The cost of health care for prison populations

Great Debates
1

I didn’t want to hijack this thread about the cost of an aging prison population, so I started this one. In that thread, Lissa says:

[QUOTE=Lissa]
With over 40K prisoners, and 1,000’s over the age of 50 in the state, hubby knows of only 1 compassionate release of a “truth in sentencing” inmate in his entire career. There may be more parole ones, but those would be hard to identify because they would just do it and it would not be that big of a deal.

In this one case, the single inmate was costing around 1,000,000 a month in medical expenses. He was over 40 and was sentenced on a non-violent offense. He had only 6 months to go and they got the governor to release him (mostly to save money). By the time the paperwork went through, he had already cost over 6 million dollars.

The fact is, as the prison population continues to age, and Life Without Parole is used more often (over 300 in my state), this will become a much larger issue. When hubby was in charge of the medical/mental health operations, he sought a “compassionate release” for a particular offender. Once again, budget was the primary issue.

He was receiving a non-formulary drug to treat an advanced form of cancer. Since the drug was rarely used, and not in production by any firm save one, it cost over 3K a dose, 3 times a day. Thus, it was costing him 300k a month for one prisoner. In addition, the prisoner needed frequent trips to the ER, or hospital for some treatments, and this costs a lot (transportation, extra security, etc…) In all, this one inmate was costing a lot of money. If you extrapolated his costs annually, he would represent almost 10% of the prisons budget to house 2,850 inmates. He was 65+ years old and was serving 5 consecutive sentences of life for rape and murder. He had been in prison for 30+ years.
[/QUOTE]

Well, I think this is stupid. I think if you’re serving life in prison for rape and murder…any violent offence, really, you shouldn’t get extremely expensive life preserving drugs. There should be a limit on how much we are willing to spend on prisoner health care; how far we are willing to go to preserve a life that will be spent in misery and waste anyway. If you get cancer while serving a life sentence, tough. If we aren’t willing to have universal health care for law abiding citizens, we should not be spending millions on incarcerated people who will never contribute anything positive to society. I’d be willing to spend some cash caring for people who are going to be released in, say, less than ten years and who aren’t terminal, particularly if their crimes weren’t violent. Other than that, no. What do you think?

2

[QUOTE=Renee]
I didn’t want to hijack this thread about the cost of an aging prison population, so I started this one. In that thread, Lissa says:
Well, I think this is stupid. I think if you’re serving life in prison for rape and murder…any violent offence, really, you shouldn’t get extremely expensive life preserving drugs. There should be a limit on how much we are willing to spend on prisoner health care; how far we are willing to go to preserve a life that will be spent in misery and waste anyway. If you get cancer while serving a life sentence, tough. If we aren’t willing to have universal health care for law abiding citizens, we should not be spending millions on incarcerated people who will never contribute anything positive to society. I’d be willing to spend some cash caring for people who are going to be released in, say, less than ten years and who aren’t terminal, particularly if their crimes weren’t violent. Other than that, no. What do you think?
[/QUOTE]

My real feelings about your above comments would only be appropriate in the Pit. :mad:

People are sent to prison as punishment, not to be confined and refused medical attention. If that were the case I am sure that it would be seen as Cruel and Unusual Punishment. Oh dear, doen’t that pesky constitution get in the way of right thinking folks. :rolleyes:

3

[QUOTE=Renee]
Well, I think this is stupid. I think if you’re serving life in prison for rape and murder…any violent offence, really, you shouldn’t get extremely expensive life preserving drugs. There should be a limit on how much we are willing to spend on prisoner health care; how far we are willing to go to preserve a life that will be spent in misery and waste anyway. If you get cancer while serving a life sentence, tough. If we aren’t willing to have universal health care for law abiding citizens, we should not be spending millions on incarcerated people who will never contribute anything positive to society. I’d be willing to spend some cash caring for people who are going to be released in, say, less than ten years and who aren’t terminal, particularly if their crimes weren’t violent. Other than that, no. What do you think?
[/QUOTE]

So let me see if I grasp your logic correctly.

  1. We should prevent convicted criminals from contributing anything positive to society by locking them up.
  2. Because convicted criminals aren’t “contributing anything positive to society”, we should kill them by denying them medical care.

Personally I’m more upset by all the folks walking around on the street

4

Excuse me for the pre-emptive post. That should read:

Personally I’m more upset by all the folks walking around on the street who are contributing nothing positive to society, but I don’t want them murdered by the state.

5

[QUOTE=Pjen]
Oh dear, doen’t that pesky constitution get in the way of right thinking folks. :rolleyes:
[/QUOTE]

Indeed it does. I’m particularly proud of that part of the amendment that mandates millions of dollars to be paid toward medical treatment of violent felons, while excluding average (e.g, non-raping and -murdering) citizens from the same sort of largesse.

