Martin Donohoe

Am I Stoned?

A 1999 Utah anti-drug pamphlet warns: “Danger signs that your child may be smoking marijuana include excessive preoccupation with social causes, race relations, and environmental issues”

Corporations

“The [only] social responsibility of business is to increase its profits.” - Milton Friedman

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

Outline

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

Outline

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

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 world’s wealth (most are financial institutions)

Corporations Dominate the Global Economy  53 of the world’s 100 largest economies are private corporations; 47 are countries  Wal-Mart is larger than Israel and Greece  Apple is larger than Poland

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)

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)

Congressional and Supreme Court Wealth and Influence  ½ of legislators are millionaires (vs. 1% of U.S. citizens)  Average personal fortune:  Senator = $13 million  Representative = $5 million  All 9 Supreme Court justices hold over $1 million in personal net worth and sit comfortably within America’s richest 2%

Corporations

 Internalize profits 

$2.1 trillion (U.S., 2013)

 Externalize health and environmental costs

Corporate Taxation

 Corporations shouldered over 30% of the nation’s tax burden in 1950 vs. 8% today  Nearly 1/3 of all large U.S. corporations pay no annual tax

Corporate Taxation

 Big business claims that U.S. corporations pay the highest corporate taxes in the world (35%)  FALSE: The rate actually paid, after foreign governments get their cuts, money sent to foreign subsidiaries, loopholes, etc. = 2.3% (U.S. Treasury Department); 17% for corporations with assets over $10 million

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

Reasons for Inadequate Corporate Taxation  Tax breaks, corporate welfare, corporation friendly 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

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

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

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  U.S. GDP = $16 trillion  Cayman Islands:  Population 150,000  Home to 92,000 corporations

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

Ugland House, Cayman Islands 18,000 Corporations Registered Here

Job Creators?

“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

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

Corporate Crime

 Companies mandating forced arbitration  SCOTUS allows corporate binding arbitration contracts, limiting class action lawsuits (AT&T v. Concepcion, 2011)  Arbitration Fairness Act would counteract ruling

Consequences of Corporatization

 Increasing industry consolidation/mergers  Inflation  Rising unemployment

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

Consequences of Corporatization

 Decline in labor union membership  Rise of workforce management technologies (destabilize schedules, turns employees into day laborers)

Political Spending Corporations vs. Labor  U.S. Chamber of Commerce spent $139 million on 2012 Congressional elections  AFL-CIO and SEIU (two largest labor unions) spend $6 million combined

Exorbitant CEO Pay

 Median U.S. CEO salary (for S and P 500 corporations) = $11.7 million (2014)  CEO salaries up 937% since 1978  Average worker pay up 10%  “Performance pay” loophole allows corporations to skirt $30 billion/yr in taxes

Exorbitant CEO Pay

 The average CEO makes 373X the salary of the average U.S. worker (1960 - 41X)  Mexico 45:1  Britain 25:1  Japan 10:1  US Military: 20:1 (top rank : lowest rank)  US ratio of average CEO to minimum wage worker = 774:1

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/narcissism  Persuasiveness  Superficial charm  Ruthlessness  Lack of remorse  Manipulation of others

The Mega-Rich

 Worried / Investing in personal security  Bodyguards  Armored cars  Bullet-proof windows; machine gun proof doors  Home security fogs  Panic rooms  Fully-stocked home medical suites  Yachts with escape submarines  Islands

Minimum Wage ≠ Living Wage

 Federal minimum wage = $7.25/hr  18 states and DC have higher minimum wages (Oregon = $9.10/hr, 2014)  $10,423/yr for full-time job  Real value down 42% compared with 1968  Inadequate to pay rent, buy food and clothing

Minimum Wage ≠ Living Wage

 Increasing to $9.25/hr on Jan 1, 2015  Movements supporting $15/hr (still inadequate)  Over ½ of nation’s basic public assistance funds go to working families (substitute for benefits, therefore, taxes support corporations)

Corporate Involvement in Education

Would You Sign a Petition to Ban Dihydrogen Monoxide?

