Abstract
Something must be done to improve access to health care in America’s prisons. A prison sentence today imposes an illegitimate burden of poor quality medical care on prisoners. The prison system neither treats inmate fairly nor effectively, and exacerbates and spreads disease. Existing pathways to reform have failed. Legislative fixes have been mired in losing political battles. Efforts at litigating for change have been derailed by hostility both from the judiciary and legislatures. Finally, common-sense prison based remedies have been stymied by extraordinarily rare application. The best hope for improving conditions comes through a radical expansion of sentencing and early-release initiatives. These proposals limit the sentences of sick inmates at the outset, and provide for early release of sick inmates who are already incarcerated. These measures serve as a safety-valve for the overburdened prison health-care system, while avoiding the problems of other measures.
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