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emerging IssuesWith momentous changes and challenges facing the incoming administration, there is concern that critically needed criminal justice reforms may be overlooked or given short shrift.
Study Finds Inadequate Care for the Serious Medical Needs of Prisoners
According to a 15 January 2009 report from Reuters, a recent study by Dr. Andrew Wilper and others found that about 40% of the U.S. prison population – 800,000 prisoners – have chronic medical problems like diabetes, heart disease, or kidney problems. “And more than 20 percent of sick inmates in state prisons and 13.9 percent in federal prisons had not seen a doctor or a nurse since their incarceration began.” It is obvious that a substantial number of prisoners do not receive even minimal medical care to treat serious medical needs. The courts have held that “deliberate indifference” to serious health care problems wantonly inflicts needless pain and suffering on prisoners in violation of the Constitution's prohibition against “cruel and unusual” punishment. Yet, the study showed that “[o]ne-quarter of jail inmates who had suffered severe injuries had received no medical attention,” while the serious medical needs of 12 percent of state prisoners and 8 percent of prisoners in federal custody were neglected. The study appears in the American Journal of Public Health and may be purchased on-line at: Click Here Cost A Factor?
With a prison population of 2.3 million in the United States, incarceration costs are estimated at between $55 and $60 billion per year. Medical costs are a significant part of that expense. Prisoners are substantially less healthy than the general population, partly due to the lack of affordable care outside prison. The average cost of treating HIV, even in prison, tops $17,000 per year.
A Rising Prison Population
Our criminal justice policies have led to staggering growth in the number of people who are confined and in associated costs. For instance, one source estimates that spending on education over the past 20 years has increased by 21%, while spending on corrections has increased by 127%. Yet, about two-thirds of the 700,000 people who are released from confinement each year find themselves back in prison within 3 years. Any pretense of rehabilitation was abandoned more than a decade ago, and increasingly, opportunities to earn a decent living are foreclosed to ex-felons. At the same time, prohibitions on housing for sex offenders have led to the homelessness of thousands of former prisoners.
Meanwhile, private prison companies are generating huge profits by incarcerating overflow populations from a number of states. The future looks rosy for these for-profit prisons as the growth of the prison population continues unabated. Indeed, prison policy experts project that during the 5-year period beginning in 2006, the number of incarcerated people in at least 10 states will have increased by at least 25%. And during the interim, profits steadily climb by tens of millions of dollars each quarter for many of the for-profit prison corporations.
A Time for Choices
The economic downturn of 2008 is predicted to grow worse in 2009, despite unprecedented governmental stimulus initiatives that may well exceed one trillion dollars. A sizable portion of that sum is earmarked for tax cuts, though our budget has been in deficit for each of the past 8 years and our national debt is a staggering $10.5 trillion, increasing at the rate of about $3.3 billion per day, at an average cost to each citizen of more than $34,000. In addition, states across the nation are experiencing billion dollar budget short-falls.
Perhaps the time has come to re-examine our criminal justice policies. For instance, a failed “war on drugs,” which itself costs more than $60 billion annually, has resulted in the incarceration of non-violent, drug offenders in numbers that exceed half of the federal prison population. Often ignored consequences of that fact include the decimation of communities, social welfare costs for families who do not have the benefit of an additional bread-winner, a lack of respect for ineffectual laws and policies, and the development of gangs and a sub-culture that views imprisonment as a rite of passage. Indeed, the corruption, mayhem, and murders that have nearly brought the Mexican government to its knees are now beginning to spill across the border into Texas and other states. Yet, drugs are no less a problem today than they were decades ago. It seems clear that a punitive approach to drug use has been an abject, costly failure.
A Better Way
With regard to serious crime, there are many less expensive alternatives to incarceration. For instance, parole or probation allow an offender to hold down a job, support and attend to his family, and repay the costs of his offense through restitution. Home confinement, placement in day centers or half-way houses are alternatives far less costly than imprisonment and perfectly appropriate for non-violent offenders. Prison beds should be seen as the expensive, limited resource they are and should be utilized only in cases which allow for no more productive alternative.
Every public dollar expended on the punishment of criminal offenders reduces resources available for schools, roads, infrastructure, and other public services provided by government. But the deprivation of one's liberty is punitive, though it is largely unproductive. Subjected to overcrowding, prisoners are provided few opportunities for self-betterment through education, job-skills development, drug treatment, or transition preparation before release from prison. So, with 95% of the millions in prison eventually to be released, what are we getting for our money? Studies and the statistics would suggest that our criminal justice systems produces people who have been incarcerated in stark conditions, treated arbitrarily and unfairly, subjected to violence, brutalized, and left with little to do other than refine the criminal endeavors that brought them to prison in the first place. Upon release, they are often penniless, without shelter or support, alone and embittered, and overwhelmingly destined to return to prison as wards of the state. It is hard to imagine a worse outcome.
But it's not as if we don't know how to do better. Scholars, corrections professionals, prisoner advocates, and even the prisoners themselves know that their chance to lead productive, law-abiding lives after prison is enhanced by education and through meaningful employment that will instill the work ethic that is often lacking. But funding for such programs must be made available, post-release support must be provided, and decent jobs will provide the hope and incentive that offenders will require to contribute productively to their communities and our societies. In short, our paradigm must shift from anger and punishment to rehabilitation and conciliation.
Decide for Yourself
Those who are skeptical of a new objective in correctional policy (indeed, we all) must admit that the system could hardly produce less successful results or cost more money. (On the contrary, adoption of alternatives to imprisonment would substantially reduce public expenditures and allow the savings to be diverted to more useful initiatives.) But this need not be an amorphous nor an abstract subject for consideration.
Given the release of 700,000 prisoners per year, there is no question that many of those people are or soon will be your neighbors. Simply ask yourself whether you would prefer to have neighbors who were treated with dignity, respect, and meaningful opportunities for advancement during their incarceration, or people who were brutalized, de-humanized, and repeatedly shown that there is no place for them in society. It's an obvious choice, and one which the financial crisis may require, whether we will, or no. Let's choose to work together and facilitate new, positive objectives.
Smart on Crime: Recommendations for the Next Administration and Congress
A group of scholars, prisoner advocates, and others convened by teleconference in late summer/early autumn this year to consider the most pressing issues in criminal justice reform to develop recommendations for the Obama Transition Team. The fruits of that combined wisdom can be found at the following links. www.2009transition.org; and www.constitutionproject.org.
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