Bringing Bad Things to Life

Bringing Bad Things to Life The alliance between GE Medical Systems and NY-Presbyterian Hospital Martin Donohoe

The Partners • NY-Presbyterian Hospital • One of the largest academic health care institutions in the U.S. • GE Medical Systems • Subsidiary of General Electric • $9 billion annual revenues

The Agreement (2003) • 10-year, $500 million agreement requires NYP to purchase products and services from GEMS in exchange for purported discounts on medical supplies and the promise of enhanced technological standardization and simplification

General Electric • Previously ranked by Forbes as world’s largest company (based on equal weighting of sales, profits, assets, and market value) • 2015 revenues of $117 billion • Close to the GDP of more than 2/3 of U.N. member states • 2015 net after-tax profits of $15.9 billion • Majority from overseas operations

General Electric 2018 revenue $122 billion; net $22.8 billion loss Shares fell 45% in 2017, another 35% in 2018

General Electric • Household appliances, lighting, and medical equipment • Plastics division, which produced bisphenol A, spun off in 2008 • Appliances division sold to China’s Haier Corporation (2018) • Agrees to sell its lighting division to American Industrial Partners (2018) • Exited railroad business [GE Transportation] (2018)

GE’s History • Charles Wilson (CEO of GE pre- and post-WW II; helped oversee U.S. military production during WW II): • “The revulsion against war…will be an almost insuperable obstacle for us to overcome. For that reason, I am convinced that we must begin now to set the machinery in motion for a permanent wartime economy.”

General Electric • Produces jet engines and military hardware • Manufactures advance surveillance technologies • Has built 91 nuclear power plants in 11 countries (including the troubled Fukushima Daishi plants in Japan) • Including 23 plants at 11 sites in U.S. • e.g., Hanford • ¼ of GE’s US reactors found to be defective

General Electric • Operates coal-burning power plants • Major releasers of toxic mercury • Number 2 corporation in oil-field services industry after joining forces with Baker Hughes (2016) • Produces nearly 40 technologies used in fracking • Increasing investments in fracking

General Electric • Operates a large financial services group • Was responsible for over 50% of company’s profits in early 2000s • 2015-2017: company sells off majority of GE Capital (now Synchrony Financial) • Under investigation by the Justice Department for over potential bankruptcy violations

General Electric • Until recently, owned 49% of a multi-billion dollar media empire • Including NBC, Telemundo, and Universal Studios • Comcast owned 51%; bought out GE in 2013

GE’s History • Conducted unethical human subject experiments on prisoners, involving testicular irradiation, from 1940s to 1960s • Intentionally-released excessive radiation from its Hanford, WA nuclear reactor in the 1980s, to determine how far it would travel • May have contributed to increased thyroid cancers, hypothyroidism, and spontaneous abortions in “Downwinders”

GE’s Record • Sued radiologist who brought to light dangers of GE’s contrast agent, Omniscan • Causes nephrogenic systemic fibrosis (FDA black box warning) • Gadolinium (heavy metal) may cause brain damage, probably not Parkinson’s Disease (remains in body for months to years) • Ordered to pay $11.4 million to BraccoDiagnositcs for falsely/misleadingly claiming that its x-ray contrast agent Visipaque was superior to BD’s Isovue

GE’s Record 2013: Recalls multiple nuclear medicine imaging systems due to mechanical problem that could cause serious injury or death 2015: Pays $2.25 million civil penalty for potentially releasing unsafe levels of air pollution (including carcinogens) from hazardous waste incinerator in Waterford, CT (falsified pollution control records)

GE’s Record • America’s largest corporate polluter • 116 Superfund sites nationwide • Approximately 13 in NY

GE’s Record • Between 1947 and 1977, two of its capacitor manufacturing plants dumped at least 1.3 million pounds of PCBs into the Hudson River • Probable human carcinogens with adverse effects on liver, kidney, nervous system, and reproductive organs (EPA) • 200 mi of Hudson Superfund site • Similar to GE’s contamination of Housatonic River (Pittsfield, MA) – cleanup still ongoing

