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CHARGING PRISON INMATES FOR HEALTH CARE.
Term Paper ID:21694
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Essay Subject:
Precedent for user fees, purposes, theory, impact on prisoners, payment structures, advantages & disaadvantages, elderly inmates.... More...
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10 Pages / 2250 Words
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Paper Abstract:
Precedent for user fees, purposes, theory, impact on prisoners, payment structures, advantages & disaadvantages, elderly inmates.
Paper Introduction:
CHARGING PRISON INMATES FOR HEALTH SERVICES
This research examines the public policy alternative of charging prison inmates a user fee for health services delivered by the state to a prisoner. Several states in the U.S. operate systems where convicted persons are required to pay a part of the costs associated with the administration of their corrections programs (Allen, Eskridge, Latessa, and Vito, 1990, pp. 74-91). Most of such fees are related to parole and probation; however, such actions provide a precedent for the imposition of user fees for health services. The establishment of user fees is a popular idea among the general public and politicians.
The Arizona legislation permits the state Bureau of Corrections to charge a prisoner $3.00 for each Health Needs Request.
Text of the Paper:
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.," and as these individuals, in most instances, "arealready subject to fines, restitution charges, victims/witness fees, andcourt costs assessments," the imposition of user fees for correctionsprograms often creates a situation for the individuals concerned where theyare "robbing Peter to pay Paul" (Ring, 1989, pp. Unfortunately, it turns out that the elderly are far morewilling to risk incarceration through the commission of antisocial actsthan has been generally characteristic of the elderly in past years. The fourth type is theindividual who is first sentenced to prison after already reaching the ageof 55, and who, thus, is an elderly prisoner from the beginning. In determining the proportion of the costs of the administration oftheir corrections programs that convicted persons should be required topay, several states that have adopted such programs have used the abilityto pay principle (Ring, 1989, pp. ." ofadministering a corrections program. Washington: U.S. In such instances, both society and the convicted persons would bepenalized to a far greater extent that society was rewarded through the feepayments.Advantages and Disadvantages of User Fees Petersilia (199 , pp. Of that number,approximately 4 , were age 55 or older. Motivation for the Imposition of User Fees The coalescing of a variety of societal and economic factors in thelate-197 s and early-198 s led to demands for changes in the way in whichpublic services are delivered and funded. Another argument favoring the imposition of user fees on prisonersfor health services delivered is that such a policy will lead to a decreasein the unnecessary use of prison health services. (1994). Some expertsproject that the number of elderly persons in prison in the United Stateswill double every four years (Carroll, 1989, p. . In such instances, two adverse outcomes forsociety may occur. 43-47)remains generally true in 1994. Some statesestablish a flat fee level. Strong arguments are made that both support and deplore a policy ofimposing prisoner user fees for health services. Probation supervision fees: Shifting costs to theoffender. for each Health Needs Request. Certainly, this latter perception was applicable toall services delivered to persons incarcerated by the state. Thus, if no other relevant factorschange, an increase in the proportion of elderly persons in the prisonpopulation could reasonably be anticipated in coming years. Second, the individuals against whom the costs of their correctionsprograms are levied may not be able to meet the prescribed payments. 43-47.Ring, C. Washington: National Council on Crime and Delinquency.Bureau of Justice Statistics. 55-65). The third type is the individual firstsentenced to prison in middle-age, for whom even a moderate sentence willresult in the individual growing old in prison. Most prisons simply are notprepared to provide geriatric health care. Whether or not true, there werewidespread public perceptions that the delivery of services by publicorganizations was inefficient, and that the persons receiving the benefitsof public services were not, in many instances, the persons who werefunding such services. Four types of incarcerated persons account for the growth in theelderly segment of the American prison population. This individualwill also grow old in prison. The Reagan era,however, prompted many states to reconsider the concept, and, by the end ofthe second Reagan term in office, a total of 26 states had adopted programsto charge convicted persons for a part of the cost of administering theircorrections programs. 