January 14, 2025
Opinion; By Anthony Biglan with input from Diana Fishbein and Ron Prinz
This opinion piece can also be found at: https://tonybiglan.medium.com/building-a-social-movement-for-corporate-accountability-in-healthcare-b2a894eb6325
The United States faces a systemic crisis: corporate profit maximization in healthcare has undermined public health and exacerbated inequities by prioritizing profits over human well-being. To reform this deeply entrenched system, a robust social movement is needed. By reframing public values, building alliances, advocating for systemic reforms, and drawing lessons from past movements, we can create a healthcare system that prioritizes health over profit.
Understanding the Problem and the Need for Change
A recent essay by Diana Fishbein of the National Prevention Science Coalition describes the problem. Numerous corporations in healthcare prioritize profits at the expense of public health. Pharmaceutical companies aggressively marketed opioids and other unnecessary medications, leading to widespread harm. Private equity firms exploit healthcare facilities, closing rural hospitals and degrading care. Health insurance companies, driven by administrative inefficiencies and profit-centered policies, inflate costs while denying coverage for many claims. These systemic failures are rooted in a policy framework that elevates profit over well-being. But simply documenting this will not solve the problem. We need a social movement that reshapes laws, regulations, and institutional practices.
Strategies to Build the Movement
A social movement to reform healthcare policies must challenge the profit-driven narrative, build strong alliances, advocate for evidence-based policies, and engage the public.
Reframing Public Values
To shift the dominant narrative, the movement must emphasize the moral and economic benefits of prioritizing health and well-being over profit. Data and personal stories can highlight the real costs of corporate abuses, such as medical debt and denial of coverage for the treatment of fatal diseases. Behavioral science supports the notion that humans thrive in cooperative, caring environments, [1] making this a powerful counterpoint to the free-market ideology.
Building Alliances
A broad coalition of stakeholders is essential. Grassroots organizations advocating for affordable healthcare, racial equity, and community well-being can amplify the movement’s reach. Public health groups, unions, and academic institutions can provide expertise, credibility, and resources to influence policy.
Advocacy for Policy Change
Systemic reforms must address the laws and policies that underpin corporate dominance. Anti-monopoly laws should be enforced to prevent harmful consolidation in healthcare. Corporations should face financial penalties for harmful practices, ensuring that all profits derived from exploitation are forfeited. We can no longer allow fines to simply be a cost of doing business. Policies should shift funding toward evidence-based preventive care, livable wages for all workers, and the use of progressive tax policies to fund public health initiatives.
Public Education and Mobilization:
Engaging the public is critical to sustaining the movement. Civic education campaigns can inform citizens about how corporate policies harm their health and why reform is necessary. Grassroots organizing can mobilize communities to demand change, while training programs for journalists, healthcare workers, and community leaders can expand the movement’s influence.
Learning from Historical Movements
Past movements provide valuable insights for shaping the fight against corporate dominance. The Progressive Era and New Deal reforms tackled wealth disparities and corporate corruption by implementing anti-trust laws, creating social safety nets, and redistributing power. These successes were built on coalition-building and bold policy innovation.
Conversely, the rise of free-market ideology in the 1970s shows the power of long-term planning and strategic funding. Advocates for deregulation invested in think tanks, academic programs, and media campaigns to shift public opinion and policymaking in favor of corporate profit maximization. This approach offers lessons for building a counter-movement that prioritizes well-being over profit.
A Modern Action Plan
To create meaningful change, the movement must focus on establishing a vision, building alliances, advocating for reform, and ensuring sustainability.
A Compelling Vision: A unified vision of health equity is needed. A nation where everyone has access to high-quality healthcare, harmful marketing of tobacco, alcohol, guns, unhealthful food and pharmaceuticals is ended, and every worker has a living wage. Personal stories of those harmed by profit-driven policies should be at the forefront to humanize the issue.
Building Alliances: Partnerships among national and local organizations, unions, and advocacy groups will strengthen the movement. Digital platforms can amplify voices and facilitate collaboration across diverse stakeholders.
Education and Advocacy: Public awareness campaigns and lobbying efforts must advocate for policies that pinpoint and penalize corporate practices that undermine human health. Training advocates in media, public health, and law will ensure consistent and effective messaging.
Sustainability and Progress Monitoring: Securing long-term funding through philanthropic partnerships will provide stability. Regularly evaluating progress using data will help adapt strategies and maintain momentum.
Yes, We Can
You may think that we have no hope of bringing about the reforms needed to fix our broken healthcare system. But consider the Tobacco Control Movement. Sixty years ago, cigarette smoking was everywhere in this country. Smoking was glamourous. Fifty-five percent of men and 35% of women smoked. Ads were everywhere — in and on busses, in every magazine, on billboards, and ashtrays in restaurants. A popular ad said, “More doctors smoke Camels than any other cigarette.” I can remember my biology class in a large lecture hall at the University of Rochester that was filled with smoke. I was one of the people smoking.
But thanks to a steady stream of research on the many ways that smoking kills, a movement to reduce smoking slowly gathered force. Numerous anti-tobacco organizations educated the public about the risks of smoking. The Tobacco industry spent millions arguing that there was no evidence that cigarettes were harmful. But step by step the movement worked to reduce smoking: ads about the harm, of smoking; increases in taxation; laws that prohibited smoking in public places; lawsuits against the industry; campaigns to promote quitting[2] and prevent adolescent smoking.[3] Today, only 1l.6% of adults say they smoke.
Building a social movement for corporate accountability in healthcare requires a cohesive and multifaceted approach. By challenging profit-driven values, forging strong alliances, advocating for policy reforms, and drawing on the lessons of past movements, we can shift the system toward prioritizing human well-being. This is a long-term effort, but the potential to address chronic inequities and preventable deaths makes it an essential one. Together, we can create a healthcare system that serves people, not profits, and build a healthier, more equitable society.
If you would like to help bring about the change that is needed, you can simply share this essay with others. And if you would like to get involved in promoting the movement, join others at Values to Action.
This paper was written by Tony Biglan, with input from Diana Fishbein and Ron Prinz. For more information about corruption in the healthcare industry see https://medium.com/@dhfishbein/the-murder-of-a-ceo-wont-fix-america-s-broken-health-care-system-851acc4dc4bc
1. Biglan A, Johansson M, Van Ryzin M, Embry D. Scaling up and scaling out: Consilience and the evolution of more nurturing societies. Clinical Psychology Review. 2020;
2. Hollis JF, Lichtenstein E, Vogt TM, Stevens VJ, Biglan A. Nurse-assisted counseling for smokers in primary care. Annals of Internal Medicine. 1993 1993;118:521–525. In File.
3. Biglan A, Ary DV, Smolkowski K, Duncan T, Black C. A randomized controlled trial of a community intervention to prevent adolescent tobacco use. Tobacco Control. 2000;9(1):24–32. doi:10.1136/tc.9.1.24
Anthony Biglan, Ph.D. is a senior scientist with the Oregon Research Institute and the CEO of Values to Action. He is also a board member of the National Prevention Science Coalition to Improve Lives.
Ronald Prinz, Ph.D. is a professor and director of the Research Center for Childhood Wellbeing at the University of South Carolina. He is also a board member of the National Prevention Science Coalition to Improve Lives.
Diana Fishbein, Ph.D. is a senior scientist in the FPG Child Development Institute at University of North Carolina-Chapel Hill and president of the National Prevention Science Coalition to Improve Lives.
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