GE’s Record • Spent millions to avoid Hudson cleanup and to weaken or eliminate Superfund Law • 2010: Cleanup begins • 2016: Cleanup completed (cost $1.6 billion to remove 310,000 lbs PCBs/2.5 million cubic yards of material) • 2016: NY State Environmental Commissioner calls cleanup inadequate • 2017: EPA to complete review

GE’s Record • Contributes to corporate front groups • Promulgate an anti-scientific and pseudo-scientific agenda • Conduct media disinformation campaigns in an attempt to weaken health and environmental regulations

GE’s Record • Tremendous influence of environmental, energy, and health policy • Spent $22 million on lobbying in 2015; $5.8 million in 2018 • More than $200 million between 2005 and 2015 • Many members of board of directors have government ties; others have insurance and pharmaceutical industry ties

GE’s Record • Eliminated 150,000 jobs in the U.S. between 1989 and 2004 • While receiving billions in federal contracts and millions in state and local subsidies • Eliminated 34,000 US jobs between 2000 and 2010 • Added 25,000 overseas jobs over same period

GE’s Record • One of nation’s top outsourcers of jobs • 1/5 of U.S. workforce eliminated since 2002 (while overseas workforce increased) • Percentage of total employees in U.S. • 1995 – 68% • 2005 – 51% • 2015 – 38% • Currently employs 300,000 (2018)

GE’s Record • Executive pension plan far more generous than for other employees • Continues to shift health care costs onto workers, despite growing profits

GE’s Record • Cited by Human Rights Watch for “systematic workers’ rights violations” in the U.S. and abroad • 858 OSHA workplace citations from 1990-2001 • Investments include for-profit prison enterprises

GE’s Record • GE has sponsored PGA Masters Tournament at Augusta National Golf Club • Club excludes women • Former CEO Immelt a member

GE’s Record • Topped 2002 Project on Government Oversight’s list of repeat offenders for defrauding U.S. taxpayers • Paid more than $982 million in fines, judgments, and out-of-court settlements between 1990 and 2002 • Financial services division fined $100 million for unfair debt collection practices and bankruptcy court malfeasance

GE and Corporate Taxes • GE topped the list of corporate tax break recipients from 2001-2003: • $9.5 billion in tax breaks • Between 2001 and 2010, paid only 2.3% of its $81 billion profits in federal taxes • Claimed tax benefits of $3.5 billion in 2010 • Under investigation for tax evasion in Brazil • Tax department has almost 1,000 employees (known as the “world’s best tax law firm”)

GE’s Record • In 1990s, Pentagon’s Defense Contract Management Agency created special investigations office specifically for GE • Nevertheless, company has been awarded increasingly costly reconstruction contracts in Iraq and Afghanistan

GE’s Record • The Patient Channel • Shown in hospital rooms throughout country • Advertising vehicle for drug companies • Criticized by JCAHO for manipulative marketing practices

GE’s Record Produces an electronic medical record, Centricity EMR Is hoping to receive some of the $19 billion earmarked for health care information technology in the current economic stimulus package.

Former CEO Jack Welch (1981-2001) Aka “Neutron Jack Welch” Rules for success: “Number one, cash is king... number two, communicate... number three, buy or bury the competition.” Named “Manager of the Century” by Forbes Magazine (1999) Recently launched an online MBA program, named after himself, at Strayer University (for-profit educational company)

Former GE CEO Jeffrey Immelt(2001-2017) 2016 total compensation = $33 million Named “World’s Best CEO” in 3 separate Barron’s polls 2006 - 2011 - On Board of NY Federal Reserve Bank

