What's Wrong With the Healthcare System: Profits Before People, By Design.
It's actually very simple. Read this whole explanation and see, and see how simple it would be for us to fix.
Most people have no idea how the healthcare system in the U.S. works (and many other places), or is designed. They seem to believe some salesmanship pitch that “We have the best healthcare system in history”, and “the best healthcare system in the world.” Both are completely false.
The U.S. pays more dollars per person and gets worse outomes than any other 'first world' country, and worse outcomes on common conditions than some '3rd world' countries.
https://r.mt.ru/r18/photo5B55/20160591142-0/jpg/bp.jpeg
https://ourworldindata.org/grapher/life-expectancy-vs-health-expenditure
How Does the U.S. Rank in Life Expectancy?
“U.S. life expectancy was 77.4 years in 2022, according to data from the World Bank, ranking it No. 49 in the world and behind countries like Cuba, Estonia and Saudi Arabia.”
U.S. Health in International Perspective: Shorter Lives, Poorer Health
National Research Council and Institute of Medicine of the National Academies
“The United States is among the wealthiest nations in the world, but it is far from the healthiest. ...Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries.”
National Academies of Sciences, Engineering, and Medicine. 2013. U.S. Health in International Perspective: Shorter Lives, Poorer Health. Washington, DC: The National Academies Press. https://doi.org/10.17226/13497.
and we have the sickest generation in U.S. history. Each generation is supposed to be getting healthier, instead it is getting less healthy. Estimates are recently that 54% of US Youth are Chronically Ill.
Why is this happening?
For 3 main reasons. The first, is that in the U.S. and some other places, the healthcare system is set up as a private, for profit business - where profit rules, and comes before people.
The lynchpin in the system is 'Patent Medicines', which took over in the 1800s. If a product is patentable, the patenter can have a monopoly over it - no one else can sell it without their permisson, which usually involves paying them a cut of the profit. This blocks normal market competition that helps keep prices reasonable for products (because, if you charge much more than something is worth, someone else can just sell it for less, and everyone will then buy it from them, instead of you.) This creates an opportunity for patent holders to raise prices as high as they can. Unfortunately, in medicine, people can be pressured by health problems to pay very high prices for medicines, whether its fair, reasonable, or affordable, or not.
This is how big pharma became a trillion dollar industry.
But the details of how it works is key, and what people are missing. For something to be patentable, it must meet certain criteria: 1. It cannot have been patented before. 2. It cannot be naturally occuring. Patents are only for things people invent, and no person invented natural things.
Also, patents expire after a number of years, and are no longer monopolizable.
This creates a temptation to only research and develop medicines that are patentable, and marketable for much higher prices, and profits. Have you noticed the dogma of the “newest” “latest” medicine? This is why. Only newer medicines patent's haven't expired.
An example is Synthroid, the patented brand name for the thyroid medicine levothyroxine. Synthroid cost at one point $71 a bottle, for a 30 day supply. When the patent expired, and other people could sell it too, as the generic 'levothyroxine', that only cost $3 a bottle, for a 30 day supply.
As long as this is the way things work, people will invest in researching patentable medicines over unpatentable ones, and market them more.
This creates a direct competition between patent medicine, and natural medicine. Whether traditional natural medicines, or modern scientific medicinal products that aren't patentable, like vitamin supplements. Or even competition between patent medicine and previously patented medicines whose patent has expired.
Unfortunately, the second main reason our healthcare system is set up for profit over people is the lack of ethics and morality widespread throughout humanity in recent generations. They didn't have to succumb to the temptation to exploit the profitability of patent medicines, or try and aggressively out compete natural medicine. But people did, including paying for massive advertising campaigns attacking natural medicine as “primitive” “obsolete” “unsophisticated” “unadvanced” and generally “bad”. Which isn't true, and never was.
The exhorbitantly higher profits that could be made from patent medicines facilitated many of these kinds of marketing campaigns, and non-patent medicine businesses could not afford an equal amount of advertising, marketing, and informational campaigns, to keep up with their new competitors. They were quickly dominated.
People also manipulated the market in other ways, such as trying to influence medical school education, especially through donations and funding, and also influence government regulators, authorities, and officials, again often through donations and 'lobbying'.
Other manipulative tactics were used, and people could fill encyclopedias with the disaster that has played out over the last 150 years or so, as patent medicine took over the healthcare system in the U.S. and many other places, facilitated partly by the opportunities created by industrialization, mass production, and economic centralization.
Have you ever seen the popular classic movie “It's a Wonderful Life”? They usually play it every year on TV in late December in the U.S., and many people have seen it. There is a famous scene, the Pharmacy scene, where, in their small town, the local pharmacists job is to compound medicines himself for his customers, before prepackaged factory produced medicines took over. He had a bad day, and gets distracted, and this time he mixed the medicine wrong. He gives it to his young delivery boy to deliver, who had seen the mistake, and doesn't want to deliver it. So he just doesn't. Later, the customer called complaining they haven't recieved the delivery yet. The pharmacist gets very upset and apologizes, and says he'll see to it at once. He goes to the delivery boy and confronts him, and starts spanking him for not delivering it. The boy protests “but you got distracted and mixed it wrong.” The pharmacist finally hears him, checks the medicine, and thanks him so much, telling him he saved the day.
People should pay more attention to this scene of traditional American life. Medicine used to be made locally, by small independent pharmacists or 'chemists', or even herbalists. These professionals lived and worked in the community, and everyone knew them. And knew where they lived. People went to school with them, and knew if they were capable, competant, skilled, and conscientious.
In the factory model of medicine production, someone you don't know, far away, makes your medicine. You don't know where they live. You don't know anyone who knows them.
Local, independent businesses are highly accountable to their customers, by nature.
Distant, big businesses, are very hard to hold accountable at all, let alone by the customers. They are also harder to get transparency on.
These simple principals and dynamics actually explain all of our problems throughout healthcare, which is a business, and an 'industry'. It's subject to the nature of business, and without good business design and practices, it fails. Catastrophically.
The 3rd main reason is the dynamics of power, and control. Healthcare is a very powerful trade, especially when centralized. This creates an opportunity and temptation to use and abuse that power for ulterior motives. This is another huge topic, too big for this post. Included herein are some documents reflecting some of the glaring financial conflicts of interest and concerns, and out of control profiteering in our healthcare system, as examples to help educate and inform, and alert and warn, and help people spread the word and inform others, and convince them.
We must all take action to improve this situation, and solve these problems. All hands on deck.
This topic is huge, with many aspects to it, but don't miss the excellent documentary series:
“How & Why Big Oil Conquered The World” https://www.corbettreport.com/bigoil
which includes how the Rockefellers, extremely rich from their oil fortune, expanded their petrochemical business into using them to make medicines, and went into the pharmaceuticals business. Then they used their money to try and take over the pharmaceutical market, and the industry, and dominated and restructured it. Includes a lot of important history, and information on how our healthcare system got shaped into the design we have now.
Also a great documentary on important aspects of these issues is “Trust WHO”,
https://www.journeyman.tv/film/7246/trustwho
https://archive.org/details/trust-who
A great book is “Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare”, by Peter C. Gøtzsche, ISBN-13: 9781846198847 | ISBN-10: 1846198844
Another great book is “The Truth About the Drug Companies: How They Deceive Us and What to Do About It”, by Dr. Marcia Angell
“During her two decades at The New England Journal of Medicine, Dr. Marcia Angell had a front-row seat on the appalling spectacle of the pharmaceutical industry. She watched drug companies stray from their original mission of discovering and manufacturing useful drugs and instead become vast marketing machines with unprecedented control over their own fortunes. She saw them gain nearly limitless influence over medical research, education, and how doctors do their jobs. She sympathized as the American public, particularly the elderly, struggled and increasingly failed to meet spiraling prescription drug prices. Now, in this bold, hard-hitting new book, Dr. Angell exposes the shocking truth of what the pharmaceutical industry has become–and argues for essential, long-overdue change.
Currently Americans spend a staggering $200 billion each year on prescription drugs. As Dr. Angell powerfully demonstrates, claims that high drug prices are necessary to fund research and development are unfounded: The truth is that drug companies funnel the bulk of their resources into the marketing of products of dubious benefit. Meanwhile, as profits soar, the companies brazenly use their wealth and power to push their agenda through Congress, the FDA, and academic medical centers.
