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Wednesday, February 26, 2025

In Depth

Local consultant: Govt's plan for HIV/Aids insurance can hit snag

HIV/Aids ac­tivist: Dis­crim­i­na­tion at pub­lic hos­pi­tals

by

20111124

Plans by the Gov­ern­ment for new leg­is­la­tion to pre­vent dis­crim­i­na­tion against HIV pos­i­tive peo­ple, by in­sur­ance com­pa­nies are be­ing met with un­cer­tain­ty.Min­is­ter in the Min­istry of State, Rodger Samuel, said the ini­tia­tive, which is be­ing dis­cussed ahead of World Aids Day next Thurs­day, is aimed at tack­ling dis­crim­i­na­tion against peo­ple liv­ing with HIV/Aids, in­clud­ing dis­crim­i­na­tion in the work­place and pub­lic places.Lead­ing lo­cal in­sur­ance con­sul­tant, Bertrand Doyle, said more strin­gent and care­ful scruti­ny need­ed to be ex­plored by Gov­ern­ment and stake­hold­ers for the pro­posed leg­is­la­tion to be suc­cess­ful.

He urged Gov­ern­ment to prop­er­ly ex­plain how the in­tend­ed laws would work. "If you're talk­ing with re­spect to tak­ing HIV/Aids pos­i­tive peo­ple and charg­ing them a dif­fer­ent pre­mi­um, I don't think that makes very much sense," Doyle said. He ex­plained that if a per­son went to an in­sur­ance com­pa­ny and it was dis­cov­ered that the per­son had a dis­ease, an ap­pro­pri­ate rate was grant­ed to the per­son, based on the type of dis­ease. He added: "If it is they have a heart con­di­tion they would not rate them in the same way they would some­one who did not have a heart con­di­tion.

"It is a mat­ter of what might take place down the road...how soon they would call up­on the fund to pay," he said."So in that sense all in­sur­ance pre­mi­um rat­ing is dis­crim­i­na­to­ry in the sense that you do charge more, de­pend­ing on what it is you are in­sured for." Doyle said that was not iso­lat­ed to just life in­sur­ance but any type of in­sur­ance.

Us­ing a house as an ex­am­ple, he ex­plained a per­son who owned a tim­ber struc­ture would pay more for cov­er­age for fire com­pared to some­one who owns a struc­ture made of con­crete. He added: "That is in a sense dis­crim­i­na­to­ry. So in that sense there al­ways would be dis­crim­i­na­tion in the in­sur­ance in­dus­try with re­spect to rat­ing for rat­ing pur­pos­es.

"In that sense dis­crim­i­nat­ing means dif­fer­en­ti­a­tion be­tween dif­fer­ent types of risks. Which ever risk it is that comes with the in­sur­ance com­pa­ny, they rate that risk ac­cord­ing­ly."He said one av­enue Gov­ern­ment might be ex­plor­ing was to have in­sur­ance com­pa­nies not re­ject peo­ple who were al­ready HIV/Aids pos­i­tive.That, he said, could add an en­tire new di­men­sion which could trans­form the in­sur­ance in­dus­try.

"It is wor­thy of dis­cus­sion. Should HIV/Aids peo­ple be re­ject­ed out­right or not by in­sur­ance com­pa­nies? I think that's the ques­tion they should start with," Doyle pro­posed. If in fact in­sur­ance com­pa­nies do ac­cept HIV/Aids peo­ple what would they of­fer? Ac­cord­ing to Doyle, an in­sur­ance com­pa­ny does not "car­ry the in­sur­ance for it­self." He ex­plained: "The in­sur­ance com­pa­ny has rein­sur­ance con­sid­er­a­tions. They have to buy in­sur­ance for the in­sur­ance they have sold.

"One will need to find out the in­ter­na­tion­al mar­ket for rein­sur­ance with re­spect to vic­tims, peo­ple who are with­in cer­tain cat­e­gories and know what kind of rate they would have to pay in or­der for them to know what kind of rates they them­selves will charge." Asked whether there were spe­cif­ic in­sur­ance poli­cies of­fered to peo­ple with HIV/Aids, Doyle said that was very un­like­ly.

