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"When your board is stacked with industry insiders, your primary funding comes from pharma, and your talking points mirror those of drug lobbyists, you're not a patient advocacy organization—you're a PR operation."
A report published Monday reveals that a number of organizations claiming to represent the interests of patients are actually pharmaceutical industry front groups working against efforts to bring down drug costs in the United States, including by lobbying the Trump administration to scale back Medicare price negotiations.
The new analysis by Patients for Affordable Drugs Now (P4AD), which stressed that it doesn't take money from organizations that profit from the production or distribution of prescription medications, spotlights six groups: the Alliance for Aging Research, the American Action Forum, the Center for Medicine in the Public Interest, the Council for Affordable Health Coverage, the Pacific Research Institute, and Seniors 4 Better Care.
The featured organizations, according to P4AD, "are posing as independent patient or policy groups while acting as mouthpieces for the drug industry's agenda—all while raking in pharma cash, fighting Medicare negotiation, and pushing misleading claims to block reforms."
Seniors 4 Better Care, for instance, is a shell group of the American Prosperity Alliance, the president of which "has a history of lobbying for the healthcare industry, including for organizations at the Healthcare Association of New York and insurance providers such as MVP Healthcare," P4AD's report observes.
"The group's treasurer, Parker Hamilton Poling, is a former lobbyist for pharmaceutical companies like Roche and Cencora," the report notes. "Brian Berry, the organization's secretary, also has a history of lobbying for Chinese biotech companies like Complete Genomics."
Earlier this year, Seniors 4 Better Care bankrolled an ad that directly urged President Donald Trump to end the "pill penalty," a label the pharmaceutical industry has used to describe the treatment of small-molecule prescription drugs under the Inflation Reduction Act's Medicare price negotiation provisions.
Last month, in a major gift to Big Pharma and industry lobbyists, Trump signed an executive order aimed at delaying Medicare negotiations for small-molecule drugs, which represent 90% of prescription medicines currently in circulation.
Another group highlighted in P4AD's report is the Center for Medicine in the Public Interest (CMPI), which describes itself as "a nonprofit, nonpartisan research and educational organization that seeks to advance the discussion and development of patient-centered healthcare."
P4AD notes that "every single member" of the organization's board has ties to the pharmaceutical industry. Peter Pitts, CMPI's president and co-founder, "primarily worked at firms hired by the pharmaceutical industry following an 18-month stint at the Food and Drug Administration," P4AD's report states.
"While working at major firms, such as Porter Novelli, Pitts retained his role at CMPI and insisted it was not a conflict of interest," the report continues. "He also currently teaches at the University of Paris, Descartes School of Medicine, a department that is funded by AstraZeneca."
Merith Basey, P4AD's executive director, said that "when your board is stacked with industry insiders, your primary funding comes from pharma, and your talking points mirror those of drug lobbyists, you're not a patient advocacy organization—you're a PR operation."
"Polling shows that Americans are aware that pharmaceutical corporations are the primary drivers of high drug prices, which is why the industry funds front groups to mislead the public and protect its bottom line," said Basey. "Patients and policymakers deserve to know whose interests these groups truly represent."
When corporations prioritize shareholder payouts over real investment, society loses—but when governments adopt the same model, the consequences are compounded.
There’s a familiar myth in American politics: that of the no-nonsense business leader who cuts through red tape and gets results. It fuels the belief that running a country is just like running a company—and that executives, with their boardroom instincts and bottom-line mindset, are exactly what government needs.
But that myth collapses under the weight of what corporate leadership has actually become—and what happens when it migrates into public office.
Economist William Lazonick has spent decades analyzing that transformation. He argues that corporate America has abandoned its commitment to innovation and productive investment, replacing it with a laser focus on cost-cutting, price gouging, and tax dodging to boost profits so they can do more stock buybacks—all in the name of maximizing shareholder value. Most executives are no longer rewarded for building durable businesses or contributing to the real economy—they’re rewarded for how efficiently they extract value from the companies that they control.
We’re not just talking about fragile companies. We’re talking about the erosion of public institutions, rising inequality, and a democracy that serves fewer and fewer people.
Lazonick calls this model a “scourge,” blaming it for weakening U.S. technological leadership, driving massive inequality, and destabilizing the broader economy. Now, he warns, this same extractive logic is infiltrating the federal government.
The ongoing 2025 budget debates are a case in point. Under the guise of “efficiency” and “fiscal responsibility,” the Trump administration has proposed slashing $163 billion from federal spending—cuts that would gut education, housing, and medical research—all of which are essential for value creation. The language mirrors what executives have long used to justify layoffs, offshoring, and disinvestment. But in this case, it’s not a corporation being hollowed out. It’s the state itself.
Lazonick argues that this shouldn’t surprise anyone. “Because these people have gotten away with looting corporations, they’ve come to believe it’s their right to loot the state,” he says. Even among tech figures who’ve built or have led the building of real products—like Elon Musk, Jeff Bezos, and Mark Zuckerberg—Lazonick notes a mindset of entitlement: “They treat the resulting wealth as entirely their own, as if they alone earned it.” That thinking now shapes public policy, where deregulation and budget cuts benefit the wealthy while dismantling protections for workers and consumers.
Take Musk, for example. As head of the Department of Government Efficiency (DOGE), he’s worked to weaken regulatory agencies like the Consumer Financial Protection Bureau and the National Labor Relations Board—both of which would typically oversee parts of his business empire. At the same time, his companies continue securing massive federal contracts, including a potential $2 billion FAA deal, raising serious concerns about conflicts of interest. As Lazonick and colleague Matt Hopkins argue in a recent piece for the Institute for New Economic Thinking, Musk has advanced through a “perilous system of corporate governance” driven by shareholder primacy—fueling inequality and eroding America’s technological leadership. His tenure at DOGE is simply more of the same: dismantling oversight, channeling public resources into private ventures, and treating government as just another asset to extract.
