Point of View

Unwise outsourcing of prison health care

April 25, 2012 

Hiring private contractors to take over the state’s prison health care system is a bad move for North Carolina and for all of us in the state who pay taxes. Privatization won’t save money, and if other states are a guide, initial low-ball bids and multiple malpractice suits will push the state’s costs even higher.

Deliberate understaffing at Central Prison has led to many negative outcomes. But it looks like the Perdue administration would rather scapegoat 2,500 prison medical professionals than acknowledge its own culpability and fix the problems.

Let’s call this privatization proposal what it is – either a leadership failure or a sweetheart deal for a private prison contractor with job promises to high-ranking lame-duck politicians and political appointees looking for a parachute because the boss decided to forgo another term.

Privatization almost never works with large government tasks. Just look at government contractors’ waste and fraud in Iraq or the horrible problems in private prisons in Ohio or Tennessee. Privatization will put a sign at our borders telling out-of-state companies to come on in and haul away piles of taxpayer dollars.

Despite the lack of evidence in other states that outsourcing saves money, the Department of Public Safety decided to look at privatization as a way to cut costs. But significant cost saving from privatized prison medical care is illusory, according to Alex Friedman, an editor at Prison Legal News. States that have turned medical care over to for-profit companies find themselves in the middle of negligent care lawsuits. It’s happened in Florida, New York and New Jersey.

The Perdue administration views privatization as a fig leaf to cover up its incompetent management of the system. Eager to look like it’s doing something – anything – to fix the problem, the governor asked for privatization proposals from companies big enough to handle a system that now spends $244 million caring for 40,000 prisoners in 70 facilities.

But the companies big enough to handle North Carolina’s system aren’t good at it. Corizon Healthcare might bid, but the two companies that merged to create it, Correctional Medical Services, Inc. (CMS) and Prison Health Services (PHS), have been under investigation in several states. A recent report on their handling of services in Idaho said it constituted “cruel and unusual punishment.”

Private prison companies make money by keeping costs down among a set of patients who, on average, are sicker than people who are not in prison. These companies misrepresent medical records, fail to treat common problems that lead to more significant problems and treat problems incorrectly. The business model is to put off care until the person is out of the system, where someone else foots the bill. That’s a win for the company.

But that win is a problem for states with privatized prison care and would be a problem for North Carolina, too. Ex-convicts with medical problems end up getting their care paid for by the taxpayer.

Even if we get past the moral issue of not giving proper medical care to a 22-year-old diabetic serving a one-year sentence for passing bad checks (which happened in Arizona), we still foot the bill for the leg amputation once he gets out of prison. The private prison medical company scores that a success – that’s money out of our pockets, not theirs.

Even the state of Texas – where privatization is a hallowed word – caught itself. Republican legislators in Texas took time to see all the problems with outsourcing prison medical care. So, this year, after Gov. Rick Perry pushed, lawmakers pushed back. The impetus? Perry had received an influx of campaign contributions from private prison lobbyists and CEOs.

A similar story is about to happen here. Now that the governor has signaled she will explore privatization, look for job promises from prison medical care companies to political appointees and lucrative lobbying contracts for well-connected Democratic operatives with ties to the governor. It will be hard for appointees with pending job losses to resist giving in, despite the evidence that taxpayers lose when prison health care is turned over to big business.

North Carolina can and should say “No” to privatizing prison medical care. Turning prison medical care over to big business will make taxpayers sick.

Dana Cope is executive director of the State Employees Association of North Carolina.

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