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Corporate Contributions to Health Organizations

Corporate Contributions to Health Organizations. Joshua Freeman, MD Left Forum, 2011. Outline. Corporate Influence on Medicine and Health Drug and device makers Insurance companies Conflict of interest Support for health organizations “Non-health related” Tobacco

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Corporate Contributions to Health Organizations

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  1. Corporate Contributions to Health Organizations Joshua Freeman, MD Left Forum, 2011

  2. Outline • Corporate Influence on Medicine and Health • Drug and device makers • Insurance companies • Conflict of interest • Support for health organizations • “Non-health related” • Tobacco • AAFP Case: “Anti-health” corporate support

  3. Health Insurance • Corporate profit taken out of the system • Administrative costs to garner the profit • Should there be insurance companies? • If so, should they be for-profit? • “Bribery” suggestion

  4. Drug and Device Makers • Drugs • High cost of drugs • Variable pricing in different markets • “Me-too” drugs • Devices • Create demand • Lack of interoperability • “Make the most irritating noise”

  5. Conflict of Interest • Direct payments to physicians: consultant, speaker fees • Funding research • Advertising funding medical journals • Heightened awareness • New rules in AHCs, Hospitals, Practices • Decrease in drug “paraphernalia”, samples

  6. Gifts to organizations • From “non-health-related” businesses • The AMA and Sunbeam, 1997 • Public outcry (unanticipated) • Now a Harvard Business School case study • AMA cancelled contract and Sunbeam sued • AMA paid $9.9 M settlement in 1998

  7. AMA Settles Sunbeam Fiasco,Sunbeam Sues the A.M.A. On Voided Marketing Deal

  8. Relationships with “Anti-Health” Corporations • Classic: Tobacco • Before and after “Doll and Hill”, 1950

  9. Doctors recommend cigarette smoking to help stuttering

  10. Modern “anti-health” relationships • “Food” and drink companies • High-calorie, high-fat, non-nutritive • Major contributors to the Obesity epidemic • Case: the American Academy of Family Physicians (AAFP) and Coca-Cola

  11. The American Academy of Family Physicians is partnering with consumer products companies to develop robust new programs and educational materials for consumers and medical professionals about making better choices with regard to nutrition, physicalactivity, emotional well-being, and other ways to achieve a balanced and healthy lifestyle

  12. Consumer Alliance Partnerships The American Academy of Family Physicians is partnering with consumer products companies to develop robust new programs and educational materials for consumers and medical professionals about making better choices with regard to nutrition, physical activity, emotional well-being, and other ways to achieve a balanced and healthy lifestyle.AAFP recognizes that consumer products companies can have significant influence over consumer health. That’s why the AAFP created its Consumer Alliance program, a strategy whereby the AAFP aims to partner with companies who demonstrate good corporate stewardship and a strategic focus on consumer health. FamilyDoctor.org, the AAFP’s award-winning consumer health and wellness resource, is the fundamental core of the AAFP Consumer Alliance. Through partnerships in the Consumer Alliance, AAFP will continue to expand educational content that focuses on healthy living to help consumers make informed decisions about nutrition, physical activity, emotional health and prevention of disease. Partners include:

  13. Ethical Issues • Howard Brody addresses justifications put forward by AAFP for the Coke relationship: • “Premature accusation” • “Wrong not to engage” • “Other party not evil” • Response by AAFP-President Heim • Annals of Family Medicine, Jul-Aug 2010

  14. Premature Accusation • Conflict of interest does not require demonstration of favoritism • Analogy to a judge • In the AAFPcase, if the final educational material includes a strong statementagainst sugary soft drinks, we will never know whether, absentthe Coca-Cola funding, the statement would have been even stronger.That such questions will inevitably be raised shows the conflictof interest is both present and serious, quite apart from theeventual contents of the educational materials”. • Is there a strong statement?

  15. Sugary drinks, including soft drinks, sports drinks and fruit drinks, are the number 1 source of added sugar in the American diet. A 12-ounce can of non-diet (regular) soda can contain 8 or more teaspoons of sugar and over 130 calories. That’s more sugar than the American Heart Association recommends for an average American woman in 1 day! Skip sugary drinks and choose water instead This content was developed with general underwriting support from The Coca-Cola Company http://familydoctor.org/online/famdocen/home/healthy/food/general-nutrition/1005.html

  16. Other “defenses” to ethical conflicts • “Wrong not to engage” • Arthur Schafer noted “…noted the propensity for engagementwith industry, in such discussions, magically to convert itselfinto accepting large sums of money from industry.” • “Other party not evil”: • The question is whether their interests may lie in opposition to the interests of the health of doctors’ patients • Non-polemical article • Heim article non-responsive

  17. But maybe they are evil…

  18. Other examples: the ADA • Not only doctors • Are dieticians more trustworthy? • “Partnership” with: • Hershey’ Chocolate! • Yum. I guess it is healthful!

  19. Press Release Hershey Teams Up With ADA Monday, July 19, 2010 American Dietetic Association and the Hershey Center for Health & Nutrition Join Forces to Educate Americans on Better, Balanced Eating

  20. Healthy Balanced Living About Consumer Consultations with RDs - Click here to learn about how consumers can receive a complimentary visit with an RD. About our Collaboration - Click here to find out more about the Hershey Center for Health & Nutrition's collaboration with the ADA. What RDs are Saying - Find out more about our recent survey of dietitians and their thoughts on chocolate's role in a balanced lifestyle. The Facts - Click to learn more about "Fitting Chocolate into Your Diet","Responsible Snacking" and "100 Calorie Portions" of your favorite candies.

  21. Conclusion • Parallel to national policy • Increase corporate influence (e.g., “Citizens United”) • Decrease alternative sources of funding (tax dollars) • Increase dependence on corporate “largesse” • Unwillingness to “tax” members (esp with recession) • Undermines trust (Brody on AAFP)

  22. Thank you. Joshua Freeman, MD jfreeman@kumc.edu www.medicinesocialjustice.blogspot.com

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