By Kent Gray
Triplicate staff writer
The cost to provide healthcare for California's inmates has tripled in recent years, an amount that comes directly out of an ailing state budget.
Spokesperson Terry Thornton of the California Department of Corrections said the amount budgeted for inmate healthcare in the 1997-98 fiscal year was $282 million. The cost for 2003-04 will exceed $841 million.
"Like all healthcare providers, we've seen our healthcare costs increase," Thornton said. "Part of the reason is because the inmates we treat, because of their lifestyles, didn't pay attention to preventive medicine and have major chronic illnesses."
Thornton said her department is required under the Constitution to provide treatment for inmates regardless of the cost.
"The only people in the United States that are entitled to healthcare under the Constitution are people that are incarcerated," Thornton said. "Otherwise, if that healthcare was denied, it would be considered cruel and unusual punishment under the law."
In California, the law defines effective medical care as protecting life, alleviating severe pain, and preventing significant illness or disability. Thornton said a a heart transplant given to a convicted felon last year serving 14 years in a California prison, which could cost as much as $1 million to taxpayers, is unusual.
According to the U.S. Medical Group in Florida, the nation's total inmate healthcare costs are somewhere between $3 and $5 billion per year.
"If you take away someone's freedom, you are responsible for that person's healthcare, whether or not they could have afforded it before they were incarcerated," Thornton said.
The National Legislative Program Evaluation Society in Washington D.C. said privatization is the best course for streamlining costs.
"(There is a) tendency for contractors to want the easy cases,' for example, in prisons or healthcare. Costs can actually end up higher due to government not knowing its actual cost for comparison purposes," the society said in a recent report.
Unlike the officers who guard them, inmates pay only $5 for a general office checkup, according to Lieutenant Rawland Swift of Pelican Bay State Prison. The $5 payment was instituted mainly for control reasons.
"Many inmates were treating doctor visits as field trips, to get out of their cells for a while," Swift said. "It had gotten way out of hand for a while. The $5 co-pay has greatly discouraged that kind of abuse."
Pelican Bay employs seven physician/surgeons, five dentists and more than 40 psychiatrists and psychologists full time for its inmates. According to Thornton, these medical personnel are not usually available to state employees.
"They have their own healthcare insurance," said Thornton. "There have been cases during emergencies when they will treat staff."
Correctional officers, on the other hand, must purchase health insurance and pay sizable deductibles often $500 per year, according to some local officers.
"Some inmates tell the officers they will violate parole on some small offense, say six to nine months (sentence), so they can come in and get straightened out," said Swift. "I suppose you can credit that with the premium healthcare the department provides."
One way of curtailing the rising costs is through telemedicine, a program recently engaged by the department.
"This way a physician, or a specialist, can treat an inmate from another location. This saves on the cost of transportation, guards and the staffing of healthcare providers," Thornton said.
Telemedicine is also being used in Arizona to contain costs. That state boasted a savings of $564,700 in a single year through telemedicine consultations.
But the main culprit in prison healthcare costs is the same as on the outside, Thornton said, and that is the rising price of pharmaceuticals.
"It is huge really huge." In 1997-98, the average pharmaceutical cost per inmate per year was $198. In 2001, that average was $768.
"In an ideal world, everyone would receive adequate healthcare for a reasonable cost. But it's not an ideal world. I wish it was," said Thornton.