Title: "Tax Cuts" and HIV/AIDS Credit: Craig Young Comment Saturday 30th July 2005 - 12:00pm1122681600 Article: 843 Rights
How will Don Brash's phantom "tax cuts" affect public health spending, particularly in the case of HIV/AIDS? It's difficult to say. Due to frequent postponements of its final policy release, the Opposition still hasn't released its whole tax policy yet. Isn't this media spin and manipulation? Dare one suspect that this is a cynical delaying tactic, until it's close enough to the general election to prevent full and careful scrutiny of its policy package? And if not, then prove me wrong, Don and John. Release National's tax policy package now. Without National's full tax policy, it is difficult to assess how it will affect our communities. True, professional community members may have extra money in their pocket, but consider this. To pay for National's tax cuts, public revenue will probably have to be cut. If not, the Brash regime would have to commit to massive international borrowing, which would drive up interest rates and hit us in the pocketbook on its backswing. And what about HIV/AIDS? What about People Living With HIV/AIDS? Granted, HIV/AIDS prevention and health promotion are primary health care issues, and cost-effective preventative strategies mean that all that is needed is an effective community strategy, condoms, and followup research that indicates that promotion programmes are working. Primary health care spending is cost-effective because it saves money down the health care track. Health economists tell us that hospital bed occupancy, medical equipment wear and tear, pharmaceutical purchase and use, and medical staff renumeration cost money. But what is going to happen to PLWAs under National's return to the past? Yes, protease inhibitors do delay the onset of serious opportunist infections, expand working life duration and overall life expectancy. Unfortunately, they have to be imported, subsidised and evaluated for benefits, risks and potential side-effects. Other palliative pharmaceutical user groups have similar concerns about Pharmac's current regulatory regime. For this reason, New Zealand needs a functional public health system to insure that PLWAs get access to the medication that they need without paying excessive proprietary costs to drug companies without subsidies. How can we insure that PLWAs get that money if money is wasted on continual costly management and administrative 'reforms,' as occurred during the Bolger and Shipley eras? And what happens to PLWAs if they get sick after National's proposed radical welfare slashbacks? Granted, protease inhibitors extend possible working lives, but then PLWAs will deplete their savings on unsubsidised medicines. And what about their rent, power and food costs? Would the HIV/AIDS epidemic have taken such a heavy toll in the United States if it had had comprehensive, let alone adequate, public health and social welfare systems? Are Brash and Key planning time-limited invalids benefits as well? Are they planning to abolish the Invalids Benefit altogether? Are they planning to reduce it? Are they planning to impose impossibly restrictive hurdles in the way of existing and potential invalids beneficiaries? We need to ask those questions. They need to answer them. From NZAF's "Male Call" survey in the nineties, we are already aware that 'underclass' men who have sex with men are at increased risk. Under National's proposed welfare policies and past record on public health, that situation can only deteriorate further. The centre-right seems to have no real answers to these PLWA issues. In the nineties, they pursued a liberal bipartisan approach to health promotion while in government, but Murray McCully's outburst about the young gay couple in the "Hubba Hubba" campaign raises some disturbing questions. Will a Brash/Peters regime satisfactorily fund reproductive and sexual health promotion programmes, or pander to unqualified social conservative pressure groups like Family Life International and the Maxim Institute on these issues? And don't forget, Don Brash and Winston Peters already voted to try to gut our antidiscrimination law protections when they voted for Stephen Franks' SOP 336, which would have removed lesbians, gay men and same-sex couples from the Human Rights Act 1993. Is even the Human Rights Commission safe under Brash and Peters? Will we see repeal of its provisions that affect sexual orientation and organisms living in the body? Under Richard Worth, it has already ruled out expanding coverage to include the transgender communities. PLWAs cannot afford tax cuts. As has already been noted in some quarters, Brash and Key are already contradicting themselves over the amount that they intend to cut from potential tax revenue. If we really care for members of our community at risk, then we must ask some hard questions about centre-right "tax cut" policies. They didn't help matters in the United States when Bush slashed taxes and government expenditure in 2001 after he assumed power. It probably won't work here, either. Recommended Reading: Paul Begala: It's Still the Economy, Stupid: George W. Bush, the GOP's CEO: New York: Simon and Schuster: 2002. Robert Blank: New Zealand Health Policy: Auckland: Oxford University Press: 1994. Christine Cheyne, Michael O'Brien and Michael Belgrave: Social Policy in New Zealand: A Critical Introduction: Auckland: Oxford University Press: 2004. Heather Worth et al: Project Male Call/Waea Mai, Tane Ma: Auckland: New Zealand AIDS Foundation: 1997-1999 (Ten volumes). Craig Young - 30th July 2005    
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