Janine Jackson interviewed Lori Wallach about vaccine equity for the June 10, 2022, episode of CounterSpin. This is a lightly edited transcript.

Janine Jackson: The World Health Organization announced that nearly 15 million people have died as a direct or indirect result of the Covid-19 pandemic. That’s almost three times as many as officially reported. The information, the group said, doesn’t just illustrate the devastating impact of the pandemic, but also “the need for all countries to invest in more resilient health systems that can sustain essential health services during crises, including stronger health information systems.”

Well, surely that includes tests, treatments and vaccines, and there’s a role there for journalism in appropriately reporting the importance and the availability of these public health tools. In particular, there are Covid vaccines that seem to be effective, yet vast portions of the global population remain unvaccinated. What is standing in the way, put simply?

Our next guest has been working on that question. Lori Wallach has been decoding trade policy for decades. She’s now executive director at Rethink Trade. She joins us by phone. Welcome back to CounterSpin, Lori Wallach.

Lori Wallach: Thank you very much.

JJ: We hear night and noon about markets, about supply and demand. If there’s a need, suppliers will rush to fill it, and everybody’s going to be satisfied.

Well, there could hardly be a more obvious need than the need for Covid vaccines. So if you were trying to break down for people why so many people, in particular in the Global South, are still not vaccinated, what’s the deal? How do we explain it?

LW: The market does not work in the face of monopolies. And in the case of these medicines, a handful of now-billionaire pharmaceutical companies have monopoly control over these life-saving medicines.

Lori Wallach: “The issue at stake isn’t taking away someone’s creation or invention. It’s taking away the ability to control how much of it’s being made.”

So, for instance, we know by far the most effective vaccines are the mRNA vaccines, including the one developed using US government money by Moderna. And we know now there are new Moderna billionaires created by the profits of selling that, and Moderna has simply refused to license the information to have more production around the world so a greater volume of that vaccine could be produced.

And part of the obstacle is big pharma got inserted, into so-called free trade agreements, binding obligations on countries to maintain and enforce these monopolies, which are government-created monopoly licenses called patents, and other forms of intellectual property monopoly that literally have made it possible for a few very big companies to control supplies, control production, and have a situation where today less than 20% of people in developing countries are vaccinated.

JJ: I don’t want to overuse the word “perverse,” but it’s hard to see past it in this case. Even folks who believe that, you know, if you build a better mouse trap, you ought to get the profit from that, can see that this is not a system working in a way that it should for the public good.

So I guess I’m asking, what has been the pushback against this? Clearly, folks are aware that this protection of patents is slowing down and harming human life around the globe. And what have been the efforts to push back against it?

LW: I will discuss that, but I want to just say one thing, which is the issue at stake isn’t taking away someone’s creation or invention. It’s taking away the ability to control how much of it’s being made.
JJ: Yes.

LW: So these companies would get paid; they would get a licensing fee. They just wouldn’t be able to make it such that they can reduce supply and drive up prices. Or, in this instance, they don’t want to share the technological innovation of the mRNA platform, because they figure the next drug, they can also monopolize.

So if the many companies around the Global South that could be making these wonder drugs learn how to do it, the companies like Pfizer and Moderna theorize, then the next drug, if it’s for cancer, if it’s for whatever, they won’t be able to control. It is diabolical.

And so, in the face of that, there’s been a huge push in numerous countries to do three things. One: to get a temporary emergency waiver of the rules in the World Trade Organization that require every WTO signatory country to enforce those corporate pharma monopolies.

Number two: to have government technology transfer. The US government has authority, under statutes like the Defense Production Act—particularly with respect to the Moderna vaccine, which the US 100% paid for to have developed and then paid for all the doses of—the access to the information, the government could require, as a matter of national emergency, be licensed; they could make them do it, even if the WTO waiver weren’t done for worldwide access.

And then number three is sufficient funding, so that, though it is no substitute for countries being able to make their own, enough doses could be bought and shared around the world. And currently, on all three fronts, there’s been total failure.

And this very weekend, the WTO’s fight is coming to a head about whether or not the European Union, the United Kingdom and Switzerland will block the entire rest of the world, block it on behalf of big pharma. The US has taken a fairly constructive position in this, and yet it could be blocked, such that we go forward into another year of pandemic with a situation that means, not just are people going to die needlessly and have their livelihoods destroyed, but new variants are going to spring up. Anyplace around the world there is rampant outbreak of Covid is the place where new variants—it could come back to get people who are vaccinated for the current variants.

