even 1985, you could make the argument that people with AIDS simply had no way to know that they were at risk. Today, this is simply not the case. The vast majority of Americans with AIDS today get it from high risk behavior. This is no different from smokers (like soon-to-be President Obama) at increased risk of cancer, or obese people at increased risk of heart disease. Why isn't Obama talking about these self-inflicted risks as a way to reduce health care costs?

There's one other aspect to the risks associated with AIDS--and that's intentional infection. You may recall a few years back when that well known right-wing magazine Rolling Stone carried an article about gay men who were intentionally infecting other gay men, and others who were intentionally seeking infection, so that they would get more attention. This October 15, 2008 AFP news story from the Netherlands makes you wonder how often this might be going on in America--but to avoid causing "homophobia," it isn't being covered:

HIV-positive men told a Dutch court on Wednesday how a three-member gay gang tried to infect them with the AIDS virus at sex orgies.
"I feel fear, anger, sadness and anxiety," one of the alleged victims testified before the district court in Groningen on the third day of the week-long trial.
"I have lost a lot of weight," lamented the student, who is infected with HIV.
The three accused, all HIV-positive, are charged with drugging gay men at sex orgies, raping them, and injecting them with blood contaminated with HIV. They are aged 39, 49 and 50.
The three, including a nurse, are accused of intentionally spreading the deadly virus at sex parties they promoted on the Internet.
They face charges of aggravated assault, rape, and illegal possession of drugs and face up to 21 years in jail.
Another witness, identified only as Erwin, questioned the motives behind intentionally infecting another with the immunodeficiency virus. He said he has been taking anti-retroviral medication for six months.
"One must have incredible hatred," he said in a statement read out to the court by the presiding judge.
"This question occupies my days and nights. For the rest of my life I will carry this crime with me, and its consequences."
The trio were arrested in May last year after 14 alleged victims -- 12 of whom are HIV-positive or sick with AIDS -- lay charges. It is not known whether they had contracted the virus before the orgies.
The prosecution alleges the victims were sedated with a combination of ecstasy and the date rape drug GHB (gamma-Hydroxybutyric acid), before being raped or injected with a cocktail of their assailants' blood.

I am frequently told that gay men are just like the rest of us--and that any little quirks in their behavior are just because they are oppressed. The whole "bug hunting" and "giving the gift" crowd, and this behavior makes me just a little suspicious that we are seeing is really an indication of something fundamentally broken. The intentional "giving the gift" and "bug hunting" wasn't just three criminals--it was an entire subculture of gay America.

But not to worry: President Obama's Supreme Court appointees will require states to recognize gay marriage, and probably a lot of other stuff quite a bit more worrisome than that. And then we will wonder why we aren't getting anywhere on health care cost containment.