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”
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 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 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 • Internalize profits – $2. 1 trillion (2013) • Externalize health and environmental costs
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 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 • 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
Job Creators?
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 • The average CEO makes 373 X the salary of the average U. S. worker (1960 - 41 X) – Mexico 45: 1 – Britain 25: 1 – Japan 10: 1 – US Military: 20: 1 (top rank : lowest rank) – US ratio of average CEO to minimum wage worker = 774: 1
Exorbitant CEO Pay • Median U. S. CEO salary (for S and P 500 corporations) = $11. 7 million (2014) • CEO salaries up 997% since 1978 – Average worker pay up 11%
Exorbitant CEO Pay • The average CEO makes 250 -400 X the salary of the average U. S. worker (1960 - 41 X) – Mexico 45: 1 – Britain 25: 1 – Japan 10: 1 – US Military: 20: 1 (top rank : lowest rank)
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
Minimum Wage ≠ Living Wage • Federal minimum wage = $7. 25/hr – 18 states and DC have higher minimum wages (Oregon = $9. 10/hr, 2014) – $10, 423/yr for full-time job • Real value down 42% compared with 1968 • Inadequate to pay rent, buy food and clothing
Minimum Wage ≠ Living Wage • Increasing to $9. 25/hr on Jan 1, 2015 • Movements supporting $15/hr (still inadequate) • Over ½ of nation’s basic public assistance funds go to working families (substitute for benefits, therefore, taxes support corporations)
Solutions: Living Wage • Over 140 municipalities have adopted living wage laws – Including NY, LA, SFO, Seattle, Chicago, and Philadelphia • 15 states now have minimum wages that exceed the federal requirement • 10 states have passed pre-emptive laws forbidding cities and counties from raising the minimum wage
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 • Corporate espionage: spying, bribes
Corporate PR tactics • Invoke poor people as beneficiaries • 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
Public Relations • $200 billion industry • PR flacks now outnumber journalists
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) 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”
Sponsored Environmental Education Materials (Examples) • American Coal Foundation’s “Power from Coal”: – “The earth could benefit rather than be harmed from increased carbon dioxide. ”
Academics/Professional Organizations Affected • Increasing corporatization of academia – For-profit schools – Charter schools – Educational corporations
Academics/Professional Organizations Affected – ↑Private commercial funding of university research • Front-end domination and rear-end repression affect research agenda, dissemination of knowledge • Undone science • Secrecy/gag clauses • Corporate-sponsored harassment of scientists
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 • Gagging of researchers at federal agencies demoralizing, can affect recruitment of quality scientists
Union of Concerned Scientists (2015)
The Media • 5 corporations control majority of US media (down from 50 in 1983) • Extensive corporate-media links
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 • Approximately 40, 000 lobbyists (11, 781 full-time) • Estimates of return on lobbying range from $28 to $212 for every $1 spent (higher values more likely) • Return on campaign contributions for elections for the most politically active companies = $760 per $1 spent
Lobbying • Federal lobbying groups spent $3. 2 billion in 2014 • All single issue ideological groups combined (e. g. , pro-choice, antiabortion, feminist and consumer organizations, senior citizens, etc. ) spent well under $100 million
Top-Spending Industries, 2014 • • • Pharmaceutical industry - $230 million Business Associations - $163 million Insurance industry - $151 million Oil and gas industry - $141 million Computers/Internet - $140 million Electric utilities - $122 million
Campaign Cash and Lobbying • Citizens United • Mc. Cutcheon v. Federal Election Commission • Lobbying promotes international noncooperation/isolationism
Case Studies
The alliance between GE Medical Systems and NY-Presbyterian Hospital
General Electric • Ranked by Forbes as world’s largest company (based on equal weighting of sales, profits, assets, and market value) • 2014 revenues of $149 billion – Close to the GDP of more than 2/3 of U. N. member states 2014 net after-tax profits of $15. 2 billion • Majority from overseas operations
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 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 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 Electric • Operates coal-burning power plants – Major releasers of toxic mercury • Produces nearly 40 technologies used in fracking – Increasing investments in fracking
General Electric • Operates a large financial services group – Responsible for over 50% of company’s profits in recent years – 2015: company plans to sell off majority of GE Capital (now Syncrhony Financial) over next 2 years – Under investigation by the Justice Department for over potential bankruptcy violations
General Electric • Until recently, owned 49% of a multibillion dollar media empire – Including NBC, Telemundo, and Universal Studios – Comcast owned 51%; bought out GE in 2013
GE’s History • Conducted unethical human subject experiments on prisoners, involving testicular irradiation, from 1940 s to 1960 s • Intentionally-released excessive radiation from its Hanford, WA nuclear reactor in the 1980 s, to determine how far it would travel
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 Record • America’s largest corporate polluter • 116 Superfund sites nationwide • Approximately 13 in NY
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
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 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 • 2014 total compensation = $37. 2 million (up from $25. 8 million in 2013) • Named “World’s Best CEO” in 3 separate Barron’s polls • 2006 - 2011 - On Board of NY Federal Reserve Bank
