Title: Corporate Control of Public Health: Case Studies and Call to Action
1Corporate Control of Public HealthCase Studies
and Call to Action
2Am 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
3Corporations
- The only social responsibility of business is
to increase its profits. - - Milton Friedman
4Corporations
- Corporations have no moral conscience. They
are designed by law, to be concerned only for
their stockholders, and not, say, what are
sometimes called their stakeholders, like the
community or the work force - -Noam Chomsky
5Outline
- Corporate Domination of World Economy
- Corporate Taxation
- Corporate Crime
- Corporations and Education
- Corporations and the Media
6Outline
- International Non-Cooperation and Isolationism
- Case Studies
- Solutions
- Discussion
7Corporations Dominate the Global Economy
- Almost 6 million corporations
- 90 of transnational corporations headquartered
in Northern Hemisphere - 500 companies control 70 of world trade
- 148 corporations control 40 of worlds wealth
(most are financial institutions)
8Corporations Dominate the Global Economy
- 53 of the worlds 100 largest economies are
private corporations 47 are countries - Wal-Mart is larger than Israel and Greece
- Apple is larger than Poland
9The 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)
10The Stock Market
- Interesting Fact As a group, U.S. Senators beat
the market by an average of 12 from 1993-98
(study published 2004) - The best fund managers average 3
- Loophole exempts Congressional lawmakers and
staff members from being prosecuted for insider
trading for using knowledge gained in their work
(political intelligence) - STOP Act held up in Congress
11Congressional Wealth and Influence
- ½ of legislators are millionaires (vs. 1 of U.S.
citizens) - Average personal fortune
- Senator 13 million
- Representative 5 million
12Corporations
- Internalize profits
- Externalize health and environmental costs
13Corporate Taxation
- Corporations shouldered over 30 of the nations
tax burden in 1950 vs. 8 today - Nearly 1/3 of all large U.S. corporations pay no
annual tax
14Corporate 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)
15Corporate 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
16Reasons for Inadequate Corporate Taxation
- Corporate tax breaks/loopholes
- Corporate welfare
- Cheating and under-payment common
- Offshore tax havens shelter capital
17Ugland House, Cayman Islands18,000 Corporations
Registered Here
18White Collar (Corporate) Crime vs. Blue
Collar (Street) Crime
- Each year in America, we lose
- 3.8 billion to burglary and robbery
- Hundreds of billions to trillions of dollars to
white collar crime
19Why So Much Corporate Crime
- Fines meager, often considered a cost of doing
business - Corporate crime under-prosecuted, prosecutors
under-funded - Confidential legal settlements keep important
public health and safety information secret - May delay governmental intervention, cause
unnecessary morbidity and mortality
20Corporate Crime
- Companies mandating forced arbitration
- SCOTUS allows corporate binding arbitration
contracts, limiting class action lawsuits (ATT
v. Concepcion, 2011) - Arbitration Fairness Act would counteract ruling
21Consequences of Corporatization
- Increasing industry consolidation/mergers
- Inflation
- Rising unemployment
22Consequences of Corporatization
- Rise of the permatemp
- Expatriation of jobs
- 2000-2011 U.S.-based multinational corporations
cut 2.9 million jobs in U.S. while increasing
foreign employment by 2.4 million - Overseas factories often lack adequate
occupational health and safety and environmental
standards - Decline in labor union membership
23Exorbitant 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 451
- Britain 251
- Japan 101
24- Corporate Involvement in Education
25Would You Sign a Petition to Ban Dihydrogen
Monoxide?
- 1. It can cause excessive sweating and
vomiting2. It is a major component in acid
rain3. It can cause severe burns in its gaseous
state4. It can kill you if accidentally
inhaled5. It contributes to erosion6. It
decreases effectiveness of automobile brakes7.
