Gross negligence in for-profit prison health care

By law, people in prison have a right to get the health care they need. In the late 1970s, the U.S. Supreme Court decision Estelle v Gamble set the standard for medical rights of prisoners. But prison authorities are being criminally negligent in not providing adequate health care to incarcerated people.

As the jailed population ages, 40% have chronic health conditions. The cost of providing health care has skyrocketed and local, state and federal governments have contracted with for-profit prison health care companies as a way of tightening their budgets. 

Private companies give a per diem rate for basic and specialty care – which would be lower if services were publicly provided. The negotiated per diem rate creates a huge profit incentive. By providing little or substandard care, companies have everything to gain and nothing to lose. In contracting the financial and bureaucratic burden of incarcerated health care to private firms, the correctional departments “win” too. 

But, to say the least, incarcerated people don’t fare well in this system. 

Private companies have little regulatory oversight. There are many first hand accounts of mistreatment and neglect. Complaints of illness are ignored or dismissed. Infirmary staff are ill-trained to handle the demanding challenges of caring for a very oppressed incarcerated population. Staff are pressured to avoid sending incarcerated patients to outside facilities for treatment, even when that is the correct course of action. 

Incarcerated people trying to access health care are blocked at almost every turn. They can’t simply walk over to the infirmary. Often the first attempt at treatment is a perfunctory exam with no resolution. Only after persistent and repeated visits does anyone on staff take the incarcerated patient seriously. And being incarcerated increases one’s risk of disease due to lack of proper food and exercise, isolation from loved ones, and the mental strain of having your individual rights violated on a daily basis. 

These are high hurdles for people who are sick and living in a demoralizing,  punitive facility. No wonder there are so many stories from the incarcerated who spent days or weeks in pain because they were too weak and debilitated to demand the care they deserve.

Profiting from prisoners

A handful of companies currently provide the majority of healthcare in prisons: WellPath, Corizon, NaphCare, PrimeCare Medical and Armor Correctional Health Services. 

WellPath is the largest of the private firms – responsible for over 300,000 incarcerated people in over 40 states. Former CEO Jerry Boyle was convicted this year on federal bribery charges related to “winning” a $3.2 million contract at a Norfolk, Virginia,  jail. The company donates to the political campaigns of sheriffs with whom it has contracts. 

Corizon manages health care for some 116,000 prisoners in state and county facilities at more than 140 locations in 15 states. In 2020, they settled a lawsuit brought by an elderly disabled incarcerated man in Florida. Corizon agreed to pay $50,000 to Henry Washington for injuries he suffered when Corizon staff failed to administer medications he was prescribed for high blood pressure and glaucoma.

NaphCare was the private firm at Alabama correctional facilities in 2003 when Timothy Oliff’s illness was ignored by infirmary staff. He subsequently collapsed and died in the hospital. A physician at the hospital told his family that he succumbed to pneumonia and a severe stomach infection which was treatable if he had been admitted sooner. Alabama dropped NaphCare as a provider but its new choice, Wexford, is being sued for bribery in Mississippi. 

PrimeCare Medical, based in Harrisburg, Pennsylvania, is the for-profit health care provider at 70 carceral facilities in five states. In 2003, the company was held liable for the suicide death of 21-year-old Kyle Flyte after the PrimeCare psychiatrist canceled his suicide watch. 

Armor Correctional Health Services, based in Florida, generated over $155 million in 2021 revenue. In 2019, Armor was criminally charged for allegedly falsifying records in the death of a man imprisoned in Wisconsin.  The company was dropped by at least seven counties in Florida, New York, Colorado and Oklahoma. After years of allegations of failing to meet its contractual obligations and placing inmates at risk in New York state, the company agreed to pay $350,000 and not bid on any state contracts for three years in a settlement with the New York state attorney general.

Examples of negligence by these for-profit companies are easy to find because they are so numerous. Incarcerated people and their families are speaking out and telling stories that will make your hair stand on end or your blood boil. It is imperative that we share their stories far and wide – because their lives depend on our solidarity.