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Contract Medical Care - Prescription for Change

NCJ Number
82614
Journal
Corrections Magazine Volume: 8 Issue: 2 Dated: (April 1982) Pages: 6-14,16-17
Author(s)
J J McCarthy
Date Published
1982
Length
11 pages
Annotation
This article documents the failure of public health care in State prisons and the rapid growth of contracts with private companies to provide inmate health care.
Abstract
Independent providers furnish most medical care in Maryland, Alabama, Arkansas, and Delaware prisons; other States have some prisons under contract medical care. This trend results from inmate lawsuits challenging the quality of prison medical care. Most corrections officials agree that contract medical service has many advantages. As subsidiaries of large health-related corporations, contracting companies have enormous resources, can recruit doctors by paying malpractice insurance premiums and offering a guaranteed schedule, are nonunion and nonpolitical, and can sometimes avoid inmate-staff conflicts because they are independent of the prison administration. However, these companies may be coopted by the profit motive in the same way that State-run prison medical care is eventually coopted by the custodial mentality. Possible abuse of excess profits (through reduced services to inmates, for example) is an additional concern, as private contractors are not required to disclose their finances. Private companies' employee turnover rates are generally lower than those for State prison health personnel. Contractors are also free of State hiring controls, so that shoddy performers can be quickly fired. A key difference between State-managed and private prison medical care is the latter's strong financial interest in quality; this business-oriented approach divorces the level of health care quality from the performance of a single supervisor. But periodic monitoring by outside agencies may be necessary to ensure quality control. Other advantages, drawbacks, and procedures involved in contract care are noted.

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