A Litany of Pharma Crimes – Part 4 – US Pharma in China
一连串的制药犯罪——第4部分——美国制药公司在中国
By Larry Romanoff, March 10, 2022
由拉里·罗曼诺夫，2022年3月10日
Part 1, Part 2, Part 3, Part 4
Credit image: https://www.hassellstudio.com/project/zhangjiang-pharmaceutical-campus
In June of 2013, Sohu China published an article by Yun Wuxin, claiming that “after more than 100 years of work, the FDA has formed a comprehensive regulatory system, which many other countries have now emulated. The core concept of the system is to protect those that abide by the rules and punish those that break the law, using penalization to prevent further incidents from occurring.”
2013年6月，搜狐中国发布了一篇云无新的文章，声称“经过100多年的工作，FDA已经形成了一个全面的监管体系，许多其他国家现在都在效仿。该体系的核心理念是保护那些遵守规则的人，惩罚那些违法的人，用惩罚来防止进一步的事件发生。”
I seldom see comments as disturbingly uninformed as these, claims so incorrect and with such tragic potential for human loss they should be treated as a criminal offense and punished by flogging and imprisonment. It is both astonishing and absolutely unforgivable that so many Chinese in authoritative positions will blindly accept the most stupidly false claims about American superiority in one field or another, apparently without doing even the most superficial investigation into the accuracy of these claims. This blind ‘white first’ attitude is in many instances so reckless, and carries such dangers for China, that any positive recommendations of American products should carry an automatic threat of imprisonment if proven false. Furthermore, someone needs to check on the original authorship of some of these articles and label them as the ghost-written foreign propaganda that they are – which practice in publication should also be a criminal offense.
我很少看到像这些评论那样令人不安的无知，如此不正确的主张，以及如此悲惨的潜在人员损失，他们应该被视为刑事犯罪，并受到鞭笞和监禁的惩罚。如此多处于权威地位的中国人会盲目地接受关于美国在某个领域的优势的最愚蠢的虚假说法，这既令人震惊，也绝对不可原谅，显然他们甚至没有对这些说法的准确性进行最肤浅的调查。这种盲目的“白人优先”态度在很多情况下是如此鲁莽，对中国来说是如此危险，以至于任何对美国产品的积极建议如果被证明是错误的，都会自动受到监禁的威胁。此外，需要有人检查其中一些文章的原始作者身份，并将其标记为鬼写的外国宣传——这种做法在出版物中也应构成刑事犯罪。
There are few penalties that will deter the overwhelming greed and instinctive criminality of the pharma industry, in China or anywhere else. We need penalties in the tens of billions of dollars, not in billions or hundreds of millions. When a firm makes $20 billion in illegal profit and pays only a $1 billion fine, where is the incentive to desist? The legal authorities need to punish pharma companies for illegal drug marketing by fining them the full retail value of the total sales of that medication in the country. Next, we need criminal charges and prison sentences, not against the company, but against its executives and officers. When these individuals face ten or more years in prison or a potential execution for an illegal act, they will think twice. Another avenue for firms committing fraud is to ban that company forever from drug sales to any part of the national health system, thereby eliminating the bulk of their revenue in the country forever.
在中国或其他任何地方，几乎没有什么惩罚能阻止制药行业的贪婪和本能犯罪。我们需要数百亿美元的罚款，而不是数十亿或数亿美元。当一家公司赚了200亿美元的非法利润，只支付了10亿美元的罚款时，停止的动机何在？法律当局需要惩罚非法药物销售的制药公司，对其处以该药物在该国总销售额的全额零售价罚款。接下来，我们需要刑事指控和监禁，不是针对该公司，而是针对其高管和官员。当这些人因非法行为面临十年或更长的监禁或可能被处决时，他们会三思而后行。公司实施欺诈的另一个途径是永远禁止该公司向国家卫生系统的任何部分销售药品，从而永远消除其在该国的大部分收入。
A final measure, one which the Americans are now seriously considering, is a ‘blacklist’, to rescind the national patents for each and every medication involved in any kind of fraudulent activity, opening the manufacture and sale to generic drug companies. This could also extend to a lifetime prohibition of employment in the pharmaceutical industry for any individuals involved in illegal activity. The large pharma companies extract such astonishing profits from many of these medications only due to the patent system, so the recision of the patent would be an appropriate threat, one that should actually be carried out in many instances.