It has been found in tumors of terminal cancer
patients
26Geographic/Scientific Ignorance, Pseudoscience
- Percent of US teens unable to locate the
following on a map - United States 11
- Pacific Ocean 29
- Japan 58
27Pseudoscientific Beliefs
- Percentage of Americans who believe at least to
some degree in these phenomena - 1997 1976
- Astrology 37 17
- UFOs 30 24
- Reincarnation 25 9
- Fortune-Telling 14 4
28Ignorance/Pseudoscientific Beliefs
- Half of US citizens do not believe in evolution
and do believe that humans and dinosaurs
coexisted (2007) - 40 think scientists still generally disagree
about evolution - Only 12 of U.S. Protestant pastors believe in
evolution
29Pseudoscientific Beliefs
- 37 believe places can be haunted (2007)
- 25 believe in UFOs (2007)
- 24 believe in astrology (2009)
- 16 believe that people with the evil eye can
cast curses or harmful spells - 14 have consulted a psychic or fortune teller
(2009
30Ignorance/Pseudoscientific Beliefs
- 22 of Americans dont know whether an atomic
bomb has ever been dropped (2000) - 20 of Americans dont know the earth revolves
around the sun (1999) - 18 believe in Bigfoot and the Loch Ness Monster
(2007) - 8 of men / 18 of women believe in astrology and
fortune tellers (2007)
31Public Education in Disarray
- U.S. Schools ranked lowest among western nations
- Some states require instructors to teach
creation science, intelligent design, and
climate change skepticism - Despite politicians statements, 72 of
Republicans believe global warming is occurring
(92 of Democrats)
32Public Education in Disarray
- Inadequate funding, decaying infrastructure
- National HS graduation rate 65-70
- No change from 1970s
- Lower incomes youths 6X as likely to drop out
- College tuition costs rising
- Increasingly marginalizes poor, minorities
33Nations Schoolchildren Call For Cuts in
Math/Science Funding
34Benefits of Education
- For every 1 spent on early childhood education,
up to 17 are saved from increased school
achievement, improved health, reduced crime, and
reduced reliance on public assistance - Income increases 11 for every year of education
35Benefits of Education
- College graduates live 5 years longer than high
school dropouts - Eliminating educational inequities would have
saved 8X as many lives as medical advances from
1996-2002
36Television and the Media
- The average American youth spends 900 hrs/yr in
school, 1,500 hrs/yr watching TV - By age 65, the average American will have spent 9
yrs watching TV
37Corporate PR Tactics
- Advertising
- Astroturf - artificially-created grassroots
coalitions - Corporate front groups
38Corporate 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
39Greenwash
- Public relations / ad campaigns
- BP invests 100 million annually in clean energy
amt. it spends annually to market itself as
moving Beyond Petroleum
40Sponsored Environmental Education Materials
(Examples)
- International Paper
- -Clearcutting promotes growth of trees that
require full sunlight and allows efficient site
preparation for the next crop - Exxons Energy Cube
- -Gasoline is simply solar power hidden in
decayed matter - -Offshore drilling creates reefs for fish
41Textbook Publishers Facilitate Corporate Messaging
- Scholastic, Inc.
- Worlds largest publisher of childrens
educational materials - Found in 90 of U.S. classrooms
- Has taken money from Big Coal, Disney, Microsoft,
Nestlé, and Shell to produce books and lesson
plans - 2011 Announces plan to terminate some industry
contracts, set up quasi-independent review board
to review corporate materials
42Academics/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 - Dramatic decrease in tenured faculty, rise in
administrators
43The Media
- 5 corporations control majority of US media (down
from 50 in 1983) - Extensive corporate-media links
44Global 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 20043061686-7
- (Study covers 1993-2003)
45Lobbying
- Over 15,000 full-time lobbyists
- Estimates of return on lobbying range from 28 to
100 for every 1 spent - Revolving door between lobbyists and Congress
- Between 2001 and 2011, 5,400 former Congressional
staffers have left to become lobbyists, and 605
lobbyists have left their positions to work for
Congress
46Lobbying
- Lobbying groups spent 3.5 billion in 2010
(federal lobbying, a record) - Financial sector spent over 1.7 billion on
campaign contributions for federal elections from
1998-2008 - All single issue ideological groups combined
(e.g., pro-choice, anti-abortion, feminist and
consumer organizations, senior citizens, etc.)
