May 8, 2019 • 54 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):
From UFOs to psychic powers and government conspiracies. History is
riddled with unexplained events. You can turn back now or
learn the stuff they don't want you to know. A
production of I Heart Gradios How Stuff Works. Hello, welcome
(00:25):
back to the show. My name is Matt. They called
me Ben when we're joined with our super producer Paul
Michig control decond. 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,
(00:47):
we're getting to a point where 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 that's a fun listen, right right. Yeah,
we're We've got stuff unicorns don't want you to know
on the slate. Okay, yeah, Well it's weird because I
(01:09):
was thinking I was reading something about unicorns. Oddly enough,
now that you mentioned this, where wherein someone who was
a zoologist of some sort or 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.
(01:29):
It's very similar to rhinos. So unicorns, if they did exist,
would probably be belligerent, antagonistic animals, capable of great violence.
They'd be and that's something unicorns don't want you to know.
That's not profile. Yeah, exactly. All the glitter and all
the shin nous and their weird thing with virgins. Have
you seen that movie Legend with very very young Tom
(01:52):
Cruise and a very awesome Tim Curry, very awesome Tim
Curry wearing a giant rubber satan suit, and there's a
whole thing where they like the unicorns play a big
part of that, very very important. There's also the animated
The Last Unicorn, which is really sad. Yeah. Yeah, I
was thinking about the Bree Larson, her directorial debut, something
about the Unicorn Store, something to that. If it's Netflix now,
(02:15):
it does not seem to have anything to actually do
with unicorns. Just putting that out, Well, thank you guys,
you've saved me a few hours. It has absolutely nothing
to do with unicorns, the healthcare in the prison systems.
So the US health care system is by any measure,
matter how you look at it, no matter what your
opinion is, and everybody has opinions about this, By any measure,
(02:36):
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 to very very impoverished countries so much
as in comparison to other countries we would consider pure
countries economically, right, And there's the one we all agree
(03:00):
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 the fact that there is a ton of
money wrapped up in this issue. Uh, doctors make a
ton of money, hospitals, of course, Insurance companies make tons
of money. There's a lot writing on this, and that
(03:21):
means there's also extensive propaganda and play. We'll hear some
people say, well, the entire problem with US healthcare is
that it is 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,
(03:44):
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 not honest, red blooded American business. It's that
the government is involved. And every time Uncle Sam is
involved in some thing, uh, it's gonna be ruinous because
the government is inefficient and corrupt. Sometimes that's a sincere argument.
(04:07):
Sometimes it's a Star of the Beast argument. Depends on
where you hear about. And today's episode is not about
that cartoonishly tragically comic 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 get sick or
(04:28):
ever needs some sort of medical treatment. Healthcare in prison.
Yeah to two things you don't wanna 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
U S population in general. As of the population in
(04:49):
this country was three hundred and twenty seven point two
million human beings. Twenty eight point seven percent of the
population is under the age of eighteen, so you know,
it's almost a third of the people are very very young.
About fifteen point six of the population is over the
age of sixty five. And then that leaves the people
(05:10):
who are not miners, you know, who are eighteen and
they're also not they're above eighteen below senior citizen, which
are going to be the primary, the primary age range
for people who are incarcerated, right right, the regular, the
regular Joe's and james. Uh. This is interesting that fifteen
point six percent number for elderly and senior citizens makes
(05:34):
sense because, due in large part to the way the
health care system here does or does not work, we
have a disturbingly low life expectancy compared to other what
are called first world countries or other developed countries is
a better phrase. So that's that's the population by the numbers.
(05:54):
What about what about the medical stuff? Do we have
any stats for that? Yeah, So the US spend is
way more on healthcare than any other nation on this
here globe UM ten thousand dollars per person, which amounts
nearly eighteen percent of g d P, which seems bonkers
(06:14):
to me. Um. Government funded Medicare and Medicaid account for
more than a dollar of every three dollars of US
healthcare spending, and a dollar every four dollars in the
federal budget. The entire federal budget, which we know is
a is like seems like one of those imaginary numbers,
you know, the trillion. Yeah, it's largely. It is largely
(06:35):
a series of which is promises, increasingly ambitious pitches I
was gonna say from Congress. And and it's been growing, right,
it's been growing Medicare at least at more than twice
the rate of inflation. It's forecast to accelerate as what
we call the baby boomer generation ages ages increasingly into
(06:55):
that elderly demographic. So that's one thing upon on which
we cannot blame millennials. Sorry, I know some of us
in the audience dig that. But and then that's just
for Medicare. That's that's the part that the government helps
out with, right, And that's for people who do have Medicare,
you're considered to have healthcare. There are a lot of
(07:16):
other healthcare comes from employers, kind of like what we
have sitting in this room, including Mission Control, over there.
You're absolutely right, matt Um. 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
(07:38):
this before in previous episodes. The concept of taxis, the
concept of taxation is at heart in a very oversimplified way,
it's the same thing as paying dues to a club,
country club perhaps, sure, a country club, um, a chess
(07:58):
club that has a nice HQ if they have those.
The the ideas you you pay into this thing, and
because you've paid into this thing, you get certain rights.
So you're a country club of golf club whatever. Uh.
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
(08:19):
you pay taxes here in a country, then those taxes
should guarantee some of your rights, guarantee some maintenance. Uh.
And then arguably they could be in a situation where
they pay to 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. Uh.
(08:41):
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 calends or year.
And then there's Medicaid nineteen point four percent, Medicare sixteen
point seven, 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
(09:03):
to do it through things like Cobra right, or military
coverage four point six. You're gonna 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
have cancer, although that still happens. But this number doesn't
answer everything, because despite all these different kind of partial
(09:24):
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. Yeah.
Eight at least that's of as of right that number.
That number may have gone up or down a little bit,
(09:45):
but it hasn't moved a ton yet. It may very
well in the in the near future, in the next
three ten years. Right. Not to mention the fact that
I don't know how this figure is in 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 incarceerate an individual.
(10:10):
It's like taxpayer money. So it's just crazy to me, like,
if we're paying that much to incarcerated person to get
people outside of the prison system, we wouldn't even consider
spending that much on them and their well being. It
is it is cheaper, or it has been for a
number of years. It is cheaper for the United States,
(10:33):
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. Then it is to incarceerate them.
And that's something I learned via a little wane originally
true story, but yeah, but it's true. It's it's we
(10:55):
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 which is a little bit
of a simplified way to 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 gonna say they lock up tons of people, and
(11:17):
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 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 and twenty
(11:38):
two countries tracked by the Institute for Criminal Policy Research,
and that is such a large net to cast the
i c PR study right now, the u n doesn't
recognize two and twenty two countries, so they gave everybody
a chance. This country locks up a half million more
(12:01):
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. Twenty Yeah. It's worse though,
because the statistic that follows right after, we're only five
(12:23):
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. Yeah, okay, so what was it we said,
three d and twenty seven something million people in the
United States. Well, the American criminal justice system holds within
(12:44):
it incarcerated human beings two point three million people. That's crazy.
There are and it holds them in over seventeen hundred
state prisons. There are a hundred and two federal prisons,
and then eighteen over eight hundred juvenile correctional facilities. Then
there are also like that. Okay, and that's just starting right.
