Mismanaged Care: Exploring the Costs and Benefits of Private vs. Public Healthcare in Correctional Facilities

Administering healthcare in prisons and jails has been an exceptionally difficult task for state, county, and city governments for decades. Facing the unprecedented rise in the correctional population, governments began contracting with private correctional healthcare companies in the 1980s for cheaper, higher-quality care. However, in practice, private correctional healthcare companies have been disastrous for inmate-patients and their families. This Note examines the structural deficiencies in the privatization of correctional healthcare, and argues that the market factors required for successful privatization, including choice, competition, and responsiveness to consumer preferences, are absent in the correctional healthcare sector. In addition, the lack of meaningful oversight, protective contractual provisions, and legal hurdles facing prospective litigants compound these structural problems and leave the companies unaccountable for their misconduct. This Note proposes switching from these private companies to publicly-run options, such as government health agencies, partnerships with universities, and private non-profit organizations. These public models increase democratic accountability and transparency, lower costs, and more appropriately treat correctional health as the public health issue that it is. While administering healthcare services in correctional settings will always be challenging, switching to public models is the first step in improving care and treating inmate-patients with dignity.