Reasons for the Rising Costs of Healthcare in Correctional Institutions
In the landmark case by the Supreme Court termed as the Estelle v. Gamble, the court pronounced itself on the treatment of prisoners, making it clear that the constitution provided for the protection to sufficient health to the prisoners. However, 40 years since the ruling was made, there is very little to see for the decisions. Correctional health care often seems to fail to meet the needs of the inmates when administered by the state health facilities. The idea of alternative such as the privatized health comes with their own set of social, economic concerns, the lack of political pressure on the issue represents the cap between practice and policy. The prison health care is at the heart of pressing state priorities. The healthcare that prison provides to the incarcerated individual and the care that detention facilitates is a critical issue with far-reaching consequences. The biggest challenge is the rising cost of healthcare in the incarceration facilities. However, there is a need to focus on the reasons that are leading to the increasing cost of healthcare. The paper looks at the view of different scholars and the reason they offer for the increase in the price of healthcare in the incarceration centers.
Background on the health information
According to a report by the Pew charitable trust, the total cost of correctional health expenditure per inmate spending increased in all the states from the fiscal year starting from 2007 to 2011. However, in a few states, there was a drop after reaching a peak in the years 2009 and 2010. Statistics from the national expenditure show that nationally there was a total of $7.7 billion that was used in treating patients. In 2009 the cost was about $8.2 billion. However, the drop in expenditure was attributed to the reduction in the prison population. As the states focus on efforts to reduce the cost of healthcare, there might be a positive development as long as the decrease is not related to the decline in quality. Several aspects threaten the rise of healthcare costs.
The increase in the number of older inmates
From the year 1999 to 2013, the population of more elderly inmates characterized by individuals that are older than 55 years is estimated to have increased. The statistics show that the increase was from 43,300 to 144,500, which represented a 234% increase(Galli et al. 2019). However, within the same period, the rate of growth for individuals younger than 55 years grow at a lower rate of about 9%(Galli et al. 2019). The increase was from 1.26 million to about 1.37 million (Galli et al. 2019). The increase in the number of older inmates had a direct link to the rise in the cost of health required to treat them. The national Institute of correction said that the annual cost of incarcerating older prisoners than 55 years and suffer from a chronic condition is about times the expense for other inmates. These statistics are quite worrying considering the fact the population of the older adults keeps increasing.
According to several medical experts in the country, inmates are at a higher risk of experiencing the effects of aging as compared to people that are outside prison. Some of the issues that make this population be at high risk include substance abuse, stress that is associated with the isolation, inadequate preventive care, and at the time, the violent prison environment(Galli et al. 2019). Just like the older people outside prisons, elderly prisoners are at a higher risk of medical and mental issues that include impaired mobility, dementia, loss of vision, and hearing, among others. This condition, push the prison to seek for more staffing in addition to special housing that all increase the cost of healthcare.
Prevalence of Disease and Mental illness
The individuals behind bars have a higher risk of chronic infections that include AIDS, mental illness, and Hepatitis as compared to the general population. These conditions that at times may exist before incarceration increase the burden on the prison department. Statistics on the prevalence of Hepatitis C in incarceration centers may vary across the states. Still, they show the difference in the region regarding high-risk behaviors such as drug use. In the year 2006, the state department of medical directors showed that the prevalence of Hepatitis C among inmates was estimated at 17.8%(Marlow et al., 2017).
In comparison, the average prevalence of the condition among the residents of the US was 1%(Marlow et al., 2017). The cost impact on the incarceration centers might shoot up if they decide to use expensive prescription drugs that are currently recommended. Besides, in the year 2010, about 65% of incarcerated adults in prison met the condition for an alcohol drug use disorder(Marlow et al., 2017). Besides, the inmates were seven times riskier to get the illness as compared to non-inmates. Moreover, a third of the inmates had a mental illness, while a quarter of them had a co-occurring psychological problem and substance abuse problems (Marlow et al., 2017). These statistics thus help to paint a clear picture of the problem that is facing most of the incarceration facilities in the country. While there might be efforts to minimize the cost, it is clear that there are many issues that stick the card against their favor.
Cost Cutting approaches
The soaring cost of healthcare in the incarceration might be a serious issue that might require some urgent approaches to solving it. Here are some of the procedures that might help in dealing with the problem.
Telehealth can be one of the best ways to minimize the cost of healthcare in incarceration facilities. The application of electronic information and telecommunication technologies to support long-distance health, among other things, could help in reducing costs. The approach can help in ensuring that prisoners can have access to primary care, doctors, and specialist that minimizing the cost.
The other approach can be to focus on outsourcing care. In recent times some healthcare facilities have focused on using outside players to provide care to the prisoners, thus lowering costs while also improving quality.
The focus on medical financing is also another approach that the health facilities can focus on. In many states, there has been a focus on enrolling many of the prisoners into Medicaid so that they can access health insurance. Besides, countries can focus on Medicaid reimbursement that covers about 50% of the patient’s costs. Else, there can be a focus on access to Medicaid through the affordable care act can be a way to save money.
In conclusion, the cost of healthcare is continually becoming a severe issue to most of the state lawmakers. While there is a focus on ensuring that the inmates can access quality healthcare just like any other American, there are several issues that make it hard for this population to access healthcare. This condition includes the environment, the use of drugs in addition to the increase in the aging population. Therefore, the Incarceration centers and the states are facing an inexorable rise in the cost of health. Both two articles tend to reach the same conclusion in the issues that regard the increasing cost of health in the incarceration centers.
References
Galli, S., Bretschneider, W., Elger, B. S., Handtke, V., & Shaw, D. (2019).Aging prisoners’ views on healthcare services in Swiss prisons. Journal of Applied Gerontology, 38(3), 365-385.
Marlow, M. A., Luna-Gierke, R. E., Griffin, P. M., & Vieira, A. R. (2017).Foodborne disease outbreaks in correctional institutions—the United States, 1998–2014. American journal of public health, 107(7), 1150-1156.
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