The Steady Drip: Are Medical Associations Compromised by Corporate Funding? (Connecting the Dots: The American Heart Association, The American Medical Association, The FDA, The CDC, Abbott Laboratories, Time magazine, The Centers for Medicare & Medicaid Services, ProPublica, America's Health Insurance Plans, The Center for American Progress & Soros Funding, All Networking)

Are Medical Associations Compromised by Corporate Funding? (Connecting the Dots: The American Heart Association, The American Medical Association, The FDA, The CDC, Abbott Laboratories, Time magazine, The Centers for Medicare & Medicaid Services, ProPublica, America's Health Insurance Plans, The Center for American Progress & Soros Funding, All Networking)

The Epoch Times

Martha Rosenberg

1/28/2023|Updated: 3/21/2023

EJ Nickerson/Shutterstock

https://www.theepochtimes.com/health/corporate-funding-raises-ethical-concerns-about-medical-associations-4976289

Professional medical associations (PMAs) are foundational to the U.S. medical system, developing practice guidelines, providing medical education, and publishing journals. While there are scores of PMAs, probably the most well-known and largest are the American Heart Association, with more than 33,000 members; the American Academy of Pediatrics, with more than 64,000 members; and the American Medical Association, with more than 200,000 members.

Yet, according to doctor-authored opinion pieces in medical journals, conflicts of interest (COIs) such as a lack of transparency about industry money received, can present ethical challenges. For example, does funding from a drug or device maker influence an association’s recommendation in its official guidelines? There are reasons to be concerned that it might.

Such conflicts of interest “require PMAs to maintain a high degree of academic independence and scientific integrity by avoiding inappropriate influence from commercial interests,” Dr. Steven Nissen wrote in the Journal of the American Medical Association.

“Some physicians focus only on their medical practices, but along with actively maintaining mine, I have chosen to speak out on matters of public policy,” Nissen, who was named one of the most influential people in 2007 by Time magazine, told the Cleveland Jewish News. “To be free of conflict of interest, I never receive an honorarium from any drug company I work with.”

Financial COIs Identified in British Medical Journal

Researchers writing in the British Medical Journal in 2020 followed the “money trail” of several prominent PMAs and found their leaders received significant drug maker largesse between 2017 and 2019.

“Leaders of the North American Spine Society received more than $9.5 million for general payments,” the researchers wrote. Orthopedic Trauma Association (OTA) leaders received more than $4.7 million during the time period. Michael McKee, president of the OTA, responded to the research article by saying most of that funding was for research. Other PMA leaders took money for similar reasons.

“Research payments linked to leaders of the American Society of Clinical Oncology were over $54 million and for those of the American College of Cardiology, almost $21 million,” the BMJ study noted.

The researchers obtained the financial information from the U.S. Centers for Medicare & Medicaid Services (CMS) Open Payments system, which maintains transparent databases mandated by the 2010 Sunshine Act to disclose financial relationships between industry and medical practitioners and teaching hospitals.

“Despite their influence over key aspects of medicine, the leaders of professional medical associations have received limited scrutiny about their relationships with industry,” the researchers wrote. “Industries interested in maximizing markets,” can easily drive “overdiagnosis, overuse, and overmedicalization,” resulting in at least 20 percent of health care spending that’s estimated to be wasted.

Is Heart Association’s Food Certification Program a Conflict?

Almost everyone is familiar with the 108-year-old American Heart Association (AHA) and its public health messaging. Yet fewer people know that the organization is paid by food manufacturers to put a “heart-check” mark on hundreds of foods that reads “American Heart Association Certified: Meets criteria for heart-healthy food.”

According to the AHA, food manufacturers can pay up to $6,000 for yearly licenses for five food products. The program not only raises conflicts of interest questions but also questions about medical veracity.

“The AHA rakes in millions from food corporations for the use of its ‘heart-check mark,’ cardiologist Barbara Roberts, author of “The Truth About Statins: Risks and Alternatives to Cholesterol-Lowering Drugs,” said in an interview with HuffPost. “Some of the so-called heart-healthy foods it has endorsed include Boar’s Head All Natural Ham, which contains 340 milligrams of sodium in a two-ounce serving, and Boar’s Head EverRoast Oven Roasted Chicken Breast, which contains 440 milligrams of sodium in a two-ounce serving.

“High sodium intake raises blood pressure, which increases the risk of cardiovascular disease. In addition, studies have shown that eating processed meat increases the risk of diabetes and atherosclerosis.”

The AHA didn’t respond to questions from The Epoch Times when contacted for this story.

Questions About Diabetes Associations

According to its website, the Juvenile Diabetes Research Foundation (JDRF) is funded by many corporations including drug makers Abbott, Lilly Diabetes, and Novo Nordisk who are “Platinum Partners” contributing between $1 million and $2.5 million annually. The Access to Medicine Foundation calls Lilly Diabetes and Novo Nordisk two of the world’s top three insulin makers (The third is Sanofi.) Since insulin is basic to diabetes care and prohibitively costly, some have asked why JDFR and the American Diabetes Association (ADA) haven’t been more aggressive in protesting the high price of insulin on behalf of patients.

The authors of a 2022 story in U.S. political magazine Jacobin say they have suffered from high insulin prices.

“Living with this illness is a precarious existence. As people with T1D [Type 1 diabetes], we have traveled to other countries to get cheaper versions of the drug and have been forced by insurance companies to use lower-quality insulin,” they wrote. “Many people with diabetes meet in parking lots to exchange supplies or starve themselves to lower the amount of insulin they need.”

