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This page created April 2000 by Michael Wynne
This page provides access to material about
multinational health care, the World Trade Organisation, the World
bank and individual countries outside the USA and Australia.
International Expansion of US
corporations
Many of the giant health care corporations in the USA have become
multinationals expanding into countries around the world. Hospital
Corporation of America (HCA), National Medical Enterprises (NME but
now renamed Tenet Healthcare), Columbia/HCA, Sun Healthcare,
Integrated Health Systems (IHS), Aetna and many others have developed
international empires. In the corporate marketplace growth is
critical for survival. Foreign countries provide opportunities for
expansion when the local US marketplace is limited. They are
particularly important for corporations in trouble in the USA as they
provide an important buffer to local financial problems, supporting
the bottom line. Corporations anticipating trouble move overseas
rapidly. Tenet/NME expanded rapidly overseas and 25% of its
opersations were outside the USA during its fraud investigation.
ColumbiaHCA's rush into Australia and Europe in February 1997 was too
late and it was blocked when the FBI raided its hospitals.
CLICK HERE -- for information about international expansion (NOT WRITTEN)
A rash of news articles:- Many if not most of those marketing healthcare across the world have persuaded themselves that their solutions to health care are enormously beneficial and the only way forward. They sell them enthusiastically. Marketing health solutions to politicians is big business and Modern Healthcare devoted a whole edition to this in 1997. The views expressed are hopelessly out of touch with the realities of health care. The benefits of a market driven system are considered to be unchallengeable. The manipulation of gullible and ill informed politicians for corporate purposes is seen as a perfectly legitimate practice.
I circulated the articles and wrote a covering page then later turned that into a www page. The page consists of an introduction, a section about the pressures on corporatised health care including the pope's criticism, and then comments about the articles.
CLICK HERE -- for the 1997 page about a rash of news articles
Advocates of marketplace systems often claim credibility of the basis that other governments have already adopted marketplace "reform" of their government run health systems. This is deceptive.
CLICK
HERE -- for some preliminary
information.
Health care corporations have been frustrated in their attempts to take over and dominate the health care systems of most countries outside the USA. Their own misconduct places them at a disadvantage in a venue where social issues and the welfare of citizens are relevant considerations.
US corporations acting through the powerful US Coalition of Service Industries have taken the initiative to outflank their critics in foreign countries. They have persuaded the US government to promote their case for including health care in international trade agreements which will guarantee them free access to the health care systems in all member countries. They are promoting their case before fellow corporate thinkers in a venue shielded from public scrutiny, one which uses paradigms of understanding congruent with their arguments. Because of this they are assured of the support of powerful groups in countries across the world. This poses a very serious threat to the health systems of these countries.
CLICK
HERE -- for more information about
health and the WTO
The world bank lends money to developing countries and health care is strongly supported. This money is clearly something which health care corporations might target. The world bank is in a position to dictate how some of its money will be spent and particularly the sort of health care system which it is prepared to fund.
In the face of modern economic theory and a staff of economists there are pressures to insist on privatisation and globalisation. In doing so the world bank creates potential markets for health care multinationals.
I became interested because Graeme Samuel chairman of Australia's National Competition Council gave a speech to a meeting of the world bank in February 2000. I found this particularly disturbing because of the nature of the arguments and the advice given to developing countries. It dutifully trotted out many of the rationalisations used to promote and justify a health care marketplace. It was by a highly credible source, and it expressed the economic arguments of which I was critical. It was entirely theoretical and simply ignored all the evidence available.
I wrote a strong criticism of the speech setting it against the facts of the marketplace and sent Samuel a copy asking for comment. He has not yet responded.
CLICK HERE -- to access the speech and my criticism.
Canada
This page contains a short summary of the attempts to privatise and corporatise health care in Canada and the revolt of citizens in Alberta. There are links to several www sites where authorative information can be obtained. This page links to an authorative review of the threat which the proposed changes pose to the Canadian health system and the care of Canadian citizens. It was written by Professor Donna Wilson from the University of Alberta. I am grateful to her for allowing me to include it on this www site.
CLICK HERE -- for information about the corporatisation of the Canadian Health System
New Zealand
New Zealand has been one of the leading countries in introducing market practices to its health care system. There has been ongoing criticisms and unhappiness in the system. A survey found that New Zealanders were more anxious about their prospects of receiving adequate care under their system than five other English speaking countries including the US. The health system was an important factor in bringing Labour to power in the recent elections. Labour have promised to radically alter the system and base it on cooperation and care before profit.
CLICK HERE -- for information about New Zealand (NOT WRITTEN - EMPTY PAGE)
The United Kingdom
Europe
Generale de Sante Internationale :- The largest health care corporation in Europe was the French group Generale de Sante Internationale (GSI) a wholly owned subsidiary of a large multinational group. There were serious concerns about its practices when it attempted to buy into Australia in 1995. Steps were taken to obtain information and use it in the interests of Australiabn ctitizens.
CLICK HERE -- for information about GSI's bid to enter Australia
Singapore
Singapore has two teaching hospitals and several major private hospitals. It is a specialist referral centre for the region and tourists from surrounding countries end here when they fall ill. Tenet/NME dominated the private sector until the end of 1995 when it sold to the Malaysian company Parkway Holdings, a company not tarnished by Tenet/NME's practices.
CLICK HERE -- for more information about Singapore
Other Countries