NCJ Number
182330
Journal
Journal of Criminal Law and Criminology Volume: 90 Issue: 1 Dated: Fall 1999 Pages: 195-237
Date Published
1999
Length
43 pages
Annotation
This analysis of the use of managed care to provide inmate health care argues that the use of managed care may result in an overemphasis on costs that sometimes rises to the level of deliberate indifference and thereby violates the Eighth Amendment’s prohibition of cruel and unusual punishment.
Abstract
The goal of managed health care is to have a health care system that operates more effectively than does the traditional fee-for-service system. However, the use of cost-cutting techniques to achieve this goal can result in inadequate treatment. Inmates have no choice about health care, cannot seek outside advice, and must use the health care provider chosen by the government. County and State governments choose managed care partly for logistical reasons. However, the primary concern is always financial. Legal issues related to the United States Supreme Court’s standard of deliberate indifference involve the liability of institutional defendants, the liability of private health care providers, and municipal liability based on acquiescence in acts of private health care providers. Additional issues relate to the placing of financial considerations ahead of inmates’ medical needs and the institutional liability of private health care providers. A rebuttable presumption of deliberate indifference for certain aspects of managed care should apply where the inmate can show that the injury resulted from inadequate or denied treatment, inadequate staffing, or any other managed care practice that creates an unjustifiable risk that the company places finances over medical considerations. These and other factors suggest either that legislatures consider either banning private managed health care in prisons and jails or that legislatures require or corrections departments contract for provisions that ensure adequate treatment of inmates. Footnotes