Who pays?

Carl Schmid, director of federal affairs for The AIDS Institute, based in Washington, D.C., told the summit Friday many people argued that informed written consent was the largest barrier to scaling up HIV testing.

He begged to differ: Funding, he said, would prove to be much more critical.

``If we are really going to have a profound effect in promoting change in HIV testing in the United States in all health care settings, we are going to have a systematic change in the ways HIV testing is paid for,’’ Schmid said.

He said that since the CDC goal is to test all Americans aged 13 to 64 who comes into a health care setting, advocates should not just look at traditional sources for HIV funding – but expand their thinking toward any kind of health care funding.

Schmid said one goal would be to enact legislation requiring that private insurers cover routine HIV tests. But he said that doesn’t even happen with the federal government’s health care insurance plan. ``You would think the federal government would lead by example – you would think that their medical health plan would include coverage of routine HIV testing -- but they don’t,’’ he said.