Prison Health Care

A Pew report shines light on a frequently unexplored area of health care–medical services for prisoners.   (Pew Report)   According to the report, spending in 44 states from which data was available total $6.5 billion in 2008 and probably is significantly higher by now, five years later.  Health care accounted for almost 20% of all correctional facility spending.  Health care is a frequent subject of inmate law suits and several states are subject to orders to improve care.  Some of the spending increase is due to increases in prison populations, although that trend has recently begun to change as states seek to avoid incarcerating non-violent offenders.  The prison population is also aging rapidly with the number of federal prisoners over age 55 almost doubling in recent years, which increases spending, and criminals tend to have unhealthy behaviors which lead to chronic diseases.   California, New Hampshire, Alaska, Washington and Massachusetts spend the most per inmate on health care; Illinois, South Carolina, Louisiana, Texas and Indiana spend the least.  While some states have employed medical staff at facilities, many contract either with local health care providers or private vendors of correctional health care services.  Telemedicine has become increasingly popular as a way to both improve quality and lower costs, while maintaining safety.  In Texas, for example, telehealth has saved tens of millions of dollars a year.  Texas is one of the few states to show a reduction in per inmate health spending in recent years.  California is in the process of expanding its use of telemedicine in prisons.  The reform law, touching as it does most aspects of health care, will allow for Medicaid financing of  some prisoner health care needs.  This, however, only transfers spending either from the states to the federal government or from one part of a state budget to another part.  Some states are beginning to look at releasing prisoners, especially older ones, with serious health issues, believing that they pose little safety risk.