Obstetrician-Gynecologists and Industry Let the Sunshine In!

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“What is an ethically responsible relationships between obstetrician-gynecologists(ob-gyns) and the pharmaceutical and medical device industries”, asks Lewis Wall in an editorial in Obstetrics & Gynecology?  He notes the inherent conflicts between the worldview of the pharmaceutical-medical device industry, where pursuit of profit overrides all other considerations, and the overriding obligation of physicians to put the health interests of their patients first.  When the trust that obligation engenders is lost, he writes “medical practice breaks down.”

Industry Payments to Obstetricians and Gynecologists Under the Sunshine Act

Another article in Obstetrics & Gynecology examines industry payments to ob-gyns. To evaluate financial relationships between obstetrician–gynecologists (ob-gyns) and industry, including the prevalence, magnitude, and the nature of payments, the authors of this report conducted a cross-sectional study using a list of industry contributions to U.S. obstetricians and gynecologists obtained through the Centers for Medicare and Medicaid Services Open Payments Database from August 1, 2013, to December 31, 2015. They concluded that obstetricians and gynecologists receive a substantial amount of payments from industry. Most of these payments were for honoraria, faculty compensation, or consulting and totaled less than $400 per health care provider. Although this total amount is less than typically received by surgical providers, the median payment value for obstetrics and gynecology subspecialists surpasses the median payment to orthopedic surgeons, the highest compensated specialty group in total. These financial relationships warrant further exploration with future research.

How a flood of corporate funding can distort NIH research

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“This month, National Institutes of Health Director Francis Collins seemed to shut down a noxious ethical problem,” writes Paul Thacker, a former Senate staff member,  in The Washington Post. “The agency released a 165-page internal investigation of an alcohol consumption study that had been funded mostly by beer and liquor companies. The study’s lead investigator and NIH officials were in frequent contact with the alcohol industry while designing the study, which, according to the postmortem, seemed predetermined to find alcohol’s benefits but not potential harms, such as cancer. In several email exchanges published in the report, NIH scientists seemed to joke about taking a drink every time somebody said “cheers,” which was a proposed acronym for their study. Collins ended the trial and promised to create new ethical boundaries for how NIH officials deal with industry.  But the intellectual corruption at our government research agencies runs much deeper, and this was only the latest scandal involving hidden corporate influence. I spent 3 1 / 2 years as a Senate investigator studying conflict-of-interest problems at the NIH and the research universities it funds. During that time, I found that the agency often ignored obvious conflicts. Even worse, its industry ties go back decades and are never really addressed unless the agency faces media scrutiny and demands from the public and Congress for change.”

Corporate Efforts to Derail Mass Transit

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In 1985, two urban policy scholars, J. Allen Whitt and Glenn Yago,  wrote:

The urban transportation systems that carry us around are not solely the result of technological innovation or efficiency. They are also a product of the rising and sinking political and market power of industrial interest groups, the changing relations among social classes, the politics of urban development struggles, and the inherent dynamics of the economic system… These factors, particularly corporate control of transportation policy, have profoundly shaped urban streetcar, automobile, bus, and rail transport in the United States during this century. We conclude that this private dominance over urban transportation policy has often led to narrow, profit-seeking behavior that has thwarted the development of more effective public transit.

This week, The New York Times reported that in the last few years Americans for Prosperity, the conservative group financed by oil billionaires Charles and David Koch has contributed hundreds of thousands of dollars to defeat plans to expand or improve mass transit in  Little Rock, Phoenix, Nashville, southeast Michigan,  and central Utah. The group has also contributed to effort to defeat more than two dozen transit-related measures such as states proposals to raise gas taxes to fund transit or transportation infrastructure.

“Stopping higher taxes is their rallying cry”,  Ashley Robbins a transportation researcher at Virginia Tech, told The New York Times. “But at the end of the day, fuel consumption helps them.”   Although Americans for Prosperity opposes pubic spending on mass transit, it supports spending tax money on highways and roads.  Koch brother-owned industries produce gasoline, asphalt, seatbelts, tires and other auto parts, businesses that could be harmed by new investments in mas transit.

Public health research shows that improving mass transit and reducing automobile use can  bring multiple health and environmental benefits:  less premature mortality from lung disease, fewer asthma symptoms, more physical activity and less sedentary time, fewer injuries and deaths from auto crashes, more social interactions and less isolation, less road rage, more walkable and attractive  cities, less air pollution, reduced carbon emissions, less urban sprawl.

