A federal appeals court has denied the Trump administration’s request to further delay enlistment of new transgender service members in the armed forces. The ruling comes in the American Civil Liberties Union’s case, Stone v. Trump.
The trial court prohibited the government from implementing President Trump’s unconstitutional ban on transgender people serving in the military on November 21. Two other federal district courts have entered similar injunctions, and the government has filed motions to stay those injunctions before three federal courts of appeals. The United States Court of Appeals for the Fourth Circuit is the first court of appeals to rule on the stay requests.
Josh Block, senior staff attorney with the ACLU LGBT & HIV Project, had this reaction:
“We are happy that the court saw through the government’s smokescreen and rejected its request to further delay the policy allowing transgender people to enlist. The military has already developed comprehensive guidance to prepare for a January 1 start date, and the government failed to offer any credible reason why transgender people should be barred from enlisting if they can meet the same rigorous standards that apply to everyone else.”
The Trump administration has banned multiple divisions within the Department of Health and Human Services including the Centers for Disease Control from using certain words or phrases in official documents being drafted for next year’s budget. The banned words are “Vulnerable,” “entitlement,” “diversity,” “transgender,” “fetus,” “evidence-based” and “science-based.”
Rush Holt, chief executive of the American Association for the Advancement of Science, said: “Among the words forbidden to be used in CDC budget documents are ‘evidence-based’ and ‘science-based.’ I suppose one must not think those things either. Here’s a word that’s still allowed: ridiculous.”
“To pretend and insist that transgender people do not exist, and to allow this lie to infect public health research and prevention is irrational and very dangerous, and not just to transgender people,” Mara Keisling, executive director of the National Center for Transgender Equality told the Washington Post.
David Stacy, the Human Rights Campaign’s (HRC) director of Government Affairs said HRC would fight the ban, “The Trump-Pence administration’s effort to eliminate entire communities from its vocabulary is a dangerous attack on LGBTQ people, women, and fact-based policy making. The move is reminiscent of a time not long ago when the government tried to ignore the reality of the HIV and AIDS crisis to the detriment of millions. This kind of erasure has potentially catastrophic consequences beyond the words used by the CDC — it could impact the very programs most vital to the health of women, transgender people, and others. But we will not be erased. The Human Rights Campaign will fight this and other politically-motivated policies, and this decision will ultimately backfire on the Trump-Pence administration.”
Shin Inouye, director of communications and media relations of The Leadership Conference on Civil and Human Rights, issued the following statement on news of the ban,
“President Trump and his administration have launched the latest salvo in their all-out war on truth and science. This latest tactic could be taken from a George Orwell novel, or taken by an oppressive authoritarian regime. Banning the use of words like transgender, science-based, and diversity will only harm the public health as the CDC carries out its important mission.
“We applaud the journalists who have brought this latest abuse to light. Trump may decry these stories as fake, but these reports show the continuing disdain of this administration to facts. The public relies on our government to provide accurate information, and these steps undermine that important trust.”
A special issue of LGBT Health includes the latest research, clinical practice innovations, and policy aimed at addressing disparities and enhancing healthcare for older LGBT populations. A collection of informative and insightful articles that contribute to the understanding of factors that affect the health of older gay, lesbian, bisexual, and transgender Americans is published in LGBT Health, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. The special issue is available free on the LGBT Health website.
Guest Editors Judith B. Bradford, PhD and Sean R. Cahill, PhD coordinated this special issue of LGBT Health. Included is an article entitled “Health Indicators for Older Sexual Minorities: National Health Interview Survey, 2013–2014,” in which Christina Dragon, MSPH, Centers for Medicare & Medicaid Services (Baltimore, MD) and coauthors from NORC at the University of Chicago (Bethesda, MD), KPMG (McLean, VA), and The Fenway Institute (Boston, MA) explored differences between older sexual minorities and heterosexuals across multiple health indicators. The researchers found better outcomes or health-related behaviors among sexual minorities for some of the indicators, but sexual minorities were more than twice as likely to report binge drinking compared with their heterosexual peers.
Stuart Michaels, PhD, NORC at the University of Chicago, IL and colleagues from NORC and the Centers for Medicare & Medicaid Services coauthored the article entitled “Improving Measures of Sexual and Gender Identity in English and Spanish to Identify LGBT Older Adults in Surveys.” They demonstrated that efforts to identify LGBT older adults may be hindered by language-related obstacles among non-LGBT Spanish speakers who might have difficulty understanding terms used to designate sexual identities.
In the article “Transgender Medicare Beneficiaries and Chronic Conditions: Exploring Fee-for-Service Claims Data,” a team of authors from the Centers for Medicare & Medicaid Services and NORC at the University of Chicago (Bethesda, MD), led by Christina Dragon, MSPH, report on differences in the chronic conditions burden between transgender and cisgender Medicare beneficiaries. Overall, transgender beneficiaries were found to have a greater burden of chronic conditions, and higher rates of asthma, autism spectrum disorder, chronic obstructive pulmonary disease, depression, hepatitis, HIV, schizophrenia, and substance use disorders compared with cisgender beneficiaries. Transgender Medicare beneficiaries also had higher observed rates of potentially disabling mental health and neurological/chronic pain conditions.