Some might call that an absurdity, but I have complete faith that the Founding Fathers knew what they were doing.

6

Yeah, my problem isn’t with inmates recieving good medical care paid for by the state, but with me NOT recieving good medical care paid for by the state!

I mean, really. My own insurance (private policy, Blue Cross Blue Shield) wouldn’t cover that treatment. The state wouldn’t pay for it for me when my insurance wouldn’t. So why do we give convicted criminals BETTER health “insurance” (covers everything, no premiums, no deductibles, no co-pays) than the rest of us get?

I’m not sure how to reconcile it fairly short of national health care, which I favor anyway.

7

So, wait - we’re locking them up for the rest of their lives (in the case of truly heinous criminals) because we can’t trust them out on the street and we’re not willing to just put them to death…and then we’re supposed to pay for medical care to prolong their lives? Why?

I would take “cruel and unusual” as a reference to denying relief from pain, not the denial of life-extending care for people who have no future. Mitigate their pain, don’t force them to suffer; but let them die when their time comes.

Several years ago I worked for a medical equipment supply company, in the service technician department. Our techs used to complain that the equipment and facilities in prisons were far superior to those in VA hospitals. THAT is a crime.

8

[QUOTE=fessie]
So, wait - we’re locking them up for the rest of their lives (in the case of truly heinous criminals) because we can’t trust them out on the street and we’re not willing to just put them to death…and then we’re supposed to pay for medical care to prolong their lives? Why?

I would take “cruel and unusual” as a reference to denying relief from pain, not the denial of life-extending care for people who have no future. Mitigate their pain, don’t force them to suffer; but let them die when their time comes.

Several years ago I worked for a medical equipment supply company, in the service technician department. Our techs used to complain that the equipment and facilities in prisons were far superior to those in VA hospitals. THAT is a crime.
[/QUOTE]

Exactly. Pain relief–great. Million dollar a month cancer treatments? No. This is hardly the equivalent of people who have done nothing more than not contribute to society being “murdered by the state.” (In response to **ITR Champion’s ** post)

9

An inmate is a “ward of the state” meaning that the state has a duty to care for their health and well-being. The courts have determined that this includes medical treatment. Different states have different standards for this. My state is sort of a middle-of-the-road state. We do what’s necessary to preserve life but every inmate does not get the latest and best treatments.

You’ll get no argument from me that it’s sad that ordinary citizens are left to fend for themselves, but I disagree that we should reduce the care for inmates as a way to make things “fair.” Instead, we should work together to ensure that everyone has health care.

10

[QUOTE=WhyNot]

I’m not sure how to reconcile it fairly short of national health care, which I favor anyway.
[/QUOTE]

Interestingly in the UK where there is universal provision of health care free at the point of delivery, prisoners are excluded from it and must generally rely on inadequate and inappropriate prison service care provided by semi qualified and the second rate. Modern medication is often unavailable to them and treatment is usually offered in sub-standard accommodation. Mental Healtrh care is particularly poor.

11

However – if the prisoner is released from prison because he is terminally ill, he is certainly too sick to commit any crimes, and is also too sick to work. Therefore, he’s STILL going to get health care at public expense, only now it will be through medicaid and/or medicare.

12

[QUOTE=Renee]
Exactly. Pain relief–great. Million dollar a month cancer treatments? No. This is hardly the equivalent of people who have done nothing more than not contribute to society being “murdered by the state.” (In response to **ITR Champion’s ** post)
[/QUOTE]

So where’s the non-equivalence?

Thus far it seems you’re basing your entire arguement on two short case summaries from an anonymous message board user. Neither case summary mentions that the inmate was a murderer or rapist, and one specifically mentions that they were not. Most inmates in the United States committed the horrible crimes of usings, buying, or selling drugs. Some were growing pot for medical purposes, in which they were actually helping other people recover. On the outside, they’d have a chance to work for a good insurance plan; in jail, they have no such opportunity. Hence to deny them the chance is the same as killing them.

13

If you want to change the standard of care for incarcerated people, you’ll need to amend the US Constitution. Courts have ruled all the way up the line to the Supreme Court that incarcerated folks are entitled to medically necessary care which meets community standards. That means if, in the local community, (which more and more means the national community) folks with prostate cancer are getting appropriate anti-cancer therapy for their condition, then inmates cannot be denied the same.

Now I’ve spent a hell of a lot of effort to deliver the medically necessary care, rather than the window dressing (repair of uncomplicated, barely relevant hernias, removal of non-suspicious lumps and bumps). I’ve also counselled patients against trying futile treatments, in a desperate attempt to fend off the inevitable. But I did the same thing in private practice.

I’ll stop doing medically necessary in prison as soon as the I’m told I can’t deliver such care, after said constitutional amendment passes.

