By Stevie Wilson and 9971 Study Group
What happens when the profit motive becomes the determinative factor in the provision of health care and is inserted into the prison? Disaster.
Across the country, on the local, state, and federal level, the health care of imprisoned people has been handed over to corporate America. A handful of companies have cornered the correctional health care business: Corizon Health Inc., Wellpath Holdings Inc., NaphCare Inc., PrimeCare Medical Inc. and Armor Correctional Health Services Inc. Wellpath and Corizon, the largest of these companies, are owned by private equity firms. Their sole purpose is to increase the bottom lines of their owners. This means cutting costs. That translates into cutting health care services.
Routinely, imprisoned people find themselves in battles with these companies over basic health services. These companies have introduced different measures to deter imprisoned people from using prison health care services. One of the most widely used is the co-pay. Imprisoned people are charged anywhere from $5 to $15 just to be seen by medical staff. And this doesn’t include the co-pay for prescriptions.
These costs lead many imprisoned people not to access medical care until their health problem becomes too severe to ignore. Some jurisdictions don’t pay imprisoned people for working. And those that do often only pay pennies per hour. Imprisoned people regularly must choose between medical care and hygiene or medical care and food or medical care and communication with family members. Many imprisoned people suffer from ailments that could have been treated earlier and effectively if costs had not deterred them from seeking treatment — that is, if private companies didn’t put profit before people.
Another common measure enacted by these companies is extended delays. There was a time, before imprisoned people’s health was turned over to big business, that all sick call requests were filled within 24 hours. If a person felt ill and filed a request to be seen by medical, this request would be filled within a day. Not anymore. Today, requests take days, sometimes a week, to be filled. And that is if they are filled at all. Imprisoned people know that these delays occur and often choose not to request care in order to avoid frustration. For the companies, this translates into fewer people to serve, which means more money saved.
This is the norm for imprisoned people. So imagine when COVID-19 struck. Disaster Capitalism has been good to these companies. Many of them saw increases in budgets allotted for correctional health care, but they actually offered fewer services. When the pandemic hit, health care services were cut or shut down completely. Requests for basic medical and dental services were returned with statements like “no treatment until we return to normal operations.” In Pennsylvania, the Department of Corrections has yet to return to normal operations. Imprisoned people have been waiting for basic services for over two years. But the health contractors continue to collect money.
Health care is an essential human need no matter where one may be. And is it important that imprisoned people stay healthy, because most imprisoned folks are coming home. It is best that they reenter their communities in good health. And yet, imprisoned people are denied their basic health needs.
One reason these companies are able to get away with endangering imprisoned people and indirectly endangering the public is because most people don’t know what goes on behind the walls. Prison is one of the most opaque institutions in the United States. The walls and fences are there not only to keep imprisoned people in, but also to keep the public out. The public isn’t aware of the quotidian struggles imprisoned people face to stay healthy.
9971 is an abolitionist study collective whose members are currently incarcerated. Stevie Wilson is a founding member of 9971.