“This special issue of LGBT Health highlights innovations in research, practice, and policy to improve healthcare and services for LGBT older adults. The articles in the issue contribute to our understanding of health disparities and resiliencies in these populations, and suggest ways to improve care and integrate support services to ensure healthy aging,” says Guest Editor Sean Cahill, The Fenway Institute. “The timing of this special issue is important, as the federal government is rolling back sexual orientation and gender identity nondiscrimination regulations and data collection. The special issue is dedicated to Judy Bradford, a leader in LGBT aging and LGBT health research, and to her vision of LGBT health and equality.”
As the holiday shopping season kicks off, equality-minded shoppers can stand with companies who stand with the lesbian, gay, bisexual, transgender and queer (LGBTQ) community by using the new Human Rights Campaign (HRC) Foundation’s popular consumer guide to hundreds of American companies to choose brands and retail outlets committed to LGBTQ-inclusive workplace policies and practices.
The Buying for Workplace Equality guide, released Thursday by the HRC Foundation, the educational arm of the nation’s LGBTQ civil rights organization, was first issued more than a decade ago. It provides invaluable consumer information based on company scores reported in HRC’s annual Corporate Equality Index (CEI), as well as HRC-researched data on additional well-known companies and their brands.
“Our annual Buying for Workplace Equality guide provides quick, user-friendly help in selecting everything from groceries to cars, allowing fair-minded consumers to use their wallets to resist attacks on the LGBTQ community by supporting brands committed to fully inclusive workplaces,” said Deena Fidas, Director of HRC Foundation’s Workplace Equality Program. “Every year we hear from members of the LGBTQ community and many other consumers who want to choose brands that align with their priorities of workplace fairness. Using the Buying for Workplace Equality guide this holiday season helps ensure that their dollars go to businesses that support equality.”
Through the CEI, the HRC Foundation proactively rates more than 1,000 Fortune 500 companies and top law firms on LGBTQ-inclusive workplace policies and practices. The new guide includes more than 750 companies, 600 of them rated in the CEI, and an additional 140 independently researched by the HRC Foundation. A total 5,600 affiliated businesses and brands are featured in this year’s report.
The Buying for Workplace Equality guide sorts businesses by sectors, assigning them a score ranging from zero to 100 based on LGBTQ workplace equality, as measured by the CEI and HRC-researched data.
Businesses and their products are divided based on their CEI rating into red, yellow and green categories so that consumers can easily determine which brands support LGBTQ workplace equality:
Green (80-100): Businesses/brands with the highest workplace equality scores.
Yellow (46-79): Businesses/brands that have taken steps toward a fair-minded workplace and receive a moderate workplace equality score.
Red (0-45): Businesses/brands that receive our lowest workplace equality scores
Now more than ever, it is important to support businesses that support equality. For more information on the Buying for Workplace Equality guide and to search by company category, go online to www.hrc.org/buyersguide.
SeniorAdvice.com, one of the nation’s top senior housing referral services, has released an article on the best fifteen thriving senior living communities for LGBT seniors. The company recognizes that the lesbian, gay, bisexual, and transgender (LGBT) senior community is currently a very important part of the American population, and that the struggle for resources and housing can sometimes be difficult.
According to the American Psychological Association, “more than 39 million people in the U.S. are age 65 years or older including 2.4 million people who identify as lesbian, gay, bisexual or transgender (LGBT). It is estimated that as the baby boomer generation ages, the older adult population will increase from 12.8 percent to an estimated 19 percent in 2030.”* Although the LGBT community is growing steadily, the options for LGBT senior housing are not as flourishing. There are a handful of these communities across the country though, and SeniorAdvice.com has put together a list of the most welcoming.
The top fifteen LGBT-friendly senior housing communities in America are:
The Palms of Manasota in Palmetto, Florida
The Resort on Carefree Boulevard in Fort Myers, FL
Stonewall Gardens in Palm Springs, California
Fountaingrove Lodge in Santa Rosa, CA
Triangle Square in Hollywood, CA
Rainbow Vista in Gresham, Oregon
Discovery Bay Resort in Washington State
The Residences at Seashore Point in Provincetown, MA
Birds of a Feather in Pecos, NM
A Place for Us in Cleveland, OH
Carefree Cove in Boone, North Carolina
John C. Anderson Apartments in Philadelphia, PA
The Pueblo in Apache Junction, Arizona
Spirit on Lake in Minneapolis, MN
Townhall Apartments in Chicago, Illinois
There is generally less acceptance of the LGBT community among older generations, which can make it very difficult to find a supportive community within the senior demographic. It is estimated that “48 percent of LGBT older couples face discrimination” according to a 2014 investigation by the nonprofit Equal Rights Center.** In addition to discrimination issues, this community can sometimes encounter financial difficulties as well. These seniors can experience discrimination in the workplace, which can make it hard to afford senior housing and save for retirement. SeniorAdvice.com recognizes these challenges and aims to be a strong resource for LGBT seniors.
Ryan Patterson, SeniorAdvice.com CEO and Founder states, “SeniorAdvice.com will continue to be dedicated and focus on the challenges and needs of seniors of all backgrounds. The LGBTQ senior community faces additional challenges that other seniors do not have to deal with, and we like to provide resources aimed at this group to help make transitioning to senior housing easier for all involved.”
The Trump administration is asking a federal judge to delay a requirement to begin accepting transgender recruits to the military on Jan. 1.
“Specifically, Defendants request that the Court stay the portion of its preliminary injunction requiring Defendants to begin accessing transgender individuals into the military on January 1, 2018, pending a decision by the D.C. Circuit on Defendants’ appeal,” the government wrote in a motion filed late Wednesday.
