THE COMPASSION OF GOVERNMENT-RUN HEALTH CARE:

A friend who visited him at the Rochester Psychiatric Center in February 1995 remembered that Mr. Langevin had pain in his jaw, eye and face that was not getting much attention from the staff. A week later, he was discovered unconscious, with a near-fatal infection spreading to his brain and other organs.

Mr. Langevin sued New York State, which operates the hospital, and probably would have won a sizable award. But the state countered by demanding that Mr. Langevin reimburse it $1.7 million for 10 years of inpatient care he had received. A judge sided with the state, and Mr. Langevin wound up with nothing.

Slip and fall in a New York prison, or suffer abuse by its guards, and inmates can keep whatever they win in court. But for patients in state-run mental hospitals — people too ill to live on their own and too poor to pay for their care — the state can drain court-awarded damages, effectively deducting the cost of their stays in the very hospitals that failed or abused them.

“It’s a Catch-22, isn’t it?” said Leo G. Finucane, the lawyer who represented Mr. Langevin. “I need to go to this facility because I’m sick. But if they hurt me worse, they’re immune.”

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