Two major Federal health care strategies are viewed as having a direct and adverse impact upon the provision of medical services within jails and prisons: (1) creation of the National Institute of Health (NIH) in the 1950's and (2) the funding of groups and organizations to develop standards of acceptable minimal levels of medical services. The creation of NIH resulted in (1) massive increases in medical technology starting in the 1950's, with corresponding increases in the cost of medical care; (2) increased specialization of health care personnel leading to a depersonalization of medicine; and (3) overspecialization, leading to difficulties in both patient access to care and continuity of treatment. Consequently, the reduced number of general practitioners has placed a major constraint upon the delivery of primary medical care within correctional institutions. Examples are provided of the difficulties encountered in procuring general medical care for Delaware prisoners. The promotion of standards of medical care termed as the 'accreditation movement in corrections,' has resulted in the creation of four different sets of medical standards, thereby raising problems of uniform and systematic application of standards of medical care. Aspects of Federal court decisions pertaining to offenders' medical rights that are discussed include (1) the nature of complaints involving medical services filed under the Civil Rights Act, (2) trends in court intervention in correctional administration, (3) the physician's duty to inmate patients, and (4) the State's responsibility for providing medical treatment to indigent offenders. Thirty-three footnotes, 32 annotated references, and an extensive cross-tabulation of standards relating to medical care are provided.