The administration and the plaintiffs have asked for a decision by noon Monday.
In October, Judge Colleen Kollar-Kotelly of the U.S. District Court for the District of Columbia blocked President Trump’s ban on transgender troops while a lawsuit against it works its way through court.Last month, after a motion by the Trump administration, Kollar-Kotelly issued a follow-up ruling clarifying the earlier one that said the military must accept transgender recruits by Jan. 1, as it had planned to do prior to Trump’s ban.
In July Trump tweeted that he would ban transgender people from serving in the military in any capacity.
He made good on the tweets in August, signing a presidential memo that prohibits the military from enlisting transgender people and from using funds to pay for gender transition-related surgery. The memo also gave Defense Secretary James Mattis six months to determine what to do with currently serving transgender troops.
The National Center for Lesbian Rights and GLBTQ Legal Advocates & Defenders sued in August on behalf of six unnamed service members and two recruits.
After Kollar-Kotelly’s rulings, the Pentagon said it was preparing to comply and accept transgender recruits by Jan. 1 even as the administration explores its legal options.
“While reviewing legal options with the Department of Justice, the Department of Defense is taking steps to be prepared to initiate accessions of transgender applicants for military service on January 1, 2018, per recent court orders,” Pentagon spokesman Army Maj. Dave Eastburn said in a statement to several news outlets this week.
But in Wednesday’s motion, the administration argued that it will be “seriously and irreparably harmed if forced” to implement the policy by Jan. 1.
“Given the complex and multidisciplinary nature of the medical standards that need to be issued and the tens of thousands of geographically dispersed individuals that need to be trained, the military will not be adequately prepared to begin processing transgender applicants for military service by January 1, 2018, and requiring the military to do so may negatively impact military readiness,” the motion said.
The motion also argued that the plaintiffs will not be negatively affected by a delay because the two recruits in the suit will not be eligible to join the military until May 2020 and spring 2021.
In a sworn statement included in the motion, Lernes Hebert, acting deputy assistant secretary of Defense for military personnel policy, added that accepting transgender recruits by the new year would “impose extraordinary burdens” on the Pentagon by needing to prepare 20,367 recruiters, 2,785 employees across 65 Military Entrance Processing Stations, 32 service medical waiver authorities and personnel at nine boot camps.
“Beyond the sheer number of components and personnel involved, the implementation of accessions criteria is itself a complex undertaking,” he wrote.
“In the case of the transgender accession standards, the standards themselves are complex, interdisciplinary standards necessitating evaluation across several systems of the body, to include behavioral and mental health (e.g. diagnosis of gender dysphoria or related comorbidities), surgical procedures (particularly thoracic and genital), and endocrinology (for the purposes of cross-sex hormone therapy). No other accession standard has been implemented that presents such a multifaceted review of an applicant’s medical history.”
Brad Carson, a former Pentagon official who worked on the Obama administration’s transgender military policy, refuted the Trump administration’s arguments.
“The Pentagon had already done most of the preparation and training in anticipation of the lifting of the accession ban before the presidential transition, so to claim that the military is not ready to lift the ban now seems a stretch,” he said in a statement released by the Palm Center.
Today, Hornet, the world’s premier gay social network, announced the company will join the international Undetectable = Untransmittable (U=U) campaign becoming the first gay social network to support the initiative. Hornet, which has a longstanding history of community engagement around gay men’s health, is working to combat HIV stigma by continuing to raise awareness that an undetectable viral load means HIV is untransmittable. This partnership will utilize one of the largest global LGBTQ platforms to empower people living with HIV, stimulate conversations about sexual health and advance the principle that access to health care is a fundamental human right.
The CDC, UNAIDS and over 500 organizations from 65 countries have confirmed the science behind the U=U campaign verifying that an undetectable HIV viral load means HIV is untransmittable. Science has proven a person achieves an undetectable viral load when medication suppresses the virus to levels so low it can’t be measured by tests. This means an HIV-positive individual can live a long and healthy life and the virus cannot be passed on. Taking medication as prescribed ensures a person will continue to be undetectable. Hornet will continue their commitment to educate the global community about U=U and combat HIV stigma.
“Our partnership with Hornet will help lift the fear about transmitting HIV, and it will begin to dismantle the HIV stigma and ignorance that is still widespread in gay communities,” said Bruce Richman, who leads the U=U campaign and is HIV positive. “The very definition of what it means to live with HIV is changing, and that changes everything for our lives and for the epidemic.
There are many complex reasons why someone may not achieve an undetectable viral load. All HIV-positive individuals have a right to live free of stigma and discrimination and to pursue a fulfilling sexuality. To access medication and achieve an undetectable viral load is a privilege, and Hornet and U=U will work together to ensure that all people living with HIV have the right to quality health care and medications, so they can live long and healthy lives.
“We are very excited about this partnership with U=U. We’ve been committed to creating an online space that is free of stigma and discrimination. U=U has been a grassroots movement that has advanced basic principles of science while empowering people living with HIV and we are happy we can be a part of that. I’ve had HIV-positive and undetectable in my Hornet profile for years. It’s a way for me to affirmatively declare my status, educate others on the benefits to your health of being undetectable, and combat HIV-related stigma.” said Alex Garner, Senior Health Innovation Strategist at Hornet.
