Are prison medical costs too expensive?
The cost of health care for ill inmates is almost three times more than a healthy inmate or the average person on the street
By Gary York
Inmate health care costs are on the rise. This is not a surprise knowing that a great percentage of the inmate population is involved in a risky life of drugs, drinking, unprotected sex and improper health habits. The cost of health care for many of these inmates is two to three times more than a healthy inmate or the average person on the street.
Six out of 10 inmates, on average, report making less than a thousand dollars a month income before prison and about 90 percent have no health insurance. Chronic disease is prevalent among the inmate population, and it is left for the correctional health care services to deal with and the correctional officers to work with.
I have stood at many first appearances in court as the inmates arrive from the streets. The judge has a line of questions regarding income, property owned, vehicles owned and the huge majority have no money or property to show, which also translates to no medical coverage.
One of the first questions asked by the new jail arrivals is, “When can I see the doctor because I need my meds?” The first thing on their mind besides getting out of jail is getting medical attention they have not had in a long while. This squarely places the burden onto jails, prisons and taxpayers.
Human immunodeficiency virus is a very serious health issue for correctional facilities. Prison and jail administrators must weigh the costs of HIV testing, treatment and care of infected inmates against other needs and necessities. Continual funding from state and federal agencies is a must to maintain the high cost of housing these inmates.
The Bureau of Justice Statistics reports that state and federal prisons have anywhere from 1.2 to 1.9 percent of inmates infected with HIV. Many of those are not discovered until incarceration and testing at the county jail level.
Treatment for this illness involves a very expensive and potent drug known as a “cocktail,” a highly active antiretroviral therapy also known as a HAART. In a Center for Disease Control and Prevention report dated March 14, 2017, it was estimated that it costs around $1,863 per month to treat an AIDS patient, or an average of $22,356 per year.
Let’s compare this to a healthy inmate in different areas of the country.
The August 23, 2013, issue of the New York Times reported that each inmate costs the city $167,731 per year to provide housing, food and correctional security.
A New Mexico treatment versus incarceration factsheet dated February 3, 2016, reported the average cost of an inmate is $45,250 per year.
A Florida quick facts sheet about the Florida Department of Corrections dated December 31, 2016, reported it costs the FDC $19, 557 per year to house an inmate.
The costs vary by state and region. By taking those numbers and adding the cost of an inmate with HIV the price really rises. The length of sentence will also play a huge factor in the cost. An inmate with HIV on a two-year sentence versus a life sentence must be taken into account.
STATE/CITY HEALTHY INMATE ANNUAL HIV COST INMATE WITH HIV
New York $167,731 $22,356 $190,087
New Mexico $45,250 $22,356 $67,606
Florida $19,557 $22,356 $41,913
*All the above figures are only estimates based on reports from correctional agencies and health articles.
The picture is painted and has been for quite some time. The question that remains: How does the prison system continue to pay and properly medicate inmates with HIV? This does not even include the lawsuits over HIV+ inmates.
HIV LAWSUITS AGAINST PRISONS
Inmates have sued in state and federal courts across our country for several reasons. Some inmates have won and some have lost. One of the big issues is the fact that HIV+ inmates feel they should not be segregated from the healthy inmates.
On September 29, 2013, it was reported by the Associated Press that the Alabama prison system may pay a settlement of $1.3 million to American Civil Liberties Union lawyers in a lawsuit over the state’s policy of segregating HIV+ inmates. U.S. District Judge Thompson ruled against the state of Alabama in this HIV segregation lawsuit.
Another common type of HIV lawsuit is healthy inmates suing jails and prisons for not protecting them from being raped by HIV-infected inmates.
The angles of HIV lawsuits are endless and very costly to the government, states and taxpayers. It appears that no matter what corrections officials do in an attempt to correct the problem or keep everyone safe, a lawsuit pops up. Who wins in the end? The prison system gets drained, lawyers get rich and the inmates remain in prison.
We do not have enough room in this article for discussion on all the other draining medical issues. Please keep in mind the prison system must also deal with the following medical issues that also cost a lot of money and produce a multitude of lawsuits.
Hepatitis C infected inmate rates have reached epidemic levels. The drugs Harvoni and Sovaldi cure about 90 percent of patients but cost about $90,000 per patient.
Severe cuts in mental health facilities have left jails and prisons to deal with persons who have a mental illness. Some reports indicate our jail system alone has a cost of $87 million dollars annually for treatment and overseeing mentally ill inmates. That figure does not include state or federal prisons.
The impact of the aging inmate population is now hitting our entire system very hard. With larger populations and longer sentences, jails and prisons are becoming nursing homes. Hospice services and assisted living in prison is coming soon. As we all get older, most of us see a rise in our healthcare needs and costs. With inmate lifestyles being the way they are, this is even more so the case for elderly inmates. Another high cost to the taxpayer.
Our corrections system has become a disease management system. The high cost of prison healthcare is affecting everyone.