(13:05):
Then you go down another level. You get to the
local jails that wouldn't even be really called a prison,
just a jail holding cell kind of thing. There are
three thousand, one hundred and sixty three of those, and
there are also eighty Native American like they're called Indian
country jails. Um, well that's not even talked, dude. We're
not even thinking about military prisons, the brig Yeah, and
(13:27):
the the detention facilities like immigration facilities, the bizarre and
labyrinthine network of detention centers for ice. Yeah, that's that's
that's a whole one that our conversation there, one of
which was famously until quite recently a series of fences
set up under a bridge. Yeah. Uh, civil commitment centers,
state psychiatric hospitals, which are still around, mostly privatized, but
(13:51):
still exists to some degree. You can be held without
against your will in those facilities and prisons in US
territories which occupy and even or uh murky legal space,
including Guantanamo, including Guantanamo. Yeah, every year, six hundred and
twenty six thousand people walk out of prison, but they
(14:14):
go to jail ten point six million times each year.
Jail in prison are as as many people will, as
many people attest. Jail in prison are two very different beasts.
Jail churn is pretty high because most people in jail
have not been convicted. They're just waiting. Yeah, they've been arrested.
(14:36):
They're desperately using that um that trope and fiction. There
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, uh, justice is
a slot machine that only takes dollars. So if jail
(14:57):
is like a holiday, in prison is like a living
community of some kind like like an apartment building. Yeah yeah,
so 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,
(15:18):
There's somebody who is arrested for something, maybe it's a
case a wrong place, wrong time, but they can't make bail,
and so they're in jail for what months, and then
they go to trial and the judges like, who is
this guy? Not to mention there in jail because they've
done something, and then they can't make bail, so then
they lose their jobs because they're sitting in jail, and
(15:39):
it just creates this cycle of being able to not
afford anything that the system voice 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 your job and become unemployable again probably
another conversation, but it's it's a problematic cycle, and it's
this number might surprise from folks. Met You recently gave
(16:01):
us the statistics of some people in jail, but of
those people in jail, only about a hundred and fifty
thousand or so on any given day have actually been convicted,
and most of them, uh to take your holiday in
comparison are ear the apartment comparisons. They're they're generally serving
sentences that are less than a year, and almost half
(16:23):
a million people are locked up purely because of drug offenses.
So mainstream media, right, we all, we all know and
love our favorite fiction films and stories, often depicts the
incarcerated population in some in some wild extremes. Right there,
there there two or three big stereotypes we see people
(16:45):
incarcerated there. I 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 like absolute
suicide squad level monsters and the state is being too
(17:08):
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 been?
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 on the inside is
(17:30):
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. 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
(17:51):
that show. It's it's super great. It does 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 ground in reality, sort of a
harbinger of the gritty realism of Orange is the New Black. So,
(18:16):
regardless of uh, 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 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
(18:38):
continue inside the walls of penitentiaries, their gangs everywhere. People
love all the vices still, you know what I mean, drugs,
sensual pleasure, old fashioned violence, and the chances of that
kind of violence are always somewhere in the cards. But
the activist policymakers and others, there is another criminal in
(19:00):
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 O. J.
Simpson level trial, right, No, you would see them in
the ads in between those programs. That's right, we're talking
about insurance companies. Wait, our insurance companies criminals. You might
(19:22):
be saying, kind of, let's have a word from our sponsor.
Here's where it gets crazy. So well, let's call this
part healthcare, profit and public perception. In the Bureau of
(19:45):
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 as bipolar disorder. And again, as
we as we noted with jail, many of the people
(20:07):
in jail are just waiting their churning through. They haven't
been convicted and sentenced to their you know, to that
misdemeanor that's less than a year. But in the same year,
the Bureau reported that about two thirds of sentenced inmates
in jail suffer from drug addiction or dependency, and that
(20:29):
that conclusion they made this is the scary part. It
comes from numbers pulled in two thousand and seven to
two thousand and nine, which means that largely does not
account for the opioid crisis. Wow. Yeah, Wow, that's ah,
that's tough. Well, well, here's the other thing. So you've
(20:51):
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 some I
don't I don't know, recovery, physical recovery from and work on.
(21:13):
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. Uh, and
then also you know, having to deal with the mental illness.
It all kind of just adds up into this pretty
(21:35):
brutal thing where you're gonna be probably experiencing withdrawal symptoms,
especially early on in your situation there. Um So, like
I guess the first year of prison, which is what
you're saying, a lot of people actually only spend about
a year and there it can be extremely rough on
your health. Oh yeah, absolutely. I mean imagine if you are,
(21:57):
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 titles up to you, maybe in the yard,
and says, hey, I can help you out if you
do something for me. Dangerous times right, And now, yes,
(22:22):
we can take a moment to talk about the politics here,
because I'm sure as we're as we're exploring this, a
lot of us are thinking, well, people aren't in prison
for good behavior. No one has 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
(22:42):
go there for being an honor student in terms of
like civic mindedness. So there's this kind of callous or
colder argument and says, well, why should we take care
of these people if they are a detriment to society?
Because of that attitude, Because of that, you know, that
(23:04):
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 what I mean. Like
back in the back in the eighties especially, it was
political suicide to say we should still treat human beings
(23:27):
as humans, because then it would be immediately equated with
being quote unquote soft on crime and the Another another
difficulty 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
(23:51):
larger proportionate numbers than politicians aren't going to go out
of their way to be I mean, largely, it's true
it's sad and it's kind of disgusting, but they're not
going to go out out of the way to represent
someone who they don't see as capable of handing a
benefit to them. I mean, it's huge downfall of our species. Right,
(24:13):
Everything is quid pro quo and stuff you should know
as a great episode about how altruism doesn't really exist,
but no one wants to hear that. That's depressing, right, Yeah,
so well it really fast. I just want to talk
about something with you guys. Uh, 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
(24:33):
that unless you have experienced something in your life or
you know someone directly who has experienced something, it's very
difficult to have true empathy about a situation. UM. And
I take this too to the concept of quitting smoking
or attempting to quit smoking. Now, just just hear me
out really fast. For a lot of people who have
(24:55):
never been addicted to something like nicotine and attempted and
fail to quit that substance or something like that, UM,
a lot of people will have, at least I've noticed
in my experience, UM, very negative thoughts on alternatives to
quitting smoking or even or you know, other things like that. Um, like,
(25:17):
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, 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 is already
(25:37):
built up around it societally experiential knowledge, right, like the
like how the stem cell conversation changed when people who
were politicians opposed to stem cell research realized that benefits
a good have for people that they personally knew, right, Yeah,
I mean I think so, I mean even CBD oil, Yes,
(25:58):
absolutely know. I think it's it's weird because here in
here in Georgia, Atlanta, Georgia, where we record this podcast,
uh one, were regardless of where you fall in drug criminalization.
I thought it was hilarious when we had some we
had some politicians when the CBD UM the Medical Medicinal
(26:22):
CBD Bill or whatever was called, was first past, the
politicians who approved of it spent the majority of their
time assuring everyone that no one would enjoy it, Like,
don't worry, no one is gonna have fun. This is
just for people with epilepsy, So you're sure you cannot
get high. If I thought people would have anything like
(26:44):
a good time on this, I would be burning down
the capital, you know what I mean? Like, I'm still
mad that people foxtrot is burning down the capital. When
you smoke a bunch of weed in the capitol a
little known fact. Yeah, and it's part of the that's
part of the Georgia congressional slang. They say their prayer
(27:05):
and then they spark up adobie. Yeah, guy Fox, I
don't know if you remember him. He thought that barrel
was actually full of doobies. Yeah, yeah, yes, and right.