I’ll also leave Corrections Medicine at that time, and good luck finding docs and nurses willing to give state-sanctioned less than the medically necessary care to inmates. That would certainly stain my soul, and I won’t do it.

QtM, physician to felons.

14

[QUOTE=Lissa]
In this one case, the single inmate was costing around 1,000,000 a month in medical expenses. He was over 40 and was sentenced on a non-violent offense. He had only 6 months to go and they got the governor to release him (mostly to save money). By the time the paperwork went through, he had already cost over 6 million dollars.
[/QUOTE]
Cite? What, was he have weekly heart transplants? :rolleyes:

There’s no way someone could cost $6 mil in a half a year.

When did this happen and what were the diseases?

15

[QUOTE=TokyoPlayer]
Cite? What, was he have weekly heart transplants? :rolleyes:

There’s no way someone could cost $6 mil in a half a year.

When did this happen and what were the diseases?
[/QUOTE]

Hubby was Deputy of Special Services about a year or so ago, so the “when” would have been about 2005. As for what ailment he had, Hubby says he doesn’t remember the name of it, but it was some sort of blood disorder.

16

My sister has to have shots that cost several thousand dollars each. She doesn’t have to have them but once a month (I think) and she has insurance. I didn’t believe her at first either.

What becomes of the man when he is released from prison? No more shots, right?

Of course veterans need excellent facilities. And ordinary citizens need decent affordable health care. I think the founders probably assumed that the common man would always be able to pay for a doctor and a bit of medicine. Now people can’t even afford the insurance!

I don’t hear people in countries that have national health care say they want to give it up for the kind of health care America has! Money here goes to line corporate pockets and to war profiteers and to bridges to nowhere.

And not everyone in prison is a savage. And not even a savage deserves to suffer.

Qadgop the Mercotan, you are aces with me.

17

Wow. This makes 3 threads today on what, essentially, is the same subject.

Quick, someone cite Estelle v. Gamble and then they’ll even be more alike!

18

[QUOTE=Zoe]
My sister has to have shots that cost several thousand dollars each. She doesn’t have to have them but once a month (I think) and she has insurance. I didn’t believe her at first either.

What becomes of the man when he is released from prison? No more shots, right?
[/QUOTE]
I can see several thousand dollars a shot for something once a month, but 10 a day? (Do the math.) I’m still saying no way to **Lissa’s ** story.

[QUOTE=Lissa]
Hubby says he doesn’t remember the name of it, but it was some sort of blood disorder.
[/QUOTE]
Cite for any disease which treatment costs anywhere near the more than $33,000 per each and every day you are claiming.

19

[QUOTE=Renee]
I think if you’re serving life in prison for rape and murder…any violent offence, really, you shouldn’t get extremely expensive life preserving drugs. There should be a limit on how much we are willing to spend on prisoner health care; how far we are willing to go to preserve a life that will be spent in misery and waste anyway. If you get cancer while serving a life sentence, tough.
[/QUOTE]
There’s only one way to avoid such costs, which are mandated by the U.S. Constitution, to wit: If you don’t want to pay for prisoners’ health care, don’t arrest them!

Your choice!

20

[QUOTE=fessie]
So, wait - we’re locking them up for the rest of their lives (in the case of truly heinous criminals) because we can’t trust them out on the street and we’re not willing to just put them to death…and then we’re supposed to pay for medical care to prolong their lives? Why?
[/QUOTE]
Because by locking them up we’re depriving them of any and all alternatives. If you don’t want to pay for their health care needs, simply don’t arrest them in the first place. But no cheating! No kicking them out of jail/prison just so that they have to pay for their own surgery (or whatever) only to re-arrest them afterwards (which has happened)!

[QUOTE=fessie]
I would take “cruel and unusual” as a reference to denying relief from pain, not the denial of life-extending care for people who have no future.
[/QUOTE]
Fortunately for our national conscience, the Eighth Amendment and the Supreme Court disagree with you.

[QUOTE=fessie]
Several years ago I worked for a medical equipment supply company, in the service technician department. Our techs used to complain that the equipment and facilities in prisons were far superior to those in VA hospitals. THAT is a crime.
[/QUOTE]
Yes, indeed. I agree with that last completely. I wonder why the recruitment posters don’t come out and honestly say: “Join the service and get the worst medical care in the industrialized world!” It’s scandalous. Who supports the troops less than the Republicans?

See: Senate GOP Fails Soldiers and Veterans

Republicans Seek to Slash VA Budget

New Veterans Day Report: Senate GOP Gets Failing Grade On Vets Issues

“Support Our Troops”: GOP Words v. Actions

Republicans Break Their Promises To The Men And Women In Uniform In Virginia

Democrats Stand By Our Nation’s Military While Republicans Falter

And there’s plenty more…