An idea that the Legislature rejected a year ago has cropped up again in the Fee Bill, one of the big money bills the Legislature has to deal with every year. It was a bad idea a year ago, it's a bad idea now, and the Legislature should kill this before it goes any farther.

You know that Douglas likes to talk about Vermont's affordability crisis, and how hard people who don't have a lot of extra money have it to afford their basic necessities of life. And it must be really hard if your job pays you a very low salary, like $.25 an hour, right?

That's right, $.25 an hour. You could get paid that little if you're employed by Correctional Industries of Vermont. I'm not sure about license plates, but if you spend any time in state office buildings you've probably sat on furniture made by prisoners.

Well, you say, what expenses do prisoners have? Aren't all their needs taken care of? They get housing, they get three hots and a cot, they probably have doctors and dentists and people like that come in to take care of them, right? How about this: the Douglas administration wants to make prisoners pay a $5.00 co-pay whenever they go to the doctor. If you're only getting paid $.25 an hour, even $5.00, which is a pretty low co-pay in the private insurance world, starts to look like a lot of money.

It's part of the Fee Bill, and here's the legislative language (from last year–I haven't seen this year's language, but it's likely to be the same):

Sec. 10 28 V.S.A.§ 801 is amended to read
§ 801. MEDICAL CARE OF INMATES

They're doing it because, in their words, “[T]he costs of medical care could be defrayed, personal responsibility enhanced, and unnecessary usage reduced) (sic) by a modest inmate co-pay per visit.” They also think they'll save $50,000. Out of $130 million.

So in their view, doing this will have the beneficial effect of keeping prisoners from seeing doctors. On the other hand, a study on corrections policy across the country a couple of years ago argues that if we are going to provide decent health care to prisoners, who are, after all, people in the custody of the taxpayers' government, one thing we have to do is get rid of co-pays. 

In a study conducted by the Centers for Disease Control and Prevention to evaluate the cause of outbreaks of methicillin-resistant Staphylococcus aureus (MRSA) in correctional facilities in Georgia, California, and Texas between 2001 and 2003, co-payments were singled out as a significant contributor to the spread of these serious and aggressive skin infections because they discouraged prisoners from seeking care (CDC 2003). . . . [I]t is impossible to devise a co-payment
program that does not erect barriers to care that could put the health of individuals n jeopardy, lead to the spread of disease, and cost correctional systems and communities much more in the long run when treatment is delayed.

Now do you know the big health care story of this week? That's right, swine flu. It's bad enough that people are dying of it, and it's spread to the United States. Is this really a smart time to start punishing people for going to the doctor?

 This is an area, one of many, in which Vermont is ahead of the rest of the country. While 33 states have adopted co-pays for prisoners, Vermont doesn't have them, and now the Douglas administration is once again racing to the bottom, trying to abandon one positive, progressive aspect of corrections policy, And it's also self-defeating. You may remember back in the fall of 2007 when the Springfield prison was locked down because of an outbreak of MRSA. How much worse would it have been if the prisoners were avoiding the doctor because they didn't have the five bucks to get into the office?

This provision of the fee bill is going to be discussed by the conference committee. It's in the Senate version of the bill, but there is still a chance if enough people contact their conference committee representatives.