Hornet and the U=U campaign will conduct a series of events in key cities around the globe to maximize the reach of the partnership and U=U campaign. The first event will be in NYC in February, followed by other activities in Paris, Sao Paulo, and Taipei.
Medicare, though not at the forefront of the healthcare debate like the Affordable Care Act and Medicaid are, is still a big concern in some circles.
What is the true status of Medicare? Is it good, bad, or somewhere in between? What would happen if Medicare was eliminated?
In this post, we’re going to discuss some pros and cons of Medicare.
Pros of Medicare
Medicare Provides Coverage to Those Who Wouldn’t Have Coverage
In many senses, Medicare does “work.” Thanks to the program, millions of aging adults have been able to receive coverage when they otherwise wouldn’t be able to afford it. Prior to 1965, when Medicare was created, around 9 millions older adults didn’t have health coverage. That number is significantly higher than the 400,000 seniors who were uninsured in 2014. Medicare also covers many younger Americans with disabilities who would not be able to get healthcare otherwise.
Consider the implications if Medicare didn’t exist. Older Americans, who typically need the most medical treatment, would find themselves paying exorbitant medical costs directly out of pocket. The total paid every year would be staggering, most likely exceeding their annual income.
Individuals with disabilities would be totally dependent on their caretakers, who may or may not be able to afford medical care.
Clearly, Medicare is useful because it covers so many people.
Medicare Costs Very Little Every Month
Medicare enrollees generally are qualified for free Part A but must pay a small amount out of pocket every month for Part B. This number is estimated to cost around $134 per month. When you compare this to the out-of-pocket cost of operations, prescriptions, and other associated costs, the savings are huge.
More and more Americans enroll in Medicare Advantage plans each year, and enrollment is expected to keep growing in the future. If fact, enrollment was at 17.6 million in 2016, tripling from 5.3 million in 2004. Part C enrollees made up 31 percent of the 57 million Medicare recipients as of 2016.
MA plans offer beneficiaries an alternative way to get Medicare benefits through plans sold by private insurance companies that contract with the Centers for Medicare & Medicaid Services (CMS).
You get all the Medicare program benefits of Part A hospital insurance and Part B medical insurance, together known as Original Medicare*, when you enroll in Part C (Medicare Advantage). Plus, Medicare Advantage plans may provide additional benefits (dental, vision, etc.) at a minimal cost.
These services are essential to older Americans who would suffer otherwise.
Medicare Has Led to Prescription Innovations
The inception of Medicare created a massive market for drug companies. Suddenly, millions of Americans had access to prescriptions they wouldn’t have had otherwise. When pharmaceutical companies saw the untapped potential in the Medicare market, they began investing billions of dollars in the development of drugs tailored specifically for seniors.
As John Holohan, fellow at the Health Policy Center at the Urban Institute, notes, “A market began for drug companies and medical device manufacturers; when you have a market willing to pay for [products], it’s worth making the investment.”
The addition of Medicare Part D Prescription Drug Plans and Medicare Advantage Prescription Drug Plans—both sold through private insurance companies—also gave Americans wider access to prescription medicines. Medicare beneficiaries have had access to these plans since 2006, and enrollments have increased every year since. In 2006, 22.5 million (52 percent) people on Medicare were enrolled in Part D compared to 40.8 million (71 percent) in 2016, according to the Kaiser Family Foundation. With millions of Americans receiving Medicare prescription drug benefits, this may have given pharmaceutical companies more opportunities to develop drugs for this market.
Medicare Has Resulted in Increased Medical Standards
With the creation of Medicaid and Medicare, Congress created a set of standards for hospital enrollment in the programs. As time went on, the government become more and more involved in overseeing these standards and now requires public reporting on things such as hospital infection rates and readmissions.
This public accountability forces hospitals to perform due diligence in ways they might not otherwise.
As Karen Davis, director of the Roger C. Lipitz Center for Integrated Health Care at the Johns Hopkins Bloomberg School of Public Health, notes, “When hospitals find out they aren’t as good as other hospitals, they get serious about improving. When they find out it’s possible to have lower rates of infections, for instance, they try to find out what good practices are and follow them to get good results.”
Cons of Medicare
Medicare Costs a Huge Amount to Administrate
In 2016, Medicare spending totaled $588 billion. Currently, that’s approximately 15% of the overall federal budget. That number isn’t expected to get smaller, with many estimating that the percentage will go up to around 18% over the next decade.
When you consider that this staggering amount could be spent on other valuable programs, such as education, eliminating poverty, mental illness cures, and social justice, it at least causes you to question the overall efficiency of the program.
Poor Health Can Actually Cost More
The Kaiser Family Foundation says that those who reported themselves to be in poor health and on Medicare had out-of-pocket costs 2.5 times higher than the healthier beneficiaries.
While it’s somewhat hard to evaluate what this statistic means given that self-reporting isn’t always reliable, it does raise questions.
Granted, Medicare does offer a significant number of free preventive programs to enrollees that can cut down on health problems. And, many of the individuals on Medicare suffer from preventive conditions (particularly before the implementation of ACA).
Hospital Stays Still Cost a Lot
Even for those enrolled in Medicare, hospitals stays can still be extraordinarily expensive, easily running into the thousands. This highlights several issues.
As noted, many of those on Medicare suffer from preventable conditions and are hospitalized for those conditions. This places an increased burden on hospitals, which can then drive up the prices across the board for all patients.
