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02/27/2013

Going to prison to save your life

Prison
Correctional officers stand watch over an inmate receiving treatment in the emergency room at California State Prison in Corcoran, California in January 2009. (AP Photo/Rich Pedroncelli)

This is what it has come to, apparently: going to jail for health care. And at least one American doctor is admitting that for some patients, this is the best medical decision that they can make.

Yesterday, the Atlantic published a story by Dr. Joshua Mezrich, an assistant professor of surgery at the University of Wisconsin School of Medicine and Public Health who specializes in transplants.

The sub-headline of Mezrich's article reads: Sometimes going to prison can be an unfortunately rational health care decision.

He tells the tale of a prison inmate who was diagnosed with life-threatening aneurysms in his hepatic artery, which feed blood to the liver. The prisoner was told he would die if he didn't have surgery.

But then, he was released from jail. Yes! But also, no -- suddenly, he had no health insurance to cover the operation.

The man's solution? To go to a department store, catch a security guard's eye, and then brazenly steal some moisturizing cream. "He looked up at the guard, smiled, and walked out," Mezrich writes.

In court, he slipped a note to the judge explaining that he needed to go back to prison so that he could have his operation. According to Mezrich, the judge said: "I'll give you 14 months, go get your surgery."

Mezrich's article is soaked with frustration as he cites statistics (more than 60% of 2,300 bankruptcies in 2007 were caused by medical illness) and describes the dire options available to dying patients without insurance: 1) try to qualify for Medicaid 2) steal moisturizing cream 3) die.

"I have personally taken care of a number of patients who did not want to put their family through the formidable weight of bankruptcy, and opted for number three," he writes.

In the end, Mezrich writes, the lotion thief survived his surgery and is now recovering.

The doctor concludes with one last thought: "I just hope he stays in prison long enough to get some follow-up care."

Jennifer Yang is the Toronto Star’s global health reporter. She previously worked as a general assignment reporter and won a NNA in 2011 for her explanatory piece on the Chilean mining disaster. Follow her on Twitter: @jyangstar

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