Duty to Warn: How Big Business Runs the Healthcare Industry

By Gary G. Kohls, MD

PART ONE—In this two-part series, Dr. Kohls explores how the intersection of big business and the pharmaceutical, vaccine and medical device corporations have come to rule the healthcare industry. Part two of the series will appear in the November issue of WestView.

“Corporations should not be involved in any aspect of the democratic process. They should not be involved in education at any level. They should not be involved in healthcare. They should not be involved in the administration of social services. They should not be involved in the administration of justice. WHY? Because they are incapable of understanding and conforming to higher human aspirations and needs. Better to leave these areas to government, and to non-profit organizations, both of which are administered by humans in the human interest… The corporation is sociopathic in its disregard for human goals and values; in fact, its behavior fits the World Health Organization’s criteria for defining the psychopath.” – Wade Rowland, Author of Greed, Inc. Why Corporations Rule the World

I have a heavily-underlined book in my library that was written in 1995 by David C. Korten, titled When Corporations Rule the World. Around the time that the book was published, I was a small-town family practitioner still trying mightily to follow the Hippocratic Oath, which I took back in 1968. I was also still trying to honor my patient’s inalienable right to be fully informed about the risks and benefits of any drug I was considering prescribing before he or she consented to the prescription. It was time-consuming to follow those ethical principles.

Korten followed up with a sequel in 1999, titled The Post-Corporate World. Here is an excerpt that nicely summarizes what he was warning his readers about:

“’When Corporations Rule the World’ told the new story as I had come to understand it: “Our relentless pursuit of economic growth is accelerating the break-down of the planet’s life support systems, intensifying resource competition, widening the gap between rich and poor, and undermining the values and relationships of family and community. The growing concentration of power in global corporations and financial institutions is stripping governments—democratic and otherwise—of their ability to set economic, social, and environmental priorities in the larger common interest.

“Driven by a single-minded dedication to generating ever greater profits for the benefit of their investors, global corporations and financial institutions have turned their economic power into political power. They now dominate the decision processes of governments and are rewriting the rules of world commerce through international trade and investment agreements to allow themselves to expand their profits without regard to the social and environmental consequences borne by the larger society. Continuing with business as usual will almost certainly lead to economic, social, and environmental collapse.

“To a considerable extent, the problem originates with the United States. Its representatives are the primary marketeers of the false promises of consumerism and the foremost advocates of the market deregulation, free trade, and privatization policies that are advancing the global consolidation of corporate power and the corresponding corruption of democratic institutions.

“Resolving the crisis depends on civil societies, mobilizing to reclaim the power that corporations and global financial markets have usurped. Our best hope for the future lies with locally owned and managed economies that rely predominantly on local resources to meet the livelihood needs of their members in ways that maintain a balance with the earth. Such a shift in institutional structures and priorities may open the way to eliminating deprivation and extreme inequality from the human experience. Instituting true citizen democracy and releasing presently unrealized potential for individual and collective growth and creativity.”

In 2005, Wade Rowland wrote a book titled Greed, Inc. Why Corporations Rule our World. Other similarly-themed books on my library shelves that warned about the evils of global capitalism include Antony Sutton’s Wall Street and the Rise of Hitler (1976) and William Greider’s Who Will Tell the People: The Betrayal of American Democracy (1992).

I am saddened to admit that I was late in understanding that what these authors were warning their readers about: the evils of global capitalism also applies to the medical, psychiatric, pediatric, family practice, pharmaceutical, vaccine, medical device industries, and beyond, each of which once was physician-controlled and therefore altruistically adhered to the “first do no harm” oath—the Hippocratic Oath pledge that all physicians take when they graduate from medical school. Times have changed, and not for the betterment of either our profession or our patients.

Three decades into my practice of medicine (about the time that Korten wrote his book), my small rural northern Minnesota family practice clinic was acquired by a regional hospital that was also acquiring other clinics in the area. Over the years, the acquiring group turned into a consortium of clinics and hospitals that eventually became Essentia Health of Duluth, Minnesota.

Essentia would eventually become a medical corporate power-house with scores of locations in Minnesota, Wisconsin, North Dakota, and even Idaho.

