Prison HMOs
The Basics

In order to understand the prison HMO (Health Maintenance Organization) or a hybrid HMO healthcare provider, one must first have a working knowledge and understanding of the HMO as it exists in general society. Armed with that knowledge as a foundation, and the "outside" HMO as a template, only then can one understand the tricks and traps of the Prison HMO, and how it utilizes those tricks and traps to their advantage---and the inmate patient's disadvantage.

The HMO In Society

Managed health care in the United States has grown by leaps and bounds. According to a 1996 Consumer Report article, How Good Is Your Health Plan (August 1996, p. 29), half of all Americans at that time who had health insurance received their benefits through some form of HMO. That number has since increased.

Problems arise because of the incongruous elements of an HMO. HMOs are neither 100% "health care provider" nor are they 100% an "insurer". They are a business, and just as with any business, they're in business to make a profit. Statutes governing HMO operations vary from state to state. Realize also, that state statutes that deal with deceptive and unfair trade practices may apply to an HMO case; and while medical malpractice and negligence laws are usually pertinent; the laws that govern how insurance companies do business may equally be applicable.

The HMO Behind Bars

The HMO behind bars (the Prison HMO) takes advantage of the public's ill will toward offenders to justify giving poor healthcare while at the same time making a profit. Patient inmates die as a result of negligence, indifference, malpractice, inadequate training, non-qualified and non-licensed personnel and cost cutting. Encounters with an HMO behind bars can become a death sentence, even for offenders whose cases have not yet gone to trial (those in jails or detention centers) or who have been convicted of relatively minor crimes. Many are people with curable conditions.

In the free world, a sick person has choices - even you as an HMO patient have choices. You can switch doctors or health plans if you're not satisfied. Clearly in a prison setting that is not the case.


Prison Healthcare - On the Inside

Patients in prison are summarily ignored. It can take anywhere from 3 days to 3 months or longer to been seen by a prison doctor. Medical emergencies aren't; unless you're in the process of dying-whether by heart attack or end-stage liver disease.

Inmate patients state their concerns to doctors and prison medical personnel oftentimes only to be met with apathy and inadequate treatment by doctors and nursing staff. Inmate requests for detailed information about their condition(s) or medications many times are also met with disdain and disgust, and are many times denied the information. If a medical personnel doesn't like the questions or inferences of questionable treatment and healthcare, they can implement a number of hurdles to prevent those questions and inferences from reoccurring.

Inmate patients may be required to succumb to medical and laboratory tests that are unnecessary. If they refuse the unnecessary tests, they may be "written up" for refusing treatment, and subsequently not be adequately treated for any current or future conditions.

Inmate patients may be misled about their health conditions. Inmate patients can be dying of cancer and told they have the flu. Inmate patients can have bleeding ulcers and be treated with antacids. Inmate patients can be told that their blood work and enzyme levels are 'normal' when in fact they are in end-stage liver disease, and eligible for medical parole. Inmate patients may have brain tumors and be treated for migraines. The result? Possible permanent disabilities or death.

Inmate patients not only have limited access to accurate and factual information from medical and correctional personnel, but are subject to retaliation techniques if they (a) are aggressive in their attempt to obtain needed healthcare and information about their health and/or (b) have no outside support from family and/or friends.

Prison HMOs
They Do Affect (Effect) You

If you are one that holds the ill-informed belief or attitude that healthcare for inmates is of no concern to you and doesn't affect you, please read on.

Your tax dollars are paying for your state's contract for prison healthcare. Those contract prices range from millions of dollars per year to billions per year. Prison healthcare expense for State governments is one of the largest expenses within the Departments of Correction across the country. In this day and age, State governments are looking for ways to cut costs and reduce their expenditures. When healthcare delivery to a population that numbers in the millions is inadequate or not sufficient to the need it effects the population at large.

Information you should know:

  • Nearly 600,000 inmates are released each year, many of them riddled with disease.
  • According to the Bureau of Justice Statistics 24,000 inmates nationwide were HIV positive (in 1996). A more recent study by the National Commission on Correctional Healthcare (NCCHC) put the number with HIV as high as 47,000; 10 times higher than the rate in the general population.
  • TB, which is a lung disease, spreads rapidly through the air in enclosed spaces, infects 1 in 4 people in some prisons, compared to less than 1 in 10,000 in the general population.
  • Hepatitis C, often a lethal liver disease, spread by blood exchange, infects approximately 41% of the inmates just in California prisons alone; compared to less than 2% of the population at large.

Something to think about. . . /p>

When inmates are released into society they are required to obtain employment-as janitors, restaurant work, etc. If they're sick with a communicable disease and they're working in a public place, there is the possibility and potential that others may become sick.

When inmates are released many do not have health insurance. If they are in need of healthcare or emergency medical treatment most often they receive medical benefits through a state Medicaid system. That cost is passed on to you, the taxpayer, which eventually drives the cost of healthcare up for everybody.

What Can You Do?

Whether an inmate or a member of free society, if you suspect negligence, medical malpractice or neglect, have suffered a personal injury by a work related accident, vehicle accident, are having difficulty getting approval from your healthcare provider for specific tests, surgeries or procedures, or a death has occurred in or as a result from:

  • A State Department of Corrections
  • Jail or Detention Center
  • A Prison Healthcare Provider
  • A hospital
  • Nursing Home / Elder Abuse
  • Physician or Nursing Staff

Contact our Consulting Services and utilize our free Attorney Referral Service.

Copyright © 2008 Karen L. Russo - The Wrongful Death Institute & Forensic Science Associates. All Rights Reserved. These articles or pages may not be copied, transmitted, forwarded, reposted, or republished, in whole or in part, electronically or in any other format, without express written permission. This is not a solicitation for legal business. The Institute is not engaged in the practice of law. Mere contact through this website does not constitute a contract for representation. Wrongful Death Institute pages are designed and maintained by Four Boys Inc.