Sick-Care for Profit: How Big Business is Keeping Us Sick
“We need to turn a profit”. This was ‘Pharma Bro’ Martin Shkreli’s shameless appeal to capitalists everywhere when he hiked the price of lifesaving drug Daraprim by 5,500 per cent. His pharma company — Turing Pharmaceuticals — acquired the AIDS-related treatment and increased the price from $13.50 to $750 per pill, after publicly acknowledging a synthesis price of only $1. Despite public outrage miring his name and leaving him in the wake of a several year scandal, the price of the drug is still hovering around the $700 mark. Was Shkreli a cold-blooded capitalist maverick acing the system? Or was he just following protocol? While ultimately he did land himself a jail sentence, turns out that everything he did with the drug remains totally legal.
How is it possible that we live in a world where exponential technology has endowed more computing power in our pockets than NASA had when they flew to the moon, yet we’re regularly bankrupting people over basic human needs? Why aren’t the same forces that made micro-processers ubiquitous — that made home grown disruptors like Tesla and the iPhone possible — democratizing and dematerializing American healthcare? With all the medical wonders — transplants, gene therapy, precision medicine and genome sequencing in a box — why is the healthcare system so bewilderingly expensive, inefficient, and inequitable? And why does this seem to be particularly acute in the United States, the land of the American Dream and the free? What went wrong in America, for a test that costs $100 in Munich to be $7,000 in Milwaukee? And why are we spending more as a society on healthcare than any previous generation?
The alarming statistics are incontrovertible and familiar; the United States spends nearly one-fifth of its gross domestic product on healthcare — more than $3 trillion a year — or about equivalent to the entire economy of France. And for all that money, the U.S. health system consistently delivers worse health outcomes than any other developed country, all of which average about half the costs. The bleak conclusion: the system is a complex, but “slow-moving heist” — and we are all potential victims of medical extortion.
SICK-CARE FOR SALE
The harsh reality is, the American health care system is deeply, perhaps fatally flawed. It both reflects society’s pathologies and reinforces them:“it is now so dysfunctional that I sometimes think the only solution is to blow the whole thing up,” says Glenn Melnick, a professor of health economics and finance at the University of Southern California. We have profoundly misaligned incentives, where treatment follows not scientific health guidelines, but the logic of commerce in an imperfect and unregulated market, whose key players spend more on lobbying than defense contractors. Financial incentives to order more and do more — to default to the most expensive treatment for whatever ails you — pervade much of our healthcare.
And the most complicated part — the conspiracy of the food industry, pharmaceutical companies, and the medical industry — all of whom are based primarily on profitability, not quality of life. They’re driven to satisfy the demands of their cap table, not the needs of citizens. And the failures of “democracy” allow for major manipulation of the legislative process by anyone willing to pony up. It’s far more lucrative to provide a lifetime of treatments, than a cure, or God forbid, encouraging a healthy population to begin with. “If we relied on the current medical market to deal with polio, we would never have a polio vaccine, instead we would have iron lungs in seven colors with iPhone apps.”
We’re stuck in this capitalist feedback loop; the very forces meant to keep us healthy are in fact, making us sick. The consolidation of healthcare and food companies has snowballed to an omnipotent oligopoly with an enormous sway over price. And when you dig deep into the money trail, it’s easy to understand why Big Agriculture, Big Food and Big Pharma are keeping us fat and sick. No one makes money when people are healthy.
IS BIG FOOD THE NEW TOBACCO?
The duplicitous dealings of the tobacco industry are well known. The old slogans, “doubt is our product”, and “the less they know, the better”, are possibly even more pertinent in today’s health and food systems than tobacco. Though the Framework Convention on Tobacco Control — the global treaty to curb smoking — now bans any relationship with, or funding by, the tobacco industry, the food industry has largely escaped public notice. Policymakers routinely cozy up with executives, with many sharing board positions between corporate, media and regulation agencies alike. Big Food is fiercely more powerful (and better resourced) than tobacco ever dreamed.
It purchases influence at every level of government, fighting regulations intended to benefit consumers by funding advocacy groups and sympathetic scientists. “Individual and political committees associated with the food industry donated nearly $34 million to federal political lobbying in 2015, along with nearly $6 million in direct contributions to House and Senate committee members responsible for food regulation that year”. The lion’s share goes to Republicans with antiregulatory records. There are no federal regulations against the funding of “scientific studies” concerning practices and health impacts by the corporations profiting from them. In a manner reminiscent of tobacco, Big Food pays medical professionals to conduct research discounting the scientific evidence of harms from sugar, salt, and saturated fats. Isn’t it convenient that science is for sale?