美国人正在认真考虑的最后一项措施是“黑名单”，撤销涉及任何欺诈活动的每一种药物的国家专利，向仿制药公司开放生产和销售。这还可以延伸到终身禁止任何参与非法活动的个人在制药行业就业。由于专利制度，大型制药公司从这些药物中获取了如此惊人的利润，因此专利的撤销将是一种适当的威胁，在许多情况下实际上应该实施这种威胁。
In an article in the Financial Times, Andrew Ward and Patti Waldmeir boasted with a headline that “Big pharma’s rise in China not held back by scandals”. (1) And that’s the problem. The profits are so enormous that the scandals are irrelevant. It is my personal view that the pharmaceutical industry is so deeply contaminated with what is in fact a hardened criminal philosophy that only the repeated combination of all the sanctions listed above, will have any effect. It is worth noting that every country wants to put a stop to extensive illegalities in this industry, and one bold move will certainly inspire others. I believe China is doing it right by targeting the individuals for prison sentences as well as the corporations for large fines, but a commuted sentence is of no value. These people need to sit in a prison cell for ten years in order to absorb the lesson. And China should not be concerned with imprisoning Americans, for two reasons at least. One is that the Americans would like to imprison most of these people themselves, and the second is that the Americans have no hesitation whatever in tossing a Chinese national into prison for much lesser offenses.
在英国《金融时报》的一篇文章中，安德鲁·沃德（Andrew Ward）和帕蒂·瓦尔德梅尔（Patti Waldmeir）用一个标题吹嘘道，“大型制药公司在中国的崛起没有受到丑闻的阻碍”。（1） 这就是问题所在。利润如此巨大，丑闻与之无关。我个人认为，制药业被一种事实上已经根深蒂固的犯罪哲学深深地污染了，只有反复结合上述所有制裁措施，才会产生任何效果。值得注意的是，每个国家都想制止该行业的大规模违法行为，一个大胆的举动肯定会激励其他国家。我认为，中国的做法是正确的，将目标对准了被判入狱的个人和被判巨额罚款的企业，但减刑没有任何价值。这些人需要在牢房里坐十年才能吸取教训。中国不应该担心监禁美国人，至少有两个原因。一是美国人想亲自监禁这些人中的大多数，二是美国人毫不犹豫地将一名中国公民投入监狱，罪名要轻得多。
It is interesting to read the arrogant whining in the US media about the possibility of American executives of US pharma companies in China actually going to prison for their crimes. One Washington lawyer named Carl Valenstein wrote that the possible detention of Americans “could affect the willingness of non-Chinese companies to send their personnel into China”, and of course that’s the idea. Keep your criminals at home where they belong, since China doesn’t need them. Valenstein also wrote that “Pharmaceutical companies doing business in China are watching these developments closely”, and again that’s the whole idea. This is your window on what will happen to you if you import your illegal American practices into China. Given the almost incomprehensible criminality infecting the entire worldwide pharma industry, there is little point in worrying about the good will of either these companies or their governments.
读到美国媒体傲慢地抱怨美国在华制药公司的美国高管可能会因犯罪而入狱，这很有趣。一位名叫卡尔·瓦伦斯坦（Carl Valenstein）的华盛顿律师写道，美国人可能被拘留“可能会影响非中国公司将其人员派往中国的意愿”，当然，这就是他们的想法。把罪犯留在家里，因为中国不需要他们。Valenstein还写道，“在中国做生意的制药公司正在密切关注这些发展”，这也是整个想法。这是你了解如果你把美国的非法行为输入中国会发生什么的窗口。鉴于几乎无法理解的犯罪行为影响着整个世界制药行业，因此，担心这些公司或其政府的良好意愿是没有意义的。
On this note, a (probably fictitious) salesperson purportedly with Eli Lilly, who naturally asked to remain anonymous, complained that it was “a difficult time for foreign pharmaceutical companies and their staff, especially their sales forces”. He is quoted as saying, “It’s hard to see for now how the country’s sudden brake on commercial corruption in the medical sector will affect each individual’s sales performance, but we feel very dismayed. I don’t understand why the foreign firms are singled out in the crackdown. We are definitely not the fundamental cause generating the disorder in the medical sector, (nor) a main contributor in the strained relations between doctors and patients.” Well, we can sympathise with the poor man’s dismay, and with his loss of sales in the absence of bribery, but he needs to be informed that his American companies are indeed the main contributor and the fundamental cause of the problems. And in the end, my concern is on the side of the millions who must pay the price of this greed and corruption, not wasting much sleep over the earnings of a drug salesman.
