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Profiting from ill-health

The coalition government’s plan to allow more profit-seeking enterprises to provide health care has stirred up controversy and opposition. But despite the NHS huge profits have long been made out of health provision.

In 2002 it was estimated that the joint profits of $35.9 billion amassed by the ten pharmaceutical companies that featured in the Fortune 500 were $2.2 billion more than the profits of all the other 490 businesses put together. So there’s plenty of money in drug-dealing. Here's what some of the top dealers pocketed in earnings in 2007 (source FiercePharma):

1. Miles White - Abbott - $33.4m
2. Fred Hassan - Schering-Plough - $30.1m
3. Bill Weldon - Johnson & Johnson - $25.1m
4. Bob Essner - Wyeth - $24.1m
5. Robert Parkinson - Baxter - $17.6m

The sale of drugs has a relatively short history when it’s compared to our own history. For tens of thousands of years we experimented with the raw materials that are freely found in nature and form the basis of the modern day pharmaceutical industry. It is recorded that pharmacists in Baghdad opened the first pharmacy in 754. This spread throughout the Islamic world and into feudal Europe. As capitalism developed out of feudalism so too did the health business. By the early 20th century the strong had been gradually eradicating the weak leaving the nucleus of today’s most powerful pharmaceutical companies.
 
The mass production of drugs arose from the discovery of insulin in the 1920s and later of penicillin. Wealth, through surplus value, was accumulating in to the hands of the capitalists who owned and controlled these companies. Trade was well on its way to becoming global, and capitalists in Europe and North America must have realised that they had found their own gold mines.

The minor companies that entered the market were continuously swallowed by the major ones via mutually beneficial partnerships, corporate buyouts, mergers and takeovers. The City as ever eased the way, greasing its own palm in the process, so that the global manufacture of drugs is now dominated by a handful of cartels.

IMS Health (7 September 2009) estimates that the value of the global pharmaceutical market in 2010 is expected to exceed $825 billion, and is expected to expand to $975+ billion by 2013. Capitalism’s drug dealers will salivate in anticipation. Only the naive and the ideologically handicapped believe that trade under capitalism is not synonymous with corruption. Once money enters into any transaction, principles, no matter how well-meaning, get undermined. And the drug trade is no exception.

Theft: Israeli bio-technology company Nogdan Immunochemicals Ltd patented a technology that can almost immediately detect any current disease and forecast the probability of disease in the future. The sharks circled Nogdan in September 1995, through the agency of Biosite and Epimmune. And, with the active complicity of an Israeli attorney and two leading academics, conspired to steal the patent. They went on to sign deals with the top drug cartels such as Monsanto, Novartis, Merck and Co., Searle GD, Elan, Pharmacia, Human Genome Sciences, IDM, and others, for the use of the patent. Billions of dollars in profits have already been generated by these companies. And it has been estimated that over the next ten years hundreds of billions of dollars more will be added to their balance sheets (chemeurope.com/news).

Bribery: Remember the scare stories that flooded the media in 2008/09 about H1N1; a global flu influenza. A report published by the British Medical Journal, reveals the hidden links that made the World Health Organisation [WHO] declare H1N1 a pandemic. The result was billions of dollars in profits for vaccine manufacturers. “Several key advisors who urged the WHO to declare a pandemic received direct financial compensation from the very same vaccine manufacturers who received a windfall of profits from the pandemic announcement… All the kickbacks were swept under the table” …the “ WHO somehow didn’t think it was important to let the world know that it was receiving policy advice from individuals who stood to make millions of dollars when a pandemic was declared” (jmbblog.com/2010/06/h1n1-and-who-scandal).

Murder: “During the meningitis epidemic in Niger in 1995, over 50,000 people were inoculated with fake vaccines, received as a gift from a country which thought they were safe. The exercise resulted in 2,500 deaths. Of the one million deaths that occur from malaria annually, as many as 200,000 would be avoidable if the medicines available were effective, of good quality and used correctly” (WHO, 2003 FS 275).

On 9 March 1983, a Peter Lumley, spokesman for the Association of the British Pharmaceutical Industry (ABPI), was pleased to inform Guardian readers “that drug companies now average a 22 per cent rate of return from the NHS”. Twenty plus years later that figure has hardly fluctuated. Between 1988 and 2008 according to; Prescriptions Dispensed in the Community, England: Statistics for 1998 to 2008. Prescription items increased by almost two thirds. In 1998, the net ingredient cost of all prescriptions dispensed was £4,701.5 million. In 2008 The net ingredient cost of all prescriptions dispensed was £8,325.5 million.