So the the reason the politics matter here, the reason
(27:25):
they're so fundamental, is because this means that excuse the
budget allocations for a lot of jails and penitentiaries. You
want to spend a lot of money securing the place, right,
making it hard to walk out of. But dude, why
would you Why would you spend money on healthcare, especially
(27:48):
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, which happens a lot. Jails
will tend to be in role 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,
(28:10):
I don't have the the resources. I can't make the
numbers work. How am I supposed to hire, train and
supervise doctors and nurses right let it like GPS lettle
them specialized medical care? Like what what on earth am
I going to be able to do to incentivize a
(28:31):
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 turned 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.
(28:51):
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 very very attractive
to administrators, containing cost. It's part of a trend that
started back in the nineteen eighties during the Reagan administration,
(29:14):
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 fat and having
cost as the having costs is the bottom line will
encourage more nimble, slimmed down, and more efficient operations. This
(29:35):
trend accelerated after the nineties, right when we had a
ton of uh tough sentencing laws like mandatory sentencing and stuff.
The Violent Crime Control Law Enforcement Act made the number
of people in jails and prisons jump from about three
(29:55):
hundred thousand to more than two million today. Yeah so,
according to a study from the Pew Charitable Trusts, more
than half of the state's higher private companies to provide
at least some of that prison healthcare UM services. Those
prison healthcare services the companies they negotiate these multi year
(30:17):
contracts with each jail and prison that they serve, medical
staff and prescription drugs, and outside services such as hospital
stays UM 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
(30:37):
that amount. UM. Sometimes contracts include provisions that increase a
company's potential profit if it holds down transfers to hospitals
or to other outside providers. Ben, can you help us
unpack this because I don't know about you, but this
seems a little on the shady side. For sure, your
spider sense is correct. Sometimes, um, this stuff can get
(30:58):
lost in the legal language. But this is a very
important turn in the story here. The companies, these uh
private health providers for prisons have negotiated these things that say, look,
we will make more money if everyone is and this
(31:19):
is just for sake of argument. If everyone is limited
to UH 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 as less than,
we will make another profit. Furthermore, if UH x number
(31:42):
of people or less than that go to a hospital
per year or to a specialist off site, then will
make another will make another windfall, another bonus. So we
know that private health insurance follows the same thing. It's
not a it's not a new game, right. They want
to avoid unnecessary tests and procedures. You probably hear that
(32:04):
a lot back in the old death panel argument days.
But this, this is very important. This means that if
someone in 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 one one. They can't you know, uh, they can't
(32:24):
play the great medical 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
(32:45):
they have to hope and pray that the diabetes doesn't
catch up to them 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
(33:05):
pitching to a warden. There you go. But we do
have some stuff. We know that the National Commission on
Correctional Healthcare has has accredited these programs around the country,
and seventy of the jails it inspects outsourced their medical
services and when they outsource, these for profit companies have
(33:28):
have a pretty big chunk of those contracts. Oh boy,
so let's uh, let's get into what we know about
some of this stuff. Um just it's gonna get even
deeper and darker. After a quick word from our sponsor,
(33:50):
we're back. So we've been talking in general terms about
private companies, right, private healthcare companies. But let's let's name
a few because we have some name tames. 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 Horizon Health. It looks like
(34:12):
Horizon but with a C. Those are two of the
bigger players. Is that like a chron nut kind of Yeah? Okay,
so it's on the horizon, but it's like correction. It's
the correction Horizon of health. It used to be called
Correctional Medical Services Incorporated, and then before that it was
Prison Health Services Incorporated. Kind of like Blackwater or Academi
(34:36):
or XE has changed up a little bit, just changed
the names. It'll be fine, it'll be grand. What an adventure. Yeah, Well,
there's a reason why those names changed. Just like you said,
like black Water. With Blackwater, it was about public perception,
right with some scandals that were occurring. And when we
say scandals, we mean pretty much murder that was occurring
(34:58):
with it. With these companies, these it's because they've been
sued a lot. The two of them together combined have
been sued about fifteen hundred times in the fast past
five years. And a lot of those were over you know,
accusations of things like neglect and malpractice and in dozens
of cases, uh, even wrongful injury or up to death. Carizon,
(35:20):
one of those companies, was the defendant, and more than
one thousand cases so of those fifteen hundred. And it's
interesting because Carison cares for about a hundred and eighty
thousand people day to day. Well Path, in contrast, handles
about two hundred and fifty thousand people day to day. Wow.
(35:41):
Representatives for both companies say, well, these lawsuits are often flimsy, frivolous,
were inconclusive, and we know you know again, people aren't
in jail or prison for being on their best behavior.
From what we understand, Uh, the vast majority of people
are inmates are just trying to get through their time
(36:01):
and get get out, and the other side of the
bars gives us a different perspective. The prison guards can
assure us that there are there are multiple people who
do have mental health problems. You know, they're they're flinging poo.
Maybe maybe there's some people malingering, which means faking an
(36:21):
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 have been decreed. Legitimate public interest
lawyers have brought class action suits alleging inadequate healthcare across
(36:43):
the entire system. There there multiple multiple examples of this,
unfortunately some which end in death. But we've we've got
let's just do one example from Arizona. So in Arizona,
civil rights groups filed a class action suit. In a
year later, after the state passed legislation privatizing prison healthcare,
(37:06):
it signed a contract with Corrison to provide medical services
in those prisons. Then, in a federal district court that
sought to resolve 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
(37:30):
remain end quote and held the state in contempt, issuing
it finds of more than one million dollars. And that's
interesting because the when when they're defending themselves, the private
prison insurance companies will say that part of their contract
(37:53):
and diemnifies the state or you know, the party from
the government that they're contracting, indemnifies them from legal costs.
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
(38:16):
and wending through the court system, people are dying, you know,
and many of whom committed crimes. But the ones who
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,
(38:38):
journalists wrote an excellent article for The New Yorker, evidence
from cases across the country suggests that four decades of
policy failures in both health care 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
(39:00):
a troubled system. They were supposed to fix it back
in the eighties, and all they did was fix their
profit marches. Yeah, and now it's become too big to
fail in a way you can't really remove it. It
even goes down to even goes down to the food, right,
because we joke about food all the time. But food
is part of your health. It's a massive part of
(39:20):
your health. You are what you eat, buddy. And it
really is like the simplest thing to to say that.
My wife, My wife and I have a an ongoing,
like joke argument about that about how important your food is. Um.
She likes to eat a lot more healthy than I do.
