Thursday, September 10, 2009

Down With Ourselves! Quickly!

This is the one, this is the one where I lose some of you. It may be in my sarcasm, it may be in the actual thoughts on the matter that the sarcasm is hiding but oh well.

Tens of thousands of inmates may be released from state prison over the next two years due to various prison related issues. When they are, they'll bring their HIV, hepatitis C and tuberculosis infections with them back to their communities.

The state prison system's health care delivery is so bad, it was deemed unconstitutional by federal judges.

I'm personally wondering why there is a prison health care system at all to be honest.

The Federal Judges decided to do what any rational group of people would do. They ordered reduction of the prison population.

(Maybe it's just me, but doesn't that technically require a reduction of crimes that would land one in prison in the first place?)

Because of cuts to already-slim services for ex-cons, there's no guarantee that the sickest parolees will be much better off on the outside.

This is where the problem begins for sure.

"We want to prevent them from spreading disease to anyone else," said Marianne Gallagher, supervisor of the Neil A. Christie Living Center, which provides services to people with HIV and AIDS in San Jose, including the formerly incarcerated.

(The easiest way to prevent them from spreading it to the population at large is of course to let them out into it, this is a fact. If you take people with poor enough morals or judgment or both to land them in prison in the first place, when you let them out this surely will not continue.)

"It's not a popular population. But they are probably the most vulnerable."

Is their "vulnerability" not self imposed?

HIV is one of the most common diseases among incarcerated populations. A 2000 study found that almost a quarter of all people living with HIV or AIDS in the United States were released from a correctional facility within the year.

If ex-cons don't see a doctor quickly, and miss even a few doses of their medications, their disease can develop drug resistance. "People are not controlling the virus in their own system, then they're passing on viruses that are already resistant to other people," said Dena Dickinson, health center manager at the PACE clinic.

Skipping medication also causes viral loads to spike. This makes it easier to transmit the infection, and makes patients more susceptible to other contagious viruses — like swine flu — that can then spread through the community.

That is an incredible shame.

The clinic is waiting to hear how many inmates will be released under the court order and when before developing a plan to serve them.

Grand! Everybody knows the best plans are always the ones that are not preventative in nature but instead are reactionary to consequences already deep rooted and in full swing!

Doctors and advocates have asked the county to release HIV-positive people with a week or month's supply of medication and during the daytime, when they can more easily access social services. But many people still slip through the cracks. Funding at the jails has been cut like all other county programs, and there's simply not enough staff to monitor release orders on a daily basis.

Go prison unions!

Currently, testing for such diseases is done only if a patient requests it or a doctor recommends it. Several hundred people with HIV pass through the system each year, Chyorny estimates, but he sees only a third of them. A third don't know they're infected, and another third know they're HIV-positive but don't want to tell anyone.

I'm not so sure I agree that telling or not telling should be the individual's right when it comes to a communicable, deadly, disease, with no cure or prevention technique other than knowledge.

That leaves clinics like PACE to treat more advanced illness, and has public hospitals footing the bill for months-long stays.

In other words, we foot the bill.

"Unfortunately, people still tend to wait until they're sick. By that time, it's AIDS defined and it's a lot harder to bring them back to baseline," Dickinson said. "If people get into care early, it optimizes their health and it also contains the cost."

A cost that the public still ends up paying for via various welfare related programs. Essentially this just prolongs their life on the outside giving far more chances to spread the diseases. I'm not going to end with an opinion but instead with a question. What would we do with any other communicable disease that is guaranteed death and easily spread through a population? Something such as small pox or ebola? We would quarantine it would we not? Why is this one any different? Do we really value political correctness more than our very lives and the lives of our children? Is this really the best option for the public and public health?


Anonymous said...

When government comes up with ideas to "help" us or save us money, we ALWAYS pay the bill.

Dillinger said...

Oh, this is true. Yet I always operate under the assumption that there are too many people who simply don't realize this yet. Though I know better, I still hope that maybe they'll read it when I point it out and a light will come on.