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General Electric and the
New York-Presbyterian Hospitalby Martin Donohoe
Health care has become increasingly corporatized in the United States, a phenomenon which has contributed to decreased access to care for the 45 million uninsured (and the millions more who are under-insured). Academic medical centers, where much of the nation’s health-related research is conducted and where new physicians and nurses are trained, have increasingly entered into corporate partnerships. These joint ventures promote secrecy in research (in order to turn out more patentable, i.e., profitable, medications and medical devices) and sometimes link educational institutions with companies possessing poor environmental and labor-relations records, and whose corporate practices have often harmed, rather than benefited, the public’s health.
Such is the case with the recent partnership between New York-Presbyterian Hospital (the organization that resulted from the merger of the hospitals of Cornell and Columbia Universities, and one of the largest academic medical conglomerates in the country) and General Electric (GE) Medical Systems, a medical products and services business with revenues of approximately $9 billion.[1]
Academic medical centers…have increasingly entered into corporate partnerships.
New York-Presbyterian, one of the dominant health care providers and educators in the state (indeed the nation), will spend a reported $500 million over 10 years on products and services from GE Medical Systems.[1] In exchange for purported discounts on medical supplies and the promise of enhanced technological standardization and simplification, New York-Presbyterian will no longer buy from competing vendors.[1] Aside from the possibility of GE’s financial incentives to not necessarily give disinterested advice regarding technology purchases, there are now increased incentives for the hospital to promote the use of expensive high-technology (read “highly reimbursable”) care, which may not necessarily be indicated, for its paying patients, while at the same time cutting basic services to those unable to afford them.[1] Ironically, this occurs in the setting of academic medical centers increasingly recruiting wealthy foreigners and opening luxury primary care practices, ventures fraught with scientific and ethical problems.[2,3]
The General Electric Empire
GE Medical Systems is a subsidiary of General Electric (GE), the world’s largest company by market share.[4] In 2003, GE had revenues of $134.2 billion, greater than the GDP of more than 2/3 of the member states of the United Nations.[4,5] In 2003, it’s net after-tax profits were $15.6 billion.[4,5]
GE is best known for its household appliances, lighting and medical equipment, plastics, and water treatment systems. It also produces jet engines and other military hardware; has built 91 nuclear power plants in 11 countries; operates coal-burning power plants, which release mercury, a neurological and reproductive toxin; operates a financial services group; and owns a $43 billion media empire including NBC, CNBC, MSNBC, Telemundo, and Universal Studios, among others.[4,6,7] It recently has been awarded an increasingly costly series of reconstruction contracts in Iraq and Afghanistan, and was number one in campaign contributions, among companies awarded such contracts, from 1990 to 2002.[5]
GE’s sordid history
It is tragically ironic that this partnership links the medical center with the subsidiary of a company possessing an abysmal record of practices harmful to the public’s health.[6] For instance, GE conducted unethical human irradiation experiments from the 1940s to the 1960s.[7] In one such experiment, 64 inmates at a prison in Walla Walla, Washington had their scrotums and testes irradiated to determine the effects of radiation on human reproductive organs.[7] While the inmates were warned about the risks of sterility and radiation burns, they were not apprised of the increased risk of testicular cancer. Other tests were conducted on the elderly and hospitalized patients. GE also intentionally released excessive radiation from its Hanford reactor in the 1980s, in order to see how far it would travel.[4,7] Such radiation may have contributed to a reported increase in hypothyroidism, thyroid cancer, and spontaneous abortions in the Pacific Northwest[8,9], although such links are controversial.[10,11]
With 78 Superfund sites nationwide (13 in NY), GE is America’s largest corporate polluter.[7,12,13] Between 1947 and 1977, two of its capacitor manufacturing plants dumped 1.3 million pounds of polychlorinated biphenyls (PCBs) into the Hudson River.[7,12,14] PCBs cause cancer in laboratory animals, are categorized as probable human carcinogens by the Environmental Protection Agency (EPA), and also adversely affect the liver, kidney, nervous, and reproductive organs. In 1983, the EPA classified 200 miles of the river as a Superfund site under the Superfund law, which authorizes the agency to order polluters to clean up their contamination. GE has been fined for contaminating groundwater in California, Florida, Kentucky, Massachusetts, New Jersey, Pennsylvania and Puerto Rico.[7] GE has spent millions of dollars to resist these court- and federal agency-ordered cleanups, including the Hudson cleanup, which is estimated to cost between $450 million and $500 million.[7,12,14]
With 78 Superfund sites nationwide (13 in NY), GE is America’s largest corporate polluter.
GE has eliminated 150,000 US jobs in the last 15 years.[15] Over the same period, it received billions of dollars in federal contracts and millions more in tax subsidies from state and local governments.[12] GE was one of the 15 US companies that outsourced the most US service jobs between 2001 and 2003.[16] Until 2001, GE was run by “Neutron” Jack Welch, who made it a matter of principle to lay off 10% of his workers per year.[4] Welch is also infamous for misleading government officials and the public about the dangers of PCBs, claiming at a 1998 shareholder meeting, “PCBs do not pose adverse health risks.”[7] Human Rights Watch has cited GE for “systematic workers’ rights violations” in the US and abroad.[17] From 1990–2001, the Occupational Safety and Health Administration cited GE for 858 workplace violations; at least 98 posed substantial probability of death or serious harm. GE continues to shift health care costs onto its workers, despite growing profits.
