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Corporate Control of Public Health: Case Studies and Call to Action. Martin Donohoe. Am I Stoned?. A 1999 Utah anti-drug pamphlet warns: “Danger signs that your child may be smoking marijuana include excessive preoccupation with social causes, race relations, and environmental issues”.

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am i stoned
Am I Stoned?

A 1999 Utah anti-drug pamphlet warns:

“Danger signs that your child may be smoking marijuana include excessive preoccupation with social causes, race relations, and environmental issues”

corporations dominate the global economy
Corporations Dominate the Global Economy
  • Almost 6 million corporations
  • 90% of transnational corporations headquartered in Northern Hemisphere
  • 500 companies control 70% of world trade
corporations dominate the global economy1
Corporations Dominate the Global Economy
  • 53 of the world’s 100 largest economies are private corporations; 47 are countries
    • Wal-Mart is larger than Israel and Greece
the stock market
The Stock Market
  • The top 1% of Americans owns 35% of all stocks, bonds, and mutual fund assets
  • Consequences of Differential Stock Ownership
    • Corporations are answerable to their shareholders
    • Governments are answerable (at least in theory) to their citizens (either through elections or revolutions)
corporations
Corporations
  • Internalize profits
  • Externalize health and environmental costs
corporate taxation
Corporate Taxation
  • Corporations shouldered over 30% of the nation’s tax burden in 1950 vs. 8% today
  • Nearly 1/3 of all large U.S. corporations pay no annual tax
corporate taxation1
Corporate Taxation
  • Big business claims that U.S. corporations pay the highest corporate taxes in the world (35%)
  • FALSE: The rate actually paid, after foreign governments get their cuts, money sent to foreign subsidiaries, loopholes, etc. = 2.3% (U.S. Treasury Department)
reasons for inadequate corporate taxation
Reasons for Inadequate Corporate Taxation
  • Corporate tax breaks/loopholes
  • Corporate welfare
  • Cheating and under-payment common
  • Offshore tax havens shelter capital
corporate taxation2
Corporate Taxation
  • 2004: Bush administration offered temporary tax holiday on foreign earnings
    • $300 billion in profit repatriated
      • 92% went to dividend payouts, stock buybacks, and corporate coffers
      • Only 8% went to R and D, new factories, and hiring
exorbitant ceo pay
Exorbitant CEO Pay
  • CEO salaries up 759% since 1978
    • Average worker pay up 6%
  • The average CEO makes 250-400X the salary of the average U.S. worker (1960 - 41X)
    • Mexico 45:1
    • Britain 25:1
    • Japan 10:1
    • US Military: 20:1 (top rank : lowest rank)
ceo personality characteristics
CEO Personality Characteristics
  • Some data suggest certain traits common among psychopaths are also commonly found in CEOs (and politicians, world leaders, and serial killers):
    • Grandiose sense of self worth
    • Persuasiveness
    • Superficial charm
    • Ruthlessness
    • Lack of remorse
    • Manipulation of others
the mega rich
The Mega-Rich
  • Worried / Investing in personal security
    • Bodyguards
    • Armored cars
    • Bullet-proof windows; machine gun proof doors
    • Home security fogs
    • Panic rooms
    • Fully-stocked home medical suites
    • Yachts with escape submarines
    • Islands
corporate pr tactics
Corporate PR Tactics
  • Advertising
    • “The art of convincing people to spend money they don\'t have for something they don\'t need.“ (Will Rogers)
  • Astroturf - artificially-created grassroots coalitions
  • Corporate front groups
  • Invoke poor people as beneficiaries
corporate pr tactics1
Corporate PR tactics
  • Characterize opposition as “technophobic,” anti-science,” and “against progress”
  • Portray their products as environmentally beneficial despite evidence to the contrary
  • Host all-expense paid educational seminars for federal judges
  • Corporate espionage: spying, bribes
public relations
Public Relations
  • $200 billion industry
  • PR flacks now outnumber journalists
greenwash
Greenwash
  • Public relations / ad campaigns
    • BP invests $100 million annually in clean energy = amt. it spends annually to market itself as moving “Beyond Petroleum”
sponsored environmental education materials examples
Sponsored Environmental Education Materials (Examples)
  • International Paper

