In 2003 forty five million Americans could not obtain, did not choose to purchase or simply could not afford health insurance. That’s 15.6 percent of the United States population. Some of these people may be here illegally but most likely they are decent, hard working Americans who were priced out of the health insurance market. Too young to retire they are not eligible for Medicare. And apparently they are not destitute enough or cannot meet some of the weird criteria in order to qualify for Medicaid provided by their state.
But if they had been convicted of a serious crime at least their health insurance would be paid for. Admittedly it might not be much fun being in prison, and just evading rape can be a full time occupation. In the state of Virginia where I live and in many other states, when prisoners have served their sentence and are released to the community they usually qualify for Medicaid coverage paid for by the State. So crime seems to pay, or at least ensures that for a while you will receive free or heavily subsidized medical care.
But did you know that until very recently that if you suffered from erectile dysfunction and were a registered sex offender you could receive Viagra on the taxpayer’s dime? Sadly, I am not making this up. According to a survey by the Associated Press, here in Virginia and in 13 other states Medicaid paid for 788 sex offenders to receive drugs for treating impotence.
Silly me. I assumed that Medicaid administrators in these states had some lick of common sense. Some of these Medicaid administrators claim a 1998 Clinton Administration Medicaid policy by inference allowed sex offenders to receive these drugs. A letter sent to certain states by the federal government required Medicaid to pay for all legal FDA approved drugs with a few limited exceptions. Apparently erectile dysfunction wasn’t on the exceptions list. But that letter also said that restrictions could be put in place to cover abuse. I would hope this issue was simply overlooked by these state Medicaid administrators. But at a minimum it suggests officials in these fourteen states were asleep at the wheel.
This is not hard to figure out. No we certainly don’t want to do anything that would make it easier for proven sex offenders to potentially have more victims. And we sure don’t want to do it on the taxpayer’s dime. So of course we don’t want to subsidize these costs for registered sex offenders. My governor Mark Warner was one of the governors figuratively caught with his pants down. He issued an emergency order to prohibit future prescriptions of these drugs to registered sex offenders by the Commonwealth.
In my opinion as a condition of probation registered sex offenders should be required to take drugs that actually cause impotence. There are a number of them out there, and certain antidepressants actually have impotence as side effect. In addition to frequent checkups from their parole officers, sex offenders out in the community should be getting therapy to reduce the likelihood that they will sexually assault anyone again. Indeed the mayor of Miami has proposed a new ordinance that prohibits registered child sex offenders from going to certain places like public parks where children are present.
Miami’s proposed ordinance is a sad but necessary policy that I would like to see in other communities. I would like to hope that even a sex offender could be rehabilitated. However when it comes to crimes that tend to profoundly affect the victim for the rest of their life, such as serious sexual, physical or emotional abuse, it is completely reasonable for society to insist that registered sex offenders have their privileges sharply limited, providing they are released back into society at all. This should be a two strikes and you are out crime. A second offense should require these offenders be locked up again for the rest of their lives.
I hope that state Medicaid administrators use this opportunity to review their implementation of the federal Medicaid statutes so egregious actions like this do not recur.
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May 28th, 2005 at 07:12pm
Posted by
Mark |
Politics 2005 |
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Discussing pornography like I did recently is probably not a popular subject. It won’t win me any Pulitzers for blogging. But after hearing this story on NPR’s “All Things Considered” I realized that ex-porn actress Sharon Mitchell is as close as one can get to being the Mother Teresa of the pornography business.
Born in 1952, Ms. Mitchell joined “the biz” in its infancy: 1974. She appeared in two thousand or so adult films before retiring in 1996. In a business where the average starlet has a career of months, not years, Ms. Mitchell somehow survived. She was cited numerous times for her acting ability in an industry where it was not valued. But Sharon Mitchell is atypical in many other ways. The caricature of a porn worker is someone with low self-esteem, possibly drug addicted who expresses her hostility at the world by letting it all hang out on film. Not Ms. Mitchell, or should I say Dr. Mitchell. Because this legacy of the adult film industry is no high school dropout. She has a PhD in Human Sexuality.
There is no denying being in porn could be very risky business for a porn actor or actress. This world in particular is rife with the potential for acquiring sexually transmitted diseases. Some like AIDS can kill. Add in the frequent numbers of sexual partners porn actors are exposed to and the risk of contracting disease can be very high. Porn consumers further stacked the odds against performers. Films where condoms are used routinely bomb in the adult box office.
The adult film industry could be awash in STDs but it isn’t thanks primarily to Dr. Sharon Mitchell. In 1998 a large HIV outbreak among porn actors and actresses called for some real leadership. The business was not going to dry up. It was too profitable. It was Dr. Mitchell that stepped up to the plate. She founded the nonprofit Adult Industry Medical Health Care Foundation. Pretty much all porn producers in California require a current clean “bill of health” from the AIM Foundation before an actor or actress can be cast in a film. Dr. Mitchell’s foundation facilitates the tests and provides the certificates. The tests cost over $100 a month. While that seems expensive it includes a battery of the most sophisticated tests available. The certificate gives actors a very high assurance that they will not contract a STD on the job.
It is not a perfect system. Perhaps you’ve read of the recent case of porn actor Darren James, who tested positive for HIV. But because a rigorous system is in place the possibility of widespread infection was quickly contained. And this was because producers are voluntarily keeping detailed lists of who was filmed having sexual relations on the set, and when. As a result of this outbreak porn producers are voluntarily limiting new productions until they are sure this outbreak is contained.
It’s hard though for many of us to think charitably of anyone in the pornography business. And that’s why I consider Dr. Mitchell something of a modern day saint. Mother Teresa cared for the most destitute, sick, impoverished and forgotten people in the slums of Calcutta. Dr. Mitchell is candid that many of those in the porn industry have major mental and psychological problems. Nonetheless she cares enough about these people to do what she can, perhaps because she was one of them. While they choose to have an adult film career she can lay excellent odds that they will not end up dead from their choice. And because they can get tested at her central facility they don’t have to suffer any embarrassment or feelings of shame.
Some would probably fault her for not doing more to reduce risks. Arguably she could be crusading for all producers to require use of condoms on the set. But at some level it’s unrealistic to be too hard on porn producers. They are after all in business and are trying to meet demand. And the movies where the actors use condoms aren’t selling.
Clearly Dr. Mitchell is not living in poverty. But she is ministering and protecting a class of people who are often scorned, marginalized and abused. You can bet you won’t see any religious organizations funneling their charitable contributions to these people.
In the final analysis one can only affect change in the realm of the possible. Dr. Mitchell chose her own peculiar ministry to protect arguably one of the most scorned classes in our society. She may have been a porn actress, but she is very much a humanitarian. No one else will say it but I will: thank you Sharon for caring where no one else would give a damn. I strongly suspect somewhere up in heaven Mother Teresa is looking down on you and smiling.
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April 30th, 2004 at 09:22pm
Posted by
Mark |
Best of Occam's Razor, Sociology |
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