Additionally, because many Medicare enrollees are in a low-income bracket, they can’t afford these stays, placing a crushing burden on them and putting the hospital in a difficult spot.
While Medicare certainly helps those who are struggling medically, it also creates significant strain on the overall healthcare system in the United States.
Older Enrollees See Costs Skyrocket
“Medicare enrollees 85 and older spend three times more on healthcare than those aged 65 to 74,” according to a Kaiser Family Foundation report. In some ways, this should be expected because more medical issues arise as a person gets older.
However, it also reveals that Medicare doesn’t adapt well for the oldest adults. A truly efficient system would take the increased costs into account and spread those across all enrollees.
Medicare Attracts Fraudulent Doctors
In 2017, the United States charged 412 doctors with medical fraud, amounting to $1.3 billion. Unfortunately, much of this fraud was connected directly to the opioid epidemic currently happening in the country. As the New York Times reported, “Nearly one-third of the 412 charged were accused of opioid-related crimes. The health care providers, about 50 of them doctors, billed Medicare and Medicaid for drugs that were never purchased; collected money for false rehabilitation treatments and tests; and gave out prescriptions for cash, according to prosecutors.”
In addition to the Medicare funds lost through fraud, the government must also employ a significant task force to investigate potential crimes, adding yet more expenses to the Medicare program.
Medicare Costs Taxpayers a Huge Amount
In 2014, an astonishing 38% of Medicare funds came from payroll taxes. With the current Medicare tax rate set at 2.9% (split between employers and employees) — and an additional 0.9% for those making more than $200,000 — this represents a significant amount of money coming out of each paycheck.
While it’s certainly understandable that Medicare funding must come from somewhere, it raises the issue of whether private insurance companies could be more efficient in terms of funding their programs.
Conclusion
The Medicare debate isn’t going anywhere anytime soon. It’s been part of the landscape for over 50 years and will probably continue to be around in one form or another for many years to come.
When enrolling in an insurance plan, your best bet is to do plenty of research. Find out what’s available and what benefits are offered. You may be able to get a better, equally affordable plan through a private insurance company.
In the past few decades, HIV has gone from being a fatal diagnosis to a manageable disease. Although no known cure exists, researchers have developed antiretroviral therapies (ARTs) that stop the HIV virus’ ability to make copies of itself in the body. Effectively, this means that individuals with HIV who consistently comply with the regimen can keep their infection under control and live a long life.
ART takes a multi-pronged approach to combating HIV – patients often have to take at least three different drugs daily to suppress their infection. With that regime comes a host of challenges, like lifelong adherence to daily medication, the cost of drugs and regular checkups, and drug resistance, to name a few.
In a paper published this year, ViiV Healthcare, a pharmaceutical company specializing in HIV therapy development, showed that another, more streamlined treatment method might be on the horizon. The LATTE-2 study combined two drugs into an injectable therapy that could be delivered to patients every eight weeks – and found it to be as effective as a daily oral treatment.
A long-acting therapy would be an exciting and momentous shift in the landscape of HIV treatment. Compared to daily oral treatments, it could improve medication adherence and ease the psychological burden of taking HIV drugs and disclosing HIV status. But getting the therapy from exciting idea to viable product is likely to be pricey, so it’s crucial to work in the meantime toward improving HIV diagnosis rates and overall treatment accessibility.
In 2016, the World Health Organization released a report highlighting that over 40 percent of people living with HIV do not know they are infected. This is thanks to a long-term latent stage of HIV infection, during which the virus slowly multiplies and individuals can display very mild symptoms, or none at all. If people are unaware of their positive status, they can continue to transmit the virus to others; between 2010 and 2015, the number of new HIV infections per year dropped, but only from 2.2 million to 2.1 million. To overcome these statistics, more resources need to be invested into creating affordable and accessible HIV detection strategies, particularly for individuals facing financial and/or access-related barriers to testing and treatment.
It’s recommended that HIV-positive individuals begin treatment right away, but the reality of ART-related costs can be an insurmountable barrier. Because of the variety in medical coverage and insurance plans, many patients are unable to cover the cost of ART, which can range from several hundred to several thousand dollars per month. This high cost of treatment disproportionately burdens low-income patients and drives the disparity in rates of HIV that puts certain minority groups at a greater risk of infection.
Where does the LATTE-2′s drug combination fit into this complex picture? Currently, the study is in phase two of a three-phase clinical trial. It enlisted adults with HIV who, for 20 weeks, followed a current standard-of-care: a three-drug combination taken daily to prevent the HIV virus from multiplying. After 20 weeks, patients were split into three cohorts: one continued the oral therapy regime, while the other two were given an injectable combination of drugs every four weeks or eight weeks. For two years, each patient’s HIV levels were regularly measured and they were monitored for any adverse effects associated with the treatment. Incredibly, over 80 percent of patients in each group had low levels of HIV by the end of the study, with no significant differences between any of the treatments.
If the new regimen continues to demonstrate effectiveness, it can be put on the market as a branded drug to be used in patients with HIV. Along with other branded ART drugs, it’s likely to cost hundreds to thousands of dollars per year. Like many new drugs, this is done intentionally to offset the costs of years of research and production that brought the drug to market. But as a consequence, this fuels the divide between HIV treatments that exist and HIV treatments that are affordable. Until patents run out, allowing for generic drugs and resulting price reductions, it’s unlikely that the reality of actually accessing and affording HIV treatment will substantially change.