Twenty-five percent of insulin-dependent diabetics “ration insulin, which can lead to complications including life-threatening diabetic ketoacidosis, blindness, amputation, and death,” Annalisa van den Bergh and Robin Cressman wrote.

The authors weren’t entirely pleased with diabetes nonprofits and recent U.S. national legislation.

“Major diabetes nonprofits have supported incremental measures but have remained silent on more meaningful reform,” they wrote.

While JDRF and ADA both supported the insulin pricing cap in the Build Back Better bill and the House-passed the Affordable Insulin Now Act, which caps insulin out-of-pocket expenses, the measure only pertains to co-pays, the Jacobin authors wrote.

“Copay caps tie our survival to the health care status quo because anyone is at risk of losing their insurance, allow the big three to continue to profit from $300 a vial insulin, and in our view give the false impression that the problem is being solved.”

The ADA didn’t respond to The Epoch Times’ request for comment about its insulin pricing efforts. Meanwhile, the JDRF told The Epoch Times it has long advocated for the lowering of out-of-pocket insulin costs for people with diabetes.

“This includes our recent multimillion-dollar investment in the Civica insulin project that will provide three of the most frequently prescribed insulins for $30 per vial and $55 for a box of five pens, regardless of insurance status. We have also spent years lobbying Congress and calling on insulin manufacturers, health plans, employers, and the government to take action to lower the cost of insulin. These efforts have led to the recent $35 monthly cap on insulin costs for Medicare enrollees,” the JDRF said.

The PMA says less than 1 percent of its funding comes from companies that manufacture insulin, and they disclose those monies on their website.

“These companies have no role in decisions about advocacy and research priorities. Most of our funding comes from those affected by Type 1 diabetes, who raise funds from their friends, families, and professional contacts through our Walk, Gala, Ride, and other fundraising programs,” the JDRF responded.

While the JDRF may provide a reasonable argument for the judicious use of corporate funders with vested interests, other examples raise more concerning issues.

Concerns About Association COIs Aren’t New

More than 10 years ago, concerns about pharmaceutical funding influencing policy guidelines and clinicians were already surfacing. Researchers wrote in the journal Annals of Family Medicine that “there has been dramatic increase in the diagnosis and pharmaceutical management of common chronic illnesses.” After conducting a study of Type 2 diabetes and hypertension treatment in 44 primary care clinics in Michigan, they recommended “limiting the influence of the pharmaceutical industry on clinical practice, toward improving the well-being of patients with chronic illness.”

One example of such apparent influence was reported by the Milwaukee Journal Sentinel.

“In 2009, the American Geriatrics Society joined others in advocating for greater opioid use to treat chronic pain in seniors, especially those 75 and older,” the newspaper reported. “The new guidelines recommended that over-the-counter pain relievers, such as ibuprofen and naproxen, be used rarely and that doctors instead consider prescribing opioids for all patients with moderate to severe pain. The group’s guidelines are a key reference for thousands of doctors on the front line of medicine.”

On the basis of disclosures filed with the American Geriatrics Society, it was found that of a panel of 10 experts who made the pain recommendations, at least “five had financial ties to opioid companies, as paid speakers, consultants or advisers at the time the guidelines were issued.”

Other Medical Associations Respond

The Epoch Times asked the North American Spine Society to comment on the BMJ’s characterization of its industry funding, and Jeff Karzen, senior manager of publications at the society, said he had no comment.

Dr. James Kirkpatrick, chair of the American College of Cardiology [ACC] Ethics and Compliance Committee, spoke to The Epoch Times about the figures identified in the BMJ article.

“The ACC itself collaborates with industry, including in the administration of unrestricted, multi-company financial support, In doing so, we follow the highest standards of oversight, transparent structure, and unbiased management.

“It is worth noting that, in the BMJ study, more than 90 percent of payments made to ACC leaders was in the form of research support, which is categorically different than direct payments to physicians and other transfers of value, as it is usually administered through a third party, such as a medical school, research institute, or granting agency.”

The American Society of Clinical Oncology (ASCO) also emphasized research support when responding to The Epoch Times’ request for comment.

“As referenced by the BMJ article, the majority of financial relationships with healthcare companies were related to research and paid directly to academic institutions,” the ASCO said. “This research serves an important role in clinical oncology and is critical to making progress against cancer through improved treatments that advance cancer care for patients.”

On its website, the society states, “ASCO regards the management of potential conflicts of interest as paramount to the integrity of ASCO’s programs, products, and services.”

Its COI policy primarily relies on “disclosure of all financial relationships that might result in actual, potential, or perceived conflicts of interest” but also “recognizes that some relationships cannot be managed with disclosure alone and identifies additional management steps in this case.”

Conclusion

Certainly, PMAs are invaluable in researching and raising awareness of respective diseases, providing medical education and publishing journals, but some medical voices would like to see greater transparency and firewalls with industry, especially when it comes to practice guidelines. As both writers in the Annals of Family Medicine and Jacobin have noted, the sales of pharmaceutical products should never come before patients’ interests.

To find out possible industry funding of medical practitioners, hospitals, and medical centers that you may visit, the CMS Open Payments database is searchable. Another useful database where such information can be searched is ProPublica’s Dollars for Docs site.

Connecting the Dots:
Sidley Austin LLP was the lobby firm for St. Jude Medical Inc., and St. Jude Children's Research Hospital.