Dr Marcia Angell, a member of Harvard Medical School's Department of Social Medicine, has written a painstakingly researched book on the wiles and ways of what has come to be called “big pharma.” It is a clear exposé of the American drug industry and is written in the impassioned but impeccable prose we expect from a former editor of the New England Journal of Medicine."
ISBN-13: 9780375760945 | ISBN-10: 0375760946
“It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of the New England Journal of Medicine.”
― Marcia Angell
https://www.bmj.com/content/346/bmj.f3830/rr/652673
“...asked Dr. Angell about the Journal’s recent policychanges regarding conflict of interest. The current Editor of the Journal, Jeffery Drazen, has loosened the conflict of interest policy, which now allows authors of editorials and review articles to receive up to $10,000 from each drug company. Dr. Angell holds firm that a zero-tolerance policy, or no allowance of payment between companies and writers, is the only way to eliminate conflict of interest in medical journalism. She discusses why the policy change is problematic and may incentivize unethical promotions.”
https://journals.library.columbia.edu/index.php/bioethics/article/view/5993/3642
Doctors Prescribe More of a Drug If They Receive Money from a Pharma Company Tied to It
“Pharmaceutical companies have paid doctors billions of dollars for consulting, promotional talks, meals and more. A new ProPublica analysis finds doctors who received payments linked to specific drugs prescribed more of those drugs.”
More than half of doctors receive industry payments, with some making millions
“A recent study in JAMA finds that 57% of physicians received a payment from pharmaceutical or medical device companies over the past ten years.”
Dollars for Docs
How Industry Dollars Reached Your Doctors
“Pharmaceutical and medical device companies are required by law to release details of their payments to a variety of doctors and U.S. teaching hospitals for promotional talks, research and consulting, among other categories. Use this tool to search for general payments (excluding research and ownership interests) made from August 2013 to December 2018.”
https://projects.propublica.org/docdollars/
OpenPaymentsData.CMS.gov
Learn about the financial relationships that drug and medical device companies have with healthcare providers.
https://openpaymentsdata.cms.gov/
Critical Care: America vs. the World
PBS NewsHour “...Despite recent reform efforts, the United States still has the most expensive health care system in the developed world — with worse health outcomes compared to its international peers and 30 million Americans with no insurance.”
https://www.pbs.org/newshour/health/watch-critical-care-america-vs-the-world-a-pbs-newshour-special
https://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/
Médecins Sans Frontières: 6 things Big Pharma doesn’t want you to know!
1. Developing drugs is not as expensive as they say
2. You’re paying twice for your medicines
3. The pharma industry is poor at innovation
About two-thirds of the new drugs that arrive on the market are no better than what we already have.
4. Patents are extended – over and over – to prolong monopolies
5. Pharma bullies developing countries for going against their corporate interests
6. Pharma pockets more than they re-invest
Big Pharma says they need huge profits so they can pay for R&D and innovation. But in reality, they spend more on share buybacks to boost their own stock prices, and on sales and marketing, than on R&D."
https://www.msf.org/6-things-big-pharma-doesn%E2%80%99t-want-you-know-access-medicines
“Prescription drugs are a massive market: Americans spent $329.2 billion on prescription drugs in 2013. That works out to about $1,000 per person in the U.S...
...drug companies spent more than $3 billion a year marketing to consumers in the U.S. in 2012, but an estimated $24 billion marketing directly to health care professionals.
...The biggest spender, Johnson & Johnson, shelled out $17.5 billion on sales and marketing in 2013, compared with $8.2 billion for R&D.
...nine out of 10 big pharmaceutical companies spend more on marketing than on research.”
Big pharmaceutical companies are spending far more on marketing than research. February 11, 2015
What are Corporate Practice of Medicine (CPOM) Laws?
"The Corporate Practice of Medicine (CPoM) doctrine was conceptualized to protect the physician-patient relationship corporations placing profits over patients in the early 1900's. Most states prohibit CPoM, but they are broadly unenforced. It's time for the profession of medicine to reclaim the ethical basis of our profession - the physician-patient relationship, by expelling corporate interests.
CPOM laws are regulations that prohibit standard corporations (or other non-physician entities) from practicing medicine or employing practicing physicians. The primary goal of these laws is to ensure that medical decisions are made solely based on patient care and not influenced by corporate interests. These laws vary by state, but they generally aim to protect the physician-patient relationship from commercial influence."
https://www.takemedicineback.org/
The Greediest 'Non-Profit' Hospital in America
“A recent survey found that 36% of University of Pittsburgh Medical Center workers are in medical debt to their employer.
UPMC is a healthcare giant. It employs more than 92,000 people, has an operating revenue of roughly $26 billion, and as a “non-profit”, it’s technically supposed to provide affordable healthcare to the people who need it most.
But its flagship hospital recently made headlines for being the least charitable non-profit hospital in the country.
In 1969, the tax code was modified so that a hospital didn't have to pay taxes as long as it was “promoting health.” Charity care" became optional.
So Vikas Saini and his colleagues at the Lown institute decided to take a closer look at just how far some non-profit hospitals have strayed from their original mandate of giving back. They looked at over 1,700 nonprofit hospitals nationwide and calculated what they call the “fair share” spending for each. If a hospital took more money in tax breaks than it gave back to the community, it had a fair share deficit.
Meanwhile, UPMC’s former CEO made $12.9 million in 2021. In total, top executives raked in $225 million — more than double what UPMC spent on charity care that year.
That’s enough money to keep hundreds of rural hospitals open, or to cancel the medical debt of hundreds of thousands of patients.
In just the last ten years, UPMC has grown from 12 hospitals to over 40.
Understaffing is pervasive at UPMC — and it’s only become worse as the hospital has gained more and more market power.
In May 2023, a coalition of unions filed an antitrust complaint with the Justice Department, accusing UPMC of using its market power to harm workers.
Three quarters of nonprofit hospitals are getting more in tax breaks than they’re spending on communities. That’s enough money to cancel the medical debt of 18 million Americans.”
Johns Hopkins Is Suing Low Income Patients | Campaigns | AFL-CIO Video
EXPOSED: For-Profit Health Care Crisis
"A North Carolina hospital owned by private equity giant Apollo is descending into extreme chaos. People are dying and ER doctors say it's the worst they've ever seen. We went inside with Moe Tkacik of American Economic Liberties Project to investigate the meltdown of for-profit health care in rural America."
Hospital Greed Is Destroying Our Nurses. Here’s Why. | NYT Opinion
America’s largest for-profit hospital system: HCA Healthcare.
How KFC’s War On Arby’s Ruined American Healthcare. No, Seriously.
Adam Ruins Everything - The Real Reason Hospitals Are So Expensive | truTV
Do no harm: Some hospitals let a preventable infection kill their patients
EMTALA violations are normal
“...there's a whole lot of hospitals that today are just violating EMTALA and throwing patients out the door letting them out on the street transferring them to other hospitals because they're not getting reimbursed adequately for even insurance coverage patients from any of the critical care items that they're coming in with so hospitals are starting to be very good at selecting the patient mix that's coming in the door and when they see a disease state that's not going to give them a good reimbursement some of the hospitals out there now are rejecting those patients one way or another
...it comes down to not only the reimbursement for the disease state, hospitals reserve beds for specific illnesses and issues that pay a very high rate, and if they have a bed set aside aside for something that's going to have a higher rate of reimbursement, and you come in with let's say pneumonia, you're not going to get that bed. I can give you a case, it happened in the Pacific Northwest, where a woman that was turned away she had pneumonia, she died two days later and that institution is paying dearly for that mistake. I'll give you another one where the same institution transferred a patient to the Harbor view who died on the way in the ambulance because they hadn't stabilized the individual nor screened them prior to sticking them in the ambulance to move them over to Harbor view. Harbor view is a trauma center in Seattle.
...some larger statistics 30% of Hospital of the United States a violated EMTALA”
S2E9 Healthcare is Hostile Part 2
between 2016 and 2018 and EMTALA violations were linked to at least 34 patient deaths
“... patient dumping, ... about hospitals now are turning patients away, or taking patients in doing an initial diagnosis and when they find that the thing that's wrong with the patient is really going to require a lot of procedures that they're not getting reimbursed well for, the patient is shoved out the door in one form or another... twelve different instances... the main point to this is in [these] cases these companies these hospitals were fined, but you know most of the fines aren't very big compared to what they would have lost if they had treated the patient in the first place because the complications with the patient were going to overwhelm their ability to get reimbursed...