-“Clearcutting promotes growth of trees that require full sunlight and allows efficient site preparation for the next crop”

  • Exxon’s “Energy Cube”

-“Gasoline is simply solar power hidden in decayed matter”

-“Offshore drilling creates reefs for fish”

academics professional organizations affected
Academics/Professional Organizations Affected
  • Increasing corporatization of academia
    • ↑Private commercial funding of university research
    • Secrecy/Gag Clauses
academics professional organizations affected1
Academics/Professional Organizations Affected
  • For-profit colleges growing, marked by corruption, high interest rates on loans to the un- and under-qualified
    • Benefit largely from taxpayer money
  • Dramatic decrease in tenured faculty, rise in administrators
academics professional organizations affected2
Academics/Professional Organizations Affected
  • Gagging of researchers at federal agencies demoralizing, can affect recruitment of quality scientists
  • 2001 – 2011: Number of published papers increased by 44%; number of retracted articles increased 15-fold (3/4 for errors, ¼ for fraud)
the media
The Media
  • 5 corporations control majority of US media (down from 50 in 1983)
  • Extensive corporate-media links
global warming controversial
Global Warming: Controversial?
  • Of 928 articles in peer-reviewed scientific journals, none were in doubt as to the existence or cause of global warming
  • Of 636 articles in the popular press (NY Times, Washington Post, LA Times, WSJ), 53% expressed doubt as to the existence (and primary cause) of global warming

Science 2004;306:1686-7

(Study covers 1993-2003)

