Remember Mitt Romney’s famous (or infamous) rejoinder to a heckler’s taunt on the campaign trail? Corporations are people! No matter how corporate personhood was explained as a legal concept, the idea was ridiculed by liberal pundits and most of the media. The gaffe even contributed to Romney’s eventual defeat in November 2012.
Not much has changed. Many of us still believe that corporations are soulless entities dedicated sole-ly to maximizing stockholder return. (We in pharma are quite familiar with this aspersion.) Writing recently in his New York Times Magazine column, The Ethicist, Kwame Appiah suggested that although corporations have practices, they have no moral character — good or bad. Only the managers of a corporation or a business have character.
I disagree. I can’t think of a public company today that doesn’t have a statement of values. For many years, Google swore by “Don’t Be Evil,” eventually dropping this motto for more positive language. But Appiah has a point — just because an organization draws up a list of values doesn’t mean it will act on them. But let’s look at Romney’s statement again as a suggestion.
Suppose corporations began acting as if they were people and demonstrated a willingness to take responsibility for their actions and a sense of obligation to fulfill their mission. And suppose the primary obligation was first toward helping others, with old bromides of preserving shareholder value and maximizing growth consigned to second place. What might this look like?
It might have a bright red logo. Shawn Tully recently wrote a provocative article in Fortune: “CVS wants to make your drugstore your doctor.”
Although the headline was a huge overstatement and probably intended to scare the pants off everyone in the healthcare business, it does make a point. As Tully makes clear, CVS, with its $70 billion acquisition of Aetna — along with a host of other initiatives such as “Recovery in a Box” and “HealthHUB” — intends not just to transform the way healthcare is delivered in the U.S., but to make it even better. Their idea is to get insurers, HMOs and even the government to pay CVS to keep people healthy.
If we are to believe CVS, corporations may soon be able to provide the care that everyone wants and deserves. We might be able to help.
What makes CVS’ initiative to escape the pharmacy and become a provider of primary and secondary care so important is the coming presidential campaign. In the coming year, we’re going to be inundated with arguments that only massive federal action can ensure that our system is both affordable and equitable. Every Democratic candidate will have his or her plan to socialize the system, perhaps with the exception of Joe Biden.
I don’t like the sound of this and I bet you don’t either. For whatever good the Affordable Care Act might have done, it also created a bureaucratic nightmare that continues to plague physicians and patients alike.
Moreover, the games that insurers and payers are playing with drug prices have bolstered the perception that pharma is the villain. As a result, we see politicians take cover by demanding price disclosures in DTC ads and shaming thought leaders who accept compensation. Unfortunately, just saying “you’re wrong” doesn’t cut it. We need to offer real alternatives.
If we are to believe CVS, corporations may soon be able to provide the care that everyone wants and deserves. We might be able to help. Shall we call it Capitalized Medicine?