Surgeon General of the U.S. Public Health Services
U.S. Department of Health and Human Services
Presented to the McKinney Foundation AIDS Forum
November 23, 1987
It was three days since I had previously spoken to an audience in public on the subject of AIDS.
The epidemic of AIDS brought responses from the public in many ways; this was one of them. Congressman Stewart B. McKinney
had died in the early years of the AIDS epidemic and his family friends and associates choose to honor him with the establishment
of the Stewart B. McKinney Foundation whose goal was to provide encouragement that ways would be found to meet the needs --
not strictly medical -- of those who carry the virus or have AIDS. They established the first Stewart McKinney AIDS residence
in Stanford and their goal was to fund others as time went on.
I began my remarks by acknowledging all of the above and confined my talk to brief observations on the highly sensitive issues
of law, ethics, economics, morality, and social cohesion beginning to surface over and above the medical challenges of AIDS.
I spent some time in discussing healthcare personnel who refuse to treat persons with AIDS, medical and surgical residents
who did not want to work in hospitals where there were many AIDS patients, and patients with elective admissions to hospitals
who did not want to go to an institution where there were many AIDS patients. All of these ideas I rejected and made a plea
for passionate care to persons with any illness, including AIDS, and stated that that was the feeling of the overwhelming
majority of Americans.
Of course all of this could lead to separate, unequal treatment for AIDS patients and could magnify the impact of the epidemic
on the American healthcare system, which was something we wished to avoid. A related issue was the rising cost of AIDS patients
-- as of this lecture -- running about 2 billion dollars annually with $20,320 per patient. This is the first time that I
talked about the upcoming bill to care for AIDS patients with a cost of 8 billion to a high estimate of 16 billion. This will
be taxpayer money and the question asked is: As AIDS cases rise, will the resources be available to meet the needs? This was
an opportunity to congratulate
those who founded the McKinney Foundation on their compassionate outlook on these problems.
Because of the nature of these remarks and their brevity there is no index.