In the meantime, we are continuing to learn more about how HIV functions, how it infects the body, and how it can be treated. Ultimately, a better understanding of the disease will drive us towards an accessible and sustainable solution for people living with HIV all over the world.
Until that happens, more work needs to be done to prevent HIV, increase the ease of testing, and interface with policymakers on how to lower the cost of treatment. We have taken a step forward in developing HIV therapies, but are several steps behind in making sure they get to the individuals they intend to treat.
Collecting information on these deaths is complicated by the fact that many trans people are misgendered in reports following their death.
There have been over 270 reported murders of trans and gender non-conforming people in the past year.
There has been a total of 2,609 reported cases in 71 countries worldwide since Transgender Day of Remembrance began in January 2008.
The names on this list are only of cases that have been reported and have attracted local media attention. The more accurate number is likely much higher, according to the Trans Murder Monitoring Project.
Argentina
Sofía Mailén Santillán
Mercedes, Argentina
1-Dec-16
Beaten to death
A. Villegas
Quilmes, Argentina
14-Jan-17
Shot in the head
Cindy Crawford Revlon
Buenos Aires, Argentina
1-Jun-17
Decapitated
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Pamela Tabarez
Rosario, Argentina
25-Jul-17
Shot multiple times
Eyelen
Tucuman, Argentina
18-Aug-17
Beaten
Brazil
Juninho da Mangueira
Guarus, Brazil
21-Nov-16
Shot at least five times.
Paola Bracho
Manaus, Brazil
24-Nov-16
Suffocated
Michele Rios
Rio de Janeiro, Brazil
26-Nov-16
Cause unclear
Patricia Araujo not reported
Sao Paulo, Brazil
27-Nov-16
Shot in the head and burned
Dandara
Natal, Brazil
28-Nov-16
Shot in the head
Name unknown
Joao Pessoa, Brazil
2-Dec-16
Asphyxiation
M. Dias Machado
Pontal do Parana, Brazil
3-Dec-16
Shot at least three times
Will Rhillary Silva
Viamao, Brazil
7-Dec-16
Shot
Name unknown
Rio de Janeiro, Brazil
7-Dec-16
Shot
R. da Silva de Sá
Maceio, Brazil
10-Dec-16
Shot in the head
G. Aquino de Godoy
Curitiba, Brazil
14-Dec-16
Shot in the head
D. de Souza
Campos, Brazil
17-Dec-16
Shot in the neck and back
J. R. T. Gomes
Crato, Brazil
18-Dec-16
Stoned to death
Gabriel Gomes
Goiania, Brazil
21-Dec-16
Shot multiple times at the same incident as F. Braz
F. Braz
Goiania, Brazil
21-Dec-16
Shot multiple times at the same incident as Gabriel Gomes
Paula Raio Laser 50
Fortaleza, Brazil
23-Dec-16
Shot
Jake Helen
Contagem, Brazil
31-Dec-16
Shot five times
Flávia Victoria Lima
Sorocaba, Brazil
31-Dec-16
Cause unclear
L. C. Marinho
Nova Cruz, Brazil
4-Jan-17
Stabbed
W. H. Soares dos Santos 16
Teresina, Brazil
6-Jan-17
Shot
Mierala da Silva
Bauru, Brazil
13-Jan-17
Beaten
Moranguinho
Paranangua, Brazil
15-Jan-17
Shot
Agatha Lios
Brasilia, Brazil
18-Jan-17
Cause not reported
Sandra
Rio de Janeiro, Brazil
19-Jan-17
shot
Lady Dyana
Manaus, Brazil
19-Jan-17
Stabbed
J. A. dos Santos
Itabaianinha, Brazil
26-Jan-17
Shot to death
Paola Oliveira
Russas, Brazil
30-Jan-17
Stoned to death
Name unknown
Recife, Brazil
3-Feb-17
Drowned; legs were tied down
Agatha Mont
Itapevi, Brazil
4-Feb-17
Suffocated
Name unknown
Guaruja, Brazil
8-Feb-17
Stoned to death
Dandara dos Santos
Fortaleza, Brazil
15-Feb-17
Beaten and stoned to death by a mob
Name unknown
Caçapava, Brazil
17-Feb-17
Shot to death
A. da Silva Maciel
Distrito de São Sebastião, Brazil
18-Feb-17
Shot
Mirella de Castro
Belo Horizonte, Brazil
19-Feb-17
Suffocated
Camila de Souza Magalhães
Sao Gonçalo, Brazil
25-Feb-17
Beaten
Emanuelle Muniz
Anapolis, Brazil
26-Feb-17
Stoned to death
Lorrane
São Luiz, Brazil
26-Feb-17
Shot to death
Z. Marrocos
Guarabira, Brazil
28-Feb-17
Stabbed to death
Michelly Garcia
Pelotas, Brazil
3-Mar-17
Shot
Name unknown
Goiania, Brazil
6-Mar-17
Shot
Rubi
Luziania, Brazil
6-Mar-17
Shot
Sandra
Laranjeiras do Sul, Brazil
8-Mar-17
Beaten
Jennifer Celia Henrique (Jenni)
Florianopolis, Brazil
10-Mar-17
Beaten
Name unknown
Cachoeirinha, Brazil
12-Mar-17
Burned to death
Lexia
Santa Fe do Sul, Brazil
13-Mar-17
Stabbed
Camila Albuquerque
Salvador, Brazil
15-Mar-17
Shot
Bruninha
Ourinhos, Brazil
16-Mar-17
Stabbed
Paola
Street Joao Candido do Camara, Brazil
22-Mar-17
Stabbed
Paulina
Recife, Brazil
23-Mar-17
Shot multiple times
Uilca or Wilka
Loteamento Luiz Gonzaga, Brazil.