Today, Essentia competes on its western border with an even larger corporate power-house, Dakota-based Sanford Health, the largest employer in North and South Dakota. Sanford is larger than Essentia in that it owns 45 hospitals and 289 clinics in nine states and three countries. It has over 28,000 employees, including over 1,300 physicians in more than 80 specialty areas of medicine. It monopolizes the practice of medicine in many of the states where it has hospitals.

Just before my small clinic was acquired by the corporate entity that was to become Essentia Health, I was still trying hard to honor the Hippocratic Oath and the Principle of Informed Consent, but my clinic’s business manager couldn’t help but complain about my spending “too much time” with each patient. (And my family was also understandably complaining about how late I arrived home after finishing my charting.) My patients didn’t complain, however, and that was what counted to me. But, partially because of the increasing pressure to conform to a business-oriented drive for increased “efficiency” and “productivity” (meaning spending less time with each patient and therefore making more money), I chose to leave that practice before the acquisition occurred. I don’t think that I would have tolerated working for a corporation.

But Essentia is no different in its corporate structure or methods than any other giant, for-profit medical corporation. The nature of all corporations is to grow, decrease the cost of doing business, resist unionization of its employees, and overcome the competition—actually trying to become a monopoly in their area of business.

Essentia’s website claims it is an “an integrated health system… combin[ing] the strengths and talents of 14,700 employees, including more than 1,900 physicians and advanced practitioners, who serve our patients and communities through the mission of being called to make a healthy difference in people’s lives… which includes many Catholic facilities [and] is guided by the values of Quality, Hospitality, Respect, Joy, Justice, Stewardship, and Teamwork.”

It hadn’t been many years after my graduation from the University of Minnesota Medical School that I became uncomfortable with the politics of the American Medical Association and even my Minnesota Academy of Family Practice, which, despite their flowery proclamations of being highly ethical organizations where the patient came first—I later came to understand were mainly lobbying groups for whatever legislation or new technology was considered profitable for the industry.

But it took me awhile before I became aware of how much Big Pharma corporations were in control of the medical profession. I guess my first clue was the prevalence of the salesmen and saleswomen (we called them “drug reps”) from every conceivable pharmaceutical or medical device company that was targeting me to prescribe their latest, patent-protected and therefore most expensive drug or product.

The drug reps always managed to act very friendly—as do all successful salespersons—to all the clinic staff members. The reps were always well-dressed, attractive, and always came bearing gifts of food and free drug samples as an incentive for me to hand them out to some of my patients, who would then be expected to come back for a follow-up office visit and a potential prescription for life, which the patient would hopefully (for the drug company) be perpetually refilling. I later tumbled to the fact that the drug rep would be getting a cut of the profits for as long as the patient continued to take the drug, which explained the enthusiasm of the reps. The best drug reps made better money than most of the physician-targets that they were seducing to prescribe their corporation’s drugs. Of course, the CEOs were making tens of millions of dollars off the same sales, and I was contributing to their schemes.

The drug rep would also often leave me with official-looking medical journal articles that supposedly provided “evidence” of the wonders of the new drug. Of course, I rarely had the time to actually read the hand-outs with any thoroughness or skepticism. It was only much later that I discovered that many of these articles were ghost-written by paid writers from Big Pharma and/or published in obscure journals that were often illegitimate or even non-existent.

I could tell a hundred similar stories about the cunning of the huge multinational medical/pharmaceutical/vaccine corporations that “rule the healthcare world,” and that would explain why I have lost any pride that I once had in my once honorable profession and now am embarrassed by my profession’s gradual acquiescence to greedy global corporations that meet the definition of sociopathic entities. The spokespersons for Big Pharma and Big Vaccine can’t help being serial liars when they try to sell physicians on the so-called “benefits” of their unaffordable patented and over-prescribed products that are so heavily advertised on TV that patients come in demanding to have the newest relatively untested drug or vaccine or other product prescribed for them—as long as they don’t have to pay for it out of pocket.

Dr. Kohls is a retired family physician from Duluth, MN. Since his retirement from his holistic mental health practice, he has been writing his weekly Duty to Warn column for the Duluth Reader, northeast Minnesota’s alternative newsweekly magazine.

Leave a Reply