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Should Prisoners Receive Better Health Care Than the General Population?
Pajamas Media ^ | 05/22/2014 | THEODORE DALRYMPLE

Posted on 05/22/2014 7:47:03 AM PDT by SeekAndFind

I remember the written response of the senior doctor in the prison in which I worked to an editorial in the British Medical Journal lamenting the difference between health care in prison and health care in the “community.” Yes, he replied, where else in the country but in prison could everyone get to see a doctor within an hour of complaining of something?

I thought of this as I read an article recently in the New England Journal of Medicine about Hepatitis C infection and the American correctional system.

About 3 million Americans are infected with the Hepatitis C virus, mainly because of having shared needles in intravenous drug abuse, but also through transfusions before blood was screened for the virus. Those who are tattooed have two or three times the average rate of infection.

Ten-to-fifteen percent of cases of untreated infection (among males) will go on to get cirrhosis of the liver, and of them an increasing proportion will develop liver cancer as the years go by. Hepatitis C infection is now the largest single cause of the need for liver transplants.

Most intravenous drug abusers in America will pass through prison at some time in their lives, and at any one time one in six prisoners – that is to say upwards of 300,000 prisoners – are infected. Of them, 30–45,000 will go on to develop cirrhosis, and perhaps 5000 or more liver cancer.

Now as the article in the NEJM points out, it is part of the law that prisoners are entitled to health care equal in quality to that in the “community.” The same edition of the NEJM reports new treatment of Hepatitis C infection that eliminates the virus in 94 percent of cases within eight weeks. This is a great triumph of medical science, but unfortunately a potentially expensive one, for one of the drugs alone costs $84,000 per head. The authors estimate that if the prisoners in prison at this very moment were screened and treated, the cost would be $33 billion; if only half of those infected and who passed through the correctional system in a year were treated, the cost would be $76 billion. If all were treated, the cost would be $152 billion. In other words, soon we’ll be talking real money.

At any one time the great majority – 90 percent – of people infected with HCV are outside prison. Unless, therefore, screening of the whole population were carried out, incarceration would confer a considerable health advantage on those incarcerated – that is, if HCV screening were done in prison and treatment offered according to the results. (It would hardly be ethical to screen and not offer treatment.) While it is now accepted that prisoners should have as good health care as non-prisoners, should they have better?

In many cases they do already. In my experience, at any rate, some prisoners care for their physique but not many for their health. Once at liberty, many prisoners do not waste their time going to doctors, even when health care is free and even when they are ill or injured. Their lifestyle, moreover, is the opposite of what doctors recommend.

There is an interesting natural experiment revealing of human nature waiting to be done. The treatment of HCV eliminates the infection but does not confer immunity to it. In other words, once cured you can get it again. Knowing that there is a cure, and having been once cured free of charge, will prisoners get it again? And if they do, will they be entitled to another cure?

With luck, by then the cost of treatment will be greatly reduced, like that of flat-screened televisions.

*****


TOPICS: Health/Medicine; Society
KEYWORDS: healthcare; prisoners

1 posted on 05/22/2014 7:47:03 AM PDT by SeekAndFind
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To: SeekAndFind

Well...at least better than Veterans.


2 posted on 05/22/2014 7:48:26 AM PDT by areukiddingme1 (areukiddingme1 is a synonym for a Retired U.S. Navy Chief Petty Officer and tired of liberal BS.))
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To: SeekAndFind

The answer is yes. Because, these days, yes is no, up is down, right is wrong.


3 posted on 05/22/2014 7:52:02 AM PDT by demshateGod (The fool hath said in his heart, There is no God.)
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To: SeekAndFind
We have a responsibility to give them basic health care but no luxury care, specifically no sex changes.

4 posted on 05/22/2014 7:54:27 AM PDT by BitWielder1 (Corporate Profits are better than Government Waste)
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To: SeekAndFind

Well, hell, Holder’s People deserve the very best! /sarc


5 posted on 05/22/2014 7:56:30 AM PDT by tgusa (gun control: deep breath, sight alignment, squeeze the trigger .......)
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To: BitWielder1

But, we see we live in a world, in which “trans-gendered” traitors get to go to the head of the line, to get their sex change operations.


6 posted on 05/22/2014 8:15:25 AM PDT by Dilbert San Diego
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To: SeekAndFind

It’s not like prison doctors get many patients that aren’t right there. Astute observation that...prisoners see a doctor within the hour.


7 posted on 05/22/2014 8:17:26 AM PDT by redhawk.44mag
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To: SeekAndFind
I can foresee the day when elderly/needy/sick individuals turn to crime.

They will have one of two possible positive outcomes...

1- They will profit from their crime and be more able to care for themselves or,

2- They will be caught, incarcerated and live out their days without the stress of providing for their meals and medical care.

8 posted on 05/22/2014 8:39:42 AM PDT by Awgie (truth is always stranger than fiction)
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To: SeekAndFind

I say treat them like the veterans at the VA!
Imagine the democrats complaining about the prisoners treatment but not a peep about the what the VA has been doing to the veterans!


9 posted on 05/22/2014 8:49:33 AM PDT by minnesota_bound
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To: SeekAndFind
Should Prisoners Receive Better Health Care Than the General Population?

YES, because they have restricted mobility and are deprived access to resources which would enable them to practice their trade and earn an income with which to provide for themselves................{/S}

10 posted on 05/22/2014 8:54:26 AM PDT by varon (Para bellum)
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To: SeekAndFind; Jim Robinson

In California, the prisoners get heart by passes and other cardiac surgical treatments, knee and hip replacements and other expensive surgeries at local hospitals on a bid basis.

It is probably a safe bet that prisoners including some of the worse criminal lifers get their exams and surgeries a lot faster than our vets do.


11 posted on 05/22/2014 9:02:45 AM PDT by Grampa Dave ( Herr Obama will not divert resources from his war on Americans to help Veterans!)
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To: redhawk.44mag

I have a relative who is in a state prison in IL (26 years so far). The doctors are not “right there”, and it can be weeks or months for them to see a doctor. The doctors seem to travel/rotate, and might be at any one prison only one day per week.

The prison system has a contract (used to be Wexford Health Care, may still be) for the medical care. Probably someone’s brother-in-law owns Wexford. The quality and timeliness of care are poor. As with so many government-run or government-contracted systems, the taxpayers are being bilked for many millions of dollars for a very poor result.

If there are prisoners receiving better health care than the general population, it is not happening in IL.


12 posted on 05/22/2014 9:58:53 AM PDT by NEMDF
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To: NEMDF

Well the first line in the original thread spoke of the senior doctor in the prison where he worked. I replied, using that as my reference.


13 posted on 05/22/2014 10:06:52 AM PDT by redhawk.44mag
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