4 February 1999
Mr A Hinton
Foreign Investment and Review Board (FIRB)
The Treasury Building
Dear Mr Hinton,
Entry to Australia:- I have been informed that this company is snooping around Australia looking for opportunities. I am aware that FIRB does not make any public announcements about companies applying to enter Australia, and that following Sun's experience multinationals will not disclose their plans to enter Australia until they have received FIRB approval via the deputy treasurer. Citizens with information which indicates that a corporation is a threat to our society are not given an opportunity to contribute to the "public good". The confidentiality interests of corporations have priority over the less important interests of citizens and their democratic right to involvement in the affairs of the country.
Aetna:- Aetna has been one of the most ruthless, aggressive and inhuman of the managed care companies, denying or restricting care, and using incentives and "fines" to secure the compliance of doctors in these cruel practices. Corporate interests do not use the words bribe or punishment but talk of "incentives". Aetna currently faces an action by the government in Texas, charging it with dealing illegally with the medical profession.
These aberrant practices have made it very successful. Through takeovers and mergers it has become the largest and most "successful" managed care group in the USA. In this it is similar to Tenet/NME, Columbia/HCA and Sun Health care. The success of all these companies is based on their aggressive business practices, their disregard for humanitarian considerations, their lack of ethics and their willingness to stretch the law beyond its elastic limits.
Objection to Aetna:- I write to you to object to Aetna's entry into Australia. I have not specifically collected material about Aetna but have nevertheless seen a large number of reports about this company and am in a position to supply you with some of this information if this is required. I can also secure additional material.
Managed care corporations:- I have a great deal of information about corporate health care and the conduct of managed care corporations. The managed system in the USA is now under considerable pressure. Managed care groups have been caught between the pressures of a government steadily reducing the medicare funding they receive and a population which is angry and responding very aggressively to what these managed care companies have done to health care. Like Sun Healthcare these companies have denied or reduced care to feed profit. The resultant outcry has forced a corporate influenced congress to accept the necessity of legislation to protect ordinary citizens from these managed care predators. This legislation has been delayed by the Zippergate Affair. Most Americans want it back on the legislative agenda as rapidly as possible.
Changing managed care:- One of the consequences of this backlash against managed care has been that citizens and their employers who often fund their managed care have shifted away from the sort of managed care which Aetna provides, towards a more open system with more choice. This is less responsive to the sort of pressures on care which Aetna has used to build its wealth.
International flight:- The consequence of all these pressures in the USA is that managed care groups are seeking international opportunities. They are selling their wares to any ignorant politician whose political pain when faced by problems in the health system is such that he or she can be manipulated into a corporate solution. Aetna, like Columbia/HCA has used its credibility as the largest managed care provider in the USA as a means of persuading doubters.
Corporate conference targets our region:- I believe that there was very recently a conference in Canada attended by corporate health care interests from around the pacific rim. The thrust of the conference was not how to address the problems revealed in managed care, but how to market the system around the world in the face of the adverse publicity it is receiving in the USA. As the thinkers of our time like John Ralston Saul and Robert Kuttner have indicated, the corporate ego and the corporate conviction is such that they never doubt the validity of their beliefs. Evidence and reason have no impact. Sun Healthcare's chairman is a typical example.
Globalisation and FIRB:- You may have listened to the interesting lecture on globalisation by the Canadian John Ralston Saul on 2 February 99 (ABC television). It gave plenty of food for thought. Saul is one of the great thinkers of our times.
I note that the Canadian health care researcher Colleen Fuller suggests in her 1998 book "Caring for Profit" that in the rush to globalise governments have entered into agreements with one another to allow multinationals almost unlimited access to the countries involved. Because of the domination of the US in these agreements health care would undoubtedly be included without any thought to the consequences. The US would have insisted on this. Saul in his Australian speech indicated that globalisation was being rushed into without any consideration of the many consequences and that there was no national or international regulatory structure to protect the "common good".
Government agreements:- It may well be that our government has entered into agreements like this and in doing so effectively neutralised those structures in society which protect citizens - including FIRB and the various licensing authorities. Politicians may have given a commitment to support foreign corporate entities. If this were so then it would explain many of the inappropriate actions taken by apparently reasonable people, and the unwillingness of our politicians to act in the interests of our citizens when multinational corporations are involved. This is most apparent in the inactivity surrounding Sun's case. A probity check in Victoria has found the company sadly wanting. Its departure is long overdue.
FIRB's obligations:- I believe that if the FIRB's effectiveness is constrained by international agreements then the FIRB has an obligation to draw these matters and its impotence to the attention of the government. If steps are not taken to address the problems then FIRB should speak out. Members should resign indicating publicly the reasons why they can no longer be party to an ineffective process which no longer protects citizens..