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

1
Corporate Control of Public HealthCase Studies
and Call to Action

• Martin Donohoe

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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

• The only social responsibility of business is
  to increase its profits.
• - Milton Friedman

4
Corporations

• 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

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Outline

• Corporate Domination of World Economy
• Corporate Taxation
• Corporate Crime
• Corporations and Education
• Corporations and the Media

6
Outline

• International Non-Cooperation and Isolationism
• Case Studies
• Solutions
• Discussion

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Corporations 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)

8
Corporations 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

9
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)

10
The 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
• STOCK (Stop Trading on Congressional Knowledge)
  Act signed (2012)
• Removes loophole exempting Congressional
  lawmakers and staff members from being prosecuted
  for insider trading for using knowledge gained
  in their work (political intelligence)

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Congressional Wealth and Influence

• ½ of legislators are millionaires (vs. 1 of U.S.
  citizens)
• Average personal fortune
• Senator 13 million
• Representative 5 million

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Corporations

• Internalize profits
• 1.75 trillion (U.S., 2012)
• Externalize health and environmental costs

13
Corporate 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

14
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)

15
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

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Reasons for Inadequate Corporate Taxation

• Tax breaks, corporate welfare, corporation-friendl
  y tax laws, loopholes, transferring assets
  overseas
• Cities and states offer incentives to companies
  to locate in their communities, in exchange for
  the promise of jobs
• Companies often leave when a better offer becomes
  available

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Reasons for Inadequate Corporate Taxation

• Incentives
• Cash grants and loans
• Sales tax breaks
• Income tax credits and exemptions
• Free services
• Property tax abatements
• Highway and school construction
• 80 billion in 2011
• Income tax breaks - 18 billion
• Sales tax relief - 52 billion

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Reasons for Inadequate Corporate Taxation

• Cheating and under-payment common
• Auditing program understaffed and underfunded
• 1/3 high school students admits to stealing
  something from a store in the past year

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Reasons for Inadequate Corporate Taxation

• Offshore tax havens shelter capital
• Up to 32 trillion estimated (1/3 of all global
  wealth)
• 11.5 trillion in individual wealth
• Cayman Islands
• Population 150,000
• Home to 92,000 corporations

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Reasons for Inadequate Corporate Taxation

• 83 of the largest 100 US companies have
  subsidiaries in tax havens
• Lost annual tax revenue
• 250 billion worldwide
• 100 billion in US

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Ugland House, Cayman Islands18,000 Corporations
Registered Here
22
Job Creators?
23
White 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

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Why 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

25
Corporate 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

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Consequences of Corporatization

• Increasing industry consolidation/mergers
• Inflation
• Rising unemployment

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Consequences 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

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Exorbitant CEO Pay

• CEO salaries up 759 since 1978
• Average worker pay up 6
• The average CEO makes 250-400X the salary of the
  average U.S. worker (1960 - 41X)
• Mexico 451
• Britain 251
• Japan 101
• US Military 201 (top rank lowest rank)

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CEO Personality Characteristics

• Some data suggest certain traits common among
  psychopaths are also commonly found in CEOs (and
  politicians, world leaders, and serial killers)
• Grandiose sense of self worth
• Persuasiveness
• Superficial charm
• Ruthlessness
• Lack of remorse
• Manipulation of others

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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

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• Corporate Involvement in Education

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Would 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

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Geographic/Scientific Ignorance, Pseudoscience

• Percent of US teens unable to locate the
  following on a map
• United States 11
• Pacific Ocean 29
• Japan 58

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Pseudoscientific 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

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Ignorance/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
• 70 believe in global warming

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Pseudoscientific 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

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Ignorance/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)

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Public 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)

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Public 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

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Public Education in Disarray

• College tuition costs rising
• Increasingly marginalizes poor, minorities
• 70 of students come from wealthiest ¼ of US
  families
• 14 from the poorest half
• But 39 of highest-achieving students from
  poorest half