在这一点上，一名（可能是虚构的）据称与礼来合作的销售人员抱怨说，“对于外国制药公司及其员工，尤其是其销售人员来说，这是一个困难的时期”。礼来自然要求匿名。引用他的话说，“目前很难看出国家对医疗行业商业腐败的突然遏制会对每个人的销售业绩产生怎样的影响，但我们感到非常沮丧。我不明白为什么在打击行动中会把外国公司挑出来。我们绝对不是医疗行业乱局的根本原因，（也不是）医患关系紧张的主要原因。“好吧，我们可以同情穷人的沮丧，同情他在没有行贿的情况下失去了销售，但他需要被告知，他的美国公司确实是问题的主要贡献者和根本原因。最后，我的担忧站在数百万人一边，他们必须为这种贪婪和腐败付出代价，不要为毒品销售员的收入浪费太多睡眠。
In 2013, China intensified an already ongoing investigation into alleged bribery in the pharmaceutical and medical services sectors, aimed at stamping out not only bribery but all fraud and anti-competitive practices among both foreign and domestic companies. Much of the focus was on illegal pricing and violations of the bidding process. SAIC, the State Administration for Industry and Commerce, stated that “Commercial bribery not only leads to artificially high prices, it undermines market order in terms of fair competition and corrupts social morals and professionalism”, is destructive to the industry, and harms patients. The SAIC also said it wanted to prevent industry associations from organising fraudulent and monopolistic behavior, since in 75% of such past cases these associations had been “the driving force” behind the corruption.
2013年，中国加强了对医药和医疗服务行业涉嫌行贿的调查，目的不仅是打击行贿，还包括打击外国和国内公司之间的所有欺诈和反竞争行为。主要关注的是非法定价和违反招标流程。国家工商行政管理总局表示，“商业贿赂不仅会导致人为抬高价格，还会破坏公平竞争的市场秩序，腐蚀社会道德和职业精神”，对行业具有破坏性，还会伤害患者。国家工商行政管理总局还表示，希望防止行业协会组织欺诈和垄断行为，因为在过去的此类案件中，75%的行业协会是腐败背后的“驱动力”。
In case you haven’t made the link, these “industry associations” are what we call NGOs, part of Hillary Clinton’s “civil society” promotion, groups supposedly vital to a nation’s development but in fact simply subversive American political organisations, their activities including the masterminding of these industry-wide frauds. They include the US Chamber of Commerce in China (AmCham), variously-named and US-funded Pharmaceutical associations, and much more.
如果你没有联系，这些“行业协会”就是我们所说的非政府组织，是希拉里·克林顿“公民社会”宣传活动的一部分，这些组织被认为对一个国家的发展至关重要，但实际上只是颠覆美国政治组织，他们的活动包括策划这些行业范围的欺诈。其中包括中国美国商会（AmCham），各种名称和美国资助的制药协会，等等。
In spite of the denigrating accusations directed at China for corruption in the medical system, it is the US, not China, with the most criminally corrupt medical and pharmaceutical environment. But in contradistinction, it is not the US but China that is actually taking real steps to eliminate the rot. When pharma executives in America commit egregious crimes even involving death on a massive scale, the only consequence is that the company’s shareholders suffer a small loss. In China, they go to prison or worse.
尽管有针对中国医疗系统腐败的诋毁性指控，但最腐败的医疗和制药环境是美国，而不是中国。但与此相反，真正采取措施消除腐败的不是美国，而是中国。当美国的制药公司高管犯下令人发指的罪行，甚至涉及大规模死亡时，唯一的后果就是该公司的股东蒙受了小损失。在中国，他们会坐牢或更糟。
When the FDA approves the continued distribution of fake or dangerous medications, or when it certifies a new killer drug, there are no consequences because the FDA, by virtue of its status, is immune to legal or criminal sanction. But when China’s chief drug regulator, Zheng Xiaoyu, approved similar medications, he was tried and executed for what were considered crimes against the entire nation. It is China, not the US, that is cleaning up the world’s pharma industry. And it needs to be noted somewhere that all of the major criminal pharmaceutical scandals in China have been committed by foreign companies, mostly American.
当FDA批准继续分销假药或危险药物，或认证一种新的致命药物时，不会产生任何后果，因为FDA凭借其地位，不受法律或刑事制裁。但当中国首席药品监督管理局局长郑晓宇批准类似药物时，他因被视为危害全国的罪行而受到审判并被处决。清理世界制药行业的是中国，而不是美国。需要指出的是，中国所有重大刑事制药丑闻都是外国公司所为，其中大部分是美国公司。
One American reader made some interesting points in commenting on a media report on corruption in big pharma:
一位美国读者在评论媒体关于大型制药公司腐败的报道时提出了一些有趣的观点：
“Upon reading the comments from other readers, it appears to me that the point of the article was lost on many. In (bad) China, people did bad things that HURT other people. Lots of people. The gov’t responded with badly needed heavy-handed proceedings and pronouncements. In (good) America, people did bad things that KILLED other people. Lots of people. The gov’t response was tepid and minimal, much of it downplayed and swept under the rug, the outrage squelched. No one paid a price for the deaths of those people, and the corporation responsible paid next to nothing as a percentage of sales and the stock (during a bad economy) has rebounded. In (bad) China, people were held responsible for their actions. In (good) America, people got off scott-free after playing the system, hiding the truth. The top man in charge retired with mega bucks and no consequences.” Precisely correct.