Michelle Obama was a lawyer at Sidley Austin LLP.

Barack Obama was an intern at Sidley Austin LLP.

Newton N. Minow is a senior counsel at Sidley Austin LLP, and a member of the Commercial Club of Chicago.

R. Eden Martin is counsel at Sidley Austin LLP, and the president of the Commercial Club of Chicago.

Commercial Club of Chicago, Members Directory A-Z (Past Research)

Tuesday, December 17, 2013

http://thesteadydrip.blogspot.com/2013/12/commercial-club-of-chicago-members.html

Sally Blount is a member of the Commercial Club of Chicago and a director at Abbott Laboratories.

W. James Farrell is a member of the Commercial Club of Chicago and a director at Abbott Laboratories.

Edward M. Liddy is a member of the Commercial Club of Chicago and a director at Abbott Laboratories.

William A. Osborn is a member of the Commercial Club of Chicago and a director at Abbott Laboratories.

Samuel C. Scott III is a member of the Commercial Club of Chicago and a director at Abbott Laboratories.

Glenn F. Tilton is a member of the Commercial Club of Chicago and a director at Abbott Laboratories.

Miles D. White is a member of the Commercial Club of Chicago and the chairman & CEO for Abbott Laboratories.

Christopher B. Begley is a member of the Commercial Club of Chicago and was the SVP for Abbott Laboratories.

Jack M. Greenberg is a member of the Commercial Club of Chicago and was a director at Abbott Laboratories.

Robert L. Parkinson Jr. is a member of the Commercial Club of Chicago and was the president & COO for Abbott Laboratories.

William D. Smithburg is a member of the Commercial Club of Chicago and was a director at Abbott Laboratories.

William M. Daley is a member of the Commercial Club of Chicago was a director at Abbott Laboratories and the chief of staff for the Barack Obama administration.

Valerie B. Jarrett was the senior adviser for the Barack Obama administration, Vernon E. Jordan Jr’s great niece and a member of the Commercial Club of Chicago.

Rahm I. Emanuel is a member of the Commercial Club of Chicago, the Chicago (IL) mayor, Ezekiel Emanuel’s brother, and was the White House chief of staff for the Barack Obama administration.

Ezekiel Emanuel is Rahm I. Emanuel’s brother, a founding chair of the Department of Bioethics for the National Institutes of Health and a senior fellow at the Center for American Progress.

Open Society Foundations was a funder for the Center for American Progress (think tank).

George Soros is the founder & chairman for the Open Society Foundations, was the chairman for the Foundation to Promote Open Society and a supporter for the Center for American Progress (think tank).

Foundation to Promote Open Society was a funder for the Center for American Progress (think tank).

Donald M. Berwick is a senior fellow at the Center for American Progress and was an administrator for the Centers for Medicare & Medicaid Services.

Center for American Progress was a funder for America's Health Insurance Plans and the CVS Caremark Corporation.

Richard A. Barasch is a director at the America's Health Insurance Plans and the chairman & president & CEO for the Universal American Corporation.

Mark T. Bertolini is a director at the America's Health Insurance Plans and the chairman & president & CEO for Aetna Inc.

Bruce G. Bodaken is a director at the America's Health Insurance Plans and was the chairman & president & CEO for the Blue Shield of California.

Mary K. Brainerd is a director at the America's Health Insurance Plans and the president & CEO for HealthPartners Inc.

Angela F. Braly is a director at the America's Health Insurance Plans and was the president & CEO for Blue Cross and Blue Shield of Missouri.

William M. Cameron is a director at the America's Health Insurance Plans and the chairman & CEO for American Fidelity Assurance.

James G. Carlson is a director at the America's Health Insurance Plans and was the chairman & president & CEO for the Amerigroup Corporation.

David M. Cordani is a director at the America's Health Insurance Plans and the president & CEO for the CIGNA Corporation.

Michael W. Cropp is a director at the America's Health Insurance Plans and the president & CEO for Independent Health.

Michael M. Dudley is a director at the America's Health Insurance Plans and the president for Sentara Health Plans Inc.

Mark B. Ganz is a director at the America's Health Insurance Plans and the president & CEO for Cambia Health Solutions, Inc.

Jay M. Gellert is a director at the America's Health Insurance Plans and the president & CEO for Health Net, Inc.

Vicky B. Gregg is a director at the America's Health Insurance Plans and the president & CEO for the BlueCross BlueShield of Tennessee.

Patricia A. Hemingway Hall is a director at the America's Health Insurance Plans and the president & CEO for the Health Care Service Corporation.

George C. Halvorson is a director at the America's Health Insurance Plans and the chairman for Kaiser Permanente.

Daniel J. Hilferty III is a director at the America's Health Insurance Plans and the president & CEO for Independence Blue Cross.

Daniel J. Houston is a director at the America's Health Insurance Plans and was a director at Catalyst Health Solutions.

Kevin P. McCarthy is a director at the America's Health Insurance Plans and the EVP for the Unum Group.

Daniel P. Neary is a director at the America's Health Insurance Plans and the chairman & CEO for Mutual of Omaha.

Robert A. Reed is a director at the America's Health Insurance Plans and the president & CEO for the Physicians Mutual Insurance Company.

James Roosevelt Jr. is a director at the America's Health Insurance Plans and the president & CEO for the Tufts Health Plan.

Eric H. Schultz is a director at the America's Health Insurance Plans and the president & CEO for the Harvard Pilgrim Health Care.

