Public Health, Kansas Style, or How I Learned to Stop Worrying and Love HB 2183

The proposed a href= and amendment/a of Kansas House Bill 2183, which, having passed the Kansas Senate, is now making its way through the state legislature, is sounding alarms in the HIV/AIDS communities — and with good reason.  Although originally intended to assist first responders who might, by virtue of their work, be potentially at risk of contracting HIV, the bill, as amended by the Kansas Department of Health and Environment, now effectuates sweeping deregulations of the criteria and methodologies for the determination of the need for isolation and quarantine by bringing all infectious diseases under a single statute.  Moreover, HB 2183 invalidates a state law from 1988, explicitly banning the quarantining of individuals diagnosed with AIDS.  This broadening of the state powers to isolate leaves wide open the possibility that individuals with HIV/AIDS could be quarantined without consent or right to appeal.  While the Republican-controlled Kansas state legislature has denied this charge, and has, in fact, promised that the state power to quarantine will not be used against individuals with HIV or AIDS, they have nevertheless defeated a Democratic push, led by Senator Marci Francisco, to specifically exclude those with HIV/AIDS from the isolation/quarantine provisions on the grounds that HIV/AIDS is not spread via casual contact.

But is this a tempest in a teapot?  As I noted above — not likely.  In a state that is among the most socially and politically conservative in the nation, obvious worries within the HIV/AIDS communities about discrimination, abuse of state powers, further stigmatization, and a deprivation of civil liberties are, I believe, well-founded.  Consider the revised statute, which reads, in relevant part:
p style=text-align: center;The secretary of health and environment is authorized to issue such orders and adopt rules and regulations as may be necessary to prevent the spread and dissemination of diseases injurious to the public health, including, but not limited to, providing for the testing for such diseases and the isolation and quarantine of persons afflicted with or exposed to such diseases./p
p style=text-align: center;(c) No later than January 1, 2014, the secretary shall develop and adopt rules and regulations providing for the protection of individuals who provide medical or nursing services, clinical or forensic laboratory services, emergency medical services and firefighting, law enforcement and correctional services, or who provide any other service {or individuals who receive any such services} or are in any other employment where the individual may encounter occupational exposure to blood and other potentially infectious materials.
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In no uncertain terms, the statute lays out the possibility of state-imposed isolation, based on broad powers granted to the secretary of health and environment  —  ia political appointment/i  —  to use his or her judgment, and very  little else, in developing regulations for, and defining, “diseases injurious to the public health.”

But, all of this sounds oddly familiar.  Have we seen this before?

Yes.  Yes, we have.  In 1986, in the midst of the emerging AIDS epidemic, Lyndon LaRouche attempted to do something similar, but much more obvious, in California with Proposition 64, designed to quarantine individuals with AIDS.  Thankfully, his efforts failed to the tune of 71% to 29%..

So, is this LaRouche, part two?  The proponents of the statute will tell you that they only have the best intentions — after all, who does not want to protect our first responders, and those whom they help?  Is the public really not interested in its own health, the health of its children – or any protection at all from the ravages of terrible diseases for which there are still no cures?  To deny this amendment, they argue, is to ignore its focus on a href= medically necessary/a, and is thus somehow self-defeating and short-sighted.

Except that it’s not.  In addition to the deliberately overbroad powers of definition, interpretation, and policy-setting given to very few, politically-motivated people, there is another “tell” in this Kansas party trick:  In ignoring the Democratic attempts to exclude the HIV/AIDS community from the amended statute, the GOP legislators have only two probable justifications for their actions:  (1)  Either they simply do not understand, from a scientific and epidemiological perspective, how HIV/AIDS differs from, say tuberculosis or SARS in that it is not transmitted casually, or through the air, and so on; or (2).  They know perfectly well what the differences are, and simply are trying to push through the kind of agenda that is intended to have exactly the sorts of consequences feared by the HIV/AIDS community.  And if we grant that the first option is much less likely than the second one, then we are still choosing between ignorance and prejudice — all in a state that is not known for a lack of the latter.

And if one suggests that this sort of analysis is an overreaction to a simple change in state law, I do, then, want to ask the following:  Even if we grant that the Kansas state legislature only has the best intentions, and that none of its stated and unstated goals include the quarantining of individuals with HIV/AIDS ijust because they happen to be individuals with HIV/AIDS/i, why not craft a law that makes this clear  —  that makes this so clear that no HIV/AIDS patient would, for example, decide not to seek out medical treatment for fear of potential isolation, or worse?  Why not place a not-insignificant portion of a state’s population more at ease with a law that presently seems, on a number of interpretations, to leave a very wide berth for abuses of power and for the public legislation of private morality?  Why, given that this amendment is ostensibly motivated by nothing more ominous than public health concerns, not make it imore,/i rather than iless/i, likely that individuals with HIV/AIDS will seek out medical care, thereby helping not only themselves, but, by extension, the public at large?

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Public Health, Kansas Style, or How I Learned to Stop Worrying and Love HB 2183 — 2 Comments

  1. It’s difficult to underestimate the amount of know-nothingism permeating the current political climate. When people like U.S. Congressman Paul Broun (R-GA), can have an MD degree and nevertheless feel free to tell members of a Baptist church, “God’s word is true. I’ve come to understand that. All that stuff I was taught about evolution and embryology and the big bang theory, all that is lies straight from the pit of Hell,” we can be pretty sure Gotlib’s second hypothesis is correct.

  2. Thanks, Hilde! What really gets to me about this whole bill, aside from its thinly-veiled bigotry, is that the public health arguments offered to justify its potentially draconian measures have very little to do with effective public health measures. The fact is that Kansas is a state where politically-motivated, scientifically-unsound drivel might actually become law, and there is no getting around that.

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