“在阅读了其他读者的评论后，我觉得这篇文章的要点在很多人身上消失了。在（糟糕的）中国，人们做了伤害他人的坏事。很多人。政府以急需的严厉程序和声明予以回应。In（好）在美国，人们做了害人的坏事。很多人。政府的反应是温和而温和的，其中大部分被淡化并掩盖了，愤怒平息了下来。没有人为这些人的死亡付出代价，负责的公司在销售额中所占的百分比几乎为零，股票（在经济不景气时）已经反弹。在（糟糕的）中国，人们要为自己的行为负责。在（好的）美国，人们在玩了这个系统后就可以自由地离开斯科特，隐瞒真相。最高负责人带着巨款退休，没有任何后果。“完全正确。
When an official in Shanghai accumulated 50 million RMB from bribes and other corrupt acts, a Shanghai court levied a suspended death sentence, and other high-level officials have been fired for ethics violations, these not only in regulatory bodies but in Chinese pharma and healthcare companies as well as in labs, hospitals and clinics. The country is serious about cleaning up the medical landscape, an effort that is by no means targeting only foreign multinationals – although it needs to be said again this latter group carry much of the responsibility for having institutionalised the problem on such a grand scale. It should be noted too, that virtually all of the major scandals related to medicine, healthcare or food safety in China in recent years have involved foreign companies – mostly American – rather than Chinese firms. The Western media either ignore or severely downplay this point.
当上海一名官员因贿赂和其他腐败行为累积5000万元人民币时，上海一家法院判处死刑缓期执行，其他高级官员因违反道德而被解雇，这不仅发生在监管机构，也发生在中国制药和医疗保健公司，以及实验室、医院和诊所。该国对清理医疗环境持认真态度，这一努力绝不只是针对外国跨国公司——尽管需要再次指出，后一类公司承担着将这一问题如此大规模地制度化的大部分责任。还应该指出的是，近年来，中国几乎所有与药品、医疗保健或食品安全有关的重大丑闻都涉及外国公司——主要是美国公司——而不是中国公司。西方媒体要么忽视这一点，要么严重淡化这一点。
It also needs to be noted that the problem of payments to physicians for prescribing medications is even more firmly entrenched in the US than in China, the practice having been largely exported from the US to China, and is now a problem for which American companies carry much of the responsibility. Similarly, the practice of hospitals profiting from the sale of medications is an American tradition and one driven by greed rather than need. In China, hospitals have used markups from medications as a normal part of their revenue stream to support operations, whereas in the US those markups are profits in the pockets of the private owners of those hospitals. But Americans praise this as “best practices” and good management when it occurs in the US, whereas the identical practice in China is just another example of Chinese corruption.
还需要指出的是，向医生支付开药费用的问题在美国比在中国更加根深蒂固，这种做法基本上是从美国出口到中国的，现在是美国公司承担大部分责任的问题。同样，医院从药物销售中获利的做法是美国的传统，是由贪婪而非需求驱动的。在中国，医院将药品加价作为其收入流的正常部分来支持运营，而在美国，这些加价是这些医院私人所有者口袋里的利润。但美国人称赞这在美国是“最佳实践”和良好管理，而在中国，同样的做法只是中国腐败的另一个例子。
To claim that American doctors and hospitals don’t profit heavily from the same practice is absurd. Countless pharma companies have paid billions in fines during the past ten years precisely for their version of this fraudulent practice. The drug firms will often publish a price of $300 for a medication but sell it to a physician for a third of that amount or less, producing enormous profits for the medical clinics and private practitioners who will then bill Medicare for the full amount. As well, many firms provide doctors with large volumes of free medications, which the doctors are then free to prescribe and bill to Medicare or the insurance companies at the full retail price.
声称美国医生和医院没有从同样的做法中获得巨额利润是荒谬的。在过去十年里，无数制药公司正是因为他们的欺诈行为支付了数十亿美元的罚款。制药公司通常会公布一种药物300美元的价格，但以该价格的三分之一或更低的价格将其出售给医生，为诊所和私人执业医生创造了巨大的利润，然后他们将全额支付医疗保险。此外，许多公司向医生提供大量免费药物，医生可以自由开处方，并以全额零售价向医疗保险或保险公司收费。
To add fuel to this China-bashing bonfire, we have a multitude of ideological fools like Huang Yanzhong, who is billed as a “senior fellow for global health” at the Rothschild’s Council on Foreign Relations (where else?) and who tells us “We know that China’s corruption is so entrenched in the pharmaceutical space that in order to get things done you have to bribe officials; it’s an open secret. Rampant bribes, commissions and corruption …”. It is truly difficult to apprehend the convoluted mental processes that must take place in what can only be a diseased mind to produce such ideological drivel. Huang claims in an article that because “government power has permeated almost every aspect of the approval, manufacture, pricing, and marketing” of pharmaceutical products in China, “foreign firms find it hard to do business without bending rules and bribing” everyone in sight.