Charles D. Baker Jr. was a director at the America's Health Insurance Plans and is the president & CEO for the Harvard Pilgrim Health Care.

Anthony L. Watson is a director at the America's Health Insurance Plans and the chairman & CEO for the HIP Health Plan of New York.

Debbie J. Ahl was a director at the America's Health Insurance Plans and is the president & CEO for the Sterling Life Insurance Company.

K. Rone Baldwin was a director at the America's Health Insurance Plans and is the EVP & COO for the Guardian Life Insurance Company of America.

Christy W. Bell was a director at the America's Health Insurance Plans and is the EVP for the Horizon Blue Cross Blue Shield of New Jersey.

Frank J. Branchini was a director at the America's Health Insurance Plans, is the president & COO for Emblem Health and the CEO for Group Health Inc.

Benjamin M. Cutler was a director at the America's Health Insurance Plans and is the chairman & CEO for USHEALTH Group Inc.

Joseph A. Frick was a director at the America's Health Insurance Plans and is the vice chairman for Independence Blue Cross.

H. Edward Hanway was a director at the America's Health Insurance Plans and the chairman & CEO & president for the CIGNA Corporation.

Robert I. Lufrano was a director at the America's Health Insurance Plans and the CEO for Blue Cross and Blue Shield of Florida.

Frederick J. Manning was a director at the America's Health Insurance Plans and is the chairman & CEO for the Celtic Insurance Company.

David M. McDonough was a director at the America's Health Insurance Plans and is the president & CEO for the Trustmark Insurance Company.

Adrienne Morrell was a lobbyist at the America's Health Insurance Plans and is a lobbyist for Health Net, Inc.

Ronald A. Williams was a director at the America's Health Insurance Plans and the chairman for the Emergency Medical Services Corp.

Center for American Progress was a funder for America's Health Insurance Plans and the CVS Caremark Corporation.

Donald M. Berwick is a senior fellow at the Center for American Progress and was an administrator for the Centers for Medicare & Medicaid Services.

Open Society Foundations was a funder for the Center for American Progress.

Foundation to Promote Open Society was a funder for the Center for American Progress and the Brookings Institution (think tank).

Vernon E. Jordan Jr. is a senior counsel for Akin, Gump, Strauss, Hauer & Feld, an honorary trustee at the Brookings Institution (think tank) and married to Ann Dibble Jordan.

Foundation to Promote Open Society was a funder for the Brookings Institution (think tank).

George Soros was the chairman for the Foundation to Promote Open Society.

Ann Dibble Jordan is an honorary trustee at the Brookings Institution (think tank), married to Vernon E. Jordan Jr. and was a director at Johnson & Johnson (COVID 19 Vaccine Manufacturer).

Charles O. Prince III was a trustee at the Brookings Institution (think tank) and is a director at Johnson & Johnson (COVID 19 Vaccine Manufacturer).

Mark B. McClellan is a director at Johnson & Johnson (COVID 19 Vaccine Manufacturer), was a commissioner for the U.S. Food and Drug Administration (FDA) and a senior fellow at the Brookings Institution (think tank).

Foundation to Promote Open Society was a funder for the Brookings Institution (think tank).

George Soros was the chairman for the Foundation to Promote Open Society.

Suzanne Nora Johnson is a trustee at the Brookings Institution (think tank) and a director at Pfizer Inc. (COVID 19 Vaccine Manufacturer).

Amy W. Schulman is a trustee at the Brookings Institution (think tank) and the EVP & general counsel for Pfizer Inc. (COVID 19 Vaccine Manufacturer).

Sidley Austin LLP was a lobby firm for Pfizer Inc. (COVID 19 Vaccine Manufacturer).

Michelle Obama was a lawyer at Sidley Austin LLP.

Barack Obama was an intern at Sidley Austin LLP, the president for the Barack Obama Administration and Obamacare is his signature policy initiative.

Obamacare is Barack Obama’s signature policy initiative.

CGI Group Inc. was the Obamacare contractor that developed Healthcare.gov web site.

Donna S. Morea was the EVP for the CGI Group Inc. and a trustee at the Committee for Economic Development.

Foundation to Promote Open Society was a funder for the Committee for Economic Development and the Center for American Progress.

George Soros was the chairman for the Foundation to Promote Open Society, a supporter for the Center for American Progress and is the founder & chairman for the Open Society Foundations.

Open Society Foundations was a funder for the Center for American Progress.

Donald M. Berwick is a senior fellow at the Center for American Progress and was an administrator for the Centers for Medicare & Medicaid Services.

Center for American Progress was a funder for America's Health Insurance Plans and the CVS Caremark Corporation.

Apple Inc. was a funder for the Center for American Progress.

AT&T Inc. was a funder for the Center for American Progress.

Bank of America Corp. was a funder for the Center for American Progress.

BMW of North America LLC was a funder for the Center for American Progress.

Citigroup Inc. was a funder for the Center for American Progress.

Coca-Cola Company was a funder for the Center for American Progress.

Facebook was a funder for the Center for American Progress.

General Electric Company was a funder for the Center for American Progress.

Goldman Sachs Group Inc. (Bailout Company) was a funder for the Center for American Progress.

Motion Picture Association of America was a funder for the Center for American Progress.

PepsiCo, Inc. was a funder for the Center for American Progress.

PG&E Corporation was a funder for the Center for American Progress.

Samsung Electronics Co. was a funder for the Center for American Progress.

