Workers without Borders: Surveillance and the workplace without the workpla
Michele Beck
The meteoric rise
of the service economy in the West has led to the spread of surveillance, not
just over individuals who produce goods, but also over consumers. Since the West’s
primary form of production is no longer carried out by workers in a factory setting,
new kinds of ‘workers’ are under the watch of surveillance technologies.
But what are these new ‘workers’ doing? While much has changed since
Charlie Chaplin made Modern Times1
and was traumatized by his repetitive work on the factory production line, Taylorism2
still reigns.
It’s not just managers and bosses who threaten an employee if his or her
productivity is not high enough. In an economy of branded products all too similar
to the products of competitors, value depends on the emotionally charged illusions
developed around the brand name. Someone is needed to make these illusion real:
the seducers, advertisers and manipulators of information about the company,
its brands and its products. These people are the advertisers and promoters,
and they take on the role of a manager who is able to seduce an employee into
performing well. Thus surveillance extends beyond the company’s boundaries,
so professionals (such as doctors) and ordinary citizens (consumers) become its
legitimate targets. These individuals "work for" a corporation insofar
as they consume or convince others to consume. The goal of surveillance within
this construction is the tracking of information and the use of this information
to seduce the chosen "employee" to perform.
For an example of the relationship between a company and an unsuspecting employee,
consider the medical professions and their relationship to the pharmaceutical
industry. There, surveillance and marketing create a rationalized system that
entices people to do the work of consumption. Those ‘employed’ by the
organization to promote its products and raise brand awareness introduce more
fluid notions of ‘employment’ which go beyond the formal employment
contract, the provision of one’s labour and presence within the organization’s
premises.
The pharmaceutical industry is currently one of the hottest markets in the United
States. New medications are continually introduced, not because they are needed
or because they offer any real advantage over already existent medications, but
simply because they offer new money making potential. In order to launch a new
medication and make it profitable, the pharmaceutical marketing companies need
to identify the doctors who would potentially ‘work’ for them by prescribing
the medication to their patients. Data collection, which has become extensive
due to advances in technology, centralizes and organizes this information for
the marketers. With the advent of sophisticated computer technology, pharmaceutical
manufacturers have been quietly compiling dossiers on the prescribing patterns
of the nation’s health care professionals, many of whom have no idea that their
decisions are open to commercial scrutiny. Information has also been gained from
patient records in pharmacies, which the pharmacies then sell to the pharmaceutical
companies. The other source of information for the pharmaceutical companies is
a master file, which they are able to buy from the American Medical Association.
This file has detailed information on all the doctors practicing in the United
States, including their medical education number, which the AMA assigns to new
medical students in order to track them throughout their careers. The pharmaceutical
companies track the doctors with this number as well.
After creating the prescriber profiles, the pharmaceutical companies work directly
on the doctors. They gain the doctor’s support by showering them with expensive
dinners, gifts and honoraria to attend conferences about their medications. Drug
representatives frequent the hospitals handing out coupons to the doctors for
free coffees at Starbucks and arranging with head residents to cater buffet lunches
at clinics. As the young doctors fill their plates at these lunches, the drug
representatives lecture about the pills they are trying to market. Other kinds
of gifts include tickets given to baseball games and even trips to the Bahamas
for the doctor and his/ her family. This is how this type of employee is ‘paid’.
These ‘tokens of appreciation’ seem to have a powerful affect on the doctors
and this is made clear by the many success stories of new drugs on the market.
These medications achieve spectacular growth without any decisive advantage over
their predecessors. Their only real advantage is the ability of the pharmaceutical
companies to watch the doctors as closely as possible, gather as much detailed
information as they can, and also for the doctors to be such diligent low paid
employees.
On the other side of the fence is the consumer. It is common knowledge that consumers
are being watched by corporations through their credit card purchases and activity
on the Internet, in order to compile data on what, when and how they purchase.
Just as the worker’s tasks were broken down and analyzed by Taylorism, consumer
taste is tracked and scrutinized. In the case of the pharmaceutical industry,
patient’s medical records, which were once private, are now accessible and this
information is being used by the pharmaceutical industry to learn how to persuade
consumers to buy their medications. One way to make this connection is through
the doctors, as mentioned above, but another way is through direct advertising
to the consumer. Pharmaceutical companies are infamous for targeting consumers
and getting the consumer to ask their doctor for specific medications. In effect,
the consumer becomes a spokesperson for the pharmaceutical company by demanding
to purchase the product and convincing the doctor of the drug’s usefulness. The
‘payment’ to the consumer for working for the pharmaceutical company
is simply the illusion that the chosen pill will cure their health problems.