GE topped the 2002 Project on Government Oversight’s list of repeat offenders for defrauding US taxpayers, with 63 instances of actual or alleged misconduct (including environmental violations, governmental and consumer fraud, workplace safety violations, and employment discrimination) since 1990, resulting in more than $982 million in fines, judgments and out-of-court settlements.[5,7] Its financial division was fined $100 million for unfair debt collection practices and bankruptcy court malfeasance.[7] In the 1990s, GE was involved in so many cases of government fraud that the Pentagon’s Defense Contract Management Agency created a special investigations office specifically for the company.[5]
Recommendations
Given the breadth and depth of the harms to human health, the environment, and its own workers resulting from GE’s shameful legacy of corporate malfeasance, New York-Presbyterian should reconsider the partnership agreement. It is abhorrent to imagine GE profiting from New York-Presbyterian Hospital requiring that a patient’s developmental anomaly or environmentally-induced cancer (a result of exposure to GE toxins) be diagnosed by a GE scanner and treated with GE-manufactured therapeutic devices. This is a macabre twist on the concept of cradle-to-grave health care.[18]
Health care providers and patients should lobby against this unholy alliance. Local and national medical and ethical organizations should also condemn the venture, and throw their collective intellectual and moral weight behind measures designed to de-corporatize medicine, particularly in academic institutions where the next generation of healers learns how to protect the public’s health and to provide just and equitable health care.
Martin Donohoe is adjunct lecturer in Community Health at Portland State University and practices internal medicine with Kaiser Permanente. He serves on the Board of Directors of Oregon Physicians for Social Responsibility (PSR) and is Chief Scientific Advisor to Oregon PSR’s Campaign for Safe Foods.
Notes
1. Garber AM. Corporate treatment for the ills of academic medicine. N Engl J Med 2004;351(16):1601–3.
2. Donohoe MT. Luxury primary care, academic medical centers, and the erosion of science and professional ethics. J Gen Int Med 2004;19:90–94.
3. Donohoe MT. Retainer practice: Scientific issues, social justice, and ethical perspectives. American Medical Association Virtual Mentor 2004 (April);6(4). Available at http://www.ama-assn.org/ama/pub/category/12249.html
4. Focus on the Corporation. War profiteers: General Electric. CorpWatch 2004. Available at http://www.warprofiteers.com/article.php?list=type&type=16 Accessed 10/25/04.
5. The Center for Public Integrity. Windfalls of war: The General Electric Company (2004). Available at http://www.publicintegrity.org/wow/bio.aspx?act=pro&ddlC=23. Accessed 10/17/04.
6. Staff, Columbia Journalism Review. Who owns what: General Electric. Available at http://www.cjr.org/tools/owners/ge.asp?printerfriendly=yes. Accessed 10/17/04.
7. Staff. GE: Decades of misdeeds and wrongdoings. Multinational Monitor 2001 (July/August);22(7&8). Available at http://www.multinationalmonitor.org/mm2001/01july-august/julyaug01corp4.html. Accessed 12/29/05.
8. Grossman CH, Nussbaum RH, Nussbaum FD. Cancers among residents downwind of the Hanford, Washington, plutonium production site. Arch Env Hlth 2003;58(5):261–2.
9.Grossman CH, Morton WE, Nussbaum RH. Hypothyroidism and spontaneous abortions among Hanford, Washington, downwinders. Arch Env Hlth 1996;51(3):175–6.
10. Robbins J, Schneider AB. Thyroid cancer following exposure to radioactive iodine. Reviews in Endocrine and Metabolic Disorders 2000;1(3):197–203.
11. Davis S, Kopecky KJ, Hamilton TE, Onstad L. Thyroid neoplasia, autoimmune thyroiditis, and hypothyroidism in persons exposed to iodine 131 from the Hanford nuclear site. JAMA 2004;292(21):2600–13.
12. Staff, Riverkeeper. GE PCB’s: The Facts — GE’s Strategy. 2004. Available at http://www.riverkeeper.org/campaign.php/ge_pcbs/the_facts. Accessed 10/25/04.
13. Staff, GE Workers United. GE Superfund sites. 2004. Available at http://www.geworkersunited.org/safety/superfund.asp. Accessed 10/17/04.
14. Pollak R. Is GE mightier than the Hudson? The Nation 2001 (May 28). Available at http://www.thenation.com/docprint.mhtml?i=20010528&s=pollak. Accessed 10/17/04.
15. Staff, GE Workers United. GE pension fund story: Workers pay, GE benefits. 2004 (April 14). Available at http://www.geworkersunited.org/pensions/index.asp?ID=61. Accessed 10/25/04.
16. Staff. Outsourcing rewards. Multinational Monitor 2004 (September):4.
17. Staff, Sweatshop Watch. NAFTA labor accord ineffective — future trade pacts must avoid pitfalls. 2001 (April 16). Available at http://www.sweatshopwatch.org/swatch/headlines/2001/nafta_apr01.html. Accessed 10/25/04.
18. Regrettably, the GE-New York-Presbyterian deal may be the first of many, as GE recently announced a similar alliance with Virtua Health Care. See Virtua Health and GE Healthcare form a strategic alliance to deliver new generation of healthcare. 2004 (February 20). Available at http://www.virtua.org/page.cfm?id=PTexperience_showstory&articleID=6. Accessed 4/8/05.
[14 mar 07]