76 million
47Lobbying
- SCOTUS Citizens United decision has opened the
floodgates for unlimited corporate contributions - 196 donors contributed nearly 80 of money raised
by super-PACs in 2011
48The Decline of Democracy
- True democracy demands an informed citizenry
(education), freedom of the press (media), and
involvement (will, time, money) - Democracy is critical to the success of public
health
49Corporations and International Agreements
- Corporations attempt to influence writing and
acceptance/rejection of international agreements - Through misinformation, lobbyists, revolving door
between industry and government - Large behind the scenes role
50International Non-Cooperation/Isolationism
- Failure to sign or approve
- Kyoto Protocol on Climate Change
- International Covenant on Economic, Social, and
Cultural Rights - Convention on the Prohibition of Anti-Personnel
Land Mines
51International Non-Cooperation/Isolationism
- Failure to sign or approve
- Treaty to ban cluster bombs Convention on the
Rights of the Child - Convention on the Elimination of Discrimination
Against Women
52International Non-Cooperation/Isolationism
- Failure to sign or approve
- WHO Code of Conduct for Marketing Breast Milk
Substitutes - Convention for the Suppression of Traffic in
Persons - The Stockholm Convention on Persistent Organic
Pollutants
53Worldwide Health and Social Justice Can Aid Help?
- US ranks 21st in the world in foreign aid as a
percentage of GDP (0.7) - Foreign Aid
- 1/3 military
- 1/3 economic
- 1/3 food and development
54 55Bringing Bad Things to Life
- The alliance between GE Medical Systems and
NY-Presbyterian Hospital - Martin Donohoe
56The Partners
- NY-Presbyterian Hospital
- one of the largest academic health care
institutions in the U.S. - GE Medical Systems (now GE HealthCare)
- Subsidiary of General Electric
- 9 billion annual revenues
57The 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
58General Electric
- Ranked by Forbes as worlds largest company
(based on equal weighting of sales, profits,
assets, and market value) - 2009 revenues of 156 billion
- Close to the GDP of about 2/3 of U.N. member
states - 2010 net after-tax profits of 14.2 billion
- 5.1 billion in U.S.
59General Electric
- Makes household appliances, lighting, and medical
equipment - Plastics division, which produced bisphenol A,
spun off in 2008 - Has built 91 nuclear power plants in 11 countries
(including Japans troubled Fukushima Daishii
reactors) - Produces jet engines and military hardware
60General Electric
- Charles Wilson (CEO of GE pre- and post-WW II
helped oversee U.S. military production during WW
II) - The revulsion against warwill 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.
61General Electric
- Operates coal-burning power plants
- Major releasers of toxic mercury
- Operates a large financial services group
- Lending accounts for gt 30 of revenue, vs. lt 6
of revenue from consumer appliances - Responsible for just over 50 of profit in recent
years - Owns a multi-billion dollar media empire
- Including NBC (49, Comcast 51), Telemundo,
and Universal Studios
62GEs 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
63GEs Record
- Sued radiologist who brought to light dangers of
GEs 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 BDs Isovue
64GEs Record
- Americas largest corporate polluter
- 116 Superfund sites nationwide
- Approximately 13 in NY
65GEs 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
66GEs Record
- Has spent millions to avoid Hudson cleanup and to
weaken or eliminate Superfund Law - 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
67GEs Record
- Tremendous influence of environmental, energy,
and health policy - Spent over 25 million on federal government
lobbying in 2009 (2 after Exxon Mobil) - 200 million over last decade
- Many members of board of directors have
government ties others have insurance and
pharmaceutical industry ties
68GE CEO Jeffrey Immelt
- 2009 compensation 5.5 million
- Named Worlds Best CEO in 3 separate Barrons
polls - 2006 - 2011 - On Board of NY Federal Reserve Bank
69GE 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)
70GE 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!
