These rights must be addressed by correctional health care providers, but the question of whether it is better to provide services inhouse or by private contracting has not been resolved. The premise of the private approach is that the user can make a choice and the marketplace will determine its success or failure. In principle, private contractors emphasize prevention, health education, behavior modification, and quality improvement. Medical problems in jails basically mirror those in the community. Incarceration provides health care professionals with the opportunity to make quality health assessments and complete treatment plans, when inmates can be held long enough to address some of their unmet needs. However, jails are filled with people who are there only a short time, and their health care needs are episodic. Service providers, therefore, often have little time for prevention and behavior modification. Jail inmates are likely to require the use of hospital emergency rooms and skilled health care professionals. As a result, the cost to provide medical services to inmates is higher than in the community. Both public and private jail health care systems have advantages and disadvantages, and providers need to look at ways of becoming more efficient. Privatization represents an alternative approach to providing health care services to inmates, but cost should not be the major factor in choosing that alternative. Health care providers must compete on the basis of quality, service, reliability, and cost. 5 references