Oral

We are in the midst of what Deborah Stone has called the second great transformation: when life itself has become an object of commerce. This commerce involves substances such as tobacco that have lethal effects when they are consumed and health goods and services such as pharmaceuticals and health insurance whose affordability, accessibility and appropriate use may be a life necessity. It is becoming increasingly controlled by large, often multinational corporations. It is a global phenomenon that affects both industrialized and developing countries. It is also a significant problem in the implementation of ACA in the coming years. ACA is introducing several initiatives or programs that are potential sources of profit for corporations. For instance, the growth of informatics will give rise to a private industry (as Ross Perot’s following introduction of Medicare). The focus on efficacy and cost-control may well give rise to an industry that might decrease costs while diverting a significant part of funds for its own profit. Involvement of private health insurance, HMOs and in-patient care industries may siphon profits out of health care. Granted that government may take its own steps to limit such hazards, large for-profit corporations have a record of often coming out on top. The public health community may play an important role as watchdog of old and emerging industries that will target ACA programs for their profits. This session will examine approaches to protect the public from corporate economic abuse in the tobacco industries, pharmaceutical industries and health insurance industries that might be applicable to other relevant industries and other countries. There is no global public health intervention of adequate effectiveness to eliminate economic abuse of health (such as the WHO program that eliminated small pox), but there are numerous local interventions, some of which may serve as models for other sites.

Session Objectives: List the different kinds of commercial interests that may have a deleterious effect on health and health care costs. Analyze the structural relationships of public health interventions in the context of corporate commercial strategies. Explain the concept of corporate economic abuse. Assess approaches to protect the public from corporate economic abuse in ACA’s implementation.