为了给这场抨击中国的篝火火上浇油，我们有许多意识形态上的傻瓜，比如黄彦忠，他被罗思柴尔德外交关系委员会（Rothschild’s Council on Foreign Relations，还有哪里？）称为“全球卫生高级研究员”谁告诉我们“我们知道中国的腐败在制药领域根深蒂固，为了完成事情，你必须贿赂官员；这是一个公开的秘密。猖獗的贿赂、佣金和腐败……”。真正难以理解的是，只有在一个患病的头脑中才能产生这种意识形态上的胡言乱语，而必须发生的错综复杂的心理过程。黄在一篇文章中称，由于“政府权力已渗透到中国药品审批、生产、定价和营销的几乎每一个方面”，外国公司发现，如果不违反规则并贿赂“所有人”，很难做生意。
As evidence, Huang quotes a former GSK executive who claimed he had to bribe not only doctors and hospitals but officials at every level of government. “Had to” bribe them? To accomplish what? Huang’s claim is not only deserving of ridicule, but is patently stupid from every angle. Nobody “had to” bribe anybody; GSK’s bribes in China – as in America and a dozen other countries – were driven solely by greed, by a perceived chance to make billions in illegal profits, but Huang seems oblivious to the facts.
作为证据，黄引用了一位葛兰素史克前高管的话说，他不仅要贿赂医生和医院，还要贿赂各级政府官员。“不得不”贿赂他们？完成什么？黄的说法不仅值得嘲笑，而且从各个角度看都明显愚蠢。没有人“不得不”贿赂任何人；葛兰素史克在中国的行贿——就像在美国和其他十几个国家一样——完全是由贪婪驱动的，被认为有机会获得数十亿的非法利润，但黄似乎无视事实。
Even more, his veiled accusation about the Chinese authorities being involved in every aspect of the medical field is presented as a bad thing. Of course the authorities need to be involved; we need only look at the rampant criminality of the pharma companies in every country to realise government control is the only public safeguard. But even more, Huang holds out the US and its unregulated free market as a guiding light. Well, if that’s true, why have pharma companies been fined $80 billion more in criminal fines in the US than in China? Why is corruption far more deeply entrenched in the US pharma market than in China’s, and with no light at the end of that tunnel given the small fines and total immunity from criminal prosecution? From the facts it would seem that it is in America where firms “find it hard to do business without bending rules and bribing”. Such pathetic, hypocritical rubbish.
更重要的是，他含蓄地指责中国当局涉及医疗领域的方方面面，这被认为是一件坏事。当然，当局需要参与；我们只需看看每个国家制药公司猖獗的犯罪行为，就能意识到政府控制是唯一的公共保障。但更重要的是，黄将美国及其不受监管的自由市场作为一盏明灯。如果这是真的，为什么制药公司在美国的刑事罚款比在中国多800亿美元？为什么腐败在美国医药市场比在中国更根深蒂固，而且考虑到罚款很小，完全免于刑事起诉，这条隧道的尽头没有光明？从事实上看，似乎是在美国，公司“发现在不违反规则和行贿的情况下很难做生意”。这些可悲、虚伪的垃圾。
One of the clever methods the US media employs to distract and trivialise the criminal activity of their close multinational friends is through the pretense of a criminal charge (in China) being quite unjustified, with one unlucky firm chosen as an ‘example’, to “send a message” or “transmit a signal” to all others in that industry to behave themselves. It was our CFR genius Huang who offered the treasured insight that since GSK probably represented “the tip of the iceberg”, China was using its investigation of that firm to send a ‘cease and desist’ message to other pharma companies. Messages notwithstanding, it seemed to not appear to the man that GSK was charged because it was guilty. I will deal with GSK later; these people deserve a chapter of their own.
