he sickening pictures of American troops humiliating Iraqi prisoners have led inevitably to questions about the standards of treatment in the corrections system at home, which has grown tenfold over the last 30 years and now jails people at eight times the rate of France and six times the rate of Canada. Conditions vary widely from state to state and community to community. But as The Times's Fox Butterfield reported recently, some of the chilling pictures from Iraq — such as the ones of inmates being paraded around naked — could have been taken at some American prisons. And humiliation by prison guards is far from the first thing on most American inmates' list of worries.

The nearly 12 million people who pass through the corrections system each year are often subject to violent attacks by other inmates, and prisoner-on-prisoner rape is endemic. Drug-resistant strains of tuberculosis, easily transmitted in tight spaces, have become a common problem. Illegal drugs ferried in by prison employees — and used by inmates who share needles — have made prison a high-risk setting for H.I.V. infection and most recently the liver-destroying hepatitis C.

Some prisons have actually cut back on testing for disease, rather than risk being required to treat large numbers of infected inmates at bankrupting costs. That means, of course, that released inmates will unknowingly pass on diseases to others. By failing to confront public health problems in prison, the country could be setting itself up for new epidemics down the line.

It is hard to quantify how many American prisoners are abused, or allowed to suffer from untreated illnesses, since the system operates largely in the shadows, outside public scrutiny. The maze of federal, state and local institutions defies easy assessment.

Things are more transparent in Europe, thanks to a powerful, independent prison commission, informally known as the Committee for Prevention of Torture. Established in 1987, The C.P.T. has unlimited access to places of detention, including prisons, juvenile centers, psychiatric hospitals and police station holding areas. Human rights violations — including medical problems — quickly become public. Such a system is long overdue in the United States.

The need for such a body was underscored last year, when Congress passed the Prison Rape Elimination Act, ordering the Justice Department to collect data on this serious problem and to create a mechanism for dealing with it. Prison officials predictably play down rape as a problem, but a harrowing report from Human Rights Watch suggested that prisoner-on-prisoner rape accompanied by savage violence was commonplace, and that officials often looked the other way.

Psychiatric care for psychotic inmates is poor to nonexistent. A recent study by the Correctional Association of New York found that nearly a quarter of inmates assigned to disciplinary lockdown — confined to small cells 23 hours a day — were mentally ill. Their symptoms worsened in isolation; nearly half had tried to commit suicide. Dissociated and sometimes violent, these people are dumped onto the streets when they finish their sentences.

The prison system can no longer be seen as the province of prison officials who cover up or mismanage problems that eventually come back to haunt the rest of the society. The country needs to formulate national prison standards and create an independent body that enforces them, if only by opening prisons to greater public scrutiny.

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