Let sheriffs be sheriffs, not health insurance operators
Oregon’s prison medical care system costs taxpayers about $100 million a year. The staggering number has been the subject of many news articles in recent years as legislators try to deal with rising costs from voter-approved measures that put more criminals in jails and prisons for longer periods.
But a step down that news reporting totem pole is the fact that county jails must spend large chunks of annual budgets on medical services. That is because, according to Yamhill County Sheriff Jack Crabtree, once people go to jail, they are stripped of health insurance coverage they might have under private policies or public programs such as Medicaid or the Oregon Health Plan.
We agree with Crabtree that this is not a fiscally responsible practice. Sheriffs’ departments are not intended to be de facto health insurance agencies. It becomes a guessing game during budget season for sheriffs to decide how much to set aside for unknown medical issues, and a string of unfortunate health problems with multiple inmates can produce a mid-year budget crisis.
For example, Yamhill County taxpayers today are paying $3,000 a month on medications for one inmate with HIV. A few weeks ago, taxpayers had to foot a $30,000 bill after an inmate ended up in the intensive care unit.
This system creates all manner of difficult decisions for budget-stressed departments. What, for example, is the appropriate cost/benefit decision involved with releasing an inmate with ongoing medical issues versus keeping certain inmates off the streets because they pose a danger to society? Those are not good decisions to require of county jail operations.
Most inmates in Oregon jails are on public health insurance, according to Crabtree. However, the system in place is not as simple as moving the cost from one government entity to another. There is no pool of money in sheriffs’ offices to handle large, unexpected bills, as there is with the Oregon Health Plan.
Oregon leaders need to develop creative options involving health insurance for inmates. Those costs should not be soaking up county law enforcement resources, and it’s going to take legislative action to change that situation.
Future news stories will discuss legislative possibilities. It’s past-due time for the Legislature to act on the best of those proposals so Oregon’s sheriffs can concentrate on what they were hired to do: protect citizens, not serve as insurance companies for inmates.