美国媒体用来分散和淡化其亲密跨国朋友犯罪活动的聪明方法之一是（在中国）以一家不走运的公司为“榜样”，以一项毫无道理的刑事指控为借口，“发送信息”或“传递信号”给该行业的所有其他人，让他们表现自己。正是我们的CFR genius Huang提供了宝贵的见解，即由于葛兰素史克可能代表“冰山一角”，中国正在利用其对该公司的调查向其他制药公司发送“停止和终止”信息。尽管有消息，但这名男子似乎并不认为葛兰素史克被指控是因为它有罪。我稍后会处理GSK；这些人应该有自己的篇章。
Then we have another ideological turkey, this time in the person of Erik Gordon of the University of Michigan’s Law School, telling us that “The talk about being appalled at the drug company practices in the US is an attempt to show that America is no better than China”. Gordon, foolishly and without evidence, claims China wants to eliminate corruption of which it is ashamed, “but they don’t want to lose face over it”, so they instead mount a media war against the US industry. I’m sorry to inform our (no doubt eminent) Prof. Gordon that the US is not only “no better than” China but is in fact much worse, and it is apparently only the Americans whose vast array of ‘democratic values’ neglected to include shame as one of those values. Whatever other accusations we can make about Americans, a desire to ‘save face’ would be absent from that list. Americans are not only not ashamed of their criminal acts, they appear proud of them or, at best, indifferent.
然后我们又有了一个意识形态的土耳其，这次是密歇根大学法学院的Erik Gordon的人告诉我们，“关于在美国的制药公司的做法感到震惊的是，试图证明美国不比中国好”。戈登愚蠢而没有证据地声称，中国想消除它感到羞耻的腐败，“但他们不想为此丢面子”，因此他们反而对美国产业发动了一场媒体战。我很抱歉地告诉我们（无疑是知名的）戈登教授，美国不仅“不比”中国好，而且事实上比中国差得多，显然只有美国人的大量“民主价值观”忽略了将羞耻作为其中一种价值观。无论我们能对美国人提出什么其他指控，“保全面子”的愿望都不会出现在这个名单上。美国人不仅不为自己的犯罪行为感到羞耻，而且似乎为自己的犯罪行为感到自豪，或者充其量只是漠不关心。
Consider how deeply entrenched in America is the assumed right to illegal activity and the categorisation of criminal penalties as mere business expenses, when a firm like Pfizer while still in the settlement process of one criminal conviction for which it paid a fine of $430 million, was discovered to have already originated and was widely executing an identical program to violate those very same laws with yet other medications. The fines were a pittance and the “corporate integrity agreement” just a charade. Corruption in the American pharma industry is like racism in American society: so much a natural part of the landscape that to even notice it would be like noticing the air you breathe.
考虑到当一个公司如辉瑞公司在一个刑事定罪程序中支付罚金4亿3000万美元时，假定在美国的根深蒂固的是对非法活动的假定权和将刑事处罚归类为商业费用。被发现已经产生并广泛执行一个相同的程序，用其他药物违反同样的法律。罚款微乎其微，而“企业诚信协议”只是一个骗局。美国制药行业的腐败就像美国社会中的种族主义：这是自然现象的一部分，以至于注意到它就像注意到你呼吸的空气一样。
It is almost comical to note the attention US authorities pay to the criminal actions of their own pharma companies in China and other nations in Asia and Africa. The payment of bribes by US companies, even if paid outside the US, is considered a crime against US law and therefore subject to the full force of legal sanction from the US Department of Justice. And sanctioned they are, at least to the extent of what we might call pocket change. For their domestic activities, these firms are occasionally fined billions of dollars in the US, but for their foreign activities – which are often greater – the same firms receive fines of only a few millions. Eli Lilly paid $25 million for bribes in China, Brazil, Russia and Poland, while Pfizer paid $60 million for crimes of all its subsidiaries in all countries, these punishments equating to about one week’s sales of the medications in question.
注意到美国当局对其在中国和亚洲及非洲其他国家的制药公司的犯罪行为的关注，几乎是滑稽可笑的。美国公司行贿，即使是在美国境外行贿，也被视为违反美国法律的罪行，因此受到美国司法部的全面法律制裁。他们是被认可的，至少在我们可以称之为零花钱的范围内。在美国，这些公司在国内的活动偶尔会被罚款数十亿美元，但在国外的活动——通常更大——这些公司只会被罚款数百万美元。礼来公司在中国、巴西、俄罗斯和波兰支付了2500万美元的贿赂，而辉瑞公司为其在所有国家的所有子公司的犯罪支付了6000万美元，这些惩罚相当于大约一周的相关药物销售。
And we have yet another ideologue, this one in the person of Liao Ran, living in Germany and employed by one of our favorite – and most idelogically corrupted – NGOs, Transparency International. According to a Bloomberg report, Mr. Liao, with absolutely no evidence to document his outrageous claim, tells us that doctors and nurses in China, due to low “standardised” salaries, “boost their income” by “regularly prescribing unnecessary medicine and surgery” while pocketing a percentage of these unjustified expenses. I think this is a good place to call Mr. Liao an unscrupulous liar. I know that isn’t very nice, but it’s the only label that fits. To suggest that doctors in China arrange surgery solely to collect a commission from the hospital fees, is a slander both repugnant and obscene but perfectly American in attitude and content.