And it’s not just the scientists being bankrolled. When former New York mayor Michael Bloomberg tried to limit portion sizes for sugary beverages, the food industry surreptitiously financed community organizations to oppose the plan, orchestrating a “Nanny Bloomberg” campaign. What the public perceived as poor minority advocacy groups were actually shadow organizations funded by the beverage industry. Similarly, a San Francisco proposal to levy an excise tax on sugar-sweetened beverages was undermined, thanks largely to the American Beverage Association’s $11 million campaign against it. Tort litigation was effective in transforming public opinion on tobacco, but Big Food has gotten wiser to the litigious potential of public health advocacy. The American Legislative Exchange Council — an industry-financed ‘think tank’ — drafted a model law virtually blocking food litigation that has been enacted in nearly half of states. The truths of inadequate (or misleading) disclosure of health risk, the employment of propaganda advertising, and conspiratorial economic levers levied by Big Business, for now, remain known to only a small minority.
So how bad is it, really?
BIG AG ‘SPONSORING’ THE GUIDELINES
Agribusiness, manufacturers, restaurant chains, and marketers are making America sick and poor. There is literally nowhere on Earth where the alliance between so many heavyweight industry leaders results in such pernicious manipulation. The posterchild for Big Ag’s influence is Monsanto — famous for their genetically engineered “Roundup Ready” seeds. These seed are bred to increase pesticide use by design, driving up costs and intentionally boosting market share for corporations like Bayer (now merged with Monsanto) and DowDuPont. Their use has dramatically driven up the use of harmful chemical inputs — one that the WHO deemed as a “likely carcinogen” — placing the burden of increased costs and health risks on farmers and local communities. The “dirty little secret of the pesticide industry? Not surprisingly, the same big biotech corporations that develop GE crops also manufacture pesticides engineered to accompany their seed products, which are the growth engines of the pesticide industry’s sales and marketing strategy”.
Furthering the whole charade, lobbying from the Grocery Manufacturers Association and the likes of Monsanto in 2015 led to the nation-wide passing of comically ambiguous GMO labeling bill. Facetiously known as the DARK Act, or the “Deny Americans the Right to Know”, the bill negated existing GMO laws to impose only a weak labeling requirement with no penalties for noncompliance, and thanks to loopholes, will likely leave many GMO ingredients exempt from labeling requirements. The Environmental Working Group estimates that more than $100,000,000 has been spent nationwide to thwart GMO-related legislation. The recognition of how deeply perverse the whole system is, led to Big Ag being claimed as akin to the banking industry in 2008: “too big to fail”.
And if bleeding out local farmers and manipulating laws for sales isn’t enough, Big Ag has been playing puppet-master for the average consumer as well. Let’s profile how one federal agency has bowed to industry interests for decades: the US Department of Agriculture (USDA). The USDA is so deeply infiltrated by agribusiness that it has repeatedly demonstrated preferential treatment to their foods, assigning them more prominence in the food pyramid than their nutritional value would scientifically dictate. Hidden behind the curtain are a variety of food industry cronies who ‘helped’ shape the pyramid. In fact, since the explosion of the processed food industry in the 50’s, it has evolved to almost exclusively benefit the interests of corporate America. Big Ag profited most off of the grand-daddy of American nutrition — the processed carb revolution — which meant they needed to exercise a healthy dose of power over the USDA to ensure people kept eating it. This resulted in the serving size of “grains” growing to double that of any natural food.
Even as recently as 2015, the USDA and the US Department of Health and Human Services rejected their own expert panel’s advice to limit consumption of sugary beverages and processed meats despite overwhelming evidence of the harm to public health. Their 2015 guidelines also initially included a section on environmental sustainability, though naturally that rubbed some people (ahem, the agriculture and meat industry) the wrong way, so eventually the proposal was nixed. And most comically, congress even went as far as labeling pizza as a vegetable in 2017 in response to lobbying efforts. For the better part of the last century, science has been mixed with the influence of powerful agricultural interests, which is simply not the recipe for healthy eating”, says Walter Willett, the Chairman of Nutrition at the Harvard School of Public Health.
BIG FOOD IS KEEPING YOU ADDICTED
“You would never give your child a can of beer, but you don’t think twice about giving them a can of soda.”
What’s the difference between marketing and propaganda? The truth, says Dr. Robert Lustig, a famous anti-sugar crusader. He vehemently claims that the food industry has propagandized the last 40 years of nutritional information. “They got rich, and we got sick. And they deliberately obfuscate nutritional information to keep consumers in the dark, targeting young people, poor people, and minorities in particular”. Researchers say that the sugar industry closely followed in the footsteps of tobacco, manipulating heart disease studies in the 1960s and ’70s by emphasizing the role of fat. Unsurprisingly, the scientists conducting the original study headed the Sugar Research Foundation. These manipulated studies were in “direct contradiction to the American Heart Association’s recommendation of no more than 6 teaspoons (25 grams) of added sugar per day, in line with the World Health Organization’s (WHO) recommendation that ideally less than 5% of daily calories come from added sugar. For a 2,000-calorie diet, 5% would be 25 grams (6 teaspoons). These are the upper limits. How much added sugar do you need in your life to maintain optimal health? ZERO. ZIP. NADA. BUPKIS”. Even as recently as 2015, a New York Times report revealed a suspicious relationship between Coca Cola and the sponsored researchers conducting studies aimed at minimizing the effects of sugary drinks on obesity.