"If you did that you would have to get a spe­cial fund, spe­cial in­sur­ers who would un­der­take that risk," Doyle said.How­ev­er, he added, if a per­son took out a pol­i­cy and sub­se­quent­ly dis­cov­ered he or she had been in­fect­ed with the dead­ly virus the con­tract should not be af­fect­ed. He said: "A life in­sur­ance con­tract is not one in which you could just can­cel. If it is a pol­i­cy that has a re­new­al date it is quite pos­si­ble that if the in­sur­ance com­pa­ny knows at that time the per­son is in­fect­ed, sub­se­quent­ly they may not want to re­new.

"But not for a life in­sur­ance pol­i­cy which is ex­ist­ing and which was bought when the per­son did not have any dis­ease when they bought it."The fact that they have now ac­quired the dis­ease is not go­ing to in­val­i­date the con­tract which is ex­ist­ing," Doyle added. A se­nior fi­nan­cial ad­vis­er, as­signed to Tatil, said lo­cal in­sur­ance com­pa­nies did not pro­vide any cov­er­age to HIV/Aids peo­ple.

He main­tained, how­ev­er, that it was not a mat­ter of dis­crim­i­na­tion but rather a sit­u­a­tion deemed to be too risky. He said: "Our mar­ket is very small and it is very dif­fi­cult to of­fer that kind of cov­er­age. The lo­cal in­sur­ance com­pa­nies take up a per­cent­age of the risk and the rein­sur­ers abroad take up the bal­ance. "But if there are no sup­port mech­a­nisms in place then it will not work."

Teeth need­ed-Equal Op­por­tu­ni­ties Com­mis­sion

Dis­crim­i­na­tion against HIV/Aids pos­i­tive peo­ple ex­ists at all lev­el of the so­ci­ety.In the work place the prob­lem was very re­al and with­out prop­er laws very lit­tle could be done to as­sist the ag­griev­ed, said Michelle Ben­jamin, Le­gal Of­fi­cer 11 with the Equal Op­por­tu­ni­ties Com­mis­sion. Ben­jamin said at present the Equal Op­por­tu­ni­ties Act of 2000 did not cov­er dis­crim­i­na­tion against HIV/Aids peo­ple in the work­place.

She said part of the com­mis­sion's man­date was to elim­i­nate dis­crim­i­na­tion and for the pe­ri­od 2009 to 2010 they re­ceived ten com­plaints from HIV/Aids pos­i­tive peo­ple who cit­ed dis­crim­i­na­tion in terms of em­ploy­ment.The fig­ure, she said, could ei­ther in­di­cate that more in­fect­ed peo­ple were gain­ing the courage to speak out and re­port such mat­ters, or that peo­ple were too afraid to come for­ward.

Ben­jamin said pro­pos­als to amend the Act al­ready have been put for­ward by the com­mis­sion and it is up to Par­lia­ment to have the leg­is­la­tion placed on the Or­der Pa­per for dis­cus­sion. "Once the Act is amend­ed, the com­mis­sion would now have the pow­er to launch an in­ves­ti­ga­tion as HIV/Aids would now be in­clud­ed as a sta­tus. HIV/Aids in­fect­ed peo­ple must al­so be pro­tect­ed just like oth­er peo­ple fac­ing dis­crim­i­na­tion," she said.

NGOs fac­ing dis­crim­i­na­tion

Non-Gov­ern­men­tal Or­gan­i­sa­tions whose man­date is to specif­i­cal­ly as­sist HIV/Aids peo­ple are al­so fac­ing dis­crim­i­na­tion from the wider so­ci­ety.One such or­gan­i­sa­tion was the Car­i­tas Aids Min­istry (CAM), based in Diego Mar­tin.CAM's chair­man, Mal­colm Joseph, re­called late last year that the own­er of a Tu­na­puna hard­ware re­fused to de­liv­er build­ing ma­te­r­i­al to the or­gan­i­sa­tion up­on dis­cov­er­ing it was to be used for con­struc­tion of a HIV/Aids screen­ing and coun­selling fa­cil­i­ty at St John's Road, St Au­gus­tine.

Joseph said when a por­tion of the ma­te­r­i­al was ini­tial­ly de­liv­ered at the site the de­liv­ery man in­quired what was the pur­pose of the fa­cil­i­ty. "We told him and ap­par­ent­ly he must have gone back and told his em­ploy­er be­cause when I went back to the sup­pli­er to query a dis­crep­an­cy on the bill all the clerks came out and were watch­ing us."The boss asked us what we're do­ing with the ma­te­r­i­al and when we told him he said we should have in­formed him about the fa­cil­i­ty. He then told us he would not be send­ing any of his em­ploy­ees to do any de­liv­er­ies again," Joseph said.

