“Privatization is a big part of the problem,” said Kara Gotsch, public policy coordinator with the ACLU’s National Prison Project in Washington, DC. “But I think the problem is over-incarceration. There’s just too many people in prison, and it’s expensive to provide health care to 2 million people.

“The reason private companies became so prevalent is because they said, ‘We can save money.’ But you can’t take blood from a stone. You have to wonder how a private corporation can make money, and we believe they’re cutting corners.”

One obvious corner to cut is sending sick patients to an outside hospital. This is a corner that any prison medical center might cut, private or not. Unfortunately, it is virtually impossible to prove specific instances of neglect. Medical records are sealed. Prisoners are automatically branded as liars. And prison authorities are reluctant or unwilling to discuss conditions in their facilities.

Not until someone is hurt badly and files a lawsuit is his story usually told. Tragically, the ones who die are never heard.

For this story, Yazoo City prison officials denied requests to interview prisoners regarding their firsthand experience with the prison’s health care system. Instead, inquir-ies were routed to the Bureau of Prison’s public affairs office in Washington, DC.

Nevertheless, through prisoners’ family members, attorneys, and the prisoners themselves, accounts of life on the inside leak out. According to prisoner accounts at Yazoo City, during a lockdown over Easter 2004, prisoners were denied medication for chronic illnesses such as diabetes. When one prisoner’s wife followed up on it, a federal bureaucrat told her “health care is a privilege.”

Not according to the Constitu-tion, but that venerable document holds little sway when it comes to prisoners.

Documenting Medical Neglect
One inmate, Jay Kimball, has made it his mission to compile firsthand accounts of medical neglect. These accounts are forwarded to the new Civil Liberties Coalition, which plans to post the results of Kimball’s investigation on the Internet at its website (www.discovery-experimental.com). The site will be dedicated to helping prisoners secure their constitutional rights to healthier, more humane treatment.

Jay Kimball’s accounts, gathered from prisoners, are chilling. They include stories of prisoners nearly beaten to death, who instead of receiving medical care are put “in the hole” as punishment, as well as stories of prison officials ignoring diabetic prisoners who were too ill to walk and therefore could not receive their insulin shots. Then there is Kimball’s own story.

Kimball received his initiation shortly after entering the federal prison system to serve a 13-year sentence for selling for what he believed to be a dietary supplement, liquid deprenyl. While awaiting transfer, Kimball spent time at a county jail in Belle Glade, FL, that was contracted by the US Marshals Service to hold federal prisoners. Kimball received numerous shoulder injuries in a Marshals Service vehicle that drove at speeds topping 100 miles per hour during his transport to Belle Glade. While he was at Belle Glade, prison officials refused to treat his shoulder injuries. In fact, the jail warden gave Kimball a message for Mrs. Kimball, which was to keep her mouth shut. This was in response to her refusal to stand by and allow the jail and the Feds to continue to abuse her husband. While at Belle Glade, he contracted a respiratory bacterial infection.

Instead of receiving immediate treatment, he was transferred to another federally contracted county facility, this time in Tampa. By the time he arrived in the Tampa jail, he had lost his voice. He was treated, and then transferred yet again to another federally contracted jail in Hernando County, north of Tampa. He was there for just a short time before being transferred to the Federal Correctional Institution in Coleman, FL.

At Coleman, Kimball was told it would be three months before he could see a physician. Kimball, who had owned and operated a business before being convicted, swung into action. His own doctor traveled hundreds of miles to see him and promptly prescribed antibiotics for his patient.

The prison medical center at Coleman, however, refused the antibiotics and instead gave Kimball an inhaler to keep him breathing.

Kimball next filed a restraining order in Ocala in an attempt to get medical attention. The restraining order was denied, and in retaliation, the prison seized Kimball’s inhaler and put him “in the hole” for 15 days.

After this experience, Kimball educated himself on how the medical system in prison is supposed to work. The federal Bureau of Prisons Health Services Manual is a comprehensive document of 340 pages. It covers everything from contract agreements with outside physicians to chronic disease management.

According to the guidelines, all inmates are supposed to receive an initial screening by a competent medical professional when they first enter a facility. Inmates with chronic conditions are referred to the medical center for treatment.

Without examining prison medical records—which are, of course, sealed—it would be impossible to confirm that any prison or jail, whether federal, state, or local, lives up to this standard. But if the Santa Fe County (New Mexico) Adult Detention Center is any indication, major problems are the norm.

This facility was investigated in early 2003 by the state attorney general’s office, acting under the authority of the 1997 Civil Rights of Institutionalized Persons Act (CRIPA). Investigators interviewed prison personnel and reviewed documents, policies, and procedures, including medical and mental health records.