Majikthise : Viagra For Sex Offenders
Majikthise neatly skewers the latest bit of media fluff:
People are talking about the Viagra for sex offenders "scandal" as if felons were exploiting some kind of loophole. In fact, they're just using the same medical services that everyone is entitled to.
Medicaid covers Viagra for anyone for whom it is medically indicated. You don't have to undergo a criminal record check to get any other kind of medical treatment. Pickpockets can be treated for carpal tunnel, peeping toms for ADD, and embezzelers for dyslexia--and that's exactly how it should be.
People are talking about the Viagra for sex offenders "scandal" as if felons were exploiting some kind of loophole. In fact, they're just using the same medical services that everyone is entitled to.
Medicaid covers Viagra for anyone for whom it is medically indicated. You don't have to undergo a criminal record check to get any other kind of medical treatment. Pickpockets can be treated for carpal tunnel, peeping toms for ADD, and embezzelers for dyslexia--and that's exactly how it should be.
posted by Management at 1:10 AM
3 Comments:
Sex offenders get Medicaid-paid Viagra
N.Y. comptroller asks HHS for ‘immediate action’
The Associated Press
Updated: 10:12 p.m. ET May 22, 2005
ALBANY, N.Y. - Scores of convicted rapists and other high-risk sex offenders in New York have been getting Viagra paid by Medicaid for the last five years, the state’s comptroller said Sunday.
Audits by Comptroller Alan Hevesi’s office showed that between January 2000 and March 2005, 198 sex offenders in New York received Medicaid-reimbursed Viagra after their convictions. Those included crimes against children as young as 2 years old, he said.
Hevesi asked Michael Leavitt, secretary of the U.S. Department of Health and Human Services, in a letter Sunday to “take immediate action to ensure that sex offenders do not receive erectile dysfunction medication paid for by taxpayers.”
A call to Leavitt’s office was not immediately returned Sunday.
According to Hevesi, the problem is an unintended consequence of a 1998 directive from federal officials telling states that Medicaid prescription programs must include Viagra. His office discovered that the state was helping sex offenders pay for Viagra by checking Medicaid pharmacy expenditures against the state’s sex offender registry.
New York’s two senators said Sunday the problem should be corrected.
Sen. Hillary Rodham Clinton said in a statement that it was “deeply disturbing and runs contrary to the purpose of Medicaid, which is to provide health care coverage for uninsured, low-income individuals.” Clinton, a Democrat, urged Leavitt to look into the matter, and said she would explore legislative options.
New York’s other senator, Democrat Chuck Schumer, said at a press conference in New York City that he hoped the issue could be resolved without a bill, but he’s prepared to offer one if needed.
“While I believe that HHS did not do this intentionally, when the government pays for Viagra for sex offenders, it could well hurt many innocent people,” he said.
New York auditors are reviewing whether other prescription drugs for sexual dysfunction are being reimbursed by Medicaid for convicted sex offenders, Hevesi spokesman David Neustadt said.
While the auditors didn’t review the situation on Viagra reimbursement by Medicaid in other states, he said they have no indication that the policies are different elsewhere.
© 2005 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
Viagra for sex offenders
I'm getting sick of the manufactured outrage over the fact that New York's Medicaid program pays for Viagra for sex offenders. People are talking about the Viagra for sex offenders "scandal" as if felons were exploiting some kind of loophole. In fact, they're just using the same medical services that everyone is entitled to.
Medicaid covers Viagra for anyone for whom it is medically indicated. You don't have to undergo a criminal record check to get any other kind of medical treatment. Pickpockets can be treated for carpal tunnel, peeping toms for ADD, and embezzelers for dyslexia--and that's exactly how it should be.
It's unnerving to see moral busybodies demanding a closer mesh between health care and the law. Medicaid is not an arm of the parole system. Prescriptions shouldn't be rationed in the name of social engineering. It sounds as if Health and Human Services might even revoke Viagra coverage for sex offenders who have already served their time. This is unconscionable. It's not up to HHS to heap extrajudicial punishments on people who've already paid their debt to society.
I agree that our insurance priorities are skewed when it comes to Viagra and other impotence remedies. Big pharma has spent a lot of money convincing us that there is a disease state known as Erectile Dysfunction that requires medical treatment. It should be controversial that public and private insurers are spending millions of dollars to treat a non-life threatening, non-disease.
I'm not saying that sexual dysfunction is trivial. But most erectile dysfunction is the result of normal aging, stress, and other non-pathological factors. Meds like Viagra and Cialis enhance quality of life, but they aren't themselves lifesaving. They don't even correct the underlying disorders that cause impotence, like atherosclerosis, diabetes, depression, etc.