And I just I just like the good tasting stuff,
(39:42):
you know, you stuff that you evolved to seek out. Yeah,
the sugar, the fat, the salt, Yeah, mostly the fats,
like the bacons. You also like the heat, though, don't you. Man? Yeah,
give me the spicy bacon. You're a spicy boy. I'm
good to go. But yeah, it's just one of those
things where it is true, if you're eating more healthier,
getting more nutrients, you are in a better spot for
(40:04):
all the other stuff and you're not going to have
as many issues, at least theoretically. But we we got
a caller some when 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
off the top of whatever money they didn't spend on
(40:25):
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 a sheriff in Alabama that
the caller was mentioning he took almost a million dollars,
seven hundred and fifty thousand dollars legally. He took this
money to buy a beach house. Money that was meant
(40:47):
to feed inmates within his county. Yeah, Ottawah County, shareff
Todd entrickin Uh Todd, if you're listening, I hope you
enjoy your beach house. What Todd did was pocket this,
you know, seven fifty large that was supposed to feed
inmates of the jail that he supervised. Then, according to
(41:11):
the Birmingham News, he used 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 sheriff's across the state of Alabama take the money
as personal income like a bonus. Yeah, for like doing
(41:34):
a good job, because they had like a surplus kind
of Well, it's not attached to doing a good job.
It's just that 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
(41:56):
an individual's personally held liable for bring the gap. But
turns out that they don't really go out of their
way to spend that much on feeding their inmates. Yeah,
this that's really depressing h and messed up sheriff. Also,
we don't know how many people are doing this, because
sheriff's across the state apparently have done this for a
(42:18):
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 sheriff's across the state
have taken because most do not report it as income
on state financial disclosure forms. Yeah, so you're not required
to specify any money that you take in in this
(42:40):
way above two and fifty thousand dollars a year, and
he brought in seven. You have to wonder what they're
what what they're eating. You know, it makes me think
of do you guys remember the controversy of neutraloaf. Do
do you remember hearing about that? I do. It was
(43:01):
like a food substitute, kind of like soilent green. Yeah,
kind of. It's like the the Okay, you know that
there's meat loaf. There's neutra loaf, which is also called
meal loaf because it is it's this un unholy amalgamation
(43:21):
of vegetables, fruit, meat, bread, other grains baked into a
solid loaf. The ingredients vary, but there is something called
dairy blend. It sounds like fruitcake to me, but with
fruitcake they at least keep the shape of the fruits
right in there. Yeah. Well, they they're just cued and
(43:41):
kind of like all said, candied and gummy looking, but
they're identifiably fruit, right, That's right. I see what you're saying.
This is just like ground into a pulp, into a taste,
and then that's baked into kind of this amalgam of
god knows what right, And that one even went to court,
uh several times. In a case called Gordon versus Barnett,
(44:05):
the District Court for the Western District of Washington ruled
that someone got all the way to court arguing that
eating neutraloaf was cruel and unusual punishment. And although 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
(44:25):
bad that you have to get like the law involved
for you to be forced to eat this, at least
according to that judge. Jeez, just a just to jump
back into 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 in tricking and tricking and tricking and tricking like
(44:49):
ettrick and the demon's that's oh, that's really cool. So yeah,
so he's an Alabama's he's a tricking um. So when
he came into office, the preview sheriff died while he
was in office, okay, and this this money, this money
that's meant for inmates for food. Um, that account got
(45:10):
drained and it was given to the family of that
sheriff that just passed, and that was about a hundred
and fifty thousand dollars or some something to that effect.
All that money was taken out. So then this current
sheriff had to take out a personal loan hundred and
fifty thousand dollars just to keep the inmates fed. And
he was paying off that for years and years and years.
(45:30):
So it is interesting how the tides kind of turned
with him having to 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, um. And then also the fact
that he makes about ninety three thousand dollars a year
(45:50):
as the sheriff of a county, just base level, base level,
and then he's able to 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. And it is legal.
It is completely not against the law yet. So this
(46:14):
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. But also
this is a ten billion plus dollar industry and those
(46:35):
companies are obligated to seek profit on behalf of their owners.
According to David Fathi, the director of the National Prison
Project at the a c l U American Civil Liberties Union,
these companies have compelling incentives to cut costs and staff
and that can result to denying care and what is
literally and I don't know if he was going for
(46:56):
a pun here a captive market like they can 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
I'm gonna have to stick with this person for at
(47:17):
least the next two to five years that you're locked
up and fought, he 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
has providing the service, there's some measure of oversight, some
measure of democratic control, and a lot of people may say, well,
(47:39):
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. You know, from
from much of US history, the idea of prisoners receiving
medical care was just like bonkers, why would you do that?
(48:02):
You know what I mean? But as the law has changed,
even though the prison system is 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, uh inmates rights
to healthcare have actually expanded in comparison to the public.
(48:26):
The inmates. 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
(48:49):
you are listening to this and you are not in prison,
in that regard, the people incarcerated have more rights than
you do. It doesn't 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.
(49:11):
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
specific examples, but just the fact that that is a
situation you can find yourself in in this country is
baffling and um terrifying, and not even mention that some
people to do it just for shelter, sometimes on purpose. Yeah, yeah,
(49:34):
it doesn't happen all the time, but people do go
to jail and purpose. Some people go to bring in
drugs from the outside one way or another, probably ingesting
it somehow right and then passing it. Uh. In two
thousand and twelve. A guy named Frank Morocco of Amherst,
New York, was unable to afford healthcare for a rare
(49:54):
form of leukemia he was He was released from prison
in two thousands. Well, 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 lukemi 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
(50:17):
stole twenty three bucks worth of goods in plain sight
so that the employees could see, 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.
Did it work. It was not reported whether Morocco got
(50:41):
the treatment, but he was released from prison on the
shoplifting charge in April. 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
(51:01):
you know, depending on your sense of morality. Uh, it
really affects the way you're gonna feel about this. Um,
it really does. In the 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 um idealism, they deserve a shot at being healthy. UM.
(51:25):
But if that person has you know, heard another in
one way or you know, 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. It is it is. Let's also, I mean,
let's ta get a step further and say that one
(51:46):
of the reasons, uh, 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
makes me think about that Psycho documentary from several years back,
and we want to hear your take. Thank you for
taking this strange journey with us. What role do you
(52:09):
feel private, uh, private medical care or private medical providers
should play in the US prison system? Is this is
this something that uh people incarcerated, you know, somehow deserve
you know, is that is that just part of the
risk that they knowingly or unknowingly took when they committed
(52:31):
a crime? How how would it be addressed? 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 this be better for someone else who who
didn't who didn't obey the rules of our land. And
(52:55):
we didn'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. You can tell us about this
on Instagram. You can find us on Twitter. You can
find us on Facebook, where you can meet our favorite
part of the show, your fellow listeners on our Facebook
(53:15):
community page. Here's where it gets crazy. If you're not
down with the social media regular roll and you want
to reach out to us using some older technology, you
can give us a call at our hotline where we
are one eight three three s C D W y
t O, or you can just chant our name like
that and we will probably um press the digitate before you.
(53:37):
That's right in. Uh, shout out to everybody who's been
calling in. Remember I told you guys the other day.
I think it was like twenty something messages. I started, uh,
you know, categorizing a lot of them and downloading them.
We're up to thirty four now in like the past
couple of days. Um, and I'm just going through these
people keep calling in, don't stop. We're loving it. You're
(53:58):
sending all kinds of really interesting stuff. We wouldn't have
known about that Alabama sheriff and the food thing if
you hadn't called us and told us about it. So
keep it coming. If you don't want to do any
of that stuff, please reach out to us via email.
