Inmate Heart Transplant Prompts Debate Over the Cost of Medical Care in State Prisons
A 31-year-old California inmate has become the first individual to receive an organ transplant while in state prison, adding "fuel to the debate over the costs of providing medical care to an expanding, and aging, prison population," the Sacramento Bee reports. The unnamed inmate, who is serving a 14-year sentence for a 1996 robbery in Los Angeles, received a new heart in an operation at Stanford Medical Center on Jan. 3. The state-funded operation and subsequent care, which Department of Corrections officials estimate could cost $1 million, will likely "raise questions as to whether there are limits to the kinds of treatment ailing inmates must be given." In 1976, the U.S. Supreme Court held that "deliberate indifference" to the health of an inmate "constituted cruel and unusual punishment" and violated the 8th Amendment. Hundreds of subsequent cases also have established that inmates have a "right to medical care equal to that of the public in general." Russ Heimerich, a spokesman for the Department of Corrections, said, "We have a requirement, based in law ... to provide medically necessary care to inmates." A Stanford Medical Center spokesperson said that a heart transplant costs between $150,000 and $200,000, but that figure does not include "security costs, aftercare or post-transplant medication," which can cost up to $21,000 per year. The Department of Corrections, which oversees a prison population "plagued with communicable diseases" such as AIDS and hepatitis C, will spend an estimated $663 million this fiscal year on inmate health care, an 11% increase over the last fiscal year.
The case also raises questions about whether inmates should receive donated organs. The Bee reports that a "paucity" of donated livers, hearts, kidneys and lungs "means thousands of people who need a new organ die each year while waiting." The United Network for Organ Sharing, the not-for-profit group that administers the national transplant network for the federal government, reports that about 4,139 individuals have registered on waiting lists for a heart transplant, including 549 California residents. "We're essentially giving a heart to an inmate when there are other people out there, potentially more productive members of society, who are in line as well," Heimerich said. But UNOS spokesperson Anne Paschke said that "[w]hether someone is in jail is not going to enter directly into consideration" when the group decides who will receive an organ. She added that "just being in prison doesn't disqualify someone" (Wiegand, Sacramento Bee, 1/25).
Meanwhile, a group of 11 inmates housed in the California Youth Authority system filed a class-action suit yesterday in U.S. District Court in Sacramento alleging that the agency's "conditions are inhumane" and that "mental health care is virtually non-existent," the San Francisco Chronicle reports. A coalition that includes the Marin County Prison Law Office, Disability Rights Advocates in Oakland and two San Francisco law firms filed the lawsuit on behalf of the inmates (Hatfield/Koopman, San Francisco Chronicle, 1/25). The lawsuit alleges violations of the 1st and 14th amendments, the Americans with Disabilities Act and the Regions Land Use and Institutionalized Persons Act (Warren, Los Angeles Times, 1/25). The plaintiffs have asked the court to order the CYA to "make reasonable, prompt and sustained efforts to fix the unlawful conditions" (San Francisco Chronicle, 1/25). CYA spokesperson George Kostyrko said that the agency has not reviewed the lawsuit (Cooper, Sacramento Bee, 1/25). However, he said that the complaints "seemed to be out of date," adding that the CYA has "made great strides in improving conditions at its institutions" (San Francisco Chronicle, 1/25).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.