26-Mar-17
Stabbed
Stephanie Montez, who was killed in October of this year
Name unknown
Acara, Brazil
2-Apr-17
Beaten
Name unknown
Campo Grande, Brazil
3-Apr-17
Not reported
R. Félix da Silva
Guarariba, Brazil
4-Apr-17
Shot to death
Bianka Gonçalves
Primavera do Leste, Brazil
7-Apr-17
Shot to death
Camila
Sao Jose do Campos, Brazil
10-Apr-17
Beaten
Vitoria Castro
Araguaina, Brazil
10-Apr-17
Beaten
Hérica Izidório
Fortaleza, Brazil
12-Apr-17
Beaten
Name unknown
Curitiba, Brazil
12-Apr-17
Beaten
Gaby
Feira de Santana, Brazil
12-Apr-17
Shot to death
Name unknown
Itabuna, Brazil
16-Apr-17
Shot to death
Samilly Guimarães
Rio de Janeiro, Brazil
20-Apr-17
Shot to death
Marooni
Belem, Brazil
22-Apr-17
Stabbed
A. Ribeiro Marcossone
Curitiba, Brazil
23-Apr-17
Shot over 25 times
Eloá Silva
Joao Pessoa, Brazil
27-Apr-17
Shot multiple times
Name unknown
Barcarena, Brazil
29-Apr-17
Stabbed
Uilca
Vitoria de Santo Antao, Brazil
29-Apr-17
Shot to death
Layza Mello
Vilha Velha, Brazil
30-Apr-17
Shot to death
Name unknown
Belem, Brazil
30-Apr-17
Shot to death
Samaielly
Lauro de Freitas, Brazil
30-Apr-17
Shot to death
Sophia Castro
Contagem, Brazil
3-May-17
Cause unclear
C. A. Lima da Silva
Monhangape, Brazil
6-May-17
Shot to death
R. C. Silva Pereira
Barretos, Brazil
7-May-17
Deliberately struck by a vehicle
Thadeu Nascimento
Grande do Retiro, Brazil
7-May-17
Shot and beaten
Jennifer
Itaitinga, Brazil
9-May-17
Shot multiple times
Fernanda
Ponta Grossa, Brazil
10-May-17
Shot
Chaiane
Cachoeira do Sul, Brazil
13-May-17
Stabbed
Ketlin
Juazeiro do Norte, Brazil
13-May-17
Stabbed
Name unknown
Fortaleza, Brazil
13-May-17
Stabbed
Name unknown
Morro Agudo, Brazil
15-May-17
Beaten to death
Pâmela
Belo Horizonte, Brazil
21-May-17
Stabbed to death
Lalá
Feira de Santana, Brazil
25-May-17
Shot to death
Grace Kelly
Lauro de Freitas, Brazil
25-May-17
Suffocated
Joyce Jane Padilha
Rio de Janeiro, Brazil
26-May-17
dismembered
Sheila Medeiros
Tres Pontas, Brazil
29-May-17
Cause not reported
Laryrssa Moura
Governador Valadares, Brazil
31-May-17
Shot in the back
Natasha
Castanhal, Brazil
5-Jun-17
Multiple gunshot wounds
A. Alves Nascimento
Criciúma, Brazil
5-Jun-17
Shot to death
Trans day of remembrance, 2006 (HECTOR MATA/AFP/Getty Images)
Natasha
Varginha, Brazil
6-Jun-17
Shot multiple times
Name unknown
Salvador, Brazil
10-Jun-17
Shot in the neck, belly, shoulder, and back.
Renata Vieira
Uberlândia, Brazil
14-Jun-17
Beaten to death
E. Shyne
Rio de Janeiro, Brazil
15-Jun-17
Tortured
Julhão Petruk
Fortaleza, Brazil
15-Jun-17
Shot multiple times
Name unknown
Caraguatatuba, Brazil
16-Jun-17
Stabbed
Bárbara
Maceió, Brazil
18-Jun-17
Struck by a vehicle
Name unknown
Belo Horizonte, Brazil
19-Jun-17
Shot to death
Camily Victoria
Belo Horizonte, Brazil
22-Jun-17
Shot to death
Denise
Aracaju, Brazil
24-Jun-17
Shot to death
C. Barroso de Oliveira
Ananindeua, Brazil
24-Jun-17
Shot to death
Nicolly Santos
Vitória de Santo Antão, Brazil
24-Jun-17
Stabbed multiple times
Ney Oliveira
Apuarema, Brazil
25-Jun-17
Stabbed to death
Salomé Bracho
São Luís do Curu, Brazil
25-Jun-17
Shot to death
Tabata Brandão
Rondonópolis, Brazil
25-Jun-17
Shot to death
Carla
Maceió, Brazil
28-Jun-17
Stabbed to death
Lola
Sorriso, Brazil
2-Jul-17
Cause not reported
Rayane
Fortaleza, Brazil
2-Jul-17
Shot
Larissa
Fortaleza, Brazil
2-Jul-17
Multiple gunshot wounds
Vicky Spears
Diadema, Brazil
3-Jul-17
Shot
Anna Sophia
João Pessoa, Brazil
8-Jul-17
Shot in the head
Bruna dos Santos
Pelotas, Brazil
9-Jul-17
Beaten and shot
Derricka Banner, who was killed in September of this year
Cauã
Porto Alegre, Brazil
9-Jul-17
Shot
Thalia
Rio Verde, Brazil
14-Jul-17
Shot
Sophia
Campo Mourão, Brazil
17-Jul-17
Stabbed to death
Michele
Caxias, Brazil
17-Jul-17
Shot
Leona Albuquerque
Salvador, Brazil
17-Jul-17
Shot multiple times
Camila Guedes
Monte Mor, Brazil
20-Jul-17
Stabbed
Gil Pereia da Costa
Rio Branco, Brazil
20-Jul-17
Shot twice
Gabriela Sousa
Maracanaú, Brazil
21-Jul-17
Shot
E. A. da Silva
Maceio, Brazil
21-Jul-17
Shot
Name unknown
Belo Horizonte, Brazil
22-Jul-17
Stabbed to death
Natalia Pimentel
Várzea Grande, Brazil
25-Jul-17
run over multiple times
Aurinete
Patos do Piauí, Brazil
31-Jul-17
Stabbed
Name unknown
João Pessoa, Brazil
1-Aug-17
Shot in the head.