Generally the belief in this illusion is created through seductive advertisements,
which rely on the consumer’s anxiety and ignorance of medical conditions in order
to coax them to ask for brand name medications. Recently even more direct avenues
have been used to get the medication to the consumer. By surveilling individuals
medical records, drug companies are able to target their audience with greater
precision. In July 2002, a case was reported in the New York Times of a woman
from Fort Lauderdale, Florida who received an unsolicited dosage of Prozac in
the mail from her local Walgreens drugstore. Inside a letter stated "Enclosed
you will find a free one month supply of Prozac Weekly. Congratulations on being
one step to full recovery."
By accessing her
medical records, the drug company, Eli Lilly discovered that this woman had sought
treatment for depression and therefore chose her for this unsolicited mailing.
Unfortunately for Eli Lilly, the makers of Prozac Weekly, they went one step
too far in connecting to the public and will face a lawsuit. The woman in Florida
was not interested in being an employee of Eli Lilly. In most cases though, the
pharmaceutical industry is extremely successful in gaining interest in their
product. A recent report by the General Accounting Office estimates that every
year at least 8.5 million Americans request and obtain specific prescriptions
after seeing or hearing ads for particular drugs. On the whole, the pharmaceutical
industry has been amazingly successful in having the consumer work for them.
The consumer is a new kind of worker, a worker who produces by buying. And since
consumers are not employed in the traditional sense, the methods to keep them
working efficiently must be more attractive and captivating. Advertising is one
of the most provocative forms which works to keep the consuming machine functioning
in much the same way that a foreman kept the factory production line running
quickly and smoothly. As long as the consumer is consuming he is doing his job.
Since Sept 11, 2001, the factors of surveillance and consumption have taken on
new levels of intensity in the United States. This affects every area of the
lives of each American, and particularly the relationship between the individual
and large corporations. Using the excuse of the terrorist attack, the Bush Administration
has created the Homeland Security Act. Among other things, this Act gives the
green light to Bush’s Total Information Awareness Program to use computer networks
to scoop up vast amounts of data on citizens. In terms of the context of this
discussion, this would make it legal to have free and easy access to an individual’s
personal medical records, among other intimate information. Why does the government
need this information? To search out terrorists? Probably not, but maybe there
are some clues in another aspect of the Security Act. In addition to having access
to a vast array of personal information, the Homeland Security Act includes a
provision that will protect all big pharmaceutical outfits from lawsuits. This
is very convenient since presently there is a lawsuit being launched against
Eli Lilly by parents who believe their children were harmed by a preservative
added to a vaccine sold by the company.3
Obviously, this has nothing to do with homeland security so, why is it there?
Perhaps it has something to do with the fact that major drug companies have become
a gigantic collective cash machine for politicians, and the vast majority of
that cash goes to the Republicans. Or maybe it’s related to the fact that
Mitch Daniels, the White House budget director, is a former Eli Lilly big shot.
Or the convenient fact that just last June President Bush appointed Eli Lilly’s
chariman, president and C.E.O Sidney Taurel, to a coveted seat on the president’s
Homeland Security Advisory Council. 4
This is just one example of the symbiotic relationship between the United States
government and big business. This is not a secret, and since it is common knowledge,
what can be done about it? There is plenty that can be done by citizens, but
perhaps less we can be done by consumers, who metaphorically work for large corporations.
One has to wonder how effective a group of people who make professional decisions
based on a free fancy dinner or make their health decisions based on an advertisement
can be. These people may be very good workers, but not very effective activists.
In fact, being more than just good workers, consumers are good patriots. As the
placards around Manhattan said the weeks after September 11, 2001, "Support
New York, Shop New York". Shopping is our real job- anything else would
be unpatriotic.
References
Gerth, Jeff and Stolberg, Sheryl Gay, "High-Tech Stealth Being Used to Sway
Doctor Prescriptions," New York Times, 16 November, 2000.
Herbert, Bob, "Whose Hands Are Dirty?", New York Times, 25 November,
2002
Kirkpatrick, David, "Inside the Happiness Business," New York Magazine,15,
May 2000.
Liptak, Adam, "Free Prozac in the Junk Mail Draws a Lawsuit," New York
Times, 6 July 2002.
Lyon, David (1994) The Electronic Eye: The Rise of the Surveillance Society.
Minneapolis: University of Minnesota Press,1994.
Marcus, Erin N., "When TV Commercials Play the Doctor, " New York Times,
3 January, 2003.
