(Source: MIRS.news, Published 09/08/2023) After the average per-prisoner cost of healthcare has grown by 34% in the last two decades, one researcher raises concern that the data isn't available to demonstrate why the extra spending is occurring and what health outcomes it is producing.
"There's a lot of different theories about what is driving the cost . . . the cost of supplies and medicine and everything is just increasing across the board," said Karley Abramson, a health policy research associate for the Citizens Research Council (CRC) of Michigan. "We don't get a lot of federal support for funding prisoner health care, so it just kind of deserves that extra attention to make sure that we're using the state resources wisely."
When Abramson kicked off her research for the CRC report that was published as "The Lack Of Data Impedes Cost-Effective Health Care In Michigan's Prisons" this month, she wondered if she could develop potential policy solutions if things like the health care needs of non-dangerous elderly inmates or the distribution of mental health and substance abuse treatments were contributing to the cost spikes.
Preemptively, she questioned if a situation where new inmates were arriving "much, much sicker than the general population" was occurring, explaining that if data illustrated such a scenario, she would have crafted policy proposals geared more toward preventative care in their respective communities.
"I wanted to see what was there and then develop potential policy solutions based on that data. However, it was very, very difficult to find the kind of data that we needed to do that," Abramson said. "Anything that we had from the (Michigan Department of Corrections (MDOC)) was a pretty broad level, overall summary of the health status, but really granular breakdowns of what's driving spending and utilization and treatment."
Following her research, Abramson said the public doesn't know how effectively money is being used because they don't know prisoners' health outcomes.
"We don't know if they're getting better in prison, if we're releasing them back into the population in a better or worse state (as) they came in…and all of these things can have huge repercussions and an impact on society at large," she said.
According to the study, the approximately $300 million annually the state has appropriated to the care of 30,000 prisoners in recent years is worth roughly 2% of all General Fund dollars. The aforementioned 34% average per-inmate spending jump comes both after inflation-related adjustments and following a decline in Michigan's incarcerated population.
With inflation adjustments being considered, per-prisoner healthcare expenditures have risen from $6,916 in the Fiscal Year (FY) of 2001 to $9,219 in FY '21.
The CRC was able to gather from the state's corrections department that 33% of Michigan's incarcerated population is being treated for mental health issues, with 10% being defined as experiencing serious mental illness like schizophrenia, bipolar disorder, or major depressive disorder.
Additionally, the MDOC has reported that prisoners older than 50-years-old account for 25% of the incarcerated population, and 172 inmates were enrolled in the department's version of hospice care in 2019.
Also, 10% of incarcerated individuals in Michigan have Hepatitis C, with about 11 new inmates being diagnosed each month at intake, the CRC relays.
"It might be that the department isn't doing anything wrong. It might be that the department is doing everything that they can and that they are using everything as efficiently as possible, but it's a problem that we don't know and we're not able to figure that out," Abramson said. "It could be that we are not doing enough to meet (the kind of) constitutional obligations we have towards prisoners to keep them healthy and productive, and (the solution to that might be) that we need more spending or just to change our spending on certain services that will benefit them more."
Kyle Kaminski, the MDOC's legislative liaison, informed MIRS that the department is currently reviewing the CRC's report, which consists of a call for more raw data to be available surrounding inmates' health outcomes.
He confirmed that the cost of health care for prisoners has gotten more expensive, with driving factors consisting of things like the cost of health care staff following the COVID-19 pandemic and the availability of new and more costly prescriptions and procedures.
"And when you look at the prisoner population, the prisoner population has higher health needs than the general population. Many folks did not routinely connect with health care in the community before they came into the criminal justice system, and so there's (often) a lot to be done in terms of a chronic care approach," Kaminski said. "Folks have a lot of conditions or other chronic care needs that will be addressed while they're incarcerated."