We are conspiracy at how stuff works dot com. Stuff
(54:33):
they Don't Want you to Know is a production of
I Heart Radio's How Stuff Works. For more podcasts from
my heart Radio, visit the I heart Radio app, Apple Podcasts,
or wherever you listen to your favorite shows.
From UFOs to psychic powers and government conspiracies. History is
riddled with unexplained events. You can turn back now or
learn the stuff they don't want you to know. A
production of I Heart Gradios How Stuff Works. Hello, welcome
(00:25):
back to the show. My name is Matt. They called
me Ben when we're joined with our super producer Paul
Michig control decond. 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,
(00:47):
we're getting to a point where 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 that's a fun listen, right right. Yeah,
we're We've got stuff unicorns don't want you to know
on the slate. Okay, yeah, Well it's weird because I
(01:09):
was thinking I was reading something about unicorns. Oddly enough,
now that you mentioned this, where wherein someone who was
a zoologist of some sort or 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.
(01:29):
It's very similar to rhinos. So unicorns, if they did exist,
would probably be belligerent, antagonistic animals, capable of great violence.
They'd be and that's something unicorns don't want you to know.
That's not profile. Yeah, exactly. All the glitter and all
the shin nous and their weird thing with virgins. Have
you seen that movie Legend with very very young Tom
(01:52):
Cruise and a very awesome Tim Curry, very awesome Tim
Curry wearing a giant rubber satan suit, and there's a
whole thing where they like the unicorns play a big
part of that, very very important. There's also the animated
The Last Unicorn, which is really sad. Yeah. Yeah, I
was thinking about the Bree Larson, her directorial debut, something
about the Unicorn Store, something to that. If it's Netflix now,
(02:15):
it does not seem to have anything to actually do
with unicorns. Just putting that out, Well, thank you guys,
you've saved me a few hours. It has absolutely nothing
to do with unicorns, the healthcare in the prison systems.
So the US health care system is by any measure,
matter how you look at it, no matter what your
opinion is, and everybody has opinions about this, By any measure,
(02:36):
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 to very very impoverished countries so much
as in comparison to other countries we would consider pure
countries economically, right, And there's the one we all agree
(03:00):
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 the fact that there is a ton of
money wrapped up in this issue. Uh, doctors make a
ton of money, hospitals, of course, Insurance companies make tons
of money. There's a lot writing on this, and that
(03:21):
means there's also extensive propaganda and play. We'll hear some
people say, well, the entire problem with US healthcare is
that it is 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,
(03:44):
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 not honest, red blooded American business. It's that
the government is involved. And every time Uncle Sam is
involved in some thing, uh, it's gonna be ruinous because
the government is inefficient and corrupt. Sometimes that's a sincere argument.
(04:07):
Sometimes it's a Star of the Beast argument. Depends on
where you hear about. And today's episode is not about
that cartoonishly tragically comic 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 get sick or
(04:28):
ever needs some sort of medical treatment. Healthcare in prison.
Yeah to two things you don't wanna 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
U S population in general. As of the population in
(04:49):
this country was three hundred and twenty seven point two
million human beings. Twenty eight point seven percent of the
population is under the age of eighteen, so you know,
it's almost a third of the people are very very young.
About fifteen point six of the population is over the
age of sixty five. And then that leaves the people
(05:10):
who are not miners, you know, who are eighteen and
they're also not they're above eighteen below senior citizen, which
are going to be the primary, the primary age range
for people who are incarcerated, right right, the regular, the
regular Joe's and james. Uh. This is interesting that fifteen
point six percent number for elderly and senior citizens makes
(05:34):
sense because, due in large part to the way the
health care system here does or does not work, we
have a disturbingly low life expectancy compared to other what
are called first world countries or other developed countries is
a better phrase. So that's that's the population by the numbers.
(05:54):
What about what about the medical stuff? Do we have
any stats for that? Yeah, So the US spend is
way more on healthcare than any other nation on this
here globe UM ten thousand dollars per person, which amounts
nearly eighteen percent of g d P, which seems bonkers
(06:14):
to me. Um. Government funded Medicare and Medicaid account for
more than a dollar of every three dollars of US
healthcare spending, and a dollar every four dollars in the
federal budget. The entire federal budget, which we know is
a is like seems like one of those imaginary numbers,
you know, the trillion. Yeah, it's largely. It is largely
(06:35):
a series of which is promises, increasingly ambitious pitches I
was gonna say from Congress. And and it's been growing, right,
it's been growing Medicare at least at more than twice
the rate of inflation. It's forecast to accelerate as what
we call the baby boomer generation ages ages increasingly into
(06:55):
that elderly demographic. So that's one thing upon on which
we cannot blame millennials. Sorry, I know some of us
in the audience dig that. But and then that's just
for Medicare. That's that's the part that the government helps
out with, right, And that's for people who do have Medicare,
you're considered to have healthcare. There are a lot of
(07:16):
other healthcare comes from employers, kind of like what we
have sitting in this room, including Mission Control, over there.
You're absolutely right, matt Um. 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
(07:38):
this before in previous episodes. The concept of taxis, the
concept of taxation is at heart in a very oversimplified way,
it's the same thing as paying dues to a club,
country club perhaps, sure, a country club, um, a chess
(07:58):
club that has a nice HQ if they have those.
The the ideas you you pay into this thing, and
because you've paid into this thing, you get certain rights.
So you're a country club of golf club whatever. Uh.
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
(08:19):
you pay taxes here in a country, then those taxes
should guarantee some of your rights, guarantee some maintenance. Uh.
And then arguably they could be in a situation where
they pay to 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. Uh.
(08:41):
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 calends or year.
And then there's Medicaid nineteen point four percent, Medicare sixteen
point seven, 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
(09:03):
to do it through things like Cobra right, or military
coverage four point six. You're gonna 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
have cancer, although that still happens. But this number doesn't
answer everything, because despite all these different kind of partial
(09:24):
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. Yeah.
Eight at least that's of as of right that number.
That number may have gone up or down a little bit,
(09:45):
but it hasn't moved a ton yet. It may very
well in the in the near future, in the next
three ten years. Right. Not to mention the fact that
I don't know how this figure is in 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 incarceerate an individual.
(10:10):
It's like taxpayer money. So it's just crazy to me, like,
if we're paying that much to incarcerated person to get
people outside of the prison system, we wouldn't even consider
spending that much on them and their well being. It
is it is cheaper, or it has been for a
number of years. It is cheaper for the United States,
(10:33):
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. Then it is to incarceerate them.
And that's something I learned via a little wane originally
true story, but yeah, but it's true. It's it's we
(10:55):
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 which is a little bit
of a simplified way to 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 gonna say they lock up tons of people, and
(11:17):
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 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 and twenty
(11:38):
two countries tracked by the Institute for Criminal Policy Research,
and that is such a large net to cast the
i c PR study right now, the u n doesn't
recognize two and twenty two countries, so they gave everybody
a chance. This country locks up a half million more
(12:01):
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. Twenty Yeah. It's worse though,
because the statistic that follows right after, we're only five
(12:23):
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. Yeah, okay, so what was it we said,
three d and twenty seven something million people in the
United States. Well, the American criminal justice system holds within
(12:44):
it incarcerated human beings two point three million people. That's crazy.
