Big Pharma’s obscene profits, not striking nurses, are killing the NHS

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Monopoly pricing and corporate greed are destroying healthcare systems in the UK and globally

Original article republished from Open Democracy under  a Creative Commons Attribution-NonCommercial 4.0 International licence.

Tarun Gidwani

21 December 2022, 12.59pm

NHS sign
There’s so much hoo-ha about the fiscal consequences of nurses resisting pay cuts, but profiting by corporations isn’t deemed an issue.

Imagine a disability almost disappearing if you flew out of the Global South. I have severe haemophilia, a genetic condition that interferes with the body’s ability to clot after bleeding. When left untreated, anything – even a bruise or merely sitting down – can trigger a bleed, internally or externally. Anti-clotting injections can stop this.

However, outside the advanced West, these injections are sold at exorbitantly high prices. When I was a child in India, my parents couldn’t afford such treatment, so they’d bury my bleeding joints under piles of ice to freeze them. Almost all the bleeds I experienced in India were left untreated, resulting in permanent damage to my joints and internal organs. In the UK, the NHS home-delivers me these injections twice a month.

This global medical apartheid is created and perpetuated by pharmaceutical monopolies. Treatment pricing pursues a single sacrosanct goal: making profits. Trade laws allow corporations to keep most of their recipes secret, so that no one else can sell the same medicines at a cheaper price. Then the very same logic of capital menaces governments into withdrawing welfare nets – leaving families absolutely at the mercy of the market.

When a friend recently sent me news about a supposedly “miraculous” new treatment for haemophilia, I was pessimistic. The new intervention replaces the need to inject yourself every other day, which would be revolutionary to many lives. And trials to date have been very positive. But our current pricing and trade regime will inevitably ensure it is out of reach for those who most desperately need it – just as it did with the Covid-19 vaccines.

Profits before patients

Not all is quiet on the Western front, however. In its search for ever-greater profits, Big Pharma is strangling healthcare in richer countries too. The same monopoly pricing and trading mechanisms that keep those in the Global South from accessing care are eating up access in the Global North too.

Between 2011 and 2017, the cost of medicines for NHS England grew from £13bn to £17.4bn – a 5% rise every year. In 2020, this reached £20.9bn. Yet the government is currently considering trade arrangements, leaked documents show, that will increase this cost even further by forcing the NHS to buy from pharmaceutical monopolies instead of buying generic medicines.

By contrast, the US pharmaceutical giant Pfizer recorded profits of $21bn last year. That amount could fund the nurses’ wage demand twice over – while also bringing in more revenue, through tax and spending, than corporate profits do. That should put the nurses’ demands in perspective. It’s not striking health workers who are holding the NHS at gunpoint – it’s the corporate compulsion to squeeze and extract.

Ending the global medical apartheid necessitates ending pharmaceutical monopolies. Saving the NHS also necessitates this. These monopolies suck up public money for the development of drugs and then suck it up again by selling those same drugs back to the public at high prices.

Studies have shown that new drugs for rare diseases can be developed at costs up to £1.2bn cheaper than claimed by corporations. Organisations such as Global Justice Now have pointed this out repeatedly.

Take the development of abiraterone, for instance, which treats advanced prostate cancer. Its development was publicly funded, but once released to the market, the NHS was forced to ration it because it was exorbitantly expensive. Meanwhile, the corporation that sold it, Janssen, made £7.2bn in sales.

The NHS spends billions buying treatments that were developed using public funding. In 2018, the UK spent around £500m on cancer drugs that were developed through publicly funded institutions. Things have only gotten worse. Prices more than doubled for several drugs between July 2018 and October 2020. A pack of 28 risperidone tablets, a commonly prescribed antipsychotic medicine used for treating mental health disorders, went from £2.68 to £49.21 – an increase of 1,736%. Drug prices in the UK are not subject to controls. They are negotiated behind closed doors.

There’s so much hoo-ha about the fiscal consequences of nurses resisting pay cuts, but profiting by corporations isn’t deemed an issue. British prime minister Rishi Sunak claims that paying minimally decent wages to nurses is “obviously unaffordable”, while saying nothing about all the extra cash being handed to pharma companies that have a stranglehold on NHS spending.