71GEs Record
- Has eliminated 150,000 jobs in last 15 years
- While receiving billions in federal contracts and
millions in state and local subsidies - One of nations top out-sourcers of jobs
- 1/5 of U.S. workforce eliminated since 2002
(while overseas workforce increased)
72GEs Record
- Executive pension plan far more generous than for
other employees - Continues to shift health care costs onto
workers, despite growing profits
73GEs 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
74GEs Record
- GE has sponsored PGA Masters Tournament at
Augusta National Golf Club - Club excludes women
- CEO Immelt a member
75GEs Record
- Topped 2002 Project on Government Oversights
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
76GE and Corporate Taxes
- GE topped the list of corporate tax break
recipients from 2001-2003 - 9.5 billion in tax breaks
- Claimed tax benefits of 3.5 billion in 2010
(4.1 billion tax benefits on 26 billion in
American profits between 2006 and 2010) - Under investigation for tax evasion in Brazil
- Tax department has almost 1,000 employees (known
as the worlds best tax law firm)
77GEs Record
- In 1990s, Pentagons Defense Contract Management
Agency created special investigations office
specifically for GE - Nevertheless, company has been awarded
increasingly costly reconstruction contracts in
Iraq and Afghanistan
78GEs Record
- The Patient Channel
- Shown in hospital rooms throughout country
- Advertising vehicle for drug companies
- Criticized by JCAHO for manipulative marketing
practices
79GEs 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.
80GEs Record
- Named Americas Most Admired Company by Forbes
- Named one of the Worlds Most Respected
Companies in polls conducted by Barrons and The
Financial Times
81Concerns About the Agreement
- Provides GE with financial incentives to promote
high technology purchases - Hospital prohibited from purchasing more
effective equipment from other companies
82Concerns 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
83Concerns About the Agreement
- Occurs at time 51 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
84Concerns About the Agreement
- Academic medical centers becoming increasingly
corporatized - Research exclusivity contracts
- Secrecy
- gag clauses
- skewing of research agenda
85Concerns About the Agreement
- I contacted the CEO of New York Presbyterian
Hospital 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
86Concerns About the Agreement
- Patients with developmental anomalies and cancers
caused by GEs pollution diagnosed with GE
scanners and treated with GE-manufactured
therapeutic devices, increasing GEs profit
87-
- A macabre twist on cradle to grave care
88Solutions
- 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
89Confronting Pseudoscience and Threats from a
Corporate Front GroupThe American Council on
Science and Health
90Background
- 2007 Essay describing health and environmental
consequences of global warming for Medscape - Described ACSH as a corporate front group and
criticized its selection of author Michael
Crichton as recipient of its 2005 Sound Science
Medal
91ACSH and Global Warming
- Leader referred to belief that burning fossil
fuels has caused global warming as pseudoscience - Criticized environmental scientists as
doomsayers and fearmongers
92ACSH Response
- Threatened litigation against Medscape
- Medscape briefly pulled article, then published
with comments removed, then republished with
additional material - ?Loss of potential readership?
93Dr Elizabeth WhelanPresident and co-founder
- Early writing career included
- Freelance writing assignment for Pfizer
criticizing the FDA - Consumer magazine pieces
- Books include Panic in the Pantry and Toxic
Terror - Whelans 2003 salary 326,612
94Dr Gilbert RossMedical/Executive Director
- Spent 1996 in federal prison after being
sentenced to 46 months for - Medicaid fraud
- Perjury
- Obstruction of justice
- Not mentioned on his bio on ACSH website
95ACSHDr Gilbert Ross Career
- Barred by the DHHS for 10 years from
participating in either Medicare or Medicaid - Now in charge of all scientific projects,
publications, and personnel issues involving
scientific staff at ACHS
96ACSH
- ACHS Board of Directors includes anti-regulatory
Individuals (2001 Survey) - George Lundberg, former editor of JAMA, current
editor of Medscape, on board of advisors - Funding from right wing foundations, corporations
- Accepted money to write and disseminate
pro-industry studies
97Corporate Front Groups
- Promote corporate agendas
- Strong financial and advisory links with
corporations - Disseminate misinformation/lies under guise of
science - Promote pro-business, conservative ideology
98ACSHPseudoscience and Misinformation
- Attacked the precautionary principle
- anti-science, elitist, and theology
- Minimized the effects of environmental tobacco
smoke (ETS) on human health - 40,000 deaths/yr in U.S.