It’s shortsighted in every front, to say nothing of immoral.

JJ: Is there a fallacy at the heart of this? Can we ever retire the notion that if manufacturers don’t get exclusive intellectual property rights, that they will never be incentivized to do anything? You’ve already indicated that this is, in fact, public spending that has gone into the creation of some of these things.

But I still feel when you read media coverage, you get the idea that, you know, if we don’t incentivize these companies, they won’t do the research. And I just feel that’s like a hardy perennial fallacy that we see again and again in media, in terms of medical research and things like this.

LW: Well, the choice isn’t between no-return investment, or price-gouging and killing people. There is a happy medium, where of course people who’ve made genius inventions should be rewarded for their creativity and hard work. But having, for instance, the ability in the face of a pandemic to simply control medicines that mean people will live or people will die, the global economy will or will not collapse—this is an emergency circumstance, for which there was to be an emergency waiver.

Again, the companies were going to get paid, so it wasn’t whether or not they would lose all control of their inventions. But once the rich countries that could pay had paid, could people in the poor countries, who were never going to pay the same amount per dose because their governments couldn’t afford it, could they have access at a lower price? Could they have access, because there’d be a larger volume at any price?

In most of the developing world, it has been entirely impossible to get the cutting edge mRNA vaccines that are most effective. And right now with Paxlovid, the treatment that is the difference between Covid being a death sentence and Covid being something that will make you uncomfortable if you’re a high-risk person, or if you’re someone who hasn’t been vaccinated, Pfizer is only licensing production of that medicine in the poorest countries. So if you’re in a middle-income country, you simply can’t get it. It’s simply not available.

That is not a matter of reward or not reward. That is extreme greed, where you could have a reward and have people live. And that is why we need to replace our current IP system to have it more balanced, so that innovation is rewarded but medicine is available at prices that people, particularly in developing countries, can pay.

JJ: Let me just ask you, finally, if you are talking to journalists about who—you know, they’re going to cover the story, the issue. But are there avenues and questions they might ask that they’ve not been doing, that might shine a more helpful light on this?

LW: I think there’s been a lot of spin about what’s gone on. Here’s the reality: At the World Trade Organization in October 2020, South Africa and India proposed an emergency short-term waiver of all the intellectual property provisions necessary to be able to make these mRNA vaccines.

And it’s not just patents. It’s certain technology transfer of undisclosed information. It’s certain copyright provisions, it’s certain what’s called “industrial design exclusivities,” and it was for the duration, short term, of the pandemic, and it would’ve made an enormous difference in who would’ve lived and who would’ve died.

Newsweek (6/10/22)

And here we are, almost two years later, and this emergency waiver mechanism has not been usable. And the press has not really covered the whys about this. And, in fact, they keep reporting things that aren’t the case.

For instance, right now, the WTO has shifted from focusing on saving lives to saving its reputation. The director general of the WTO has put forward a rump tax supported only by the European Union, i.e., the key blocker of the actual needed removal of the IP barriers, and is trying to ramrod that into approval, to announce the WTO is relevant, and is locking countries, big developing countries, that have been having a role in this debate for two years, locking them in the hall. Literally won’t let them in the negotiating room.

It’s spinning up a storm of how “We’ve come to a compromise.” In fact, the text that’s now being discussed explicitly is not a waiver and does not get any of the IP barriers out of the way, and wouldn’t put a single more vaccine into access in the developing world.

And a lot of reporters keep calling it a waiver, when there isn’t one, right? Keep calling it a compromise, when there isn’t one, keep pretending that negotiations on the WTO’s IP barriers getting out of the way are still ongoing, when they’re not, and they’re not really holding accountable the pharmaceutical corporations, the European Union or the WTO staff.

Plus, the US has basically, in the last six months, not played a great hand, in that the US position has been any WTO deal can only be about vaccines, not about the treatments. And so the treatments, basically, under any circumstance under the US view being excluded from this potential ability to make more volume, mean that the US strategy, which is treat and test, test and treat, would not be available for most of the world.

And it’s just something that didn’t have to be. So what we see happening around the world is countries basically ready to escalate, and civil society activists as well. If you can’t use the legal procedures, then it’s time for direct action, ideally going around all of these limits, but if necessary to just ignore them. Basically direct action to get the meds made, and let the lawsuits fall later.

