The Dark Side of Privatization

This is a glimpse of the dark side of privatization:

Meet Lloyd Martell, MDOC prisoner No. 335246. He will die soon of colon cancer that could have been contained had prison doctors treated it 18 months ago.

Martell, 41, a Detroit auto mechanic, caught a small-time case in 2004 -- fleeing from Redford police after they tried to pull him over for a broken rear window. Martell has a history of petty crimes and took off because he had a suspended driver's license. After police arrested him, Martell got one to four years. It turned into a veritable death sentence.

In December 2004, Martell had what he believed was a hemorrhoid lanced in prison. Medical records show it was actually a cancerous polyp. Martell said Dr. Jerome Wisneski, who works for Correctional Medical Services, told him he would be fine.

"He said it was a clean cut," Martell, in a wheelchair with a colostomy bag on his stomach, told me two weeks ago inside the Charles Egeler Center in Jackson. "He said it was all contained in the tumor and I didn't have anything to worry about."

By October of last year, Martell was bleeding from the rectum and unable to walk. He was sent to Foote Hospital in Jackson, which contracts with CMS for specialty services. Doctors told him he had terminal cancer.

An oncology report from Foote in November is damning: "Lloyd Martell is a 40-year-old inmate whose history dates back to December of 2004 when he underwent resection of a polyp that, in fact, did have evidence of adenocarcinoma, but no further intervention was made."

A request for a medical parole, supported by physicians, in December stated that Martell had roughly 20 months to live. Even if broke, Martell could have walked into the emergency room of Detroit Receiving Hospital, or practically any hospital, and gotten better care for his cancer. In prison, he didn't have that choice, and now he's going to die.

With help from family and the media, Martell was released on Tuesday so he could go home to die, a fate he didn't deserve. Unfortunately, Martell is not the only victim of medical neglect while in prison according to the Free Press.

[...]Yet the quality of prison health care seems to have gotten worse since 2000, when the state contracted with Correctional Medical Services Inc. for primary care physicians and other services. It should be getting better. The Michigan Department of Corrections has been under a federal consent decree since 1985 to improve medical care and other conditions at prisons in Jackson.

"The medical neglect seems worse, not better," Patricia Streeter of Ann Arbor, an attorney for the prisoners in the Hadix case, told me. "CMS has not adequately supervised its doctors or made timely specialist referrals, and MDOC appears unwilling or unable to see that it does."

Medical records, court documents and rulings, and interviews with inmates and advocates show a pattern of misdiagnosis, delayed or denied treatment, withheld pain medication and inadequate accommodations for people with disabilities.

This problem is not limited to Michigan. CMS has prison and jail health care contracts in 26 states, with 80 employees in Michigan. State officials say CMS has saved the state nearly $10 million, and they contracted with them for primary care mostly because it could not retain physician employees. However, CMS gets $65 million a year from Michigan taxpayers. Where is the accountability? Taxpayers don't send people to prison to die at the hands of negligent companies.

There needs to be accountability. Our state failed to provide oversight under Republican and Democratic administrations, and CMS itself has been less than transparent - for good reason.

Correctional Medical Services is not merely the nation's largest provider of prison medicine; it is also the nation'’s cheapest provider, a perfect convergence of big business and low budgets. But unlike the traditional HMO, whose risk of a malpractice suit is real, and is felt, and is reflected to at least some degree in the quality of medical care, companies such as CMS have little or no reason to protect themselves. Most juries are reluctant to decide in favor of a convict, and those juries that do favor the convict are often reluctant to award money. Cost-benefit analysis takes on special, human overtones behind bars.

Perhaps even more significantly, private companies such as CMS feel no responsibility, and have no legal obligation, to account to the public for what goes on inside their facilities. So, while CMS receives about $550 million of taxpayer money each year, the company chooses not to provide any accounting of how that money is spent or even how much of it is spent-----and how much unspent, to be pocketed as profit.

In addition to providing poor health care on the taxpayer's dime, CMS is also a union-buster.

According to a June 2000 Associated Press story in the Detroit News, the United Auto Workers Union, which represents doctors, physician's assistants and nurse practitioners employed by the Michigan Department of Corrections, "sued over Michigan's privatizing health care for prison inmates, claiming prisoner health could suffer if the state expands its contract with the for-profit provider scrutinized in several states."

That's an added bonus that must have delighted many right-wingers even though the UAW's concerns proved to be deadly accurate, but providing the best service is not one of the Right's goals. Their goal is to outsource tax dollars to private companies who only care about one thing - the bottom line. So what if somebody dies in the process.