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INCOME-BLIND JUSTICE >> Medical Co-Pays
Campaign Brief:
Eliminating Health Care Co-Pays
A $5 co-pay to see a doctor might sound like a good deal — unless you earn just 18 to 33 cents per hour, like incarcerated food service workers in Michigan prisons. It takes up to 27 hours for them to afford that co-pay. This is counterproductive: it discourages people from seeking healthcare, leading to larger and more expensive problems down the road, and it is regressive – draining resources from those who can least afford it. So, it’s time to eliminate copays.
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Background
Everyone knows health care is expensive, and that’s true even in prison. That’s why the state has assessed a $5 co-pay on incarcerated people who wanted to see a doctor. Like copays on the outside, the rationale is that requiring a co-pay would deter frivolous use of health care — a limited resource in prison — while also offsetting the cost of providing that care.
While this may have been a good idea, in reality, it had negative consequences. Someone earning 18 cents an hour in a prison kitchen will have to work 27 hours to afford a doctor’s visit. That’s not the only expense someone in prison has to worry about — that same meager pay must cover things like stamps, access to email and phone calls home — things needed to stay connected to their families. And just as inflation is a concern in the outside world, it affects people in prison, too.
As a result, some people who need to see a doctor simply don’t. Or, they put off a doctor’s visit until a simple condition becomes more complicated and expensive to treat. If a person can’t afford a doctor’s visit and doesn’t realize they have a contagious condition, it could put the health of others at risk — and in a crowded environment like prison, the spread of disease is always a concern.
Vision
It’s true that the cost of health care in Michigan prisons is rising. It will likely continue to rise, as the average age of our prison population is getting older, and older people are associated with higher health care costs. But balancing the rising cost of prison health care on the backs of people who earn just pennies an hour isn’t fair, reasonable, safe or effective.
It’s simply unrealistic to expect incarcerated people, who are paid less than $1 an hour for unskilled labor, can make a meaningful dent in the $305.4 million spent annually on medical and mental health care in Michigan prisons. Even if each of the 35,000 people incarcerated saw a doctor six times a year, that would still just repay $1 million of the $305.4 million health care budget. Eliminating their co-pay creates a small deficit that could be made up through a reduction in downstream costs due to early intervention, additional funding, or cost-saving reforms.
Solution
The demand for a $5 co-pay to see a health care professional in prison is written into law. That means it will take another legislative action to undo it. We’re ready to work with lawmakers who understand the importance of encouraging health care in crowded settings like prison, and early interventions when medical issues arise. Ending the co-pay will create a minimal gap in the budget that can be filled by reduced costs, additional funding, or cost-saving reforms in other areas.
