The Institutionalization of Corporate Power within Policy

Addressing corporations’ effects on health requires fundamental changes in markets. Among other things, these changes relate to what products and services are sold, at what price, how and to whom, the conditions under which people live and work, and maximum thresholds of industrial pollution. States’ capacity to regulate corporations is central to this process. As the area of law and public policy that mediates between public and private interests, regulation goes to the heart of effective democratic control of corporations. More specifically, regulation works to prevent corporations from shifting the costs associated with their activities onto the general population and, in this sense, provides a system of rules to protect the planet and its people from profit-driven externalities. In practice, states do not have complete freedom over how they regulate. In fact, governments’ policy space – the freedom, scope, and mechanisms that they have to choose, design, and implement public policy and regulation1 – has steadily contracted over the last forty years as a result of a combination of processes, which have worked to strengthen corporate power within policymaking. This chapter is concerned with one of these processes – the emergence of cost-benefit analysis and new regulatory oversight mechanisms, which increasingly govern how policies and regulations (hereafter referred to as policy) are developed. The chapter is based on the premise that understanding health policy in the context of the commercial determinants of health requires us to look behind discrete forms of business political activity, such as lobbying, and focus on how corporations institutionalize their advantage in policymaking.