September 17, 2024 • 55 mins
While the United States is home to some of the world's most advanced medical technology, it's no secret that it has a terrible healthcare system -- millions of people are one bad diagnosis away from bankruptcy or death if they cannot pay the insurance companies controlling their access to life-saving treatments, medicines and therapy. Yet the US also has the world's highest incarceration rate, with over 700 people out of every 100,000 currently serving time -- what happens when they get sick? Tune in to learn the Stuff They Don't Want You To Know about healthcare in prison.
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Episode Transcript
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Speaker 1 (00:00):
Fellow conspiracy realist. We returned to you this evening with
a classic episode about a terrible, terrible conspiracy that continues
today in twenty twenty four and continued far before we
first spoke about this in twenty nineteen.
Speaker 2 (00:21):
Oh yeah, and we've learned so much more about the
prison system and healthcare, you know, as two separate things
since that time. I'm specifically thinking back to the discussion
you guys had with the Lava for Good folks, like
all the different hosts there, and just learning about the
dangers of the prison system. But the weirdest thing, the
(00:41):
weirdest thing for me was learning from them through you guys,
that private prisons are actually way smaller of a deal
than I thought because there's so fewer of them.
Speaker 3 (00:54):
But yet they're the ones that get all the headlines.
Speaker 2 (00:56):
Right, Yeah, well that's the headlines, and that's at least
my perception. And the reason why that was mind blowing
to me is because I imagined there was pretty good healthcare
for prisoners because there is a profit motive to keep
that prisoner alive and in jail, because the private prison
gets money per person per bed, right, But that's not
(01:18):
that's not the way it goes in most prisons.
Speaker 3 (01:22):
Accurate. Let's check out the episode.
Speaker 4 (01:25):
From UFOs to Psychic Powers and government conspiracies. History is
riddled with unexplained events. You can turn back now or
learn this stuff they don't want you to know.
Speaker 1 (01:37):
A production of iHeart Radios How Stuff Works.
Speaker 2 (01:49):
Hello, welcome back to the show. My name is Matt,
my name is Nolan.
Speaker 1 (01:52):
They call me Ben. When we were joined with our
super producer Paul Michigan, control decand most importantly, you are you.
You are here that makes this stuff they don't want
you to know. We've been going down some dark alley
ways figuratively speaking or conversationally speaking in the past few episodes,
and you know, honestly, we're getting to a point where
(02:13):
maybe we should do something a little more lighthearted in
the future. Well that's not true. We have a lighthearted
interview for the Legend of Cocaine Island that's out now
by the time you hear this. So that's a fun listen, right.
Speaker 2 (02:26):
Right, Yeah, We've got stuff unicorns don't want you to
know on the slate.
Speaker 1 (02:31):
M Okay, yeah, I know. Well it's weird because I
was thinking I was reading something about unicorns oddly enough,
now that you mentioned this, wherein someone who was a
zoologist of some sort of another said, based on the
fact that they had a single horn, and based on
the fact that was positioned in the center of their
forehead facing forward, what that tells us about their behavior.
(02:55):
It's very similar to rhinos. So unicorns, if they did exist,
would probably be legerent, antagonistic animals, capable of great violence.
Speaker 3 (03:03):
They'd be very stabby, and that's something unicorns don't want
you to know.
Speaker 2 (03:06):
That's right, not the profile, Yeah, exactly, all the glitter
and all the shininess.
Speaker 1 (03:13):
And they're weird thing with virgins.
Speaker 3 (03:14):
Have you seen that movie Legend with a very very
young Tom.
Speaker 1 (03:17):
Cruise and a very awesome Tim Curry.
Speaker 3 (03:19):
Very awesome Tim Currey wearing a giant rubber satan suit,
And there's a whole thing where they like the unicorns
play a big part in that, very very important.
Speaker 1 (03:27):
There's also the animated The Last Unicorn, which is really sad. Yeah.
Speaker 2 (03:31):
Yeah, I was thinking about the Brie Larson, her directorial debut,
something about the Unicorn Store something to that.
Speaker 3 (03:38):
Effects on Netflix. Now it is is it spoiler alert?
Does not seem to have anything to actually do with unicorns,
I know, just putting that out.
Speaker 1 (03:45):
Well, thank you guys, you've saved me a few hours.
Speaker 3 (03:47):
No, it else has absolutely nothing to do with unicorns.
Speaker 1 (03:49):
The healthcare in the prison systems. So the US healthcare
system is by any measure, no matter how you look
at it, no matter what your opinion is, and everybody
has opinions about this, by any measure, it's anomalous. One
of the world's wealthiest countries with one of the world's
worst performing healthcare sticks. You know, like not in comparison
(04:14):
to very very impoverished countries so much as in comparison
to other countries we would consider peer countries economically. Right. Yeah,
And there's the one thing we all agree on is
that this thing is rife with problems. It's lousy with
problems and things that don't work, and it's complicated by
(04:34):
the fact that there is a ton of money wrapped
up in this issue. Doctors make a ton of money, hospitals,
of course, insurance companies make tons of money. There's a
lot writing on this, and that means there's also extensive
propaganda in play. We will hear some people say, well,
the entire problem with US healthcare is that it is
(04:56):
to a great degree run by privatized insurance companies, that
they're the root of the problem as they continually put
profits over the greater good. For some people, that's fighting words.
For other people, it's like, you know, shrug, dot gift,
that's what companies do, that's what for profit businesses do.
Other people say, no, it's broken. But the problem is
(05:17):
not honest, red blooded American business. It's that the government
is involved. And every time Uncle Sam is involved in something,
it's going to be ruinous because the government is inefficient
and corrupt. Sometimes that's a sincere argument. Sometimes it's a
Star of the Beast argument. Depends on what you hear about.
And today's episode is not about that cartoonishly tragically comic
(05:40):
state of medical care in the US overall. That's probably
its own podcast. Today's episode instead is about one of
the worst case scenarios for anyone who lives in this
country and ever gets sick orrever needs some sort of
medical treatment. Healthcare in prison.
Speaker 2 (06:00):
Two things you don't want to be a part of.
Sick and incarcerated. So just to get a better understanding
of this problem, it's best to start with some statistics.
We all love those. So let's look at just the
US population in general. As of twenty eighteen, the population
in this country was three hundred and twenty seven point
two million human beings. Twenty eight point seven percent of
(06:21):
the population is under the age of eighteen, so you know,
that's almost a third of the people very very young.
About fifteen point six of the population is over the
age of sixty five. And then that leaves the people
who are not minors, you know, who are eighteen and
they're also not they're above eighteen below senior citizen, which
(06:44):
are going to be the primary, the primary age range
for people who are incarcerated.
Speaker 1 (06:49):
Right right, the regular, the regular Joe's and James. This
is interesting that fifteen point six percent number for elderly
and senior citizens makes sense because do in large part
to the way the healthcare system here does or does
not work, We have a disturbingly low life expectancy compared
(07:10):
to other what are called first world countries or other
developed countries is a better phrase. So's that's the population
by the numbers. What about the medical stuff? Do we
have any stats for that?
Speaker 3 (07:23):
Yeah, so the US spends way more on healthcare than
any other nation. On this here globe three and forty
eight dollars per person, which amounts nearly eighteen percent of GDP,
which seems bonkers to me. Government funded Medicare and Medicaid
account for more than a dollar of every three dollars
(07:45):
of US healthcare spending, and a dollar every four dollars
in the federal budget. The entire federal budget, we know
is a is like seems like one of those imaginary numbers,
you know, the trillions.
Speaker 1 (07:57):
Yeah, it's largely, it is largely a series of which
is promises, increasingly ambitious pitches. I was going to say
from Congress. Absolutely, and and it's been growing, right, it's
been growing Medicare at least that more than twice the
rate of inflation. It's forecast to accelerate as what we
call the baby boomer generation ages increasingly into that elderly demographic.
(08:23):
So that's one thing upon which we cannot blame millennials. Sorry,
I know some of us in the audience are dig that.
Speaker 2 (08:31):
But yeah, and then that's just for Medicare. That's that's
the part that the government helps out with, right, right,
And that's for people who do have Medicare, you're considered
to have healthcare. There are a lot of other healthcare
comes from employers, kind of like what we have sitting
in this room, including Michigan control over there.
Speaker 1 (08:48):
You're absolutely right, Matt twenty sixteen. Private health insurance covered
more people than the government does. So you pay like
think of think of every country as a club. We've
said this before in previous episodes. The concept of taxes,
the concept of taxation is at heart in a very
(09:12):
oversimplified way, it's the same thing as paying dues to
a club, country club perhaps, sure, a country club, a
chess club that has a nice HQ, if they have those.
The idea is, you pay into this thing, and because
you've paid into this thing, you get certain rights. So
(09:34):
you're a country club, a golf club, whatever. That goes
to the maintenance of the place, but it also goes
to the maintenance of things you use. So the argument
that people will have is that, well, if you pay
taxes here in a country, then those taxes should guarantee
some of your rights, guarantee some maintenance, and then arguably
they could be in a situation where they pay to
(09:56):
help keep you alive or at least make your existence
a little bit less painful than it would be without
health insurance. Again, not everybody agrees with that. A lot
of people think privatization is the answer. So that's why
employer based coverage covers more than half of the population
for part or all the calendar year. And then there's
Medicaid nineteen point four percent, Medicare sixteen point seven percent,
(10:20):
what's called direct purchase, I go out and buy my
own stuff sixteen point two percent of people either thought
that was a good idea or were forced to do
it through things like Cobra right, or military coverage four
point six percent. You're going to lay your life on
the line for a country. The least we can do is,
you know, not put you in the poorhouse if you
(10:41):
have cancer, although that still happens. But this number doesn't
answer everything, because despite all these different kind of partial
band aids for keeping people alive and healthy, twenty eight
point five million people in this country have no form
of health insurance whatsoever all the year, all the livelong day.
Speaker 2 (11:02):
Yeah, eight point eight percent. At least that's as of
twenty seventeen.
Speaker 1 (11:06):
Right, that number may have gone up or down a
little bit, but it hasn't moved a ton yet. It
may very well in the near future, in the next
three ten years. Right.
Speaker 3 (11:20):
Not to mention the fact that I don't know how
this figures is the puzzle here, but I think it's
fascinating and it certainly should be part of the conversation.
It costs an average of thirty one thousand dollars per
inmate per year to incarcerate an individual. It's like tax
payer money. So it's just crazy to me that if
we're paying that much to incartrate a person, yet people
(11:42):
outside of the prison system, we wouldn't even consider spending
that much on them and their well being.
Speaker 2 (11:49):
It is.
Speaker 1 (11:51):
It is cheaper, or it has been for a number
of years. It is cheaper for the United States, on
a state and federal level to send someone to community
college for two to four years and pay for their
dorm or their apartment than it is to incarcerate them.
(12:11):
And that's something I learned via Little Wayne originally true story,
but yeah, but it's true. It's we can get into
the political reasons for that, because the argument here doesn't
bear out when you look at the math. It bears
out when you look at what people like voting for, right,
which is a little bit of a simplified way to
(12:32):
say it, but it's true, and it's a big business.
