Penalty Enhancement for Hate Crimes: An Economic Analysis

The issue of bias-motivated crimes has attracted consderable attention in recent years. In this paper, we develop an economic framework to analyze penalty enhancements for bias-motivated crimes. We extend the standard model by introducing two different groups of potential victims of crime, and assume that a potential offender's benefits from a crime depend on the group to which the victim belongs. We begin with the assumption that the harm to an individual victim from a bias-motivated crime is identical to that from an equivalent non-hate crime. Nonetheless, we derive the result that a pattern of crimes disproportionately targeting an identifiable group leads to greater social harm. This conclusion follows both from a model where disparities in groups' victimization probabilities lead to social losses due to fairness concerns, as well as a model where potential victims have the opportunity to undertake socially costly victimization avoidance activities. In particular, penalty enhancements can reduce the incentives for avoidance activity, and thereby protect the networks of profitable interactions that link members of different groups. We also argue that those groups that are covered by hate crime statutes tend to be those whose characteristics make it especially likely that penalty enhancement is socially optimal. Finally, we consider a number of other issues related to hate crimes, including teh choice of sanctions from behind a Rawlsian 'veil of ignorance' concerning group identity.

Barriers to Timely Screening Colonoscopy

Objective: Colorectal cancer (CRC) can be largely prevented or effectively treated in its early stages, yet disparities exist in timely screening. The aim of this study was to explore the disparities in CRC screening on the basis of health insurance status including private, Medicare, Medicaid, and State Administered General Assistance (SAGA). Methods: A retrospective chart review for the period January 2000 to May 2007 (95 records) was conducted at two clinic sites; a private clinic and a university hospital clinic. All individuals at these sites who met study criteria (>50 years old with screening colonoscopy) were included. Age, gender, date of first clinic visit when screening referral was made, and date of completed procedure (screening colonoscopy) were recorded. Groups were dichotomized between individuals with private health insurance and individuals with public health insurance. Individuals with any history of CRC, known pre-cancerous conditions as well as family history of CRC requiring frequent colonoscopy were excluded from the study. Linear model analysis was performed to compare the average waiting time to receiving screening colonoscopy between the groups. T-test was performed to analyze age or gender related differences between the two groups as well as within each group. Results: The average waiting time (33 days) for screening colonoscopy in privately insured individuals was significantly lower than publicly insured individuals (200 days). The time difference between the first clinic visit and the procedure was statistically significant (p < 0.0001) between the two groups. There was no statistical difference (p=0.089) in gender between these groups (public vs. private). There were also no statistically significant gender or age related differences found within each group. Conclusions: Disparities exist in timely screening for CRC and one of the barriers leading to delayed CRC screening includes health insurance status of an individual. Even within the insured group, type of insurance plays major role. There is a negative correlation between public health insurance status and timely screening. Differences in access to medical care and delivery of care experienced by patients who are publicly insured through Medicaid, Medicare, and SAGA, suggests that the State of Connecticut needs to implement changes in health care policies that would provide timely screening colonoscopy. It is evident that health insurance coverage facilitates timely access to healthcare. Therefore, there is a need for increased efforts in advocacy for policy, payment and physician participation in public insurance programs. A state-wide comprehensive program involving multiple components targeting different levels of change such as provider, patients and the community should help reduce some of the observed causes of healthcare disparities based on the insurance status.