...so it's patient dumping is a big problem... there's a couple [examples] that I think we want to take note of... Kaiser Bellflower a few years ago... in big trouble but they only paid a $250,000 fine they dumped a patient now on skid row, I think more than one I'm not exactly sure... and the other big one was Garden Regional Hospital... both in Los Angeles, they did the exact same thing, they paid a $450,000 fine. so you know $450,000 fine to a hospital that, that's peanuts in most cases when it comes to cash flow to be honest... about things that have been done to stop this behavior but unfortunately in some cases it still occurs...
...they look at the patient as soon as possible and if they they'll tell people in the in the ambulance not to come. ambulances call in and say they've got this thing coming in sometimes hospitals say we're full we can't take anybody else, even though they may not be full, but that kind of patient coming in the door is gonna cost them money.”
S2E8: Healthcare is Hostile part 1
HealthReform 2.0: Beyond the Partisan Divide
Hospitals Turn Away Patients for Inability to Pay
This is completely legal, unless the patient isn't stable. At this time, legally most hospitals have to stabilize patients. Then they can turn them away, or transfer them somewhere else. They do not have to provide any necessary further treatment or care. However, the law requiring hospitals to stabilize patients before turning them away is extremely po…
More than two-thirds of Congress cashed a pharma campaign check in 2020, new STAT analysis shows
https://www.statnews.com/feature/prescription-politics/federal-full-data-set/
Elizabeth Warren grilled RFK Jr on drug company money, but received over $5M from health industry
Sen. Tina Smith condemns drug companies but invests more than a quarter million in them
"In 2022 and 2023, pharmaceutical and healthcare companies paid the National Institutes of Health a sum of $710,381,160 in third party royalties."
https://www.openthebooks.com/assets/1/6/6.14_Statement_by_Adam_Andrzejewski.pdf
Kennedy noted that four of the leading developers of coronavirus vaccines, GlaxoSmithKline, Sanofi, Pfizer, Merck, are “convicted serial felon[s].”
“In the past 10 years, just in the last decade, those companies have paid 35 billion dollars in criminal penalties, damages, fines, for lying to doctors, for defrauding science, for falsifying science, for killing hundreds of thousands of Americans knowingly,” Kennedy said.
https://web.archive.org/web/20210414221722/
Big Pharma Companies Are Convicted Criminals: Check the Records
“We collected data on financial penalties for pharmaceutical firms listed on the Global 500 or Fortune 1000 lists using procedures similar to Almashat et al.1
FDA Scientist Says He Faces Retaliation
Dr. David J. Graham, the Food and Drug Administration scientist who publicly criticized the agency’s approach to drug safety during a Senate hearing last week, said Wednesday that he was facing pressure to transfer to a different job in the FDA -- a move he said was in retaliation for his remarks.”
https://www.latimes.com/archives/la-xpm-2004-nov-25-na-fda25-story.html
“The FDA is inherently biased in favor of the pharmaceutical industry. It views industry as it’s client, whose interests it must represent, It views it’s primary mission as approving as many drugs it can, regardless of whether the drugs are safe or needed.”
2005 by David Graham, then associate director of the FDA’s Office of Drug Safety. In an interview given to Fraud Magazine
"He is also speaking out in public against what he describes as a culture of fear within the FDA. "The FDA's suppression and intimidation of scientists is a threat to public health. Unless it changes, and scientists can speak without fear, they cannot defend the public," he said.
The matter is a pressing one because the US is the world's largest and most lucrative drugs market. Due to a campaign spearheaded in large part by Dr Graham, serious doubts are now being raised on Capitol Hill about whether the FDA as it is currently configured is fit to act as the watchdog of the pharmaceuticals industry.
According to Dr Graham and other critics, the agency is not up to the task because it is too close to the companies it is supposed to be policing. "The FDA has become an agent of industry. I have been to many, many internal meetings and, as soon as a company says it is not going to do something, the FDA backs down. The way it talks about industry is `our colleagues in industry'," he said.
That is not because FDA employees are "people with bad motivations", Dr Graham said. It is rather because the body is entirely geared towards concentrating on approving drugs, doing little once they are on the market.
"There has been a strong impetus in the FDA to say `yes'. Clinical trials are not designed to address safety and people who handle the approval of a drug also handle post-marketing. But they are not able to make decisions because they have been too closely involved with the approval", he said.
There is also a problem because, under the Prescription Drug User Fee Act in 1992, the drug industry funds the applications process, and as a consequence puts pressure on the regulator to speed up approvals.
"There is a sense that you get what you pay for. The industry is paying the piper and calling the tune," Dr Graham said."
Scientists Accuse FDA of Corruption
March 16, 2010, By Jane Mundy
"People everywhere are writing, blogging and tweeting about the corruption letter penned by the US Food and Drug Administration (FDA). The FDA has now "certified" this letter, which comes as good news to lawyers and plaintiffs. But inquiring minds want to know who penned the letter—a secret FDA whistleblower?
According to the Wall Street Journal, it's no secret. The Journal reported in January 2009 that nine FDA scientists sent a letter to John Podesta, the transition team head of then President-elect Barack Obama, pleading that the agency be restructured due to FDA managers who "ordered, intimidated and coerced scientists to manipulate data in violation of the law." The agency, they wrote, is "fundamentally broken."
https://www.lawyersandsettlements.com/legal-news/whistleblower/fda-corruption-letter-13788.html
FDA scientists allege mismanagement at agency
Fri January 9, 2009, CNN
"Nine scientists at the Food and Drug Administration have written a letter to President-elect Barack Obama and his transition team, alleging gross mismanagement at the agency that has "placed the American public at risk."
The agency is "fundamentally broken" and "failing to fulfill its mission," according to a copy of the six-page letter obtained by CNN.
The scientists work in the FDA's Center for Devices and Radiological Health, which regulates items ranging from rubber gloves and contact lenses to heart stents and mammogram machines.
The scientists claim that "the scientific review process for medical devices at FDA has been corrupted and distorted by current FDA managers, thereby placing the American people at risk."Video
"Currently, there is an atmosphere at FDA in which the honest employee fears the dishonest employee, and not the other way around," the letter said. "Disturbingly, the atmosphere does not yet exist at FDA where honest employees committed to integrity and the FDA mission can act without fear of reprisal."
Among the charges:
• Scientists and doctors have been threatened and told, on occasion, to ignore FDA regulations.
• Devices have not been properly labeled.
• Managers without appropriate experience have been given authority to make final decisions about device regulation and have done so while ignoring serious safety and effectiveness concerns.
• FDA experts have been excluded from product meetings because manufacturers felt that they were "biased."
• Manufacturers have been allowed to market their products without FDA approval.
An internal investigation of the charges, the scientists said, has resulted "in absolutely nothing: No one was held accountable, no appropriate or effective actions have been taken, and the same managers who engaged in the wrongdoing remain in place and have been rewarded and promoted."
https://www.cnn.com/2009/POLITICS/01/09/fda.scientists/index.html
U.S. Department of Health and Human Resources (HHS)
“1.9 trillion agency it's the biggest agency in the government
...there's no overall mission to that agency that everybody wakes up every day and says my job today is to improve the health of the American public”
"When it was announced that I was being put on a vaccine safety commission, there was panic throughout the industry and the public health regulatory agencies. Pfizer made a $1 million contribution to Trump and Trump then appointed two people who were hand-picked by Pfizer ― Alex Azar and Scott Gottlieb ― to run the public health agency and they killed the vaccine safety commission."
The Medical Elite, Scott Gottlieb, and the Censorship Regime in America, with Robert F. Kennedy, Jr.
Senator Warren Calls on Former FDA Commissioner Scott Gottlieb to Resign from Pharmaceutical Giant Pfizer's Board of Directors
“When former FDA commissioner Scott Gottlieb, M.D., resigned back in March, he said he wanted to spend more time with his family.
Since then, Gottlieb has nabbed a partnership at a VC firm and a think tank fellowship. And now, less than three months since his last day regulating pharma, Gottlieb has joined Pfizer, one of the biggest companies in the business.
Gottlieb snagged a spot on Pfizer's board of directors, the drug giant said Thursday. He'll also serve on the board's regulatory and compliance committee and its science and technology committee.