1. It can cause excessive sweating and vomiting 2. It is a major component in acid rain 3. It can cause severe burns in its gaseous state 4. It can kill you if accidentally inhaled 5. It contributes to erosion 6. It decreases effectiveness of automobile brakes 7. It has been found in tumors of terminal cancer patients

Geographic/Scientific Ignorance, Pseudoscience

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

Pseudoscientific Beliefs

Percentage of Americans who believe “at least to some degree” in these “phenomena”     Astrology UFOs Reincarnation Fortune-Telling 1997 37% 30% 25% 14% 1976 17% 24% 9% 4%

Ignorance/Pseudoscientific Beliefs

 Half of US citizens do not believe in evolution and many 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

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

Ignorance/Pseudoscientific Beliefs  22% of Americans don’t know whether an atomic bomb has ever been dropped (2000)  20% of Americans don’t 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)

Public Education in Disarray

 U.S. Schools ranked lowest among western nations  ¼ of Americans functionally illiterate  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)

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

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

Legislative Mandates

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

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”

Anti-Science Legislators

 Members of the House Science Committee (2012)  Todd Akin (R-MO): “If it’s 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

Nation’s Schoolchildren Call For Cuts in Math/Science Funding

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

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

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

Corporate PR Tactics

 Advertising  “The art of convincing people to spend money they don't have for something they don't need.“ (Will Rogers)  Astroturf - artificially-created grassroots coalitions  Corporate front groups  Corporate espionage: spying, bribes

Corporate PR tactics

 Invoke poor people as beneficiaries  Characterize opposition as “technophobic,” anti-science,” and “against progress”  Portray their products as environmentally beneficial despite evidence to the contrary  Host all-expense paid educational seminars for federal judges

Public Relations

 $200 billion industry  PR flacks now outnumber journalists

Greenwash

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

Sponsored Environmental Education Materials (Examples)  International Paper -“Clearcutting promotes growth of trees that require full sunlight and allows efficient site preparation for the next crop”  Exxon’s “Energy Cube” -“Gasoline is simply solar power hidden in decayed matter” -“Offshore drilling creates reefs for fish”

Sponsored Environmental Education Materials (Examples)  American Coal Foundation’s “Power from Coal”:  “The earth could benefit rather than be harmed from increased carbon dioxide.”  National Potato Board’s “Count Your Chips” computational skills curriculum

Textbook Publishers Facilitate Corporate Messaging  Scholastic, Inc.

 World’s largest publisher of children’s 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

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

Academics/Professional Organizations Affected  ↑ Private commercial funding of university research  Front-end domination and rear-end repression affect research agenda, dissemination of knowledge  Undone science  Secrecy/gag clauses

Academics/Professional Organizations Affected  For-profit colleges growing, marked by corruption, high interest rates on loans to the un- and under-qualified  Student loan debt almost $2 billion one decade ago, now $1.2 trillion  Greater than all Americans’ credit card debt  Benefit largely from taxpayer money

Academics/Professional Organizations Affected  Dramatic decrease in tenured faculty, rise in administrators  75% of faculty members now adjunct  2001 – 2011: Number of published papers increased by 44%; number of retracted articles increased 15 fold (3/4 for errors, ¼ for fraud)  Gagging of researchers at federal agencies demoralizing, can affect recruitment of quality scientists

Union of Concerned Scientists (2015)

The Media

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

Global Warming: Controversial?

 Of 928 articles in peer-reviewed scientific journals, none were in doubt as to the existence or cause of global warming  Of 636 articles in the popular press (NY Times, Washington Post, LA Times, WSJ), 53% expressed doubt as to the existence (and primary cause) of global warming

Science 2004;306:1686-7 (Study covers 1993-2003)

Lobbying

 Approximately 40,000 lobbyists (11,781 full-time)  Estimates of return on lobbying range from $28 to $100 for every $1 spent  Return on campaign contributions for elections for the most politically active companies = $760 per $1 spent

Lobbying

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

Top-Spending Industries, 2014

 Pharmaceutical industry - $230 million  Business Associations - $163 million  Insurance industry - $151 million  Oil and gas industry - $141 million  Computers/Internet - $140 million  Electric utilities - $122 million

