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County Jails Outsource Health Care, What Could Go Wrong? Inmates Denied Medication, Die of Gangrene.

Photo by StockMonkeys.com, via Flickr Creative CommonsIn Madison County, Alabama, a jail inmate died naked, on the floor of his cell from untreated gangrene. In  2008, in Cuyahoga County, Ohio, jail inmates went for weeks without their prescription medications. In 2011, a Wayne County, Tennessee, inmate died after being denied his medications for 11 days. In 2011, a Bureau County, Illinois jail inmate was denied his HIV medications for a week. In Tippecanoe County, Indiana, doctors switched an inmate to a cheaper medication and she almost died from an allergic reaction.

The common thread here? Each jail had contracted with a large, private health care company to provide health care in the jails. In every case, jail and county officials presented the contract as being a "cost saving" solution for taxpayers.  Well, somebody paid, and it was often people arrested (but who hadn't been to trial yet). 

Advanced Correctional Healthcare is a physician-owned, for-profit company that provides health care "solutions" to county jails. Yet these doctors seem to have forgotten their Hippocratic Oaths and have instead sworn themselves loyal to profits over health care.

The Alabama story is particularly horrific:

Instead of receiving treatment, the suit states, Woods was placed in a "medical observation cell" on Aug. 6, 2013. He had no access to water after Aug. 12. There is no record of him eating after Aug. 14. No nurses visited him after Aug. 14.

The suit contends that as his rotting foot began to stink, guards dragged him from the cell on Aug. 17, sprayed him down with water and placed him in a new cell.

Actually, there are a trio of other suits (two involving inmate deaths) against the Madison County jail, and hopefully voters will take notice that Sheriff Blake Dorning is running for re-election. 

Woods' lawsuit asserts that Dorning, jail administrator Steve Morrison, Dr. Arthur Williams, the director of medical care at the jail, and Dr. Norman Johnson, who is the CEO of Advanced Correctional Healthcare, are "part of an explicit or implicit agreement or plan to delay or deny necessary medical care to avoid having to pay for medical care."

The Woods suit refers to two other similar deaths in the county lockup last year. 

None of this should surprise us. The Alabama chapter of the ACLU has been vigorously reporting on the dreadful conditions in Alabama county jails. Often, the media focuses on state prison conditions, and those are bad enough, but cash-strapped county governments have every incentive to cut costs wherever they can — and why not start with the criminals?

Except that many county jail inmates aren't "official" criminals. They have been arrested and are awaiting trial. Often, they're too poor to post bail. They aren't convicted criminals yet, but they are people who deserve basic medical care while in custody. 

Often, when government gets the bright idea to outsource public services, the public suffers. 

Not all privatization is bad, but when it's done quickly, with no public input, and via crony capitalism, it is always bad for everyone (except those who use it to line their pockets at the expense of the public good).

Madison County Sheriff Blake Dorning has a Democratic opponent: Tim Clardy.

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