Reader Phillip Baker sent this response to the first installment of Brian’s series, Gaming the System:

What I read in your article hardly shocked me. I battled Texas Criminal Justice Department for medical care for an inmate for 2 years, literally daily. The young man has a severe form of Type 1 diabetes that is hard to control outside and impossible on the time scheduled medications inside. Within 6 weeks of going in, his A1c [blood glucose test] went from 6-7 to over 10, and he was in DKA [Diabetic ketoacidosis, a life-threatening condition].

The Pakistani-trained unit doctor tried to treat his metabolic imbalance not with insulin changes, but with constant IV fluids (to dilute the blood glucose?). They did not even have diabetic or other special diets, but rely on their Diet for Health. They claim that an inmate must choose from the various food offerings just those items appropriate for their medical care. They ignore the fact that that leaves an inadequate overall diet, since inmates with dietary needs must just eat a portion of their trays. That also assumes these prisoners know what to choose. And the first thing that TDCJ cuts is food portions. It took me two years to get him decent care.

I thought Texas was bad, but then I got asked to see what I could do for another Type 1 inmate in the Illinois system. Another type 1 inmate had complained about his care, so they simply stopped his insulin! He had to go onto parole to get back on insulin. The guy I was looking at couldn’t get his insulin at or around meal times, since ALL meds were given out during set pill lines, sometimes hours after meals. When he was struck in the eye by a baseball, the medical section dismissed it as insignificant. The pain continued for six weeks, but by that time he had lost vision in that eye permanently.

Another inmate in the federal system had the same problems with care for his Type 1 diabetes. The system refused to allow diabetics to have a separate insulin line, so that insulin and meals could be synced up. I fought them for 8 months and lost totally. There dismissive attitude was shocking even to me. They did not give a damn. Period.

These corrections facilities without exception hold the belief that inmates are entitled only to a certain level of care, certainly not what is available by community standards. Health care is viewed as a privilege that can be withheld by the system at will.

I only got into this because I’m a retired PA. I thought I might be able to help that first diabetic by using my training to advocate for him. The American Diabetes Association was consulted, and they became aware of what I was doing. They asked me to check on several other inmates who had reached out to them. It was all pro bono and informal, but the stories I can tell of deliberate indifference and callousness would curl your hair!

Keep up the good work of exposing this nasty business. I have not seen a single privatized correctional healthcare system that is not an abomination. But very profitable!

Thanks Phillip, for sharing your experience advocating for prisoners. I’ve asked Brian to stop by in the comments to this post today.