43-48). Growing old behind bars. Probation andparole in America. S., Newman, D. Requiring the convictedperson to pay for her or his corrections program, however, tends tooverlook societal benefits derived from corrections, and, in effect, actsmore as an additional penalty imposed on the convicted and incarceratedperson. In 1992, approximately 724, persons were federal and stateprisoners (Bureau of Justice Statistics, 1994, p. As mostpersons receiving corrections services are in the country's lowersocioeconomic classifications, however, the level of elasticity isrelatively low, and the persons receiving such services are, in mostinstances, charged for only a fraction of the actual costs ofadministration of their corrections programs (Baird, Holien, and Hall,1991, pp. First, the wives and children of convicted persons, whoare guilty of nothing more than being related to the convicted persons, maybe severely penalized (Allen, Eskridge, Latessa, and Vito, 199 , pp. The several states that have adopted programs requiring convictedpersons to pay a proportion of the costs associated with their correctionsprograms have adopted a variety of payment structures. A., and Hall, A. A fee-for-service policy is a form of tax shifting.Tax shifting is a procedure whereby the burden of taxation is shifted fromthe entity on which the tax is being applied to another entity. Similarly, health needs of female prisoners associated withpregnancy, health needs of prisoners of either gender involving seriousmental illness, and the health needs of all juvenile prisoners are notsubject to the imposition of a user fee. Similarly, health needs of female prisoners associated withpregnancy, health needs of prisoners of either gender involving seriousmental illness, and the health needs of all juvenile prisoners are notsubject to the imposition of a user fee. (1993). New York: Oelgeschlager, Gunn & Hain.Petersilia, J. Therefore, in Massachusetts, it is entirely possible thatconvicted persons on parole or probation may be required to pay fees inexcess of the actual costs of administering their corrections programs.Should such situations arise, the Massachusetts approach to the costshifting of corrections program costs would amount to an additional fine,as opposed to a reimbursement of costs by the convicted individualsconcerned. Those data in and of themselvesdo not appear to constitute a significant problem. (Eds.). Petersilia's reasoning supports the impositionof user fees on prisoners for health services. Others provide a range (most often from $1 to$5 per month), from which the presiding judge is permitted to set the feelevel. 43-48). The stereotype of the imprisoned person as poor, of minority origin,and young (Prison Research Education Action Project, 1993, pp. Fees for probationservices. Most such fees are related to parole andprobation; however, such actions provide a precedent for the imposition ofuser fees for health services. Massachusetts requires that convictedpersons on parole or probation pay a monthly supervision fee "equal to notless than one day's net wages nor more than three days' net wages" (Ring,1989, p. User fees are popular with both the generalpublic and politicians. Thus, in 2 , based on these projections, atotal of 1,6 6, will likely be incarcerated in the United States, ofwhich approximately 16 , , or almost 1 . Health needsassociated with catastrophic and chronic diseases and conditions (cancer,heart disease, diabetes, and so forth) are not subject to the imposition ofa user fee. 23-27) contends that, as penalties andprocedures associated with corrections programs are developed andimplemented both by and from the perspective of the social elite (or, atleast, not the socially deprived) in American society, that the entireconcept of requiring convicted persons to pay a part of the costsassociated with the administration of their corrections programs might bemissing the point. An argument against sucha policy is that it make life more dangerous for corrections officers asprisoners lose some motivation not to misbehave. In the United States, programs to charge convicted persons for a partof the cost of administering their corrections programs were initiated byMichigan in the 193 s, and by Colorado in the 194 s (Ring, 1989, pp. Therefore, elderly prisoners more sothan most prisoners tend to have some money available to pay for healthservices. Prisons cannot protectsociety. The Arizona legislation permits the state Bureau of Corrections tocharge a prisoner $3. 6).One of the most serious of the problems faced byelderly prisoners involves health care. for each Health Needs Request. Such a policy was implemented by the State of Arizona in theFall of 1994. . 