Academic journal article Health Sociology Review

Multinational Corporations, the State, and Contemporary Medicine

Academic journal article Health Sociology Review

Multinational Corporations, the State, and Contemporary Medicine

Article excerpt

INTRODUCTION

Global corporations have become powerful economic and political actors. The benefits accrued to insurance and pharmaceutical companies due to total or partial privatisation of public health care systems worldwide are an example of this. These benefits, however, are not the result of competition and have not necessarily resulted in the improvement of health services for patients. Instead, investigation of recent developments in the pharmaceutical industry strengthens David Harvey's claim that neoliberalism was a specific project intended to restore economic power to the capitalist class, and more specifically to corporate elites (Harvey 2005). Studying the behaviour of pharmaceutical companies in the United States and Latin America, we found that 'revolving door' practices - public officials leaving offices in the public sector to join private corporations - are prevalent in the American political system. These practices benefit the corporate elites to the extent that, in our opinion, merits a reconsideration of Marx's concepts of class struggle and the role that the state plays in the maintenance of the dominant class and the enhancement of its privileges.

MARX REVISITED: CORPORATE POWER, STATE POWER, AND CLASS STRUGGLE

Writing in the late 1980s, Ralph Miliband underscored the relevance of the class struggle, despite efforts, he argues, to neglect class structure and divisions, and to deny the existence of the dominant class (Miliband 1989). Miliband argues that class struggle in contemporary capitalism, is not necessarily conceived in the narrow sense as owners of means of production against workers. Rather, it is a struggle between the dominant class - the capitalist elite composed of owners and corporate managers, and the state elite - and the working class, which now encompasses much more than industrial workers. The capitalist elite is composed of people who wield power by virtue of their control of major industrial, commercial, and financial forms, while the state elite is composed of people at the highest spheres of state power: presidents, prime ministers and their immediate ministerial advisers, top civil servants, the police, surveillance and intelligence agencies, and senior judges among others. In Miliband's representation of class divisions, the corporate elite and the state elite stand on a par with each other at the same highest level of the social order; they form a partnership where state power is capable of exercising some constraints on the extraordinary freedoms of the corporate elites (Miliband 1989:33, italics in original). This perspective is somewhat different from Marx's original theory, which views the state as a subordinate to the capitalist class; this is a difference which we shall return to in the conclusion section of the paper. What is important at this point is to emphasise that the state has 'a unique, indispensable, and pre-eminent role in the defense of the prevailing order and the conduct of the class struggle' (Miliband 1989:13).

Our argument for the relevance of Marx's framework rests on two elements. One is the claim that the neoliberal project was intended to restore power to the capitalist class, which had been negatively affected by economic policies in the decades after 1930 (Harvey 2005). Another is the behavior and the historical relationship of the United States government with multinational corporations. We shall now address these two arguments.1

Harvey (2005) persuasively argues that neoliberalism was a specific project intended to restore power to the capitalist class, which had been negatively affected by economic policies in the decades after 1930. The Great Depression of the 1930s affected not only the United States but the global economy as well, leading economists worldwide to question the free market economic ideology predominant in those years (Green 2003; Guillen Romo 1997; Harvey 2005). This questioning led to the exploration of alternatives based on the work of economist John Maynard Keynes, which assigned a more influential role to the state in economic development. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.