lobbying
Lobbying
  • Approximately 40,000 lobbyists (12,600 full-time)
  • Estimates of return on lobbying range from $28 to $100 for every $1 spent
lobbying1
Lobbying
  • Federal lobbying groups spent 3.5 billion in 2010 (3.3 billion in 2011)
  • All single issue ideological groups combined (e.g., pro-choice, anti-abortion, feminist and consumer organizations, senior citizens, etc.) = $76 million (2010)
top spending industries 2011 low estimates
Top-Spending Industries, 2011(Low Estimates)
  • Pharmaceutical industry - $236 million
  • Insurance industry - $158 million
  • Oil and gas industry - $146 million
  • Electric utilities - $144 million
campaign cash and lobbying
Campaign Cash and Lobbying
  • Citizens United
  • Lobbying promotes international non-cooperation/isolationism
general electric
General Electric
  • Ranked by Forbes as world’s largest company (based on equal weighting of sales, profits, assets, and market value)
  • 2012 revenues of $145 billion
    • Close to the GDP of more than 2/3 of U.N. member states
    • 2012 net after-tax profits of $15 billion
      • Just over 1/3 from U.S. operations
general electric1
General Electric
  • Makes household appliances, lighting, and medical equipment
    • Plastics division, which produced bisphenol A, spun off in 2008
  • Produces jet engines and military hardware
general electric2
General Electric
  • Charles Wilson (CEO of GE pre- and post-WW II; helped oversee U.S. military production during WW II):
    • “The revulsion against war…will be an almost insuperable obstacle for us to overcome. For that reason, I am convinced that we must begin now to set the machinery in motion for a permanent wartime economy.”
general electric3
General Electric
  • Has built 91 nuclear power plants in 11 countries (including the troubled Fukushima Daishi plants in Japan)
    • Including 23 plants at 11 sites in U.S.
      • e.g., Hanford
    • ¼ of GE’s US reactors found to be defective
general electric4
General Electric
  • Operates coal-burning power plants
    • Major releasers of toxic mercury
  • Produces nearly 40 technologies used in fracking
    • Increasing investments in fracking
general electric5
General Electric
  • Operates a large financial services group
    • Lending accounts for > 30% of revenue, vs. < 6% of revenue from consumer appliances
    • Responsible for over 50% of company’s profits in recent years
  • Owns a multi-billion dollar media empire
    • Including NBC (49%, Comcast – 51%), Telemundo, and Universal Studios
ge s history
GE’s History
  • Conducted unethical human subject experiments on prisoners, involving testicular irradiation, from 1940s to 1960s
  • Intentionally-released excessive radiation from its Hanford, WA nuclear reactor in the 1980s, to determine how far it would travel
ge s record
GE’s Record
  • Sued radiologist who brought to light dangers of GE’s contrast agent, Omniscan
    • Causes nephrogenic systemic fibrosis (FDA black box warning)
  • Ordered to pay $11.4 million to Bracco Diagnositcs for falsely/misleadingly claiming that its x-ray contrast agent Visipaque was superior to BD’s Isovue
ge s record1
GE’s Record
  • America’s largest corporate polluter
  • 116 Superfund sites nationwide
  • Approximately 13 in NY
ge s record2
GE’s Record
  • Between 1947 and 1977, two of its capacitor manufacturing plants dumped 1.3 million pounds of PCBs into the Hudson River
    • Probable human carcinogens with adverse effects on liver, kidney, nervous system, and reproductive organs (EPA)
    • 200 mi of Hudson = Superfund site
ge s record3
GE’s Record
  • Eliminated 34,000 US jobs between 2000 and 2010
  • Added 25,000 overseas jobs over same period
    • One of nation’s top out-sourcers of jobs
ge s record4
GE’s Record
  • Cited by Human Rights Watch for “systematic workers’ rights violations” in the U.S. and abroad
  • Extensive record of tax violations, military procurement fraud
ge ceo jeffrey immelt
GE CEO Jeffrey Immelt
  • 2012 total compensation = $25.8 million
  • Named “World’s Best CEO” in 3 separate Barron’s polls
  • 2006 - 2011 - On Board of NY Federal Reserve Bank
ge ceo jeffrey immelt1
GE CEO Jeffrey Immelt
  • 2008 – Named one of the “100 Most Influential People in the World” by TIME Magazine
  • 2009 - Appointed by President Obama to his Economic Recovery Board
    • GE then became eligible, via a loophole, for ¼ of the $340 billion Temporary Liquidity Guarantee Program (debt support)
ge ceo jeffrey immelt2
GE CEO Jeffrey Immelt
  • 2011 - Appointed by Obama as Chair of his outside panel of Economic Advisors and of his Council on Jobs and Competitiveness
  • On the board of directors of “The Robin Hood Foundation”!
ge s record5
GE’s Record
  • Named “America’s Most Admired Company” by Forbes
  • Named one of the “World’s Most Respected Companies” in polls conducted by Barron’s and The Financial Times
concerns about the agreement between ge medical systems and ny presbyterian hospital 2003
Concerns About the Agreement between GE Medical Systems and NY-Presbyterian Hospital (2003)
  • Provides GE with financial incentives to promote high technology purchases
  • Hospital prohibited from purchasing more effective equipment from other companies
concerns about the agreement
Concerns About the Agreement
  • Augments trend in academic medical centers to promote the use of expensive, high-technology care at expense of preventive care and public health measures
    • Highly reimbursable
    • Services may be redundant in certain locations
concerns about the agreement1
Concerns About the Agreement
  • Patients with developmental anomalies and cancers caused by GE’s pollution diagnosed with GE scanners and treated with GE-manufactured therapeutic devices, increasing GE’s profit
solutions
Solutions
  • NY-P should cancel agreement
  • Health care providers and organizations should condemn this alliance
  • Medical and ethical organizations should develop standards regarding future agreements
slide55

