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On a recent edition of the PBS NewsHour host Hari Sreenivasan interviewed the New Yorker’s Patrick Radden Keefe about Purdue Pharma’s marketing of OxyContin. What Keefe told his host provides a case study of why progressivism is required, for what the pharmaceutical company did was put profits first. Before any ethical considerations. Before the interests of people. Even if it killed them.

Opioid Crisis

But this should not surprise us. It has happened frequently before. A central principle for many nineteenth-century capitalists, especially in Great Britain and the United States, was laissez faire, which was hostile to almost any government regulation of business or private property, especially any that would curtail employers’ rights to make as big a profit as possible. During the nineteenth century, slaveowners and factory owners sometimes trotted out this principle to defend their “right” to own human property (slaves) or to pay low wages, hire young children, or maintain unsafe working conditions.

The principle still exercised considerable influence at the time of the Irish famine of the late 1840s, contributing to the death of approximately 1 million people between 1846 and 1851, and the emigration of about twice that number from 1845 to 1855. As one economist wrote, “Ship after ship sailed down the river Shannon laden with rich food, carrying it from starving Ireland to well-fed England, which had greater purchasing power.” (For the source of this and other quotes about capitalism and progressivism, see Chapter 3 of my An Age of Progress? Clashing Twentieth-Century Global Forces.) The British government refused to allow food grown by the Irish peasants to feed themselves partly because it was the private property of absentee English landlords.

Making a profit is after all the central purpose of capitalism. As the conservative economist Milton Friedman once wrote, "The social responsibility of business is to increase its profits." Capitalism is amoral. As Daniel Bell noted, it has “no moral or transcendental ethic.”

That is exactly why progressivism was—and is—required. It arose as a movement in the final decades of the nineteenth century “to limit the socially destructive effects of morally unhindered capitalism, to extract from those [capitalist] markets the tasks they had demonstrably bungled, to counterbalance the markets’ atomizing social effects with a countercalculus of the public weal [wellbeing].” It did not attempt to overthrow or replace capitalism but to constrain and supplement it in order to insure that it served the public good. It had enough successes for historians to refer to the period of 1890 to 1914 in U. S. history as “The Progressive Era.” Then, after three Republican presidents, Franklin Roosevelt’s New Deal continued the progressive tradition.

Despite sporadic attempts to roll back progressivism’s “countercalculas” of insuring public wellbeing by regulating capitalism, the need for such a check on capitalism has generally been recognized.

Despite sporadic attempts to roll back progressivism’s “countercalculas” of insuring public wellbeing by regulating capitalism, the need for such a check on capitalism has generally been recognized. Even the U. S. State Department in 2001 declared that a “mixed” economy better describes our economic system than a “capitalist” economy because the government has often intervened to “address many of the social problems associated with unchecked private commercial interests.”

But the advance of progressivism has not prevented companies from continuing to place profits before public wellbeing. We have seen it, for example, most egregiously with coal, oil, cigarette, and arms manufacturers, and now most blatantly with Purdue Pharma.

According to the interview with Keefe, even though OxyContin in only one of various opioids, it “sparked the opioid crisis …when Purdue first introduced the drug” in the mid-1990s. It did so by successfully changing some doctors’ minds about the dangers of prescribing strong opioids. Relying on documents produced by a mid-2018 Massachusetts lawsuit against the company, Keefe stated that “Purdue's budget just for food bought for [wined-and-dined] physicians who prescribe opioids every year was $9 million dollars a year.” Keefe also noted that in 2007 Purdue had pled guilty to “deceiving people about the dangers of the drug,” and “paid a $600 million dollar fine.” Moreover, today “more than half of the states in the United States are suing Purdue Pharma.”

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Earlier, in an October 2017 issue of The New Yorker, Keefe had already reported on the OxyContin scandal and mentioned that “since 1999, two hundred thousand Americans have died from overdoses related to OxyContin and other prescription opioids.” By the beginning of 2018, about 48,000 people a year were dying of opiod overdoses in the USA. In October 2018, the government enacted a new law “intended to help tackle the opioid crisis, the deadliest epidemic of overdoses in the country's history.”

Keefe’s long New Yorker article details much more information about the Sackler family, owners of Purdue, especially Arthur (d. 1987) and his nephew Richard. Keefe quotes one source as stating, “Most of the questionable practices that propelled the pharmaceutical industry into the scourge it is today can be attributed to Arthur Sackler.” It was also Arthur, who once wrote that “all health problems devolve upon the individual”—a position that Purdue adopted in denying any blame for OxyContin overdoses.

But in both his interview and article, Keefe states that it is Richard who, despite all we know today, continues to push the sale of OxyContin, which has been reformulated but still contributes to the opioid epidemic. And Keefe argues effectively that the cause of the problem is not just individual weakness, but also other factors, especially Purdue’s deceitful practices.

The article also often quotes former Mississippi Attorney General Mike Moore, who played an important part in forcing tobacco companies in 1998 to agree to a $246 billion settlement payment. Moore sees an “ethical parallel” between what the tobacco companies and the Sacklers did: “They’re both profiting by killing people.” Moore also sees a parallel in the strategies of both big tobacco and the Sacklers after U. S. public opinion turned against them: “They got caught in America, they saw their market share decline, so they export it to places with even fewer regulations than we have . . . . You know what’s going to happen. You’re going to see lots and lots of death.” Keefe confirms that Purdue, now operating through a company called Mundipharma, is marketing OxyContin in Asia, Latin America, and the Middle East.

Keefe’s article also details how a company with big profits like Purdue Pharma and an influential family like the Sacklers—who also contributed to various philanthropic causes—can work our system to obtain even bigger profits at the expense of the common good. Thankfully, however, the progressive tradition of journalists like Ida Tarbell and politicians like Wisconsin’s Robert La Follette, first a Republican governor and then a senator, continues today with journalist like Patrick Keefe and politicians like Sen. Bernie Sanders, Sen. Elizabeth Warren, and Massachusetts Attorney General Maura Healey, who is continuing the court fight against the Sacklers.

In a new 274-page memorandum, filed in January 2019, Healey “implicates eight Sackler family members, as well as nine Purdue board members or executives, in the nation's deadly opioid epidemic.” She claims that the “Sacklers flooded Massachusetts with sales reps, influenced state legislation, and financially backed medical facilities and universities so they could tout Purdue opioids.’ She describes former chairman and president of the company, Richard Sackler “as a micromanager, obsessed with profits in Massachusetts and the rest of the country.”

walter moss

Walter Moss

Trumpian Republicans, including Rudy Giuliani, who once acted as a Purdue lawyer, tend to rant about government regulations that hamper business profits—witness the actions of Trump’s Environmental [Non] Protection Agency. And it is true that big government and its bureaucrats are not without fault and sometimes fail to serve the public good. But what the Trumpians fail to acknowledge is that the primary purpose of government is to do just that—foster the common good—while that of businesses is to earn profits. Progressives in the Progressive Era knew that. Franklin Roosevelt knew it. And progressives today know it.

Walter G. Moss