WASHINGTON, DC – A report titled “Cut-Rate Care” by the Prison Policy Initiative (PPI) released in February exposes the systemic failures of correctional healthcare systems in the U.S., highlighting how these systems prioritize cost-cutting and liability management over the well-being of incarcerated individuals.
According to PPI, correctional healthcare often functions as a “liability management system,” where the needs of patients are secondary to minimizing legal risks for prisons.
PPI explains people in prison have unique health needs, suffering disproportionately from illnesses such as Hepatitis C, HIV, and substance use disorder, but these needs are routinely unmet, as correctional healthcare systems focus more on avoiding lawsuits than providing quality medical care.
“Correctional healthcare systems are services for corrections departments, not incarcerated people,” PPI charges, emphasizing the primary objective of these systems is often to shield corrections agencies from legal consequences.
PPI outlines various tactics used by prisons to avoid accountability for inadequate healthcare, including the outsourcing of healthcare responsibilities to private companies through contracts that limit liability and exploiting federal and state laws that make litigation difficult.
The history of privatization in prison healthcare is a key driver of these issues, with PPI claiming the shift away from healthcare control by departments of corrections has allowed private companies to prioritize profit over patient care.
The PPI report also reveals existing quality control measures, such as government oversight, accreditation, and litigation, have consistently failed to bring meaningful improvements to prison healthcare.
“With prison healthcare, you regularly see that incarcerated people’s complaints get ignored, their requests for exams get denied, and their care gets slow-walked,” said Brian Nam-Sonenstein, the report’s author.
Beyond diagnosing the problem, PPI offers policy recommendations for lawmakers, including urging state and federal officials to transfer the provision of healthcare from departments of corrections to public health agencies.
PPI argues that this change would break down the “wall” separating correctional healthcare from broader public health systems and refocus care on patient outcomes rather than institutional protection.
The report also includes firsthand accounts from six incarcerated individuals across different prison systems, describing their experiences with substandard healthcare. PPI emphasizes these anecdotes reflect a broader, systemic issue within correctional institutions nationwide.
Nam-Sonenstein underscored the systemic nature of the issue in the PPI report, stating, “These are medical systems caught up not just culturally, but systemically, with the handing out of punishment. That won’t change until we take correctional healthcare out of the hands of departments of corrections and give it to professionals who are solely focused on public health.”
