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Corporate%20Control%20of%20Public%20Health:%20Case%20Studies%20and%20Call%20to%20Action

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Title: Corporate%20Control%20of%20Public%20Health:%20Case%20Studies%20and%20Call%20to%20Action


1
Corporate Control of Public HealthCase 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 worlds 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 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)

6
Corporations
  • Internalize profits
  • 2.1 trillion (2013)
  • Externalize health and environmental costs

7
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

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

10
Ugland House, Cayman Islands18,000 Corporations
Registered Here
11
Job Creators?
12
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

13
Exorbitant CEO Pay
  • The average CEO makes 373X the salary of the
    average U.S. worker (1960 - 41X)
  • Mexico 451
  • Britain 251
  • Japan 101
  • US Military 201 (top rank lowest rank)
  • US ratio of average CEO to minimum wage worker
    7741

14
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

15
Exorbitant CEO Pay
  • 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)

16
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17
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

18
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

19
Minimum Wage ? Living Wage
  • Increasing to 9.25/hr on Jan 1, 2015
  • Movements supporting 15/hr (still inadequate)
  • Over ½ of nations basic public assistance funds
    go to working families (substitute for benefits,
    therefore, taxes support corporations)

20
SolutionsLiving 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

21
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

22
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

23
Public Relations
  • 200 billion industry
  • PR flacks now outnumber journalists

24
Greenwash
  • Public relations / ad campaigns
  • BP invests 100 million annually in clean energy
    amt. it spends annually to market itself as
    moving Beyond Petroleum

25
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

26
Sponsored Environmental Education Materials
(Examples)
  • American Coal Foundations Power from Coal
  • The earth could benefit rather than be harmed
    from increased carbon dioxide.

27
Academics/Professional Organizations Affected
  • Increasing corporatization of academia
  • For-profit schools
  • Charter schools
  • Educational corporations

28
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

29
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

30
Union of Concerned Scientists (2015)
31
The Media
  • 5 corporations control majority of US media (down
    from 50 in 1983)
  • Extensive corporate-media links

32
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)

33
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34
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

35
Lobbying
  • Federal lobbying groups spent 3.2 billion in
    2014
  • All single issue ideological groups combined
    (e.g., pro-choice, anti-abortion, feminist and
    consumer organizations, senior citizens, etc.)
    spent well under 100 million

36
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

37
Campaign Cash and Lobbying
  • Citizens United
  • McCutcheon v. Federal Election Commission
  • Lobbying promotes international
    non-cooperation/isolationism

38
  • Case Studies

39
  • The alliance between GE Medical Systems and
    NY-Presbyterian Hospital

40
General Electric
  • Ranked by Forbes as worlds 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

41
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

42
General 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.

43
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

44
General Electric
  • Operates coal-burning power plants
  • Major releasers of toxic mercury
  • Produces nearly 40 technologies used in fracking
  • Increasing investments in fracking

45
General Electric
  • Operates a large financial services group
  • Responsible for over 50 of companys 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

46
General Electric
  • Until recently, owned 49 of a multi-billion
    dollar media empire
  • Including NBC, Telemundo, and Universal Studios
  • Comcast owned 51 bought out GE in 2013

47
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

48
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

49
GEs Record
  • Americas largest corporate polluter
  • 116 Superfund sites nationwide
  • Approximately 13 in NY

50
GEs 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

51
GEs Record
  • Eliminated 34,000 US jobs between 2000 and 2010
  • Added 25,000 overseas jobs over same period
  • One of nations top out-sourcers of jobs

52
GEs 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

53
GE CEO Jeffrey Immelt
  • 2014 total compensation 37.2 million (up from
    25.8 million in 2013)
  • Named Worlds Best CEO in 3 separate Barrons
    polls
  • 2006 - 2011 - On Board of NY Federal Reserve Bank

54
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)

55
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!

56
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

57
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

58
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

59
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

60
  • A macabre twist on cradle to grave care

61
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

62
WHO Tobacco Treaty
  • U.S. attempted to undermine treaty through Bush
    administration appointees with strong ties to
    tobacco industry

63
Medical Technologies Industry
  • Successful lobbying effort against Medicare
    physician payment policies relevant to unproven
    imaging studies
  • Whole body CT scans (scams)

64
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

65
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!

66
Corporate Agribusiness
  • Successful campaign against Oregons Proposition
    27 (labeling of GM foods)
  • Lobbying for pre-emptive labeling laws re GMOs,
    rBGH

67
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

68
Prison-Industrial Complex
  • Construction and management of prisons
  • Providing (substandard) health care to inmates

69
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70
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71
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)

72
Health Insurance Industry
  • Large profit margins
  • Loyalty shareholders (not patients)
  • Corruption

73
Medical Care
  • Sponsor luxury care consortiums, clinics
  • Facilitate medical tourism
  • Participation in medical transfer market
    (facilitates medical repatriations of
    undocumented immigrants - e.g., MexCare)

74
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

75
Pharmaceutical Industry
  • Only 10 of new drugs treat life-threatening
    conditions
  • 90 of new drugs little or no better than
    pre-existing agents (or cause harm)
  • Thus only 1 of new drugs life-saving

76
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

77
Drug Companies Cost Structure
  • Manufacturing 35
  • Marketing 27
  • Profits (after taxes) 18
  • R and D 13
  • Taxes 7

78
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

79
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

80
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

81
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82
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

83
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

84
PPACAPatient 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

85
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

86
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

87
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

88
Solutions
  • Living wage laws
  • Work with corporations
  • Benefit corporations
  • Healthy PR
  • Shareholder activism
  • Risks/benefits

89
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

90
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

91
Voter Turnout
92
Solutions
  • Activism / Letter writing / Protesting /
    Whistleblowing
  • Join community groups become involved in local
    as well as national issues
  • Lobby legislators
  • Run for office

93
Solutions
  • Increase funding of public education
  • Independent scientific review of school curricula
  • Prohibit use of sponsored curricula

94
Solutions
  • Establish safeguards re corporate involvement in
    academic research
  • Higher standards of journalism
  • Support alternative media

95
Solutions
  • Augment and improve international aid package
  • Sign, ratify, and adhere to major international
    treaties

96
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

97
  • All men are created equal
  • Declaration of Independence
  • Some people are more equal than others
  • George Orwell

98
Voltaire
  • The comfort of the rich rests upon an abundance
    of the poor

99
Hudson River, 2009
100
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.

101
Günter Grass
  • The first job of a citizen is to keep your mouth
    open.

102
African Proverb
  • If you think you are too small to have an
    impact, try going to bed with a mosquito in your
    tent

103
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104
Contact Information and References
  • Public Health and Social Justice Website
  • http//www.publichealthandsocialjustice.org
  • http//www.phsj.org
  • martindonohoe_at_phsj.org
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