Confronting Pseudoscience and Threats from a Corporate Front Group:The American Council on Science and Health

who tobacco treaty
WHO Tobacco Treaty
  • U.S. attempted to undermine treaty through Bush administration appointees with strong ties to tobacco industry
medical technologies industry
Medical Technologies Industry
  • Successful lobbying effort against Medicare physician payment policies relevant to unproven imaging studies
    • Whole body CT scans (scams)
drug testing
Drug Testing
  • 2011: Florida Governor Rick Scott (R) issues executive order requiring drug tests on current state workers and new applicants
  • 2011: Scott signs bill requiring drug tests for TANF program
    • positive test allows parent to choose another individual to receive benefits on behalf of children
    • Aid recipients responsible for cost of tests
drug testing1
Drug Testing
  • Florida Governor Rick Scott
    • Former CEO of Columbia/HCA
    • Fired after presiding over massive Medicare fraud that cost corporation $1.7 billion federal fine
    • Then set up Solantic (FL chain of emergency care clinics); transferred ownership to his wife upon entering statehouse
      • Solantic is in the drug-testing business!
corporate agribusiness
Corporate Agribusiness
  • Successful campaign against Oregon’s Proposition 27 (labeling of GM foods)
  • Lobbying for pre-emptive labeling laws re GMOs, rBGH
corporate agribusiness1
Corporate Agribusiness
  • Supports spread of GMOs to developing world
  • Keeps GM seeds from non-corporate academic researchers
  • Promoting agriculture bills which provide large subsidies to large industrial farms
corporate agreements with medical associations
Corporate Agreements with Medical Associations
  • AAP – Abbott Nutrition (manufacturers of Similac)
  • AAP – Babies “R” Us
  • AAFP – Coca Cola, Inc.
  • AMA – Sunbeam
  • AMA – sells access to Physician Masterfile
medical care
Medical Care
  • Sponsor luxury care consortiums, clinics
  • Facilitate medical tourism
  • Participation in “medical transfer market” (facilitates medical repatriations of undocumented immigrants - e.g., MexCare)
health insurance industry
Health Insurance Industry
  • Dubious practices:
    • Delisting
    • Cherry picking
    • Pre-existing conditions
  • Often lower quality of care
  • High administrative costs
    • 15-30% (vs. 2-3% for Medicare and Medicaid)
health insurance industry1
Health Insurance Industry
  • Large profit margins
  • Loyalty: shareholders (not patients)
  • Corruption
prison industrial complex
Prison-Industrial Complex
  • Construction and management of prisons
  • Providing (substandard) health care to inmates
pharmaceutical industry
Pharmaceutical Industry
  • Influence over physicians through control of CME, gifts, research funding
    • Physician Payments Sunshine Act – reporting requirements
  • Conduct seeding trials to alter prescribing patterns
  • Secrecy, statistical torturing of data sets, selective publication
pharmaceutical industry1
Pharmaceutical Industry
  • Data mining of prescribing practices
    • OK’d by SCOTUS in Sorrell v. IMS Health
  • Unethical trials in developing world
  • Poor compliance with Clinical Trials Registry rules
drug company malfeasance
Drug Company Malfeasance
  • The pharmaceutical industry is the biggest defrauder of the federal government, as determined by payments made for violations of the federal False Claims Act (FCA)
    • Accounted for 25% of all FCA payouts between 2000 and 2010
    • Defense industry – 11%
pharmaceutical industry2
Pharmaceutical Industry
  • Avoided $7 billion in US taxes in 2012 by shifting profits overseas
  • $240 million dollars spent on lobbying in 2011
    • 1,228 lobbyists (2.3 for every member of Congress)
    • Revolving door between legislators, lobbyists, executives and government officials
pharmaceutical industry3
Pharmaceutical Industry
  • Effectively lobbied and threatened trade sanctions against developing countries in order to prevent production and importation of much cheaper, generic versions of life-saving anti-AIDS drugs
  • Patent extensions
pharmaceutical industry4
Pharmaceutical Industry
  • Opposes legislation aimed at limiting pharmaceutical industry influence by publicizing gifts to providers
