Should Prison Inmates Receive Treatment For Hepatitis C?

This is a question that is often answered with the knee-jerk response, “No.” Why? It’s because for hundreds of years, our society has viewed incarceration not as an opportunity for rehabilitation, but rather as a tool of punishment. When we give our inmates amenities such as television and air conditioning, some say we’re turning our prisons into country clubs. Our prisoners are supposed to suffer. Prison is our society’s act of revenge against criminals. Oddly, ours is the only Western culture that thinks this way. In most European countries, there is no death penalty. In fact, there is no such thing as a life sentence. Not even murder can get a lawbreaker more than 25 years in most of Europe. They believe that 25 years of incarceration is long enough to change a person, to give him job skills, to counsel him into good citizenship. But then, theirs is not a goal of revenge. Their goal is redemption.

In the United States, we’re big on revenge, even to the point of withholding advanced healthcare until the last possible minute. It comes down to a matter of cost. Why spend money on people who have no regard for our laws? Ironically, when it comes to hepatitis C, cost is the reason why some states are shelling out huge dollars for the Harvoni cure. In an NPR article entitled, Treating Prisoners With Hepatitis C May Be Worth The Hefty Price (11/23/2015), Alison Kodjak writes, “Treating inmates is a good investment that would save money in the long run…” The rationale: prison systems spend far too much money treating the inevitable complications of hepatitis C, including liver transplantation. But according to Jagpreet Chhatwal, an assistant professor at Harvard Medical School, the most profound benefit of treatment is saving ordinary citizens from infection after the treated offender returns to society. So, should prison inmates receive treatment for hepatitis C? Yes. Why? Because, according to the article on NPR’s website, without treatment, a released infected inmate is an expensive medical danger to society at large, mostly due to the ensuing cost of the complications of new infections.

So, in a cost vs. benefit analysis, if our prison systems are able to realize that early treatment of HCV-infected prisoners will save our society at large billions of dollars in healthcare costs, why do insurances in the private sector refuse to approve early treatment for those of us who actually pay for major medical coverage? Is there some actuarial table that says most of us are likely to die before we need emergency intervention? Do they simply wait until the cost of treating hep C exceeds the cost of complications? This is a battle we must win. But how? Should we write our congressmen? Stage organized demonstrations? Petition the CDC? Ultimately, we’re fighting a legal battle – perhaps even a legislative battle. Perhaps we must demand more of the Affordable Care Act, because one thing we cannot afford is inaction.

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