The US locks up a lot of people. I was
thinking about this earlier. I was going to say they
lock up tons of people, and then I read back
through it, and it's true. If you do the math
on how much a single person weighs, and you do
the math on how many people are locked up, we
are literally locking up tons and tons of people, tons
(12:52):
of human flesh. Our prison population rate is roughly seven
hundred per one hundred thousand. That makes it the second
highest incarceration rate of two hundred and twenty two countries
tracked by the Institute for Criminal Policy Research, and that
is such a large net to cast the ICPR study
(13:16):
right now, the UN doesn't recognize two hundred and twenty
two countries, so they gave everybody a chance. This country
locks up a half million more than China, and that
has a population five times larger than the US. This country,
and this is a statistic that many of us have
heard before, and I wish it wasn't still true. This
country holds twenty five percent of the world's prison population.
(13:40):
Twenty five percent. Yeah, it's worse though, because the statistic
that follows right after, we're only five percent of the
people in the world, which means that, if you think
about it, just from living here, you have one of
the highest chances in the world of going to prison.
Speaker 2 (14:00):
Yep, Okay, So what was it we said, three hundred
and twenty seven something million people in the United States. Well,
the American criminal justice system holds within it incarcerated human
beings two point three million people. That's crazy. There are
and it holds them in over seventeen hundred state prisons.
(14:21):
There are one hundred and two federal prisons, and then
eighteen over eighteen hundred juvenile correctional facilities. Then there are
also like that. Okay, and that's just starting right. Then
you go down another level. You get to the local jails.
They wouldn't even be really called a prison, just a jail,
a holding cell kind of thing. There are three thy
one hundred and sixty three of those, and there are
(14:41):
also eighty Native American like they're called Indian country jails.
Well that's not even talk, dude. We're not even thinking
about military prisons, the brig yeah, and the oh, the
detention facilities like immigration facilities.
Speaker 3 (14:56):
The bizarre and labyrinthine network of detention centers. Yeah, that's
that's that's a whole on other conversation.
Speaker 1 (15:03):
There, one of which was famously until quite recently, a
series of fences set up under a bridge. Yeah, civil
commitment centers, state psychiatric hospitals, which are still around, mostly privatized,
but still exists to some degree.
Speaker 2 (15:18):
You can be held without against your will in those facilities.
Speaker 1 (15:21):
And prisons in US territories which occupy an even more
murky legal space, including Gano, including Guantanamo. Yeah, every year
six hundred and twenty six thousand people walk out of prison,
but they go to jail ten point six million times
(15:42):
each year. Jail and prison are as as many people will,
as many people attest. Jail and prison are two very
different beasts. Jail churn is pretty high because most people
in jail have not been convicted.
Speaker 2 (15:58):
They're just waiting.
Speaker 1 (15:59):
Yeah, they've been arrested. They're desperately using that trope and fiction.
They're one phone call to get a bail bondsman, or
to get some money together to get out before they
have to go to trial, or in many, many, many,
many cases, they are too poor. And you know, justice
is a slot machine that only takes dollars.
Speaker 3 (16:21):
So if jail is like a holiday, in prison is
like a living community of some kind in an apartment building.
Speaker 1 (16:30):
Yeah yeah, So again, jail is like kind of like
a slot machine that only takes dollars. So other people
are too poor to make bail and they have to
stay behind bars until their trial. And we've all seen
these stories, right, There's somebody who has arrested for something.
Maybe it's a case, wrong place, wrong time, but they
can't make bail, and so they're in jail for what months,
(16:53):
and then they go to trial and the judge is like,
who is this guy?
Speaker 3 (16:56):
Not to mention they're in jail because they've done something.
Then they can't make bail, so then they lose their
jobs because they're sitting in jail, and it just creates
this cycle of being able to not afford anything that
the system foists upon you, especially then once you are
convicted and then have some kind of you know, fee
schedule that you have to deal with, but you've lost
(17:17):
your job and become unemployable again, probably another conversation, but
it's a problematic cycle.
Speaker 1 (17:23):
And this number might surprise some folks. Met you recently
gave us the statistics of some people in jail. But
of those people in jail, only about one hundred and
fifty thousand or so on any given day have actually
been convicted, and most of them to take your holiday
in comparison or the apartment comparisons. They're generally serving sentences
(17:45):
that are less than a year, and almost half a
million people are locked up purely because of drug offenses.
So mainstream media, right, we all know and love our
favorite fiction films and stories, often depicts the incarcerated population
in some in some wild extremes, right, there are two
(18:07):
or three big stereotypes we see people incarcerated. There are
either woefully disenfranchised, you know what I mean, The system
is broken. It crushed my life, you know, I got
arrested wrongfully, but I lost everything while I was waiting
for my day in court. Or there might be the
other extreme where these people are absolute suicide squad level
(18:30):
monsters and the state is being too nice by putting
these people in time out for life and should just
kill them. And then you'll see things like red and
Shawshank redemption right, who who has attained wisdom or higher
enlightenment despite their physical confines and stuff like that. But
regardless of how these people are depicted in fiction, life
(18:54):
on the inside is not like what you'll see in
a lot of those things. Like what's that HBO series
OZ got praised for being a little more realistic than most.
Speaker 3 (19:03):
Yeah, that show is insanely good. It was also like
one of the early big HBO dramas, So it has
this look of like video where it looks very real,
almost like you're watching a play, but it's like it's
I love everything about that shows it's super great.
Speaker 2 (19:18):
Does it hold up?
Speaker 1 (19:19):
It does?
Speaker 2 (19:20):
Okay?
Speaker 3 (19:20):
I mean I don't know. It's a little data because
it's super square, like the framing or whatever. And also
some of the some of the performances are a little
over the top, but no, the stuff that it covers,
it's very theatrical, but it's also very grounded in reality.
Speaker 1 (19:34):
Mmm, sort of a harbinger of the gritty realism of
Orange is the New Black. So, regardless of any of
us listening now, regardless of our stance on the prison system,
whether you think it's chugging right along, whether it's the
best we can do, even if it's not perfect, whether
(19:54):
you think it's broken, whether you think it's a system
meant to oppress certain demographics here in this country. It's
clear that crime does continue inside the walls of penitentiaries.
There are gangs everywhere. People love all the vices still,
you know what I mean, drugs, sensual pleasure, old fashioned violence,
(20:17):
and the chances of that kind of violence are always
somewhere in the cards. But to activist policymakers and others,
there is another criminal in the mix here. And it's
not a criminal that you're going to see on America's
Most Wanted. It's not a criminal that you will see
in a highly publicized OJ Simpson level trial, right.
Speaker 2 (20:37):
No, you would see them in the ads in between
those programs.
Speaker 1 (20:41):
That's right, we're talking about insurance companies. Wait, our insurance
companies criminals. You might be saying, kind of, let's have
a word from our sponsor. Is where it gets crazy.
(21:03):
So well, let's call this part healthcare, profit and public perception.
In twenty seventeen, the Bureau of Justice Statistics released a
study and they said that nearly half of the people
held in jails suffer from some sort of mental illness,
and more than a quarter have a severe condition such
(21:24):
as bipolar disorder. And again as we as we noted
with jail, many of the people in jail are just waiting,
they're churning through. They haven't been convicted and sentenced to
that misdemeanor. That's less than a year. But in the
same year twenty seventeen, the Bureau reported that about two
(21:46):
thirds of sentenced inmates in jail suffer from drug addiction
or dependency. And that conclusion they made this is the
scary part. It comes from numbers in two thousand and
seven to two thousand and nine, which means it largely
does not account for the opioid crisis. Wow.
Speaker 2 (22:09):
Yeah, Wow, that's uh, that's tough. Well, well, here's the
other thing. So you've got a life sentence, let's say
you're going to be in prison for a long time.
You're also going to be dealing with just what happens
to your body as you're getting older. Just age related stuff, right,
like all kinds of diseases, all kinds of stuff that
you need medication for, stuff that you need maybe even
(22:32):
some I don't know, recovery, physical recovery from and work on.
And these people are dealing with that. There's also you know,
we talked about the addiction, the mental illness, and when
you put these together, kind of as you're saying, Ben
getting older, being addicted to something, probably maybe continuing to
be addicted while you're in while you're incarcerated, and then
(22:55):
also you know, having to deal with the mental illness.
It all kind of just adds up into this pretty
brutal thing where you're going to be probably experiencing withdrawal symptoms,
especially early on in your situation there. So, like I guess,
the first year of prison, which is what you were saying,
a lot of people actually only spend about a year
and there it can be extremely rough on your health.
Speaker 1 (23:17):
Oh yeah, absolutely. I mean imagine if you are, if
you are encountering withdrawal symptoms from some sort of drug addiction,
and the medical staff on hand says we're not going
to give you your drug of choice, but then another
inmate sidles up to you, maybe in the yard, and says, hey,
(23:39):
I can help you out if you do something for me.
Dangerous times right, And now, I guess we can take
a moment to talk about the politics here, because I'm
sure as we're exploring this, a lot of us are thinking, well,
people aren't in prison for good behavior. No one has
(24:01):
ever helped an old lady across the street so many
times that they got put in jail, you know what
I mean. You don't go there for being an honors student.
In terms of like civic mindedness, so there's this kind
of callous or colder argument that says, well, why should
we take care of these people if they are a
(24:22):
detriment to society? Because of that attitude or because of
that you know, that school of thought, it's very difficult
for politicians to argue in favor of advocacy for people
who have medical conditions while they are incarcerated, you know
(24:42):
what I mean. Like back in the eighties especially, it
was political suicide to say we should still treat human
beings as humans, because then it would be immediately equated
with being quote unquote soft on crime. And another difficulty
(25:02):
there a twists there is that it's very difficult in
many cases for felons to vote. So until the demographics
that are far more likely to get arrested and far
more likely to serve longer sentences are voting in larger
proportionate numbers, then politicians aren't going to go out of
their way to be I mean largely. It's true. It's
(25:24):
sad and it's kind of disgusting, but they're not going
to go out of the way to represent someone who
they don't see as capable of handing a benefit to them.
I mean, it's a huge downfall of our species, right,
everything is quid pro quo and stuff you should Know
has a great episode about how altruism doesn't really exist,
but no one wants to hear that.
Speaker 2 (25:45):
That's depressing, right, yeah, So well, really fast, I just
want to talk about something with you guys. Something I
don't know if this even really fits in the show,
but something I think we can apply to this is
the fact that unless you have experienced something in your life,
or you know someone directly who has experienced something, it's
(26:05):
very difficult to have true empathy about a situation. And
I take this to the concept of quitting smoking or
attempting to quit smoking. Now, just hear me out really fast.
For a lot of people who have never been addicted
to something like nicotine and attempted and failed to quit
(26:26):
that substance or something like that, a lot of people
will have, at least I've noticed in my experience very
negative thoughts on alternatives to quitting smoking even or you know,
other things like that, Like they have an immediate negative
reaction to something like that unless you are someone who
has actually attempted and failed to do something like quitting smoking,
(26:50):
And so I wonder if it's the same thing with
the prison system and a lot of these other things
where unless you have that direct experience with it, it's
very difficult to even see it outside of the negative
context which has already built up around it societally experiential knowledge.
