In prison healthcare, everything is about decreasing cost.
You may have seen some of the stories I've posted before on popsupplements.com but I'll share this story to give you a crystal clear idea:
To avoid major legal ramifications, I won't say the name of the healthcare company I worked with.
I can say it was in a prominent and trending Netflix documentary about systemic racism.
The guy who was our regional director was a physician who was promoted because he was grossly negligent to patient behind the walls.
I had a patient that he also tried to neglect. I can't say that this was intentional. His lack of knowledge about medicine made it clear he had no clue that his decisions could cause a patient to suffocate to death.
A man was transferred from an outside facility for a large thyroid mass that was compressing his trachea causing his O2 saturation levels to go to 90-92%. Usually when your blood oxygen is at this point you should probably get supplemental oxygen and, well, surgery.
I remember transferring him urgently to an outside hospital that did surgery and got a call from the hospital saying he would be transferred back because it was "not urgent." They were told by this director that he could be safely cared for at our correctional facility even though there was no monitoring equipment.
I was a little confused. Truly in any other situation where the man was free he would have gotten the care he needed.
After he came back, I just transferred him again to the same hospital because at our facility there was no way to know when he would asphyxiate to death.
To make a long story short after the second transfer the director was irate. He told me, without even examining the patient, that I was costing his organization a lot of money, without even showing giving a whiff that he gave two shits about this patient's livelihood.
After his initial rant I yelled, with the entire emergency room listening, that it was apparent that cost was his number one concern. I also gave him basic education that when O2 saturation levels usually decrease when your trachea is compressed 85%. It was clear, that in any other situation, this man would have already been admitted and that he was profiting off a population of people that could not defend themselves. As I told him these facts the line became progressively more silent.
The silence continued for 10 seconds. Then, he just repeated his tirade.
It was clear I could not do my job because of the system. So, I called a nurse to watch him with a pulse oximetry device all night and asked her to call me the second his vitals changed so I could transfer him a third time.
In the morning he was transferred again.
While this story is anecdotal, and I have others like it, it was apparent that the healthcare organization my company contracted for had little interest in providing care to inmates. Their number one priority was making money.
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