Musk’s corporate empire—Tesla, SpaceX, and Neuralink—owes much of its success to taxpayer-funded research and government support. Tesla was launched with the help of federal loans and electric vehicle subsidies. SpaceX builds on decades of NASA-funded R&D and now depends on billion-dollar public contracts. Even Neuralink draws heavily on publicly funded neuroscience work. Despite the mythology of private-sector genius, these companies are deeply rooted in public investment. Yet the public sees little return.
And the mindset isn’t limited to Musk. President Donald Trump and his family are taking the corporate model Lazonick describes to new heights, using government as a platform for private enrichment. Eric Trump recently promoted the family’s latest crypto venture, making the president a major crypto player while shaping federal policy toward that very industry. The Trump family’s 60% stake in World Liberty Financial, now attracting major investment, has intensified concerns over conflicts of interest. Meanwhile, under Eric’s leadership, the Trump Organization has struck a controversial $5.5 billion deal with a Qatari state firm to build a luxury golf resort—despite Trump’s previous pledge to avoid foreign deals while in office.
Trump has also issued executive orders to “streamline” federal procurement and contract reviews. While marketed as anti-waste measures, critics see them as a backdoor for directing government business to favored contractors, including those with family ties. The line between public service and private gain has rarely been thinner.
Lazonick warns that the stakes are high. When corporations prioritize shareholder payouts over real investment, society loses—but when governments adopt the same model, the consequences are compounded. We’re not just talking about fragile companies. We’re talking about the erosion of public institutions, rising inequality, and a democracy that serves fewer and fewer people.
To reverse course, Lazonick argues we need deep structural reform in how corporations—and by extension, governments—operate. That means banning stock buybacks; reining in executive compensation tied to manipulated stock performance; and reinvesting profits in innovation, workers, and communities. It means embracing a stakeholder model of governance that sees corporations not just as wealth machines, but as stewards of social value.
Because if we don’t fix these systemic flaws, the looting won’t stop. It’ll only deepen—and spread.
Starbase is a company town, and America is starting to look like one big national company town.
On Saturday, the town of Starbase, Texas was born. The town includes Elon Musk’s SpaceX launch facility and company-owned land covering 1.6 square miles.
If Musk and President Donald Trump have their way, America as a whole could eventually be Starbase, Texas.
Starbase is hardly a democracy. It’s the brainchild of Elon Musk, the richest man in the world, who founded the town because he didn’t want to deal with local regulations in getting approvals for his space launches.
Consider:
Starbase is a company town. That company is Musk’s SpaceX. Its new mayor, Bobby Peden, is a SpaceX vice president. He was the only name on the ballot. Its two commissioners are also SpaceX employees. The local measure creating Starbase passed 212 to 6. Almost everyone who voted works for SpaceX or has a relative who does.
America is starting to look like one big national company town. The largest 1% of U.S. corporations now own a record 97% of all U.S. corporate assets. Fewer big corporations dominate every American industry, and they’re exerting more political influence than ever. Musk and Trump are twisting tax laws and regulations in favor of even fewer big corporations.
Starbase is hardly a democracy. It’s the brainchild of Elon Musk, the richest man in the world, who founded the town because he didn’t want to deal with local regulations in getting approvals for his space launches. Musk’s Department of Government Efficiency has hamstrung federal agencies under whose authority SpaceX falls, such as the Environmental Protection Agency and Federal Aviation Administration—which just decided to allow him to go from five Starship launches a year to 25.
America, too, is looking less and less like a democracy. One man posts executive orders on social media, often without explanation or reason—and entire industries are created or destroyed, hundreds of thousands of jobs are terminated, universities and law firms are threatened, and legal residents of the United States are abducted without court hearings. Several of his advisers have disdained democracy and openly admired authoritarian Viktor Orbán’s Hungary and the late Lee Kuan Yew’s Singapore.
It’s hard to know what’s happening in Starbase. There’s no independent press, and Starbase has explained little about its plans for the new city. Reporters can’t simply wander in and interview whomever they wish.
It’s getting to be that way in America too. We don’t know what Trump is going to do next or why. The White House selects the reporters and outlets it wants in its press pool. Some big outlets, such as The Washington Post and CBS, are owned by the super-rich who want to curry favor with Trump and don’t want to anger him, so they limit what their outlets can say.
Starbase is harming the environment. The first integrated Starship vehicle launched from the site in April 2023 exploded in midflight, igniting a 3.5-acre fire south of the pad site in Boca Chica State Park and sending debris thousands of feet into the air. State and federal regulators fined SpaceX for violations of the Clean Water Act and said the company had repeatedly polluted waters in the Boca Chica area.
America’s environment is also endangered—due in part to Musk and Trump, who are eviscerating environmental protections in favor of large private profit-making ventures like, well, Musk’s Starship.
Starbase is the brainchild of a single multibillionaire. He plans to live there part of the time with some of his 14 children and their four mothers, and he ultimately decides all important matters for the town.
America is the part-time home of many of the world’s billionaires, who also have outsized influence over important matters the nation deals with.
Finally, Starbase is insular. It will not share its tax revenue with anyone else. Because it’s incorporated separately, the town will keep for itself all the revenue generated by its property-owning taxpayers.
Trump’s America is becoming as insular as Starbase. Trump has all but eliminated USAID along with medical and humanitarian aid to war-ravaged people around the world. He’s cutting trade and deporting residents with student visas and green cards who don’t toe the company line.
So is Musk’s Starbase the future of America? Only if we let it become so.