Prison Health Care Nightmare

Mumia’s Life Still in Danger

Mumia Abu-Jamal, America’s foremost class-war prisoner, is once again fighting for his life against Pennsylvania prison authorities. Mumia is demanding treatment for hepatitis C and a ravaging hepatitis C-associated skin condition that has plagued him for over a year. He is demanding damages for the deliberate indifference to his high blood sugar that caused him to be admitted to intensive care last March on the verge of a diabetic coma, and he is protesting that his family and lawyers were later prevented from visiting him in the hospital. In September, a magistrate judge recommended dismissing his case, stating that Mumia would not be “irreparably harmed” by the withholding of hepatitis C treatment! In fact, Mumia nearly died last year and his life remains in danger.

This past December, federal district judge Robert Mariani decided to hear Mumia’s case over the objections of the Pennsylvania Department of Corrections (DOC). The hearing shined a spotlight on the state’s callous disregard and negligence for the prisoners in their “care.” Mumia himself captured what is at stake when he told the court that with hepatitis C medication “I can live; without it I may die.”

The punitive treatment of Mumia Abu-Jamal is part of a decades-long vendetta by the capitalist state against this former Black Panther who became known as “the voice of the voiceless” for his searing journalism in the 1970s. He exposed the racist Philadelphia police campaign against the MOVE organization, the largely black back-to-nature group he came to support. Mumia was framed up for the 1981 killing of Philly police officer Daniel Faulkner. Police and prosecutors manufactured evidence to convict him, including by terrorizing witnesses and concocting a fake confession two months after his arrest. Following a 1982 trial, Mumia was sentenced to death explicitly for his political views. In 1995, a warrant was signed for his execution, but protests around the world helped make his name known internationally and the execution was stayed.

The courts have time and again refused to consider evidence proving Mumia’s innocence, including the sworn confession of Arnold Beverly that he, not Mumia, shot Faulkner. Mumia was on death row for nearly 30 years until his death sentence was set aside, and in 2011 the Philadelphia district attorney’s office dropped its longstanding effort to legally lynch him. He is now serving life without parole, and the state is intent on seeing him die in prison. At his December hearing, the DOC counsel sneeringly asked Mumia why he did not get a hepatitis C test earlier than 2012. Mumia replied: “I never agreed to blood tests while I was on death row, because I didn’t trust the doctors.” We have long championed freedom for Mumia, a demand that is even more urgent now given his dire prognosis. Free Mumia Now!

The same is true for other class-war prisoners locked up in America’s dungeons. Leonard Peltier has been incarcerated for nearly 40 years for his activism in the American Indian Movement. He has long had severe health problems, including diabetes and a heart condition, which have been exacerbated by prison conditions. After suffering months of excruciating abdominal pain, Peltier now needs emergency surgery for a potentially fatal abdominal aortic aneurysm. Peltier and Mumia are two of the 14 class-war prisoners who are supported by the Partisan Defense Committee’s stipend program and annual Holiday Appeal.

Medical neglect of those incarcerated in America is pervasive. According to the Centers for Disease Control and Prevention, one in three prisoners is infected with hepatitis C, which can lead to deadly liver disease. New antiviral pills cure over 90 percent of patients in as little as 12 weeks with few side effects. Price-gouging pharmaceutical companies charge nearly $100,000 per treatment, which the prison authorities and politicians are determined not to cough up. Prisoners in Pennsylvania, Minnesota and Massachusetts have filed class-action suits demanding hepatitis C treatment. During Mumia’s hearing, the head of Pennsylvania DOC medical services admitted that only five men are being treated for hepatitis C—out of an estimated 10,000 infected men in the state prison population!

Prisons are the concentrated expression of the depravity of capitalist society. Those the ruling class sees as the useless residue of a system rooted in exploitation and racial oppression are locked up, brutalized and tortured. Thanks to the decades-long crusade for mass incarceration, promoted by both the Democrats and Republicans under the guise of the racist “war on crime” and “war on drugs,” the U.S. now has more than two million people behind bars, the highest proportion in the world, the majority of them black and Latino. Not only have greater numbers of people been locked up, but their sentences are longer and their treatment more barbaric—all in the name of “punishment.”