The announcement comes 85 days after Gottlieb left the FDA on April 5 to spend more time with his family. In his resignation letter to colleagues, Gottlieb wrote that “there’s nothing that could pull me away from this role other than the challenge of being apart from my family for these past two years and missing my wife and two young children."
RELATED: FDA chief Scott Gottlieb steps down, leaving pet projects behind
Since leaving the FDA, Gottlieb joined New Enterprise Associates as a special partner. He’s also a resident fellow at the American Enterprise Institute, according to Pfizer.
While the new roles surely aren't as demanding as FDA commissioner, Gottlieb’s quick jump back to industry is sure to raise eyebrows. He was arguably among the most popular Trump appointments as agency chief, but his quick leap back to industry conflicts with President Donald Trump’s campaign pledge to “drain the swamp” and fight corporate influence in Washington.
Pfizer Executive Chairman Ian Read said Gottlieb’s “expertise in health care, public policy and the industry will be an asset to our company and enable our shareholders to continue to benefit from a board representing a balance of experience, competencies and perspectives.”
“Alex Michael Azar II, served as the 24th Secretary of the U.S. Department of Health and Human Services (HHS) 2018-2021. He oversaw the historic transformation of the healthcare system in the United States and HHS’s response to the unprecedented COVID-19 pandemic. Azar served as president of Lilly USA, LLC, from 2012-2017, the largest affiliate of global biopharmaceutical leader Eli Lilly and Company, producing over $10 billion in revenue. Azar previously was vice president of Lilly’s U.S. Managed Healthcare Services and Puerto Rico from 2009-2011.
Before his tenure at Lilly, Azar was the Deputy Secretary of the U.S. Department of Health and Human Services (2005-2007), where he was the number two official and chief operating officer. From 2001-2005, he served HHS as General Counsel.
Azar received a bachelor’s degree summa cum laude in government and economics from Dartmouth College in 1988, and a J.D. degree from Yale Law School in 1991. After law school, he clerked for Associate Justice Antonin Scalia on the Supreme Court of the United States.
Azar is an American attorney, businessman, lobbyist, and former pharmaceutical executive. He was also chairman of the White House Coronavirus Task Force from its inception in January 2020 to February 2020, when he was replaced by Vice President Mike Pence.
In 2021, he was appointed a senior executive in residence at the Miami Herbert Business School at the University of Miami.
On August 3, 2001, Azar was confirmed as general counsel of the United States Department of Health and Human Services. George W. Bush's first HHS secretary, Tommy Thompson, said Azar played an important role in responding to the 2001 anthrax attacks, ensuring there was a vaccine ready for smallpox, and dealing with outbreaks of SARS and influenza. On July 22, 2005, Azar was confirmed as the deputy secretary of Health and Human Services. He was twice confirmed unanimously by the United States Senate.
Working under Secretary Mike Leavitt, Deputy Azar supervised the operation of HHS, which would grow to an annual budget of over $1 trillion by 2017 when he was appointed secretary. Azar led the development and approval of HHS regulations, led U.S. government efforts to encourage worldwide pharmaceutical and medical device innovation, and was in charge of the HHS response to an initiative implemented by President George W. Bush to improve government performance. Azar resigned in January 2007.
In June 2007, Azar was hired by Eli Lilly and Company chief executive officer Sidney Taurel to be the company's top lobbyist and spokesman as its senior vice president of corporate affairs and communications....
Effective January 1, 2012, Azar became president of Lilly USA, LLC, the largest division of Eli Lilly and Company, and was responsible for the company's entire operations in the United States. Prices for drugs rose substantially under Azar's leadership, including the tripling of the cost of the company's top-selling insulin drug. Also under Azar's watch, Eli Lilly was one of three companies accused in a class-action lawsuit of exploiting the drug pricing system to increase profits for insulin. Eli Lilly was also fined in Mexico for colluding on the price of insulin.
In connection with the position, Azar served on the board of directors of the Biotechnology Innovation Organization, a pharmaceutical lobby.
In January 2017, Azar resigned from Eli Lilly "to pursue other career opportunities" as a result of a company reorganization. He also resigned from the board of directors of the Biotechnology Innovation Organization. In his last year at the corporation he earned $2 million.
In November, 2017, President Trump announced that he would nominate Azar to be the next secretary of health and human services.
...Speaking in favor of his nomination were two former U.S. Senate majority leaders, Democrat Tom Daschle and Republican Bill Frist. Both those endorsers were affiliated with the Bipartisan Policy Center, a Washington, D.C., think-tank which receives support from Eli Lilly.
Senator Bernie Sanders said in a press release, "The nomination of Alex Azar, the former head of Eli Lilly's U.S. operations, shows that Trump was never serious about his promise to stop the pharmaceutical industry from 'getting away with murder'." "The last thing we need is to put a pharmaceutical executive in charge of the Department of Health and Human Services."
Azar had additionally consulted with numerous other biopharmaceutical and health insurance corporations regarding government policy, product access, sales and marketing, pricing, reimbursement, and distribution. He was confirmed by the Senate January, 2018, and sworn in by Vice President Pence.
In 2022, Azar was co-defendant in a civil rights suit in the Ninth Circuit Court seeking to compel the CDC to publish mortality statistics in which COVID-19 was unequivocally the primary cause of death.
Azar served for two years on the board of HMS Holdings.
Azar is a Republican and has contributed to the campaigns of Mike Pence, Mitch McConnell, Orrin Hatch, Lamar Alexander, Jeb Bush, and Donald Trump, according to OpenSecrets.”
https://ysph.yale.edu/event/leaders-in-public-health-the-honorable-alex-m-azar-ii/
https://en.wikipedia.org/wiki/Alex_Azar
“Newly disclosed financial records show that President Trump’s nominee to become Health and Human Services secretary reaped big earnings during his tenure as a top pharmaceutical executive.
As a top drug industry veteran from 2007 to 2017, former Eli Lilly and Co. executive Alex Azar built a substantial financial portfolio now worth $9.5 million to $20.6 million, and he was paid nearly $2 million in his final year at the company.”
https://www.statnews.com/2017/11/20/alex-azar-hhs-drug-industry/
“Alex Azar has extensive healthcare experience in the senior-most levels of the U.S. government and the private sector that gives him a unique perspective and background...
Azar served as the 24th Secretary of the U.S. Department of Health and Human Services (2018-2021), leading over 85,000 employees with a budget of over $1.4 trillion, the largest budget of any cabinet department on Earth. He was the architect of Operation Warp Speed, delivering COVID-19 vaccines and therapeutics in record time. He led the historic transformation of the healthcare system in the United States and HHS’s response to the unprecedented COVID-19 pandemic. He drove U.S. Government efforts to tackle the opioid crisis, increase private insurance options, bring transparency of price and quality information to healthcare, expand telehealth, give patients ownership of their health records and make those records interoperable and transportable, enable healthcare provider collaborative care models, remove regulatory barriers to low-cost, high-quality care... Azar also led key public health initiatives such as banning flavored e-cigarettes... creating and implementing the program to end the HIV epidemic in America in 10 years, preparing for and responding to public health threats, crafting the first rural health initiative to improve access and quality of care, and launching a program to reduce dramatically maternal mortality. Azar has played significant roles on the global health stage, leading many of the U.S.’s global health security efforts, representing the U.S. in the World Health Assembly, working with the WHO to end Ebola outbreaks in the Democratic Republic of the Congo, chairing the most active G7 health ministerial in history in 2020, and convening and leading western hemisphere coordinated efforts to assist with the Venezuelan refugee crisis.
