You probably don't need a lot of incentive to avoid going to prison, what with the shankings, the anal rape, the race riots, the crowding, the racist gangs you'll have to join for protection, and the general tendency of our society to treat prison as a legalized form of torture. But believe it or not, prison may actually worse than these facts have led you to believe.

Let's say you're a doctor. Doctors are respectable and highly educated, right? Yes, but like any other profession there is a bottom of the barrel, people who went to barely-accredited medical schools and barely graduated. The kind who are routinely disciplined by state medical boards and repeatedly sued with good cause for medical malpractice. The Doctor Nick Rivieras of the world, if you will. What does a doctor do in that situation? Where do you work after you are suspended for fondling an anaesthetized patient? After too many patients end up dying from ridiculous mistakes?

Well, you go to work in a prison.

There was a brief spike in interest a few years ago, prompted by heavy coverage in the New York Times and budget/overcrowding crisis in the California Dept. of Corrections (where an inmate dies "every six or seven days" from inadequate care), in the sorry excuse for healthcare that inmates receive. In addition to being denied (expensive) medications and other forms of treatment due to shortages of funding and serious understaffing, inmates are routinely treated by physicians who see prisons as the employer of last resort. The reasons are not mysterious. Would you want to be a prison doctor? I certainly wouldn't. I'd take that low-paying, dangerous job only if normal society wouldn't take me. Then again, people will take unpleasant work if compensated accordingly – note how inner-city hospitals are rarely short on staff because of the extra incentives they provide.

Unfortunately prison health care, like so many other aspects of our correctional system, has been farmed out in the misguided belief that money is saved. Prison Health Services, Inc., the "profiteer of human misery of the week," controls an overwhelming amount of this corner of the market in human suffering. It also provides yet another example of why privatization of public services rarely makes sense. PHS sure is cheap, which saves the states some badly needed cash, right? Well, yes, they save money up front. But gosh are those wrongful death lawsuits expensive to settle. Like all other profiteers on the government tit, PHS gets paid a lump sum and then maximizes profits by cutting every cost known to man. By hiring Dr. Nick Riviera. By refusing to provide prescription drugs. By having one doctor for 7,000 inmates. State and local governments are quickly learning that withholding insulin from diabetics is a risky cost-control measure. When they die, well, it isn't real cheap to make that problem disappear.

So, in addition to all of the other horrendous aspects of being in prison, remember that five years for stealing a car can easily turn into a death sentence if you have medical problems. Aside from the human rights issues involved (and recognizing that most people have limited sympathy for convicted criminals) you can sit back and enjoy yet another example of how privatization does little more than move costs from one pile to another, usually increasing them in the process.