The goal is to transfer them to a service representative for a “free debt relief consultation.” But only if they have the right kind of debt, so first we need to get them talking about whether there’s anything besides IRS back taxes they might need help with.

Credit card debt. Medical debt. Personal loans. State-level student loans. Mortgages. Repossessions. All of these are things we say we can potentially reduce or clear, but the vast majority of the people who pick up our calls are senior citizens who are retired and owe nothing to the IRS. Their education predates the student loan crisis. They’ve never taken out a mortgage. A lot of them have $10,000 or $20,000 in medical debt, but there’s nothing I can do for them.

The only people who actually get the consultation are those with IRS back taxes or credit card debt, which the service rep will be glad to help with for a modest fee. I can keep an elderly woman on the phone long enough for her to start crying and tell me about the $120,000 in unpaid hospital bills shows left with after her husband died, but when I transfer her the call will just be disconnected.

I don’t like this job. It’s demoralizing. I feel dirty about it. But I also have to eat, and the call center pays $1.30 an hour—more than double most jobs at this facility. There’s a bonus system wherein for each successful transfer of, say, credit card debt over $12,000, or tax debt over $20,000, we get $5. It would take three or four days to earn that at other jobs here.

We’re supposed to make minimum wage.

For obvious ethical reasons, there are restrictions on how products manufactured with prisoner labor can be sold, but there are ways around that.

Prison labor is often thought of in terms of making physical products, like license plates. Though making glorified telemarketing calls is less tangible, the call center is considered a job training program where we learn valuable marketing skills.

For obvious ethical reasons, there are restrictions on how products manufactured with prisoner labor can be sold. One way corrections departments can get around this is through the Private Sector/Prison Industry Enhancement Certification Program (PIECP). Not all prison call centers operate under this certification, but many do.

The PIECP authorizes partnerships with private companies to produce cost-effective goods using prisoner labor. Those goods are then exempted from restrictions that would otherwise hamper profits. The justification is that we’re get real-world job experience, including making local minimum wage.

For starters, the PIECP allows up to 80 percent of our wages be deducted—to offset the rising cost burden of incarcerating us. In states without a minimum wage, 20 percent of the federal standard $7.25 an hour would still be $1.45 an hour. The more private contractors are involved, the more ways to end up at $1.30 per hour, or less at the other PIECP jobs here.

Since the call center jobs arrived earlier in 2024, the company’s name has changed four or five times.

Some states have programs that allow private companies to use prisoner labor outside the PIECP entirely. The correctional industries program that runs our call center does pay a few dollars more other facilities in the state, but at this one just quietly pays less. You might want to ask how they are able to do that, but you can’t so long as there is no “they.”

The correctional industries program, for example, is separate from the department of corrections but still a state entity. It contracts with private entities such as the one I work for, which at time of publication at least appears to be Tax Relief Services. Since the call center jobs arrived earlier in 2024, the name has changed four or five times, always over the weekend. We come in Monday morning and find new paperwork that says we’re now calling from Credit Consolidation Services, or Hardship Debt Relief, or Consumer Alliance.

Some people here are under the impression they work for the company that runs the actual phone service—that’s Call Wizards. Meanwhile, call center jobs are proudly advertised as an opportunity for private companies to repatriate jobs that would otherwise go overseas.

“Imagine… All the benefits of domestic outsourcing at offshore prices,” Unicor, the federal correctional industries program, states on its website. “It’s the best kept secret in outsourcing!”

Photograph (cropped) via Unicor

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You’re always in pain, but the past few weeks you’ve been in a lot of pain. You can’t see how you’re going to make it through another week at your Maintenance job, even though you need the 22 cents per hour. So you get a Sick Call form, write a brief description of your condition and symptoms, and submit it to staff to get on the list allowing you to go to medical. Theoretically, once you submit the form you can see someone the next weekday.

Once you’re at medical, a nurse weighs you and takes your vitals, then asks what brings you in. They tell you that before you can see a cardiologist they’ll need to run some tests in-house, like a chest X-ray and an echocardiogram, so you’ll need to come back next week. The ultrasound technician comes on Mondays, the X-ray technician comes in on Wednesdays, and so forth.

After the test results come back, medical agrees you should see a cardiologist. The appointment request moves up to the senior staff. They approve it the next day, and send it up to the warden who approves it a few days later. So within about three weeks, you’re cleared to see a doctor as far as the prison is concerned. Except that everyone up to this point works for the private contractor the state is paying to run the facility instead of the department of corrections (DOC), which now has to approve it too.

The warden sends the request to the DOC liaison, who sends it to the DOC commissioner. The commissioner approves it and sends it back to the prison. So within four or five weeks, you’re cleared to see a doctor as far as the prison and DOC are concerned. Except now the request goes to the different private company that’s been contracted to do the scheduling. The schedule they propose has to go back to the prison and DOC for approval. So anywhere from one to eight months after you filled out the Sick Call, you’ll be approved for an appointment the following year.

The issue is not bureaucracy; it’s cost.

That’s been my experience in the facility where I’m currently incarcerated, but everyone here has a story like that. Sure, requests can be designated as “urgent,” but that doesn’t mean they’re treated as such; it can take weeks or months for broken bones to be set. 

“Medical put me off for four years, denying I needed open heart surgery,” Jim*, in his mid-60s, told Filter. “When they finally sent me out … I needed a quadruple bypass. And then waited another three years before [DOC] approved a procedure that expensive. So … that tells you pretty much everything you need to know about health care here.”

Fundamentally, the issue is not bureaucracy. It’s cost. When you’re paid per prisoner no matter what happens to them, and your goal is to maximize profits for shareholders, what reason is there to keep us healthy?

The Federal Bureau of Prisons is phasing out its use of private prisons, though it’s taking longer than it was supposed to. Twenty-seven states contract with private prison operators, mostly in the South and the West. Some of those facilities use a different private contractor for health care. But state-run facilities are also increasingly outsourcing health care to private contractors, and in many of them the experience of trying to access care isn’t likely to be less miserable than at a privately run prison.

They disagreed with the doctors about what constituted “life-saving treatment.”

Frenchie* has been incarcerated for 15 years, most of them in this facility. In 2019 he kept passing out, until the problem forced him to fill out a Sick Call. His fainting spells were dismissed as panic attacks, his hypertension as nothing that required medication, and he waited almost a year to be transported out to the hospital where he was diagnosed with a blood disorder.

“They tried to refuse paying for the blood transfusion because they deemed it unnecessary. They put me on two medications I’d told them I was allergic to, because they were cheaper. I’d been told I needed surgery sometime [in] 2020,” Frenchie told Filter. He didn’t get it until 2023. “According to the hospital I was sent out to, I was on the door of death. I had to receive several emergency transfusions that the facility again tried to deny payment on.”

They disagreed with the doctors about what constituted “life-saving treatment.” After they were forced to pay, they next tried to deny his post-surgery check-up.

“Whatever problem you have,” Frenchie said, “they will deny it is a problem.”

One man here, in his mid-30s with life-threatening haemochromatosis—too much iron building up in your blood—was for a time able to access the expensive treatment. But when he didn’t show signs of responding to it, he was cut off.

I remember a man with Stage IV cancer who was told there was nothing more that could be done. So they stopped his chemotherapy and refused him any further treatment. Why throw money away?

*Names have been changed to protect sources

Image via Centers for Disease Control and Prevention

The post When You Need to Go to a Hospital, and Private Prison Says You Don’t appeared first on Filter.