我们还有另一位理论家，这位是廖冉，住在德国，受雇于我们最喜欢的、也是思想上最腐败的非政府组织之一透明国际。根据彭博社的一份报告，廖先生在完全没有证据证明他的无理主张的情况下告诉我们，中国的医生和护士由于“标准化”工资较低，通过“定期开不必要的药和手术处方”来“增加收入”，同时将这些不合理的费用的一部分收入囊中。我认为这是一个称廖先生为无良骗子的好地方。我知道这不太好，但这是唯一合适的标签。建议中国的医生安排手术只是为了从医院费用中收取佣金，这是一种既令人厌恶又猥亵的诽谤，但在态度和内容上完全是美国式的。
He tells us further that it isn’t only corruption but the structure of the entire system that is apparently badly flawed, even condemning the practice of Chinese giving hongbao (the red packets) to doctors. He seems to claim that China’s “high medical costs” are due entirely to corruption, thereby placing all of China in the precarious position where “you cannot afford to be born, get sick or die”. Bloomberg quoted him as saying health care costs were “A huge worry. If you have an extra 10,000 yuan, you won’t dare spend it on travel or leisure – you’ll put it away in case mom or dad get sick next year”.
他进一步告诉我们，不仅是腐败，而且整个体系的结构显然存在严重缺陷，甚至谴责中国人给医生发红包的做法。他似乎声称，中国的“高额医疗费用”完全是腐败造成的，从而使整个中国处于“生不起、病不起、死不起”的危险境地。彭博社援引他的话说，医疗费用是“一个巨大的担忧。如果你有额外的1万元，你就不敢把它花在旅行或休闲上——你会把它收起来，以防妈妈或爸爸明年生病”。
Not to be argumentative, but just as a point of interest, an ECG is a commodity, performed with similar equipment all over the world. In New York, an ECG costs between $650 and $1,800, depending on location. In Shanghai, an ECG costs 20 RMB – about $4.00. In New York again, an MRI costs between $500 for an ankle, about $4,800 for a breast (each), and about $200 per month for the rest of your life for a full-body scan. In Shanghai, a full-body MRI costs about $50.00. All else is comparable, to put paid to Liao’s claims of China’s ‘high medical costs’.
不需要争论，但作为一个兴趣点，ECG是一种商品，使用世界各地类似的设备进行。在纽约，ECG的价格在650美元到1800美元之间，具体取决于地点。在上海，一台心电图机的价格是20元人民币——大约4美元。同样，在纽约，一次核磁共振成像的费用在脚踝500美元、乳房4800美元（每个）和全身扫描的余生每月200美元之间。在上海，全身核磁共振成像的费用约为50美元。所有这些都是可比的，以廖的中国“高医疗成本”的说法为例。
I won’t dwell on the practice of the hongbao here, but it needs to be noted that few foreigners have any useful understanding of Chinese tradition and culture and too often simply interpret a foreign practice in the light of what it might mean if it occurred in their own country. National traditions can never be understood in this way, and certainly not when viewed through the severely-distorted chromatic lens of American ideology, religion, and so-called values. Unlike the West, these gifts are common in China for doctors, teachers, almost all superiors, as a kind of recognition of status or influence. It is true they are sometimes a competitive gesture, and sometimes a kind of obligation that is resented by the younger generation, but nevertheless are also badly misunderstood by non-Chinese and an explanation to binary-mentality Americans would be fruitless to attempt.
我不会在这里详细讨论红包的做法，但需要指出的是，很少有外国人对中国传统和文化有任何有用的了解，而且往往只是根据发生在他们自己国家的实践可能意味着什么来解释外国实践。民族传统永远不可能以这种方式被理解，如果从美国意识形态、宗教和所谓价值观的严重扭曲的彩色镜头来看，当然也不可能。与西方不同的是，这些礼物在中国对医生、教师和几乎所有上级都很常见，作为对地位或影响力的一种认可。诚然，他们有时是一种竞争姿态，有时是一种义务，受到年轻一代的憎恨，但同时也被非中国人严重误解，美国人试图解释二元心态是徒劳的。
The whining by the pharma companies of price pressures forcing them to cut corners and cut costs to survive, is all fiction, which would be easily evidenced simply by looking at the profit margins of these firms. This public lobbying and intense pressure has recently been placed on China, the firms demanding China eliminate its drug price controls to let the market set appropriate rates. But this is all a fraud. “The Market” as defined in these claims does not exist in reality, and the pressure is simply driven by greed. Some officials in the Chinese medical industry hold the hope that competition in an unregulated market will of its own accord produce lower prices, but this is a fairy-tale, with no evidence anywhere in the world to support it. These firms have shown themselves quite able to collude on maintaining high price levels by competing only on branding or some other category that will serve only to greatly magnify the costs to the public.