Speaker 1 (27:06):
Right, like the uh like how the stem cell conversation
changed when people who were politicians opposed to stem cell
research realized the benefits it could have for people that
they personally knew.
Speaker 2 (27:19):
Right, Yeah, I mean I think so, I mean even
the CBD oil, Yes, absolutely, you know, I.
Speaker 1 (27:26):
Think it's it's weird because here in here in Georgia, Atlanta, Georgia,
where we record this podcast, uh one, regardless of where
you fall in drug criminalization. Uh. I thought it was
hilarious when we had some we had some politicians when
the CBDU the Medical Medicinal CBD Bill or whatever was called,
(27:49):
was first past, the politicians who approved of it spent
the majority of their time assuring everyone that no one
would enjoy it. I don't worry. No one is gonna
have fun. This is just for people with epilepsy.
Speaker 2 (28:04):
So you're sure you cannot get high.
Speaker 1 (28:06):
If I thought people would have anything like a good
time on this, I would be burning down the capitol.
You know what I mean. I'm still mad that people
Fox trot.
Speaker 3 (28:17):
He is burning down the capitol. When you smoke a
bunch of weed in the capitol, Uh.
Speaker 1 (28:21):
Little known fact. Yeah, it's part of the that's part
of the Georgia congressional slang.
Speaker 3 (28:28):
They say their prayer and then they spark up a doobie.
Speaker 2 (28:32):
Yeah, guy Fox, I don't know if you remember him.
He thought that barrel was actually full of doobies.
Speaker 1 (28:38):
Yeah no, yeah, yeah, yeahah yes and right. So the
the reason the politics matter here, the reason they're so fundamental,
is because this means that exkews the budget allocations for
(28:58):
a lot of jails and pin tentries. You want to
spend a lot of money securing the place, right, making
it hard to walk out of. But why would you
spend money on healthcare, especially if it means you could
be accused of going soft on crime. This problem is
exacerbated in jails that are in rural or poor counties,
(29:22):
which happens a lot. Jails will tend to be in
rural and poor counties because they can be advertised as
a source of jobs right for an ailing community. So
administrators complain, you know, they say, look, I don't have
the resources. I can't make the numbers work. How am
I supposed to hire, train, and supervise doctors and nurses
(29:44):
right like GPS, let alone specialized medical care? Like, what
what on earth am I going to be able to
do to incentivize a medical health professional to work with me?
I certainly can't pay her or him as much as
they can make in the private sector, So increasingly they
(30:06):
turn to for profit companies. And this is a field
of healthcare that a lot of people have probably not
heard about. I don't know if any of us heard
about it beforehand. I certainly didn't. Correctional health care, so
think of like blue Cross, Blue Shield, just for people
in lock up. They pledge to deliver quality care, while
(30:29):
very very attractive to administrators, containing cost. It's part of
a trend that started back in the nineteen eighties during
the Reagan administration, where the idea was that in general,
we will start to privatize things. We as a country
in general will privatize things because we'll be cutting the
(30:50):
fat and having cost as the Having costs as the
bottom line will encourage more nimbles, slimmed down and more
efficient operations. This trend accelerated after the nineties, right when
we had a ton of tough sentencing laws like mandatory
sentencing and stuff. The Violent Crime Control Law Enforcement Act
(31:14):
nineteen ninety four made the number of people in jails
and prisons jump from about three hundred thousand to more
than two million today. Yeah so.
Speaker 3 (31:27):
According to a twenty eighteen study from the Pew Charitable Trusts,
more than half of the states hire private companies to
provide at least some of that prison healthcare services. Those
prison healthcare services the companies they negotiate these multi year
contracts with each jail and prison that they serve. Medical
staff and prescription drugs, and outside services such as hospital stays,
(31:50):
constitute the bulk the line to share of these costs. Oftentimes,
the companies receive a per day, per individual rate, so
profits depend on keeping costs below that amount. Sometimes contracts
include provisions that increase a company's potential profit if it
holds down transfers to hospitals or to other outside providers. Ben,
(32:12):
can you help us unpack this because I don't know
about you, but this seems a little on the shady side.
Speaker 1 (32:17):
For sure, your spider sense is correct. Sometimes this stuff
can get lost in the legal language. But this is
a very important turn in the story here. The companies,
these private health providers for prisons have negotiated these things
(32:38):
that say, look, we will make more money if everyone
is and this is just for sake of argument. If
everyone is limited to four hundred dollars a day, the
medical care for all these inmates is four hundred dollars
per person per day or less, and as probably is
less than we will make another profit. Furthermore, if x
(33:07):
number of people or less than that go to a
hospital per year or to a specialist off site, then
we'll make another We'll make another windfall, another bonus. So
we know that private health insurance follows the same thing.
It's not a new game, right. They want to avoid
unnecessary tests and procedures. You probably hear that a lot
(33:30):
back in the old death panel argument days. But this
is very important. This means that if someone in jail
or in prison believes that their health or even their
life is in jeopardy. They can't do what any of
us do. They can't just call nine to one one.
They can't, you know, they can't play the great medical
(33:51):
debt game that's killing this country and pay eleven grand
for an ambulance over time. Instead, they have to hope
and pray. If they are the religious type, that someone
in the prison believes that they are exhibiting the signs
of a stroke and they have to hope and pray
that it's a minor stroke, or they have to hope
and pray that the diabetes doesn't catch up to them
(34:15):
and they get some help before they go into insulin shock.
There are no comprehensive statistics about the prevalence of private
healthcare companies in jail, and that makes sense because why
would you want people to know that outside of maybe
a trade show where you're pitching to a warden. There
you go, well, we do have some stuff. We know
(34:36):
that the National Commission on Correctional Healthcare has accredited these
programs around the country, and seventy percent of the jails
it inspects outsource their medical services and when they outsource.
These for profit companies have a pretty big chunk of
those contracts.
Speaker 2 (34:58):
Oh boy, So let's get into what we know about
some of this stuff. Just it's gonna get even deeper
and darker. After a quick word from our sponsor, we're back.
Speaker 1 (35:15):
So we've been talking in general terms about private companies, right,
private healthcare companies. But let's name a few because we
have some names.
Speaker 2 (35:25):
Right. So we've got at least one big one, and
it used to be called Correct Care Solutions, and that's
the one that I had heard of before, but it's
now called well Path. And there's also Corizon Health. It
looks like Horizon but with a C. Those are two
of the bigger players.
Speaker 3 (35:42):
Is that like a kronat kind of Yeah?
Speaker 2 (35:45):
Okay, so it's on the horizon, but it's correction. It's
the Correction Horizon of health.
Speaker 1 (35:51):
It used to be called Correctional Medical Services Incorporated, and
then before that it was Prison Health Services Incorporated. Kind
of like Backwater or Academi or EXE. Just changed up
a little bit, Just change the names. It'll be fine,
it'll be grand. What an adventure.
Speaker 2 (36:09):
Yeah, well, there's a reason why those names changed. Just
like you said with Blackwater, well, with Blackwater, it was
about public perception, right with some scandals that were occurring.
When we say scandals, we mean pretty much murder that
was occurring. With these companies, it's because they've been sued
a lot. The two of them together combined have been
(36:30):
sued about fifteen hundred times in the past past five years,
and a lot of those were over, you know, accusations
of things like neglect and malpractice and in dozens of
cases even wrongful injury or up to death. Carizon, one
of those companies, was the defendant in more than one
thousand cases, so of those fifteen hundred.
Speaker 1 (36:52):
And it's interesting because Karison cares for about one hundred
and eighty thousand people day to day. Well Passed, in contrast,
handles about two hundred and fifty thousand people day to day. Wow.
Representatives for both companies say, well, these lawsuits are often flimsy, frivolous,
or inconclusive, and we know, you know again, people aren't
(37:16):
in jail or prison for being on their best behavior.
From what we understand, the vast majority of people are
inmates are just trying to get through their time and
get out and the other side of the bars gives
us a different perspective. The prison guards can assure us
(37:37):
that there are multiple people who do have mental health problems.
You know, they're flinging pooh. Maybe there's some people malingering,
which means faking an illness simply to change up their
routine to get out somewhere, you know what I mean.
But be that as it may, it doesn't negate the
fact that these cases of wrongful injury or death have
(38:01):
been decreed. Legitimate public interest lawyers have brought class action
suits alleging inadequate healthcare across the entire system. There are multiple,
multiple examples of this, unfortunately some which end in death.
But we've got let's just do one example from Arizona.
Speaker 3 (38:21):
So in Arizona, civil rights groups filed a class action
suit in twenty twelve. A year later, after the state
passed legislation privatizing prison healthcare, it signed a contract with
Coruson to provide medical services in those prisons. Then, in
twenty fifteen, a federal district court that sought to resolve
(38:42):
the suit approved a settlement in which the state pledged
to overhaul its care. But last June, Judge David Duncan
found that quote, widespread and systematic failures remain end quote
and held the state in contempt, issuing it fines of
more than one million dollars.
Speaker 1 (39:04):
And that's interesting because when they're defending themselves, the private
prison insurance companies will say that part of their contract
indemnifies the state or you know, the party from the
government that they're contracting with, indemnifies them from legal costs.
(39:28):
But in the case of Arizona, the judge wasn't having
it and essentially said, no, don't put this on them.
You're the ones who agreed to let this happen. In
the meantime, by the way, while these things are winding
and wending through the court system, people are dying, you know,
and many of whom committed crimes. But the ones who
(39:49):
are dying were not sentenced to the death penalty. And
the question then becomes, is this sentencing people to death?
Which I know is a really messed up way to
look at it, but it's not unfair. According to Steve Cole,
a journalist wrote an excellent article for The New Yorker
in twenty nineteen, evidence from cases across the country suggests
(40:09):
that four decades of policy failures in both healthcare and
criminal justice reform have left a largely neglected population vulnerable
and at times at risk, and that for profit companies,
which were promoted as a solution have instead become an
integral part of a troubled system. They were supposed to
fix it back in the eighties, and all they did
(40:30):
was fix their profit margins.
Speaker 2 (40:32):
Yeah, and now it's become too big to fail in
a way you can't really remove it.
Speaker 1 (40:36):
It even goes even goes down to the food, right,
because we joke about food all the time. But food's
part of your health.
Speaker 2 (40:44):
It's a massive part of your health. Yo, are what
you eat, buddy, And it really is like the simplest
thing to say that. My wife, My wife and I
have an ongoing joke argument about that about how important
your food is. She likes to eat a lot more
healthy than I do. And I just like the good
(41:06):
tasting stuff, you know, you know.
Speaker 1 (41:08):
Stuff that you evolved to seek out, right.
Speaker 2 (41:12):
Yeah, the sugar, salt, yeah, mostly the fats, like the bacons.
Speaker 3 (41:17):
You also like the heat, though, don't you.
