<p>Clinton's plan to welcome infected foreigners may be medically
justifiable, but it's politically explosive
</p>
<p>By CHRISTINE GORMAN--With reporting by Cathy Booth/Miami and Bernard
Diederich/Guantanamo Bay
</p>
<p> Somewhere between the heavenly promise of America and the hellish
reality of Haiti lies a way station on the Cuban coast called
Guantanamo Bay. There, at a U.S. naval base, more than 200 Haitians
have languished in tin-roofed barracks for up to 17 months,
surrounded by wire fences and plagued by banana rats. Last year
the Bush Adminis tration ruled that they had plausible claims
for political asylum. But because most of them tested positive
for the AIDS virus, they are barred from the U.S. Suspicious
of their captors and even their doctors, many have staged a
hunger strike, and their situation has now become critical.
"The next few days will determine whether or not the Haitians
live or die," says attorney Michael Ratner.
</p>
<p> The Haitian refugees are the most visible symbol of what may
be the next unnecessary controversy to distract the Clinton
Administration from its attempt to focus on economic issues.
Last week the President announced plans to lift the ban that
prevents foreigners with the AIDS virus from immigrating to--or even visiting--the U.S. Most medical experts support
the change on the grounds that the virus is not easily transmitted.
"This shouldn't be a hot-button issue, especially when you consider
the lack of a public health threat," says Dr. June Osborn, chairman
of the National Commission on AIDS. But opponents believe the
plan could be both dangerous and costly. "Unless you believe
we have the AIDS crisis under control, I would advise you to
resist this potentially explosive policy change," Senate Republican
leader Robert Dole wrote last week to Health and Human Services
Secretary Donna Shalala.
</p>
<p> Under current regulations, there is a list of communicable diseases--including AIDS, syphilis, gonorrhea, leprosy and tuberculosis--that are grounds for barring entry into the U.S. The Clinton
proposal is to remove all of them except active tuberculosis,
which unlike the others can spread through the air. The National
Commission on AIDS estimates that as a result between 300 and
600 people with AIDS or infected with HIV might immigrate into
the country every year.
</p>
<p> "You don't open your gates when you're trying to control a disease
within your borders," insists Republican Representative Tom
DeLay of Texas. He is worried that the tab for infected Haitian
refugees and other immigrants could land in the taxpayers' lap.
According to the government's own estimate, the cost of treating
the average AIDS patient from diagnosis to death is $100,000.
"Our medical care, social-services net and free public education
are a magnet for immigrants," argues Dan Stein, executive director
of the Federation for American Immigration Reform, a conservative
lobbying group in Washington. "We can't bring people here en
masse for medical treatment."
</p>
<p> Refugees and immigrants aren't the only groups that would be
affected. In 1990 many non-American members of the World Federation
of Hemophilia could not attend their annual convention, which
was held in Washington, because they carry the AIDS virus. Ironically,
most of them had been infected by American blood products exported
to their countries. Under current rules, even a child dying
of AIDS could be barred from crossing the border to visit Disneyland.
"Let them go to Disneyland in France," DeLay says. "You've got
to be hard in situations like this."
</p>
<p> Clinton's plan to lift the current ban is supported by most
of the medical community, including officials at the Public
Health Service, the Centers for Disease Control and Prevention,
and the National Academy of Sciences. "AIDS is not transmitted
by casual contact, so we don't have a public health concern
with Clinton's proposal," says Dr. Charles Mahan, Florida's
state health officer. "The argument has been that it's expensive
to take care of these patients, but we let in chronic kidney
and cancer patients, whose treatment can be even more costly."
</p>
<p> Foreigners are actually at higher risk of being infected by
Americans than vice versa. With 1 out of 200 Ameri cans carrying
the virus, the U.S. is a net exporter of AIDS. "It was tempting
early in the epidemic to blame AIDS on strangers from other
countries," says Mahan. "But you can go down the street and
get AIDS from someone whose ancestors came over on the Mayflower
too." Some doctors also argue that the AIDS ban actually contributes
to health problems in the U.S. by discouraging resident aliens,
who fear deportation, from seeking treatment.
</p>
<p> Opponents of the ban deny that an open-door policy will cost
the taxpayer money. According to a 1991 report by the National
Commission on AIDS, HIV carriers typically remain employed and
self-sufficient for 10 years or more from the time of infection
to development of clinical disease. "Their economic contribution
to our society," concluded the report, "will far outweigh the
estimated lifetime cost of treating HIV-infected individuals."
</p>
<p> Clinton is unlikely to be able to lift the ban without congressional
approval. Senator Jesse Helms helped establish the restriction
in 1987 by introducing it as an amendment that, after some compromising,
passed unanimously. Although the Helms legislation is not still
in effect, Dole and other Republicans say they plan to introduce
a similar measure if Clinton tries to open the borders by executive