制药公司抱怨价格压力迫使他们抄近路，削减成本以生存，这完全是虚构的，只要看看这些公司的利润率就很容易证明这一点。最近，这种公开游说和巨大压力已经施加在中国身上，这些公司要求中国取消药品价格管制，让市场设定适当的价格。但这都是骗局。这些说法中定义的“市场”在现实中并不存在，而压力只是由贪婪驱动的。中国医药行业的一些官员希望，在一个不受监管的市场中，竞争会自动产生更低的价格，但这是一个童话故事，世界上任何地方都没有证据支持它。这些公司已经证明，他们很有能力通过仅在品牌或其他类别上进行竞争来串通，以维持较高的价格水平，这只会大大放大公众的成本。
And I think it needs to be said somewhere that Chinese traditional medicine has been in active employment for millennia, the Chinese race surviving just fine, thank you very much, without the God-given benefits of American pharma companies and their synthetic patented medicines. Since the 1950s, China has modernised its hospitals, added decades to life expectancy, halved infant mortality and eliminated diseases such as polio, and much more. Moreover, Chinese treatments, not having been corrupted by either patents or profit-maximising capitalism, are designed to cure ailments and diseases rather than simply keep them under control.
我认为有必要在某个地方说，中国传统医学在几千年来一直处于活跃的就业状态，中国人生存得很好，非常感谢，没有美国制药公司及其合成专利药物的上帝赐予的好处。自20世纪50年代以来，中国对医院进行了现代化改造，延长了几十年的预期寿命，将婴儿死亡率降低了一半，消除了脊髓灰质炎等疾病，等等。此外，中国的治疗方法既没有被专利或利润最大化的资本主义所腐蚀，也旨在治疗疾病，而不是简单地控制它们。
To this I would add that one area of concern is that the foreign pharma companies are already very busy in China, attempting to identify the active ingredients in many Chinese traditional medical treatments so they can patent those items (as Roche did with star aniseed in its Tamiflu), then attempt to use trade agreements and political pressure to extract royalties from Chinese hospitals for using these new “American” medications.
除此之外，我还想补充一点，一个令人担忧的领域是，外国制药公司在中国已经非常忙碌，试图识别许多中国传统疗法中的活性成分，以便为这些药物申请专利（就像罗氏在达菲中使用八角茴香所做的那样），然后试图利用贸易协议和政治压力，从中国医院收取使用这些新的“美国”药物的版税。
Next: Part 5 –Fines and Penalties
下一篇：第5部分——罚款和处罚
*
Mr. Romanoff’s writing has been translated into 32 languages and his articles posted on more than 150 foreign-language news and politics websites in more than 30 countries, as well as more than 100 English language platforms. Larry Romanoff is a retired management consultant and businessman. He has held senior executive positions in international consulting firms, and owned an international import-export business. He has been a visiting professor at Shanghai’s Fudan University, presenting case studies in international affairs to senior EMBA classes. Mr. Romanoff lives in Shanghai and is currently writing a series of ten books generally related to China and the West. He is one of the contributing authors to Cynthia McKinney’s new anthology ‘When China Sneezes’. (Chapt. 2 — Dealing with Demons).
罗曼诺夫先生的作品已被翻译成32种语言，他的文章发布在30多个国家的150多个外语新闻和政治网站上，以及100多个英语平台上。拉里·罗曼诺夫是一位退休的管理顾问和商人。他曾在国际咨询公司担任高级管理职位，并拥有国际进出口业务。他曾是上海复旦大学的客座教授，向高级EMBA课程介绍国际事务的案例研究。罗曼诺夫住在上海，目前正在撰写一系列十本书，内容大致与中国和西方有关。他是辛西娅·麦金尼新文集的撰稿人之一“当中国打喷嚏时”（第2章-对付恶魔).
His full archive can be seen at
https://www.bluemoonofshanghai.com/ + https://www.moonofshanghai.com/
他的完整档案可在
https://www.bluemoonofshanghai.com/ + https://www.moonofshanghai.com/
He can be contacted at: 2186604556@qq.com
联系方式如下：2186604556@qq.com
*
Notes
注释
(1)https://www.ft.com/content/1ee62c8e-b406-11e3-a102-00144feabdc0
Big pharma’s rise in China not held back by scandals
大型制药公司在中国的崛起没有受到丑闻的阻碍
Copyright © Larry Romanoff, Blue Moon of Shanghai, Moon of Shanghai, 2022
版权所有（拉里·罗曼诺夫, 上海的蓝月亮, 上海之月, 2022