JJ: All right, then. We’re going to pick this up again in the future, but we’ll end it here for now.

We’ve been speaking with Lori Wallach. She’s executive director of Rethink Trade, online at RethinkTrade.org. Lori Wallach, thank you so much for joining us this week on CounterSpin.

LW: Thank you.

The post ‘A Handful of Billionaire Companies Have Monopoly Control Over Life-Saving Medicines’ appeared first on FAIR.

This post was originally published on FAIR.

Janine Jackson interviewed Steffie Woolhandler about Covid and health insurance for the June 10, 2022, episode of CounterSpin. This is a lightly edited transcript.

Physicians for a National Healthcare Program

Janine Jackson: We don’t generally do media criticism by counterfactual, but it seems fair to ask, given that we are told that insurance companies protect us, you pay into them for a reason, and that it’s about things happening to you that you don’t have control over: So how are insurers responding to a genuinely public health crisis like Covid-19?

You don’t have to be poor or Black or an immigrant to be affected by this, so it should be a genuine test.

Joining us now with an assessment is Steffie Woolhandler. She’s a physician and professor at City University of New York, and co-founder of Physicians for a National Health Program. She joins us now by phone.

Welcome back to CounterSpin, Steffie Woolhandler.

Steffie Woolhandler: My pleasure.

JJ: Like I say, we don’t generally talk about what media don’t do, but I have not seen, really, any coverage about the way that insurers are responding to a public health crisis. So I guess I would ask you, what would insurers have done, ideally, but then what’s actually happening.

Steffie Woolhandler: “Media failed to cover the figures that were there in plain sight, showing a massive increase in insurance companies overhead and profit.”

SW: The major insurers saw 2020 as a giant opportunity for profiteering. What had happened is they had been receiving a little more than half of their total revenues from the government, either the federal government through the Medicare program or combined federal and state through the Medicaid program. So our so-called private insurers were already largely publicly funded.

When the pandemic hit, believe it or not, the total cost of delivering healthcare fell dramatically. And that’s because so many people were afraid to go get elective surgery, afraid to see their doctors, so that the revenues of hospitals and doctors’ offices plummeted, the payments to doctors and hospitals plummeted. Even as some hospitals were swimming in Covid patients, they still saw their total revenues, for all disease categories, go way down.

Now, the insurance industry, meanwhile, had already collected the premiums from the government, and they never bothered to give any of it back. And apparently the federal and state governments never demanded any of it back, because by the end of the year, the largest insurers had seen huge jumps in their insurance overhead. That’s the money they received as premiums and never paid out to doctors and hospitals, massive increases in what is known as insurance overhead.

And they put virtually all of that into their pockets as profits; you can hide some of it by expanding, or something called “intercorporate transfers,” where they mush the money around within their own corporation between subsidiaries. But by and large, they just pocketed this money as high overhead.

And the thing that’s interesting from a media criticism point of view is that this was right there in plain sight when the official government figures for health spending were released in December. The official government figures showed huge increases in private insurance company overhead, and they showed that most of those increases came from the overhead they were getting from the federal and state government.

So what ended up happening is they just got a whole lot richer, and they turned around and have used that for high profits, for expansion, to take over more of the public Medicare and Medicaid programs. And there was essentially no coverage of it.

What happened when the government figures came out in December was much of the media covered the other finding, which was quite expected, which was government public health expenditures jumped in 2020. Of course they did. That was what was supposed to happen. But the media failed to cover the figures that were there in plain sight, showing a massive increase in insurance companies overhead and profit.

JJ: I feel like a dummy in looking at this, because we are in a moment where we are supposedly really seriously looking at healthcare, and health expenses in this country. And so I feel genuinely confused about why we have a system, or continue to have a system, that would do that, where we would be facing a genuine public health crisis and we would be seeing profiteering from the very people who we’re told, yes, you pay when you’re healthy, and that seems bad, but when you’re sick, that’s when you’ll be really grateful for it. And that seems like the opposite of what’s happening here.

SW: Well, when you go into a public health system, a public health insurance system, that is kind of what happened.

So before Medicare was privatized by the Medicare Advantage industry, we were all paying a lot of money into Medicare payroll taxes. Once you turned 65, you paid a premium, but then if you got sick, essentially all of that money was paid out to take care of sick people. Ninety-eight percent of all the money that goes into traditional Medicare comes out as payments to doctors or hospitals or drug companies. Only 2% ever went for Medicare’s overhead, pushing the papers around and keeping track of people.