7 ). . Thus, discussion of this issue is not simply a hypotheticalexercise, but rather is an examination of the potential advantages anddisadvantages of the implementation of such a policy. Several states in the United States operate systems wherein convictedpersons are required to pay a part of the costs associated with theadministration of their corrections programs. J. J., & Gerwitz, M. The principle upon which policies are based for requiring convictedpersons to pay a part of the costs associated with the administration oftheir corrections programs is the benefit principle-those who benefit frompublic services should also be those who pay them. (1994). Thus, in 1992, approximately5.5 percent of the nation's prison population was age 55 or older, whilethat age group accounted for approximately 21.4 percent of the totalpopulation (Bureau of the Census, 1994). Although the generalprison population will also grow, its rate of growth is projected at onlyabout 8.5 percent per year. The establishment of user fees is a popularidea among the general public and politicians. ., provided thatthe reasonable cost does not exceed the actual average cost . Most of such fees are related to parole andprobation; however, such actions provide a precedent for the imposition ofuser fees for health services. 7 ). Rather, they may deprive the wives and children of convictedpersons of milk and egg money. . 145-147). Several states in the U.S. St.Paul, Minnesota: Greenhaven Press, pp. operate systems where convictedpersons are required to pay a part of the costs associated with theadministration of their corrections programs (Allen, Eskridge, Latessa, andVito, 199 , pp. There are otherfactors, however, which cause the proportion of elderly persons in theprison population to be a cause of concern. Whensuch payments are imposed for health services, the response of theprisoners unable to make such payments will be a deferral of health care.When needed health care is deferred, serious health-related complicationsoften ensue. In states where the ability topay principle is not considered in the establishment of cost reimbursementlevels for the administration of corrections programs, two major adverseoutcomes occur. ReferencesAllen, H., Eskridge, C., Latessa, E., & Vito, G. The reasons forthe increased costs of housing older prisoners is associated with theincreased needs of older persons for medical care of all types, forcritical care for such diseases and conditions as heart problems, cancer,stroke, and emphysema, which are more prevalent among older persons thanamong younger persons, and special maintenance needs, such as diets and eyeglasses. When serious health-related complications do occur, the statewill be forced to provide free health services at a much higher expensethan would have been required if the required health services had not beendeferred. 43-48). (1989). The Massachusetts approach is based solely on the ability topay principle. User fees are popular withboth the general public and politicians. (1989, 2 November). 121-124). The increasing proportion of elderly persons in the prison populationalso argues in favor of imposing user fees on prisoners for healthservices. Elderlycriminals. Insuch instances, these costs to society will be far greater than whatevermonies are collected through a cost shifting system for the recovery of thecosts of administering corrections programs. As anexample, a tax levied on a manufacturer of a product will, in mostinstances, be shifted forward by the manufacturer to the consumer of theproduct. Department of Justice.Carroll, G. In the instance ofrequiring convicted persons to pay a part of the costs of theadministration of their corrections programs, the tax shift is away fromall taxpayers who contribute to governmental general revenue funds toconvicted individuals receiving corrections services. Such cost shifting programs may prove to be detrimental to society inthe short-run. 74-91). Precedent for Health Services User Fees Several states in the United States operate systems wherein convictedpersons are required to pay a part of the costs associated with theadministration of their corrections programs (Allen, Eskridge, Latessa, andVito, 199 , pp. The contention of this line of thought is that, formany offenders in the country's lowest socioeconomic classifications, thepunitive power of imprisonment has diminished to a significant degree. The first type is thechronic offender, who, because of one major sentence or a series of shortersentences, grows old in prison (Newman, Newman, and Gerwitz, 1994, pp. uneducated, and . Elderly prisoners frequentlyreceive social security benefits. Thisfactor in itself will cause the proportion of incarcerated elderlyprisoners to increase. If corrections program fees are beyond the financialcapacity of the individuals subjected to them, they may not, as proponentscontend, deprive convicted and incarcerated persons of beer and cigarettemoney. . 