1. 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 “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

5. 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

7. 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)

8. 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

9. The Stock Market The top 1% of Americans owns 51% of all stocks, bonds, and mutual fund assets Consequences of Differential Stock Ownership Corporations are answerable to their shareholders Governments are answerable (at least in theory) to their citizens (either through elections or revolutions)

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 passes Congress (2012): Removes loophole exempting Congressional lawmakers and staff members from being prosecuted for “insider trading” for using knowledge gained in their work (political intelligence)

11. Congressional Wealth and Influence ½ of legislators are millionaires (vs. 1% of U.S. citizens) Average personal fortune: Senator = $13 million Representative = $5 million

12. Corporations Internalize profits Externalize health and environmental costs

13. 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

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

16. 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

17. 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

18. 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

19. Reasons for Inadequate Corporate Taxation Offshore tax havens shelter capital Estimated 1/3 of global assets $11.5 trillion in individual wealth alone 83 of the largest 100 US companies have subsidiaries in tax havens Lost annual tax revenue: $250 billion worldwide $100 billion in US

20. Ugland House, Cayman Islands 18,000 Corporations Registered Here

21. Job Creators?

22. “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

23. 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

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

25. Consequences of Corporatization Increasing industry consolidation/mergers Inflation Rising unemployment

26. 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

28. Exorbitant CEO Pay CEO salaries up 759% since 1978 Average worker pay up 6% The average CEO makes 350-400X the salary of the average U.S. worker (1960 - 41X) Mexico 45:1 Britain 25:1 Japan 10:1 US Military: 15-20:1 (top rank : lowest rank)

29. CEO Personality Characterisitics 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

31. 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

32. Corporate Involvement in Education

33. 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

34. Geographic/Scientific Ignorance, Pseudoscience Percent of US teens unable to locate the following on a map: United States – 11% Pacific Ocean – 29% Japan – 58%

35. Pseudoscientific Beliefs Percentage of Americans who believe “at least to some degree” in these “phenomena” 19971976 Astrology37% 17% UFOs30% 24% Reincarnation25% 9% Fortune-Telling14%4%

36. 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

37. 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

38. 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)

39. 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)

40. 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 College tuition costs rising Increasingly marginalizes poor, minorities

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

42. 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”

43. 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

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

45. 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

46. 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

47. 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

48. Corporate PR Tactics Advertising Astroturf - artificially-created grassroots coalitions Corporate front groups Invoke poor people as beneficiaries

49. Corporate PR tactics Characterize opposition as “technophobic,” anti-science,” and “against progress” Portray their products as environmentally beneficial despite evidence to the contrary Corporate espionage: spying, bribes

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

51. 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”

52. 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

53. Academics/Professional Organizations Affected Increasing corporatization of academia ↑ Private commercial funding of university research Secrecy/Gag Clauses

54. 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

55. 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)

56. The Media 5 corporations control majority of US media (down from 50 in 1983) Extensive corporate-media links

57. 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)

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

60. 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

61. 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

62. Top-Spending Industries, 2011 (Low Estimates) Pharmaceutical industry - $236 million Insurance industry - $158 million Oil and gas industry - $146 million Electric utilities - $144 million

63. 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

64. 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

65. 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

66. 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

67. 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

68. 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

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

70. Foreign Aid 0.9% of the total federal budget, 1.6% of the U.S. discretionary budget Americans think that 24% of the federal budget goes toward foreign aid

71. Case Studies

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

73. 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

74. 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

75. General Electric Ranked by Forbes as world’s largest company (based on equal weighting of sales, profits, assets, and market value) 2011 revenues of $148 billion Close to the GDP of more than 2/3 of U.N. member states 2011 net after-tax profits of $14 billion Just over 1/3 from U.S. operations

76. General Electric Makes household appliances, lighting, and medical equipment Plastics division, which produced bisphenol A, spun off in 2008 Has built 91 nuclear power plants in 11 countries (including Japan’s troubled Fukushima Daishii reactors) Produces jet engines and military hardware

77. General Electric Operates coal-burning power plants Major releasers of toxic mercury Produces nearly 40 technologies used in fracking

78. General Electric Operates a large financial services group Lending accounts for > 30% of revenue, vs. < 6% of revenue from consumer appliances Responsible for over 50% of company’s profits in recent years Owns a multi-billion dollar media empire Including NBC (49%, Comcast – 51%), Telemundo, and Universal Studios

79. 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.”