Time Warner Inc. was a funder for the Center for American Progress.

T-Mobile USA, Inc. was a funder for the Center for American Progress.

Toyota Motor North America was a funder for the Center for American Progress.

Visa Inc. was a funder for the Center for American Progress.

Wal-Mart Stores Inc. was a funder for the Center for American Progress.

Wells Fargo & Co. was a funder for the Center for American Progress.

Carol M. Browner is a director, senior fellow at the Center for American Progress, and was the energy czar for the Barack Obama Administration.

Tom Daschle is a director at the Center for American Progress, was the nominee for health and human services secretary for the Barack Obama Administration.

Ezekiel Emanuel is a senior fellow at the Center for American Progress and was the health care policy adviser for the Barack Obama Administration.

Lawrence H. Summers is a distinguished fellow at the Center for American Progress and was the National Economic Council chairman for the Barack Obama Administration.

Cassandra Q. Butts was the SVP for the Center for American Progress and the deputy White House counsel for the Barack Obama Administration.

Philip J. Crowley was the director of homeland security at the Center for American Progress and the assistant secretary of state for the Barack Obama Administration.

Derek Douglas was an associate director of economic policy at the Center for American Progress and a special assistant for urban affairs for the Barack Obama Administration.

Bradley J. Kiley was a VP for the Center for American Progress, and the director of management and administration for the Barack Obama Administration.

Karen Kornbluh was a visiting scholar at the Center for American Progress and a policy director for Barack Obama.

Jeanne Lambrew was a senior fellow at the Center for American Progress and is the deputy assistant to the president for health policy for the Barack Obama Administration.

Denis McDonough was a senior fellow at the Center for American Progress and is the chief of staff; former deputy national security adviser for the Barack Obama Administration.

Esther M. Olavarria was the director of immigration policy at the Center for American Progress and is the deputy assistant secretary at the U.S. Department of Homeland Security for the Barack Obama Administration.

Dan Restrepo was the Americas Project director at the Center for American Progress and a special assistant to the president for the Barack Obama Administration.

Gene B. Sperling was a senior fellow at the Center for American Progress and is the assistant to the president for economic policy for the Barack Obama Administration.

Todd Stern was a senior fellow at the Center for American Progress and is the special envoy for climate change at the U.S. Department of State for the Barack Obama Administration.

Melody C. Barnes was the EVP for the Center for American Progress, the domestic policy council, director for the Barack Obama Administration and is Barack Obama’s golf partner.

Jose H. Villarreal is a director at the Center for American Progress and a senior adviser at the Akin, Gump, Strauss, Hauer & Feld, LLP.

Vernon E. Jordan Jr. is a senior counsel for Akin, Gump, Strauss, Hauer & Feld, LLP, Valerie B. Jarrett’s great uncle, an honorary trustee at the Brookings Institution (think tank).

Center for American Progress was a funder for America's Health Insurance Plans and the CVS Caremark Corporation.

Donald M. Berwick is a senior fellow at the Center for American Progress and was an administrator for the Centers for Medicare & Medicaid Services.

Open Society Foundations was a funder for the Center for American Progress.

Foundation to Promote Open Society was a funder for the Center for American Progress.

Center for American Progress (think tank) was a funder for America's Health Insurance Plans.

Scott Armstrong is a director at the America's Health Insurance Plans, a member of the Medicare Payment Advisory Commission and the president & CEO for the Group Health Cooperative.

Michael B. McCallister is a director at the America's Health Insurance Plans and the chairman for Humana Inc.

J. Mario Molina is a director at the America's Health Insurance Plans and the chairman & president & CEO for the Molina Healthcare Inc.

Jeannine M. Rivet was a director at the America's Health Insurance Plans and is the EVP for the UnitedHealth Group Inc.

Gail K. Boudreaux is a director at the America's Health Insurance Plans and the EVP for the UnitedHealth Group Inc.

Lewis G. Sandy was a director at the America's Health Insurance Plans and is the SVP for the UnitedHealth Group Inc.

Tom Daschle was an adviser for the UnitedHealth Group Inc., the nominee for health and human services secretary for the Barack Obama administration and a director at the Center for American Progress (think tank).

Donald M. Berwick is a senior fellow at the Center for American Progress and was an administrator for the Centers for Medicare & Medicaid Services.

Open Society Foundations was a funder for the Center for American Progress (think tank).

Foundation to Promote Open Society was a funder for the Center for American Progress (think tank).

Jose H. Villarreal is a director at the Center for American Progress and a senior adviser at the Akin, Gump, Strauss, Hauer & Feld, LLP.

Akin, Gump, Strauss, Hauer & Feld, LLP was the lobby firm for the Center for American Progress (think tank), the America's Health Insurance Plans and Johnson & Johnson (COVID 19 Vaccine Manufacturer).

Vernon E. Jordan Jr. is a senior counsel for Akin, Gump, Strauss, Hauer & Feld, LLP, Valerie B. Jarrett’s great uncle, an honorary trustee at the Brookings Institution (think tank).

Foundation to Promote Open Society was a funder for the Brookings Institution (think tank).

George Soros was the chairman for the Foundation to Promote Open Society.

Ben S. Bernanke is a distinguished fellow at the Brookings Institution (think tank) and was the 2009 person of the year for Time magazine.

Strobe Talbott is the president of the Brookings Institution (think tank), was an editor for Time magazine and William J. Clinton’s roommate at Oxford.