There are and it holds them in over seventeen hundred
state prisons. There are a hundred and two federal prisons,
and then eighteen over eight hundred juvenile correctional facilities. Then
there are also like that. Okay, and that's just starting right.
(13:05):
Then you go down another level. You get to the
local jails that wouldn't even be really called a prison,
just a jail holding cell kind of thing. There are
three thousand, one hundred and sixty three of those, and
there are also eighty Native American like they're called Indian
country jails. Um, well that's not even talked, dude. We're
not even thinking about military prisons, the brig Yeah, and
(13:27):
the the detention facilities like immigration facilities, the bizarre and
labyrinthine network of detention centers for ice. Yeah, that's that's
that's a whole one that our conversation there, one of
which was famously until quite recently a series of fences
set up under a bridge. Yeah. Uh, civil commitment centers,
state psychiatric hospitals, which are still around, mostly privatized, but
(13:51):
still exists to some degree. You can be held without
against your will in those facilities and prisons in US
territories which occupy and even or uh murky legal space,
including Guantanamo, including Guantanamo. Yeah, every year, six hundred and
twenty six thousand people walk out of prison, but they
(14:14):
go to jail ten point six million times each year.
Jail in prison are as as many people will, as
many people attest. Jail in prison are two very different beasts.
Jail churn is pretty high because most people in jail
have not been convicted. They're just waiting. Yeah, they've been arrested.
(14:36):
They're desperately using that um that trope and fiction. There
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, uh, justice is
a slot machine that only takes dollars. So if jail
(14:57):
is like a holiday, in prison is like a living
community of some kind like like an apartment building. Yeah yeah,
so 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,
(15:18):
There's somebody who is arrested for something, maybe it's a
case a wrong place, wrong time, but they can't make bail,
and so they're in jail for what months, and then
they go to trial and the judges like, who is
this guy? Not to mention there in jail because they've
done something, and then they can't make bail, so then
they lose their jobs because they're sitting in jail, and
(15:39):
it just creates this cycle of being able to not
afford anything that the system voice 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 your job and become unemployable again probably
another conversation, but it's it's a problematic cycle, and it's
this number might surprise from folks. Met You recently gave
(16:01):
us the statistics of some people in jail, but of
those people in jail, only about a hundred and fifty
thousand or so on any given day have actually been convicted,
and most of them, uh to take your holiday in
comparison are ear the apartment comparisons. They're they're generally serving
sentences that are less than a year, and almost half
(16:23):
a million people are locked up purely because of drug offenses.
So mainstream media, right, we all, we all know and
love our favorite fiction films and stories, often depicts the
incarcerated population in some in some wild extremes. Right there,
there there two or three big stereotypes we see people
(16:45):
incarcerated there. I 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 like absolute
suicide squad level monsters and the state is being too
(17:08):
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 been?
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 on the inside is
(17:30):
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. 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
(17:51):
that show. It's it's super great. It does 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 ground in reality, sort of a
harbinger of the gritty realism of Orange is the New Black. So,
(18:16):
regardless of uh, 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 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
(18:38):
continue inside the walls of penitentiaries, their gangs everywhere. People
love all the vices still, you know what I mean, drugs,
sensual pleasure, old fashioned violence, and the chances of that
kind of violence are always somewhere in the cards. But
the activist policymakers and others, there is another criminal in
(19:00):
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 O. J.
Simpson level trial, right, No, you would see them in
the ads in between those programs. That's right, we're talking
about insurance companies. Wait, our insurance companies criminals. You might
(19:22):
be saying, kind of, let's have a word from our sponsor.
Here's where it gets crazy. So well, let's call this
part healthcare, profit and public perception. In the Bureau of
(19:45):
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 as bipolar disorder. And again, as
we as we noted with jail, many of the people
(20:07):
in jail are just waiting their churning through. They haven't
been convicted and sentenced to their you know, to that
misdemeanor that's less than a year. But in the same year,
the Bureau reported that about two thirds of sentenced inmates
in jail suffer from drug addiction or dependency, and that
(20:29):
that conclusion they made this is the scary part. It
comes from numbers pulled in two thousand and seven to
two thousand and nine, which means that largely does not
account for the opioid crisis. Wow. Yeah, Wow, that's ah,
that's tough. Well, well, here's the other thing. So you've
(20:51):
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 some I
don't I don't know, recovery, physical recovery from and work on.
(21:13):
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. Uh, and
then also you know, having to deal with the mental illness.
It all kind of just adds up into this pretty
(21:35):
brutal thing where you're gonna be probably experiencing withdrawal symptoms,
especially early on in your situation there. Um So, like
I guess the first year of prison, which is what
you're saying, a lot of people actually only spend about
a year and there it can be extremely rough on
your health. Oh yeah, absolutely. I mean imagine if you are,
(21:57):
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 titles up to you, maybe in the yard,
and says, hey, I can help you out if you
do something for me. Dangerous times right, And now, yes,
(22:22):
we can take a moment to talk about the politics here,
because I'm sure as we're as we're exploring this, a
lot of us are thinking, well, people aren't in prison
for good behavior. No one has 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
(22:42):
go there for being an honor student in terms of
like civic mindedness. So there's this kind of callous or
colder argument and says, well, why should we take care
of these people if they are a detriment to society?
Because of that attitude, Because of that, you know, that
(23:04):
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 what I mean. Like
back in the back in the eighties especially, it was
political suicide to say we should still treat human beings
(23:27):
as humans, because then it would be immediately equated with
being quote unquote soft on crime and the Another another
difficulty 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
(23:51):
larger proportionate numbers than politicians aren't going to go out
of their way to be I mean, largely, it's true
it's sad and it's kind of disgusting, but they're not
going to go out out of the way to represent
someone who they don't see as capable of handing a
benefit to them. I mean, it's huge downfall of our species. Right,
(24:13):
Everything is quid pro quo and stuff you should know
as a great episode about how altruism doesn't really exist,
but no one wants to hear that. That's depressing, right, Yeah,
so well it really fast. I just want to talk
about something with you guys. Uh, 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
(24:33):
that unless you have experienced something in your life or
you know someone directly who has experienced something, it's very
difficult to have true empathy about a situation. UM. And
I take this too to the concept of quitting smoking
or attempting to quit smoking. Now, just just hear me
out really fast. For a lot of people who have
(24:55):
never been addicted to something like nicotine and attempted and
fail to quit that substance or something like that, UM,
a lot of people will have, at least I've noticed
in my experience, UM, very negative thoughts on alternatives to
quitting smoking or even or you know, other things like that. Um, like,
(25:17):
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, 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 is already
(25:37):
built up around it societally experiential knowledge, right, like the
like how the stem cell conversation changed when people who
were politicians opposed to stem cell research realized that benefits
a good have for people that they personally knew, right, Yeah,
I mean I think so, I mean even CBD oil, Yes,
(25:58):
absolutely know. I think it's it's weird because here in
here in Georgia, Atlanta, Georgia, where we record this podcast,
uh one, were regardless of where you fall in drug criminalization.
