The Bottom Line or Public Health: Tactics Corporations Use to Influence Health and Health Policy, and What We Can Do to Counter Them

591 Pages·2010·2.995 MB·English

by  William H. Wiist

The Bottom Line or
Public Health
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The Bottom Line or
Public Health
Tactics Corporations Use to Infl uence
Health and Health Policy,
and
What We Can Do to Counter Them
edited by
william h. wiist
1
2010
3
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other services to a for-profi t corporation, nor served on a corporate board, corporate advisory group,
corporation sponsored institute or foundation, nor have they held fi nancial interest in a corporation or
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Preface
There are two things the reader needs to know about this book
before proceeding further:
1. The book takes a point of view, a viewpoint that is critical of
the institution known as the corporation, its practices, and the
economic philosophy and legal rulings upon which the corporation
is founded and by which it operates. The focus of the book is on the
fundamental characteristics of the corporation, not the operations
of specifi c corporations or industries that have an infl uence on
health. That information is merely illustrative of the corporate
institution. The book is not intended to provide a balanced
perspective about corporations, including the benefi ts society may
derive from corporations. The ideology and beliefs that underpin
the corporation are already ubiquitous and promulgated by most
news media (e.g., Wall Street Journal, CNBC), publishers, policy
institutes, the educational system, particularly business schools,
legislatures, and the courts. While harmful practices or products
of a single company or an entire industry are sometimes criticized,
the above institutions rarely critique the fundamental nature of the
corporation or its operating principles. The conventional wisdom
is that the corporation as it is currently structured and operates is
necessary and always benefi cial. Therefore, it is unnecessary for
this book to present that viewpoint.
vii
viii preface
2. This book is intended for both academic and advocacy audiences. The
chapters were written by both academics familiar with research about
corporations and by staff of organizations who are working directly on
issues related to the corporation.
Readers may think that my perspective as a university professor working
for government is entirely theoretical without the benefi t of fi rsthand experi-
ence that would give me a more favorable viewpoint about corporations. To the
contrary, my personal experience with a publically traded, for-profi t corpora-
tion and a private, for-profi t corporation contributed to my academic interest in
further studying the corporation as an institution.
For many years prior to completing my formal education, I worked at the
minimum wage on an assembly line in a factory. This was the same factory at
which my father worked for 30 years and that did not have a retirement plan,
and where he was likely exposed to the substance that ended his life two years
after retirement.
More recently, during my professional career, I was employed by a small
privately held corporation that operated in an informal manner with consid-
erable employee involvement in corporate decision making. Employees were
well acquainted with each other and most were on a fi rst name basis with the
owner, the board, and other offi cials. When the corporation was purchased by
a larger, publically traded corporation, the goals, operations, and management
style quickly changed. One morning, not long after the new management took
over, I dropped off my company laptop with the technicians for repairs. As
usual, the technicians were pleasant and in a cheerful mood. They promised
to have the laptop ready in 2 hours. When I returned at the designated time
to retrieve the laptop, the technicians were not in their offi ce. As I looked for
my laptop, a stranger walked in and asked if he could help me. He informed
me that the two technicians no longer worked there and that he was now in
charge. Although many employees still worked closely with top corporate
offi cials, those offi cials used the sudden, unexpected termination procedure
many times over the coming years to terminate numerous employees working
at all levels.
Because of my personal experience working on a factory assembly line and
for the corporation described above, I understand, in a way that many academ-
ics do not, fi rsthand how the corporation operates.
Due to space limitations, the chapters in this book are not the “last word”
on a topic nor do they provide a comprehensive review of the subject mat-
ter. The chapters serve as an introduction to the topics and as a stimulus for
further scholarship and advocacy by others who might be willing to work on
preface ix
in this new frontier for public health, “the corporation.” In making the argu-
ments they make, the chapter authors courageously take positions contrary to
conventional wisdom.
Often those who are experts in a fi eld have vested interests in the status
quo, particularly if they have ties to corporations from a consultancy, grants,
and so forth that make their fi nancial confl icts of interest so extensive that
they are unwilling, or intellectually unable, to make the arguments that the
authors in this book have made. Or, it may never have occurred to them to even
consider examining the corporation in such a fundamental way as the chapter
authors of this book have. The other individuals have simply accepted the con-
ventional wisdom. The authors of chapters in this book are critical thinkers
who do not accept the conventional wisdom. By defi nition they are radicals:
they examine the root causes of the problem. Because of the nature of this
book, the chapter authors have all provided a statement that they have no cor-
porate confl icts of interests.
Chapter authors use both scholarly and journalistic sources: journals,
books, popular press books, news media, magazines, Web sites and personal
experience. Sources from outside traditional academic sources are also used, in
part because, compared to a few scholars and advocacy organizations, relatively
few academics critically examine the fundamental nature of the corporation as
an institution, its source of power and infl uence, or the tactics the corporation
uses. Few academics conduct research on the relationships between corporate
or market variables and public health measures or publish such material in
scholarly journals.
The thesis of the book is that because of the way the corporation, as an
institution, was structured historically, mainly through court rulings, all cor-
porations either use the same tactics to infl uence health policy or they have the
same tactics available for their use. When I presented this thesis for the fi rst
time at the 2007 Annual Meeting of the American Public Health Association
in Washington, D.C., I also laid out counter tactics that public health profes-
sionals and advocates can use. Based on this schema, the book is divided into
three sections.
The fi rst section of the book serves as an introduction to the topic. In
Chapter 1, “The Corporation: An Overview of What It Is, Its Tactics and What
Public Health Can Do” I provide an overview of the history of the corporation
and the lessons that history holds for public health professionals, the prevailing
economic model underlying the corporation, an enumeration of the six tactics
the corporation uses, and provide examples of their use, and describe the key
counter tactics public health professionals and advocates can use. In Chapter 2,
“Corporations, Public Health and the Historical Landscape that Defi nes Our