Some battles are between forces larger than those visibly involved. The NHS strike against dramatic wage cuts (not for outrageous wage demands, as the government would have it) is one of them. The struggle of NHS workers can strike at the heart of the forces that profit from a segregated global health system.

This is a system that is only interested in making nauseating profits. Even if the pharmaceutical giants lost 20% of their profits, they’d still outperform 75% of other industries. They are also avoiding billions in taxes, according to a 2018 report by Oxfam – money that could otherwise expand the ever-shrinking pool of public-sector healthcare workers.

These profits, by the way, are by definition on top of what is spent on research and marketing. Taxing these profits will not only bring their profitability down to less nauseating levels. It’s the only way to curb treatment prices – and bring dignity to NHS workers. The bonanzas to corporations come at the cost of our health. And they come at the cost of decent wages for healthcare workers.

Big Pharma isn’t patriotic. These corporations don’t love the NHS. They may operate in the UK (and the US), but they suck the life out of working people around them.

But working people in the Global North, especially workers in the NHS and in the pharmaceutical industry, hold legitimate power over Big Pharma because they foot the bill for its profiteering. They can demand price controls and transparency. Therefore they play an important role in taming the beast that has come back West to stalk Frankenstein. The NHS strikes should be seen as a manifestation of this larger struggle.

There is a Himalayan distance between the healthcare that people receive in the Global South and in the Global North. I know – I have lived this distance first-hand. But we are united in being subjected to the same systemic forces. Everywhere, the same corporations are hollowing out people’s ability to exercise their right to health; a right that is foundational to the meaningful exercise of any other right.

What the nurses are up against when they go on strike should unite us all.

Original article republished from Open Democracy under  a Creative Commons Attribution-NonCommercial 4.0 International licence.

Continue ReadingBig Pharma’s obscene profits, not striking nurses, are killing the NHS

Now Let’s Do the American Oligarchs

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What can we do about our oligarchy in the United States? President Biden’s blueprint for ones in Russia is a good place to start.

Republished from Common Dreams under Creative Commons (CC BY-NC-ND 3.0) licence. Note by dizzy: There’s a photo of Jeff Bezo’s superyacht at the original article. He’s got a new one now of course requiring an historic bridge to be dismantled in Rotterdam.

12/3/22 ed: I’ve emphasized one paragraph in red typeface. That part is particularly important showing that we do not live in democracy. 13/3/22 The West is imposing it’s model of oligarchs on Russia by imposing sanctions. Western oligarchs control and dictate to Western governments but that’s not the case in Russia.

RICHARD ESKOWMarch 8, 2022

From President Biden’s State of the Union:

Tonight I say to the Russian oligarchs and corrupt leaders who have bilked billions of dollars off this violent regime: no more.

The U.S. Department of Justice is assembling a dedicated task force to go after the crimes of Russian oligarchs.  

We are joining with our European allies to find and seize your yachts, your luxury apartments, your private jets. We are coming for your ill-begotten gains.

With these words, the president unintentionally laid out a blueprint for responding to the American oligarchs, superpredators who dwarf their Russian counterpoints in wealth and political power.

America’s oligarchs, like their Russian counterparts, have bilked billions—no, make that trillions—from their own regime.

Oligarchs in a Violent Regime

About that “violent regime” business: It’s possible to condemn the violence perpetrated by Russia’s government while at the same time recognizing and condemning of our own. Our direct attacks on Iraq and Afghanistan, among other countries, have been matched by the proxy violence we have funded in nations like Palestine and Syria. Our sanctions have taken countless lives around the world, a form of bloodshed we pretend isn’t warfare.

America’s oligarchs, like their Russian counterparts, have bilked billions—no, make that trillions—from their own regime. Some of their bilking comes directly from its violence, in the form of “defense” contracts to entities like Halliburton, Lockheed Martin, and the Carlyle Group.

A 2014 Princeton political science study showed that government actions nearly always conform to the wishes of wealthy and powerful US elites. “Our central finding was this: Economic elites and interest groups can shape U.S. government policy — but Americans who are less well off have essentially no influence over what their government does,” wrote co-authors Martin Gilens and Benjamin Page.