Speaker 2 (41:18):
Man, Yeah, give me the spicy bacon.
Speaker 3 (41:20):
You're a spicy boy.
Speaker 2 (41:21):
I'm good to go. But yeah, it's just one of
those things where it is true, if you're eating more
healthy or getting more nutrients, you are in a better
spot for all the other stuff and you're not going
to have as many issues, at least theoretically. But we
got a caller, someone a listener called in from Alabama
and told us about this story where there was a
local sheriff's office that was getting they would make money
(41:45):
off the top of whatever money they didn't spend on
food for the prison system within the county. And we
haven't looked into it fully yet. We do have a
story here from NPR about if sheriff in Alabama that
the caller was mentioning he took almost a million dollars
seven and fifty thousand dollars legally. He took this money
(42:10):
to buy a beach house. Money that was meant to
feed inmates within his county.
Speaker 1 (42:15):
Yeah, Atawa County, SHAREFF Todd intrickin Todd, if you're listening,
I hope you enjoy your beach house. What Todd did
was pocket this, you know, seven hundred and fifty large
that was supposed to feed inmates of the jail that
he supervised. Then, according to the Birmingham News, he used
(42:38):
the money that he pocketed or the majority of it
to buy a beach house. Because Alabama has this law
that allows sheriffs to quote keep and retain unspent money
from jail food provision accounts. So sheriffs across the state
of Alabama take the money as personal income.
Speaker 3 (42:57):
Like a bonus. Yeah, for like doing a good job,
because they had like a surplus.
Speaker 1 (43:02):
Kind of Well, it's not attached to doing a good job.
It's just a I mean, if the good job is
defined as taking less money to feed people, then they
can take it. There. It goes both ways, though. People
are quick to point out if they have a shortfall
in the budget in that regard, then the sheriff as
an individual's personally held liable for covering the gap. But
(43:26):
turns out that they don't really go out of their
way to spend that much on feeding their inmates.
Speaker 2 (43:32):
Yeah, that's really depressing and messed up sheriff.
Speaker 1 (43:37):
Also, we don't know how many people are doing this,
because sheriffs across the state apparently have done this for
a long time. That law dates back to the Depression,
and according to the Southern Center for Human Rights quote,
it is presently unknown how much money sheriffs across the
state have taken because most do not report it as
income on state financial disclosure forms.
Speaker 2 (44:00):
Yeah, so you're not required to specify any money that
you take in in this way above two hundred and
fifty thousand dollars a year. And he brought in seven
hundred and fifty.
Speaker 1 (44:12):
We have to wonder what they're what they're eating.
Speaker 2 (44:16):
You know.
Speaker 1 (44:17):
It makes me think of do you guys remember the
controversy of neutral loaf? Do you remember hearing about that?
Speaker 3 (44:25):
Yeah? I do. It was like a food substitute, kind
of like soilent green.
Speaker 1 (44:29):
Yeah, kind of. It's like the the Okay, you know
that there's meat loaf, there's neutral loaf, which is also
called meal loaf because it is it's this unholy amalgamation
of vegetables, fruit, meat, bread, other grains baked into a
(44:51):
solid loaf. The ingredients vary, but there is something called
dairy blend.
Speaker 3 (44:57):
Sounds like fruitcake to me, but.
Speaker 1 (45:00):
With fruitcake they at least keep the shape of the
fruits right in there.
Speaker 2 (45:04):
Yeah.
Speaker 3 (45:04):
Well, they dice and kind of like also candied and
gummy looking.
Speaker 1 (45:10):
But they're identifiably fruit, right. I see what you're saying.
Speaker 3 (45:13):
This is just like ground into a pulp into a
paste and then that's baked into kind of this amalgam
of god knows.
Speaker 1 (45:20):
What, right, yeah, oh god, And that one even went
to court several times. In a case called Gordon versus Barnett,
the District Court for the Western District of Washington ruled
that someone got all the way to court arguing that
eating neutral loaf was cruel and unusual punishment. And although
(45:41):
the court ruled that it was not cruel and unusual,
it was a punishment and that prisoners should be entitled
to due process before they have to eat it. It's
so bad that you have to get like the law
involved for you to be forced to eat this, at
least according to that judge.
Speaker 2 (45:58):
Geez, just a just to jump back in this, I'm
reading a little bit further down in the article. It
gives a little more context to this. So apparently this
sheriff and how did we say it in and tracing
entricn entrican.
Speaker 1 (46:14):
Like the demon, he's in Albata.
Speaker 2 (46:16):
Oh that's ooh, that's really cool. So yeah, so he's
in Alabama's he's Entrican. So when he came into office,
the previous sheriff died while he was in office. Okay,
and this this money, this money that's meant for inmates
for food, that account got drained and it was given
to the family of that sheriff that just passed, and
(46:39):
that was about one hundred and fifty thousand dollars or
something to that effect. All that money was taken out.
So then this current sheriff had to take out a
personal loan one hundred and fifty thousand dollars just to
keep the inmates fed. And he was paying off that
for years and years and years. So it is interesting
how the tides kind of turned with him having to
(47:00):
take out this initial loan to him getting a beach
you know, a beach house, and then ultimately owning property
that's worth over one point seven million dollars through you know,
all these various things that's he and his wife. And
then also the fact that he makes about ninety three
thousand dollars a year as the sheriff of a county,
just base level, base level, and then he's able to
(47:20):
make the bonus essentially on this one account that is
directly tied to the food that would go to inmates.
That is puzzling and strange, and I will never fully
understand that.
Speaker 1 (47:31):
And it is legal, it is completely not against the law, yepet.
So this this is such a brief look, but it
leads us to the question what is to be done.
The problem comes down to profit, but it also comes
down to accountability. Right the healthcare providers say, you know, again,
we take care of the legal cost in many cases.
(47:54):
But also this is a ten billion plus dollar industry
and those companies are obligated to seek profit on behalf
of their owners. According to David Fothy, the director of
the National Prison Project at the ACLU American Civil Liberties Union,
these companies have compelling incentives to cut costs and staff,
(48:17):
and that can result to denying care. And what is
literally and I don't know if he was going for
a pun here a captive market like they can't they
cannot switch insurance providers, right, They can't say, well, this
doctor stinks and they misdiagnosed my appendicitis and I almost died.
I want someone else, and they'll say, no, sorry, you're
(48:40):
gonna have to stick with this person for at least
the next two to five years that you're locked up.
And Fathi says, you know, he says, I don't mean
to suggest that government run prison healthcare is perfect. It's
often appallingly deficient. But at least when the government is
providing the service, there's some measure of oversight, some measure
of democratic control, and a lot of people may say, well,
(49:05):
this is a rock and a hard place situation, because
neither is particularly great for people incarcerated. But then there's
something weird that we didn't talk about because of the
way that the law changed to guarantee. For much of
US history, the idea of prisoners receiving medical care was
just like bonkers, why would you do that? You know
(49:27):
what I mean. But as the law has changed, even
though the prison system is terrible for people who are
caught up in it, and even though it often increases
a person's chances of committing a crime or recidivism, which
is when they return to prison, inmates rights to healthcare
have actually expanded in comparison to the public the inmates.
(49:53):
The rulings that gave inmates a right to access to healthcare,
at least on paper, have never been applied to free citizens.
I want to say that one more time, inmates access
to a doctor, to healthcare have been guaranteed in this country,
at least on paper. If you are listening to this
(50:15):
and you are not in prison, in that regard, the
people incarcerated have more rights than you do.
Speaker 2 (50:24):
It doesn't. Yeah, Yeah, it makes you wonder. It makes
you wonder if sometimes it would be a better move
to do something to get incarcerated to get your health back.
If you're in a tight enough spot. That's scary to
think about. And I will have done that, That's what
I'm saying. I know it has been done. There are
(50:45):
specific examples, but just the fact that that is a
situation you could find yourself in in this country is
baffling and terrifying.
Speaker 3 (50:53):
And not even to mention that some people do it
just for shelter, sometimes on purpose.
Speaker 1 (50:58):
Yeah, yeah, it doesn't happen all the time, but people
do go to jail on purpose. Some people go to
bring in drugs from the outside one way or another,
probably ingesting it somehow right and then passing it. In
twenty twelve, a guy named Frank Morocco of Amherst, New York,
was unable to afford healthcare for a rare form of leukemia.
(51:21):
He was released from prison in twenty twelve. He had
been in jail for twenty years on felony drug charges.
So he's fifty six years old. So he went in
when he was thirty six. He had leukemi. He had
no way to pay for it. He had been incarcerated
for so long that he walked into a grocery store,
stepped up to the counter, just stole twenty three bucks
(51:43):
worth of goods in plain sight so that the employees
could see him, and then walked out. Got arrested on shoplifting,
which violated his supervised release, and he was hoping it
would land him back in prison so that he could
get some help with his leukemia.
Speaker 2 (52:01):
Did it work.
Speaker 1 (52:04):
It was not reported whether Morocco got the treatment, but
he was released from prison on the shoplifting charge in
April of twenty thirteen.
Speaker 2 (52:12):
Wow, well, I guess I hope he did. But again,
you know, this is such a tough topic because there really,
there really is such a range of humanity that exists
within the prison system, and just of you know, depending
on your sense of morality, it really affects the way
you're gonna feel about this. It really does. In the
(52:34):
In the end, every single person in a prison everywhere
is a human being that that, you know, and the
best of times and the best of idealism, they deserve
a shot at being healthy. But if that person has
you know, heard another in one way, or you know,
(52:55):
in one fashion or another, it's tough to it's tough
to stomach the thought of them getting better healthcare than
just someone who isn't doing so great financially outside of prison.
This is a really tough topic.
Speaker 1 (53:07):
It is it is. Let's also, I mean, let's take
a step further and say that one of the reasons
the prison system in the US has so many problems
is that it is not a program meant to rehabilitate
people in along in many ways.
Speaker 2 (53:23):
Makes me think about that Sicko documentary from several years back.
Speaker 1 (53:28):
And we want to hear your take. Thank you for
taking this strange journey with us. What role do you
feel private, private medical care or private medical provider should
play in the US prison system? Is this is this
something that people incarcerated, you know, somehow deserve, you know?
(53:51):
Is is that just part of the risk that they
knowingly or unknowingly took when they committed a crime? How
how would it be a I'm sure we have several
people who are saying, right now, you know that I
pay my taxes, I pay a lot right and I
still struggle to pay my own medical bills. Why should
(54:14):
this be better for someone else didn't, who didn't obey
the rules of our land. And we don't want to
say it's necessarily better because I think, as we've illustrated here,
people are dying from easily preventable conditions in prison exactly.
And that's our classic episode for this evening. We can't
(54:34):
wait to hear your thoughts. We try to be easy
to find online.
Speaker 3 (54:37):
Find this at the handle Conspiracy Stuff, where we exist
on Facebook X and YouTube, on Instagram and TikTok. We're
conspiracy Stuff.
Speaker 2 (54:44):
Show call our number. It's one eight to three three
std WYTK. Leave a voicemail and.
