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Corpocracy vs. Democracy in Health Care Reform

Since corporate dollars trump individual votes, we have a corpocracy, not a democracy.
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Corporate America has highjacked the health care debate and threatens to make real health care reform impossible. Since corporate dollars trump individual votes, we have a corpocracy, not a democracy.

This is not a new story, but is still an under-recognized one. By a landmark ruling of the U. S. Supreme Court in 1886 (Santa Clara), corporations were granted rights as "persons". Over the years since then, corporate values and goals have been codified into law, and courts have defended the rights of corporations to pursue their primary goal -- making a profit for their shareholders.

The scope of corpocracy goes beyond what most of us realize. According to a 2007 report of the Institute for Policy Studies, 51 of the top 100 economic entities in the world are corporations. Wal-Mart and Exxon Mobil each have higher annual revenues than the gross domestic product of Poland or Saudi Arabia. The top 200 corporations account for about one-quarter of total economic activity in the entire world.

Most of these large corporations are multinational and largely immune from the laws of any one nation. They are free to set up partnerships of convenience across borders, seek out countries that best serve their interests, and often pay little or no taxes.

But there are serious downsides to all this corporate power. In a 2009 assessment of the long-term effects of conservative economic policy (International Journal of Health Services), Robert Chernomas and Ian Hudson at the University of Manitoba document the extent to which corporations have redistributed wealth and power away from most of the population to themselves, thereby contributing to increasing poverty, illness and economic instability. And of course, the war chests of the large corporations trump the democratic process along the way. FDR recognized this hazard in 1938 in these words:

"The liberty of a democracy is not safe if the people tolerate the growth of private power to a point where it becomes stronger than their democratic State itself. That, in its essence is Fascism -- ownership of government by individual, by a group, or any controlling private power."

Corporate influence and control within the medical industrial complex is also much larger than it may appear. General Electric, for example, as one of the twelve largest corporations in the world, in addition to its interests in manufacturing of jet engines, locomotives and industrial turbines, is heavily involved in medical diagnostic equipment, information technology, and development of robotics. Moreover, as a media giant with broadcast and cable television operations such as NBC, its reach also extends into banking and financial services.

When it comes to trying to rein in the uncontrolled costs of health care, corporate interests naturally use their economic and political power to protect their markets. For them, our costs are their revenues, so their battle is to perpetuate the status quo and limit government intrusion. They do so by campaign contributions to both sides of the aisle in Congress, lobbying, and control of the media. Over the last 40 years, the lobbying industry has grown from a small group of lawyers and influence peddlers to a multi-billion dollar industry employing thousands of people, including almost 200 ex-senators and ex-House members who became lobbyists through the revolving door. The five largest private health insurers and their trade group (America's Health Insurance Plans) spent more than $6 million on lobbying in the first quarter of 2009, while Pfizer, the world's biggest drugmaker, spent more than $9 million during the last quarter of 2008 and the first three months of this year. And as expected, conflicts of interest abound in the political process. The Washington Post recently reported that up to 30 members of Congress who hold key committee memberships in Congress (in both parties) have major investments in health care companies totaling somewhere between $11 and $27 million. Conflicts of interest even extend into the White House, where the Director of Health Care Policy has served on the boards of several health care corporations.

Corporate control of the media largely shapes what the public learns about the issues, thereby distorting the democratic process. The U.S. media system is dominated by about 25 corporations, which range across TV networks, cable TV channels, radio stations, newspapers, book publishing, magazines, motion pictures and others. Seven are in the first tier, including Time Warner, Viacom, News Corporation, General Electric and Disney. A second tier includes about 20 corporations, including Gannett, Clear Channel and the New York Times. The reach of these giants stretches the imagination. Clear Channel, for example, is the largest radio chain in the country, owning 1,240 radio stations with only 200 employees. According to Ben Bagdikian, dean emeritus of the Graduate School of Journalism at the University of California at Berkeley, most of these stations are operated with the same pre-recorded material. The great majority of content disseminated by these media giants is slanted to the conservative side.

So business being business, why is this bad? Again, corporate media favor their own interests, and work against objective analysis of events and issues. As a result, an under-informed voting public is disadvantaged and marginalized in the political process.

What does the body politic want concerning health care reform? Everyone wants affordable access to health care with free choice of physician and hospital. A majority of the public has wanted national health insurance (NHI) for many years. Changes in the electorate will further increase the numbers of Americans wanting NHI. Baby Boomers, the first of whom reach 65 years of age next year, are being bombarded by the high costs of their health care as their savings have dried up, 401(k)s have evaporated, and their planned retirements delayed. And three of five of the Millennial Generation, now 80 to 95 million strong, support NHI. The public will be angry and bitter when they discover how far short of their needs any of the current "reforms" now on the table will fall.

So when, if ever, will the democratic process prevail over corpocracy? In his recent interview of Wendell Potter, past director of public relations for Cigna and now vocal critic of the private health insurance industry, Bill Moyers answers this question:

"The game goes on and the insiders keep dealing themselves winning hands. Nothing will change - nothing - until the moneylenders are tossed out of the temple, the ATM's are wrested from the marble walls, and we tear down the sign they've place on government - the one that reads, 'For Sale.'"

John Geyman, M.D. is the author of The Cancer Generation and Do Not Resuscitate: Why the Health Insurance Industry is Dying, and How We Must Replace It, 2008 by John Geyman. With permission of the publisher, Common Courage Press.

Buy John Geyman's Books here