ANNAPOLIS -- A state health department bill requiring certain doctors and patients to be tested for the virus that causes AIDS may be sinking under the weight of its own cost.
An official at the Johns Hopkins University School of Medicine in Baltimore said the legislation is a "financial disaster" that could cost Maryland's health care system $74 million a year.
"These costs would obviously be borne by the consumer, meaning higher health care costs," according to Dr. John G. Bartlett, infectious diseases division chief at Hopkins.
Dr. Bartlett registered his alarm in a letter to the chairman of the House of Delegates Environmental Matters Committee, which heard testimony on the bill yesterday.
The risk of health care workers and patients getting the deadly virus from each other is extremely small, he wrote.
The governor's chief lobbyist, David S. Iannucci, said the $74 million estimate is too high, but state health officials could not provide another estimate.
Several legislators said privately that they're worried by the bill's cost, which includes an annual $1 million expense for the strapped state government.
Associations representing nurses and hospitals also oppose mandatory testing because they say it does nothing to stop the spread of the deadly AIDS virus.
The bill requires doctors, dentists and other health care workers who perform invasive surgical or dental procedures to be tested for the human immunodeficiency virus (HIV) that causes AIDS.
Although the bill doesn't say exactly what an invasive procedure is, health experts generally define it as one that is very bloody and poses a risk of HIV transmission.
In addition, the legislation calls for patients to be tested for HIV before an invasive procedure, which could apply to everyone who goes to a dentist for regular teeth cleaning.
Although he is not officially sponsoring the bill, Gov. William Donald Schaefer has been pushing for mandatory testing of health care workers for months, despite the objections of his own Task Force on HIV Prevention and Treatment.
State health department officials say they introduced the bill at the request of citizens worried about contracting the HIV virus in a doctor's or dentist's office.
Dr. David Acer, a Florida dentist who has died of AIDS, is believed to have infected five patients while working on their teeth. One of them, Kimberly Bergalis, 23, died from the disease in December. It's unclear how Dr. Acer's patients became infected, and lax sterilization of dental instruments has been cited as a possibility.
Under the Maryland bill, someone who sees a dentist for regular cleanings twice a year might have to undergo an HIV test before each appointment, state health officials said yesterday.
An HIV test costs $30 to $100, and patients may have to pay for their own tests if their insurance company won't, officials said.
"Eighty percent of the population truly believes they're not getting answers to their questions and have a feeling of mistrust," State Health Secretary Nelson J. Sabatini said. "The taxpayers are saying, 'Why doesn't someone do what I want for once in a while.' "
Opponents say the bill will not prevent the spread of AIDS, since health care workers are already expected to take certain precautions when coming into contact with a patient's blood.