99ACSHPseudoscience and Misinformation
- Denied many of the adverse neurological effects
of lead exposure - Denied endocrine-disrupting effects of PCBs
- Claimed court ordered-cleanup of Hudson River by
GE based on false claims of PCBs causing cancer - Claimed uncertainty regarding effects of
agricultural antibiotics on food-borne,
antibiotic-resistant human infections
100ACSHPseudoscience and Misinformation
- Called warnings regarding tuna consumption by
pregnant women unfounded health scare - Critiqued health concerns re trans fatty acids
- There is no such thing as junk food
- There is insufficient evidence of a relationship
between diet and any disease.
101ACSHPseudoscience and Misinformation
- Claimed irradiated food is safe, wholesome and
nutritious and no radioactive isotopes are
involved - Denied link between dioxins and pesticides and
adverse health effects - Supported use of human volunteers in pesticide
toxicity studies
102Phony Health Scares
- Flame retardant traces found in blood and breast
milk - Diesel exhaust fumes from school busses
- Arsenic in drinking water
- Phthalates in medical devices and childrens toys
103ACSH Attacks on Scientists and the Scientific
Enterprise
- Threat of litigation against Medscape
antithetical to the rules of science - requires the free exchange of information and
opinion in pursuit of the truth
104ACSH Attacks on Scientists and the Scientific
Enterprise
- ad hominem attacks
- environmentalists toxic terrorists
- Whelan criticized Dr. Barry Levy and
citizen-activist Erin Brockovich
105Implications of Attacks on Science and Scientists
- ACSH has broad media presence
- Web site attracts large numbers of individuals
- 100,000 hits per month for 2005
- Dr. Whelan has been featured on NBCs Today Show,
CNN Live, and CNBCs Business Insiders
106Implications of Attacks on Science and Scientists
- Editorials by Whelan and Ross have appeared in
the New York Times and Wall Street Journal - Publications in Medscape, other journals
107Implications of Attacks on Science and Scientists
- Mislead public
- May cause alterations in lifestyle and/or
purchasing habits - Adverse health consequences
- Threats of litigation distract, intimidate, and
deplete the scientific, legal, and financial
resources of individuals and groups committed to
public health
108Implications of Attacks on Science and Scientists
- Faulty pronouncements influence elected officials
- Threats of litigation divert the valuable time of
health care providers, editors, and legal
departments away from more productive missions of
research, teaching, writing, and patient care
109Implications of Attacks on Science and Scientists
- Scientists and health care advocates may decide
it is wiser to avoid conflict than publish
content to which ACSH and other such groups might
object
110- Other Examples of Corporate Meddling in Public
Health
111WHO Tobacco Treaty
- U.S. attempted to undermine treaty through Bush
administration appointees with strong ties to
tobacco industry
112Medical Technologies Industry
- Successful lobbying effort against Medicare
physician payment policies relevant to unproven
imaging studies - Whole body CT scans (scams)
113Drug 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
114Drug 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!
