Corporate shaping of basic public health definitions including disease entities and primary prevention

This presentation uses existing research on relatively new diseases, such as osteopenia and hypercholesteremia, to document how the web of corporate interests shapes the most basic definitions of health, illness and primary prevention. It will then explicate how these definitional strategies are used by the three major corporate sectors (big pharma, medical equipment companies and private health insurers) within health care to leverage public payment programs to the maximum. Through corporate involvement, particularly by pharmaceutical companies, in the definition of diagnoses, new “illnesses” are created as drugs are available to treat them, e.g., hypercholesteremia, which used to be a symptom of heart disease and is now a stand-alone diagnosis. The growth of this definitional strategy by pharmaceutical companies is examined in combination with the insurance company strategy of paying for treatment of recognized disease entities, and the need for expensive medical equipment to “diagnose” these diseases definitively. Osteopenia, for example, is diagnosed using expensive imaging machines. The test is covered under Medicare and often is considered primary prevention. The “disease” is defined statistically (not biologically) such that at a minimum more than 13% of adults over 50 who have bone density tests will be diagnosed as having osteopenia. Medication, paid for under Medicare Part D, is available, and treating osteopenia before it becomes osteoporosis can be defined as primary prevention. Research across diseases will be used to expose the role of the three for-profit sectors in disease creation and treatment using mainly public money.