Former GE CEO Jeffrey Immelt • 2008 – Named one of the “100 Most Influential People in the World” by TIME Magazine • 2009 - Appointed by President Obama to his Economic Recovery Board • GE then became eligible, via a loophole, for ¼ of the $340 billion Temporary Liquidity Guarantee Program (debt support)

Former GE CEO Jeffrey Immelt 2011 - Appointed by Obama as Chair of his outside panel of Economic Advisors and of his Council on Jobs and Competitiveness Served on CEO committees for both Obama and Trump

Former GE CEO Jeffrey Immelt Charitable works include membership on the board of directors of “The Robin Hood Foundation”! 2016: Immelt steps down (and given $211 million severance package)

Former CEO John Flannery (2017- 18) 2017 compensation = $9 million Focused on health care, power, and aviation Signaled a willingness to consider an outright breakup of the company 2018: H Lawrence Culp appointed CEO

GE’s Record Named “America’s Most Admired Company” by Forbes Named one of the “World’s Most Respected Companies” in polls conducted by Barron’s and The Financial Times GE worst performing stock in the Dow during Immelt’s reign

GE’s Record Company has lost over $100 billion in market value since November, 2016 Lost ½ its value in 2017, another 25% in 2018 Removed from Dow Jones Industrial Average (2018)

Concerns About the Agreement • Provides GE with financial incentives to promote high technology purchases • Hospital prohibited from purchasing more effective equipment from other companies

Concerns About the Agreement • Augments trend in academic medical centers to promote the use of expensive, high-technology care at expense of preventive care and public health measures • Highly reimbursable • Services may be redundant in certain locations

Concerns About the Agreement • Occurs at time 41 million Americans uninsured • Academic medical centers promoting luxury primary care clinics and seeking wealthy overseas patients while cutting back on services to the un- and under-insured

Concerns About the Agreement • Academic medical centers becoming increasingly corporatized • Research exclusivity contracts • Secrecy • gag clauses • Skewing of research agenda

GE’s Record • Signed licensing agreement with Cornell Medical School in 2001 re CT scan technologies to screen for lung cancer • Cornell Research Foundation funding primarily from the Vector Group (parent company = Liggett = tobacco company) • Antonio Gotto (Cornell Medical School Dean) and Arthur Mahon (Vice Chairman of College Board of Overseers) on Foundation’s Board of Directors

GE’s Record • Dean Gotto stated Cornell publicly disclosed the Vector Group’s role in funding the Foundation • However, searches via google and Cornell’s own search engine turn up no such disclosure, and Cornell’s press office did not respond to inquiry re the original disclosure • Foundation funded EL-CAP study (NEJM), which concluded that screening asymptomatic smokers for lung cancer can detect curable tumors • Controversial finding, contradicted by other studies

GE’s Record • Vector Group/Liggett’s role as funding source not mentioned in original article, in violation of conflict of interest disclosure policy • Patents and royalties from GE technology not noted either • Large profit potentials for GE (increased screening) and Liggett (reassured smokers less likely to quit) • For references, see http://phsj.org/wp-content/uploads/2008/05/elcap-vector-cornell-coi-bioethics-listserv-posts-4-08.doc

Concerns About the Agreement • I contacted the CEO of New York Presbyterian Hospital, the Dean, and the head of the Ethics Department to obtain more information re the agreement and the nature of the discussion preceding the agreement • No Response

Concerns About the Agreement • Patients with developmental anomalies and cancers caused by GE’s pollution diagnosed with GE scanners and treated with GE-manufactured therapeutic devices, increasing GE’s profit

A macabre twist on “cradle to grave care”

Reference • Donohoe MT, Robinson C. Corporations and Public Health: Overview and Case Study of GE Healthcare - "Most Admired Company" or Foe of Public Health. Social Medicine 2010;5(4):237-244. Availableathttp://www.socialmedicine.info/index.php/socialmedicine/article/view/482/1035.

Contact Information Public Health and Social Justice Website http://www.phsj.org martindonohoe@phsj.org

Bringing Bad Things to Life