Sure, across the nation, health care costs are still rising. But there’s one place where it’s really skyrocketing: Behind bars.
State spending on prisoner health care increased in 42 states between 2001 and 2008, with a median growth of 52 percent, according to a report from the Pew Charitable Trusts and the John D. and Catherine T. MacArthur Foundation.
That’s an all-time high.
States spent a total of $6.5 billion on inmate health care in 2008, up from $4.2 billion in 2001 (amounts in 2008 dollars). Per-inmate health care spending grew in 35 states, with a median growth rate of 32 percent. And in 39 states, prison health care costs claimed a larger share of the total budget for correctional institutions, on average increasing from 10 percent in fiscal 2001 to 15 percent in fiscal 2008.
So what’s the reason for the growth? Researchers said it’s mainly because of aging inmates. But a prevalence of physical and mental illness and the costly nature of delivering health care to inmates also contributes to the cost spike.
From 2001 to 2008, the number of sentenced state and federal inmates age 55 and older grew from 40,200 to 77,800 — a 94 percent increase — while the overall U.S. prison population increased by about 200,000 prisoners, or 15 percent. The 55-and-over age group has continued to grow, reaching 121,800 in 2011.
Elderly offenders — like their counterparts outside prison walls — are more likely to have chronic medical and mental conditions, which can require expensive treatment, special correctional housing, and additional training for prison staff, researchers said. The annual cost of incarcerating an inmate age 55 or older with a chronic or terminal illness is, on average, two to three times that of the cost for other inmates.
Plus, “the remote locations of some correctional facilities can increase costs for on-site health personnel and for transporting and guarding inmates when services off prison grounds are needed,” researchers noted.
“Health care is consuming a growing share of state budgets, and corrections departments are not immune to this trend,” said Maria Schiff, director of the State Health Care Spending Project, an initiative of Pew and the John D. and Catherine T. MacArthur Foundation.
Of the states in the study, prisoner health care costs in Illinois and Texas decreased. Georgia, Kansas, Kentucky, New Mexico, Vermont, Wyoming and Washington, D.C. did not have data to participate in the study.
It’s not all hopeless information, though. Pew researchers identified four approaches that some states are using to control spending:
•Employing telehealth technologies — video conferencing and digitally transmitted diagnostic data, for example — to facilitate prisoners’ access to care and reduce guarding and transportation costs.
•Implementing outsourcing agreements that ensure the quality of care and control costs.
•Enrolling eligible prisoners in Medicaid and billing the program for qualifying services.
•Using medical or geriatric parole policies to release offenders who are deemed too sick or frail to pose a public safety risk.
“There is no single solution to all of the health care challenges facing prisons, but several states have achieved savings in ways that protect, or even enhance, inmate health and public safety,” Schiff said.