Thursday, July 10, 2014

Texas ranks near bottom in per-inmate healthcare spending

Here's a remarkable chart from the Pew Charitable Trust depicting the increase and, in Texas' case, the reduction in prison health care spending from 2001 to 2008:

Now, Texas has increased healthcare spending since that time frame, but we still rank among the lowest among states in per capita health spending on inmates in inflation-adjusted dollars:

Grits has watched with interest as the feds spanked California over inadequate prison health care and can't help but wonder if, at some point, the state may face similar litigation if the state doesn't either spend more on prison health care or reduce the prison population more to make the health budget stretch further.


Anonymous said...

The feds can't pay their own bills without driving this country deeper and deeper in debt. They can't even figure out how to keep a bunch of children from entering this country illegally. I'm thinking they don't have a lot of business telling Texas how to run its prisons!

Gritsforbreakfast said...

What you think won't matter much if the courts do here what they did in California, though admittedly, here, heat litigation will likely come to a head before healthcare.

Anonymous said...

Again you nailed it, Grits. Heat is the next big issue. Currently medical staff are asked to make educated guesses as to will have heat problems and who won't, and give "heat restrictions" to the former; however, with non-airconditioned facilities, it is pretty hard to get away from heat--most work areas are cooler than the housing areas.

Regarding medical expenditures, great improvement has been made in the current biennium. For example, surgical services for elective (non-emergency) conditions are more widely available.

IMHO treatment for major illnesses such as cancer, heart disease, renal failure, liver failure, TB, and HIV have always been adequate or even good. Furthermore, treatment for the other sleeping giant (other than heat illness)--Hepatitis C--has expanded and improved.

The vast majority of medical complaints from offenders remain simple--cold/allergy symptoms, low back pain, requests for cosmetics and various work avoidance issues. It's pretty hard to gain offender satisfaction in this arena anyway.

The private sector could learn a great deal from corrections in general and UTMB in particular about treating medical problems efficiently, economically, and appropriately.

Prison Doc

Anonymous said...

Just like with education, dollar spent does not necessarily correllate with good results achieved. The total dollar amount may not be representative of the actual care.

Gritsforbreakfast said...

Prison Doc, just curious: How has Hep C treatment improved?

At a Lege hearing recently the House Corrections and Appropriations committees were told that 15,000 TDCJ inmates have been diagnosed with Hepatitis C, but only about 100 are presently undergoing treatment.

Also, I know the Lege gave prison health a budget bump last session. Have y'all staffed back up to the levels prior to the 2011 layoffs?

Anonymous said...

" The total dollar amount may not be representative of the actual care"

Or it may. Did you ever the saying "You get what you pay for"? Usually true.

Anonymous said...

Regarding Hepatitis C, more patients are being evaluated, more are being treated, the timeline moves faster. Still, a surprisingly large cohort refuse evaluation, abandon evaluation mid-stream, do not meet selection criteria based on severity, and many are released before a course of treatment can be given.


Anonymous said...

I see you took down the post on how Hepatitis C is contacted. I suggest that people check this out and learn for themselves how prisoners are doing to contact this disease.

Gritsforbreakfast said...

Yes, 7:15, off topic comments that you cut and pasted from elsewhere get deleted. If you want to participate in a conversation, great. If you just want to cut and paste Web MD's greatest hits, start your own blog.

And @Prison Doc, to me, the factors you cite can't fully explain why 100 are getting treatment out of 15,000 diagnosed. May explain some of it, but what the Lege was told was that treatment is only being given to 100 because of cost, not because people are refusing treatment.

Jake Johnson said...

It's hard to see how massive overhauls are likely. First, most of the Texas government (and several states around the country) reject mandatory healthcare for its citizens. If they give it to inmates, they're essentially saying "if you get locked up, you get healthcare. But if you can't afford it and you're not locked up, you may want to commit a crime." The state will never justify giving prisoners better healthcare on its own. Either the Federal government will need to step in, or nothing will be done.

Gritsforbreakfast said...

"if you get locked up, you get healthcare. But if you can't afford it and you're not locked up, you may want to commit a crime."

Jake, that's the case right now! Texas is required by federal court decisions to give healthcare to inmates, but since we didn't expand Medicaid, poor citizens don't get the same benefit.

Anonymous said...

OTOH $14 Billion
A shocking new (June 22, 2014) report from the Government Accountability Office has found that Medicaid wrongly paid out more than $14 billion to managed care organizations (MCO’s) — partners with states in providing health care services to clients.

The improper payments included services that were not necessary, never performed or weren’t eligible for coverage.