Bringing Bad Things to Life

1. Bringing Bad Things to Life The alliance between GE Medical Systems and NY-Presbyterian Hospital Martin Donohoe

2. The Partners • NY-Presbyterian Hospital • One of the largest academic health care institutions in the U.S. • GE Medical Systems • Subsidiary of General Electric • $9 billion annual revenues

3. The Agreement (2003) • 10-year, $500 million agreement requires NYP to purchase products and services from GEMS in exchange for purported discounts on medical supplies and the promise of enhanced technological standardization and simplification

4. General Electric • Ranked by Forbes as world’s largest company (based on equal weighting of sales, profits, assets, and market value) • 2013 revenues of $147 billion • Close to the GDP of more than 2/3 of U.N. member states • 2013 net after-tax profits of $13.6 billion • Just over 1/3 from U.S. operations

5. 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 • Manufactures advance surveillance technologies

6. GE’s History • 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.”

7. 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

8. General Electric • Operates coal-burning power plants • Major releasers of toxic mercury • Produces nearly 40 technologies used in fracking • Increasing investments in fracking

9. 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

10. 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 • May have contributed to increased thyroid cancers, hypothyroidism, and spontaneous abortions in “Downwinders”

11. 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 BraccoDiagnositcs for falsely/misleadingly claiming that its x-ray contrast agent Visipaque was superior to BD’s Isovue

12. GE’s Record 2013: Recalls multiple nuclear medicine imaging systems due to mechanical problem that could cause serious injury or death

13. GE’s Record • America’s largest corporate polluter • 116 Superfund sites nationwide • Approximately 13 in NY

14. GE’s Record • Between 1947 and 1977, two of its capacitor manufacturing plants dumped at least 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 • Similar to GE’s contamination of Housatonic River (Pittsfield, MA)

15. GE’s Record • Has spent millions to avoid Hudson cleanup and to weaken or eliminate Superfund Law • Cleanup going slowly • Contributes to corporate front groups • Promulgate an anti-scientific and pseudo-scientific agenda • Conduct media disinformation campaigns in an attempt to weaken health and environmental regulations

16. GE’s Record • Tremendous influence of environmental, energy, and health policy • Spent over $21 million on federal government lobbying in 2011 (#4) • More than $200 million over last decade • Many members of board of directors have government ties; others have insurance and pharmaceutical industry ties

17. GE’s Record • Has eliminated 150,000 jobs in the U.S. in the last 15 years • While receiving billions in federal contracts and millions in state and local subsidies • One of nation’s top out-sourcers of jobs • 1/5 of U.S. workforce eliminated since 2002 (while overseas workforce increased)

18. GE’s Record Eliminated 34,000 US jobs between 2000 and 2010 Added 25,000 overseas jobs over same period

19. GE’s Record • Executive pension plan far more generous than for other employees • Continues to shift health care costs onto workers, despite growing profits

20. GE’s Record • Cited by Human Rights Watch for “systematic workers’ rights violations” in the U.S. and abroad • 858 OSHA workplace citations from 1990-2001 • Investments include for-profit prison enterprises

21. GE’s Record • GE has sponsored PGA Masters Tournament at Augusta National Golf Club • Club excludes women • CEO Immelt a member

22. GE’s Record • Topped 2002 Project on Government Oversight’s list of repeat offenders for defrauding U.S. taxpayers • Paid more than $982 million in fines, judgments, and out-of-court settlements between 1990 and 2002 • Financial services division fined $100 million for unfair debt collection practices and bankruptcy court malfeasance

23. GE and Corporate Taxes • GE topped the list of corporate tax break recipients from 2001-2003: • $9.5 billion in tax breaks • Between 2001 and 2010, paid only 2.3% of its $81 billion profits in federal taxes • Claimed tax benefits of $3.5 billion in 2010 • Under investigation for tax evasion in Brazil • Tax department has almost 1,000 employees (known as the “world’s best tax law firm”)

24. GE’s Record • In 1990s, Pentagon’s Defense Contract Management Agency created special investigations office specifically for GE • Nevertheless, company has been awarded increasingly costly reconstruction contracts in Iraq and Afghanistan

25. GE’s Record • The Patient Channel • Shown in hospital rooms throughout country • Advertising vehicle for drug companies • Criticized by JCAHO for manipulative marketing practices

26. GE’s Record Produces an electronic medical record, Centricity EMR Is hoping to receive some of the $19 billion earmarked for health care information technology in the current economic stimulus package.

27. GE CEO Jeffrey Immelt 2013 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

28. 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)

29. 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

30. GE CEO Jeffrey Immelt Charitable works include membership on the board of directors of “The Robin Hood Foundation”!

31. 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

32. Concerns About the Agreement • Provides GE with financial incentives to promote high technology purchases • Hospital prohibited from purchasing more effective equipment from other companies

33. 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

34. Concerns About the Agreement • Occurs at time 49 million Americans uninsured • Academic medical centers promoting luxury primary care clinics and seeking wealthy overseas patients while cutting back on services to the un- and under-insured

35. Concerns About the Agreement • Academic medical centers becoming increasingly corporatized • Research exclusivity contracts • Secrecy • gag clauses • Skewing of research agenda

36. GE’s Record • Signed licensing agreement with Cornell Medical School in 2001 re CT scan technologies to screen for lung cancer • Cornell Research Foundation funding primarily from the Vector Group (parent company = Liggett = tobacco company) • Antonio Gotto (Cornell Medical School Dean) and Arthur Mahon (Vice Chairman of College Board of Overseers) on Foundation’s Board of Directors

37. GE’s Record • Dean Gotto stated Cornell publicly disclosed the Vector Group’s role in funding the Foundation • However, searches via google and Cornell’s own search engine turn up no such disclosure, and Cornell’s press office did not respond to inquiry re the original disclosure • Foundation funded EL-CAP study (NEJM), which concluded that screening asymptomatic smokers for lung cancer can detect curable tumors • Controversial finding, contradicted by other studies

38. GE’s Record • Vector Group/Liggett’s role as funding source not mentioned in original article, in violation of conflict of interest disclosure policy • Patents and royalties from GE technology not noted either • Large profit potentials for GE (increased screening) and Liggett (reassured smokers less likely to quit) • For references, see http://phsj.org/wp-content/uploads/2008/05/elcap-vector-cornell-coi-bioethics-listserv-posts-4-08.doc

39. Concerns About the Agreement • I contacted the CEO of New York Presbyterian Hospital, the Dean, and the head of the Ethics Department to obtain more information re the agreement and the nature of the discussion preceding the agreement • No Response

40. 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

41. A macabre twist on “cradle to grave care”

42. 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

43. Reference • Donohoe MT, Robinson C. Corporations and Public Health: Overview and Case Study of GE Healthcare - "Most Admired Company" or Foe of Public Health. Social Medicine 2010;5(4):237-244. Availableathttp://www.socialmedicine.info/index.php/socialmedicine/article/view/482/1035.

44. Contact Information Public Health and Social Justice Website http://www.phsj.org martindonohoe@phsj.org