William J. Clinton was Strobe Talbott’s roommate at Oxford, the 1992 & 1998 person of the year for Time magazine, an adviser for the 2016 Hillary Rodham Clinton presidential campaign and is the founder & director for the Bill, Hillary & Chelsea Clinton Foundation.

Ready PAC (Ready For Hillary) supported the 2016 Hillary Rodham Clinton presidential campaign.

George Soros was a co-chair, national finance council for the Ready PAC (Ready For Hillary) the chairman for the Foundation to Promote Open Society and is the founder & chairman for the Open Society Foundations.

Foundation to Promote Open Society was a funder for ProPublica.

Gara LaMarche was a director at ProPublica and the VP & a director of U.S. programs for the Open Society Foundations.

Open Society Foundations was a funder for the Bill, Hillary & Chelsea Clinton Foundation.

Scott M. Curran is an assistant general counsel for the Bill, Hillary & Chelsea Clinton Foundation and a director at the Alliance for a Healthier Generation.

Bill, Hillary & Chelsea Clinton Foundation is a co-founder for the Alliance for a Healthier Generation.

Alliance for a Healthier Generation was a funder for the Bill, Hillary & Chelsea Clinton Foundation.

Nancy Brown is a director at the Alliance for a Healthier Generation and the CEO for the American Heart Association.

American Heart Association is an Edelman client.

Edelman was a funder for the Bill, Hillary & Chelsea Clinton Foundation.

PepsiCo, Inc. was a funder for the Bill, Hillary & Chelsea Clinton Foundation and is an Edelman client.

PepsiCo, Inc. was a funder for the Center for American Progress.

Open Society Foundations was a funder for the Bill, Hillary & Chelsea Clinton Foundation and the Center for American Progress.

Foundation to Promote Open Society was a funder for the Center for American Progress (think tank) and the Brookings Institution (think tank).

Larry D. Thompson is a trustee at the Brookings Institution (think tank) and the EVP of governmental affairs, general counsel & secretary for PepsiCo, Inc.

Michael H. Jordan was an honorary trustee at the Brookings Institution (think tank) and a division chairman & CEO for PepsiCo, Inc.

PepsiCo, Inc. is a snack foods manufacturer.

Kimberly Cheatle served as Senior Director in Global Security at PepsiCo. and was the 27^th director for the U.S. Secret Service.

Daniel Vasella is a director at PepsiCo, Inc., and a trustee at the Carnegie Endowment for International Peace (think tank).

Foundation to Promote Open Society was a funder for the Carnegie Endowment for International Peace (think tank).

George Soros was the chairman for the Foundation to Promote Open Society.

Donald Kennedy was a trustee at the Carnegie Endowment for International Peace (think tank) and a commissioner for the U.S. Food and Drug Administration (FDA).

Andrew Carnegie was the founder of the Carnegie Endowment for International Peace (think tank) and the founder of the Carnegie Corporation of New York.

Geoffrey T. Boisi is a trustee at the Carnegie Corporation of New York and an honorary trustee at the Brookings Institution (think tank).

Foundation to Promote Open Society was a funder for the Brookings Institution (think tank).

George Soros was the chairman for the Foundation to Promote Open Society.

Cameron F. Kerry is a fellow at the Brookings Institution (think tank), John F. Kerry’s brother and a senior counsel at Sidley Austin LLP.

Sidley Austin LLP was the lobby firm for St. Jude Medical Inc. and St. Jude Children's Research Hospital.

Michelle Obama was a lawyer at Sidley Austin LLP.

Barack Obama was an intern at Sidley Austin LLP.

R. Eden Martin is counsel at Sidley Austin LLP and the president of the Commercial Club of Chicago.

Newton N. Minow is a senior counsel at Sidley Austin LLP, a member of the Commercial Club of Chicago and an honorary trustee at the Carnegie Corporation of New York.

David A. Hamburg is the president emeritus for the Carnegie Corporation of New York, Margaret A. Hamburg’s father and an adviser for the Nuclear Threat Initiative (think tank).

Carnegie Endowment for International Peace (think tank) was a funder for the Nuclear Threat Initiative (think tank).

Margaret A. Hamburg is the VP for the Nuclear Threat Initiative (think tank), David A. Hamburg’s daughter and was the commissioner for the U.S. Food and Drug Administration (FDA).

Mark B. McClellan was a commissioner for the U.S. Food and Drug Administration (FDA), a senior fellow at the Brookings Institution (think tank) and a director at Johnson & Johnson (COVID 19 Vaccine Manufacturer).

Foundation to Promote Open Society was a funder for the Brookings Institution (think tank), Millennium Promise and the Human Rights Watch.

George Soros was the chairman for the Foundation to Promote Open Society a benefactor for the Human Rights Watch and is the founder & chairman for the Open Society Foundations.

Open Society Foundations was a funder for the Human Rights Watch.

Amy Robbins Towers was a director at the Millennium Promise, married to Larry Robbins, is a director at the Human Rights Watch and a board member for the CDC Foundation.

CDC Foundation is a foundation for the Centers for Disease Control and Prevention (CDC).

Robert Jeffrey was a board member for the CDC Foundation and is a director at the Atlantic Council of the United States (think tank).

Open Society Foundations was a funder for the Atlantic Council of the United States (think tank).

George Soros is the founder & chairman for the Open Society Foundations and was the chairman for the Foundation to Promote Open Society

Foundation to Promote Open Society was a funder for the Robin Hood Foundation.