So why have we been hearing for the past four decades that fat is the culprit of our illness? It’s one of the many handsomely funded disinformation scandals using a famous neuro-marketing tactic called “diversion and evasion”. They employ cutting edge marketing concepts such as “neuromarketing” and “choice architecture” to manipulate you as a consumer. The hypocrisy is so blatant that there is even a company promising to funnel your dopamine right into addictive behavior patterns and company profit margins. Big Food is exploiting our paleolithic hormones, selling us “hyperpalatable foods” — processed products that are high in sugar, salt and fat — that haven proven to be chemically addictive. Researchers at the University of Michigan found that 92% of study participants exhibited addictive-like behavior towards some foods. See, it’s much easier to sell a product when people are addicted to it. Profits are higher too for these packaged products, as they cost less to produce. They use genetically modified organisms use gene splicing, gene modification, or transgenic technology, to create food that does not occur in nature or through traditional cross-breeding methods. Essentially, Frankenstein foods. It appears that it is no longer enough in America to buy a product and use it. Now, food companies want you addicted to it as well.
And sugar is not alone. In 2015, the WHO released a study labeling processed meats as carcinogenic, landing in the same category of toxicity as cigarettes and asbestos. Yet powerful lobbying efforts have kept America near the top of the world in meat consumption. “Beef and dairy items have even been promoted on the websites of the American Diabetes Association (ADA), the American Cancer Society (ACS), the American Heart Association (AHA), effectively promoting the very foods linked to the diseases they’re supposed to be fighting against”. When you break through the funding details, the tomfoolery becomes clear: Kraft Foods, Oscar Mayer, Dannon and Yoplait Yogurts, KFC, Taco Bell, Domino’s, and the beef and dairy industries themselves are the top financiers of these non-profit health associations. And the whole system is so deeply convoluted, Senators made it illegal to challenge Big Food for your health woes. The so-called “Cheeseburger Bill” bans lawsuits related to industry culpability of any health-related issues caused by consumption of their foods.
Meanwhile, the food industry continues its juggernaut of revenues and profits. The domestic fast food industry revenues have exhibited a 20% rise, adjusted for inflation, over the past decade. Fast food was worth $273 billion a year in 2019, up from $165 billion in 2009. Beef alone is a $95 billion-a-year business, according to the USDA. That translates into some heavy political influence: in 2014, the industry dished out approximately $10.8 million in contributions to political campaigns, and another $6.9 million directly on lobbying the federal government. Governments are bought businesses, and democracy is for sale to the highest bidder.
BIG PHARMA TO FIX THE PROBLEMS WE CREATED
“The real money in drugs is in selling them to healthy people” — CEO of Merck
So once the industry has gotten us fat and sick, they will need to prescribe us with medication to alleviate our symptoms. In today’s world of “sick care”, illnesses are treated as if you have a drug deficiency — high cholesterol, you have a statin deficiency, high blood pressure, could be a diuretic deficiency, hyper-active and unable to control your mind in the attention economy? Well, that’s why they made Ritalin, right?
The ACS, AHA, and ADA are accepting millions of dollars from pharmaceutical companies that are making billions of dollars from the diseases the health organizations are supposedly trying to combat. It’s a diabolical domino effect of drugs through our lives: “if you become addicted to painkillers, there are pills to help you stop taking the pills, by reducing the symptoms of withdrawal. And if you take too many pills, there’s a pill for that too”. Indeed, adverse drug effects are creating chronic diseases requiring additional drugs. And it’s pervasive: a study from the Mayo Clinic showed that 7 out of 10 Americans take at least one prescription drug.