Speaker 5 (54:50):
If you have more to say, we can't wait to
hear from you at our good old fashioned email address
where we are conspiracy at iHeartRadio dot com.
Speaker 2 (55:17):
Stuff they Don't Want You to Know is a production
of iHeartRadio. For more podcasts from iHeartRadio, visit the iHeartRadio app,
Apple Podcasts, or wherever you listen to your favorite shows.
Fellow conspiracy realist. We returned to you this evening with
a classic episode about a terrible, terrible conspiracy that continues
today in twenty twenty four and continued far before we
first spoke about this in twenty nineteen.
Speaker 2 (00:21):
Oh yeah, and we've learned so much more about the
prison system and healthcare, you know, as two separate things
since that time. I'm specifically thinking back to the discussion
you guys had with the Lava for Good folks, like
all the different hosts there, and just learning about the
dangers of the prison system. But the weirdest thing, the
(00:41):
weirdest thing for me was learning from them through you guys,
that private prisons are actually way smaller of a deal
than I thought because there's so fewer of them.
Speaker 3 (00:54):
But yet they're the ones that get all the headlines.
Speaker 2 (00:56):
Right, Yeah, well that's the headlines, and that's at least
my perception. And the reason why that was mind blowing
to me is because I imagined there was pretty good healthcare
for prisoners because there is a profit motive to keep
that prisoner alive and in jail, because the private prison
gets money per person per bed, right, But that's not
(01:18):
that's not the way it goes in most prisons.
Speaker 3 (01:22):
Accurate. Let's check out the episode.
Speaker 4 (01:25):
From UFOs to Psychic Powers and government conspiracies. History is
riddled with unexplained events. You can turn back now or
learn this stuff they don't want you to know.
Speaker 1 (01:37):
A production of iHeart Radios How Stuff Works.
Speaker 2 (01:49):
Hello, welcome back to the show. My name is Matt,
my name is Nolan.
Speaker 1 (01:52):
They call me Ben. When we were joined with our
super producer Paul Michigan, control decand most importantly, you are you.
You are here that makes this stuff they don't want
you to know. We've been going down some dark alley
ways figuratively speaking or conversationally speaking in the past few episodes,
and you know, honestly, we're getting to a point where
(02:13):
maybe we should do something a little more lighthearted in
the future. Well that's not true. We have a lighthearted
interview for the Legend of Cocaine Island that's out now
by the time you hear this. So that's a fun listen, right.
Speaker 2 (02:26):
Right, Yeah, We've got stuff unicorns don't want you to
know on the slate.
Speaker 1 (02:31):
M Okay, yeah, I know. Well it's weird because I
was thinking I was reading something about unicorns oddly enough,
now that you mentioned this, wherein someone who was a
zoologist of some sort of another said, based on the
fact that they had a single horn, and based on
the fact that was positioned in the center of their
forehead facing forward, what that tells us about their behavior.
(02:55):
It's very similar to rhinos. So unicorns, if they did exist,
would probably be legerent, antagonistic animals, capable of great violence.
Speaker 3 (03:03):
They'd be very stabby, and that's something unicorns don't want
you to know.
Speaker 2 (03:06):
That's right, not the profile, Yeah, exactly, all the glitter
and all the shininess.
Speaker 1 (03:13):
And they're weird thing with virgins.
Speaker 3 (03:14):
Have you seen that movie Legend with a very very
young Tom.
Speaker 1 (03:17):
Cruise and a very awesome Tim Curry.
Speaker 3 (03:19):
Very awesome Tim Currey wearing a giant rubber satan suit,
And there's a whole thing where they like the unicorns
play a big part in that, very very important.
Speaker 1 (03:27):
There's also the animated The Last Unicorn, which is really sad. Yeah.
Speaker 2 (03:31):
Yeah, I was thinking about the Brie Larson, her directorial debut,
something about the Unicorn Store something to that.
Speaker 3 (03:38):
Effects on Netflix. Now it is is it spoiler alert?
Does not seem to have anything to actually do with unicorns,
I know, just putting that out.
Speaker 1 (03:45):
Well, thank you guys, you've saved me a few hours.
Speaker 3 (03:47):
No, it else has absolutely nothing to do with unicorns.
Speaker 1 (03:49):
The healthcare in the prison systems. So the US healthcare
system is by any measure, no matter how you look
at it, no matter what your opinion is, and everybody
has opinions about this, by any measure, it's anomalous. One
of the world's wealthiest countries with one of the world's
worst performing healthcare sticks. You know, like not in comparison
(04:14):
to very very impoverished countries so much as in comparison
to other countries we would consider peer countries economically. Right. Yeah,
And there's the one thing we all agree on is
that this thing is rife with problems. It's lousy with
problems and things that don't work, and it's complicated by
(04:34):
the fact that there is a ton of money wrapped
up in this issue. Doctors make a ton of money, hospitals,
of course, insurance companies make tons of money. There's a
lot writing on this, and that means there's also extensive
propaganda in play. We will hear some people say, well,
the entire problem with US healthcare is that it is
(04:56):
to a great degree run by privatized insurance companies, that
they're the root of the problem as they continually put
profits over the greater good. For some people, that's fighting words.
For other people, it's like, you know, shrug, dot gift,
that's what companies do, that's what for profit businesses do.
Other people say, no, it's broken. But the problem is
(05:17):
not honest, red blooded American business. It's that the government
is involved. And every time Uncle Sam is involved in something,
it's going to be ruinous because the government is inefficient
and corrupt. Sometimes that's a sincere argument. Sometimes it's a
Star of the Beast argument. Depends on what you hear about.
And today's episode is not about that cartoonishly tragically comic
(05:40):
state of medical care in the US overall. That's probably
its own podcast. Today's episode instead is about one of
the worst case scenarios for anyone who lives in this
country and ever gets sick orrever needs some sort of
medical treatment. Healthcare in prison.
Speaker 2 (06:00):
Two things you don't want to be a part of.
Sick and incarcerated. So just to get a better understanding
of this problem, it's best to start with some statistics.
We all love those. So let's look at just the
US population in general. As of twenty eighteen, the population
in this country was three hundred and twenty seven point
two million human beings. Twenty eight point seven percent of
(06:21):
the population is under the age of eighteen, so you know,
that's almost a third of the people very very young.
About fifteen point six of the population is over the
age of sixty five. And then that leaves the people
who are not minors, you know, who are eighteen and
they're also not they're above eighteen below senior citizen, which
(06:44):
are going to be the primary, the primary age range
for people who are incarcerated.
Speaker 1 (06:49):
Right right, the regular, the regular Joe's and James. This
is interesting that fifteen point six percent number for elderly
and senior citizens makes sense because do in large part
to the way the healthcare system here does or does
not work, We have a disturbingly low life expectancy compared
(07:10):
to other what are called first world countries or other
developed countries is a better phrase. So's that's the population
by the numbers. What about the medical stuff? Do we
have any stats for that?
Speaker 3 (07:23):
Yeah, so the US spends way more on healthcare than
any other nation. On this here globe three and forty
eight dollars per person, which amounts nearly eighteen percent of GDP,
which seems bonkers to me. Government funded Medicare and Medicaid
account for more than a dollar of every three dollars
(07:45):
of US healthcare spending, and a dollar every four dollars
in the federal budget. The entire federal budget, we know
is a is like seems like one of those imaginary numbers,
you know, the trillions.
Speaker 1 (07:57):
Yeah, it's largely, it is largely a series of which
is promises, increasingly ambitious pitches. I was going to say
from Congress. Absolutely, and and it's been growing, right, it's
been growing Medicare at least that more than twice the
rate of inflation. It's forecast to accelerate as what we
call the baby boomer generation ages increasingly into that elderly demographic.
(08:23):
So that's one thing upon which we cannot blame millennials. Sorry,
I know some of us in the audience are dig that.
Speaker 2 (08:31):
But yeah, and then that's just for Medicare. That's that's
the part that the government helps out with, right, right,
And that's for people who do have Medicare, you're considered
to have healthcare. There are a lot of other healthcare
comes from employers, kind of like what we have sitting
in this room, including Michigan control over there.
Speaker 1 (08:48):
You're absolutely right, Matt twenty sixteen. Private health insurance covered
more people than the government does. So you pay like
think of think of every country as a club. We've
said this before in previous episodes. The concept of taxes,
the concept of taxation is at heart in a very
(09:12):
oversimplified way, it's the same thing as paying dues to
a club, country club perhaps, sure, a country club, a
chess club that has a nice HQ, if they have those.
The idea is, you pay into this thing, and because
you've paid into this thing, you get certain rights. So
(09:34):
you're a country club, a golf club, whatever. That goes
to the maintenance of the place, but it also goes
to the maintenance of things you use. So the argument
that people will have is that, well, if you pay
taxes here in a country, then those taxes should guarantee
some of your rights, guarantee some maintenance, and then arguably
they could be in a situation where they pay to
(09:56):
help keep you alive or at least make your existence
a little bit less painful than it would be without
health insurance. Again, not everybody agrees with that. A lot
of people think privatization is the answer. So that's why
employer based coverage covers more than half of the population
for part or all the calendar year. And then there's
Medicaid nineteen point four percent, Medicare sixteen point seven percent,
(10:20):
what's called direct purchase, I go out and buy my
own stuff sixteen point two percent of people either thought
that was a good idea or were forced to do
it through things like Cobra right, or military coverage four
point six percent. You're going to lay your life on
the line for a country. The least we can do is,
you know, not put you in the poorhouse if you
(10:41):
have cancer, although that still happens. But this number doesn't
answer everything, because despite all these different kind of partial
band aids for keeping people alive and healthy, twenty eight
point five million people in this country have no form
of health insurance whatsoever all the year, all the livelong day.
Speaker 2 (11:02):
Yeah, eight point eight percent. At least that's as of
twenty seventeen.
Speaker 1 (11:06):
Right, that number may have gone up or down a
little bit, but it hasn't moved a ton yet. It
may very well in the near future, in the next
three ten years. Right.
Speaker 3 (11:20):
Not to mention the fact that I don't know how
this figures is the puzzle here, but I think it's
fascinating and it certainly should be part of the conversation.
It costs an average of thirty one thousand dollars per
inmate per year to incarcerate an individual. It's like tax
payer money. So it's just crazy to me that if
we're paying that much to incartrate a person, yet people
(11:42):
outside of the prison system, we wouldn't even consider spending
that much on them and their well being.
Speaker 2 (11:49):
It is.
Speaker 1 (11:51):
It is cheaper, or it has been for a number
of years. It is cheaper for the United States, on
a state and federal level to send someone to community
college for two to four years and pay for their
dorm or their apartment than it is to incarcerate them.
(12:11):
And that's something I learned via Little Wayne originally true story,
but yeah, but it's true. It's we can get into
the political reasons for that, because the argument here doesn't
bear out when you look at the math. It bears
out when you look at what people like voting for, right,
which is a little bit of a simplified way to
(12:32):
say it, but it's true, and it's a big business.