...Secretary Azar is currently an advisor to Foresite Capital, sits on several corporate boards and advisory boards, is a part-time Adjunct Professor of Business and Senior Executive-in-Residence at the University of Miami Herbert Business School, is represented by the Washington Speakers Bureau, and is a member of the Board of Trustees of the Aspen Institute, the Aspen Institute’s Health Strategy Group, the Stanford University School of Medicine Department of Health Policy Advisory Board, the American Task Force On Lebanon’s Policy Advisory Board, the Bipartisan Policy Center’s Future of Health Care Advisory Group, the advisory board of the National Institute for Healthcare Management Foundation, and the Healthcare Leadership Council. Azar previously served on the boards of HMS Holdings Corporation (NASDAQ: HMSY), the Biotechnology Innovation Organization (BIO), the Healthcare Leadership Council, the National Association of Manufacturers, the Indianapolis Airport Authority, the American Council on Germany, and the Indianapolis Symphony Orchestra.”
https://www.aspeninstitute.org/people/alex-m-azar-ii/
'Health' insurance
"I Was a Health Insurance Executive. What I Saw Made Me Quit.", Wendell Potter
https://pnhp.org/news/i-was-a-health-insurance-executive-what-i-saw-made-me-quit/
Wendell Potter, former Cigna Insurance executive tells all at Fighting Bob Fest 2009
"...folks I would like to apologize really, to all of you for the role that I played 15 years ago and cheating you out of a reformed Health Care System. had it not been for greed insurance companies other special interest, and their army of lobbyist and Spin Doctors like I used to be, we wouldn't be here today, or we wouldn't be talking about this today, and people would not need to be lining up for hours in the rain to get medical care in animal stalls in this country. As a former journalist, I'm also ashamed that I let myself get caught up in deceitful and dishonest PR campaigns, that work so well that hundreds of thousands of our citizens have died, and millions of others have lost their homes and been forced into bankruptcy, so that a very few corporate Executives and their Wall Street masters could become exceedingly rich. but it was only during the last few years of my career that I came to realize the full scope of the harm that my colleagues and I had caused, and the lengths that insurance companies will go to increase their profits at the expense of working families. as I told the Senate Commerce Committee earlier this summer, the higher up the corporate ladder I climbed the more I could see how insurance companies confuse their customers and dump the sick, all so they can satisfy those Wall Street investors, their masters. I describe for the Senators how insurance companies make promises they have no intention of keeping, how they flout regulations designed to protect consumers and how they make it nearly impossible to understand, or even to obtain the information that that we all need. I also told the Senators how the industry has conducted duplicitous and well financed PR and lobbying campaigns every time Congress has tried to reform our Health Care system, and how its current behind the scenes efforts may well shape or form in a way that benefits them and Wall Street far more than average Americans. in fact, I've watched the stock price of the the for-profit health insurance companies that I used to work for and their competitors over the last 3 months, the last company I worked for Signa, the stock price has increased 50% because the investors on Wall Street don't think that Congress is going to pass any legislation that's going to hurt them.”
prior authorization
Whistleblower Exposes Health Insurers' Most Evil Scheme
“...found an older newspaper article where a real person's job title was simply denial nurse”
What United Healthcare Doesn’t Want You To Know
...a giant monopoly that's been slowly plundering every part of our health care system
bulk claim denials
denials of claims
ACA insurers deny 20% of claims - Jan 30, 2025
https://www.axios.com/2025/01/30/aca-insurers-deny-claims-rate
Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans, by Wendell Potter, John D. Rockefeller IV (Foreword)
ISBN-13: 9781608194049 | ISBN-10: 1608194043
Nation on the Take: How Big Money Corrupts Our Democracy and What We Can Do About It, by Wendell Potter, Nick Penniman
ISBN-13: 9781632861092 | ISBN-10: 1632861097
Healthcare is Getting EVEN WORSE
Patient Harm: When An Attorney Won’t Take Your Case
"Studies show that nine of 10 patients seeking a medical malpractice attorney won’t find one — women, children and the elderly in particular.
...a problem faced by many who are harmed in a medical setting: Attorneys refuse their cases, not because the harm didn’t happen but because the potential economic damages are too low.
It’s estimated that hundreds of thousands of patients a year suffer some type of preventable injury or die while undergoing medical care. For many of these patients or surviving family, a lawsuit is the only hope to recover losses, learn the truth about what happened and ensure the problem is corrected.
But lawyers may have to invest $50,000 or more to pursue a case, and they usually only get paid if they win or settle. The payout is determined largely by economic damages – lost earnings, medical bills and future costs caused by the injury. Those who don’t earn big paychecks – including children, the elderly and stay-at-home-moms – are the least likely to find an attorney, studies show.
A 2013 Emory University School of Law study found that 95 percent of patients who seek an attorney for harm suffered during medical treatment will be shut out of the legal system, primarily for economic reasons. Most attorneys would not accept a case – even one they might win – if the damages likely were less than $250,000.
“You’re basically saying for someone who doesn’t earn a lot of money, ‘It’s OK for a hospital to harm them,’” Ciccotelli said.
https://www.propublica.org/article/patient-harm-when-an-attorney-wont-take-your-case
“If you browse website for the Centers for Disease Control and Prevention (CDC), you will soon find the CDC “disclosure” statement:
“CDC, our planners, content experts, and their spouses/partners wish to disclose they have no financial interests or other relationships with the manufacturers of commercial products, suppliers of commercial services, or commercial supporters. Planners have reviewed content to ensure there is no bias. CDC does not accept commercial support.”
Despite the claim that “CDC does not accept commercial support,” this agency does indeed have financial ties to industry organizations, through their government-charted foundation. Congress has created foundations for many government organizations, including the Food and Drug Administration (FDA), National Institutes of Health (NIH), and Centers for Disease Control and Prevention (CDC), to supplement the agencies’ funding for specific projects and encourage more public-private partnerships.
In a recently-released petition to the CDC, several watchdog groups including Public Citizen, the Project on Government Oversight, and U.S. Right to Know, are demanding that the CDC be transparent about the industry funding they receive through their foundation.
Since the CDC Foundation was created in 1995, hundreds of corporations have contributed to public health programs, for a total of $161 million in donations. Many of these contributions could be seen as conflicts of interest–for example, a $193,000 donation from Roche, the maker of antiviral drug Tamiflu, to fund a CDC flu prevention campaign. Despite the significant funding the CDC receives from industry via its foundation, few were aware of these conflicts until Jeanne Lenzer called attention to the foundation in The BMJ a few years ago.
Recently, the CDC accepted $3.4 million from Pfizer for the prevention of Cryptococcal disease, $1 million from Merck & Co. pharmaceutical company for a program on preventing maternal mortality, and $750,000 from Biogen for a program on screening newborns for spinal muscular atrophy, the petition states.
The petitioners ask that CDC should stop publishing the false disclaimers, remove the disclaimers from their website and resources, and issue corrections to retroactively disclose financial relationships with industry.
“It’s time for the CDC to be truthful with health professionals and all Americans, and to stop denying that it takes corporate money,” said Gary Ruskin, co-director of U.S. Right to Know, in STAT. “The CDC is violating the public trust by misleading us in this way.”
Disclosing these conflicts is the first step toward a clearer separation between government agencies meant to serve the public interest and industry companies. The next should be demanding that public agencies not accept any industry funding through their foundations. “The foundations exist at least in part because they allow industries to directly fund and thus control the work of agencies that are either supposed to regulate them, or conduct research that can help or hurt their business,” said Lown Institute Senior Vice President Shannon Brownlee.
We need to question why these foundations exist and push for more public funding of these agencies, rather than force public health agencies to rely on industry funding for their programs and compromise their independence.
Judith Garber is a Senior Policy Analyst at the Lown Institute. She holds a masters degree in public policy from the Heller School of Social Policy and Management.”
https://lowninstitute.org/cdc-disclaimers-hide-financial-conflicts-of-interest/
How Big Pharma Bought The Federal Government
“..Within the federal government, this impoverishment comes through budgets being slashed and agencies inevitably looking to the private sector for funding. In turn, something similar to what is observed in the educational sector happens, although the scale of it is often far worse.
For example, in 1983, Congress authorized the CDC to accept gifts “made unconditionally…for the benefit of the [Public Health] Service or for the carrying out of any of its functions.” Then in 1992, Congress established The National Foundation for the Centers for Disease Control & Prevention so that CDC could obtain additional funding for its work, or put differently, created a third party for passing tainted money to the CDC.
The CDC Foundation has been accused of egregious conduct since its inception and has received nearly 1 billion dollars from corporate “donors.” The potential for the foundation enabling corruption in turn has been criticized by many, including by a scathing editorial in one of the world’s top medical journals. Many examples of its corruption are documented within this 2019 letter to the CDC. They include:
Being paid by a pesticide industry firm to conduct a study to prove the safety of two pesticides.
During the years 2010-15, Coca-Cola contributed more than 1 million dollars to the CDC Foundation. In return, the CDC offered numerous services including collaborative meetings and advice from a top CDC staffer on how to lobby the World Health Organization to curtail the WHO’s initiative to reduce global consumption of added sugars — which is really something given that the CDC has been tasked with fighting obesity.
