Medicare in prisons: the case for reform

Most people are surprised to hear that people in prison lack access to Medicare, Australia’s ‘universal’ health care system. The lack of Medicare access for people in prison in Australia causes many issues not only for prisoners themselves, but also for the general community. The consequences of the Medicare exclusion include unnecessary deaths, the exacerbation of mental health conditions, increased recidivism, and increased strain on public health services once those in custody are released. While the costs of providing Medicare access in prisons may appear substantial, it would likely be highly cost effective as improved mental health support will reduce reoffending, avoiding high costs of reincarceration. The improved health of prisoners will also reduce strain on the public health system once they are released. Introducing Medicare into prisons will also ensure Australia meets its human rights obligations under international law and will support Australia’s commitment to the 2030 Sustainable Development Goals. It will be an effective way of preventing Indigenous suicides and deaths in custody and reducing reincarceration rates. Providing greater access to healthcare for Indigenous people in custody is also necessary to achieve the targets listed in the National Agreement on Closing the Gap. This policy brief also outlines the history of the Medicare exclusion for prisoners and provides multiple recommendations for the introduction of Medicare in prisons.