Private Prison Healthcare Providers: The ultimate recidivists

Anthony Carvajal's excruciating pain from terminal bone cancer was reated with tylenol and ibuprofen.

Anthony Carvajal's excruciating pain from terminal bone cancer was reated with tylenol and ibuprofen.

The Florida Department of Corrections (FDC) is making a lot of headlines—this week I’ve even written about it over at Prison Legal News. It seems like nearly every story about prisoner abuse these days is coming out of Florida, and this should have us all worried. It means that an entire state’s corrections system is so fundamentally broken as to be falling apart at the seams. Incarcerated individuals are being dehumanized in ways that we’d think more typical of a police state or dictatorship.

As we pointed out in the piece on Lowell, funding cutbacks have played a serious role in creating an environment where corruption not only survives, but thrives. With levels of institutional corruption seemingly so high, one would be tempted to point to the problems being fundamentally related to individual activities,  but there is another factor at play that must be examined: corporate corruption.

Part of the Florida corrections puzzle right now has to do with the growing levels of corporate involvement in corrections. It simply cannot be a coincidence that in the 100-days following privatization  of prison health care the state saw monthly prisoner mortality rates reaching a 10-year high (especially given that the number of prisoners has decreased). 

At the end of November prison health care provider Corizon announced its intention to withdraw from their contract with the state of Florida to serve roughly 75,000 prisoners. 

The announcement took place just shortly after the Miami Herald announced the record number of prisoner deaths in the state over the last year—176 of the 346 listing no “immediate cause of death,” and a number of those deaths classified as “natural” being highly suspicious. 

Corizon cited that the state’s contract was “too constraining,” the translation of which is that they couldn't see themselves making enough of a profit while being able to provide a decent standard of care. 

As any health care policy analyst will tell you, the dividends earned by privatizing health care are short-term only. When you cheap out on preventative or early intervention care, you pay for it later. Such care allows you to nip problems in the bud for relatively little cost, whereas waiting until a problem becomes acute results in astronomical costs.

Think of it this way, providing a preventative course of antibiotics to someone who has a serious wound in the beginning stages of an infection is a heck of a lot cheaper than having to deal with a bout of necrotizing fasciitis and the resulting amputations and round-the-clock care. Most medical interventions can be thought of this way. Health is not a commodity that can be bought and sold like a stereo, so why do we continue to apply a market model to it? It’s not rocket science, but DOCs complete failure to understand this logic would make you think it was.

Add to the mix that prisons typically have higher rates of mental illness and addiction than found in the general population, and you have a client base where the need for prevention and early intervention are absolutely critical.

Florida privatized its prisoner health care system in 2012. The switch was supposedly to save the state money, but as predicted by virtually every observer who understands how health care privatization works, it did nothing of the sort:

“The contract requires that both companies provide medical care to inmates for 7 percent less than it cost the state in 2010, but both companies sought and received increases in the terms of their original agreement. 

In 2014, former FDC Secretary Michael Crews agreed to raise the annual contract with Corizon and Wexford by $3.2 million. Subsequent audits revealed that even after the increased payments, Corizon failed to meet its contract obligations regarding staffing and medical care.” 

Corizon’s medical practices have fallen under intense scrutiny over the last year, even well before to the Herald investigations regarding suspicious deaths. The Palm Beach Post. This isn’t the first time Corizon has been under scrutiny for some time, losing myriad contracts due to serious concerns over the quality of care and facing a number of investigations and lawsuits across the country. Palliative cancer patients were given Tylenol to deal with unimaginable pain, pain that couldn’t even be eased with morphine once prisoners were finally transferred to hospital.  Diabetics are withheld insulin for months.  The mentally ill are inexplicably taken off their medications.  Cancer patients are misdiagnosed leading to (potentially avoidable) deaths.

People are often quick to criticize the amount of money spent on prison health care, yet remain completely silent when we privatize the industry and companies swoop in and double both the social and economic costs. Companies like Corizon are reaping billion dollar profits, but we give them a free pass when it comes to killing our prisoners. Killing prisoners out of neglect stemming from a desire to grow profits is a criminal act, no less deserving of imprisonment than the crimes committed by the inmates themselves.

Since the major shift towards privatizing prison health care swept across the country in 2012, the overall standard of care in these institutions has fallen consistently while raising the very costs to the state the private companies purported they could reduce.  Research on the effectiveness of applying a private market model to prison health care has demonstrated a clear correlation: “we find that a 20 percent increase in percentage of medical personnel employed under contract increases mortality by 2 percent.” None of this news, investigations had revealed this nearly 15 years ago, yet we continue to repeat the same mistakes over and over and over again ; it’s recidivism in action.