Taking money from Roche to push Tamiflu (which the CDC continues to do to this day), an ineffective and harmful flu treatment which was approved off of data that was kept secret from the public.
Note: As of 2019, the CDC also owned 57 vaccine patents and recently spent $4.9 of its $12.0 billion-dollar annual budget buying and distributing vaccines. This may help to explain why the CDC always recommends every vaccine regardless of the evidence arguing against of doing so or how much opposition they receive from the public (and sometimes even their advisors).
Members of Congress have even formally complained about the payments to the CDC foundation (as have anonymous whistleblowers within the CDC). In short, the conflicts of interest with the CDC foundation are immense and help to explain why the CDC always pushes corrupt and harmful policies (e.g., many of the profiteers who benefitted immensely from the COVID-19 vaccination campaign had previously given the CDC millions).
Note: Many other agencies within the federal government, including the CIA and the NIH, have their own foundations that were also created by Congress to allow them to access corporate bribes donations that are not subject to legal oversight such as freedom of information act requests).
Not surprisingly, many of the directors of these foundations, like their peers in government, often follow the revolving door and end up in high-paying executive roles at major pharmaceutical companies after leaving the foundations.
The pernicious influence of industry cash can also be seen at the FDA. On October 29, 1992, in response to public concerns that no AIDS treatments were getting to market (which was a result of Fauci deliberately blocking all of them to clear the way for the deadly and ineffective AZT), Congress and then George Bush Sr. signed into law the Prescription Drug User Fee Act, which authorized the FDA to take money from the drug makers it approved drugs for.
As a result of this act, drug approval times were shortened (going from 29 months in 1987 to 10 months in 2018), and the percentage of drugs that were approved the first time an approval was requested dramatically increased. Conversely, prior to the act, 21% of medications were removed from the market or had new black box warnings added to them.
After the act, this figure increased to 27% as a result of factors such as senior FDA officials overturning its scientists’ recommendations, and the evidence required for a medication approval being lowered.
As a result of these changes, user fees now comprise a significant portion of the FDA’s budget (e.g., 46% in 2022, and approximately of the 65% of that allotted for regulating drugs used in humans) — which not surprisingly has had an increasingly corrupting influence on the FDA’s drug approval process.
One of the best illustrations of this can be seen with the current FDA commissioner Robert Califf, who in 2009, was considered to be too close to the industry to nominate to the position, yet in 2021 was appointed to it, and ever since gaining control of the FDA has advanced the interests of his industry.
For example shortly after the backdoor approval of a controversial Alzheimer’s drug, Califf was a keynote speaker at the annual pharmaceutical industry conference which emphasized the incredible investment opportunities offered by the new Alzheimer’s and obesity drugs (which the agency was also pushing through).
Furthermore in addition to being overtly compensated by the industry for supporting its interests (e.g., Califf had taken a lot of money from Big Pharma), a revolving door also exists to pay them off after the fact. Consider for instance that the second official appointed by Trump to head the FDA, Scott Gottleib is now on Pfizer’s board.
Likewise, Stephan Hahn the commissioner who was in charge of the FDA for the entirety of Operation Warp Speed (and as Peter Navarro showed, against the president’s orders, actively sabotaged affordable and effective treatments for COVID-19) Hahn is now an executive for the venture capital firm that launched Moderna (and thus owns a significant portion of it).
Note: This issue exists beyond the healthcare sector — for instance Lloyd Austin was first a four-star general under Obama, then left to become a board member for Raytheon, and then left that position to become Biden’s Secretary of Defense. Since becoming in charge of our military, one of the worst wars in modern history has broken out, which coincidently required a massive amount of weaponry to be purchased from defense contractors like Raytheon.
All of this has effectively created a “pay-to-play” situation, where it’s almost impossible to get a drug approved unless you have a lot of money and as a result, therapies that put people before profits have a very difficult time getting through.”
https://www.cdcfoundation.org/FY2021/donors?group=corp
How Both The FDA And The European Medicine Agency Are Controlled By Pharmaceutical Companies - Brightwork Research & Analysis
FDA industry user fees
“The Prescription Drug User Fee Act (PDUFA) was created by Congress in 1992 and authorizes FDA to collect user fees from persons that submit certain human drug applications for review or that are named in approved applications as the sponsor of certain prescription drug products.”
https://www.fda.gov/industry/fda-user-fee-programs/prescription-drug-user-fee-amendments
“FDA collects user fees from the regulated industry; for medical products, this includes biopharmaceutical and medical device companies
User fees vary substantially across FDA programs. In FY2022, across FDA’s medical product centers, user fees accounted for $1.4 billion (66%) of the human drugs program budget, $197 million (43%) of the biologics program budget, and $228 million (35%) of the medical device program budget”
user fees accounted for $3.3 billion of the FDA’s $6.9 billion 2025 budget
https://www.biospace.com/fda/threat-to-fda-user-fees-program-could-set-us-back-35-years
https://www.fda.gov/media/166050/download
“The FDA collects fees from companies that produce certain products, such as drugs and medical devices, and from some other entities, such as certain accreditation and certification bodies. These fees are called “user fees.” Federal law authorizes the FDA to collect user fees to supplement the annual funding that Congress provides for the agency.”
https://www.fda.gov/industry/fda-user-fee-programs/fda-user-fees-explained
“FDA’s budget for Fiscal Year 2024 is:
■ approximately $6.9 billion.
■ provided by federal budget authorization (52% or $3.6 billion) and industry user fees (48% or $3.3 billion).”
https://www.fda.gov/media/182749/download
FDA is largely funded by the drug industry direct cash payment
“...so this is the current fiscal 2017 which began October 1st budget the total FDA budget for drugs is $1.41 billion 66% or 917 million come in direct cash from the drug industry whenever they apply for a drug they have to pay they have to pay whether it gets approved or not this has had a earth shattering or life shattering effect on the relationship between the FDA and the industry.”
FDA and Drug Industry: Too Close for Comfort by Sidney Wolfe, MD
Table 15—Fee Schedule for FY 2024
Fee category
Fee rates for FY 2024
Application:
Requiring clinical data $4,048,695
Not requiring clinical data 2,024,348
administrator of the Centers for Medicare & Medicaid Services
Dr. Mehmet Oz
“Oz has a long history with the program he is now in charge of overseeing. I would be signing up. So why are not more folks signed up? Oz used to hawk Medicare Advantage on his show. Medicare beneficiaries have another option. And was even a licensed insurance broker in more than 20 states. His ethics disclosure forms show a number of investments in for-profit health companies, including up to $600,000 in stock in UnitedHealth Group, the leading Medicare Advantage plan provider in the country.
...His 2022 Senate campaign was marked by an insistence on moving more public dollars to private insurers.
“Medicare Advantage for all, not Medicare... We should do this now.”
“When he is somebody who's getting paid by these companies, it makes perfect sense to me that he would recommend it.”
But the push for privatization is not just coming from Oz... In his first term, Trump signed an executive order bolstering Medicare Advantage, and the Department of Health and Human Services actively promoted the plans in direct email campaigns. Then there's Project 2025, which has designs on making Medicare Advantage “the default enrollment option,” which would push even more of the public's Medicare trust fund money into the pockets of private insurers.
And then there's the lobbying from insurers themselves and from what's called the Better Medicare Alliance. The group, whose backers and funders include the largest private insurers in America, have been lobbying big time. They’re an organization trying to make more of our Medicare dollars be spent on shareholder dividends, on CEO salaries, on something other than actual health care.
...A former lobbyist for the Better Medicare Alliance, Don Dempsey, was tapped by Trump to serve as the top health official at the U.S. Office of Management and Budget, giving him—and the insurance industry he has benefited from—power over budget decisions regarding Medicare and Medicare Advantage. Between 2020 and 2024, the largest Medicare Advantage providers spent a combined $332 million lobbying on the program.
...In his ethics agreement, Dr. Oz pledged to divest from some of his conflicts of interest, including his investment in the number one Medicare Advantage plan provider in the nation. [Dr. Diljeet Singh] But morally, it tells us that he has a bias and that he has the potential to have a relationship that enriches him after these four years.”
We Found The Real Government Waste & Fraud. Trump Endorses It.
Private Equity
Who owns the world’s largest pharmaceutical companies?