Similar to Big Food, Big Pharma contributes heavily to the annual budget of the U.S. Food and Drug Administration through application fees for its new products. In fact, experts say the industry contributes about two thirds of the FDA’s budget. It is illegal in every country in the world except for the US and New Zealand to advertise drugs directly to consumers. And Big Pharma really takes advantage of this unique opportunity, spending more than $9.6 billion annually on ads. Advertising and marketing is so important to their bottom line that 9 out of the top 10 industry leaders spend more on marketing than on R&D. That works out to something in the ballpark of $19 on promotions and advertising for every $1 spent on “basic research”. They’re even employing “weapons of mass seduction”, adopting the neuro-marketing strategy of the cosmetic industry to create discontent and anxiety about perceived imperfections. They’re using psychological weapons to prey on people’s fear of sickness, aging, loneliness, death — all calculated to create a demand for the latest pill. “Public awareness campaigns are turning the worried well into the worried sick. Mild problems are painted as serious disease, so shyness becomes a sign of social anxiety disorder and premenstrual tension a mental illness called premenstrual dysphoric disorder. Everyday sexual difficulties are seen as sexual dysfunctions, the natural change of life is a disease of hormone deficiency called menopause, and distracted office workers now have adult ADD”. Despite paying out 373 settlements for marketing fraud totaling $35.7 billion, there’s no signs of Big Pharma stopping.
And much like their Big Food peers, Big Pharma also uses its profits and an army of paid lobbyists to peddle its influence on Capitol Hill. From 1998 to 2016, Big Pharma spent nearly $3.5 billion on lobbying expenses — almost twice as much as any other industry. The typical politician received nearly $40,000 in kickbacks. In 2016 alone, about $246 million was spent. That’s more than the defense industries and corporate business lobbyists combined. Medical device manufacturers also have a lobbying group which contributed $1.2 million in lobbying funds in 2016, focusing its efforts on medical-device-friendly bills in Congress. They mostly relate to how companies pay taxes.
And of course, on trend, Big Pharma also regularly funds studies that reach conclusions that support their interests. In only five years, medical companies and big pharma paid out $3.5 billion in kickbacks to 546,000 physicians and 1,360 teaching hospitals. Each year from 2014 to 2018, drug and medical device companies spent between $2.1 billion and $2.2 billion paying doctors for “consulting services”. The AHA acknowledges that around 20% of their total revenues come from corporate donations. That’s a whopping $157,726,113. And why would Big Pharma, insurance, and medical equipment makers want to sponsor the AHA? It’s simple economics: every single one of them need you to be sick to survive and thrive. This monolithic corporate influence has resulted in the perversion of the practice of medicine and the goal of a “healing” profession.
In his former life as a hedge fund manager, the aforementioned Shkreli was accused of pressuring the FDA against approving drugs from companies whose stock he was shorting. And his famed antics of buying low and selling high, well it turns out that buying rights to drugs — older, even generic drugs — and raising their price sharply has been something of a business model for American pharmaceutical companies. Valeant, who allegedly raised the price of a heart drug more than 500 percent the day it bought the rights to it, and another company raised the price of Doxycycline, a common antibiotic, from $20 a bottle in 2013 to $1,849 by 2014.
Last year the U.S. Department of Justice leveled charges at Insys founder John Kapoor saying he lead a “nationwide conspiracy to profit” through the use of bribes and fraud in order to sell the company’s fentanyl-based sublingual spray for cancer pain. Through 2018, the company’s total spending on the drug had reached $17.6 million. Last year, Danish drugmaker Novo Nordisk settled a U.S. Department of Justice probe into is the company’s marketing activities for its diabetes drugs that allegedly included paybacks to doctors and disguising salespeople as medical educators. Abilify earns $7 billion a year as a top selling drug for diseases unrelated to its license. As a result, there are myriad claims against it for being the culprit of other chronic personality consequences. And the famed Viagra wasn’t working well for what it was designed for, but it had interesting effects, so they hired an ad agency and created a disease it could be prescribed for. Notice a pattern?
HIPCRATIC OATH, WHAT?
Most people that enter the medical field do so with noble intentions of helping people. But once they’re in the rat race, they become a cog in the wheel of the system, reducing them to highly educated pharmacists. Prescribing pills and recommending surgery is how they profit. They don’t suggest diet, lifestyle, stress management. In fact, earning a medical degree in the United States doesn’t even require a single nutrition course. Doctors, insurance companies, medical equipment vendors, hospital and clinic operators — all of them need you to be sick to make money. Healthy people don’t fill up hospital beds. They don’t use MRI machines. They don’t buy extravagant insurance plans and get a lifetime prescription of drugs.
Media companies need pharmaceutical company ads to survive. Pharmaceutical companies need you to be sick to sell product. Food companies want you to be addicted to their products, so you’ll keep using them. The government pushes health care policies that keep you sick because the government needs healthcare for a strong economy.
It is easy to feel helpless; our sense of medical urgency combined with bureaucratic confusion is a debilitating cocktail. And it’s a Faustian bargain to be sure: your time and your wallet, or your health. The food supply has not changed; it has only gotten worse. Robbing us to pay both Peter and Paul. It’s time for government to step up and amend our current food and pharma policy — for the aesthetic, for the socio-ecologic and for the biochemical damage that it is doing to America.