As part of it man­date, CAM coun­sels HIV/Aids in­fect­ed peo­ple.Dis­crim­i­na­tion in the work­place, Joseph said, of­ten caus­es se­vere men­tal and emo­tion­al stress. He added: "Most times our clients were emo­tion­al­ly dis­turbed. We know of sit­u­a­tions where peo­ple were dis­missed when it was dis­cov­ered they were HIV pos­i­tive."CAM has no lo­cal stand­ing to go in­to the work­place and talk to em­ploy­ers but we would ad­vise work­ers to talk to their su­per­vi­sors hop­ing they would be­come sym­pa­thet­ic," Joseph said.

He said in some cas­es there is no dis­crim­i­na­tion by em­ploy­ers but in oth­er in­stances in­fect­ed peo­ple are trans­ferred to dif­fer­ent de­part­ments."There was one par­tic­u­lar cas­es where the em­ploy­ees were so in­censed that one of their col­leagues had the dis­ease that the em­ploy­er was forced to trans­fer him to a dif­fer­ent lo­ca­tion and al­so told him to keep qui­et and not let his sta­tus be known," Joseph said.

He is call­ing for leg­is­la­tion to be im­ple­ment­ed to deal with all forms of dis­crim­i­na­tion and said the ini­tia­tive should not be "puni­tive" but must al­so fo­cus on ed­u­cat­ing em­ploy­ers to deal with HIV/Aids pos­i­tive em­ploy­ees.At 18, Lor­na Hen­ry con­tract­ed the HIV virus. Sev­en­teen years lat­er she has full blown Aids.Hen­ry, a vo­cif­er­ous HIV/Aids ac­tivist, nev­er be­lieved she would live past her 30th birth­day, or even be­come a moth­er.In Jan­u­ary this year, Hen­ry gave birth to her third child, Janaya.

Janaya and her sib­lings Je­quan, sev­en, and Japhia, five, were born HIV neg­a­tive due the avail­abil­i­ty of med­ica­tion to pre­vent moth­er to child trans­mis­sion of the dis­ease. Janaya's birth, how­ev­er, was cloud­ed with bit­ter sweet mo­ments as Hen­ry was ver­bal­ly hu­mil­i­at­ed and shunned by nurs­es at the Port-of-Spain Gen­er­al Hos­pi­tal."I was placed at the very back of the ward. The nurse was very rude and ob­nox­ious and I was cry­ing.

"The nurse was say­ing, 'I don't know who send you all to make chil­dren. Why all you does make chil­dren to put oth­er peo­ple life in dan­ger?' What about the oth­er in­fect­ed moth­er who would again come in­to the sys­tem and re­ceive the same treat­ment. When will it end?" Hen­ry asked.In Au­gust this year, Hen­ry launched her NGO, Moth­ers to Moth­ers Trinidad and To­ba­go.She said: "Moth­ers to Moth­ers man­date is to sup­port HIV pos­i­tive moth­ers. Some women who are al­ready HIV pos­i­tive may de­cide they want to have a fam­i­ly.

"The or­gan­i­sa­tion will go to clin­ic ap­point­ments with them, en­sure they take prop­er med­ica­tion and we are try­ing to get the Gov­ern­ment on board to help some of them who may not have a prop­er place to live or ac­cess a prop­er meal," Hen­ry said.She said Moth­er to Moth­ers al­so was seek­ing to es­tab­lish nurs­eries to en­able in­fect­ed moth­ers to be gain­ful­ly em­ploy­ment to sus­tain them­selves.In her com­mu­ni­ty of Mal­ick, Hen­ry and her chil­dren are of­ten forced to deal with con­stant harsh and hurt­ful re­marks from neigh­bours.

"Most of my neigh­bours talk be­hind my back. Most of the times my chil­dren would get re­marks like, 'Your moth­er have Aids.' But that bounces off them. They would leave the oth­er chil­dren out­side and come in­side the house."My son asked me the oth­er day what is Aids and I told him. He told me the oth­er chil­dren kept say­ing I have Aids and he asked me why they have to say that. I told him be­cause his mum­my is very im­por­tant and that's why they talk about me."


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