Privatization and Quality of Carceral Healthcare: A difference-in-differences Analysis of Jails in the United States, 2008-2019

Abstract

ABSTRACTThis article analyzes the impact of privatization on service quality in a novel context: jail health care. More than 1,000 people die annually while incarcerated in US jails. In recent years, privatization health care for jail inmates has increased, and many journalists have described abuses by private health care providers in jails. Despite longstanding theoretical interest in the (de)merits of privatization, scholars have been silent on jail health care privatization. Difference-in-differences analyses of mortality trends in a panel of more than 500 jails in the United States from 2008–2019 produce little evidence that switching from publicly to privately provided jail health care increases inmate mortality death in the short-run or long-run. Furthermore, in one state with available data, jail medical spending per inmate day increased following medical care privatization, contrary to theoretical predictions. Further research is needed to uncover the determinants of jail mortality and consequences of correctional health care privatization.