The US locks up a lot of people. I was
thinking about this earlier. I was going to say they
lock up tons of people, and then I read back
through it, and it's true. If you do the math
on how much a single person weighs, and you do
the math on how many people are locked up, we
are literally locking up tons and tons of people, tons
(12:52):
of human flesh. Our prison population rate is roughly seven
hundred per one hundred thousand. That makes it the second
highest incarceration rate of two hundred and twenty two countries
tracked by the Institute for Criminal Policy Research, and that
is such a large net to cast the ICPR study
(13:16):
right now, the UN doesn't recognize two hundred and twenty
two countries, so they gave everybody a chance. This country
locks up a half million more than China, and that
has a population five times larger than the US. This country,
and this is a statistic that many of us have
heard before, and I wish it wasn't still true. This
country holds twenty five percent of the world's prison population.
(13:40):
Twenty five percent. Yeah, it's worse though, because the statistic
that follows right after, we're only five percent of the
people in the world, which means that, if you think
about it, just from living here, you have one of
the highest chances in the world of going to prison.
Speaker 2 (14:00):
Yep, Okay, So what was it we said, three hundred
and twenty seven something million people in the United States. Well,
the American criminal justice system holds within it incarcerated human
beings two point three million people. That's crazy. There are
and it holds them in over seventeen hundred state prisons.
(14:21):
There are one hundred and two federal prisons, and then
eighteen over eighteen hundred juvenile correctional facilities. Then there are
also like that. Okay, and that's just starting right. Then
you go down another level. You get to the local jails.
They wouldn't even be really called a prison, just a jail,
a holding cell kind of thing. There are three thy
one hundred and sixty three of those, and there are
(14:41):
also eighty Native American like they're called Indian country jails.
Well that's not even talk, dude. We're not even thinking
about military prisons, the brig yeah, and the oh, the
detention facilities like immigration facilities.
Speaker 3 (14:56):
The bizarre and labyrinthine network of detention centers. Yeah, that's
that's that's a whole on other conversation.
Speaker 1 (15:03):
There, one of which was famously until quite recently, a
series of fences set up under a bridge. Yeah, civil
commitment centers, state psychiatric hospitals, which are still around, mostly privatized,
but still exists to some degree.
Speaker 2 (15:18):
You can be held without against your will in those facilities.
Speaker 1 (15:21):
And prisons in US territories which occupy an even more
murky legal space, including Gano, including Guantanamo. Yeah, every year
six hundred and twenty six thousand people walk out of prison,
but they go to jail ten point six million times
(15:42):
each year. Jail and prison are as as many people will,
as many people attest. Jail and prison are two very
different beasts. Jail churn is pretty high because most people
in jail have not been convicted.
Speaker 2 (15:58):
They're just waiting.
Speaker 1 (15:59):
Yeah, they've been arrested. They're desperately using that trope and fiction.
They're one phone call to get a bail bondsman, or
to get some money together to get out before they
have to go to trial, or in many, many, many,
many cases, they are too poor. And you know, justice
is a slot machine that only takes dollars.
Speaker 3 (16:21):
So if jail is like a holiday, in prison is
like a living community of some kind in an apartment building.
Speaker 1 (16:30):
Yeah yeah, So again, jail is like kind of like
a slot machine that only takes dollars. So other people
are too poor to make bail and they have to
stay behind bars until their trial. And we've all seen
these stories, right, There's somebody who has arrested for something.
Maybe it's a case, wrong place, wrong time, but they
can't make bail, and so they're in jail for what months,
(16:53):
and then they go to trial and the judge is like,
who is this guy?
Speaker 3 (16:56):
Not to mention they're in jail because they've done something.
Then they can't make bail, so then they lose their
jobs because they're sitting in jail, and it just creates
this cycle of being able to not afford anything that
the system foists upon you, especially then once you are
convicted and then have some kind of you know, fee
schedule that you have to deal with, but you've lost
(17:17):
your job and become unemployable again, probably another conversation, but
it's a problematic cycle.
Speaker 1 (17:23):
And this number might surprise some folks. Met you recently
gave us the statistics of some people in jail. But
of those people in jail, only about one hundred and
fifty thousand or so on any given day have actually
been convicted, and most of them to take your holiday
in comparison or the apartment comparisons. They're generally serving sentences
(17:45):
that are less than a year, and almost half a
million people are locked up purely because of drug offenses.
So mainstream media, right, we all know and love our
favorite fiction films and stories, often depicts the incarcerated population
in some in some wild extremes, right, there are two
(18:07):
or three big stereotypes we see people incarcerated. There are
either woefully disenfranchised, you know what I mean, The system
is broken. It crushed my life, you know, I got
arrested wrongfully, but I lost everything while I was waiting
for my day in court. Or there might be the
other extreme where these people are absolute suicide squad level
(18:30):
monsters and the state is being too nice by putting
these people in time out for life and should just
kill them. And then you'll see things like red and
Shawshank redemption right, who who has attained wisdom or higher
enlightenment despite their physical confines and stuff like that. But
regardless of how these people are depicted in fiction, life
(18:54):
on the inside is not like what you'll see in
a lot of those things. Like what's that HBO series
OZ got praised for being a little more realistic than most.
Speaker 3 (19:03):
Yeah, that show is insanely good. It was also like
one of the early big HBO dramas, So it has
this look of like video where it looks very real,
almost like you're watching a play, but it's like it's
I love everything about that shows it's super great.
Speaker 2 (19:18):
Does it hold up?
Speaker 1 (19:19):
It does?
Speaker 2 (19:20):
Okay?
Speaker 3 (19:20):
I mean I don't know. It's a little data because
it's super square, like the framing or whatever. And also
some of the some of the performances are a little
over the top, but no, the stuff that it covers,
it's very theatrical, but it's also very grounded in reality.
Speaker 1 (19:34):
Mmm, sort of a harbinger of the gritty realism of
Orange is the New Black. So, regardless of any of
us listening now, regardless of our stance on the prison system,
whether you think it's chugging right along, whether it's the
best we can do, even if it's not perfect, whether
(19:54):
you think it's broken, whether you think it's a system
meant to oppress certain demographics here in this country. It's
clear that crime does continue inside the walls of penitentiaries.
There are gangs everywhere. People love all the vices still,
you know what I mean, drugs, sensual pleasure, old fashioned violence,
(20:17):
and the chances of that kind of violence are always
somewhere in the cards. But to activist policymakers and others,
there is another criminal in the mix here. And it's
not a criminal that you're going to see on America's
Most Wanted. It's not a criminal that you will see
in a highly publicized OJ Simpson level trial, right.
Speaker 2 (20:37):
No, you would see them in the ads in between
those programs.
Speaker 1 (20:41):
That's right, we're talking about insurance companies. Wait, our insurance
companies criminals. You might be saying, kind of, let's have
a word from our sponsor. Is where it gets crazy.
(21:03):
So well, let's call this part healthcare, profit and public perception.
In twenty seventeen, the Bureau of Justice Statistics released a
study and they said that nearly half of the people
held in jails suffer from some sort of mental illness,
and more than a quarter have a severe condition such
(21:24):
as bipolar disorder. And again as we as we noted
with jail, many of the people in jail are just waiting,
they're churning through. They haven't been convicted and sentenced to
that misdemeanor. That's less than a year. But in the
same year twenty seventeen, the Bureau reported that about two
(21:46):
thirds of sentenced inmates in jail suffer from drug addiction
or dependency. And that conclusion they made this is the
scary part. It comes from numbers in two thousand and
seven to two thousand and nine, which means it largely
does not account for the opioid crisis. Wow.
Speaker 2 (22:09):
Yeah, Wow, that's uh, that's tough. Well, well, here's the
other thing. So you've got a life sentence, let's say
you're going to be in prison for a long time.
You're also going to be dealing with just what happens
to your body as you're getting older. Just age related stuff, right,
like all kinds of diseases, all kinds of stuff that
you need medication for, stuff that you need maybe even
(22:32):
some I don't know, recovery, physical recovery from and work on.
And these people are dealing with that. There's also you know,
we talked about the addiction, the mental illness, and when
you put these together, kind of as you're saying, Ben
getting older, being addicted to something, probably maybe continuing to
be addicted while you're in while you're incarcerated, and then
(22:55):
also you know, having to deal with the mental illness.
It all kind of just adds up into this pretty
brutal thing where you're going to be probably experiencing withdrawal symptoms,
especially early on in your situation there. So, like I guess,
the first year of prison, which is what you were saying,
a lot of people actually only spend about a year
and there it can be extremely rough on your health.
Speaker 1 (23:17):
Oh yeah, absolutely. I mean imagine if you are, if
you are encountering withdrawal symptoms from some sort of drug addiction,
and the medical staff on hand says we're not going
to give you your drug of choice, but then another
inmate sidles up to you, maybe in the yard, and says, hey,
(23:39):
I can help you out if you do something for me.
Dangerous times right, And now, I guess we can take
a moment to talk about the politics here, because I'm
sure as we're exploring this, a lot of us are thinking, well,
people aren't in prison for good behavior. No one has
(24:01):
ever helped an old lady across the street so many
times that they got put in jail, you know what
I mean. You don't go there for being an honors student.
In terms of like civic mindedness, so there's this kind
of callous or colder argument that says, well, why should
we take care of these people if they are a
(24:22):
detriment to society? Because of that attitude or because of
that you know, that school of thought, it's very difficult
for politicians to argue in favor of advocacy for people
who have medical conditions while they are incarcerated, you know
(24:42):
what I mean. Like back in the eighties especially, it
was political suicide to say we should still treat human
beings as humans, because then it would be immediately equated
with being quote unquote soft on crime. And another difficulty
(25:02):
there a twists there is that it's very difficult in
many cases for felons to vote. So until the demographics
that are far more likely to get arrested and far
more likely to serve longer sentences are voting in larger
proportionate numbers, then politicians aren't going to go out of
their way to be I mean largely. It's true. It's
(25:24):
sad and it's kind of disgusting, but they're not going
to go out of the way to represent someone who
they don't see as capable of handing a benefit to them.
I mean, it's a huge downfall of our species, right,
everything is quid pro quo and stuff you should Know
has a great episode about how altruism doesn't really exist,
but no one wants to hear that.
Speaker 2 (25:45):
That's depressing, right, yeah, So well, really fast, I just
want to talk about something with you guys. Something I
don't know if this even really fits in the show,
but something I think we can apply to this is
the fact that unless you have experienced something in your life,
or you know someone directly who has experienced something, it's
(26:05):
very difficult to have true empathy about a situation. And
I take this to the concept of quitting smoking or
attempting to quit smoking. Now, just hear me out really fast.
For a lot of people who have never been addicted
to something like nicotine and attempted and failed to quit
(26:26):
that substance or something like that, a lot of people
will have, at least I've noticed in my experience very
negative thoughts on alternatives to quitting smoking even or you know,
other things like that, Like they have an immediate negative
reaction to something like that unless you are someone who
has actually attempted and failed to do something like quitting smoking,
(26:50):
And so I wonder if it's the same thing with
the prison system and a lot of these other things
where unless you have that direct experience with it, it's
very difficult to even see it outside of the negative
context which has already built up around it societally experiential knowledge.