But you have to look at the Medicare Advantage industry, which is taking over traditional Medicare, where year upon year they report overhead of 15%. So 15% of the total cost is being scraped off the top for the overhead and profits of Medicare Advantage industry.

And in 2020, they got an extra opportunity to make even larger profits. So the year before the pandemic, their overhead was about $1,800 per Medicare enrollee. I mean, already a huge amount of money. That’s $1,800 for every Medicare Advantage enrollee is just going for insurance overhead. Outrageous.

But during the pandemic, that overhead soared, and was more than $2,200 per enrollee in 2020. And what should have happened is that government should have said, “Wait, we paid for this, we’re calling it right back, using it for medical care or returning it to the taxpayers.” But, in fact, it was ignored, this giant leap in overhead, and just recently the Biden administration announced that he was going to actually increase the payments to the private Medicare Advantage Industry. He gave them an 8.5% increase this year.

So there’s lots of talk about, oh, what are we going to do about cost? What are we going to do about inflation? But no one is talking very much about what are we going to do with the private insurance industry taking over Medicare and Medicaid, and inflating the cost of care in those programs, which is exactly what we saw in 2020, which is right there in the national health expenditure accounts, the numbers the government released.

And no one wants to talk about it, because the private health insurance industry has this formidable lobbying force in every state and every congressional district. And they’re just getting a message across to Congress and the government: Don’t interfere with our profit-making.

Extra! (7-8/09)

JJ: And private insurers also play a big role in board membership in media organizations, which is a thing that FAIR has looked at, but it’s a very silent or stealthy influence, because it’s not made explicit. It’s just kind of guardrails; we can’t do this. You know, it might make sense. “Oh, oh no, no, no. Somehow, for some reason, we can’t take this common sense response, or this public health response, to what’s going on.” It’s very weird.

SW: It’s weird. And it’s a public health response and it’s also, if we’re going to fight costs and inflation, we have to look for unnecessary costs, and there it is sitting there, huge overhead and profits in these private insurance industries. They’re private in name only, since at this point, more than half of their funding is coming straight out of the taxpayers.

We ought to be looking at that and saying, “No, we cannot afford to waste 15% or more on private insurance industry overhead when the fully public, traditional Medicare program could do the same job for 2% overhead.”

JJ:  Absolutely.

Well, Steffie, we use you as an object lesson at FAIR. You might not know this, but years ago, there was a conversation on what was then called the MacNeil/Lehrer NewsHour, I guess, PBS NewsHour, in which we were talking about public healthcare and single payer and a response to public healthcare needs.

And you were one of four participants on a panel talking about actually publicly funding healthcare, and the host, which I’m guessing was Jim Lehrer, said, “Well, Miss Woolhandler, you’re in the minority here with your trying to argue for single payer,” or something like that. And you, because you had the presence of mind to do it, said, “Well, I’m only in the minority here because of the panel that you have selected,” you know?

And in fact, and this is what I’m bringing it round to, in fact, the US public has in mind  this frustration that we’re talking about, has an understanding that there is a better way to do this, and media, it’s not just what they hide, but they don’t actually fairly represent public opinion in terms of what the US public is interested in and needs in terms of healthcare.

SW: I think that’s true. I think the majority of American people hate the private health insurance industry, recognize that their business model is to get as much money from you as they can in premiums and pay out as little as they possibly can in healthcare. That’s not gonna be surprising to listeners that that’s the business model of private health insurance. Polls are still showing more than 60% of Americans support a single payer Medicare for all.

And, certainly, there are bills in Congress. The Sanders bill in the Senate was just reintroduced, the Jayapal bill in the House was just reintroduced. But the media coverage of it, the discussion of anger at private insurance companies, of the profiteering by private insurance companies, is really very minimal.

And I do think media can be doing a better job when data comes out, as came out in December, showing the extent of profiting the private insurance industry, covering that information, and not what in fact happened, was the only thing what was said was, “Oh, look, healthcare costs went up 10%. It’s all because of public health spending.” That’s not true.

There was public health spending and then there was insurance industry profiteering that caused health costs to go up so fast.

JJ: All right. We’ve been speaking with Steffie Woolhandler, physician, professor at CUNY and co-founder of Physicians for a National Health Program. Thank you so much, Steffie Woolhandler, for joining us this week on CounterSpin.

SW: Thanks for having me.

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