Along with the cops, courts and military, the prisons are a core component of the capitalist state, which exists to defend the rule of the bourgeoisie against the working class and oppressed and to suppress labor struggle. It is in the vital interest of the multiracial working class to fight against the brutal conditions of prison life. Many workers, especially black workers, are directly affected by mass incarceration, either themselves having served time or having family and friends who are entangled in the capitalist injustice system.

The purpose of the Spartacist League is to build the multiracial revolutionary workers party that can unite the power of the working class with the anger of the ghettos in the fight for workers power. It will take proletarian socialist revolution to destroy the capitalist prison system and to sweep away all the barbaric institutions of the bourgeois state.

Cruel, but not Unusual

In racist capitalist America, the apparatus of punishment is based on religious precepts of retribution and penitence. All the basics for good health—decent food, clothing and shelter—are rationed so as to cause physical and mental distress, destroy dignity and reduce the prisoner to a subhuman condition. Tens of thousands, including teenagers, are locked in solitary confinement that makes and keeps people insane, while others suffer overcrowding, which aids the spread of infections. Brutal beatings by sadistic guards happen every day.

A 2013 public health study calculated that the conditions in U.S. state prisons are so deadly that life expectancy drops two years for every year incarcerated and begins to recover as soon as inmates are released. Even a court-appointed medical monitor of the California prisons said in 2006: “Needless deaths occur weekly in our prisons, either from lack of access to care, or worse, from access to it.”

The Department of Justice’s own figures show that strokes, diabetes and issues relating to heart and kidney problems are all significantly more prevalent in prison than in the general population. High blood pressure is the most common chronic condition in prison. Infectious diseases are rife, from hepatitis C to outbreaks of flu and tuberculosis. The HIV rate in prisons is more than three times that of the general population.

While the prison population is slightly shrinking, the number of women in prison is increasing. Incarcerated women face particular medical cruelties. Prisons ration pads, tampons and pain medication, making daily life, even for healthy women, an exercise in degradation. About one in 30 women who enter prison are pregnant. They are often forced to carry unwanted pregnancies to term as part of their punishment. The Hyde Amendment, enacted in 1977 under Democrat Jimmy Carter, requires that federal prisoners cover the total cost of abortion. Even if they have the money, women are subject to extra delays and stigmatizing rules that make getting an abortion nearly impossible. Furthermore, prenatal care is commonly denied, and many women are shackled during labor. Those wanting to have a child suffer the cruelty of separation, as their babies are ripped from them soon after birth.

The denial of adequate health care for prisoners is not a question of money; it reflects the ideology of punishment that goes hand in hand with the puritanical crusade that criminalizes addiction to drugs and alcohol. An article on the Al Jazeera America website (26 October 2015) reports that cities and counties across the country have shelled out tens of millions of dollars to settle lawsuits over jail inmate deaths from drug or alcohol withdrawal, even though the treatments cost pennies. Those prisoners who manage to receive treatment have to overcome enormous obstacles to keep getting their medication; those who complain of side effects risk being labeled uncooperative and removed from treatment altogether.

The unspeakable horrors of America’s prisons were highlighted by the September 1971 Attica prison uprising in upstate New York. The courageous prisoners declared: “WE are MEN! We are not beasts,” and raised demands including for a healthy diet and decent medical care. New York governor Nelson Rockefeller responded by ordering a massacre that crushed the uprising and killed 39. After the slaughter, hundreds of naked, overwhelmingly black prisoners were lined up in the yard like slaves at auction. Here was a searing image of the reality of black oppression in the U.S. where it endures as a fundamental prop of capitalist class rule.

The uprising brought attention to the conditions of prisoners, not least their health care. In the following years, many states were found to be providing health care so poor that it was deemed unconstitutional in federal courts. But rather than providing medical care, prison authorities contracted out prison health care to private companies—a trend that accelerated with the explosive growth of the prison population in the 1980s and ’90s. States have privatized some services or whole prisons, allowing ghoulish entrepreneurs to rob prisoners and their families blind for phone calls, visits and medical fees.