80. 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”

81. 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

82. GE’s Record America’s largest corporate polluter 116 Superfund sites nationwide Approximately 13 in NY

83. GE’s 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

84. 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

85. GE’s 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

86. 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)

87. GE’s Record Eliminated 34,000 US jobs between 2000 and 2010 Added 25,000 overseas jobs over same period

88. GE’s Record Executive pension plan far more generous than for other employees Continues to shift health care costs onto workers, despite growing profits

89. 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

90. GE’s Record GE has sponsored PGA Masters Tournament at Augusta National Golf Club Club excludes women CEO Immelt a member

91. 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

92. 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”)

93. 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

94. GE’s Record The Patient Channel Shown in hospital rooms throughout country Advertising vehicle for drug companies Criticized by JCAHO for manipulative marketing practices

95. 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.

96. GE CEO Jeffrey Immelt 2011 total compensation = $21.6 million Named “World’s Best CEO” in 3 separate Barron’s polls 2006 - 2011 - On Board of NY Federal Reserve Bank

97. 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)

98. 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

99. GE CEO Jeffrey Immelt Charitable works include membership on the board of directors of “The Robin Hood Foundation”!

100. 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

101. Concerns About the Agreement Provides GE with financial incentives to promote high technology purchases Hospital prohibited from purchasing more effective equipment from other companies

102. 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

103. Concerns About the Agreement Occurs at time 51 million Americans uninsured Academic medical centers promoting luxury primary care clinics and seeking wealthy overseas patients while cutting back on services to the un- and under- insured

104. Concerns About the Agreement Academic medical centers becoming increasingly corporatized Research exclusivity contracts Secrecy gag clauses skewing of research agenda

105. 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

106. 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

107. A macabre twist on “cradle to grave care”

108. 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

110. 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

111. 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”

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

113. Dr Elizabeth Whelan: President 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 Whelan’s 2003 salary = $326,612

114. 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

115. 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

116. 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”

117. 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

118. 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.

119. 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

120. 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.”

121. 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

122. “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

123. 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

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

125. 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

126. 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

127. 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

128. 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

129. 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

130. Other Examples of Corporate Meddling in Public Health

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

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

133. 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

134. 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!

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

136. 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

137. 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

138. Medical Care Sponsor luxury care consortiums, clinics Facilitate medical tourism Niche in “medical transfer market,” facilitating medical repatriations of undocumented immigrants (e.g., MexCare)

139. 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)

140. Health Insurance Industry Large profit margins Loyalty: shareholders (not patients) Corruption

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

142. Pharmaceutical Industry Influence over physicians through control of CME, gifts, research funding Conduct seeding trials to alter prescribing patterns Secrecy, statistical torturing of data sets, selective publication Data mining of prescribing practices Ok’d by SCOTUS in Sorrell v. IMS Health

143. 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

145. Pharmaceutical Industry $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

146. 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 Sneaky patent extensions, carve-outs

147. Pharmaceutical Industry 2011 NIH rules require reporting of over $5000 financial largesse from industry (database not public) Opposes legislation aimed at limiting pharmaceutical industry influence by publicizing gifts to providers

148. 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

149. 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)

150. Chemicals Industry Chisso Corporation Methylmercury poisoning Minimata Disease

151. Minimata Disease W Eugene Smith

152. Energy Industry Oil and gas, coal, fracking, nuclear power Sponsorship of faculty, training programs Funding research and policy papers Lobbying

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

154. 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)

155. Solutions Punish corporate scofflaws with large fines and jail time Increase enforcement budgets to combat corporate crime Eliminate confidential legal settlements relevant to public health and safety

156. Solutions Living wage laws Work with corporations Healthy PR Shareholder activism Risks/benefits

157. 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

158. 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

159. 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

160. Voter Turnout

161. 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)

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

163. Solutions Increase funding of public education Independent scientific review of school curricula Prohibit use of sponsored curricula

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

165. 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

166. 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

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

168. Air Pollution

169. Factory Farming

170. Global Warming

171. Famine

174. 2009 Federal Budget $2.65 trillion

176. 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

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

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

179. Hudson River, 2009

180. 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.”

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

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

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

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