Larry Robbins is a director at the Robin Hood Foundation and was married to Amy Robbins Towers.

Michael R. Bloomberg was a donor for the Robin Hood Foundation, is the founder of the Bloomberg Family Foundation and Emma Bloomberg’s father.

Emma Bloomberg was the chief of staff for the Robin Hood Foundation, Michael R. Bloomberg’s daughter, and is a director at the Bloomberg Family Foundation.

Bloomberg Family Foundation was a funder for the CDC Foundation.

Bloomberg Philanthropies is an umbrella organization for the Bloomberg Family Foundation and was a funder for the Global Polio Eradication Initiative.

Jeffrey P. Koplan is a board member for the Global Polio Eradication Initiative and was a director at the Centers for Disease Control and Prevention (CDC).

CDC Foundation is a foundation for the Centers for Disease Control and Prevention (CDC).

Donald R. Hopkins was a board member for the CDC Foundation and is the VP, health programs for the Carter Center.

Jimmy Carter was a co-founder & trustee at the Carter Center and an honorary co-chairman for the Millennium Promise.

Foundation to Promote Open Society was a funder for the Millennium Promise and the Human Rights Watch.

George Soros was the chairman for the Foundation to Promote Open Society a benefactor for the Human Rights Watch and is the founder & chairman for the Open Society Foundations.

Open Society Foundations was a funder for the Human Rights Watch.

Amy Robbins Towers was a director at the Millennium Promise married to Larry Robbins, is a director at the Human Rights Watch and a board member for the CDC Foundation.

CDC Foundation is a foundation for the Centers for Disease Control and Prevention (CDC).

Bloomberg Family Foundation was a funder for the CDC Foundation and the World Health Organization (WHO).

World Health Organization (WHO) is a U.N. coordinating agency for world health.

Jim Yong Kim was a director, HIV-AIDS department for the World Health Organization (WHO), a guest at George Soros’s 2013 wedding, the 12^th president of the World Bank and is a trustee at the World Economic Forum.

George Soros was married in 2013 & Jim Yong Kim was a guest.

A.W. Clausen was the president of the World Bank and an honorary trustee at the Brookings Institution (think tank).

David Dollar was a country director for China and Mongolia for the World Bank and is a senior fellow at the Brookings Institution (think tank).

Klaus Kleinfeld is a trustee at the World Economic Forum and a trustee at the Brookings Institution (think tank).

Foundation to Promote Open Society was a funder for the Brookings Institution (think tank) and the Carnegie Endowment for International Peace (think tank).

George Soros was the chairman for the Foundation to Promote Open Society.

Jon M. Huntsman Jr. is a trustee at the Carnegie Endowment for International Peace (think tank) and an ambassador to China for the Barack Obama administration.

J. Stapleton Roy is a trustee at the Carnegie Endowment for International Peace (think tank) and was a U.S. ambassador for China.

Moises Naim is a fellow at the Carnegie Endowment for International Peace (think tank), a global board member for the Open Society Foundations, was an executive director for the World Bank and a board member for the International Crisis Group.

George Soros is a board member for the International Crisis Group, the founder & chairman for the Open Society Foundations and was the chairman for the Foundation to Promote Open Society.

Foundation to Promote Open Society was a funder for the Carnegie Endowment for International Peace (think tank) and the Brookings Institution (think tank).

George Soros was the chairman for the Foundation to Promote Open Society and is a member of the Bretton Woods Committee.

Carole Brookins is a member of the Bretton Woods Committee and was a U.S. executive director for the World Bank.

E. Patrick Coady is a member of the Bretton Woods Committee and was a U.S. executive director for the World Bank.

Peter L. Woicke is a member of the Bretton Woods Committee and was a managing director for the World Bank.

David de Ferranti is a member of the Bretton Woods Committee and was a VP for the World Bank.

Eli Whitney Debevoise II is a member of the Bretton Woods Committee and was a U.S. executive director for the World Bank.

Stanley Fischer is a member of the Bretton Woods Committee and was a chief economist for the World Bank.

Robert B. Zoellick is a member of the Bretton Woods Committee and was a president for the World Bank.

Jeffrey A. Goldstein is a member of the Bretton Woods Committee and was a managing director & CFO for the World Bank.

Caio Koch-Weser is a member of the Bretton Woods Committee and was a managing director operations for the World Bank.

Johannes F. Linn is a member of the Bretton Woods Committee and was a VP for the World Bank.

Matthew F. McHugh is a member of the Bretton Woods Committee and was a counselor to the president for the World Bank.

Jim Yong Kim was the 12^th president of the World Bank, a director, HIV-AIDS department for the World Health Organization (WHO) and a guest at George Soros’s 2013 wedding and is a trustee at the World Economic Forum.

World Health Organization is a U.N. coordinating agency for World Health.

Klaus Kleinfeld is a trustee at the World Economic Forum and a trustee at the Brookings Institution (think tank).

Foundation to Promote Open Society was a funder for the Brookings Institution (think tank).

George Soros was the chairman for the Foundation to Promote Open Society and married in 2013.

Klaus Kleinfeld is a trustee at the Brookings Institution (think tank) and a trustee at the World Economic Forum.

Jim Yong Kim is a trustee at the World Economic Forum, was a guest at George Soros’s 2013 wedding, the 12^th president of the World Bank, a director, HIV-AIDS department for the World Health Organization (WHO).

World Health Organization is a U.N. coordinating agency for World Health.