Unsurprisingly, Daily Telegraph readers discovered in 2004 that “The Royal College of General Practitioners has accused drug companies of ‘disease-mongering’ in order to boost sales… says the pharmaceutical industry is taking the National Health Service to the brink of collapse by encouraging unnecessary prescribing of costly drugs…The college lists hypertension, high cholesterol, osteoporosis, anxiety and depression as examples of common conditions that, in mild forms, are often inappropriately treated with drugs” (29 August 2004).

Conflicts emerged when Richard Ley, a spokesman for the ABPI, said: “It seems odd for this criticism to come from the Royal College of all organisations, because a decision on when and how to treat a patient is the doctor's.” And the conflict continues according to the same article: “Some observers are also worried about “hard-sell” methods applied to general practice. Last year, a survey of 1,000 GPs published in the British Medical Journal found that those who saw drugs-company representatives at least once a week were more likely to prescribe drugs that were not needed.”

Then there’s the Observer (29 June 2003) quoting Glasgow GP Des Spence who “had started an advisory post, which meant he influenced prescribing practices for half a dozen local practices, when he started receiving invitations to meetings abroad, ‘endless’ lunches and dinners and offers of substantial fees for lectures and chairmanships – and felt he was finally getting the recognition he deserved. That is until his wife made him realise that he was ‘just being used and manipulated by big pharma, that it was the patients they were interested in, not me’.” He underlined this by claiming that “GPs who see drug reps at least once a week are more likely to prescribe drugs for conditions that will probably clear up on their own”.
 
Even if your GP has the best of intentions and closes the surgery door to the drug rep (pusher) the drug cartels still influence events, the Observer reported, because: “around half of postgraduate education for doctors is funded by industry. And around two-thirds of clinical trials in Britain are funded by the pharmaceutical Industry. A new study shows that such research is four times more likely to be biased in favour of the product belonging to the sponsors than independent studies . . . Equally worrying, medical experts featured in press coverage of the latest pharmaceutical breakthrough or disaster could well have been ‘recruited and trained as opinion leaders to speak on behalf of the sponsoring company.’ says the BMJ.”

The state has devised new roles for doctors in line with their ideological aims. In March last year Yvette Cooper, then Work and Pensions Secretary under the Labour government, notified us that more than 500 doctors are to be mobilised to assess whether the 2.6 million people on incapacity benefit are capable of work. That’s 500 doctors removed from the work that they swore by the Hippocratic oath to undertake. And later in the year that the Coalition’s Health and Social Care Bill will allow doctors to take control of a huge slice of the NHS health budget in England, which for 2010-11 is forecast to be just under £110bn. A bait that will have the drug cartels smiling confidently. Or perhaps it is being too cynical to ask a couple of pertinent questions as Michele Bohan did in evidence to a parliamentary committee in February 2011:

“Why is £80 billion pounds of public money to be handed over to GPs with no experience of commissioning health services and why are GP’s to be awarded cash bonuses for running the consortia?”

and

“How are we to prevent unscrupulous companies like United Healthcare (an American firm bidding to run services here) – which has been fined millions of pounds over a number of years for defrauding the American healthcare system doing the same thing here in the UK? Their offences involved ‘cheating patients out of money‘, ‘denying treatment’ and ‘overcharging’”. (www.publications.parliament.uk/pa/cm201011/cmpublic/health/memo/m40.htm)

Good questions Michele, but don’t expect a lucid answer.

Here’s a tip for survival under capitalism borne out of experience: don’t get ill. Unemployment is one quick way to penury. But getting ill compounds that situation. In 1989 Dr Iona Heath, a North London GP drew attention to capitalism’s ultimate answer to the problem of ill-health: “How can we escape the logical conclusion of the market-place that for the elderly and the chronically sick the most economic solution is death.” (quoted Socialist Standard, January 1990).

So would healthcare be any different if socialism were established? Yes it would. Why? Because from day one money would disappear. And that means the market would cease to exist. Take one or two minutes out and just think how the non-existence of wages, profits and budgets would change the present situation. Then think about the end of the hierarchies that dominate healthcare at present. No more capitalist ponces, and no more layers of useless bureaucrats skimming their share of the kitty.        

Instead healthcare would be conceived and administered, democratically by us, the people who brought socialism about. Globally, doctors, nurses, scientists and everyone at present involved in healthcare at the human level would act as guides. Informing people as to where healthcare is capable of going once the artificial barriers of money had been eliminated. It’s up to you. Use your imagination and join us. Or sit back on your sofa and hope that you don’t get ill.

ANDY MATTHEWS