Speaker 1 (27:06):
Right, like the uh like how the stem cell conversation
changed when people who were politicians opposed to stem cell
research realized the benefits it could have for people that
they personally knew.
Speaker 2 (27:19):
Right, Yeah, I mean I think so, I mean even
the CBD oil, Yes, absolutely, you know, I.
Speaker 1 (27:26):
Think it's it's weird because here in here in Georgia, Atlanta, Georgia,
where we record this podcast, uh one, regardless of where
you fall in drug criminalization. Uh. I thought it was
hilarious when we had some we had some politicians when
the CBDU the Medical Medicinal CBD Bill or whatever was called,
(27:49):
was first past, the politicians who approved of it spent
the majority of their time assuring everyone that no one
would enjoy it. I don't worry. No one is gonna
have fun. This is just for people with epilepsy.
Speaker 2 (28:04):
So you're sure you cannot get high.
Speaker 1 (28:06):
If I thought people would have anything like a good
time on this, I would be burning down the capitol.
You know what I mean. I'm still mad that people
Fox trot.
Speaker 3 (28:17):
He is burning down the capitol. When you smoke a
bunch of weed in the capitol, Uh.
Speaker 1 (28:21):
Little known fact. Yeah, it's part of the that's part
of the Georgia congressional slang.
Speaker 3 (28:28):
They say their prayer and then they spark up a doobie.
Speaker 2 (28:32):
Yeah, guy Fox, I don't know if you remember him.
He thought that barrel was actually full of doobies.
Speaker 1 (28:38):
Yeah no, yeah, yeah, yeahah yes and right. So the
the reason the politics matter here, the reason they're so fundamental,
is because this means that exkews the budget allocations for
(28:58):
a lot of jails and pin tentries. You want to
spend a lot of money securing the place, right, making
it hard to walk out of. But why would you
spend money on healthcare, especially if it means you could
be accused of going soft on crime. This problem is
exacerbated in jails that are in rural or poor counties,
(29:22):
which happens a lot. Jails will tend to be in
rural and poor counties because they can be advertised as
a source of jobs right for an ailing community. So
administrators complain, you know, they say, look, I don't have
the resources. I can't make the numbers work. How am
I supposed to hire, train, and supervise doctors and nurses
(29:44):
right like GPS, let alone specialized medical care? Like, what
what on earth am I going to be able to
do to incentivize a medical health professional to work with me?
I certainly can't pay her or him as much as
they can make in the private sector, So increasingly they
(30:06):
turn to for profit companies. And this is a field
of healthcare that a lot of people have probably not
heard about. I don't know if any of us heard
about it beforehand. I certainly didn't. Correctional health care, so
think of like blue Cross, Blue Shield, just for people
in lock up. They pledge to deliver quality care, while
(30:29):
very very attractive to administrators, containing cost. It's part of
a trend that started back in the nineteen eighties during
the Reagan administration, where the idea was that in general,
we will start to privatize things. We as a country
in general will privatize things because we'll be cutting the
(30:50):
fat and having cost as the Having costs as the
bottom line will encourage more nimbles, slimmed down and more
efficient operations. This trend accelerated after the nineties, right when
we had a ton of tough sentencing laws like mandatory
sentencing and stuff. The Violent Crime Control Law Enforcement Act
(31:14):
nineteen ninety four made the number of people in jails
and prisons jump from about three hundred thousand to more
than two million today. Yeah so.
Speaker 3 (31:27):
According to a twenty eighteen study from the Pew Charitable Trusts,
more than half of the states hire private companies to
provide at least some of that prison healthcare services. Those
prison healthcare services the companies they negotiate these multi year
contracts with each jail and prison that they serve. Medical
staff and prescription drugs, and outside services such as hospital stays,
(31:50):
constitute the bulk the line to share of these costs. Oftentimes,
the companies receive a per day, per individual rate, so
profits depend on keeping costs below that amount. Sometimes contracts
include provisions that increase a company's potential profit if it
holds down transfers to hospitals or to other outside providers. Ben,
(32:12):
can you help us unpack this because I don't know
about you, but this seems a little on the shady side.
Speaker 1 (32:17):
For sure, your spider sense is correct. Sometimes this stuff
can get lost in the legal language. But this is
a very important turn in the story here. The companies,
these private health providers for prisons have negotiated these things
(32:38):
that say, look, we will make more money if everyone
is and this is just for sake of argument. If
everyone is limited to four hundred dollars a day, the
medical care for all these inmates is four hundred dollars
per person per day or less, and as probably is
less than we will make another profit. Furthermore, if x
(33:07):
number of people or less than that go to a
hospital per year or to a specialist off site, then
we'll make another We'll make another windfall, another bonus. So
we know that private health insurance follows the same thing.
It's not a new game, right. They want to avoid
unnecessary tests and procedures. You probably hear that a lot
(33:30):
back in the old death panel argument days. But this
is very important. This means that if someone in jail
or in prison believes that their health or even their
life is in jeopardy. They can't do what any of
us do. They can't just call nine to one one.
They can't, you know, they can't play the great medical
(33:51):
debt game that's killing this country and pay eleven grand
for an ambulance over time. Instead, they have to hope
and pray. If they are the religious type, that someone
in the prison believes that they are exhibiting the signs
of a stroke and they have to hope and pray
that it's a minor stroke, or they have to hope
and pray that the diabetes doesn't catch up to them
(34:15):
and they get some help before they go into insulin shock.
There are no comprehensive statistics about the prevalence of private
healthcare companies in jail, and that makes sense because why
would you want people to know that outside of maybe
a trade show where you're pitching to a warden. There
you go, well, we do have some stuff. We know
(34:36):
that the National Commission on Correctional Healthcare has accredited these
programs around the country, and seventy percent of the jails
it inspects outsource their medical services and when they outsource.
These for profit companies have a pretty big chunk of
those contracts.
Speaker 2 (34:58):
Oh boy, So let's get into what we know about
some of this stuff. Just it's gonna get even deeper
and darker. After a quick word from our sponsor, we're back.
Speaker 1 (35:15):
So we've been talking in general terms about private companies, right,
private healthcare companies. But let's name a few because we
have some names.
Speaker 2 (35:25):
Right. So we've got at least one big one, and
it used to be called Correct Care Solutions, and that's
the one that I had heard of before, but it's
now called well Path. And there's also Corizon Health. It
looks like Horizon but with a C. Those are two
of the bigger players.
Speaker 3 (35:42):
Is that like a kronat kind of Yeah?
Speaker 2 (35:45):
Okay, so it's on the horizon, but it's correction. It's
the Correction Horizon of health.
Speaker 1 (35:51):
It used to be called Correctional Medical Services Incorporated, and
then before that it was Prison Health Services Incorporated. Kind
of like Backwater or Academi or EXE. Just changed up
a little bit, Just change the names. It'll be fine,
it'll be grand. What an adventure.
Speaker 2 (36:09):
Yeah, well, there's a reason why those names changed. Just
like you said with Blackwater, well, with Blackwater, it was
about public perception, right with some scandals that were occurring.
When we say scandals, we mean pretty much murder that
was occurring. With these companies, it's because they've been sued
a lot. The two of them together combined have been
(36:30):
sued about fifteen hundred times in the past past five years,
and a lot of those were over, you know, accusations
of things like neglect and malpractice and in dozens of
cases even wrongful injury or up to death. Carizon, one
of those companies, was the defendant in more than one
thousand cases, so of those fifteen hundred.
Speaker 1 (36:52):
And it's interesting because Karison cares for about one hundred
and eighty thousand people day to day. Well Passed, in contrast,
handles about two hundred and fifty thousand people day to day. Wow.
Representatives for both companies say, well, these lawsuits are often flimsy, frivolous,
or inconclusive, and we know, you know again, people aren't
(37:16):
in jail or prison for being on their best behavior.
From what we understand, the vast majority of people are
inmates are just trying to get through their time and
get out and the other side of the bars gives
us a different perspective. The prison guards can assure us
(37:37):
that there are multiple people who do have mental health problems.
You know, they're flinging pooh. Maybe there's some people malingering,
which means faking an illness simply to change up their
routine to get out somewhere, you know what I mean.
But be that as it may, it doesn't negate the
fact that these cases of wrongful injury or death have
(38:01):
been decreed. Legitimate public interest lawyers have brought class action
suits alleging inadequate healthcare across the entire system. There are multiple,
multiple examples of this, unfortunately some which end in death.
But we've got let's just do one example from Arizona.
Speaker 3 (38:21):
So in Arizona, civil rights groups filed a class action
suit in twenty twelve. A year later, after the state
passed legislation privatizing prison healthcare, it signed a contract with
Coruson to provide medical services in those prisons. Then, in
twenty fifteen, a federal district court that sought to resolve
(38:42):
the suit approved a settlement in which the state pledged
to overhaul its care. But last June, Judge David Duncan
found that quote, widespread and systematic failures remain end quote
and held the state in contempt, issuing it fines of
more than one million dollars.
Speaker 1 (39:04):
And that's interesting because when they're defending themselves, the private
prison insurance companies will say that part of their contract
indemnifies the state or you know, the party from the
government that they're contracting with, indemnifies them from legal costs.
(39:28):
But in the case of Arizona, the judge wasn't having
it and essentially said, no, don't put this on them.
You're the ones who agreed to let this happen. In
the meantime, by the way, while these things are winding
and wending through the court system, people are dying, you know,
and many of whom committed crimes. But the ones who
(39:49):
are dying were not sentenced to the death penalty. And
the question then becomes, is this sentencing people to death?
Which I know is a really messed up way to
look at it, but it's not unfair. According to Steve Cole,
a journalist wrote an excellent article for The New Yorker
in twenty nineteen, evidence from cases across the country suggests
(40:09):
that four decades of policy failures in both healthcare and
criminal justice reform have left a largely neglected population vulnerable
and at times at risk, and that for profit companies,
which were promoted as a solution have instead become an
integral part of a troubled system. They were supposed to
fix it back in the eighties, and all they did
(40:30):
was fix their profit margins.
Speaker 2 (40:32):
Yeah, and now it's become too big to fail in
a way you can't really remove it.
Speaker 1 (40:36):
It even goes even goes down to the food, right,
because we joke about food all the time. But food's
part of your health.
Speaker 2 (40:44):
It's a massive part of your health. Yo, are what
you eat, buddy, And it really is like the simplest
thing to say that. My wife, My wife and I
have an ongoing joke argument about that about how important
your food is. She likes to eat a lot more
healthy than I do. And I just like the good
(41:06):
tasting stuff, you know, you know.
Speaker 1 (41:08):
Stuff that you evolved to seek out, right.
Speaker 2 (41:12):
Yeah, the sugar, salt, yeah, mostly the fats, like the bacons.
Speaker 3 (41:17):
You also like the heat, though, don't you.
Speaker 2 (41:18):
Man, Yeah, give me the spicy bacon.
Speaker 3 (41:20):
You're a spicy boy.