Rockefeller Foundation was a funder for the World Health Organization, the Nuclear Threat Initiative (think tank) and the Carnegie Endowment for International Peace (think tank).

Carnegie Endowment for International Peace (think tank) was a funder for the Nuclear Threat Initiative (think tank).

Margaret A. Hamburg was the VP for the Nuclear Threat Initiative (think tank) and the commissioner for the U.S. Food and Drug Administration (FDA).

Donald Kennedy was a trustee at the Carnegie Endowment for International Peace (think tank) and a commissioner for the U.S. Food and Drug Administration (FDA).

Foundation to Promote Open Society was a funder for the Carnegie Endowment for International Peace (think tank) and the Center for American Progress.

Open Society Foundations was a funder for the Center for American Progress.

Center for American Progress (think tank) was a funder for America's Health Insurance Plans.

Donald M. Berwick is a senior fellow at the Center for American Progress and was an administrator for the Centers for Medicare & Medicaid Services.

Jose H. Villarreal is a director at the Center for American Progress and a senior adviser at the Akin, Gump, Strauss, Hauer & Feld, LLP.

Akin, Gump, Strauss, Hauer & Feld, LLP was the lobby firm for the Center for American Progress (think tank), the America's Health Insurance Plans, the American Medical Association, Johnson & Johnson (COVID 19 Vaccine Manufacturer), Pfizer Inc. (COVID 19 Vaccine Manufacturer) and the Pharmaceutical Research and Manufacturers of America “Big Pharma”.

Vernon E. Jordan Jr. is a senior counsel for Akin, Gump, Strauss, Hauer & Feld, LLP and an honorary trustee at the Brookings Institution (think tank).

Foundation to Promote Open Society was a funder for the Brookings Institution (think tank).

George Soros was the chairman for the Foundation to Promote Open Society.

Kenneth M. Duberstein is a trustee at the Brookings Institution (think tank) and the chairman & CEO for the Duberstein Group, Inc.

Duberstein Group, Inc. is a lobby firm for Pfizer Inc. (COVID 19 Vaccine Manufacturer).

Constance J. Horner is a director at Pfizer Inc. (COVID 19 Vaccine Manufacturer) and was a guest scholar at the Brookings Institution (think tank).

Suzanne Nora Johnson is a director at Pfizer Inc. (COVID 19 Vaccine Manufacturer) and a trustee at the Brookings Institution (think tank).

Amy W. Schulman is a trustee at the Brookings Institution (think tank) and the EVP & general counsel for Pfizer Inc. (COVID 19 Vaccine Manufacturer).

Sidley Austin LLP was a lobby firm for Pfizer Inc. (COVID 19 Vaccine Manufacturer), St. Jude Medical Inc., St. Jude Children's Research Hospital, Johnson & Johnson (COVID 19 Vaccine Manufacturer), Pfizer Inc. (Covid 19 Vaccine Manufacturer) and the Pharmaceutical Research and Manufacturers of America “Big Pharma”.

Michelle Obama was a lawyer at Sidley Austin LLP.

Barack Obama was an intern at Sidley Austin LLP.

Valeant Pharmaceuticals International is a member of the Pharmaceutical Research and Manufacturers of America “Big Pharma”.

Colleen A. Goggins was a director at Valeant Pharmaceuticals International, a board member for the CDC Foundation and a worldwide chairman, consumer group for Johnson & Johnson (Covid 19 Vaccine Manufacturer).

Bloomberg Family Foundation was a funder for the CDC Foundation.

Johnson & Johnson (Covid 19 Vaccine Manufacturer) was a funder for the Bill, Hillary & Chelsea Clinton Foundation.

Monsanto Company was a funder for the Bill, Hillary & Chelsea Clinton Foundation.

Pfizer Inc. was a funder for the Bill, Hillary & Chelsea Clinton Foundation.

Open Society Foundations was a funder for the Bill, Hillary & Chelsea Clinton Foundation.

Gara LaMarche was the VP & a director of U.S. programs for the Open Society Foundations and a director at ProPublica.

Foundation to Promote Open Society was a funder for ProPublica.

George Soros is the founder & chairman for the Open Society Foundations, was the chairman for the Foundation to Promote Open Society and a co-chair, national finance council for the Ready PAC (Ready For Hillary).

Ready PAC (Ready For Hillary) supported the 2016 Hillary Rodham Clinton presidential campaign.

William J. Clinton is the founder & director for the Bill, Hillary & Chelsea Clinton Foundation, was an adviser for the 2016 Hillary Rodham Clinton presidential campaign, was Strobe Talbott’s roommate at Oxford and the 1992 & 1998 person of the year for Time magazine.

Strobe Talbott was William J. Clinton’s roommate at Oxford, an editor for Time magazine and is the president of the Brookings Institution (think tank).

Foundation to Promote Open Society was a funder for the Brookings Institution (think tank) and ProPublica.

George Soros was the chairman for the Foundation to Promote Open Society.

Ben S. Bernanke is a distinguished fellow at the Brookings Institution (think tank) and was the 2009 person of the year for Time magazine.

Vernon E. Jordan Jr. is an honorary trustee at the Brookings Institution (think tank), Valerie B. Jarrett’s great uncle and a senior counsel for Akin, Gump, Strauss, Hauer & Feld, LLP.

Jose H. Villarreal is a senior adviser at the Akin, Gump, Strauss, Hauer & Feld, LLP and a director at the Center for American Progress.