I'm not a pharmaco-economist, but I doubt the true cost benefit ratio for impotence drugs justifies their inclusion in the Medicaid formulary--especially if the same program can't afford treatments for female sexual dysfunction or contraception. (Maybe someone knows whether the NY Medicaid formulary is as solicitous of female sexual health is it is of men's quality of life.)
We can debate whether Viagra and other ED meds should be on a public insurance formulary, but the sex offender issue is a total red herring. The unsubstantiated implication is that Viagra is facilitating rapes. That might be true, but then again, so might angina medication, antibiotics, or any other medical treatment for a sex offender who would otherwise be out of commission.
Ironically, as Njorl suggests in the comments, some sex offenders might have a stronger medical claim to Viagra than many healthy men.
Developing a healthy normal sex life might be an integral part of a sex offender's rehabilitation. I have no idea if it is ever true, but it is certainly conceivable that sex crimes are the result of abnormal development. If a rapist is incapable of erection in consensual circumstances, it could easily result in frustration, violence and recidivism. While viagra wouldn't fix the problem, it would enable therapy to be more effective. Of course, this assumes that paroled criminals are receiving real therapy, which might be a stretch.
States end Viagra coverage for sex offenders
Predictably, States Ending Payments for Sex Offenders' Erectile Treatments [NYT].
More interesting is the background information towards the end of the article.
Federal regulations have required states to provide erectile dysfunction treatments, including Viagra, Cialis and Levitra, to Medicaid recipients since 1998. Recipients can receive four pills a month.
But in a letter Monday to Medicaid issuers in all 50 states, the federal Centers for Medicare and Medicaid Services ordered state agencies to stop offering the drugs to sex offenders or face sanctions. The letter, signed by Dennis G. Smith, the centers' director, stated that under the federal Medicaid statute, states were obligated to prevent inappropriate or unnecessary medical care. The letter said that the use of the drugs by sex offenders was not appropriate.
The issue became publicized after Alan G. Hevesi, the New York State comptroller, said on Sunday that 198 rapists and other high-risk sex offenders in New York had been reimbursed for the drugs in the past five years. Since then, other states have reported paying for the drugs to sex offenders under the Medicaid statute. The reports have prompted debate about whether Medicaid should pay for the drugs at all.
So, only 198 New York sex offenders have been reimbursed for any ED prescription over the past five years. Pretty thin fodder for a moral panic, if you ask me.
The article fails to dispel the key misperception that fueled this entire controversy. Viagra for sex offenders isn't a program. Medicaid covers ED drugs, some registered sex offenders are on Medicaid, so a few sex offenders got prescriptions
Now New York has issued a temporary ban on all publicly-funded ED drug coverage. Nice going, moral busybodies. Now, a lot of innocent guys won't get their drugs reimbursed because New York hasn't updated its sex offender database.
The new, temporary ban will ensure that no convicted sex offender receives these drugs through Medicaid and other publicly-funded health care programs, until legislation the Governor will propose authorizing the Health and Insurance Departments to obtain the State's complete sex offender registry database is enacted. The legislation must be enacted to allow the State's Division of Criminal Justice Services to provide the complete sex offender registry to the Health and Insurance Departments.
"We're pleased that on Monday the Federal government heeded our call to overturn the misguided Clinton Administration policy that allowed convicted sex offenders to receive Medicaid-funded erectile dysfunction drugs," Governor Pataki said. "This temporary ban will ensure that no sex offender receives these drugs at taxpayer expense while we push to pass legislation that will allow the Health and Insurance Departments to obtain the complete sex offender registry and put a targeted ban in place."
Under current New York State law, full and complete information about all levels of sex offenders is not publicly available. Only information about Level 3 sex offenders is currently available on the sex offender registry website. Due to stringent statutory restrictions on access to and use of sex offender registry information regarding convicted sex offenders, specific information about Level 1 and 2 offenders - most of those listed on the State's sex offender registry -- is not generally available to the public and/or non-law enforcement State and local government agencies.
Notice the widening Orwellian scope of this project. Initially, comptroller Hevesi objected to a handful of high risk (Level 3) offenders getting full Medicaid coverage.
Now, Pataki's ban will extend to all convicted sex offenders, even those at low risk of recidivism. Apparently, the governor wants to deny ED coverage for life to anyone who has been convicted of any sexual offense, even something as minor as patronizing prostitute. The ban will affect not only offenders on parole or probation, but also those who have already done their time. This is staggeringly unfair, especially for designated low risk offenders who have paid their debt to society.
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