Local hospitals treat the uninsured for hepatitis C

BY AMY SKARNULIS | JUNE 28, 2012 6:30 AM

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People with hepatitis C may have problems finding health insurance — because the virus is a pre-existing condition — if the U.S. Supreme Court deems the Affordable Care Act unconstitutional.

However, Iowa City hospitals offer alternative programs for uninsured people infected with the virus. Both Mercy Hospital and the University of Iowa Hospitals and Clinics treat people who are infected with no insurance.

Vivek Mittal, a gastroenterologist and herpetologist at Mercy Hospital, said the facility has an entire team devoted to helping people without insurance.

"I haven't had any issue with insurance so far," he said. "We have a team; there is a specialty pharmacy involved as well as the hospital team."

Bryce Smith, lead health scientist for Centers for Disease Control and Prevention's Division of Viral Hepatitis, told The Daily Iowan in a statement the center recommends all adults born between 1945 and 1965 to be tested once.

"[The] CDC believes that the devastating effects of hepatitis C in the U.S. demand a bold response and that a number of factors make it important to expand testing to include a targeted group of Americans now," he said.

Government health officials drafted a proposal in May, and it could see a final ruling later this year, according to an MSNBC article.

Douglas LaBrecque, a UI professor of internal medicine and a specialist in liver disease, said that facility has a similar program. It has treated people with hepatitis C since the early 1990s, he said.

"We're a state hospital, so we get most of the patients without insurance," he said. "And we go to great lengths to get them their treatment."

LaBrecque said if people do have insurance, it may not cover their treatment if they test positive for the virus after they have a certain insurance coverage plan. If the insurance company is aware that people have hepatitis C, it will either deny the request for insurance or put them on a much more expensive plan.

"I suppose we'll know about by Friday, when the Supreme Court makes its decision on Obamacare," LaBrecque said. "[With Obama' plan], they cannot deny you because of a pre-existing condition."

LaBrecque said baby boomers are at a much higher risk of having hepatitis C because of the blood transfusions and drug use. He said people often are unaware they have the virus.

"Hepatitis C is a real stealth disease," he said. "The liver is very forgiving — it can endure quite a bit of damage before it starts to complain."

Hepatitis C is contracted through blood, but usually affects the liver. LaBrecque said it could take 20 or 30 years before patients experience any symptoms, but the liver can function adequately with only about 30 percent of it left.

"I always think of the liver as the space shuttle," he said. "They have five different computers, so if you knock out four computers, it can still fly fine because there's one working."

Mittal said approximately 3.2 million Americans are affected by hepatitis C, and three-fourths of them are baby boomers. He said before the late-1980s, health officials did not know the virus existed, so they never tested for it. It was not until 1992 that a test was available.

"If someone is tested [positive] for hepatitis C, the first thing is not to panic because there is a treatment, meaning we can cure it and not just suppress it like HIV," he said.

Mittal said new drugs have been introduced in the last year. Only 30 or 40 percent of patients diagnosed before May 2011 could be cured in about a year, but now, that rate stands at 75 percent in roughly six months.

He said a big question is who is going to test all of the baby boomers who are concerned or others who feel they may have contracted the disease. Specialists are still concerned about who should administer the test for the virus — primary physicians or specialists.

"The physicians already have everything else to do [with a regular doctor's appointment]," Mittal said.

LaBrecque said it is going to take teamwork on both the side of the specialists and the primary physicians.

"I think it's part of our job to frankly educate the physicians [about recommending patients to be tested for hepatitis C]," he said.

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