I drive every morning from a farm in NJ to NYC to go to work. Lately, more than one person has asked me why I don’t just live in the city. There are many reasons, and most of them have to do with nature and how it balances me out after stressful days in the urban jungle. But, sometimes, nature is way more stressful than the hot concrete, claustrophobia-inducing crowds and incessant din that permeate New York. Recently, the nightime chorus of frogs in the stream below my house has been keeping me awake. Appararently, frogs do not sleep, or, if they do, there are so many of them that they can take turns contributing to a nonstop, all-night blast of sound I can only liken to the sound of hundreds of wild geese being simultaneously choked mid-honk.

I bring up the frog noise as it - and the resulting lack of zzzzs - was part of the reason I was a raging lunatic when I got pulled over by one of NYPD’s finest the other morning, as I headed into the Holland Tunnel. (More on that in a minute.)

The OTHER reason I was a raging lunatic was I’d just heard an extremely well-reported and well-written piece on NPR radio exploring reasons why universal testing for HIV in America might not be a great idea. They did not, as I hoped, discuss the privacy issues surrounding such a decision, the delicate issues of proper pre- and post-test counseling, the issue of HIV testing as it relates to a recent increase in criminalization of those who test positive, nor the issue of the lack of federal and state funding to help those who test positive and need medical care.

Instead, the piece made several key points all aimed at justifying why we should not test more widely for HIV in America. The first was that universal testing through the exisiting medical system will fail to reach many of those suspected to be HIV positive (we estimate there are 250,000 living with the disease in the U.S. who don’t know they have it) as the alleged profile of that group of people suggests they are not regularly coming through the heathcare system (read: they are druggies or derelicts, illegal immigrants, people living on the street, or people without healthcare ((hello! do they know how many Americans can not afford healthcare?))). Two, that the increased cost of pre- and post-test counseling will cripple the medical system and that three, even if we are able to identify people who are positive, and find a way for doctors and medical providers to afford to counsel them, we do not have the money to pay for their treatment (Again, the assumption in this piece was that many HIV positive people who don’t currently know their status are underpriviledged or disenfranchised. Which may be true. But, from the anecdoctal feedback I get in life, there are a lot of white, middle class people with health insurance, going regularly to their doctors who also have no idea what their HIV status is. So, this seems like a pretty big assumption to me.)

I’ve heard the arguments on both sides of the testing issue and while I understand both sides, I think it’s a ludicrous supposition that we shouldn’t test people for HIV because we can’t figure out a way to afford a way to treat them medically. Hey, I have an idea. Let’s just let those 250,000 people spend the rest of their lives infecting other people (unless they are practicing safer sex) before they die of a disease we know how to treat, simply because we can’t come up with the money to help save their lives.

I am not naive. I understand the delicacy of economic systems as best I can (I get that healthcare companies and state and federal goverments can’t just pony up for everyone in need without imploding financially) and I am not advocating for socialized medicine. BUT, the story and the way it was presented just irked me so, because there was no talk of looking for a solution. Hundreds of thousands are infected, it’s a giant financial burden to figure out how to care for them, so...let’s just avoid it! How American. If 250,000 people were infected with something else - and risked spreading it to the rest of the population because of ignorance of their infected status - you’d bet there’d be some clamouring (it might even rival the sound of the frogs outside my window).

Listening to the NPR piece, it struck me that there is still a clear undercurrent of the old “if we just let people with HIV/AIDS die off, maybe the problem will go away and we won’t have to come up with the cash to deal with the massive health crisis” line of thinking. And we all know how well that approach has worked.

I read once, in Harper’s magazine’s “Index” that the cost savings to Pan Am airlines (jeez, I am dating myself) as the result of removing a single olive from each first class salad was $40,000 in one calendar year. The point being that if Pan Am can get creative to save their bottom line, perhaps we could at least have a dialogue about creative ways to be able to afford care for those with HIV.

We do have the medical knowledge to care for the 250,000 (at least) who unwittingly carry HIV around with them. We just don’t have the cash. I get it. But let’s not stop the conversation there and move on to the next sound byte. Don’t make me aware of the problem, offer no solutions, and get on with the news. A quarter of a million Americans are walking retrovirus time bombs. This is news.

While I was, like so many of us, thrilled to hear of Warren Buffet’s recent endowment to the Gates Fund, and while I am eternally grateful for the incredible generosity that the Gates Fund has provided to life saving treatments in so many areas of health concerns, I can’t help but wonder why the bulk of the money goes towards prevention (vaccines) when there are so many alive already whose suffering is not being addressed. Call me an idealist. I can see the point in focusing on a vaccine GIVEN that we currently have treatment to keep those currently infected with HIV alive and relatively comfortable. But while we work hard to prevent future suffering, it should remain a consideration that there are so many who need help in the here and now.

I’m no better than NPR. I don’t have a solution to offer either. Maybe that’s why I was so mad. Sometimes the seeming impossibility and the magnitude of the problems with HIV/AIDS just gets to me.

Oh, about that cop. He pulled me over as there had been a report of a hit-and-run on the Turnpike involving a car that looked like mine. It wasn’t me. We cleared it all up, but not before I unloaded the bulk of my stress over the frog-induced sleep deprivation and unending frustration over the complexities of the global AIDS problems on him via a screaming match that thoroughly entertained those inching their way through the tunnel traffic. At the end, I found my composure, explained about the frogs and legions of those needing treatment who can’t get it, and apologized profusely. He apologized for wasting my time by stopping me and offered a solution for the frogs (earplugs). He had no suggestions for how to help find enough almighty greenbacks to give treatment to those folks who carry HIV but have yet to discover it. He said he’d keep thinking about it, parted the rush hour traffic and let me skip ahead, straight to the EZ Pass lane. That’s all I ask. That we keep thinking about it.