Pay now, pay later: states impose prison peonage - Life In Prison - includes related article on prison factories - Cover Story

Progressive, The, July, 1996 by Christian Parenti

In a recent letter to The Progressive, prisoner Ricky Davis argued that the law will merely "ensure that re-entry into society is even more difficult for ex-cons" and that the wage attachments will lead to further poverty and thus more crime and recidivism. Davis also points out that former prisoners already pay for prisons--as does everyone else--with taxes.

One of the most inhumane policy innovations sweeping the corrections establishment is the introduction of co-payments for medical care, dental work, and mental-health services. These small (but, for prisoners, nonetheless expensive) fees are usually introduced with the stated aim of "deterring frivolous health complaints."

In October 1995, Allen County, Kentucky, started charging $10 for a doctor's visit. Not surprisingly, the average number of monthly doctor visits plunged from 1,125 to 225.

According to a 1994 report in Corrections Forum magazine, a similar co-payment program in Mobile, Alabama, showed a 50 percent reduction in inmate visits to the clinic. Between 1989 and 1993, the Mobile County jail saw its inmate population double while its total medical expenses dropped from $883,000 to $262,000.

The same story emerges throughout the nation, from the San Diego County jail to numerous state prison systems. Florida charges $3 a visit; Oklahoma $2, plus $2 per prescription; California $5 (soon to be boosted to $10), plus up to 200 for dentures and over $60 for eyeglasses; Nevada $4, with the costs of medication and prosthetics running much higher.

"No one is actually denied treatment due to lack of funds," says Whorton of the Nevada Department of Prisons. Instead, "the prisoner's account goes into negative balance," and if someone is ultimately unable to pay, "the prisoner's welfare fund is charged." That fund is the repository of all prison canteen profits and is intended to be used for recreation and entertainment, such as buying basketballs, weights, and common-area televisions.

A similar practice holds true in many other states: Indigent inmates with no cash will have their accounts debited for medical costs and thus will be without any spending money until all debts are paid.

Colorado state prisons had charged $3 per visit, but the practice was found unconstitutional and amended. Now prisoners are charged only for a second opinion.

The Orleans Parish jail in Louisiana had been charging $3 to $5 for over-the-counter medication but this practice was likewise enjoined.

But other states have overcome numerous legal challenges. In Maryland, Prison Legal News reports, a prisoner named Jerome Johnson, who earned eighty-five cents a day and suffered from severe asthma, challenged the state's right to charge $4 to $40 for doctor visits and inhalers. The court threw out Johnson's case, holding that the inmate's inability to pay for the medication necessary for him to breathe freely was not cruel and unusual punishment.

One particularly harrowing incident occurred in Comanche County, Oklahoma, where a jail simply refused to pay for a pretrial inmate's cancer treatments. Only after the prisoner filed a federal lawsuit were the treatments allowed.