Documents reveal McKinsey's role increasing opioid sales until 2019 | Hacker News Reader

Documents reveal McKinsey's role increasing opioid sales until 2019

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354 pointsJerry2168 comments

I was hanging out with my pharmacist friend and he mentioned that a decade his friend invited him to go into business opening up a pain clinic but it was pretty obvious it was a pill mill and he told his friend no thanks. His friend went on to make multiple millions of dollars very quickly and will never face consequences.

It got me thinking that there were probably tens of thousands of people who each made millions of dollars knowing full well what they were doing was killing people and they will never face any consequences for their actions.

I recommend reading “empire of pain” it’s mostly a history of the Sackler family (the family that owned OxyContin). It does a good job of showing how thoroughly rotten and knowledgeably harmful the actions of the owners, lawyers, sales execs, sales reps, docs and government were.

The line that stuck with me was about the CEO at the launch party for oxy comparing confetti to a “blizzard of prescriptions”.

Consequences are only for Julian Assange and Snowden.

The mil complex, pill complex, big tech-advertistng-attention capture complex, wall street market manipulation crypto bs complex have all gotten away with taking advantage of the weakness in the population, exploiting the bottom of the food chain at scale, for so long that there is no fear at all.

I really don't know how the situation is going to change in the US..

>I really don't know how the situation is going to change in the US..

As an Aussie, I've always found this strange.

You've got the second amendment.

At any point in time, you've got hundreds of thousands of people with a shed full of assault rifles and a prognosis that gives them less than 6 months to live.

Yet rather than going after Wall Street or Big Pharma, every single violent rampage seems to target school kids or just random members of the public.

The fantasy and education of "individual values" as well as "superhero" pretty much proofs the mind of US people to work on meaningful organized resistance.

There is also high tech surveillance.

They're civilized, normal, rational people - guess they don't see violence as a solution. Not like those mentally unstable, radicalized and frequently immature shooters.

Glad we're in agreement that the government is neither, civilised, normal or rational.

The government is just a set of people that changes over time not some singular entity that has distinct behavior compared to humans.

Speaking about it as like you do makes no sense

I don't think "the government" is /just/ a set of people that changes over time. Government, based on the people who were previously in it and incentive structures, change/enable the people who are in the government to varying degrees.

> government is just a set of people that changes over time

Then use the 2nd amendment , until rational people enter the scene

> “In politics, my dear fellow, you know, as well as I do, there are no men, but ideas — no feelings, but interests; in politics we do not kill a man, we only remove an obstacle, that is all.” ― Alexandre Dumas, The Count of Monte Cristo

> every single violent rampage seems to target school kids or just random members of the public

Which, ironically, might be connected to SSRI‘s.

The government has bigger guns and drones

The Rambo fantasy stuff is a joke

Its also not middle aged cancer patients doing mass shootings, its teenagers

We mostly have criminals shooting other criminals.

Schools shootings are insanely rare.

More males dies of breast cancer than all people who die in mass shootings.

Mass shootings just get lots of press. But they’re super rare.

Probably not true, but only just. 570 men die of breast cancer each year in the US (latest stats from the Cancer Statistics Center) while 330 people have died in mass shootings in the US this year so far. You can see the stats, taken from the Gun Violence Archive, here: https://docs.google.com/spreadsheets/d/1xB5VWgcpvw5UrWYq-6so...

Mass shootings are more traumatic though as they're extremely brutal, graphic, and sudden. I'd weight the actual impact of someone I know being shot in a mass shooting far worse than someone I know dying of breast cancer. The latter won't have them leave in the morning and not come back at 5pm randomly. It also won't create a general climate of fear, distrust between people, and terrible politics. Both are tragic, but tragedies of different kind, which is why direct comparisons always seem technically correct but missing so badly the way people actually think about and experience tragedy.

> also won't create a general climate of fear, distrust between people, and terrible politics

Also why they're allowed to continue. "It's good for business."

Not debating any of that; originally thought the comment above mine was wrong, looked at the stats, and found they were far closer than I assumed.

I personally know people who were injured in a mass shooting. It sends shockwaves throughout the surrounding community in a way many crimes do not.

That document says 330 people died from mass shootings.

I was comparing males who died from breast cancer to males who died from mass shootings.

I’m also a bit confused … your stats show more males dying from breast cancer than people dying from mass shootings.

