I arrived at the hospital in shackles. I’ve always been very proud of my slender ankles, but that morning, I cursed them. Before leaving the prison, the transport officers fitted me in handcuffs with a long chain around my waist attached to the manacles around my feet. I couldn’t feel them seated in the van on the way from the prison. It was only with the weight of my body that the pain began, step-by-step. When the two escorting guards walked briskly towards the fluorescent glow of the hospital entrance in the early morning darkness, I felt the manacles clamp down with every flex of my foot. I lifted the chain like a skirt as I struggled to keep up, not wanting one of them to turn and admonish me. As we passed through the automatic doors, some patients and employees watched me clank by. Others looked away.
The health care system at Lee Arrendale State Prison, where I’ve been incarcerated, uses Wellpath, one of the largest for-profit health care companies for incarcerated people. Wellpath has had over 1,400 federal lawsuits filed against it for allegations such as medical malpractice, patient injury, and wrongful death. It’s a managed care organization (MCO), a type of health care provider that charges a flat price to the prison to provide care. Currently, most health care providers in America employ aspects of managed care. But in the carceral system, these models encourage dangerous cost-cutting measures. MCOs compete with each other for contracts with the state by offering the lowest monthly fees. As a result, their policies reduce both the cost and amount of care, with devastating consequences. Atlanta News First reported that in Cobb County, Georgia, an inmate in the county jail died less than 24 hours after he entered without receiving medical attention — despite jail medical staff, contractors provided by Wellpath, being aware of his medical issues. Wellpath declined to comment on the case.