Corporate Control of Public Health: Case Studies and Call to Action

1. Corporate Control of Public Health:Case Studies and Call to Action Martin Donohoe

2. 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”

3. Corporations Dominate the Global Economy • Almost 6 million corporations • 90% of transnational corporations headquartered in Northern Hemisphere • 500 companies control 70% of world trade

4. 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

5. 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)

6. Corporations • Internalize profits • Externalize health and environmental costs

7. 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

8. 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)

9. 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

10. Reasons for Inadequate Corporate Taxation • Corporate tax breaks/loopholes • Corporate welfare • Cheating and under-payment common • Offshore tax havens shelter capital

11. Ugland House, Cayman Islands18,000 Corporations Registered Here

12. Exorbitant CEO Pay • CEO salaries up 500% since 1980 • 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

13. Corporate PR Tactics • Advertising • Astroturf - artificially-created grassroots coalitions • Greenwash • Corporate front groups

14. 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

15. Greenwash • Public relations / ad campaigns • BP invests $100 million annually in clean energy = amt. it spends annually to market itself as moving “Beyond Petroleum”

16. 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”

17. 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

18. The Media • 5 corporations control majority of US media (down from 50 in 1983) • Extensive corporate-media links

19. 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)

20. Lobbying • Over 15,000 full-time lobbyists • Estimates of return on lobbying range from $28 to $100 for every $1 spent

21. Lobbying • Lobbying groups spent 3.5 billion in 2010 (federal lobbying, a record) • All single issue ideological groups combined (e.g., pro-choice, anti-abortion, feminist and consumer organizations, senior citizens, etc.) = $76 million • Lobbying promotes international non-cooperation/isolationism

22. Case Studies

23. The alliance between GE Medical Systems and NY-Presbyterian Hospital

24. General Electric • Ranked by Forbes as world’s largest company (based on equal weighting of sales, profits, assets, and market value) • 2010 net after-tax profits of $14 billion • $5.1 billion in U.S.

25. General Electric • Makes household appliances, lighting, and medical equipment • Has built 91 nuclear power plants in 11 countries (including Japan’s troubled Fukushima Daishii reactors) • Produces jet engines and military hardware

26. 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.”

27. General Electric • Operates coal-burning power plants • Major releasers of toxic mercury • Operates a large, highly profitable financial services group • Responsible for over 30% of revenue and 50% of profits in recent years • Owns a multi-billion dollar media empire • Including NBC (49%, Comcast – 51%), Telemundo, and Universal Studios

28. 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

29. GE’s Record • Sued radiologist who brought to light dangers of GE’s contrast agent, Omniscan • Causes nephrogenic systemic sclerosis (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

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

31. 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

32. GE’s Record • CEO Jeffrey Immelt named “World’s Best CEO” in 3 separate Barron’s polls • On Board of NY Federal Reserve Bank and appointed by President Obama to his Economic Recovery Board

33. GE’s Record • Has eliminated 150,000 jobs in last 15 years • One of nation’s top out-sourcers of jobs • Cited by Human Rights Watch for “systematic workers’ rights violations” in the U.S. and abroad • Extensive record of tax violations, military procurement fraud

34. 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

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

36. 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

37. 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

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

39. Solutions • NY-P should cancel agreement • Health care providers and organizations should condemn this unholy alliance • Medical and ethical organizations should develop standards regarding future agreements

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

41. WHO Tobacco Treaty • U.S. attempted to undermine treaty through Bush administration appointees with strong ties to tobacco industry

42. Medical Technologies Industry • Successful lobbying effort against Medicare physician payment policies relevant to unproven imaging studies • Whole body CT scans (scams)

43. 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

44. Drug Testing • Florida Governor RickScott • 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!

45. Corporate Agribusiness • Successful campaign against Oregon’s Proposition 27 (labeling of GM foods) • Lobbying for pre-emptive labeling laws re GMOs, rBGH

46. 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

47. 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

48. Medical Care • Sponsor luxury care consortiums, clinics • Facilitate medical tourism • Niche in “medical transfer market,” facilitating medical repatriations of undocumented immigrants (e.g., MexCare)

49. 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)

50. Health Insurance Industry • Large profit margins • Loyalty: shareholders (not patients) • Corruption