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Legislative Mandates

• Bills allowing teaching of creationism or
  intelligent design alongside evolution
• Bills requiring global warming to be taught as a
  theory

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Anti-Science Legislators

• Members of the House Science Committee (2012)
• Paul Broun (R-GA) Evolution, embryology, and the
  Big Bang Theory are lies straight from the pit
  of hell climate change is a hoax
• Ralph Hall (R-TX) Agrees with TX Governor Rick
  Perry that climate scientists are involved in a
  conspiracy to receive research funding.
• Jim Sensenbrenner (R-WI) The science on global
  warming is inconclusive

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Anti-Science Legislators

• Members of the House Science Committee (2012)
• Todd Akin (R-MO) If its legitimate rape,
  women will not get pregnant (lost 2012 election)
• Dana Rohrbacher (R-CA) Claimed an earlier period
  of global warming may have been caused by
  dinosaur flatulence, suggested that if global
  warming is real it could be addressed by cutting
  down trees, does not believe that CO2 is a cause
  of global warming

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Nations Schoolchildren Call For Cuts in
Math/Science Funding
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Benefits 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

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Benefits 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

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Television 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

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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

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Corporate PR tactics

• 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
• Corporate espionage spying, bribes

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Public Relations

• 200 billion industry
• PR flacks now outnumber journalists

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Greenwash

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

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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
• Exxons Energy Cube
• -Gasoline is simply solar power hidden in
  decayed matter
• -Offshore drilling creates reefs for fish

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Textbook 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

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Academics/Professional Organizations Affected

• Increasing corporatization of academia
• ?Private commercial funding of university
  research
• Secrecy/Gag Clauses

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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
• 75 of faculty members now adjunct

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Academics/Professional Organizations Affected

• Gagging of researchers at federal agencies
  demoralizing, can affect recruitment of quality
  scientists
• 2001 2011 Number of published papers increased
  by 44 number of retracted articles increased
  15-fold (3/4 for errors, ¼ for fraud)

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The Media

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

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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 20043061686-7
• (Study covers 1993-2003)

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Lobbying

• Approximately 40,000 lobbyists (12,600 full-time)
• Estimates of return on lobbying range from 28 to
  100 for every 1 spent

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Lobbying

• 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

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Lobbying

• 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)
• Lobbying promotes international
  non-cooperation/isolationism

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Top-Spending Industries, 2011(Low Estimates)

• Pharmaceutical industry - 236 million
• Insurance industry - 158 million
• Oil and gas industry - 146 million
• Electric utilities - 144 million

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Lobbying

• 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

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The 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

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Corporations 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

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International 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

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International 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
• UN Declaration of the Rights of Indigenous Peoples

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International 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

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Worldwide Health and Social Justice Can Aid Help?

• In total dollars U.S. 1
• As a of GDP, U.S. ranks 21st among the worlds
  wealthiest nations
• U.S. Aid Over 1/3 military, 1/4 economic, 1/3
  for food and development
• Most U.S. aid benefits U.S. corporations

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Foreign Aid

• 0.19 of the total federal budget, vs. UN target
  of 0.7
• Americans think that 24 of the federal budget
  goes toward foreign aid
• Corporations involved in massive land grabs in
  developing nations

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• Case Studies

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Bringing Bad Things to Life

• The alliance between GE Medical Systems and
  NY-Presbyterian Hospital
• Martin Donohoe

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The 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

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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

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General Electric

• Ranked by Forbes as worlds 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

79
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

80
GEs History

• 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.

