Sunday, September 20, 2009

Largest NY HIV Care Provider: Prison.


Editorial
Medical Inattention in New York Prisons
NY Times
Published: September 15, 2009


Prison inmates are the sickest people in society, with infection rates for blood-borne viruses like H.I.V. and hepatitis C far higher than the general population. Failing to test, counsel and treat these inmates makes it more likely that they will spread infection once they are released and suffer catastrophic illnesses that shorten their lives and drive up public health costs.

The New York State Legislature had this problem in mind when it passed a bill that requires the State Department of Health to ensure that prison H.I.V. and hepatitis programs are operating effectively and meet prevailing medical standards. Corrections officials, who tend to rebel against oversight of just about any kind, want Gov. David Paterson to veto this bill. He should ignore them and sign it.

The state correctional system has unquestionably improved medical care over the last several years. But a recent report by the Correctional Association of New York, which is authorized by the Legislature to monitor the prisons, found troubling inconsistencies in care in the state prison system, which is said to house 20 percent of the H.I.V.-infected inmates in the United States.

The report, based on state records, estimates that the state has identified through testing fewer than half of the H.I.V.-positive inmates and only about 70 percent of those with hepatitis C. The report finds that the number of people receiving treatment varies  significantly from place to place, which is suspicious given that the population is fairly homogenous. The variation raises questions about the consistency and effectiveness of medical policies from prison to prison.

Prison medical officials argue that the treatment regime is fine and that oversight is unnecessary. But critics in the Legislature rightly point out that the prison health system is the only one in the state not overseen by the Health Department. The prison system, with about 4,000 infected inmates, is the largest provider of treatment for H.I.V., the virus that causes AIDS, in the state.

Other critics argue than the Health Department’s initiative would cost money at time when the state can’t afford it. But better diagnoses and treatment in prison would save more money than it would cost by preventing further infections and keeping many patients from moving on to costly, catastrophic illnesses.

A version of this article appeared in print on September 15, 2009, on page A32 of the New York edition. http://www.nytimes.com/2009/09/15/opinion/15tue2.html?_r=1
This and other news about mass incarceration can be found at
www.realcostofprisons.org/blog/

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