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Monday, August 8, 2022

Prison Health Care

     There is something profoundly wrong with a government that provides convicted felons with better health care than it does to many sick people who haven't committed crimes against their fellow citizens. Perhaps this is what happens when a criminal justice system is organized around the idea of protecting the defendant. In Massachusetts, for example, a judge ordered the state to finance the sex change of a man who had murdered his wife. If Robert Kosilek hadn't strangled his wife to death, taxpayers would not have been forced to pay the cost of changing him into a female.

     In 2005, a judge in California, after determining that prison health in that state was unconstitutionally substandard, granted a so-called "receiver" the power to hire state medical personnel and set their pay levels. In 2004, the prison health care bill cost California taxpayers $1.1 billion. In 2012, the cost of providing California inmates quality health care cost the state $2.3 billion. Between 2005 and 2012 the number of California prison system health care workers--doctors, nurses, dentists, physical therapists and psychiatrists--jumped from 5,100 to 12,000. The system also employed 1,400 health care paper shufflers.

     In 2011, 44 of California's highest paid employees worked in the prison health care system. A psychiatrist who worked at the Salinas Valley State Prison made $803,271 in 2012. A prison doctor in northern California made, in 2011, a base salary of $239,572 plus $169,548 in overtime for working nights and weekends. A registered nurse at the High Desert State Prison pulled down $246,000 that year. In bankrupt California, when it came to health care, nothing was too good for the state's 124,700 state prison inmates. (These prison health care expenses didn't include the tens of thousands of county jail prisoners throughout the state.)

     Since 2006, heroin addicted inmates at Albuquerque's Metropolitan Detention Center, New Mexico's largest jail, have been treated with methadone to ease the trauma of withdrawal. Warden Ramon Rustin, in November 2012, announced that the $10,000-a-month program was too expensive, that the taxpayers of his county simply couldn't afford this in-jail drug treatment measure. Rustin, the former warden of the Allegheny County Jail in Pittsburgh, Pennsylvania with 32 years experience in the corrections field, said he didn't believe the costly program helped drug-addicted inmates stay out of jail once they were released.

     A month after Warden Rustin's effort to save the county serious money, the  county commissioners ordered him to extend the program two months during which time a study of its effectiveness would be conducted. (This is typical government. In the private sector, studies of cost-effectiveness are ongoing, and if a measure wastes money it's immediately cut.) The county also received $200,000 a year from the state to help fund its methadone program.

     When a person commits a crime that is serious enough to land him in prison, any health care he or she receives while in custody should be treated as a privilege rather than a constitutional right. The rule should be this: If you want good health care, don't murder anyone, rob a store, break into a home, beat your wife and children or commit a sexual assault. If good health is your priority, exercise, quit smoking, eat right and stay off drugs and booze. Also, get a job. If you want to switch genders while in prison that's fine, but you don't deserve to have law obeying taxpayers foot the bill.

     In the United States, when it comes to health care, crime pays and at the expense of law obeying tax payers. 

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