Lobbying/Campaign Contributions  Koch brothers spent over $400 million  All single issue ideological groups combined (e.g., pro-choice, anti-abortion, feminist and consumer organizations, senior citizens, etc.) = $76.2 million  Lobbying promotes international non cooperation/isolationism

Lobbying

 SCOTUS’ Citizens United and

McCutcheon v. Federal Election

Commission decisions have opened the floodgates for unlimited corporate contributions  196 donors contributed nearly 80% of money raised by super-PACs in 2011

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

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

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

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

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

Worldwide Health and Social Justice: Can Aid Help?

 In total dollars: U.S. #1  As a % of GDP, U.S. ranks 21 st the world’s wealthiest nations among  U.S. Aid: Over 1/3 military, 1/4 economic, 1/3 for food and development  Most U.S. aid benefits U.S. corporations

Foreign Aid

 0.19% of the total federal budget, vs. UN target of 0.7%  Americans think that 28% of the federal budget goes toward foreign aid  Corporations involved in massive land grabs in developing nations

Case Studies

The alliance between GE Medical Systems and NY Presbyterian Hospital

Martin Donohoe

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

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

General Electric

 Ranked by Forbes as world’s largest company (based on equal weighting of sales, profits, assets, and market value)  2014 revenues of $149 billion  Close to the GDP of more than 2/3 of U.N. member states 2014 net after-tax profits of $15.2 billion  Majority from overseas operations

General Electric

 Makes household appliances, lighting, and medical equipment  Plastics division, which produced bisphenol A, spun off in 2008  Produces jet engines and military hardware

GE’s History

 Charles Wilson (CEO of GE pre- and post-WW II; helped oversee U.S. military production during WW II):  “The revulsion against war…will be an almost insuperable obstacle for us to overcome. For that reason, I am convinced that we must begin now to set the machinery in motion for a permanent wartime economy.”

General Electric

 Has built 91 nuclear power plants in 11 countries (including the troubled Fukushima Daishi plants in Japan)  Including 23 plants at 11 sites in U.S.

 e.g., Hanford  ¼ of GE’s US reactors found to be defective

General Electric

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

General Electric

 Operates a large financial services group  Responsible for over 50% of company’s profits in recent years  2015: company plans to sell off majority of GE Capital (now Syncrhony Financial) over next 2 years  Under investigation by the Justice Department for over potential bankruptcy violations

General Electric

 Until recently, owned 49% of a multi billion dollar media empire  Including NBC, Telemundo, and Universal Studios  Comcast owned 51%; bought out GE in 2013

GE’s History

 Conducted unethical human subject experiments on prisoners, involving testicular irradiation, from 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”

GE’s Record

 Sued radiologist who brought to light dangers of GE’s contrast agent, Omniscan  Causes nephrogenic systemic fibrosis (FDA black box warning)  Ordered to pay $11.4 million to Bracco Diagnositcs for falsely/misleadingly claiming that its x-ray contrast agent Visipaque was superior to BD’s Isovue

GE’s Record

 America’s largest corporate polluter  116 Superfund sites nationwide  Approximately 13 in NY

GE’s Record

 Between 1947 and 1977, two of its capacitor manufacturing plants dumped at least 1.3 million pounds of PCBs into the Hudson River  Probable human carcinogens with adverse effects on liver, kidney, nervous system, and reproductive organs (EPA)  200 mi of Hudson = Superfund site

GE’s Record

 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

GE’s Record

 Tremendous influence of environmental, energy, and health policy  Spent over $16 million on lobbying in 2014  More than $200 million over last decade  Many members of board of directors have government ties; others have insurance and pharmaceutical industry ties

GE’s Record

 Eliminated 150,000 jobs in last 15 years  While receiving billions in federal contracts and millions in state and local subsidies  One of nation’s top out-sourcers of jobs  1/5 of U.S. workforce eliminated since 2002 (while overseas workforce increased)

GE’s Record

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

GE’s Record

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

GE’s 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

GE’s Record

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

GE’s Record

 Topped 2002 Project on Government Oversight’s 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

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 “world’s best tax law firm”)

GE’s Record

 In 1990s, Pentagon’s Defense Contract Management Agency created special investigations office specifically for GE  Nevertheless, company has been awarded increasingly costly reconstruction contracts in Iraq and Afghanistan

GE’s Record

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

GE’s 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.