I thought it was hilarious when we had some we
had some politicians when the CBD UM the Medical Medicinal
(26:22):
CBD Bill or whatever was called, was first past, the
politicians who approved of it spent the majority of their
time assuring everyone that no one would enjoy it, Like,
don't worry, no one is gonna have fun. This is
just for people with epilepsy, So you're sure you cannot
get high. If I thought people would have anything like
(26:44):
a good time on this, I would be burning down
the capital, you know what I mean? Like, I'm still
mad that people foxtrot is burning down the capital. When
you smoke a bunch of weed in the capitol a
little known fact. Yeah, and it's part of the that's
part of the Georgia congressional slang. They say their prayer
(27:05):
and then they spark up adobie. Yeah, guy Fox, I
don't know if you remember him. He thought that barrel
was actually full of doobies. Yeah, yeah, yes, and right.
So the the reason the politics matter here, the reason
(27:25):
they're so fundamental, is because this means that excuse the
budget allocations for a lot of jails and penitentiaries. You
want to spend a lot of money securing the place, right,
making it hard to walk out of. But dude, why
would you Why would you spend money on healthcare, especially
(27:48):
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, which happens a lot. Jails
will tend to be in role 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,
(28:10):
I don't have the the resources. I can't make the
numbers work. How am I supposed to hire, train and
supervise doctors and nurses right let it like GPS lettle
them specialized medical care? Like what what on earth am
I going to be able to do to incentivize a
(28:31):
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 turned 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.
(28:51):
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 very very attractive
to administrators, containing cost. It's part of a trend that
started back in the nineteen eighties during the Reagan administration,
(29:14):
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 fat and having
cost as the having costs is the bottom line will
encourage more nimble, slimmed down, and more efficient operations. This
(29:35):
trend accelerated after the nineties, right when we had a
ton of uh tough sentencing laws like mandatory sentencing and stuff.
The Violent Crime Control Law Enforcement Act made the number
of people in jails and prisons jump from about three
(29:55):
hundred thousand to more than two million today. Yeah so,
according to a study from the Pew Charitable Trusts, more
than half of the state's higher private companies to provide
at least some of that prison healthcare UM services. Those
prison healthcare services the companies they negotiate these multi year
(30:17):
contracts with each jail and prison that they serve, medical
staff and prescription drugs, and outside services such as hospital
stays UM 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
(30:37):
that amount. UM. Sometimes contracts include provisions that increase a
company's potential profit if it holds down transfers to hospitals
or to other outside providers. Ben, can you help us
unpack this because I don't know about you, but this
seems a little on the shady side. For sure, your
spider sense is correct. Sometimes, um, this stuff can get
(30:58):
lost in the legal language. But this is a very
important turn in the story here. The companies, these uh
private health providers for prisons have negotiated these things that say, look,
we will make more money if everyone is and this
(31:19):
is just for sake of argument. If everyone is limited
to UH 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 as less than,
we will make another profit. Furthermore, if UH x number
(31:42):
of people or less than that go to a hospital
per year or to a specialist off site, then will
make another will make another windfall, another bonus. So we
know that private health insurance follows the same thing. It's
not a it's not a new game, right. They want
to avoid unnecessary tests and procedures. You probably hear that
(32:04):
a lot back in the old death panel argument days.
But this, this is very important. This means that if
someone in 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 one one. They can't you know, uh, they can't
(32:24):
play the great medical 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
(32:45):
they have to hope and pray that the diabetes doesn't
catch up to them 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
(33:05):
pitching to a warden. There you go. But we do
have some stuff. We know that the National Commission on
Correctional Healthcare has has accredited these programs around the country,
and seventy of the jails it inspects outsourced their medical
services and when they outsource, these for profit companies have
(33:28):
have a pretty big chunk of those contracts. Oh boy,
so let's uh, let's get into what we know about
some of this stuff. Um just it's gonna get even
deeper and darker. After a quick word from our sponsor,
(33:50):
we're back. So we've been talking in general terms about
private companies, right, private healthcare companies. But let's let's name
a few because we have some name tames. 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 Horizon Health. It looks like
(34:12):
Horizon but with a C. Those are two of the
bigger players. Is that like a chron nut kind of Yeah? Okay,
so it's on the horizon, but it's like correction. It's
the correction Horizon of health. It used to be called
Correctional Medical Services Incorporated, and then before that it was
Prison Health Services Incorporated. Kind of like Blackwater or Academi
(34:36):
or XE has changed up a little bit, just changed
the names. It'll be fine, it'll be grand. What an adventure. Yeah, Well,
there's a reason why those names changed. Just like you said,
like black Water. With Blackwater, it was about public perception,
right with some scandals that were occurring. And when we
say scandals, we mean pretty much murder that was occurring
(34:58):
with it. With these companies, these it's because they've been
sued a lot. The two of them together combined have
been sued about fifteen hundred times in the fast past
five years. And a lot of those were over you know,
accusations of things like neglect and malpractice and in dozens
of cases, uh, even wrongful injury or up to death. Carizon,
(35:20):
one of those companies, was the defendant, and more than
one thousand cases so of those fifteen hundred. And it's
interesting because Carison cares for about a hundred and eighty
thousand people day to day. Well Path, in contrast, handles
about two hundred and fifty thousand people day to day. Wow.
(35:41):
Representatives for both companies say, well, these lawsuits are often flimsy, frivolous,
were inconclusive, and we know you know again, people aren't
in jail or prison for being on their best behavior.
From what we understand, Uh, the vast majority of people
are inmates are just trying to get through their time
(36:01):
and get get out, and the other side of the
bars gives us a different perspective. The prison guards can
assure us that there are there are multiple people who
do have mental health problems. You know, they're they're flinging poo.
Maybe maybe there's some people malingering, which means faking an
(36:21):
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 have been decreed. Legitimate public interest
lawyers have brought class action suits alleging inadequate healthcare across
(36:43):
the entire system. There there multiple multiple examples of this,
unfortunately some which end in death. But we've we've got
let's just do one example from Arizona. So in Arizona,
civil rights groups filed a class action suit. In a
year later, after the state passed legislation privatizing prison healthcare,
(37:06):
it signed a contract with Corrison to provide medical services
in those prisons. Then, in a federal district court that
sought to resolve 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
(37:30):
remain end quote and held the state in contempt, issuing
it finds of more than one million dollars. And that's
interesting because the when when they're defending themselves, the private
prison insurance companies will say that part of their contract
(37:53):
and diemnifies the state or you know, the party from
the government that they're contracting, indemnifies them from legal costs.
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
(38:16):
and wending through the court system, people are dying, you know,
and many of whom committed crimes. But the ones who
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,
(38:38):
journalists wrote an excellent article for The New Yorker, evidence
from cases across the country suggests that four decades of
policy failures in both health care 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
(39:00):
a troubled system. They were supposed to fix it back
in the eighties, and all they did was fix their
profit marches. Yeah, and now it's become too big to
fail in a way you can't really remove it. It
even goes down to even goes down to the food, right,
because we joke about food all the time. But food
is part of your health. It's a massive part of
(39:20):
your health. You are what you eat, buddy. And it
really is like the simplest thing to to say that.
My wife, My wife and I have a an ongoing,
like joke argument about that about how important your food is. Um.
She likes to eat a lot more healthy than I do.
