From We The Sheeple [www.sheeple.com]

July 1999 has been a bad PR month for those whose job it is to provide medical care to our nation's 1.9 million prisoners. Here's our contribution.

At the county level, if you think your HMO treats you badly, meet (or rather say goodbye to) Joseph R. Erazo, director of Correctional Health Services, the New York City agency that oversees health care for more than 15,000 inmates at Rikers Island, the world's largest jail complex. During one contentious year on the job, Erazo's agency handed out $342 million to bring managed care to Rikers. Now Erazo, after a year of scandal and infighting among city officials, has resigned, while the Manhattan DA investigates whether at least four inmates died because of substandard medical care.

Further up the food chain, the Department of Justice released its first comprehensive study on the rapidly growing number of emotionally disturbed people in America's penal institutions. The report identifies more than 283,000 inmates, 16 percent of the total, as mentally disturbed. The New York Times describes a "grim statistical portrait, detailing how mentally ill inmates tend to follow a revolving door from homelessness to incarceration and then back to the streets with little treatment." The report, as well as the Times article, are must reads for anyone who ever wondered what happened to those who were "set free" from our budget-conscious public mental health systems in the 1980s.

Which brings us to Perri v. Coughlin, Docket No. 90-CV-1160 (N.D.N.Y. 6/11/99) (Judge McGurn), in which Judge McGurn held that a severely mentally ill inmate was entitled to an award of damages for the inhuman and degrading treatment he received while incarcerated in a New York State prison. He described those conditions as follows:

"[Plaintiff's] cell contained only a sink, toilet and a brightly glaring light that shone twenty-four hours a day. A small window in the solid metal door was the only means of seeing into or out of the cell except for an outside window that could be opened or closed from outside the cell by a correction officer. . . . He was held in this cell without clothes or a blanket for two months, and he developed body sores from having to sleep naked on the cold floor. He had no personal possessions and no basic necessities such as soap or a toothbrush in his cell. He had no writing materials and was denied all legal work, his address book and mail. There was no opportunity for personal contacts between inmates . . . because there was no programming, exercise, recreation, or group therapy. Inmates were only permitted to leave their cells for a five minute shower twice a week or to go to the visiting room.

On two occasions, the plaintiff attempted to hang himself, and no one even attempted to cut him down until he had lost consciousness."

In assessing damages of $50,000 against the defendants, Judge McGurn observed that "the true measure of a medical care system's constitutionality is not in its brilliantly crafted policies and state of the art facilities, but its accessibility by, and the quality of service to, real people in need of actual medical service." He characterized the plaintiff's incarceration as a "misery-go-round", during which the plaintiff would be sent from a psychiatric facility, where he would be stabilized, right back to the general prison facility where he received no long-term care.

Oxymoron, noun, pl. -mora, a figure of speech in which words of opposite meaning or suggestion are used together. A combination of contradictory or incongruous words. Examples. Ex. a wise fool, cruel kindness, prison hospital, military intelligence.

"What a sad kettle of fish!"

By Peter Schmidt, Esq. of Punch & Jurists

Those were the words that Judge Bright used to describe his feelings about the misguided policy and the inherent unfairness of a system of justice that allowed two "long-time drug dealers who made hundreds of thousands of dollars" selling drugs to receive sentences of three days ands seven days in prison, while Delaine Berg­­"the smallest fish in the kettle, a man who had no one else to snitch on"­­received a sentence of "ten thousand, nine hundred and fifty days in prison." With searing words, Judge Bright dissented from the decision of the Eighth Circuit in which it denied the defendant a jury instruction on entrapment and held that there was no sentencing entrapment or manipulation. Judge Bright, a frequent critic of the Guidelines, made the following comments about those rulings:

"The government may conduct sting operations. But for it to engage in conduct that for the citizen would be criminal and thereby authorize the imposition of the harshest sentence on an obviously small-time lawbreaker represents government conduct at its worst, not its best. This court should set its face against such activity.

While Berg is now but 33, he will emerge from the penitentiary an old man-if he doesn't die there first. In the intervening years, the cost of his incarceration for the American taxpayer will total well over $660,000, not including the expense incurred to construct the institutions in which he and others like him will be housed. As a matter of national policy, such costs can scarcely be justified as rational even when they are imposed by a discerning legislature. Such costs are made intolerable however where, as here, they are the product of prosecutorial zeal and law enforcement manipulation." - Judge Bright, dissenting in U.S. v. Berg, 178 F.3d 976, 987 (8th Cir. 1999).