The Impact of AIDS on the Medical Care System

IN THIS eighth year of the war against acquired immunodeficiency syndrome (AIDS), the front lines in the United States are surely the hospitals of our major cities. It is to these institutions that the afflicted come, whatever their risk group, and in increasing numbers. Gay and bisexual men bring with them a history of discrimination and fear. Drug users reveal an entire family at risk. The worried well crowd our clinics to be tested for infection a second, third, or fourth time. People come in hope of being given the latest experimental drug protocol, and people come to die because they have no family or friends to provide their care. It has been estimated by the Centers for Disease Control that 270 000 cumulative cases of AIDS will occur in the United States by 1991.1The task of assimilating this enormous burden of disease into existing health care structures