74-91). The fastest growing segment of the general population in the UnitedStates are 55 years of age and older. Most such fees are relatedto parole and probation; however, such actions provide a precedent for theimposition of user fees for health services. (Ed.). When probation becomes more dreaded than prison.Federal Probation, 54(1), 23-27.Prison Research Education Action Project. (199 ). R. 43-44). There is at present nodefinitive argument. America's prisons: Opposing viewpoints. In recognition ofthis problem, many states have established payment priority hierarchies.Most jurisdictions place corrections program fees in a range from themiddle to the bottom of the list of applicable payments. . The Arizona legislation permits the state Bureau of Corrections tocharge a prisoner $3. Further, as the lifespan of people in the UnitedStates is lengthened, increasing numbers of elderly people will be vigorousindividuals. In Szumski, B. Second, in order to be ableto pay the fees levied for corrections program costs, the convicted personsinvolved may resort to further, and, perhaps, even more serious, criminalactivity, in order to be able to meet the fee payments (Ring, 1989, pp. If such a shift werefully elastic, the total costs of corrections administration could beshifted to the convicted persons receiving corrections services. California requires that presiding judges "determine defendants'ability to pay all or a portion of the reasonable cost . Thisincreased willingness by elderly persons to commit crimes combined with anincreased proportion of elderly persons in the general population, has theeffect of increasing the proportion of elderly persons in the prisonpopulation by a factor which is greater than the population proportionrepresented by the elderly segment of American society. Newsweek, 7 .Newman, E. State and local governments, already fiscally pinched by reduced taxrevenues were hit further with federal revenue sharing reductions. Correctional Populations in theUnited States in 1992. The concept was slow to gain widespread acceptance, and, by 198 ,such programs were in place in a total of only 1 states. The increase in the proportion of elderlyprisoners, however, is rapidly changing the profile of the typicalprisoner, and the stereotype of that prisoner will likely be completely outof date by 2 . percent, may be expected to beage 55 or older. Oneresponse by many state and local governments was the imposition of fee-for-services policies. New York: The Free Press.Baird, C., Holien, D. Exceptionallylong sentences, with little or no probability of parole, mean that manyyoung persons sentenced to incarceration will grow old in prison. The aging of prison populations is a significant issue for bothcorrections officials and politicians, because it costs about three timesas much to house (in prison) and inmate age 55 and older as it does tohouse an inmate age 54 or younger (Carroll, 1989, p. (1991). 7 ; Bureau of JusticeStatistics, 1994, p. .unemployable . (3rd ed.). The second type is the individual who enters prison at an age under3 , and who has been sentenced to a long mandatory term. Health needsassociated with catastrophic and chronic diseases and conditions (cancer,heart disease, diabetes, and so forth) are not subject to the imposition ofa user fee. 45). Tax elasticity determines, in general, the extent to which a taxburden may be shifted from producer to consumer. First, the convicted persons and/or their wives andfamilies may be required to seek social assistance in order to survive. CHARGING PRISON INMATES FOR HEALTH SERVICES This research examines the public policy alternative of chargingprison inmates a user fee for health services delivered by the state to aprisoner. Forthis group of people, the argument goes, so many in the neighborhoods wherethey live have been in prison that imprisonment is no longer a stigma andmay even be a badge of honor in the struggle against what they perceive tobe an oppressive social elite. Federal Probation, 52(2), 43-48.Abstract This research examined the public policy alternative of chargingprison inmates a user fee for health services delivered by the state to aprisoner. Considering the increased costs associated with providing healthcare to such prisoners, the imposition of user fees appears to many peopleto be justified. Thegrowth in the proportion of this type of prisoner in the general prisonpopulation is not only one of the most surprising, it is also one of thestrongest growth trends (Carroll, 1989, p. 4). Petersilia pointed out that going to prisonfor many of the socioeconomically deprived can, far from being a traumaticexperience, be a sort of homecoming where they meet people with whom theyhave had long associations. As most incarcerated persons are "poor . (199 ).
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