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 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 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) • Provides GE with financial incentives to promote high technology purchases • Hospital prohibited from purchasing more effective equipment from other companies
Concerns About the Agreement • Augments trend in academic medical centers to promote the use of expensive, hightechnology care at expense of preventive care and public health measures – Highly reimbursable – Services may be redundant in certain locations
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
A macabre twist on “cradle to grave care”
The American Council on Science and Health Corporate Front Group Promulgates unsound science Pro-corporate agenda Major media presence – Medical director spent time in federal prison for Medicaid fraud, perjury, and obstruction of justice • Threatened to sue me, Medscape over allegations in article on global warming • •
WHO Tobacco Treaty • U. S. attempted to undermine treaty through Bush administration appointees with strong ties to tobacco industry
Medical Technologies Industry • Successful lobbying effort against Medicare physician payment policies relevant to unproven imaging studies • Whole body CT scans (scams)
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 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 • Successful campaign against Oregon’s Proposition 27 (labeling of GM foods) • Lobbying for pre-emptive labeling laws re GMOs, r. BGH
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
Prison-Industrial Complex • Construction and management of prisons • Providing (substandard) health care to inmates
Health Insurance Industry • Dubious practices: – Delisting – Cherry picking – Pre-existing conditions – Limiting coverage of medications for high cost illnesses • Often lower quality of care • High administrative costs – 15 -30% (vs. 2 -3% for Medicare and Medicaid)
Health Insurance Industry • Large profit margins • Loyalty: shareholders (not patients) • Corruption
Medical Care • Sponsor luxury care consortiums, clinics • Facilitate medical tourism • Participation in “medical transfer market” (facilitates medical repatriations of undocumented immigrants - e. g. , Mex. Care)
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
Pharmaceutical Industry • Only 10% of new drugs treat lifethreatening conditions • 90% of new drugs little or no better than pre-existing agents (or cause harm) • Thus only 1% of new drugs “life-saving”
Pharmaceutical Industry • Pay-for-delay costs consumers and taxpayers $3. 5 billion in additional drug costs/yr • Over 40, 000 drug-related deaths not reported to FDA, as required, over last decade
Drug Companies’ Cost Structure • • • Manufacturing – 35% Marketing – 27% Profits (after taxes) – 18% R and D – 13% Taxes – 7%
Pharmaceutical Industry • Influence over physicians through control of CME, gifts, research funding – Over $3. 7 billion to at about 366, 000 physicians and 900 teaching hospitals in 2014 (excluding research funding) – Physician Payments Sunshine Act – reporting requirements
Pharmaceutical Industry • Conduct seeding trials to alter prescribing patterns • Secrecy, statistical torturing of data sets, selective publication • Data mining of prescribing practices • Unethical trials in developing world • Poor compliance with Clinical Trials Registry rules
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 Industry • Avoided $7 billion in US taxes in 2012 by shifting profits overseas • $230 million dollars spent on lobbying in 2014 – 2. 3 lobbyisits for every member of Congress – Revolving door between legislators, lobbyists, executives and government officials
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 • Promotion of agricultural antibiotic overuse
PPACA Patient Protection and Affordability Care Act • Career arc of Elizabeth Fowler (architect of plan): – VP for Public Policy and External Affairs (informal lobbying) at Well. Point (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
Other Areas of Corporate Malfeasance • Military-industrial complex • Energy and chemicals industry • Law enforcement/prison-industrial complex • Payday loan industry • Genetically-modified crops/biopharming • Breast milk substitutes
Solutions • Restructure tax system • Improve regulation of banks (e. g. , enforce Dodd Frank law) • Punish corporate scofflaws with large fines and jail time – Hide no Harm Act (pending in Senate) would hold corporate officers criminally accountable if they knowingly concealed serious dangers that led to consumer or worker deaths or injuries
Solutions • Increase enforcement budgets to combat corporate crime • Eliminate confidential legal settlements and confidential business information relevant to public health and safety • Eliminate mandatory binding arbitration clauses
Solutions • Living wage laws • Work with corporations – Benefit corporations – Healthy PR – Shareholder activism – Risks/benefits
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 US voter turnout low Wealthy vote at almost twice rate of poor Whites > Blacks > Hispanics Old > Young Property owners > Renters Physicians < general population
Voter Turnout
Solutions • Activism / Letter writing / Protesting / Whistleblowing • Join community groups – become involved in local as well as national issues • Lobby legislators • Run for office
Solutions • Increase funding of public education • Independent scientific review of school curricula • Prohibit use of sponsored curricula
Solutions • Establish safeguards re corporate involvement in academic research • Higher standards of journalism • Support alternative media
Solutions • Augment and improve international aid package • Sign, ratify, and adhere to major international treaties
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
• “All men are created equal” –Declaration of Independence • “Some people are more equal than others” –George Orwell
Voltaire “The comfort of the rich rests upon an abundance of the poor”
Hudson River, 2009
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. ”
Günter Grass “The first job of a citizen is to keep your mouth open. ”
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 Public Health and Social Justice Website http: //www. publichealthandsocialjustice. org http: //www. phsj. org martindonohoe@phsj. org
Скачать презентацию Corporate Control of Public Health Case Studies and
4ca00502e6afabc949b32dceddf75440.ppt