Nicholas Freudenberg on Corporations and Public Health

Every major industrial sector in the global economy is now controlled by no more than five transnational corporations.

In about a third of these sectors, a single company accounted for more than 40 percent of global sales. 

Now comes Nicholas Freudenberg, a Professor of Public Health at the City University of New York (CUNY).

He is out with a new book – At What Cost: Modern Capitalism and the Future of Health (Oxford University Press, 2021).

In it, Freudenberg confronts how globalization, financial speculation, monopolies, and control of science and technology have enhanced the ability of corporations and their allies to overwhelm influences of government, family, community, and faith.

Freudenberg says that corporations are in control of the six pillars of public health – food, healthcare, education, transportation, social connections, and work – and that this world created by corporate capitalism is simply not fit to solve our most serious public health problems.

“In epidemiology there is a saying – we have to understand the cause of the causes,” Freudenberg told Corporate Crime Reporter in an interview last week. “It’s getting to the fundamentals that allows us to make differences. Modern capitalism is the fundamental cause of so many of the world’s most serious health problems. If we are going to address those problems, we need to change the dynamics of that system. That’s what led me to the book.”

“The six pillars of health are the essentials that people need to maintain well being. The search for those six pillars of health has become much more challenging as a result of changes in 21st century capitalism. In fact, the majority of the population here in the United States struggles to get the food, health care, education, transportation, work, social connections that they need to sustain health.”  

“We need to connect people’s lived experiences with broader political and economic structures. I’m hoping that this framework will connect people working in different areas to link together the now mostly separate struggles to create a healthier, more equitable, more sustainable society.”

Many communities across the country have vibrant farmers’ markets, where the capitalists food producers go to market and sell their healthful goods. Exactly what you are calling for – the transformation of the system. In that case, the market is the solution, not the problem.

“I don’t equate markets with 21st century capitalism. There are a variety of solutions that include markets that would be fundamentally different from the current form of capitalism. That’s why I choose not to put a label on it.” 

“In the book, I describe the rise of the ultra processed food system, the food system controlled by a dozen or fifteen giant multinational food corporations that have, over the last thirty to forty years, transformed the diet both here in the United States and around the world to one where the majority of calories now come from food that is high in fat, salt and sugar with hundreds of additives – flavorings and preservatives. Scientific evidence shows that these are associated with diet related diseases like cardiovascular disease, certain forms of cancer, diabetes and hypertension. These are the dominant causes of premature death.”

“They chose this diet because it was more profitable. It was easier to ship around the world. They could use a limited number of crops like corn, soy, sugar and palm oil. They gained control of those foundational crops and then controlled the markets for the foods made from them.”

“For most Americans, including those who shop at the farmers markets, what you buy in the corporate market economy is primarily ultra processed foods. And that is especially true for low income people, who experience a much higher incidence of diet related disease.” 

“Farmers markets are part of the solution. Small and middle sized farmers are part of the solution. They might have their own businesses that look to make enough money to support themselves, their families and their communities. But I don’t believe a system controlled by a dozen global transnational corporations can ever feed the world in a way that sustains health and addresses our climate emergency.” 

“We will need a fundamentally different food economy. The question we should be asking is – what is the transition process from the food economy we have now that charges for food more at the hospital than at the supermarket. And what pieces already in place like farmers markets, like school food programs, could be part of a food economy that sustains health rather than undermines health.”

In food, the answer seems to be more grassroots movements – people growing their own food, farmers markets, food cooperatives. 

But in healthcare, you want to draw a circle and say – the market isn’t allowed here. The market has no place in health care. 

The Medicare for All bills in Congress would replace the for profit health insurance industry with one single public payer. The old HR 676 would prohibit for profit hospitals.

“We can see that many capitalist economies have figured a way to reduce the influence of capital on health. I would say there are so many intersections in our current system between big investors, capitalists and health care that we have a lot of work to do.” 

“In the book, I write about private equity firms buying up oncology centers. That’s just a stark example of what happens when capitalists can make a profit in the health care system. Amazon and Google are now getting into healthcare. What are going to be the rules of them getting into healthcare, where they can make a profit and how they can collect surveillance data from their various endeavors to target people inside and outside health care?” 

“In every sector it will be a little different. The process of making human well being rather than profit the priority is going to be a long struggle. It’s not an overnight transformation. We need to think about what it will take to design a system that puts human needs first.”

Why hasn’t there been a concerted national movement to challenge corporate power across all sectors of the economy?

“That is the challenge I’m trying to understand in this book. The proposal I put forward is for these various movements to develop a shared agenda and to begin to bring these now mostly separate struggles into a powerful movement.” 

“I suggest they organize around well being, because it is so connected to people’s day to day experiences. That’s one possible rubric to bring these different movements together and to develop a common agenda that would be as clear to the American people as the corporate agenda has become – lower taxes, deregulation and individual responsibility.”

[For the complete q/a format Interview with Nicholas Freudenberg, see 35 Corporate Crime Reporter 16(12), April 19, 2021, print edition only.] 

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