Ira Magaziner, chairman of the Clinton HIV/AIDS Initiative, told an audience in Filene Auditorium Tuesday of the pressing need to address the worldwide AIDS crisis. The former Clinton senior policy advisor also attempted to set the record straight concerning the controversial healthcare plan he co-authored with former First Lady Hillary Rodham Clinton.
The AIDS crisis currently affects 40 million people in the developing world outside of Brazil, and that number will skyrocket to 100 million in the next few years, Magaziner said. While many organizations deal with the epidemic preventatively, little effort had been made to directly treat those with the disease.
"Essentially, the developed world was going to let 100 million people die in the developing world in the next couple of years," he said. "Never mind that it would take about one month's cost of the Iraq war to treat everyone in the developing world. It was viewed as too expensive."
Magaziner added that from a national security perspective, the AIDS crisis isn't something we can ignore for long. Poverty is a breeding ground not only for the spread of AIDS, but for terrorists, he said.
"Suicide bombers are often drawn from people who are HIV-positive or who have other conditions and figure they are going to die anyway," Magaziner said.
The Clinton HIV/AIDS Initiative worked with generic drug companies in India and Africa to lower the cost of treatment for an AIDS patient from $1,600 per person per year to $145 dollars per person per year -- a 90 percent cut. In developing areas such as sub-Saharan Africa, where the average per capita income is $400 per person, this price drop was key to making treatment a viable option.
Magaziner said drug companies agreed to cut their costs because CHAI helped open up a new market. CHAI promised the companies two million new patients and has delivered several hundred thousand in the last few years, Magaziner said.
Despite the success of the AIDS Initiative and the positive press it has received, the domestic healthcare plan Clinton tried to implement during his presidency famously crashed and burned. Magaziner, who co-authored the bill with Hillary Clinton, blamed the $400 million advertising campaign the health industry launched against the plan as the principle reason for its failure.
The plan aimed to offer universal healthcare coverage and to stop insurance companies from experience rating, or "cherry-picking the healthiest people to insure," Magaziner said in a question-and-answer session. Instead of offering lower fees to healthier patients, Clinton's plan would have offered citizens an equal community rate with slight penalties for smokers and the obese.
Insurance companies could continue to compete, Magaziner said, but by offering better care, not by finding healthier customers.
Opponents argued that the plan would prevent citizens from choosing their own coverage and create costly, ineffective bureaucracy. Magaziner said the plan actually offered about three insurance companies to choose from, while today most people are covered by only the company of their employer's choosing.
Many employers choose not to cover their employees at all, however. The 35 percent of physicians in the American Medical Association who were not paying insurance for their employees -- generally those with their own practices -- feared the bill would compel them to do so. Due to this concern, the AMA backed down from its initial support of the bill.
Magaziner said the physicians were worried the bill would interfere with the way they interacted with patients and let insurance companies run their lives.
"That trend was already there," he said, adding that insurance costs and the threat of lawsuits makes "it a nightmare to be a physician right now."
"They didn't understand then, but I think are painfully aware of now, that we were not the enemy," he said.
According to Magaziner, party politics also played an integral part in the bill's stoppage, with Republicans succeeding in their attempts to vilify the bill and its authors.
"They realized that if any health reform passed, the Democrats would be in power for 20 years, it would be so popular," Magaziner said. "It would be like the New Deal. They had to defeat it."