115Corporate Agribusiness
- Successful campaign against Oregons Proposition
27 (labeling of GM foods) - Lobbying for pre-emptive labeling laws re GMOs,
rBGH
116Corporate 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
117Corporate 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
118Medical Care
- Sponsor luxury care consortiums, clinics
- Facilitate medical tourism
- Niche in medical transfer market, facilitating
medical repatriations of undocumented immigrants
(e.g., MexCare)
119Health 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)
120Health Insurance Industry
- Large profit margins
- Loyalty shareholders (not patients)
- Corruption
121Prison-Industrial Complex
- Construction and management of prisons
- Providing (substandard) health care to inmates
122Pharmaceutical Industry
- Influence over physicians through control of CME,
gifts, research funding - Conduct seeding trials to alter prescribing
patterns - Secrecy, statistical torturing of data sets,
selective publication - Data mining of prescribing practices
- Okd by SCOTUS in Sorrell v. IMS Health
123Drug 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
- Has paid out almost 20 billion in civil and
criminal penalties over the last 20 years
124Pharmaceutical 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
125Pharmaceutical Industry
- 2011 NIH rules require reporting of over 5000
financial largesse from industry (database not
public) - Opposes legislation aimed at limiting
pharmaceutical industry influence by publicizing
gifts to providers
126Pharmaceutical Industry
- 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 - Poor compliance with Clinical Trials Registry
rules
127Breast Milk Substitute Manufacturers
- Marketed to women in developing world
- Nestlé, others
- Discourage (and make more difficult) breast
feeding - WHO International Code of Conduct
- U.S. has not signed
- 91 of U.S. hospitals distribute formula packs
(which would violate WHO code)
128Chemicals Industry
- Chisso Corporation
- Methylmercury poisoning
- Minimata Disease
129Minimata DiseaseW Eugene Smith
130Solutions
- Restructure tax system
- Decrease taxes on work and savings
- Increase taxes on wealthy
- Maximum income (France, England considering)
131Solutions
- Restructure tax system
- Increase capital gains tax from 15 to (at least)
prior 25 rate - Resume transaction tax on stock sales/purchases
- Increase taxes on destructive activities (e.g.,
carbon emissions, toxic waste generation)
132Solutions
- Punish corporate scofflaws with large fines and
jail time - Increase enforcement budgets to combat corporate
crime - Eliminate confidential legal settlements relevant
to public health and safety
133Solutions
- Living wage laws
- Work with corporations
- Healthy PR
- Shareholder activism
- Risks/benefits
134Solutions Fair, Representative Elections
- Publicly financed campaigns and campaign finance
reform - Members of Congress spend between 30 and 70 of
their time fundraising - 50 of Senators and 42 of Representatives become
lobbyists after leaving office
135Solutions Fair, Representative Elections
- Open debates, free air time for candidates
- Proportional representation
- Instant runoff voting/cumulative voting/range
(rating) voting
136Solutions Vote
- US voter turnout low
- Wealthy vote at almost twice rate of poor
- Whites gt Blacks gt Hispanics
- Old gt Young
- Property owners gt Renters
- Physicians lt general population
137Voter Turnout
138Solutions
- Activism / Letter writing / Protesting /
Whistleblowing - Unfortunately, SCOTUS sharply restricted public
employees whistleblowing rights in Garcetti v.
Ceballos (2006)
139Solutions
- Join community groups become involved in local
as well as national issues - Lobby legislators
- Run for office
140Solutions
- Increase funding of public education
- Independent scientific review of school curricula
- Prohibit use of sponsored curricula
141Solutions
- Establish safeguards re corporate involvement in
academic research - Higher standards of journalism
- Support alternative media
142Solutions 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
143Solutions 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
144Solutions
- Augment and improve international aid package
- Sign, ratify, and adhere to major international
treaties - Support Millenium Development Goals
145Air Pollution
146Factory Farming
147Global Warming
148Famine
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1512009 Federal Budget2.65 trillion
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153Solutions
- Based on Precautionary Principle
- Recognize natures net worth
- Calculate economic prosperity based on Genuine
Progress Index or Global Happiness Index, rather
than Gross Domestic Product
154Voltaire
- The comfort of the rich rests upon an abundance
of the poor
155- All men are created equal
- Declaration of Independence
- Some people are more equal than others
- George Orwell
156Hudson River, 2009
157Primo 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.
158Günter Grass
-
- The first job of a citizen is to keep your mouth
open.
159Anita Roddick
- "If you think you are too small to have an
impact, try going to bed with a mosquito in your
tent"
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161Contact Information and References
- Public Health and Social Justice Website
- http//www.publichealthandsocialjustice.org
- http//www.phsj.org
- martindonohoe_at_phsj.org