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

OutlineCorporate Domination of World

EconomyCorporate TaxationCorporate CrimeCorporations and EducationCorporations and the Media

OutlineInternational Non-Cooperation and

IsolationismCase StudiesSolutionsDiscussion

Corporations Dominate the Global Economy

Almost 6 million corporations90% of transnational corporations headquartered in Northern Hemisphere

500 companies control 70% of world trade

Corporations Dominate the Global Economy53 of the world’s 100 largest economies are private corporations; 47 are countriesWal-Mart is larger than Israel and Greece

The Stock MarketThe top 1% of Americans owns 51% of all

stocks, bonds, and mutual fund assetsConsequences of Differential Stock

OwnershipCorporations are answerable to their

shareholdersGovernments are answerable (at least in

theory) to their citizens (either through elections or revolutions)

CorporationsInternalize profits

Externalize health and environmental costs

Corporate TaxationCorporations 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

Reasons for Inadequate Corporate TaxationCorporate tax breaks/loopholesCorporate welfareCheating and under-payment common

Offshore tax havens shelter capital

“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 CrimeFines meager, often considered a cost of

doing businessCorporate crime under-prosecuted,

prosecutors under-fundedConfidential legal settlements keep

important public health and safety information secretMay delay governmental intervention,

cause unnecessary morbidity and mortality

Consequences of CorporatizationIncreasing industry consolidation/mergers

Inflation

Rising unemployment

Consequences of CorporatizationRise of the “permatemp”

Expatriation of jobsOverseas factories often lack adequate

occupational health and safety and environmental standards

Decline in labor union membership

Exorbitant CEO PayCEO salaries up 500% since 1980The average CEO makes 350-400X the salary of the average U.S. worker (1960 - 41X)Mexico 45:1Britain 25:1Japan 10:1

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

Pseudoscientific BeliefsPercentage of Americans who believe “at least to some degree” in these “phenomena”

1997 1976Astrology 37% 17%UFOs 30% 24%Reincarnation 25% 9%Fortune-Telling 14% 4%

Ignorance/Pseudoscientific BeliefsHalf 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

Pseudoscientific Beliefs37% 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

Ignorance/Pseudoscientific Beliefs22% 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 DisarrayU.S. Schools ranked lowest among western nations

Inadequate funding, decaying infrastructure

National HS graduation rate stagnant at 65-70%

College tuition costs rising

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

Television and the MediaThe 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 TacticsAdvertisingAstroturf - artificially-created grassroots coalitions

Corporate front groups

Corporate PR tacticsInvoke poor people as beneficiaries

Characterize opposition as “technophobic,” anti-science,” and “against progress”

Portray their products as environmentally beneficial despite evidence to the contrary

Greenwash

Public relations / ad campaignsBP 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”

Academics/Professional Organizations AffectedIncreasing corporatization of academia↑Private commercial funding of university research:

Secrecy/Gag Clauses

The Media5 corporations control majority of US media (down from 50 in 1983)

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)

LobbyingOver 15,000 full-time lobbyists

Estimates of return on lobbying range from $28 to $100 for every $1 spent

LobbyingLobbying groups spent 3.5 billion in 2009

(federal lobbying, a record)Financial sector spent over $1.7 billion on

campaign contributions for federal elections from 1998-2008

All single issue ideological groups combined (e.g., pro-choice, anti-abortion, feminist and consumer organizations, senior citizens, etc.) = $76.2 million

The Decline of DemocracyTrue 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 AgreementsCorporations attempt to influence

writing and acceptance/rejection of international agreementsThrough misinformation, lobbyists, revolving door between industry and government

Large behind the scenes role

International Non-Cooperation/IsolationismFailure to sign or approve:

Kyoto Protocol on Climate ChangeInternational Covenant on Economic, Social, and Cultural Rights

Convention on the Prohibition of Anti-Personnel Land Mines

Treaty to ban cluster bombs

International Non-Cooperation/IsolationismFailure to sign or approve:

Convention on the Rights of the ChildConvention on the Elimination of Discrimination Against Women

Convention for the Suppression of Traffic in Persons

The Stockholm Convention on Persistent Organic Pollutants

Worldwide Health and Social Justice: Can Aid Help?US ranks 21st in the world in foreign aid as a percentage of GDP (0.7%)

Foreign Aid:1/3 military1/3 economic1/3 food and development

Case Studies

The alliance between GE Medical Systems and NY-

Presbyterian Hospital

Martin Donohoe

The PartnersNY-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 Agreement10-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)• 2008 revenues of $183 billion–Greater than the GDP of more than 2/3 of U.N. member states2008 net after-tax profits of $17 billion

