Free Medical Treatment for Prisoners: A Different Perspective

by Katherine Scardino

Do prisoners deserve free medical treatment? You recently read WIC’s most competent contributor, Diane Dimond, ask this question in her post last week. I was a bit concerned that there may actually be people out there who think the answer should be a resounding “no”. I gave this subject some thought and felt the need to respond.

Yes, there are many people in the United States who cannot afford quality medical care - or any medical care at all. For those of us who do have insurance policies and premiums each month, we suffer financially because the premiums are extraordinarily high and at times wonder what it would be like living in Canada. But, generally, we pay the premiums and complain. And, yes, the inmates who are incarcerated in prisons all over the United States get free medical care. It’s not really free, because all of us pay for it. And, it is expensive.

But, let’s stand back and think about this for a moment. Let’s take my state, Texas, and look at the statistics here, because, as you know, Texas is big on sending people to prison. We all believe in being tough on crime, but don’t you also think it is important to be smart on crime. I remember many years ago when a person caught with a marijuana joint could have gone to prison for decades and some did. In my jurisdiction, only a few years ago it was very common for anyone caught with a small, usable amount of cocaine to be sentenced to many years in prison. It has become more common now for first-time drug offenders with small amounts of drugs to obtain some form of alternative punishment that includes counseling and rehab. Texas, however, as far as I can tell, has been a leader in long sentences.

While some prosecutors and judges espouse toughness, it seems to me that smartness is just as critical in the big scheme of things. When a 25 year old individual is sentenced to 30 and 40 years in prison for non-violent crimes, such as delivery or possession of some prohibited controlled substance or other non-violent crimes, he or she is going to get old. Their bodies are going to creak and groan just like free people at that age. There are many inmates who are up for parole and who should be paroled. I am not saying open the doors and let them all out. I am simply stating that of those inmates who may be qualified for a parole, or for the inmates who are serving time for possession of small amounts of drugs, for God’s sake, let them out instead of paying for them for many years and for many inmates on into their golden years. In the Texas prisons, a defendant is almost twice as likely to be incarcerated for a drug offense as a murder.

The inmate’s right to medical care was made clear by the Supreme Court in Estelle v. Gamble, 429 U.S. 97 (1976). The Supreme Court established “the government’s obligation to provide medical care for those whom it is punishing by incarceration.” And, there have been several cases since 1976. For Texas, it was Ruiz v. Estelle out of the Fifth Circuit dealing with prison conditions in Texas and culminated with a requirement that the Texas Department of Corrections to “prepare and file with the court a plan which will assure that prisoners receive necessary medical, dental, and psychiatric care from the moment of their arrival in TDC.” In Ms. Dimond’s post, she pointed out a severe and ridiculous case where an inmate in Massachusetts had sued the state for a sex change operation. This surely is a sole case of an inmate who has more time on his hands than any other logical individual and has taken this on as his personal play-toy. There will always be one of these cases somewhere. 

I could also recite many cases where the inmate died as a result of receiving no medical attention or the quality of medical attention they did get was atrocious. We probably take better care of our pets. Actually, I will recite one - Adam Whitford injured his ankle in 2004, before he went to prison. The limited care and unsanitary conditions in prison caused him to develop a severe staph infection, which became an oozing wound., He was prescribed antibiotics for the infection to be taken every 6 hours, at 4 am, 10 am, 4 pm. But the prison pill window system of distributing medication meant he often had to wait up to two hours for his medication from the time he was supposed to take it. Apparently, if not taken at proper intervals, antibiotics allow the bacteria they are supposed to fight to develop immunities and grow stronger - and this is what happened to Adam Whitford’s body. His foot had to be amputated above the ankle.

So, what is to be done to alleviate the unbelievable amount of money spent on medical care for inmates and to provide quality medical care? It is apparent to me, and I wish to legislators, that our war on drugs is not working. If we really want to help addicts or perhaps young people who commit non-violent crimes, direct the money you would spend on those individuals toward fixing the problem. Send them to rehabs; force them to either go to prison or counseling; send them to lock-up for shorter periods of time and then place them on probation with a real officer of the court who will oversee them while they put their life back on the right track. Or, we could just get them out of our hair and away from us by sending them to prison for 20 years and then complain about the medical care as they age. I am all in favor of criminals being punished. But, over the years we seem to harshly punish everyone. That has never worked and it is not working now.

Ms. Dimond was correct when she said that providing medical care for inmates is what a humane society should do. We have to pay for medical care for people we assume responsibility for and it is a huge expense if we want to keep them under our finger for 40 or 50 years. Just as ludicrous as the inmate who wanted a sex change operation is the 80 year old inmate who is ill and dying, and we keep him locked in a box and complain about his medical care. That is not reasonable to me. One more point out of Ms. Dimond’s post - I caught a bit of complaining about free lawyers for indigent defendants “on the taxpayer’s dime”. That issue has been long settled as a right of every indigent citizen of the United States. People complain about these things until it is their son or daughter, their husband or wife who cannot afford a high-priced, free-world lawyer and they want a good lawyer appointed to represent them and get them off. The appointed lawyer who works for a fee not even close to the fee a hired lawyer would charge is the grease that keeps our justice system running. There are many, many more indigent people in the criminal justice system than those with money. My opinion about the reason for that is the grist for another post.