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Corporations and Public Health: Profits Before People. 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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Corporations and public health profits before people

Corporations and Public Health:Profits Before People

Martin Donohoe

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 51% 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)


  • 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

Ugland house cayman islands 18 000 corporations registered here
Ugland House, Cayman Islands18,000 Corporations Registered Here

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 350-400X 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)

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

  • Corporate espionage: spying, bribes


  • 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

  • For-profit colleges growing, marked by corruption, high interest rates on loans to the un- and under-qualified

Academics professional organizations affected1
Academics/Professional Organizations Affected

  • Dramatic decrease in tenured faculty, rise in administrators

  • Gagging of researchers at federal agencies demoralizing, can affect recruitment of quality scientists

The media
The Media

  • 5 corporations control majority of US media (down from 50 in 1983)

  • Extensive corporate-media links

  • American Council on Science and Health

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)


  • Approximately 40,000 lobbyists (12,600 full-time)

  • Estimates of return on lobbying range from $28 to $100 for every $1 spent


  • Corporate 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 Hospital

  • 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 Hospital

  • 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 Hospital

  • 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 Hospital

  • 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 Hospital

  • 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 Hospital

  • Operates a large financial services group

    • Responsible for over 50% of company’s profits in recent years

  • Until recently, owned 49% of a multi-billion dollar media empire

    • Including NBC, Telemundo, and Universal Studios

    • Comcast owned 51%; bought out GE in 2013

Ge s history
GE’s History Hospital

  • 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 Hospital

  • 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 Hospital

  • America’s largest corporate polluter

  • 116 Superfund sites nationwide

  • Approximately 13 in NY

Ge s record2
GE’s Record Hospital

  • 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 Hospital

  • 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 Hospital

  • 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 Hospital

  • 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 Hospital

  • 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 Hospital

  • 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 Hospital

  • 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 NY-Presbyterian Hospital (2003)

  • 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 NY-Presbyterian Hospital (2003)

  • 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

Corporations and public health profits before people

A macabre twist on “cradle to grave care” NY-Presbyterian Hospital (2003)

Solutions NY-Presbyterian Hospital (2003)

  • NY-P should cancel agreement

  • Health care providers and organizations should condemn this alliance

  • Medical and ethical organizations should develop standards regarding future agreements

Health insurance industry
Health Insurance Industry NY-Presbyterian Hospital (2003)

  • 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 NY-Presbyterian Hospital (2003)

  • Large profit margins

  • Loyalty: shareholders (not patients)

  • Corruption

Pharmaceutical industry
Pharmaceutical Industry NY-Presbyterian Hospital (2003)

  • 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 NY-Presbyterian Hospital (2003)

  • 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 NY-Presbyterian Hospital (2003)

  • 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 NY-Presbyterian Hospital (2003)

  • $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 NY-Presbyterian Hospital (2003)

  • 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

Ppaca patient protection and affordability care act
PPACA NY-Presbyterian Hospital (2003)Patient 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

Solutions NY-Presbyterian Hospital (2003)

  • Restructure tax system

  • Punish corporate scofflaws with large fines and jail time

  • Increase enforcement budgets to combat corporate crime

Solutions NY-Presbyterian Hospital (2003)

  • Eliminate confidential legal settlements and confidential business information relevant to public health and safety

  • Eliminate mandatory binding arbitration clauses

Solutions NY-Presbyterian Hospital (2003)

  • Living wage laws

  • Work with corporations

    • Healthy PR

    • Shareholder activism

    • Risks/benefits

Solutions fair representative elections
Solutions: Fair, Representative Elections NY-Presbyterian Hospital (2003)

  • Publicly financed campaigns and campaign finance reform

  • Overturn Citizens United

  • Proportional representation

  • Instant runoff voting

  • Halt disenfranchisement, overturn voter restriction laws

  • Vote

Solutions NY-Presbyterian Hospital (2003)

  • Activism / Letter writing / Protesting / Whistleblowing

  • Work in groups

  • Lobby legislators

  • Run for office

Solutions NY-Presbyterian Hospital (2003)

  • Increase funding of public education

  • Independent scientific review of school curricula

  • Prohibit use of sponsored curricula

Solutions NY-Presbyterian Hospital (2003)

  • Establish safeguards re corporate involvement in academic research

  • Higher standards of journalism

  • Support alternative media

Solutions NY-Presbyterian Hospital (2003)

  • Augment and improve international aid package

    • 0.9% of the total federal budget, 1.6% of the discretionary budget

    • Charitable giving approximately $250 billion/year (2.5% of income vs. 2.9% at height of Great Depression)

  • Sign, ratify, and adhere to major international treaties

Solutions NY-Presbyterian Hospital (2003)

  • Based on Precautionary Principle

  • Recognize nature’s net worth

  • Measure prosperity based on Genuine Progress Index or Global Happiness Index, rather than Gross Domestic Product

Corporations and public health profits before people

Voltaire NY-Presbyterian Hospital (2003)

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

Hudson river 2009
Hudson River, 2009 NY-Presbyterian Hospital (2003)

Primo levi
Primo Levi NY-Presbyterian Hospital (2003)

“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
G NY-Presbyterian Hospital (2003)ünter Grass

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

African proverb
African Proverb NY-Presbyterian Hospital (2003)

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 NY-Presbyterian Hospital (2003)

Public Health and Social Justice Website