Prisoners' doctor bills

The recent compromise worked out by the Scott and Mississippi county commissions over who would pay for medical costs incurred by Scott County residents housed in the Mississippi County Jail underscores the fact that the state has a lousy system for determining who is responsible for prisoners costs.

Mississippi County agreed to pay the $18,000 medical bill of a Scott County resident whose jaw was broken by inmates in its jail. Scott County agreed to pay the $4,500 expenses of another Scott County prisoner because the medical condition treated was pre-existing.

But the Scott County Commission and the Missouri Association of Counties think the state should be responsible for these costs.

The state pays the medical expenses of prisoners who are in the state correctional system but does not pay the medical bills for inmates lodged in county jails.

Twice in the past the sitting governor has vetoed legislation that would have provided state funding for the medical bills of convicted criminals housed in county jails.

The cost is considerable. Scott County spent $100,000 in medical expenses in 2004. Multiply that by 114 counties and the reason for the vetoes becomes clear.

The fear at the county level is that a prisoner's severe medical emergency could amount to catastrophic costs.

The state needs to establish equitable and clear-cut rules determining where the counties' responsibilities begin and end. The state also should require the prisoners themselves to bear some of this responsibility.