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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 GEs US reactors found to be defective

82
General Electric

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

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General Electric

• Operates a large financial services group
• Lending accounts for gt 30 of revenue, vs. lt 6
  of revenue from consumer appliances
• Responsible for over 50 of companys profits in
  recent years
• Owns a multi-billion dollar media empire
• Including NBC (49, Comcast 51), Telemundo,
  and Universal Studios

84
GEs 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

85
GEs 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

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GEs Record

• Americas largest corporate polluter
• 116 Superfund sites nationwide
• Approximately 13 in NY

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GEs 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

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GEs 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

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GEs Record

• Tremendous influence of environmental, energy,
  and health policy
• Spent over 26 million on federal government
  lobbying in 2011 (2 after U.S. Chamber of
  Commerce)
• More than 200 million over last decade
• Many members of board of directors have
  government ties others have insurance and
  pharmaceutical industry ties

90
GEs Record

• 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)

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GEs Record

• Eliminated 34,000 US jobs between 2000 and 2010
• Added 25,000 overseas jobs over same period

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GEs Record

• Executive pension plan far more generous than for
  other employees
• Continues to shift health care costs onto
  workers, despite growing profits

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GEs 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

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GEs Record

• GE has sponsored PGA Masters Tournament at
  Augusta National Golf Club
• Club excludes women
• CEO Immelt a member

95
GEs 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

96
GE 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)

97
GEs 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

98
GEs Record

• The Patient Channel
• Shown in hospital rooms throughout country
• Advertising vehicle for drug companies
• Criticized by JCAHO for manipulative marketing
  practices

99
GEs 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.

100
GE CEO Jeffrey Immelt

• 2012 total compensation 25.8 million
• Named Worlds Best CEO in 3 separate Barrons
  polls
• 2006 - 2011 - On Board of NY Federal Reserve Bank

101
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)

102
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

103
GE CEO Jeffrey Immelt

• Charitable works include membership on the board
  of directors of The Robin Hood Foundation!

104
GEs 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

105
Concerns About the Agreement

• Provides GE with financial incentives to promote
  high technology purchases
• Hospital prohibited from purchasing more
  effective equipment from other companies

106
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

107
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

108
Concerns About the Agreement

• Academic medical centers becoming increasingly
  corporatized
• Research exclusivity contracts
• Secrecy
• gag clauses
• skewing of research agenda

109
Concerns 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

110
Concerns 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

111

• A macabre twist on cradle to grave care

112
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

113
Confronting Pseudoscience and Threats from a
Corporate Front GroupThe American Council on
Science and Health
114
Background

• 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

115
ACSH and Global Warming

• Leader referred to belief that burning fossil
  fuels has caused global warming as pseudoscience
• Criticized environmental scientists as
  doomsayers and fearmongers

116
ACSH Response

• Threatened litigation against Medscape
• Medscape briefly pulled article, then published
  with comments removed, then republished with
  additional material
• ?Loss of potential readership?

117
Dr 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

118
Dr 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

119
ACSHDr 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

120
ACSH

• 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

121
Corporate Front Groups

• Promote corporate agendas
• Strong financial and advisory links with
  corporations
• Disseminate misinformation/lies under guise of
  science
• Promote pro-business, conservative ideology

122
ACSHPseudoscience 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.

123
ACSHPseudoscience 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

124
ACSHPseudoscience 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.

125
ACSHPseudoscience 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

126
Phony 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

127
ACSH 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

128
ACSH Attacks on Scientists and the Scientific
Enterprise

• ad hominem attacks
• environmentalists toxic terrorists
• Whelan criticized Dr. Barry Levy and
  citizen-activist Erin Brockovich

129
Implications 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

130
Implications 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

131
Implications 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

132
Implications 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

133
Implications 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

134

• Other Examples of Corporate Meddling in Public
  Health

135
WHO Tobacco Treaty

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

136
Medical Technologies Industry

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

137
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

138
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!