General ElectricMakes household appliances, plastics,

lighting, and medical equipmentPlastics division, which produced bisphenol A, spun off in 2008

Produces jet engines and military hardware

Has built 91 nuclear power plants in 11 countries

General ElectricOperates coal-burning power plantsMajor releasers of toxic mercury

Operates a financial services groupOwns a multi-billion dollar media empireIncluding NBC, Telemundo, and Universal Studios

GE’s HistoryConducted 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 travelMay have contributed to increased thyroid cancer risk in “Downwinders”

GE’s RecordAmerica’s largest corporate polluter

116 Superfund sites nationwide

Approximately 13 in NY

GE’s RecordBetween 1947 and 1977, two of its

capacitor manufacturing plants dumped 1.3 million pounds of PCBs into the Hudson RiverProbable human carcinogens with adverse effects on liver, kidney, nervous system, and reproductive organs (EPA)

200 mi of Hudson Superfund site

GE’s RecordHas spent millions to avoid Hudson

cleanup and to weaken or eliminate Superfund Law

Contributes to corporate front groupsPromulgate an anti-scientific and pseudo-scientific agenda

Conduct media disinformation campaigns in an attempt to weaken health and environmental regulations

GE’s RecordTremendous influence of environmental,

energy, and health policySpent over $25 million on federal

government lobbying in 2009 (#2 after Exxon Mobil)

Many member’s of board of directors have government ties; others have insurance and pharmaceutical industry ties

GE’s RecordCEO Jeffrey Immelt named “World’s Best

CEO” in 3 separate Barron’s polls2008 salary $3.3 million (+)On Board of NY Federal Reserve Bank and

appointed by President Obama to his Economic Recovery BoardGE then became eligible, via a loophole,

for ¼ of the $340 billion Temporary Liquidity Guarantee Program (debt support)

GE’s RecordHas eliminated 150,000 jobs in last 15 yearsWhile receiving billions in federal contracts and millions in state and local subsidies

One of nation’s top out-sourcers of jobs

GE’s RecordExecutive pension plan far more generous than for other employees

Continues to shift health care costs onto workers, despite growing profits

GE’s RecordCited 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 RecordGE has sponsored PGA Masters Tournament at Augusta National Golf ClubClub excludes womenCEO Immelt a member

GE’s RecordTopped 2002 Project on Government

Oversight’s list of repeat offenders for defrauding U.S. taxpayersPaid 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 TaxesGE topped the list of corporate tax break recipients from 2001-2003:$9.5 billion in tax breaks

Under investigation for tax evasion in Brazil

GE’s RecordIn 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 RecordThe Patient Channel

Shown in hospital rooms throughout country

Advertising vehicle for drug companies

Criticized by JCAHO for manipulative marketing practices

GE’s RecordProduces 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’s RecordNamed “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 AgreementProvides GE with financial incentives to promote high technology purchases

Hospital prohibited from purchasing more effective equipment from other companies

Concerns About the AgreementAugments trend in academic

medical centers to promote the use of expensive, high-technology care at expense of preventive care and public health measuresHighly reimbursableServices may be redundant in certain locations

Concerns About the AgreementOccurs at time 47 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 AgreementAcademic medical centers becoming increasingly corporatizedResearch exclusivity contracts

Secrecygag clausesskewing of research agenda

Concerns About the AgreementI 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 agreementNo Response

Concerns About the AgreementPatients 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”

SolutionsNY-P should cancel agreementHealth care providers and organizations should condemn this unholy alliance

Medical and ethical organizations should develop standards regarding future agreements

Background2007: 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 WarmingLeader referred to “belief” that burning fossil fuels has caused global warming as pseudoscience

Criticized environmental scientists as “doomsayers” and “fearmongers”

ACSH ResponseThreatened litigation against Medscape

Medscape briefly pulled article, then published with comments removed, then republished with additional material

?Loss of potential readership?

Dr Elizabeth Whelan:President and co-founderEarly writing career included:

Freelance writing assignment for Pfizer criticizing the FDA

Consumer magazine piecesBooks include Panic in the Pantry and Toxic Terror

Whelan’s 2003 salary = $326,612

Dr Gilbert Ross:Medical/Executive DirectorSpent 1996 in federal prison after being sentenced to 46 months forMedicaid fraudPerjuryObstruction of justiceNot mentioned on his bio on ACSH website

ACSH:Dr Gilbert Ross’ CareerBarred 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

ACSHACHS 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 GroupsPromote corporate agendasStrong financial and advisory links with corporations

Disseminate misinformation/lies under guise of “science”

Promote pro-business, conservative ideology

ACSH:Pseudoscience and MisinformationAttacked the precautionary principle“anti-science,” “elitist,” and “theology”

Minimized the effects of environmental tobacco smoke (ETS) on human health40,000 deaths/yr in U.S.

