Prisoner medical care is so abysmal the Federal government is discontinuing the use of private prisons altogether. Unfortunately, this does not apply to state level prisons.
Prisoners are subject to inherent and sometimes deadly delays in medical care with little to no oversight over the decision to delay or altogether deny medically necessary care.
How are prisoners denied medical care?
Failure to timely return an inmate for surgery.
Imagine you fracture a bone and the fracture is displaced. This usually means you need corrective surgery to reset your bones to ensure proper healing. If you are a prisoner, odds are you will be sent back to the prison and told to return in a few days when the "swelling subsides." But you are not returned for a follow-up visit or for surgery. You are only taken back once the bones have begun to heal, making surgery impossible without re-breaking your bones.
Failure to monitor metastatic cancer or other rapidly progressing disease.
Imagine you are at risk for metastatic cancer. Your doctors know your risk factors and these risks are documented on your medical records. You are told to follow-up regularly (active surveillance or watchful waiting). If you are a prisoner, you are required to submit a health needs request to the prison medical provider to ask to be seen by a medical specialist for your regular follow-up visits. These requests can be approved, denied, or conveniently "misplaced." Worse yet, approved requests can be delayed, "misplaced," or simply left unscheduled requiring you to start the approval process all over. When time is of the essence for you or your loved one, delay, incompetence, or plain disregard can have deadly consequences.
Failure to refer an inmate for surgery or other medical treatment.
If you are a prisoner who needs surgery or other specialized medical care, you will need approval from the prison medical provider. Sometimes, we presume, the medical provider will approve your surgery. Other times, you can be delayed or altogether denied medically necessary surgery for non-medical reasons such as cost, date of onset of a condition, or length of incarceration. Why is your length of incarceration important? If you are being released soon, the medical provider may simply delay medical treatment until you are released so that it does not have to pay for the medical treatment.
Why don't more lawyers get involved? The Prison Litigation Reform Act ("PLRA").
Prisoner rights are civil rights. Civil rights violations give rise to damages, including attorneys' fees. This is a significant deterrent to anyone that would abuse a position of authority to deprive another of his or her civil rights. Unfortunately, the Prison Litigation Reform Act ("PLRA") diminishes this deterrent by "capping" an award of attorneys' fees to a prisoner's overall recovery. This means that unless there is the potential to recover hundreds of thousands of dollars or more, prisoners will be left to navigate state and federal courts on their own. This is not just bad news for prisoners, who lose access to competent legal counsel.
Courts are left to "screen" prisoner civil rights cases (most of which are handwritten or scarcely legible) and to effectively "babysit" prisoner civil rights actions. This hardly promotes a just, speedy or inexpensive determination of civil rights actions.
The PLRA doesn't just hurt prisoners and their families. With little to no opposition from competent lawyers (or any lawyer in most cases), governments and private contractors have little trouble dispensing prisoner civil rights lawsuits behind their armies of lawyers. Private contractors who violate the Eighth Amendment prohibition on "cruel and unusual punishment" en masse are rewarded with new or renewed contracts. Meanwhile, courts are left to make "sense" of deliberate indifference to serious medical needs with rulings that erode our Constitutional protections.
Should you even care about prisoners?
Most people do not, until they become one or know someone who becomes one. Violent crime has plummeted over the past 25 years but the incarceration rate has skyrocketed. Like any other private enterprise, the prison industrial complex has organized powerful lobbies that influence elected officials at the state and federal level at the taxpayer's expense. These lobbies sell harsher punishments and sentencing laws to the public under the guise of "public safety." But this is hardly the case. For decades, the incarceration rate for non-violent offenders has far outpaced violent offenders. Today, a majority of prisoners serve time for non-violent offenses. In Pennsylvania, two judges were sentenced to prison after investigators revealed they accepted money for sentencing children to juvenile detention centers in a "Kids for Cash" scandal. Does this sound like public safety?
What we can do.
Raise awareness. Get involved with the American Civil Liberties Union and the ACLU National Prison Project (visit the ACLU National Prison Project by clicking here). A prison sentence should not mean a death sentence.
Society's least favorite citizens are now becoming victims as for-profit prison healthcare providers reap hundreds of millions of dollars in taxpayer funds while cutting care to the prisoner population. The trend, known as privatization, essentially vests unchecked power in private healthcare providers who deliver little to no effective healthcare to inmates, many of whom suffer chronic illness, disease and sickness.
In Arizona, a recent class action in the matter of Parsons v. Ryan resulted in a multi-million dollar settlement (mostly attorneys' fees) stemming from prisoner health conditions under the Arizona Department of Corrections, Wexford Health Sources, Inc. and Corizon Health, Inc. During an inspection by Robert Cohen, M.D. Dr. Cohen remarked healthcare within the ADC was amongst the worst he had ever seen and that, "[T]here were multiple cases in which the lapses were so shocking and dangerous that I felt ethically obligated as a medical professional to bring them to the immediate attention of the ADC and Corizon staff."
Unfortunately, it does not appear that privatization will result in effective healthcare anytime soon. Private healthcare providers are routinely shuffled in and out of state department of corrections systems and are largely insulated from civil actions due in part to unfavorable Federal court rulings and the enactment of the Prison Litigation Reform Act which caps attorneys' fees dissuading many attorneys from becoming involved. The horrific conditions in prisons throughout the country are leading to growing awareness. Companies like Wexford Health Sources, Inc. and Corizon Health, Inc., though largely unknown to the vast majority of citizens, are slowly being exposed. Taxpayers can and should demand accountability for how their tax dollars are being spent