139
Corporate Agribusiness

• Successful campaign against Oregons Proposition
  27 (labeling of GM foods)
• Lobbying for pre-emptive labeling laws re GMOs,
  rBGH

140
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

141
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

142
Medical Care

• Sponsor luxury care consortiums, clinics
• Facilitate medical tourism
• Participation in medical transfer market
  (facilitates medical repatriations of
  undocumented immigrants - e.g., MexCare)

143
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)

144
Health Insurance Industry

• Large profit margins
• Loyalty shareholders (not patients)
• Corruption

145
Prison-Industrial Complex

• Construction and management of prisons
• Providing (substandard) health care to inmates

146
Pharmaceutical Industry

• 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

147
Pharmaceutical Industry

• Data mining of prescribing practices
• OKd by SCOTUS in Sorrell v. IMS Health
• Unethical trials in developing world
• Poor compliance with Clinical Trials Registry
  rules

148
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
• Has paid out almost 20 billion in civil and
  criminal penalties over the last 20 years

149
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150
Pharmaceutical Industry

• Avoided 7 billion in US taxes in 2012 by
  shifting profits overseas
• 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

151
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

152
Pharmaceutical 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

153
PPACA (Obamacare)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 (nations
  largest insurer)
• Chief health policy counsel to Senator Max Baucus
  (who drafted legislation)
• Head of Global Health Policy at pharmaceutical
  giant Johnson and Johnson

154
Breast 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)

155
Chemicals Industry

• Chisso Corporation
• Methylmercury poisoning
• Minimata Disease

156
Minimata DiseaseW Eugene Smith
157
Energy Industry

• Oil and gas, coal, fracking, nuclear power
• Sponsorship of faculty, training programs
• Funding research and policy papers
• Lobbying

158
Solutions

• Restructure tax system
• Decrease taxes on work and savings
• Increase taxes on wealthy
• Maximum income (France, England considering)

159
Solutions

• 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)

160
Solutions

• Restructure tax system
• Punish corporate scofflaws with large fines and
  jail time
• Increase enforcement budgets to combat corporate
  crime

161
Solutions

• Eliminate confidential legal settlements and
  confidential business information relevant to
  public health and safety
• Eliminate mandatory binding arbitration clauses

162
Solutions

• Living wage laws
• Work with corporations
• Healthy PR
• Shareholder activism
• Risks/benefits

163
Solutions 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

164
Solutions Fair, Representative Elections

• Open debates, free air time for candidates
• Proportional representation
• Instant runoff voting/cumulative voting/range
  (rating) voting
• Halt disenfranchisement, overturn voter
  restriction laws

165
Solutions 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

166
Voter Turnout
167
Solutions

• Activism / Letter writing / Protesting /
  Whistleblowing
• SCOTUS sharply restricted public employees
  whistleblowing rights in Garcetti v. Ceballos
  (2006)
• But, Congress passed Whistleblower Protection
  Enhancement Act (2011)

168
Solutions

• Join community groups become involved in local
  as well as national issues
• Lobby legislators
• Run for office

169
Solutions

• Increase funding of public education
• Independent scientific review of school curricula
• Prohibit use of sponsored curricula

170
Solutions

• Establish safeguards re corporate involvement in
  academic research
• Higher standards of journalism
• Support alternative media

171
Solutions 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

172
Solutions 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

173
Solutions

• Augment and improve international aid package
• Sign, ratify, and adhere to major international
  treaties
• Support Millenium Development Goals

174
Air Pollution
175
Factory Farming
176
Global Warming
177
Famine
178
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180
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181
Discretionary Federal Spending (2013)
182
World Military Spending (2012)
183
Solutions

• Based on Precautionary Principle
• Recognize natures net worth
• Calculate prosperity based on Genuine Progress
  Index or Global Happiness Index, rather than
  Gross Domestic Product

184

• All men are created equal
• Declaration of Independence
• Some people are more equal than others
• George Orwell

185
Voltaire

• The comfort of the rich rests upon an abundance
  of the poor

186
Hudson River, 2009
187
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.

188
Günter Grass

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

189
Alice Walker

• The most common way people give up their power
  is by thinking they dont have any

190
African Proverb

• If you think you are too small to have an
  impact, try going to bed with a mosquito in your
  tent

191
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192
Contact Information and References

• Public Health and Social Justice Website
• http//www.publichealthandsocialjustice.org
• http//www.phsj.org
• martindonohoe_at_phsj.org