• Doug Tjapkes

Medical co-pay behind bars: unfair, ineffective, and stupid!

Medical co-pay in Michigan prisons has been a burr under my saddle for a long time. It’s so ridiculous. So counter-productive! Here’s the deal. In hopes of discouraging prisoners from abusing the medical system (if you can call it that), the Michigan Department of Corrections imposes a $5 charge any time an inmate makes a healthcare visit. The poor devil has been worrying about a headache for a week, finally goes to health-care, and the nurse tells him to take two aspirin. “Five dollars please!” The good news is that, to its credit, the MDOC has waived the medical co-pay for anything COVID related since March. We’re told it will stay that way until the threat if over. We sincerely applaud that decision. The bad news is that, for all other medical reasons, the co-pay remains. First, a comment on the “good” decision. Even that compassionate move has its problems because quite often infected people show no symptoms. The CDC estimates that some 40% are asymptomatic. Our guess is that, in prison, where social distancing and other sanitation measures are marginal, the percentage is considerably higher. But now let’s talk about this darned co-pay thing. Because of ridiculously low wages in prison, this fee could be equivalent to a week’s work, thus discouraging prisoners from seeking care. If a Michigan inmate can get a job (many have been eliminated), he or she will likely earn between 75 cents and $3 a day. Not an hour…a day! (No one can remember when wages last went up!) Keep in mind that many of the 35,000 don’t have jobs at all, or work part-time. The HFP team can tell you that individuals often delay seeing a doctor and may wait too long. That can bring on an emergency situation, and the cost of treatment goes even higher! Then there’s the ripple effect. A prisoner chooses soap or snacks over medical co-pay, and as a result gets sicker…and as a result threatens the health of other prisoners with whom he or she comes into contact. Twelve states have decided to drop medical co-pay for prisoners. We think Michigan should be number thirteen. California did away with the policy saying, “Copays are dangerous barriers to healthcare access that force incarcerated people into a risky waiting game and ultimately undermine public health throughout the state.” It’s time for our state legislature to do the same. There’s no good reason to charge medical co-pay in prison. There’s every good reason to discontinue the practice.

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