The company provides health services to more than 273,000 inmates at 334 correctional facilities in 29 states.[38] For nearly 20 years, CMS and a few other managed care companies have been taking over prison and jail health care from government agencies coast to coast. Concerns of the quality of care delivered, however, has been the subject of intense scrutiny. A big private correctional health care provider, Prison Health Services, Inc., has been the subject of a growing list of litigation from prisoners who allege deliberate disregard for their health care needs.[42] Because prisoners are not paying customers, there is little incentive to provide good quality care. In the United States, the National Commission on Correctional Health Care is responsible for accrediting prison health facilities, but they do not serve as a watchdog organization monitoring health care abuses in prisons and jails.

In the United Kingdom, the provision monitoring of prison health care had been under the purview of the Prison Health Service (PHS), established in 1877. When the National Health Service (NHS) was formed in 1948, the PHS was incorporated into the NHS. But in 2003, funding for prison health services was transferred from the Home Office (the government department responsible for Her Majesty’s Prison Service) to the Department of Health (the government department responsible for running the NHS). Prison health care was now delivered as part of the primary health care system, which had profound implications for general practitioners, many of whom provided medical care for the local prison population. Like the United States, the United Kingdom spends a substantial amount of money on providing health care to prisoners.

One approach for improving the efficiency of prison health services is public-private health partnerships (PPHP) supported by the WHO. In 1993, the World Health Assembly called on the WHO to encourage the support of PPHPs as a strategy for bringing about health for all.[43] The WHO PPHPs bring together industry associations and government organizations to work toward a health goal that is based on a mutually agreed-on and clearly defined division of labor. The WHO has been involved in more than 70 global health partnerships to achieve health goals on the basis of a mutually agreed-upon and well-defined division of labor.[44] The PPHP initiative has a strong potential to capitalize on the presumed advantages of public and private sectors jointly providing prison health services. Time will tell how successful this initiative actually is.

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Madelon L. Finkel, PhD
Madelon L. Finkel, PhD, is professor of clinical public health and director of the Office of Global Health Education at the Weill Cornell Medical College in New York City, NY. Dr Finkel is an epidemiologist whose work focuses on women’s health issues. Her interests also include global public health issues with ongoing research projects in rural India and Peru. Dr. Finkel has published extensively, including Praeger’s Understanding the Mammography Controversy: Science, Politics, and Breast Cancer Screening and Truth, Lies, and Public Health: How We Are Affected When Science and Politics Collide.

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REFERENCES

1. Walmsley R. World prison population list. 7th ed.
2. Wikipedia. Prisoner population rate 2007-2008.
3. Mauer M. Comparative international rates of incarceration: an examination of causes and trends: Presented to the US Commission on Civil Rights; June 20, 2003; Washington, DC.
4. US Department of Justice, Bureau of Justice Statistics, Office of Justice Programs. Correction statistics.
5. Ibid.
6. Federal Bureau of Investigation. FBI uniform crime report.
7. Maruschak LM for US Department of Justice, Bureau of Justice Statistics, Office of Justice Programs. Medical problems of prisoners.
8. Griefinger RB, Heywood NJ, Glaser JB. Tuberculosis in prison: balancing justice and public health. J Law Med Ethics. 1993;21:332-341.
9. World Health Organization. Tuberculosis in prisons.
10. Shalit M, Lewin MR. Medical care of prisoners in the USA. Lancet. 2004;364:34-35.

Full References  »