Despite these benefits, for more than a century public policy at the federal, regional, state and local levels has been disproportionately influenced by commercial interests that favor increased automobile use over the well-being of our population and our environment.  Public health professionals and researchers need to explore new ways to bring this debate about democracy, health and the environment into the policy and political arenas.

How do Americans rate the fairness of US corporate practices?

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Responses to: Which of these behaviors is most important in evaluating how just a corporation is?   Source

What do Americans think of corporate practices?  And what business practices most disturb Americans?  Each year JUST Capital conducts a poll of a representative sample of U.S. adults to answer these questions.

JUST Capital, a nonprofit group, seeks to “build a more just marketplace that better reflects the true priorities of the American people.”  The group believes that “business, and capitalism, can and must be a positive force for change.”   We believe that if they have the right information, people will buy from, invest in, work for, and otherwise support companies that align with their values. And we believe that business leaders are searching to win back the trust of the public in ways that go beyond money. By shifting the immense resources and ingenuity of the $15 trillion private sector onto a more balanced – and more just – course, we can help build a better future for everyone.

The findings from its 2017 survey of about 4,100 adult US respondents, shown above, provides some informative insights.  First, the outcome most important to corporate managers, i.e., providing returns to investors, is the least important practice that respondents use to rate the fairness of a corporation. Second, the national discourse on jobs and job creation makes that practice by far the highest rated factor in judging a corporation’s fairness. Third, some of the practices of greatest interest to health advocates, such as the health consequences of products (rated as most important by 35.4% of respondents), efforts to minimize pollution (38.6%), and providing a safe workplace (11.5%) rank lower than other factors.

The survey also compares responses by several demographic characteristics, including age, gender, income, region, political party, ideology and investor status.  Of interest, none of these factors predict large differences in beliefs about fairness.  Any survey is of course influenced by the wording of questions and other surveys have shown age and other differences in how Americans view corporations.

JUST Capital provides more detailed reports of their annual surveys from 2014 to 2017. It also publishes Roadmap for Corporate America, its summary of the 2017 survey and recommendations for how corporations can respond to survey findings.

A Bid to Increase Gun Exports, Stalled After Sandy Hook, Moves Ahead

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When cigarette, Coca Cola or whiskey sales fall in the United States, manufacturers look to recoup their losses by promoting sales of their lethal but legal products overseas, especially to the growing middle classes in middle income nations like China, Brazil, Mexico and India.  Now the Trump administration wants to streamline the process for exporting American firearms, reports the New York Times,  a change sought for years by domestic gun companies as a way to increase sales of both military weapons and small arms.

“A proposed rule published in the Federal Register would transfer jurisdiction of consumer gun exports from the State Department, where the licensing process is expensive and extensive, to the Commerce Department, which has a simpler application process.

Gun industry groups said that the shift, which was first conceived during the Obama administration but halted after the Sandy Hook school shooting in 2012, would pare down a bureaucratic process that currently discourages American firearms companies from sending their products abroad.

Lawrence Keane of the National Shooting Sports Foundation called the proposal “a significant positive development for the industry that will allow members to reduce costs and compete in the global marketplace more effectively, all while not in any way hindering national security.”

But critics of the proposal worry that American guns, including AR-15s and similar semiautomatic rifles frequently used in mass shootings, could more easily find their way into the hands of foreign criminals. Among the reasons: a change in the disclosure rules for certain sales. The State Department is required by the Arms Export Control Act to submit any commercial arms sale worth $1 million or more to congressional review. The Commerce Department has no equivalent mandate.”

Firearm sales in the United States have struggled since President Trump, a vocal supporter of the gun industry, was elected. Fears of gun control, which helped propel demand to record highs during the Obama administration, have waned during Mr. Trump’s tenure.

Representative Elizabeth Esty, whose Connecticut district includes Newtown, said on Wednesday that she would try to “stop this if I can.” “This is a national security and diplomacy question, but moving it to Commerce makes it an economic promotion of an industry,” she said. “It’s putting profits ahead of people.”

The Public and Nonprofit Sectors: An Alternative to Corporate Control

The practices of the pharmaceutical, unhealthy food and automobile industries contribute to premature deaths and preventable illnesses and injuries throughout the world.  One strategy for reducing these burdens is to strengthen the public and non-profit sectors.  This can create alternative healthier sources for needed goods and services, put pressure on the market sector to address health externalities more directly, and make the common good a higher public goal than profitability. The posts illustrate ways to grow this sector in pharmaceuticals, food, and transportation.

Tracking the Effects of Corporate Practices on Health