GE CEO Jeffrey Immelt

 2014 total compensation = $37.2 million (up from $25.8 million in 2013)  Named “World’s Best CEO” in 3 separate Barron’s polls  2006 - 2011 - On Board of NY Federal Reserve Bank

GE CEO Jeffrey Immelt

 2008 – Named one of the “100 Most Influential People in the World” by TIME Magazine  2009 - Appointed by President Obama to his Economic Recovery Board  GE then became eligible, via a loophole, for ¼ of the $340 billion Temporary Liquidity Guarantee Program (debt support)

GE CEO Jeffrey Immelt

 2011 - Appointed by Obama as Chair of his outside panel of Economic Advisors and of his Council on Jobs and Competitiveness

GE CEO Jeffrey Immelt

 Charitable works include membership on the board of directors of “The Robin Hood Foundation”!

GE’s Record

 Named “America’s Most Admired Company” by Forbes  Named one of the “World’s Most Respected Companies” in polls conducted by Barron’s and The Financial Times

Concerns About the Agreement

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

Concerns About the Agreement

 Augments trend in academic medical centers to promote the use of expensive, high-technology care at expense of preventive care and public health measures  Highly reimbursable  Services may be redundant in certain locations

Concerns About the Agreement

 Occured at time when 41 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

Concerns About the Agreement

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

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

Concerns About the Agreement

 Patients with developmental anomalies and cancers caused by GE’s pollution diagnosed with GE scanners and treated with GE-manufactured therapeutic devices, increasing GE’s profit

A macabre twist on “cradle to grave care”

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

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”

ACSH Response

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

Dr Elizabeth Whelan: Former president and co-founder (d. 2014)  Early writing career included:  Freelance writing assignment for Pfizer criticizing the FDA  Consumer magazine pieces  Books include Panic in the Pantry and Toxic Terror  Whelan’s 2003 salary = $326,612

Dr Gilbert Ross: Medical/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

ACSH: Dr 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

ACSH

 ACSH 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”

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

ACSH: Pseudoscience 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.

ACSH: Pseudoscience 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

ACSH: Pseudoscience 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.”

ACSH: Pseudoscience 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

“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 children’s toys

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

ACSH: Attacks on Scientists and the Scientific Enterprise  ad hominem attacks  environmentalists = “toxic terrorists”  Whelan criticized Dr. Barry Levy and citizen-activist Erin Brockovich

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 NBC’s Today Show, CNN Live, and CNBC’s Business Insiders

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

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

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

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

Other Examples of Corporate Meddling in Public Health

WHO Tobacco Treaty

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

Medical Technologies Industry

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

Drug Testing  2011: Florida Governor Rick Scott (R) issues executive order requiring drug tests on current state workers and new applicants  2011: Scott signs bill requiring drug tests for TANF program  positive test allows parent to choose another individual to receive benefits on behalf of children  Aid recipients responsible for cost of tests  Law struck down by courts

Drug Testing  Florida Governor Rick Scott  Former CEO of Columbia/HCA  Fired after presiding over massive Medicare fraud that cost corporation $1.7 billion federal fine  Then set up Solantic (FL chain of emergency care clinics); transferred ownership to his wife upon entering statehouse  Solantic is in the drug-testing business!

