Care Costs Rising As Prison Population
Health Care Costs Rising As Prison Population Grows And
Care Costs Rising As Prison Population Grows And Ages
Kaplan, Staff Writer
June 24, 1999
-- Prison inmates are the only Americans with a constitutional
health care, and the cost to deliver it is on the rise. States
of their corrections budgets on average to cover the cost of
a total of over $3 billion annually.
prison population increases, ages and increasingly suffers
illnesses such as AIDS and hepatitis, state policy makers must
bill, change the way health care is delivered or rethink the
laws that led to the problem in the first place.
"get-tough-on-crime laws" such as California’s
people are going to prison and staying behind bars longer,
States the number one incarcerator in the world.
criminals make up a large percentage of the nation’s prison
State and federal drug laws have put 277,000 offenders in
accounts for 20 percent of state prisoners and over 60 percent
prisoners, according to the Justice Department.
prisoner's constitutional right to health care dates back to a
Court ruling that held that deliberate indifference to a
illness or injury constitutes cruel and unusual punishment.
demographic look at state prisoners shows:
last decade, state prison populations doubled from 577,672 in
in 1998, according to the Justice Department’s Bureau of
Women accounted for 6.4% of all prisoners nationwide in 1998,
in 1980 and 5.7% in 1990.
of inmates 55 and older more than doubled from 1981 to 1990,
to the Bureau of Justice Statistics. The Federal Bureau of
that by 2005, the number of federal inmates 50 and older will
from 11.7 percent of the of the prison population to 16
existing prisons are not designed structurally or
inmates, and caring for them can be costly.
more inmates have chronic and terminal illnesses, such as HIV
tuberculosis and Hepatitis B and C. Texas state officials
one-third of the state’s inmates may be infected with
similar study in California found that 41 percent of incoming
infected with the virus. Hepatitis C infects the liver, and is
contaminated blood or needles. Also, one inmate in 10 is
having ended up in prison when budget cuts closed state mental
in the 1980s.
prisoner’s constitutional right to health care dates back to
a 1976 U.S.
Court decision in the Texas case, Estelle v. Gamble. The
deliberate indifference to a prisoner's serious illness or
cruel and unusual punishment under the Eighth Amendment.
the attitude of most Americans may be that prisoners are not
of top-notch medical care because they have broken the law,
that are released into the community take their illnesses with
which can then be transmitted to others.
is short-sighted to say these people don’t really affect me.
You could be
on a bus
with an ex-inmate who has tuberculosis. We should focus more
care these people are getting," said Georgia State
burgeoning health care costs while hoping to provide quality
states have turned to private managed care organizations to
medical facilities. Also, more than half the states are trying
money by collecting a co-payment from prisoners, and at least
Connecticut, Louisiana, Michigan, Montana, New York, South
Tennessee and Texas -- have established medical parole laws to
and seriously ill out of prison when they no longer pose a
with the highest rate of incarceration in the country, has
worry about increasing health costs. The state pays nearly
for inmate health care per year -- about $2,150 per inmate.
state has set about [made] public policy that has yielded 720
100,000 going to prison. As long as our state pursues that
have to pursue that budget," said Glen Castlebury, the
Texas Department of Criminal Justice.
Care in Prisons on the Rise
nation’s largest correctional health-care firm, St.
Medical Services, Inc., insures one out of every seven inmates
company provides health services to more than 273,000 inmates
facilities in 29 states. For nearly 20 years, CMS and a few
managed care companies have been taking over prison and jail
government agencies coast to coast.
is a lot of anecdotal evidence of problems with privatized
some cases medical care has improved, but in many cases the
precedence over health care," said Georgia State’s
also questions the quality of prison health staffers. This
conducting a study to find out why medical personnel choose to
His thesis is that some of the people in correctional health
because they have difficulty finding employment elsewhere due
drives a person to the practice of correctional health care?
Is it that
graduates and says ‘I really want to work in a prison,’ or
they have had problems?" he says.
Louis Post-Dispatch investigation of the prison managed care
last fall showed that nine prison doctors in Missouri working
Medical Services had been disciplined by licensing boards.
physicians in the state that accounted to nearly one in four
prison doctors disciplined for misconduct. In contrast, about
40 of the
nation's 689,000 doctors has been disciplined, the
prisoners so that they can go back in society and perform is
something that profit-making companies are concerned with.
is to their stockholders," said Kara Gotsch, a
ACLU’s National Prison Project.
National Commission on Correctional Health Care is responsible
prison health facilities, but they do not serve as a watchdog
monitoring health-care abuses in prisons and jails. Some
departments have ombudsmen or patient liaison departments, but
malpractice suits against physicians are not uncommon.
is not unusual to see suits. Nationwide there are a half dozen
or a dozen
a year --
probably one or more suits at any given time," said NCCHC
effort to recoup some of the increasing costs of treating
states require prisoners to pay a co-payment for their medical
from about $2 to $10. The co-payment is waived for indigent
is trying to pass a bill this year that would mandate a
for federal prisoners.
Vaughn said that in most states when a co-pay is instituted
question is whey are the sick-call visits going down? Have the
the frivolousness or is it that they are using their money to
else like cigarettes or a candy bar at the commissary?"