Getting Their Pound of Flesh--Prison Medical "Services" as Punishment

 I'm grateful I have not had a lot of need for medical attention since I've been in prison. I've had stitches once (solo injury from a failed "box jump"), surgery once (appendicitis), and a heart scare about a year ago (turned out to be anxiety). Otherwise, I've only had to utilize the prison medical services for annual checkups (which consists of measly BP, temp, and weight checks) and attempts to get proper allergy meds (refused).

Of all the "services" in prison, though, medical services are the most criticized, and for good reason. Michigan's prison medical services are sorely lacking even the most basic quality. Furthermore, they are often sued for medical deliberate indifference. It's no wonder with the horror stories I've heard. 

Occasionally, though, medical staff are kind, responsive, and helpful, but this is not the norm. Instead, prison medical services are fraught with many challenges and problems, including:

1. Putting profits before people
Michigan outsources its medical services, which they pay on a contract basis. Whatever the provider saves in expenses is additional profit for the provider. This puts profits over people and care becomes secondary. If a treatment can be denied, it guarantees to save the provider money, at least in the short term. 

2. An unhealthy population
Prisoners have a higher than average rate of disease and mental health challenges. Treatments for Hepatitis C, for example, are extremely expensive, as are medications for other chronic conditions that require treatment. Prison food notoriously lacks nutrition (including commissary food), so the prison population cannot change its diet to naturally combat (or avoid!) conditions like diabetes. They must be medicated. 

3. An entrenched bureaucracy
Malingering (faking an illness) is likely more common among the prison population than the general public. High rates of addiction lead to prisoners seeking medications they may not need in order to itch the addiction scratch. As a result, and probably to enhance profits, the process for getting necessary treatment in prison is arduous. The provider's policy is that prisoners must see a nurse three times before seeing a physician's assistant or doctor. This policy sometimes weeds out malingerers, but it also forces unnecessary medical visits and delays needed treatment. 

Recently, I have had severe back pain due to a strained muscle. I do not know the cause of the strain, but I have seen a nurse twice now about the problem. Both times, I was told to do stretches that I've already been doing for months, and to continue to use heat packs using a homemade heat pack since they will not provide me one. On my second visit, I was told I would have to see the nurse once more before I can see the doctor, despite not even being physically examined on either visit by nurses. 

I do not have a history of drug abuse, and I expressed a desire to avoid pain medication as much as possible. But even low cost interventions, like a hot pack, a detail for an extra mat for my bunk, or a chiropractor visit are dismissed out of hand. Instead, I must see a nurse three times (even if that visit consists of "Are you still having pain? Okay, we'll see you again next week...") before I can even see a PA or doctor. 

I'm in pain, but I'm not likely dying. Imagine what prisoners who are suffering from cancer and other terminal illnesses experience! Who ever thought that a prison sentence might literally require a pound of flesh?