America Living With AIDS

ER ICA Living

ognize our obligations to future generations in these tasks, for further indifference or misdirected efforts spells
doom for millions.
For two years, the National Commission on AIDS has pursued its mandate from Congress to make recommendations to Congress and the
President "for a consistent national
policy concerning AIDS" and the HIV
epidemic. We have held hearings, site
visits, and consultations; we have
heard from over one thousand voices
across the country in direct testimony,
voices that have described the horror
of the HIV tragedy and the heroism of
brave men, women, and children as
they grapple with HIV. Some have
told of their struggle with their own
illnesses. Some have told of remarkable commitment to care for and
about others. We have been heartened
and inspired by the thousands of people throughout the land who have selflessly given of themselves to develop
programs of prevention, care, and
advocacy in their communities. It has
been a privilege to experience the richness of diversity that could give unconquerable strength to our efforts if it
were honored and fully harnessed; and
it has been a source of constant sorrow
to witness the accelerating loss of talent as young adults die of AIDS in
ever increasing numbers.
This report attempts to address a
number of the central themes that
have emerged from this process. It
brings out the fact that, in an important sense, the only thing new about

our present quandary is the virus, that
most of what we are experiencing represents old problems that have been
poorly patched and bandaged or
ignored entirely. The HIV epidemic
did not leave 37 million or more
Americans without ways to finance
their medical care-but it did dramatize their plight. The HIV epidemic
did not cause the problem of homelessness-but it has expanded it and
made it more visible. The HIV epidemic did not cause collapse of the
health care system-but it has accelerated the disintegration of our public
hospitals and intensified their financing problems. The HIV epidemic did
not directly augment problems of substance use-but it has made the need
for drug treatment for all who request
it a matter of urgent national priority.
Rural health care, prison health care,
access to health care for uninsured and
underinsured working men and
women-these issues and many more
form the fabric of our concern. The
report is not all-encompassing, for we
have focused on certain issues that the
Commission viewed as most important during our first two years of work.
The Introduction, the first chapter,
paints an overview of the current status of the epidemic in America. It
notes that, in endeavoring to solve
problems of HIV care in the context of
our current epidemic crisis, we can
develop better ways to manage other
chronic relapsing illnesses, innovations that will serve society well in the
years to come. By taking away our
right to procrastinate further, HIV
presses us to confront the shortfalls in
our health care system more honestly.