America’s oligarchical influence extends from healthcare and fossil fuels to the industry of war itself. American companies account for more than half of all arms sales worldwide. The Center for Responsive Politics reports that “in the past two decades, (the arms industry’s) extensive network of lobbyists and donors have directed $285 million in campaign contributions and $2.5 billion in lobbying spending to influence defense policy.”

Arms manufacturers (more commonly known by the Orwellian appellation, “defense industry”) shrewdly concentrate on hiring ex-government officials to advance their agenda and pump up their “ill-begotten gains.” This ensures that their interests are represented by people who know the officials they’re lobbying. Even more importantly, it puts those officials on notice that there is a lucrative future in store for them if they play along. Arms oligarchs have hired more than 200 lobbyists who, in the report’s words, “have worked in the same government that regulates and decides funding for the industry.”

Arms manufacturers played a dominant role under Trump, but are also well-represented in the Biden Administration:

While Biden has touted strict ethics rules that attempt to thwart the influence of lobbyists on the administration, several of his earliest appointees, including Secretary of Defense Lloyd Austin and Secretary of State Antony Blinken consulted for a private equity firmthat emphasized its “access, network and expertise” in the defense industry. Austin also had a seat on the United Technologies and Raytheon board, earning more than $250,000 from the now merged companies.

“Ill-Begotten Gains”

It’s not just the arms industry, of course. Other oligarchs have bilked the people of the United States in more creative ways. Jeff Bezos built his Amazon empire off his ability to sell products online without charging sales tax. This government-granted loophole made him an oligarch, a position he has used to further cement his power and influence. He has purchased the most influential paper in the nation’s capital—an oligarch’s move if there ever was one—while constantly extending his monopolistic power into new markets.

Despite the fact that he already possessed great wealth, Elon Musk has received billions in subsidies and contracts for his automobile and space ventures. Bill Gates parlayed a government contract and some aggressive patent strategies into his own oligarchical status. Insurance executives have bilked billions from the violence of our privatized healthcare system, which takes an estimated 45,000 lives per year.

Money, of course, is only part of an oligarch’s wealth. President Biden also mentioned the property that belongs to Russian oligarchs: “your yachts, your luxury apartments, your private jets. We are coming for your ill-begotten gains.” (He meant “ill-gotten,” but I suppose you could call such malapropisms part of Biden’s charm.)

If a “supertax” were levied against America’s oligarchs by the federal government, it would produce as much as $755 billion in revenue.

Russians own an estimated 7-10 percent of the world’s superyachts, leaving plenty for their American counterparts. Luxury apartments? Check out “New York Condo Sells for Close to $190 Million; Hedge-Fund Billionaire Doubles His Money.”  Private jets? Jeffrey Immelt, job outsourcer and financial predator at GE, used to take two jets when he traveled so that he’d have a spare—and charged it back to GE’s shareholders.

Little Oligarchs, Big Oligarchs

We’re told that the Russians whose yachts have been seized include Alisher Usmanov, whose net worth is $20 billion, and Alexei Mordashov, whose wealth is described as “nearly” $30 billion. Compare that with Elon Musk, who’s worth nearly $300 billion, or Jeff Bezos at $202 billion. These guys are pikers.

Globally, in the US-led world financial order, billionaires have gained $5 trillion in wealth since the pandemic began. Think of our economic leadership as a “global endowment for oligarchy.” Oxfam reports that the ten richest men in the world (yes, they’re all men) own more wealth than the bottom 3.1 billion people (“six times more, in fact”). Oxfam also notes that “if the 10 richest men”—nine of whom live in the US—”lost 99.999% of their combined wealth, they would still be richer than 99% of the world.”

Now that’s oligarchy.

Making a Killing

No industry has taken more advantage of government-granted patent monopolies than Big Pharma. Even when its oligarchs misled the country into an opioid epidemic—one of the largest mass-casualty events in American history—they are able to escape criminal culpability for their actions.

Then came Covid-19. As Forbes reported in January, US billionaires held an estimated $3.5 trillion before the pandemic struck, a figure that reached nearly $5.3 trillion two years later. That’s $1.8 trillion in gains, divided among only twenty oligarchs. Musk led the pack, with Bezos in second place. The billionaires’ list is a cavalcade of monopolists and speculators whose wealth has been fueled by their government’s benign view of their predatory business practices.

