Pennsylvania's prison co-pay threatens people's lives - suspend it

Physicians for Criminal Justice Reform recently issued a letter to Acting Secretary George Little of the Pennsylvania Department of Corrections requesting the elimination of the $5 prison co-pay currently required of incarcerated individuals in Pennsylvania state prisons to receive health care. The co-pay was previously suspended for COVID-19 under an emergency suspension by the department and should be suspended again to eliminate this barrier that keeps people in prisons from requesting health care when they need it.

Researchers at the Mailman School of Public Health at Columbia University found through a 1987-2017 analysis of U.S. county-level data "a strong association between jail incarceration and death rates from infectious diseases." People in prisons are more likely to contract an illness, given their living conditions in close quarters, and deserve to receive necessary medical attention like anybody else. Unfortunately, Pennsylvania has made receiving necessary care for both major and minor illnesses in state prisons difficult, deterring incarcerated individuals from receiving medical attention via the $5 prison co-pay. Requiring a $5 co-pay for treatment may seem like a small cost, but when factoring in that incarcerated individuals in Pennsylvania are paid a minimum wage of only 19 cents per hour and a maximum wage of 51 cents, $5 becomes a large expense, creating a big hurdle for people to surmount.

Those supporting the co-pay argue that it keeps people in prisons from abusing their access to health care for minor discomforts. However, most of us do not have the medical education to distinguish what could be a major medical concern from a minor one. If a minor concern is left unattended due to the burden of the co-pay, it could become a neglected warning sign of a larger, more dangerous and expensive problem for the person. In fact, this is exactly what regular primary care visits are all about.

For example, adenocarcinoma of the lung, the most common primary lung cancer seen in the United States, has subtle early symptoms such as chronic dry cough, labored breathing, or weight loss that may be dismissed as insignificant. Adenocarcinoma is an aggressive lung cancer that disproportionately affects healthy non-smokers and is therefore often unexpected and too often caught in its later stages. Thus, an early diagnosis of adenocarcinoma can be particularly lifesaving. For all lung cancers, an early diagnosis boasts an astonishing five-year survival rate of 70% to 85%, while a later diagnosis after the cancer spreads throughout the organ sees the survival rate drop to less than 30%. Once the cancer spreads to other organs, the five-year survival rate drops to less than 5%.

It's obvious that access to regular primary care is a true matter of life and wrongful death for people in prisons. For these reasons, many organizations across Pennsylvania, including Physicians for Criminal Justice Reform, FAMM Foundation, the Pennsylvania Prison Society, and the Coalition to Abolish Death By Incarceration, recognize the benefits of removing the $5 co-pay and are actively advocating for its removal. Along with them, our legislators have joined the effort to eliminate the co-pay permanently with PA Senate Bill 1296, introduced by Sen. Camera Bartolotta (R-Greene) and its sister bill, PA House Bill 1753, introduced by Rep. Amen Brown (D-Philadelphia). Both bills are currently in their respective judiciary committees.

Now, it is crucial for Pennsylvania citizens to join in this pursuit if we are to eliminate the $5 co-pay in correctional facilities and uphold the basic human rights of people in prisons. You can call Gov. Tom Wolf, who is in charge of the PA Department of Corrections, at 717-200-7122 and let him know that you want him to suspend the $5 prison co-pay immediately across the commonwealth so that we can return to people the basic humanity that every person deserves.

Maryam Ismail is a student at the University of Pittsburgh and a member of Physicians for Criminal Justice Reform (PfCJR) For inquiries about the $5 co-pay in PA, contact Zane Kaleem, M.D., Pennsylvania Liaison for PfCJR.

This article originally appeared on Erie Times-News: Call Gov. Wolf, stop PA's prison co-pay and save lives