Speaker 2 (41:21):
I'm good to go. But yeah, it's just one of
those things where it is true, if you're eating more
healthy or getting more nutrients, you are in a better
spot for all the other stuff and you're not going
to have as many issues, at least theoretically. But we
got a caller, someone a listener called in from Alabama
and told us about this story where there was a
local sheriff's office that was getting they would make money
(41:45):
off the top of whatever money they didn't spend on
food for the prison system within the county. And we
haven't looked into it fully yet. We do have a
story here from NPR about if sheriff in Alabama that
the caller was mentioning he took almost a million dollars
seven and fifty thousand dollars legally. He took this money
(42:10):
to buy a beach house. Money that was meant to
feed inmates within his county.
Speaker 1 (42:15):
Yeah, Atawa County, SHAREFF Todd intrickin Todd, if you're listening,
I hope you enjoy your beach house. What Todd did
was pocket this, you know, seven hundred and fifty large
that was supposed to feed inmates of the jail that
he supervised. Then, according to the Birmingham News, he used
(42:38):
the money that he pocketed or the majority of it
to buy a beach house. Because Alabama has this law
that allows sheriffs to quote keep and retain unspent money
from jail food provision accounts. So sheriffs across the state
of Alabama take the money as personal income.
Speaker 3 (42:57):
Like a bonus. Yeah, for like doing a good job,
because they had like a surplus.
Speaker 1 (43:02):
Kind of Well, it's not attached to doing a good job.
It's just a I mean, if the good job is
defined as taking less money to feed people, then they
can take it. There. It goes both ways, though. People
are quick to point out if they have a shortfall
in the budget in that regard, then the sheriff as
an individual's personally held liable for covering the gap. But
(43:26):
turns out that they don't really go out of their
way to spend that much on feeding their inmates.
Speaker 2 (43:32):
Yeah, that's really depressing and messed up sheriff.
Speaker 1 (43:37):
Also, we don't know how many people are doing this,
because sheriffs across the state apparently have done this for
a long time. That law dates back to the Depression,
and according to the Southern Center for Human Rights quote,
it is presently unknown how much money sheriffs across the
state have taken because most do not report it as
income on state financial disclosure forms.
Speaker 2 (44:00):
Yeah, so you're not required to specify any money that
you take in in this way above two hundred and
fifty thousand dollars a year. And he brought in seven
hundred and fifty.
Speaker 1 (44:12):
We have to wonder what they're what they're eating.
Speaker 2 (44:16):
You know.
Speaker 1 (44:17):
It makes me think of do you guys remember the
controversy of neutral loaf? Do you remember hearing about that?
Speaker 3 (44:25):
Yeah? I do. It was like a food substitute, kind
of like soilent green.
Speaker 1 (44:29):
Yeah, kind of. It's like the the Okay, you know
that there's meat loaf, there's neutral loaf, which is also
called meal loaf because it is it's this unholy amalgamation
of vegetables, fruit, meat, bread, other grains baked into a
(44:51):
solid loaf. The ingredients vary, but there is something called
dairy blend.
Speaker 3 (44:57):
Sounds like fruitcake to me, but.
Speaker 1 (45:00):
With fruitcake they at least keep the shape of the
fruits right in there.
Speaker 2 (45:04):
Yeah.
Speaker 3 (45:04):
Well, they dice and kind of like also candied and
gummy looking.
Speaker 1 (45:10):
But they're identifiably fruit, right. I see what you're saying.
Speaker 3 (45:13):
This is just like ground into a pulp into a
paste and then that's baked into kind of this amalgam
of god knows.
Speaker 1 (45:20):
What, right, yeah, oh god, And that one even went
to court several times. In a case called Gordon versus Barnett,
the District Court for the Western District of Washington ruled
that someone got all the way to court arguing that
eating neutral loaf was cruel and unusual punishment. And although
(45:41):
the court ruled that it was not cruel and unusual,
it was a punishment and that prisoners should be entitled
to due process before they have to eat it. It's
so bad that you have to get like the law
involved for you to be forced to eat this, at
least according to that judge.
Speaker 2 (45:58):
Geez, just a just to jump back in this, I'm
reading a little bit further down in the article. It
gives a little more context to this. So apparently this
sheriff and how did we say it in and tracing
entricn entrican.
Speaker 1 (46:14):
Like the demon, he's in Albata.
Speaker 2 (46:16):
Oh that's ooh, that's really cool. So yeah, so he's
in Alabama's he's Entrican. So when he came into office,
the previous sheriff died while he was in office. Okay,
and this this money, this money that's meant for inmates
for food, that account got drained and it was given
to the family of that sheriff that just passed, and
(46:39):
that was about one hundred and fifty thousand dollars or
something to that effect. All that money was taken out.
So then this current sheriff had to take out a
personal loan one hundred and fifty thousand dollars just to
keep the inmates fed. And he was paying off that
for years and years and years. So it is interesting
how the tides kind of turned with him having to
(47:00):
take out this initial loan to him getting a beach
you know, a beach house, and then ultimately owning property
that's worth over one point seven million dollars through you know,
all these various things that's he and his wife. And
then also the fact that he makes about ninety three
thousand dollars a year as the sheriff of a county,
just base level, base level, and then he's able to
(47:20):
make the bonus essentially on this one account that is
directly tied to the food that would go to inmates.
That is puzzling and strange, and I will never fully
understand that.
Speaker 1 (47:31):
And it is legal, it is completely not against the law, yepet.
So this this is such a brief look, but it
leads us to the question what is to be done.
The problem comes down to profit, but it also comes
down to accountability. Right the healthcare providers say, you know, again,
we take care of the legal cost in many cases.
(47:54):
But also this is a ten billion plus dollar industry
and those companies are obligated to seek profit on behalf
of their owners. According to David Fothy, the director of
the National Prison Project at the ACLU American Civil Liberties Union,
these companies have compelling incentives to cut costs and staff,
(48:17):
and that can result to denying care. And what is
literally and I don't know if he was going for
a pun here a captive market like they can't they
cannot switch insurance providers, right, They can't say, well, this
doctor stinks and they misdiagnosed my appendicitis and I almost died.
I want someone else, and they'll say, no, sorry, you're
(48:40):
gonna have to stick with this person for at least
the next two to five years that you're locked up.
And Fathi says, you know, he says, I don't mean
to suggest that government run prison healthcare is perfect. It's
often appallingly deficient. But at least when the government is
providing the service, there's some measure of oversight, some measure
of democratic control, and a lot of people may say, well,
(49:05):
this is a rock and a hard place situation, because
neither is particularly great for people incarcerated. But then there's
something weird that we didn't talk about because of the
way that the law changed to guarantee. For much of
US history, the idea of prisoners receiving medical care was
just like bonkers, why would you do that? You know
(49:27):
what I mean. But as the law has changed, even
though the prison system is terrible for people who are
caught up in it, and even though it often increases
a person's chances of committing a crime or recidivism, which
is when they return to prison, inmates rights to healthcare
have actually expanded in comparison to the public the inmates.
(49:53):
The rulings that gave inmates a right to access to healthcare,
at least on paper, have never been applied to free citizens.
I want to say that one more time, inmates access
to a doctor, to healthcare have been guaranteed in this country,
at least on paper. If you are listening to this
(50:15):
and you are not in prison, in that regard, the
people incarcerated have more rights than you do.
Speaker 2 (50:24):
It doesn't. Yeah, Yeah, it makes you wonder. It makes
you wonder if sometimes it would be a better move
to do something to get incarcerated to get your health back.
If you're in a tight enough spot. That's scary to
think about. And I will have done that, That's what
I'm saying. I know it has been done. There are
(50:45):
specific examples, but just the fact that that is a
situation you could find yourself in in this country is
baffling and terrifying.
Speaker 3 (50:53):
And not even to mention that some people do it
just for shelter, sometimes on purpose.
Speaker 1 (50:58):
Yeah, yeah, it doesn't happen all the time, but people
do go to jail on purpose. Some people go to
bring in drugs from the outside one way or another,
probably ingesting it somehow right and then passing it. In
twenty twelve, a guy named Frank Morocco of Amherst, New York,
was unable to afford healthcare for a rare form of leukemia.
(51:21):
He was released from prison in twenty twelve. He had
been in jail for twenty years on felony drug charges.
So he's fifty six years old. So he went in
when he was thirty six. He had leukemi. He had
no way to pay for it. He had been incarcerated
for so long that he walked into a grocery store,
stepped up to the counter, just stole twenty three bucks
(51:43):
worth of goods in plain sight so that the employees
could see him, and then walked out. Got arrested on shoplifting,
which violated his supervised release, and he was hoping it
would land him back in prison so that he could
get some help with his leukemia.
Speaker 2 (52:01):
Did it work.
Speaker 1 (52:04):
It was not reported whether Morocco got the treatment, but
he was released from prison on the shoplifting charge in
April of twenty thirteen.
Speaker 2 (52:12):
Wow, well, I guess I hope he did. But again,
you know, this is such a tough topic because there really,
there really is such a range of humanity that exists
within the prison system, and just of you know, depending
on your sense of morality, it really affects the way
you're gonna feel about this. It really does. In the
(52:34):
In the end, every single person in a prison everywhere
is a human being that that, you know, and the
best of times and the best of idealism, they deserve
a shot at being healthy. But if that person has
you know, heard another in one way, or you know,
(52:55):
in one fashion or another, it's tough to it's tough
to stomach the thought of them getting better healthcare than
just someone who isn't doing so great financially outside of prison.
This is a really tough topic.
Speaker 1 (53:07):
It is it is. Let's also, I mean, let's take
a step further and say that one of the reasons
the prison system in the US has so many problems
is that it is not a program meant to rehabilitate
people in along in many ways.
Speaker 2 (53:23):
Makes me think about that Sicko documentary from several years back.
Speaker 1 (53:28):
And we want to hear your take. Thank you for
taking this strange journey with us. What role do you
feel private, private medical care or private medical provider should
play in the US prison system? Is this is this
something that people incarcerated, you know, somehow deserve, you know?
(53:51):
Is is that just part of the risk that they
knowingly or unknowingly took when they committed a crime? How
how would it be a I'm sure we have several
people who are saying, right now, you know that I
pay my taxes, I pay a lot right and I
still struggle to pay my own medical bills. Why should
(54:14):
this be better for someone else didn't, who didn't obey
the rules of our land. And we don't want to
say it's necessarily better because I think, as we've illustrated here,
people are dying from easily preventable conditions in prison exactly.
And that's our classic episode for this evening. We can't
(54:34):
wait to hear your thoughts. We try to be easy
to find online.
Speaker 3 (54:37):
Find this at the handle Conspiracy Stuff, where we exist
on Facebook X and YouTube, on Instagram and TikTok. We're
conspiracy Stuff.
Speaker 2 (54:44):
Show call our number. It's one eight to three three
std WYTK. Leave a voicemail and.
Speaker 5 (54:50):
If you have more to say, we can't wait to
hear from you at our good old fashioned email address
where we are conspiracy at iHeartRadio dot com.
Speaker 2 (55:17):
Stuff they Don't Want You to Know is a production
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Ben Bowlin
Noel Brown
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