Faceless private equities and hedge funds control the firms essential to our health and survival.
“How often do you hear about Dodge & Cox, SSgA Funds Management, BlackRock, Mawer Investment or The Vanguard Group? Well, if you recently popped a Tylenol for a headache, took a Lantus insulin shot or got your kid a flu shot at the local clinic - then you’ve probably come across these investment funds as they own the pharmaceutical firms that made those drugs.
In the last two decades, private equities and investment management companies — known as institutional investors — have mopped up the majority shareholding in the world’s largest medicine-makers.
Many of these investors simultaneously hold stakes in more than one large pharmaceutical company and their generic counterparts, something known as “common ownership”. This has raised concern that it undermines competition and as a result consumers end up paying more.
A recent paper co-authored by researchers Albert Banal-Estanol, Melissa Newham and Jo Seldeslachts for DIW Berlin found that large pharmaceutical companies have become connected to each other through their shareholders.
“Public companies are increasingly owned by a handful of large institutional investors so we expected to see many ownership links between companies — what was more surprising was the magnitude of common ownership,” the authors told TRT World in an emailed response.
“We frequently find that more than 50 percent of a company is owned by ‘common’ shareholders who also own stakes in rival pharma companies.”
For instance in 2014, the same investors collectively owned half the shares of Switzerland-based Novartis and Germany’s Bayer, the maker of Aspirin.
The three largest shareholders of Pfizer, J&J and Merck are Vanguard, SSGA and BlackRock, the multi-trillion dollar funds which make investments on behalf of their clients and keep a cut for their service.
What institutional investors do is perfectly legal. They are not even reviewed by competition authorities as long as an investor such as BlackRock keeps its shareholding at less than 10 percent in a pharma firm. They are classified as passive investors.
“The concern is how passive are they?” the DIW Berlin report authors said.
Institutional investors may not directly interfere in a pharma company’s day-to-day business. But knowing who the shareholders are and their stake in rival companies, the pharma executives can end up working in the interest of common institutional investors, they said.
“The increase in connectivity between brand firms (such as Pfizer and AstraZeneca) may also affect drug prices. This is because economic theory clearly indicates that intense price competition between firms that share the same owner, ultimately reduces the profits of the common owner.”
Institutional investors having a stake in multiple Big Pharma firms at the same time may hamper efforts to find new medicines for diseases. “This is potentially to the detriment of consumers if it means that fewer drug variants are available,” the authors said.
Pharmaceutical companies spend considerable sums of money on bringing new drugs to the market. They prefer monopolies and resist the entry of generic makers.
To counter such competition, large industry players such as J&J, Pfizer, Novartis and Merck have bought stakes in generic drug companies like Perrigo.
Where the Big Pharma faces difficulty in acquiring generic makers such as those in India, it refuses to share patents and knowhow even during a health emergency like was seen recently in the run-up to make Covid-19 vaccines.
The involvement of institutional investors might also be having an impact on how pharma companies reward their shareholders.
The moneymakers
Pharma companies have become money-making machines and this is evident from the massive increase in returns they have given to their shareholders in the past two decades.
“Payouts to shareholders have increased by almost 400 per cent — from $30 billion in 2000 to $146 billion in 2018,” the Amsterdam-based Centre for Research on Multinational Corporations said in a report last year.
Put another way, the return to shareholders went up from 88 percent of investment in R&D to 123 percent in the same period.
The authors of this report looked at the financial statements of 27 largest pharma companies and found that shareholders netted a total of $1.54 trillion in profits over the 18 year period. That’s more than $1.4 trillion the companies poured into R&D for new medicines.
The pharma industry has become hostage to what’s known as financialisation — a practice in which a company uses its resources to reward the shareholders instead of investing it in plants, machinery and labs.
For instance, companies use the strength of their balance sheets to borrow money from banks and then use the cash to buy their own shares from the stock market. Such share buybacks inflate the value of the remaining stock, consequently increasing the net worth of the largest shareholders.
“When you look at the financial statements of pharma companies and see Blackrock and other funds as shareholders it tells you something immediately,” said Gerlad Posner, the author of Pharma, a book on history of the industry.
“These are groups with big profit margins and they don't invest in industries which are not giving a return on the bottom line.”
https://www.trtworld.com/magazine/who-owns-the-world-s-largest-pharmaceutical-companies-42983
Private Equity's Latest Target: Your Emergency Room
Private equity ‘gobbling’ up care facilities for people with disabilities
Rising PE ownership of care facilities has led to abuse, neglect and even deaths, new report finds
“...residents of nursing homes, for example, owned by private equity firms, experience 10% more deaths because of staffing shortages and reduced compliance with standards of care. Private equity owns hospitals and has created a health crisis. Nursing shortages have contributed to one of every four unexpected hospital deaths or injuries caused by errors. The private equityfirms do not serve patients but profits. They have closed hospitals, especially in rural America, and they cut back on stockpiles of vital medical devices including ventilators and personal protective equipment. In 1975, the US had about 1.5 million hospital beds and a population of about 216 million people. Now, with a population of over 330 million people, we have around 925,000 beds. 56% of Americans have medical debt, even though many have insurance, and 23% owe $10,000 or more. Emergency room visits and emergency rooms, often run by private equity firms, contributed to medical debt for 44% of Americans.”
How private equity conquered America | The Chris Hedges Report
"The Flexner Report "
Medical Education in the United States and Canada,
A Report to the Carnegie Foundation for the Advancement of Teaching, 1910
by Abraham Flexner
ISBN-13: 9781014590268 | ISBN-10: 1014590264
ISBN-13: 9781646796175 | ISBN-10: 1646796179
https://archive.org/details/carnegieflexnerreport
https://ia803109.us.archive.org/32/items/carnegieflexnerreport/Carnegie_Flexner_Report.pdf
Medical education or marketing?
“Although billed as a medical education plan, the document is clearly part of the Lotronex marketing strategy. One clause explicitly stipulates that all publications and manuscripts must be approved by the drug company's marketing, medical, and legal departments. The document also makes clear the media's role in changing public perceptions about irritable bowel syndrome, stating that “PR [public relations] and media activities are crucial to a well-rounded campaign—particularly in the area of consumer awareness.”
Whatever the integrity or competence of the professionals or consumer advocates involved, and without seeking to minimise the importance of the disorder for some individuals, this plan shows that staff and organisations sponsored by a drug company are helping to shape medical and public opinion about the condition that company is targeting with its new product. Although GlaxoSmithKline has argued that its sponsorship of education can improve doctors' prescribing habits (personal communication, 7 March 2002), the conflict of interest is obvious and potentially dangerous. Self evidently, the drug company's primary interest will be shaping opinion about irritable bowel syndrome in a way that will maximise sales of its medication.”
https://pmc.ncbi.nlm.nih.gov/articles/PMC1122833/
“The US government is filing a law suit against the drug company, Novartis, for giving $65 million kickbacks to physicians and pharmacists to prescribe Lotrel, Valturna, Starlix, and Myfortis over the past decade. These kickbacks were in the form of dinners at high end restaurants, cash, rebates, and discounts.
One extreme example is from a six person oncology group that received $2.9 million in kickbacks in just one year! It is a huge conflict of interest that is common practice for many oncologists to make in excess of a hundred thousand dollars a year in drug company rebates for using their drugs. Many of these profits involve Medicare, Medicaid, and the VA hospital system. For more information please visit www.doctorsaputo.com”
Drug Company Kickbacks to Doctors and Pharmacists
Drug Companies Hire Troubled Doctors As Experts
“Drug companies say they hire the most-respected doctors in their fields for the critical task of teaching about the benefits and risks of the companies' drugs.
But an investigation by ProPublica has uncovered hundreds of doctors receiving company payments who had been accused of professional misconduct, were disciplined by state boards or lacked credentials as researchers or specialists.
Compiled from disclosures by seven companies, the database covers $257.8 million in payouts... for speaking, consulting and other duties. The companies include Lilly, Cephalon, AstraZeneca, GlaxoSmithKline, Johnson & Johnson, Merck and Pfizer.”
https://www.npr.org/2010/10/19/130644774/drug-companies-hire-troubled-doctors-as-experts
“Hundreds of doctors paid by pharmaceutical companies to promote their drugs have been accused of professional misconduct, were disciplined by state boards or lacked credentials as researchers or specialists, ProPublica has found. We compiled data from seven companies, covering $257.8 million in payouts since 2009 for speaking, consulting and other duties
The Physician Payments Sunshine Act (PPSA) requires reporting of financial payments by pharmaceutical and medical device companies to teaching hospitals and individual physicians in the US. Industry payments made to psychiatrists were quantified.