Corporate Agribusiness

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

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

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

Corporate Structure of American Board of Internal Medicine  Annual budget over $50 million  CEO Richard Baron’s 2010 salary = $800,000  Salary determined by Board of Directors  Baron: “If they were trying to hire somebody to do this job, what other job would they be doing and what would people in comparable organizations be paid”

Corporate Structure of American Board of Internal Medicine  Controversies surrounding Maintenance of Certification  Utility and cost  Alternatives (e.g., National Board of Physicians and Surgeons)

Medical Care

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

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)

Health Insurance Industry

 Large profit margins  Loyalty: shareholders (not patients)  Corruption

Prison-Industrial Complex

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

Pharmaceutical Industry

 Limited innovation  90% of new drugs little or no better than existing agents (“me too drugs”) and only 1% offer improved care for life-threatening conditions  Improved somewhat recently

Pharmaceutical Industry

 Influence over physicians through control of CME, gifts, research funding  Over $3.7 billion to at about 366,000 physicians and 900 teaching hospitals in 2014 (excluding research funding)  Physician Payments Sunshine Act – reporting requirements

Pharmaceutical Industry

 Conduct seeding trials to alter prescribing patterns  Secrecy, statistical torturing of data sets, selective publication  Data mining of prescribing practices  OK’d by SCOTUS in Sorrell v. IMS Health  Unethical trials in developing world

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

Pharmaceutical Industry

 Avoided $7 billion in US taxes in 2012 by shifting profits overseas  $230 million dollars spent on lobbying in 2011  2.3 lobbyists for every member of Congress  Revolving door between legislators, lobbyists, executives and government officials

Pharmaceutical Industry

 Effectively lobbied and threatened trade sanctions against developing countries in order to prevent production and importation of much cheaper, generic versions of life-saving anti-AIDS drugs  Patent extensions

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

Pharmaceutical Industry

 Promotion of agricultural antibiotic overuse  Pharmaceuticals in the Developing World  Up to 30% poor quality due to:  Improper manufacturing  Degradation due to age or poor storage  Counterfeiting by rogue factories

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 (nation’s largest insurer)  Chief health policy counsel to Senator Max Baucus (who drafted legislation)  Head of Global Health Policy at pharmaceutical giant Johnson and Johnson

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)

Chemicals Industry

 Chisso Corporation  Methylmercury poisoning  Minimata Disease

Minimata Disease W Eugene Smith

Energy Industry

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

Solutions

 Restructure tax system  Decrease taxes on work and savings  Increase taxes on wealthy  Maximum income (France, England considering)  Increase capital gains tax from 15% to (at least) prior 25% rate

Solutions

 Restructure tax system  Resume transaction tax on stock sales/purchases  Increase taxes on destructive activities (e.g., carbon emissions, toxic waste generation)  Improve regulation of banks (e.g., enforce Dodd Frank law)

Solutions

 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  Increase enforcement budgets to combat corporate crime

Solutions

 Eliminate confidential legal settlements and confidential business information relevant to public health and safety  Eliminate mandatory binding arbitration clauses  Living wage laws

Solutions

 Work with corporations  Benefit corporations  Healthy PR  Shareholder activism  Risks/benefits

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

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

Solutions: Vote

 US voter turnout low  Wealthy vote at almost twice rate of poor  Whites > Blacks > Hispanics  Old > Young  Property owners > Renters  Physicians < general population

Voter Turnout

Voter Turnout

 Average senator = 62 yo  Average representative = 57 yo  Increased voter turnout by marginalized groups likely to lead to a younger, more progressive Congress  Limiting incumbency would also help (incumbents have a huge advantage in elections)

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)

Solutions

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

Solutions

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

Solutions

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

Solutions: 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

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

Solutions

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

Air Pollution

Factory Farming

Global Warming

Famine

Discretionary Federal Spending (2013)

World Military Spending (2012)

Solutions

 Based on Precautionary Principle  Recognize nature’s net worth  Calculate prosperity based on Genuine Progress Index or Global Happiness Index, rather than Gross Domestic Product

 “All men are created equal”  Declaration of Independence  “Some people are more equal than others”  George Orwell

Voltaire

“The comfort of the rich rests upon an abundance of the poor”

Hudson River, 2009

Primo Levi

“A country is considered the more civilized the more the wisdom and efficiency of its laws hinder a weak man from becoming too weak or a powerful one too powerful.”

Günter Grass “The first job of a citizen is to keep your mouth open.”

Alice Walker

“The most common way people give up their power is by thinking they don’t have any”

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

Contact Information and References Public Health and Social Justice Website http://www.publichealthandsocialjustice.org

http://www.phsj.org

[email protected]