Mary Monttila
Palmeira dos Índios, Brazil
2-Aug-17
Stabbed
Charliane
Itabuna, Brazil
2-Aug-17
Shot
Bruna Laclose
Pinheiro Machado, Brazil
6-Aug-17
Stabbed
Paulinha
Palmares, Brazil
8-Aug-17
Stabbed
T. J. Gomes da Silva
João Pessoa, Brazil
12-Aug-17
Shot
Dianna
Limoeiro, Brazil
18-Aug-17
Shot
Evelin Ferrari
Caruaru, Brazil
22-Aug-17
Shot
Lilly
Cachoeira, Brazil
27-Aug-17
Shot to death
Daniele Jesus Lafon
Poços de Caldas, Brazil
2-Sep-17
Stabbed with a pair of scissors
Flávia
Santos, Brazil
3-Sep-17
Shot
Rai
Petrolândia, Brazil
3-Sep-17
Stoned to death
Ana Carolina Nascimento
Araraquara, Brazil
5-Sep-17
Beaten to death
Nicole
Sorriso, Brazil
5-Sep-17
Stabbed
Alessandra
São Paulo, Brazil
7-Sep-17
Shot
Bruna Monteiro
Taguatinga Sul, Brazil
8-Sep-17
Shot to death
Lorane
Camocim de São Felix, Brazil
9-Sep-17
Shot
Larissa Paiva
Serra, Brazil
14-Sep-17
Serra, Brazil
Safira
Salvador, Brazil
15-Sep-17
Shot to death
Name unknown
Camaçari, Brazil
16-Sep-17
Shot
Ana Coutti
Cabo Frio, Brazil
18-Sep-17
Multiple gunshot wounds
Kaleane
Belo Horizonte, Brazil
20-Sep-17
Shot in the head
Spencer
Campinas, Brazil
23-Sep-17
Beaten and stabbed
D.R.P.
Campinas, Brazil
24-Sep-17
Stabbed to death
Pâmela
Moreilândia, Brazil
25-Sep-17
Shot and beaten
Danhy Zn
Leme, Brazil
25-Sep-17
Not specified
Rayssa
Uberaba, Brazil
26-Sep-17
Shot twice
Lu Brasil
Altamira, Brazil
26-Sep-17
Cut and strangled
Renatha Lemos
Nova Mamoré, Brazil
30-Sep-17
Burned
Natália
Fortaleza, Brazil
30-Sep-17
Shot
Canada
Sisi Thibert
Montreal, Quebec, Canada
18-Sep-17
Stabbed to death
Chile
Vanessa Valenzuela
Viña del Mar, Region Valparaiso, Chile
28-Apr-17
Beaten with hammers and sticks by five people who yelled “kill the fag.”
Colombia
Alejandro Polanco Botero
Risaralda, Colombia
30-Nov-16
Shot four times in the head
Vikichy
Cali, Colombia
20-Jan-17
Stabbed in the chin and stomach
Silvana Fabian Pineda
La Dorada, Colombia
28-Jan-17
Multiple gunshot wounds
Angelo Ramos
Garzon, Colombia
9-Feb-17
Not reported
Name unknown
Chaparral, Colombia
16-Feb-17
Beaten to death
C. Camilo Valencia
Valle del Cauca, Colombia
19-Feb-17
Shot
Medicare, though not at the forefront of the healthcare debate like the Affordable Care Act and Medicaid are, is still a big concern in some circles.
The inception of Medicare created a massive market for drug companies. Suddenly, millions of Americans had access to prescriptions they wouldn’t have had otherwise. When pharmaceutical companies saw the untapped potential in the Medicare market, they began investing billions of dollars in the development of drugs tailored specifically for seniors.
With the creation of Medicaid and Medicare, Congress created a set of standards for hospital enrollment in the programs. As time went on, the government become more and more involved in overseeing these standards and now requires public reporting on things such as hospital infection rates and readmissions.
In 2016, 
“Medicare enrollees 85 and older spend 
