Prisoner medical co-pay: A terrible idea!

If your doctor charged a $500 co-pay for every visit, how bad would your health have to get before you made an appointment? 

That’s the question Wendy Sawyer asked last year, in a Prison Policy Initiative blog. She was talking about the shameful co-pay policy for prisoners. 42 states have co-pay policies, ranging from $3.50 to $8 per visit. Here in the State of Michigan, prisoners are charged $5 for every visit to the health center. BUT, keep in mind the prisoner pay scale. Michigan inmates can earn as little as 75 cents a day, or at the peak, up to about $3.35 per day.  So, according to the estimates calculated by PPI, the average Michigan prisoner would have to work 35 hours a week to make one co-payment. That’s just unacceptable!

I bring all of this up because I just learned that Illinois lawmakers have eliminated the medical co-pay plan for prisoners. Illinois prisoners make 5 cents an hour, so the $5 co-pay was roughly equivalent to a month’s wages.

The main argument for medical co-pay for prisoners is to discourage frivolous visits. Now, just as in the free world, I’m sure you might find a few hypochondriacs behind bars. But really, how many people do you know who just love to go to the doctor, and who cannot wait for the next visit? And if we’re talking expense, these tiny co-payments certainly cannot make much of a dent in the cost of medical care for prisoners.

In an office where we respond to 20 messages from prisoners per day, 7 days a week, you can bet that we hear complaints about medical co-pay. Especially when a prisoner finally breaks down and agrees to give up a week’s wages, and the PA tells him to take two aspirins and get out of there! Sometimes they charge for doing absolutely nothing. Not even any medical advice!

Our congratulations to the State of Illinois. It’s way past time for Michigan lawmakers to consider the same action.

Back to Wendy Sawyer again:

Out-of-reach co-pays in prisons and jails have two unintended but inevitable consequences which make them counterproductive and even dangerous. First, when sick people avoid the doctor, disease is more likely to spread to others in the facility – and into the community, when people are released before being treated. Second, illnesses are likely to worsen as long as people avoid the doctor, which means more aggressive (and expensive) treatment when they can no longer go without it. Correctional agencies may be willing to take that risk and hope that by the time people seek care, their treatment will be someone else’s problem. But medical co-pays encourage a dangerous waiting game for incarcerated people, correctional agencies, and the public – which none of us can afford.

Amen and Amen!