Medical Care in Prisons

Until the 1970s, a sentence to imprisonment deprived one not only of liberty but also put one's health at risk. Medical care was inadequately available and frequently primitive. This changed when federal courts intervened, forcing improvements in prisoners' care. Rights to adequate care were established, standards were promulgated, medical staffs were expanded, and providers in the surrounding community were called on to fill gaps. Spending for prisoners' health care consequently rose dramatically. Prison administrators began adopting various "managed care" procedures to allocate resources in less costly and more efficient ways. These include efforts to buy needed goods and services in the larger health care marketplace at more advantageous prices, establishing controls and incentives to reduce unnecessary care, and contracting with private firms to manage and deliver care. Imprisoned criminals are the only persons in the United States enjoying a constitutional right to adequate health care. Support for s...