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The Prison Complex

Thursday, Jul 30, 2015, 9:00 am

Should Prisoners Pay Medical Bills?

By George Lavender

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Should prisoners pay for their own medical care? 

There are a number of reasons why that's something many states do or are considering, not least of which is that medical care makes up a large part of prison budgets. The Pew Charitable Trusts estimates one-fifth of state's prison expenditure goes towards medical care. 

According to the Brennan Center for Jusice at New York University School of Law and Statelinereporting 38 states currently authorize prisons and jails to collect fees for care  

The fees are typically small, $20 or less. And states must waive them when a prisoner is unable to pay but still needs care, in keeping with a U.S. Supreme Court ruling that prisoners have a constitutional right to “adequate” health care.

The rationale for charging copays is the same for prisoners as it is for people not behind bars: to discourage seeking medical care when it is not really needed.

“We do it for the same reason your insurance company does — to eliminate abuse by making the inmates put a little skin the game,” said Tommy Thompson, the jail administrator at the Rutherford County Sheriff’s Office in Tennessee. Continue reading...

Medical care in prison is a costly business. An analysis by the Pew Charitable Trusts found that in 2011 states spent $7.7 billion on healthcare in prisons and jails. But the idea of allowing prisons and jails to charge for medical care also has its critics, like Robert Greifinger, the former chief medical officer of the New York Department of Corrections.  

Medical fees, usually for services rendered in the prisons or jails, typically are deducted from a prisoner’s commissary fund, which is replenished with money earned in prison jobs or contributions from family members. Prisoners also use their commissary funds to buy snacks, toothpaste, soap and other supplies. Sometimes, according to the Brennan Center, prisoners leave prison with a debt for their medical fees.

Though the fees are slight in most states, there are exceptions. In Texas, for example, the Brennan Center says that a state prison inmate who requests a medical visit can be charged $100, though all health service appointments that inmate makes in the ensuing 12 months are free. In Utah, state prison inmates can be charged up to 10 percent for any hospitalization outside of prison facilities — not to exceed $2,000 in a year.

“It may not seem like a lot of money but, typically, the prisoners are impoverished and, often, so are their families,” Greifinger said. “Sometimes, their choices come down to a medical appointment or shampoo.”  Continue reading...

The National Commission on Correctional Healthcare, a non-profit group, has its own guidelines for prisons and jails on charging for medical care. Among the suggestions are that prisons and jails should monitor infection levels before and after introducing charges for medical care to assess whether the cost is "blocking access to needed care."   

George Lavender is an award-winning radio and print journalist based in Los Angeles. Follow him on Twitter @GeorgeLavender.

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