Methods:
Using the 2016–2017 Sunshine Act Open Payments database, general payments made to psychiatrists were descriptively analyzed. The number of psychiatrists who received payments, and median number, value (in US dollar), and nature of payments to psychiatrists were quantified. Top 10 manufacturers who paid the most to psychiatrists were also reported.
Results:
Over half of active psychiatrists (55.7%) received some form of payments from pharmaceutical manufacturers. Of these, top 2.8% of psychiatrists received 82.6% of the payments. Pharmaceutical manufacturers provided 812,877 payments worth $110,512,607.18 to 26,422 psychiatrists in the US. Compensation for services (e.g., speaker’s bureaus) and consulting fees altogether constituted 71.4% of the total payment, with a median value of $1,725.00 and $700, respectively. Among all psychiatrists who received payments, manufacturers that paid the most included Otsuka Pharmaceuticals, Alkermes, and Sunovion Pharmaceuticals.”
https://pmc.ncbi.nlm.nih.gov/articles/PMC7260092/
American Psychiatric Association (APA)
Undisclosed financial conflicts of interest in DSM-5-TR: cross sectional analysis
BMJ 2024; 384 doi: https://doi.org/10.1136/bmj-2023-076902 (Published 10 January 2024) Cite this as: BMJ 2024;384:e076902
Contributors to psychiatry’s bible, the DSM-5, got $14 million from industry
“In March 2009, the American Psychiatric Association announced that it would phase out pharmaceutical funding of continuing medical education seminars and meals at its conventions. However, the decision came only after years of controversial exposure of its conflict of interest with the pharmaceutical industry and the U.S. Senate Finance Committee requesting in July 2008 that the APA provide accounts for all of its pharmaceutical funding. Despite its announcement, within two months, the APA accepted more than $1.7 million in pharmaceutical company funds for its annual conference, held in San Francisco.”
https://www.cchrint.org/issues/the-corrupt-alliance-of-the-psychiatric-pharmaceutical-industry/
“Pharmaceutical companies gave at least $116 million to patient advocacy groups in a single year, reveals a new database logging 12,000 donations from large publicly traded drugmakers to such organizations.
Even as these patient groups grow in number and political influence, their funding and their relationships to drugmakers are little understood. Unlike payments to doctors and lobbying expenses, companies do not have to report payments to the groups.
The database, called “Pre$cription for Power,” shows that donations to patient advocacy groups tallied for 2015 — the most recent full year in which documents required by the Internal Revenue Service were available”
https://kffhealthnews.org/patient-advocacy/#
astroturfing
“Medical debt is the leading cause of bankruptcy in the United States and affects almost a third of working Americans.”
Health and Wealth: Why Americans are drowning in medical debt
“Back in 1912, when hardly anyone smoked cigarettes, lung cancer was like a museum curiosity: extremely rare. In the next few decades, however, it rose dramatically around the world, roughly fifteen-fold. But researchers had already nailed it way back then. By mid-century, the evidence linking lung cancer and tobacco was considered overwhelming. Says who? Says the tobacco industry’s own research scientists in an internal memo. We now know that “senior scientists and executives within the cigarette industry knew about the cancer risks of smoking at least as early as the 1940s.”
Publically, though, they said things like, “Sure there are statistics associating lung cancer and cigarettes. There are statistics associating lung cancer with divorce, and even with lack of sleep. But no scientist has produced clinical or biological proof that cigarettes cause the diseases they are accused of causing.”
...No problem—your doctor can write you a prescription for cigarettes, according to an ad from the Journal of the American Medical Association.
The tobacco industry gave medical journals big bucks to run ads...
...What did the AMA have to say for itself? Like most other medical journals, they accepted tobacco ads but asserted that “[p]ostmortem examinations do not reveal lesions in any number of cases that could be definitely traced to the smoking of cigarettes.” So, as far as the AMA was concerned, case closed.
In fact, even after the Surgeon General’s Report on Smoking and Health came out, the American Medical Association, American Cancer Society, and Congress continued to drag their feet. The government was still subsidizing tobacco, just as our tax dollars subsidize the sugar and meat industries today. The AMA actually went on record refusing to endorse the Surgeon General’s report. Could that have been because they had just been handed ten million dollars from the tobacco industry?”
The Disconnect Between Science and Policy
Written By Michael Greger M.D. FACLM • April 4, 2019
https://nutritionfacts.org/blog/the-disconnect-between-science-and-policy/
Wilk v. American Medical Association, 719 F.2d 207
"conspiracy " to stop competition AMA vs chiropracy re: federal court
https://www.chiropractic.org/advocacy/the-history-of-wilk-versus-the-ama/
https://journalofethics.ama-assn.org/article/chiropractics-fight-survival/2011-06
Canada
“The Charter of Health Freedom seeks to protect the right to access natural health products by putting them into a distinct legal category and shifting the method of their regulation. Constitutional lawyer and CHD.TV guest, Shawn Buckley, is leading the charge on this effort.”
Health Canada wants more funds from pharma
“An amendment buried in the federal budget bill would pave the way for Health Canada to increase the fees it charges drug companies to cover more of the costs of regulating medicines. The proposed amendment to the Food and Drugs Act would empower the Minister of Health to set fees by ministerial order, rather than going through the more complicated process prescribed by the User Fees Act, which includes justifying any fee changes to parliament.
At a recent senate committee meeting, drug companies warned that the amendment will reduce oversight and transparency of Health Canada’s fees, a point that also troubles health policy experts. But Health Canada told senators the current rules make it almost impossible to adjust fees in pace with the increasing costs of the drug review.”
https://doi.org/10.1503/cmaj.1095439
For some information to start to understand the health care industry's interaction with the mass media, including Interlocking Directorates, see:
How Trustworthy Is the Mainstream Media: Facts and Figures.
Who are they? Who pays for the distribution of mass media? The production?
Financial conflicts of interest also escalate exponentially the problem of medical facilities covering up when their practitioners commit malpractice, even to the point of aiding and abetting intentional murders. See some information on this in
Healthcare Serial Killers
There is a large amount of preventable death at the hands of our healthcare systems,
Please help spread the word.
* All of the posts on this substack are intended to be primers to help make necessary information and comprehension accessible to everyone, and help everyone spread the word to all people. Some are written to be easy to print and distribute, others are collections of documentation to help provide evidence and proof to convince those who doubt the truth.
Please print things out and distribute them. Some posts here are fairly print ready, others can be edited. Please make your own print outs, and distribute them, everywhere, until every human is aware. Bulletin boards, bus stop benches, telephone poles, door steps, windshields, fliers, handouts, etc.
The local newspapers are shut down. We, The People, have to be the reporters, editors, and distributors. 4th estate = Journalism = By the People, For the People. Participatory government = participatory journalism. We need to mobilize. Tell everyone else to help spread the word. This matter is urgent - we are far behind.
Feel free to ask any questions, and to leave comments and suggestions.
“Educate and inform the whole mass of the people, enable them to see that it is their interest to preserve peace and order, and they will preserve it, and it requires no very high degree of education to convince them of this. They are the only sure reliance for the preservation of our liberty.”
- Thomas Jefferson
Jamie, I think we're on the same page, so to speak. That was a lot of information in your post and I didn't have time to go through it all but I could see that you've done a lot of research and made it available.
I know a lot of people who won't look at this kind of information for one reason or another. It can be disturbing to see and understand the implications of big pharma and where it's all going, so I think people generally avoid looking too closely at the disturbing stuff. Almost everybody these days has a smartphone, and is being manipulated through various pharma controlled narratives. Maybe they have ties to the financial networks surrounding healthcare or maybe they prefer to take an easier path of passive acceptance.
I find that most people don't question the narrative unless they're really motivated by some health problem and have been forsaken by the system. The floodgates opened after the covid scam threw us under the bus and mortality reared it's ugly head. Some, like myself, have been aware for some time due to curiosity and critical thinking. I decided to reject "healthcare" and become a researcher of alternative and natural treatments. That's how I knew not to take the shot when everyone around me succumbed to the fear porn.