ACSH:Pseudoscience and MisinformationDenied many of the adverse neurological

effects of lead exposureDenied endocrine-disrupting effects of

PCBsClaimed 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 MisinformationCalled 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 MisinformationClaimed “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 waterPhthalates in medical devices and children’s toys

ACSH: Attacks on Scientists and the Scientific EnterpriseThreat of litigation against Medscape antithetical to the rules of sciencerequires the free exchange of information and opinion in pursuit of the truth

ACSH: Attacks on Scientists and the Scientific Enterprisead hominem attacks

environmentalists = “toxic terrorists”

Whelan criticized Dr. Barry Levy and citizen-activist Erin Brockovich

Implications of Attacks on Science and ScientistsACSH has broad media presenceWeb site attracts large numbers of individuals100,000 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 ScientistsEditorials 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 ScientistsMislead publicMay cause alterations in lifestyle and/or

purchasing habitsAdverse 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 ScientistsFaulty 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 ScientistsScientists 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 TreatyU.S. attempted to undermine treaty through Bush administration appointees with strong ties to tobacco industry

Medical Technologies IndustrySuccessful lobbying effort against Medicare physician payment policies relevant to unproven imaging studiesWhole body CT scans (scams)

Corporate AgribusinessSuccessful campaign against Oregon’s Proposition 27 (labeling of GM foods)

Lobbying for pre-emptive labeling laws re GMOs, rBGH

Corporate AgribusinessSupports 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

Medical CareSponsor luxury care consortiums, clinics

Facilitate medical tourismNiche in “medical transfer market,” facilitating medical repatriations of undocumented immigrants (e.g., MexCare)

Health Insurance IndustryDubious practices:

DelistingCherry pickingPre-existing conditions

Often lower quality of careHigh administrative costs

15-30% (vs. 2-3% for Medicare and Medicaid)

Health Insurance IndustryLarge profit margins

Loyalty: shareholders (not patients)

Corruption

Prison-Industrial ComplexConstruction and management of prisons

Providing (substandard) health care to inmates

Pharmaceutical IndustryInfluence over physicians through control of CME, gifts, research funding

Conduct seeding trials to alter prescribing patterns

Secrecy, statistical torturing of data sets, selective publication

Pharmaceutical IndustryEffectively 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

Pharmaceutical IndustryOpposes legislation aimed at limiting

pharmaceutical industry influence by publicizing gifts to providers

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

Chemicals IndustryChisso Corporation

Methylmercury poisoning

Minimata Disease

Minimata DiseaseW Eugene Smith

SolutionsRestructure tax systemPunish corporate scofflaws with

large fines and jail timeIncrease enforcement budgets to

combat corporate crimeEliminate confidential legal

settlements relevant to public health and safety

SolutionsLiving wage lawsWork with corporations

Healthy PRShareholder activismRisks/benefits

Solutions: Fair, Representative ElectionsPublicly financed campaigns and campaign finance reform

Open debates, free air time for candidates

Proportional representationInstant runoff voting/cumulative voting/range (rating) voting

Solutions: VoteUS voter turnout low

Wealthy vote at almost twice rate of poor

Whites > Blacks > HispanicsOld > YoungProperty owners > RentersPhysicians < general population

Voter Turnout

SolutionsActivism / Letter writing / Protesting / Whistleblowing

Join community groups – become involved in local as well as national issues

Lobby legislatorsRun for office

SolutionsIncrease funding of public education

Independent scientific review of school curricula

Prohibit use of sponsored curricula

SolutionsEstablish safeguards re corporate involvement in academic research

Higher standards of journalism

Support alternative media

Solutions: EducationMedical 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: EducationIOM recommends ¼ to ½ of medical students earn the equivalent of an MPHOnly 10% of students at US public health schools are physicians, down from 60% in the 1960s

SolutionsAugment and improve international aid package

Sign, ratify, and adhere to major international treaties

Support Millenium Development Goals

Air Pollution

Factory Farming

Global Warming

Famine

2009 Federal Budget$2.65 trillion

SolutionsBased on Precautionary PrincipleRecognize nature’s net worthCalculate economic prosperity based on Genuine Progress Index or Global Happiness Index, rather than Gross Domestic Product

Voltaire

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

“All men are created equal”Declaration of Independence

“Some people are more equal than others”George Orwell

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.”

Anita Roddick"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.orgmartindonohoe@phsj.org