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South Carolina’s Department of Corrections, despite a previous costly, inefficient and troubled experience with commercialized health care in a portion of its prison medical services system, has announced that it will soon be privatizing all of its prison health care services. This report documents the many problems—from seriously deficient services provided to prisoners to cost over-runs and unpredictable, unstable contracting arrangements—associated with privatized prison health services in South Carolina and the nation at large.

From 1986 to 2000, South Carolina contracted with Corrections Medical Services [hereafter, CMS], a private corporation with a checkered record of providing comprehensive health services—that is, medical and psychiatric care– to prisons and jails around the country. CMS’ contract with the Department of Corrections [hereafter, SCDC] initially provided services to three prisons (Coastal Pre-Release Center, Lieber, and MacDougall); by 1999, its contract covered ten facilities and it received $31 million from the state in the two fiscal years ending in June, 1999.

As the South Carolina General Assembly’s Legislative Audit Council’s report, A Review of the Medical Services at the SC Department of Corrections, documents with great clarity, the experience of privatized health care in the S.C. prison system was rife with problems that ranged from medical care of very poor quality to failures of the Department to exercise its mandated oversight responsibilities to cost over-runs and substantial funds expended on services that were never provided.

The record of the CMS contract with the State of South Carolina is a dismal one, and though it is clear that the state failed in its monitoring responsibilities, CMS nevertheless complained that monitoring was “excessive and disruptive” in citing its reasons for terminating its contract. This attitude is likely to prevail in any future privatized prison health system and bodes ill for both sick prisoners and for the state’s taxpayers.

South Carolina has already had a bad experience with commercial prison health care, and there is no doubt that it has wasted many thousands of dollars on shoddy care to the nearly 24,000 people in its prisons. Instead, this money could have been spent on better, state-provided health services and on vigilant monitoring to assure those services were, in fact, being given. The sorry experience that other states have had with privatized prison health care should be caution enough to halt the drive toward re-privatizing South Carolina’s system.

Indeed, we agree with a recent editorial in The State which cautioned: “…officials should not rush to privatize health care at prisons—or any other public function…out of desperation because of a tight budget.” South Carolina has the opportunity to learn from its own past mistakes and from the problems experienced elsewhere. It also has an opportunity to examine effective and humane improvements that it and other state governments have achieved that have modernized and made more efficient their prison medical services without sacrificing quality or cost.

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