- Klim McPherson, visiting professor of public health epidemiology
- 1Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK
We live in a world where consumers are meant to operate free markets according to their own preferences, and that process keeps our world going—and supposedly efficient. It keeps us all happy because customers are always right. But all large public companies have a dominant responsibility to their shareholders. The economist J K Galbraith argued many years ago that commercial investment in product formulation and development must therefore deliver an adequate return and that this can often mean that it becomes essential to manipulate markets, even in the face of informed consumer preferences. Other economists, however, who like to believe that rational and exogenous consumer behaviour dominates markets, largely tended to ignore this argument, which is still regarded as marginal. It is not: the methods that industry uses to manipulate markets have become increasingly refined and development continues apace.
Galbraithian arguments have huge implications now for better health in the longer term.1 Modern industry has become increasingly technical and sophisticated, which …