  • Opposes Federal Research Public Access Act, which would require federal agencies that fund over $100 million in external research per year to make their study results publicly available online
ppaca patient protection and affordability care act
PPACAPatient Protection and Affordability Care Act
  • Career arc of Elizabeth Fowler (architect of plan):
    • VP for Public Policy and External Affairs (informal lobbying) at WellPoint (nation’s largest insurer)
    • Chief health policy counsel to Senator Max Baucus (who drafted legislation)
    • Head of Global Health Policy at pharmaceutical giant Johnson and Johnson
solutions1
Solutions
  • Restructure tax system
  • Punish corporate scofflaws with large fines and jail time
  • Increase enforcement budgets to combat corporate crime
solutions2
Solutions
  • Eliminate confidential legal settlements and confidential business information relevant to public health and safety
  • Eliminate mandatory binding arbitration clauses
solutions3
Solutions
  • Living wage laws
  • Work with corporations
    • Healthy PR
    • Shareholder activism
    • Risks/benefits
solutions fair representative elections
Solutions: Fair, Representative Elections
  • Publicly financed campaigns and campaign finance reform
  • Open debates, free air time for candidates
  • Proportional representation
  • Instant runoff voting/cumulative voting/range (rating) voting
  • Halt disenfranchisement, overturn voter restriction laws
solutions vote
Solutions: Vote
  • US voter turnout low
    • Wealthy vote at almost twice rate of poor
    • Whites > Blacks > Hispanics
    • Old > Young
    • Property owners > Renters
    • Physicians < general population
solutions4
Solutions
  • Activism / Letter writing / Protesting / Whistleblowing
    • Unfortunately, SCOTUS sharply restricted public employees’ whistleblowing rights in Garcetti v. Ceballos (2006)
    • But, Congress passed Whistleblower Protection Enhancement Act (2011)
solutions5
Solutions
  • Join community groups – become involved in local as well as national issues
  • Lobby legislators
  • Run for office
solutions6
Solutions
  • Increase funding of public education
  • Independent scientific review of school curricula
  • Prohibit use of sponsored curricula
solutions7
Solutions
  • Establish safeguards re corporate involvement in academic research
  • Higher standards of journalism
  • Support alternative media
solutions education
Solutions: Education
  • Medical ethics overemphasizes fascinating dilemmas involving expensive technologies (e.g., gene therapy, cloning, face transplants)
  • Medical ethics underemphasizes the psychological, cultural, socioeconomic, occupational, and environmental contributors to health
solutions education1
Solutions: Education
  • IOM recommends ¼ to ½ of medical students earn the equivalent of an MPH
    • Only 10% of students at US public health schools are physicians, down from 60% in the 1960s
solutions8
Solutions
  • Augment and improve international aid package
  • Sign, ratify, and adhere to major international treaties
  • Support Millenium Development Goals
solutions9
Solutions
  • Based on Precautionary Principle
  • Recognize nature’s net worth
  • Calculate prosperity based on Genuine Progress Index or Global Happiness Index, rather than Gross Domestic Product
slide89

“All men are created equal”

    • Declaration of Independence
  • “Some people are more equal than others”
    • George Orwell
voltaire
Voltaire

“The comfort of the rich rests upon an abundance of the poor”

primo levi
Primo Levi

“A country is considered the more civilized the more the wisdom and efficiency of its laws hinder a weak man from becoming too weak or a powerful one too powerful.”

g nter grass
Günter Grass

“The first job of a citizen is to keep your mouth open.”

african proverb
African Proverb

If you think you are too small to have an impact, try going to bed with a mosquito in your tent

contact information and references
Contact Information and References

Public Health and Social Justice Website

http://www.publichealthandsocialjustice.org

http://www.phsj.org

[email protected]

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