Once the pandemic hit, Big Pharma’s oligarchs were able to parlay their political power into exclusive patent rights for Covid-19 vaccines. Moderna made $17.7 billion from its vaccine in 2021 and anticipates making $22 billion this year, from a formula developed with $2.5 billion in funding commitments from the US government. The money from these government-granted profits could vaccinate the entire world, but they’ve been used to enrich shareholders instead. That’s oligarchy.

Restoring the Balance

What can Americans do about their oligarchy? President Biden’s blueprint is a good place to start. A “dedicated task force to go after the crimes of American oligarchs” is an excellent place to start. It could address questions such as:

1. Why have nine American billionaires acquired more than $755 billion during the Covid pandemic, while so many other people struggled?

2. What role did government and central bank policy play in this enrichment?

3. What unethical or illegal actions, if any, were undertaken in amassing this wealth?

4. What effect will these levels of economic inequality have on social justice, political power, social mobility, and the rights of consumers and workers?

5. Is there any reason why this money should not be taxed at 99 or 100 percent?

Item #4 would not be unprecedented. It would revive a proposal from President Franklin D. Roosevelt for a “100 percent war supertax” on extremely high incomes and would echo the 94 percent top tax rate passed during World War II. (The top marginal tax rate stayed above 90 percent for the next two decades.)

We certainly face a World War-level emergency. Oxfam observes that “a 99% windfall tax on the COVID-19 wealth gains of the 10 richest men could pay for enough vaccines to vaccinate the entire world and fill financing gaps in climate measures, universal health and social protection, and efforts to address gender-based violence in over 80 countries, while still leaving these men $8bn better off than they were before the pandemic.”

I don’t hate these oligarchs. I see them.

If a “supertax” were levied against America’s oligarchs by the federal government, it would produce as much as $755 billion in revenue. That’s enough to pay for the original, ten-year “Build Back Better” proposal—twice.

To See, and to Act

It’s striking that the current debate about American democracy ignores its biggest antagonist: the oligarchs who have undermined the political process and drained the nation of its wealth. Restraining the oligarchs would help build true democracy. It would be good politics, too.

“We know from polling that (anti-oligarchical) policies and rhetoric like these are wildly popular,” writes Eleanor Eagan of the Revolving Door Project. “In our deeply divided country, anger at elite impunity and a desire to see it end are among the rare uniting forces that we have left.”

Not that we can expect an anti-oligarchical agenda from this government any time soon. Politicians know that America’s oligarchs, unlike Russia’s, have the ability to crush their careers at any time. But the rest of us are free to speak out and demand an end to oligarchical rule anywhere in the world. Our condemnation of other country’s oligarchs will ring hollow until we do.

Someone once asked me, “Why do you hate billionaires?” The answer is, I don’t. I’ve met a few, and they were always sociable enough (unless you worked for them). I don’t hate these oligarchs. I see them. As we build the anti-oligarchical movement here in the US, Noah Liebman’s handy browser add-on (for Firefox only) helps everyone see them. It replaces the word “billionaire” with “oligarch” on every web page, producing headlines like “Bloomberg’s Oligarch Index,” “Forbes’ Oligarchs 2021,” “Inside the Financial Holdings of Oligarch Betsy DeVos” … you get the idea.

Another headline now reads, “Oligarch investor Bill Ackman says Russia’s attack on Ukraine means World War III has ‘likely already started.'”  Maybe it has, or maybe it will start soon. The best way to prevent it is by eliminating all oligarchies, foreign or domestic, and replacing them with genuine democracy.


Our work is licensed under Creative Commons (CC BY-NC-ND 3.0). Feel free to republish and share widely.

RICHARD ESKOW

Richard (RJ) Eskow is a freelance writer. Much of his work can be found on eskow.substack.com. His weekly program, The Zero Hour, can be found on cable television, radio, Spotify, and podcast media. He is a senior advisor with Social Security Works.

Continue ReadingNow Let’s Do the American Oligarchs