HEALTH CARE FOR CRIMINALS: A QUANDARY

One aspect of health care receives little attention: medical care for criminals. This topic became important to law enforcement officials and health-care providers recently as hospital bills mounted for a suspect who was shot when apprehended in Jackson. St. Francis Medical Center provided some $20,000 in care, but who will pay the bill?

Gene Huckstep, presiding commissioner of Cape Girardeau County, doesn't want the county to pay the bill for Khamata Kornkhamsee, a 19-year-old Illinois man who attempted to fire a semiautomatic pistol at a Missouri State Highway Patrol trooper. The Laotian gang member is back in Illinois now, where he faces felony charges related to a shooting in Rockford, Ill., last August. Because the Illinois charges were pending when Kornkhamsee was shot in Missouri, and because Illinois wanted the suspect back to stand trial, the hospital bill will be sent to Winnebago County in Illinois.

Meanwhile, the expense of guarding Kornkhamsee while he was in the Cape Girardeau hospital will come out of county funds here.

It is a complicated scenario, but it is one that is repeated often enough to raise questions about financial responsibility and to suggest some protocol be established to clear up the confusion.

No charges were filed in Cape Girardeau County against Kornkhamsee. Part of the reasoning was the county would have to bear the medical expenses for the wounded suspect if he were charged and tried here. The rationale is that the entity that wants a suspect bad enough to stand trial is the one that ought to bear any and all expenses, including hospital care for those wounded by law enforcement officers.

Another perspective would place the responsibility of costs related to injuries caused by law enforcement officers on the agency involved. Still another idea would be to create a state or federal fund to cover costs in situations like this. No one wants to be left holding the bag, and there need not be inter-agency quibbling over who should pay.

There is another aspect of providing health care for criminals that has been all but overlooked in the Kornkhamsee case. Whenever unsavory types who point semiautomatic weapons at police officers are put in a hospital, there is a significant risk for other patients and hospital staff.

All of which suggests that health care is complicated and full of ethical and life-saving considerations that are far removed from the headline-grabbing reform efforts in the United States. Legislators who are considering a federally imposed system might want to spend a few days with a county commissioner, a hospital administrator and a few law enforcement officers to find out what the real world of health care is all about.