And I just I just like the good tasting stuff,
(39:42):
you know, you stuff that you evolved to seek out. Yeah,
the sugar, the fat, the salt, Yeah, mostly the fats,
like the bacons. You also like the heat, though, don't you. Man? Yeah,
give me the spicy bacon. You're a spicy boy. I'm
good to go. But yeah, it's just one of those
things where it is true, if you're eating more healthier,
getting more nutrients, you are in a better spot for
(40:04):
all the other stuff and you're not going to have
as many issues, at least theoretically. But we we got
a caller some when 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
off the top of whatever money they didn't spend on
(40:25):
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 a sheriff in Alabama that
the caller was mentioning he took almost a million dollars,
seven hundred and fifty thousand dollars legally. He took this
money to buy a beach house. Money that was meant
(40:47):
to feed inmates within his county. Yeah, Ottawah County, shareff
Todd entrickin Uh Todd, if you're listening, I hope you
enjoy your beach house. What Todd did was pocket this,
you know, seven fifty large that was supposed to feed
inmates of the jail that he supervised. Then, according to
(41:11):
the Birmingham News, he used 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 sheriff's across the state of Alabama take the money
as personal income like a bonus. Yeah, for like doing
(41:34):
a good job, because they had like a surplus kind
of Well, it's not attached to doing a good job.
It's just that 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
(41:56):
an individual's personally held liable for bring the gap. But
turns out that they don't really go out of their
way to spend that much on feeding their inmates. Yeah,
this that's really depressing h and messed up sheriff. Also,
we don't know how many people are doing this, because
sheriff's across the state apparently have done this for a
(42:18):
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 sheriff's across the state
have taken because most do not report it as income
on state financial disclosure forms. Yeah, so you're not required
to specify any money that you take in in this
(42:40):
way above two and fifty thousand dollars a year, and
he brought in seven. You have to wonder what they're
what what they're eating. You know, it makes me think
of do you guys remember the controversy of neutraloaf. Do
do you remember hearing about that? I do. It was
(43:01):
like a food substitute, kind of like soilent green. Yeah,
kind of. It's like the the Okay, you know that
there's meat loaf. There's neutra loaf, which is also called
meal loaf because it is it's this un unholy amalgamation
(43:21):
of vegetables, fruit, meat, bread, other grains baked into a
solid loaf. The ingredients vary, but there is something called
dairy blend. It sounds like fruitcake to me, but with
fruitcake they at least keep the shape of the fruits
right in there. Yeah. Well, they they're just cued and
(43:41):
kind of like all said, candied and gummy looking, but
they're identifiably fruit, right, That's right. I see what you're saying.
This is just like ground into a pulp, into a taste,
and then that's baked into kind of this amalgam of
god knows what right, And that one even went to court,
uh several times. In a case called Gordon versus Barnett,
(44:05):
the District Court for the Western District of Washington ruled
that someone got all the way to court arguing that
eating neutraloaf was cruel and unusual punishment. And although 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
(44:25):
bad that you have to get like the law involved
for you to be forced to eat this, at least
according to that judge. Jeez, just a just to jump
back into 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 in tricking and tricking and tricking and tricking like
(44:49):
ettrick and the demon's that's oh, that's really cool. So yeah,
so he's an Alabama's he's a tricking um. So when
he came into office, the preview sheriff died while he
was in office, okay, and this this money, this money
that's meant for inmates for food. Um, that account got
(45:10):
drained and it was given to the family of that
sheriff that just passed, and that was about a hundred
and fifty thousand dollars or some something to that effect.
All that money was taken out. So then this current
sheriff had to take out a personal loan hundred and
fifty thousand dollars just to keep the inmates fed. And
he was paying off that for years and years and years.
(45:30):
So it is interesting how the tides kind of turned
with him having to 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, um. And then also the fact
that he makes about ninety three thousand dollars a year
(45:50):
as the sheriff of a county, just base level, base level,
and then he's able to 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. And it is legal.
It is completely not against the law yet. So this
(46:14):
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. But also
this is a ten billion plus dollar industry and those
(46:35):
companies are obligated to seek profit on behalf of their owners.
According to David Fathi, the director of the National Prison
Project at the a c l U American Civil Liberties Union,
these companies have compelling incentives to cut costs and staff
and that can result to denying care and what is
literally and I don't know if he was going for
(46:56):
a pun here a captive market like they can 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
I'm gonna have to stick with this person for at
(47:17):
least the next two to five years that you're locked
up and fought, he 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
has providing the service, there's some measure of oversight, some
measure of democratic control, and a lot of people may say, well,
(47:39):
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. You know, from
from much of US history, the idea of prisoners receiving
medical care was just like bonkers, why would you do that?
(48:02):
You know what I mean? But as the law has changed,
even though the prison system is 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, uh inmates rights
to healthcare have actually expanded in comparison to the public.
(48:26):
The inmates. 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
(48:49):
you are listening to this and you are not in prison,
in that regard, the people incarcerated have more rights than
you do. It doesn't 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.
(49:11):
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
specific examples, but just the fact that that is a
situation you can find yourself in in this country is
baffling and um terrifying, and not even mention that some
people to do it just for shelter, sometimes on purpose. Yeah, yeah,
(49:34):
it doesn't happen all the time, but people do go
to jail and purpose. Some people go to bring in
drugs from the outside one way or another, probably ingesting
it somehow right and then passing it. Uh. In two
thousand and twelve. A guy named Frank Morocco of Amherst,
New York, was unable to afford healthcare for a rare
(49:54):
form of leukemia he was He was released from prison
in two thousands. Well, 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 lukemi 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
(50:17):
stole twenty three bucks worth of goods in plain sight
so that the employees could see, 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.
Did it work. It was not reported whether Morocco got
(50:41):
the treatment, but he was released from prison on the
shoplifting charge in April. 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
(51:01):
you know, depending on your sense of morality. Uh, it
really affects the way you're gonna feel about this. Um,
it really does. In the 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 um idealism, they deserve a shot at being healthy. UM.
(51:25):
But if that person has you know, heard another in
one way or you know, 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. It is it is. Let's also, I mean,
let's ta get a step further and say that one
(51:46):
of the reasons, uh, 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
makes me think about that Psycho documentary from several years back,
and we want to hear your take. Thank you for
taking this strange journey with us. What role do you
(52:09):
feel private, uh, private medical care or private medical providers
should play in the US prison system? Is this is
this something that uh people incarcerated, you know, somehow deserve
you know, is that is that just part of the
risk that they knowingly or unknowingly took when they committed
(52:31):
a crime? How how would it be addressed? 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 this be better for someone else who who
didn't who didn't obey the rules of our land. And
(52:55):
we didn'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. You can tell us about this
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(53:15):
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t O, or you can just chant our name like
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(53:37):
That's right in. Uh, shout out to everybody who's been
calling in. Remember I told you guys the other day.
I think it was like twenty something messages. I started, uh,
you know, categorizing a lot of them and downloading them.
We're up to thirty four now in like the past
couple of days. Um, and I'm just going through these
people keep calling in, don't stop. We're loving it. You're
(53:58):
sending all kinds of really interesting stuff. We wouldn't have
known about that Alabama sheriff and the food thing if
you hadn't called us and told us about it. So
keep it coming. If you don't want to do any
of that stuff, please reach out to us via email.
We are conspiracy at how stuff works dot com. Stuff
(54:33):
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