Weathered old-timers often postulate that incarceration preserves the human body. Absent the stresses of life on the street—no bills to pay, no job to grind, no imbibing hard booze or drugs—the body heals, even reverses course, and rests peacefully until their imminent release date.

It's a beautiful theory, but far from reality, as Minnesota's aging prison population and the rising costs of prisoner healthcare can attest.

According to a March 2012 Minneapolis Star-Tribune report, more than 10% of Minnesota's prisoners are over age 50. a demographic considered "elderly" in prison that has doubled just in the past decade. Many of them—more than 550—are serving life sentences and face an average of at least 30 more years in prison.

The longer any offender in Minnesota spends incarcerated, the more likely that the state's Department of Corrections (MDOC)—which had a $68-million medical budget in 2011, a three-fold increase over the last 10 years—is forced to decide whether to provide specialized treatment for expensive illnesses like cancer, diabetes and heart disease caused by the abuses of nicotine, liquor and deadly chemicals.

MDOC officials have taken to calling the ones who get treatment "million-dollar prisoners," a catchy perjorative that political opportunists and tough-on-crimers like to use to blame state budget woes on criminal offenders. They argue that prisoners shouldn't be provided healthcare that those on the outside can't afford themselves.

To that, however, MDOC medical director Nan Larsen has a quick retort.

"Their punishment is that they are separated from us, from society and from their families—but not from our care," said Larsen, who noted that prisoners are the only Americans who have a guaranteed right to healthcare, thanks to a U.S. Supreme Court ruling.

James Vogel, 52, is one of those prisoners who has, so far, benefited from that decision. In 2009, Vogel began serving a five-year sentence for his sixth DUI conviction. As he began his sentence, he felt a bulge in his stomach the size of a football. Ultimately, the bulge was diagnosed as a rare form of non-Hodgkins lymphoma, a terminal illness with an average life expectancy of five years.

MDOC decided to treat Vogel with a year of intensive chemotherapy and then sent him to the Mayo Clinic for a month to receive a bone-marrow transplant. He left Mayo in August 2010 and was returned to a prison yard in Oak Park Heights, Minn.

"I probably would not have gone to see a physician, or had the cancer found as soon as it was, if I hadn't been arrested," said Vogel, who worked in construction before being incarcerated. "I'll admit that. So there's a level of gratitude over the treatment I've received."

The treatment currently extends to prisoners throughout MDOC. According to the state's data. MDOC has spent $14.4 million the last five years to treat prisoners with cancer, like Vogel. Cardiac care has cost nearly $2 million the last four years. Nearly 20% of Minnesota's prisoners are hepatitis-C positive, and a dialysis program is expected to cost $1.8 million by 2020. A fifth of male prisoners and almost 70% of female prisoners are taking psychotropic meds. Obesity, hypertension and diabetes are pervasive.

But it is basic medical care—especially for prisoners over 50—that makes up the bulk of prison healthcare costs. Nationally, per-person medical costs for older prisoners, said a recent report from Human Rights Watch, range from $8,500 to $11,000 per year.

"Prisons were never designed to be geriatric facilities," said Jamie Fellner, the author of the HRW report. "Yet, U.S. corrections officials now operate old-age homes behind bars."

To control costs, MDOC has contracted medical care for prisoners since 2006 to Corizon, a for‑profit company that will he paid $28 million in 2012 to provide basic care for prisoners. While MDOC says that Corizon is saving taxpayers millions of dollars, prisoners see a decline in the care they once received, waiting months for illnesses to be diagnosed or to receive treatment at all.

And the locus on fiscal prudence is determining the level of specialized treatment MDOC delivers—a "community standard." according to Larsen, established by Minnesota's Board of Medical Practice—to reduce the number of million-dollar prisoners."

Vogel, who considers each day borrowed time, asked MDOC to allow him to participate in clinical trials to advance his cancer treatment. Vogel was scheduled to be released in November 2012. At the time of the Star-Tribune report. he was concerned he might not make it that long.

"I'd like to have Thanksgiving with my family." Vogel said. "I don't want to die in prison."

Larsen, however, in spite other supposed compassion for prisoners' rights, declined.

"Your condition is presently neither grave nor terminal by any medical standard." she wrote in a letter to Vogel. "While it may be true that the lymphoma will someday claim your life. You are currently well-managed within our system."

Source: Minneapolis Star-Tribune

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