As a result of the tough sentencing laws of the 1990s and harsh parole revocation policies, the prison population is aging, with one in six prisoners now over 50 years old. These prisoners make up a large portion of those with chronic health conditions. The private “health care” companies have responded by further curtailing necessary tests and medications. Corizon, the largest prison health care company, recently lost several contracts with state prisons and with Rikers Island jail in New York City. At Rikers, medical failures by the company have been linked to up to a dozen deaths, including that of Bradley Ballard, who died in 2013 after being deprived of insulin and left in a cell with no food or running water for six days. Nationwide, more than 1,300 legal suits have been filed against Corizon in the last five years. Showing their utter contempt for the well-being of prisoners, the Pennsylvania DOC brought in Corizon’s medical director at Rikers as an “expert witness” at Mumia’s recent hearing!

The Pennsylvania class-action suit for hepatitis C treatment points out that denying prisoners medicine because of financial considerations is unconstitutional. In November 1976, the Supreme Court ruled in Estelle v. Gamble that prisoners have a constitutional right to health care under the Eighth Amendment’s ban on cruel and unusual punishment. (A few months before, this same Court reinstated the death penalty, ruling that execution was not cruel and unusual punishment!) Whatever recourse the Estelle ruling gave prisoners to fight medical negligence and malpractice was dealt a hefty blow with the 1996 Prison Litigation Reform Act (PLRA).

The Act, signed into law by President Bill Clinton, further curtailed the rights of prisoners to fight against all kinds of abuse, requiring them to exhaust local grievance procedures before filing suit in court. The burden of proving compliance with the whims and technicalities of prison bureaucracy can be truly Sisyphean—the goalposts keep being moved further away. As a lawyer for the Southern Center for Human Rights explained: “We lost numerous prisoners who died because of the PLRA. These issues should have been in front of the court long ago, but we were forced to wait and watch our clients die” (quoted in Benjamin Fleury-Steiner, Dying Inside [2011]).

Even prisoners with terminal illnesses are not spared the indignities of America’s prison system. Compassionate release for those facing death, allowing them to spend their last days with their loved ones, is routinely denied. The federal prison system, in which over 200,000 people are locked up, grants on average less than two dozen compassionate releases each year. Among those few who have been released is former class-war prisoner and leftist lawyer Lynne Stewart, who was framed up in a “war on terror” show trial. Suffering from stage IV breast cancer, Stewart was finally released in December 2013, after a months-long fight for compassionate release, a demand supported by more than 40,000 petitioners worldwide, including the PDC. The fact that Stewart was released has allowed her to get proper medical care, which has arrested the spread of the cancer for now.

Marxism vs. Crime and Punishment

The vast, historically ingrained system of racist state repression cannot be fundamentally changed through tinkering here and there. It has to be overturned through a workers revolution that erects in its place a workers state to defend the revolution against capitalist restoration. When the workers internationally take political power and put the wealth now appropriated by the tiny class of exploiters to the service of humanity, they will lay the material basis for achieving an egalitarian communist society, ultimately doing away with any need for a state apparatus of repression.

As Marxists, our attitude toward crime and punishment is that we are against it. Much of the theft, fraud and violence in society is a result of the material scarcity inherent in capitalism and is bolstered by reactionary ideologies like racism and bigotry. We do not proceed from the standpoint of punishing the offender. A humane and rational society may well find a need to separate certain dangerous individuals—for the protection of others, as well as of the offenders themselves. This separation would be done without the brutality and deprivation that define the American prison system, but rather with education, medical care, rehabilitation and the goal of reintegration as productive members of society.

Such was the approach of the Bolshevik Party of Lenin and Trotsky that led the October 1917 Russian socialist revolution. Their determination that the legal apparatus of a workers state would not be based on retribution found its fullest expression in the 1919 party program, which advocated “a fundamental alteration in the character of punishment, introducing conditional sentences on an extensive scale, applying public censure as a means of punishment, replacing imprisonment by compulsory labour with retention of freedom, and prisons by institutions for training” (quoted in E.H. Carr, Socialism in One Country, Vol. 2 [1959]).

There can be no fair or “humane” system of justice for the working class and oppressed in a society based on exploitation. Our perspective is that of Lenin and Trotsky—for socialist revolutions to overturn capitalism worldwide and the repressive state machinery that defends it. With its central position in production, the working class has both the social power and the material interest to shatter the capitalist order. To bring that consciousness to the proletariat requires forging a revolutionary workers party of the Bolshevik type.