Doesn’t that support my position? Did one of us misspeak?

If our male breast cancer rate was as out-of-wack with the rate of the same cancer in other developed countries we absolutely would have people talking about it, like we have with the “obesity” epidemic or other issues that seem correlated with being an american.

Why do you think that level of development is a relevant criteria? The homicide rate in Bangladesh is 2.37 per 100,000. The homicide rate in Puerto Rico is 18.5 per 100,000. Both have very strict gun control and the populations are virtually disarmed. Indeed, the US has always had vastly higher homicide rates than Europe, long before modern gun control.

Compared to other countries in the Americas, however, the US homicide rate doesn’t seem that high.

So it’s all fine as long as you consistently compare things to places that are going badly?

"America: We're not the worst country in the world... yet." ;)

I believe the point GP was making is that policies driven by reductionist arguments aren't going to actually fix the problems they purport to.

I think you've missed gp's point of comparison, as well as misunderstood the logical notions of necessity and sufficiency. If the murder rate in place X is lower than in places Y and Z, both of which have (a) disarmed their people and (b) have whatever undefined things "going badly," then it is logical to assume that neither (a) nor (b) is logically necessary or sufficient for a lower murder rate. The comparison suggests that disarmament and having things "go badly," whatever that means, are not causally related to a lower murder rate.

expect that's not true because homicide rates don't exist in a vacuum. there's factors like education, poverty, drug use, gangs etc at play and you really can't compare two very big and very different countries with vastly different cultures, temperaments and conditions. its an oversimplification of the world we live in and imo it's better to admit that we don't know.

OP argued guns are responsible for high US homicide rates by attempting to rule out another salient difference, namely economic development.

But it’s wrong to assume that economic development is the only, or even a particularly salient difference. Asia has much lower homicide rates than Latin America, despite Asia being poorer and both having strict gun control. Similarly, the US had ten times the homicide rate of the UK even in 1900, long before significant British gun control.

The point is that comparisons with Europe and Asia overlook that the US is more like Latin America in many regards, as a post-colonial, post-slavery, low-social-trust immigrant society, than it is like other “developed countries.”

Put differently, people wave away comparisons between the US and Latin America (which also has strict gun control) on the assumption that high homicides there are caused by poverty. But Latin America is mostly middle income countries. Yet their homicide rates are vastly higher than poorer Asian countries. (Puerto Rico has the same GDP per capita as Spain, is an island with strict gun control, and has a homicide rate ten times higher than Spain.)

Sure, even if homicide rates == mass shootings, that’s still worth talking about why they are different in the Americas than developed European countries? Any major negative difference from a peer country is discussion worthy. Note I am not arguing for a specific remedy, I am arguing that this issue isn’t overblown relative to rates of male breast cancer or whatever else due to the absolute number of deaths, but because the difference in the number of deaths per capita suggests possible known solutions worth considering the trade-offs of.

this makes no sense, because the reason US school shootings get press is because they are a. a very American phenomenon and b. easily stopped hy policy change. breast cancer can't be reduced by simply making cancer cells illegal, but shorting can stop by regulating guns. this is a very bad take on so many levels.

I haven't heard of any medical related ones, but there have been cases where an adult shot their boss, or a judge that had ruled against them or a cop that had arrested them. These just don't get the press coverage, for whatever reason.

Laws have created an environment that makes it facially difficult to lay blame. Technology has made it easier and faster and safer to conspire. Police were created to catch slaves and they’re culturally incapable of doing any more than that. Imagine Joe average local cop trying to go undercover at McKinsey. Done laughing? What about the fbi you ask? They’re just as bad as local police but think and act like they’re better. Other regulatory agencies either have been entirely corrupted and co-opted or they’ve been neutered or will be soon by this law making body we formerly called the Supreme Court.

People crave Justice. Vigilantes do not create Justice. Thus harming people harming society without due process is unjust. The founding fathers and other visionaries like Malcolm X and MlK have written more on this topic but personally I find it a too boring to have read into. Look at the Arab spring for a recent successful reactionary rights movement that was not started by a massacre and look to China for the leading edge of suppressing dissent. The champions of advancing human rights are largely not cold blooded killers whereas those suppressing such movements must regress to these tactics to maintain their hard and soft power.

If you disagree I wish you’d bother to tell me why so I can learn from you.

