Opportunities for Cost Savings in Corrections Without Sacrificing Service Quality: Inmate Health Care, a new Urban Institute report tells us that between 9 and 30 percent of correctional costs involve inmate health care.
Inmates are subject to various medical problems. As prisoners grow older, age-related illnesses appear. Many inmates have mental illnesses that have led them to prison. Hepatitis C is prevalent in prison. Chronic illnesses that must be treated can cause correctional budgets to burst. Prisoners are guaranteed medical treatment under the Eighth Amendment, so what can correctional facilities do to provide adequate care without going over-budget?
Opportunities for Cost Savings outlines several strategies including using more preventative measures, cross-training correctional officers as EMTs, using less costly medications, and granting release to inmates with chronic or terminal illnesses who are not considered to be a threat to society.
Co-pays are another strategy. Many prisons already charge an inmate a co-pay fee for medical services, if the inmate is not “indigent” and has money in his or her commissary account. That amount can be as little is $5.25 in federal prisons. The co-pay solution can be problematic in instances where an inmate has to choose between a medical visit or making phone calls home to a family experiencing a crisis. Inmates sometimes put off sick-call visits knowing that the co-pay will prevent them from purchasing a needed, or wanted, item from commissary. Delaying a visit due to a co-pay can result in a worsening condition that is more costly to treat.
Another cost saving strategy has the potential of being dangerous to the health and welfare of inmates. Not having medical staff available overnight can result in a delay in medical treatment that can prove to be fatal. Heart attacks, strokes, respiratory problems and other life-threatening illnesses happen at all hours. Having to call a medical staff member, or community emergency response team, to come from a distance for a medical emergency can cause serious medical complications, or even death, particularly when responding to a huge prison complex with various security measures such as fences and gates in place. Training correctional officers to be EMTs is only a partial solution.
Telemedicine is another suggestion to reduce prison medical budgets. Real-time interactive telemedicine might be the wave of the future in prisoner health care, but it does not come without the initial cost of special equipment, and is more cold and impersonal than a visit with a doctor or nurse who is physically in the same room with a prisoner. The Federal Bureau of Prisons has used telemedicine for inmates under the care of a psychologist or psychiatrist. Talking to a medical professional over the phone, or on a TV monitor, can be unnerving, or embarrassing for some.
The problem of providing adequate health care to prisoners while correctional budgets explode is not an easy issue to resolve. Almost every solution involves a trade-off. Opportunities for Cost Savings in Corrections Without Sacrificing Service Quality: Inmate Health Care attempts to provide correctional administrators and legislatures with strategies to be taken under consideration.