Things aren't great right now, but they would have to be pretty damn shit for a civil war to seem like an improvement.

I also wondered about this. Why aren't more rich people murdered by people who have a fixed amount of time to live.

1. People are cowards even if they are dying

2. Only sociopaths can kill for revenge.

Going off the topic a bit- I was recently listening to an American podcast and it was talking about a single mother who worked multiple jobs finally getting a good full time job who said that they would visit the doctor even though they aren't sick "just because they can", and this made me, a non American, tear up. how could people in the developed world, even poor people, not have access to healthcare, when even our government with a fraction of the US govt budget provides free basic Healthcare and people are generally able to see doctors.. seems like a very strange thing right? has the word "developed" lost all meaning? or is the US not a developed country anymore?

I saw a Tweet to the effect of "Instead of thinking of the US as a version of Norway or the Netherlands that happens to be failing on virtually every metric, it's more accurate to think of the US as a version of Brazil that happens to be rich."

would be very interesting to see what metrics one can use to visualise this sentiment, and if it's true or not (my feeling is it's true). imo metrics like GDP, healthy birth, education etc provide a distorted and inaccurate view of citizen welfare. to have a good society, we need to choose metrics that will rank a perfect utopia better than a dystopia (which we don't have, a slave state will have higher GDP, cuz, well, slaves) . but ofc, everyone can't agree on what utopia looks like, so how do you get the metrics? maybe by agreeing on some basic ground rules (slavery bad, murder bad, work-life balance good etc) and build metrics based on these. ofc now no one will agree on the ground rules, but I suppose it's the elected governments job to decide those based on the specific culture of a country. ofc this is a very simplified view of reality and will fall apart in mere minutes in the real world, but kight serve as a starting point, no?

> see what metrics one can use to visualise this sentimen

the Gini coefficient goes some way.

In percent:

Norway 27.6

US 41.5

Brazil 53.4

See https://worldpopulationreview.com/country-rankings/gini-coef...

That’s a hilarious and great point.

I’ve had the same thought before - America does a great job within its population bracket, but it doesn’t make sense at all comparing us to, say, a Switzerland or a New Zealand.

Switzerland has what may be one of the more comparable health insurance systems to that in the US. I definitely thought twice or three times before contacting a doctor (and ended up not doing so), and somewhat regretted an ambulance being called for me due to the ensuing bill.

This is the correct approach, but I think the real answer is "a version of Brazil that fully capitalized on European wobbles in the first half of the XX century". The US effectively conquered Europe in WW2, hence acquiring complete leadership of the rich world.

I blame WWII, and the idiots we had in Congress at the time. Before WWII, health care was super cheap. It was so inexpensive that nobody budgeted for it, or considered how they would ever pay for it. Health insurance technically existed, but it was rarely used; most people would never have high medical bills, so most people saw no advantage in paying a monthly fee for the insurance instead of just paying for the health care as they needed it.

During WWII, Congress wanted to be seen to help the war effort, so they started passing bills. Some of those were ok, some were terrible. The worst were the price and wage controls. Price controls create shortages, and wage controls create shortages of workers. Since the supply of employees went down drastically (with so many people going into the military), naturally wages had to rise. But once wage controls were in place, employers could not offer more money. The best that they could do was to offer perks instead. Waiters started asking for tips. White–collar employers started offering free health insurance and other perks. Others offered free housing, and even whole company towns. Pensions are another good example. By the time the war ended, these and other perks were rapidly becoming ubiquitous.

Free housing and company towns were too easily abused, so in the 50s those were gradually done away with. You can read about the problems with tipping elsewhere.

Ever since the end of WWII, the cost of healthcare has risen steadily. (So did the quality of the care, of course.) People no longer pay for health care as they need it. They no longer shop around for the best prices, even for predictable expenses such as childbirth. Most hospitals won’t even tell you what their prices are, even though they are now technically required to maintain a webpage with that information. (Most primary care physicians are much more reasonable about such things, but even they might not know ahead of time what everything will cost, since it might depend on what insurance you have.)

It’s pretty easy to see why prices are rising. People pay thousands of dollars per year for insurance, whether they need any health care or not. Nobody knows exactly what anything will actually cost until afterwards, when they are arguing with their insurance company about it.

In fact, prices are so opaque that hundreds or thousands of people every year make simple mistakes that cost them tens of thousands of dollars. There are as many sob stories as you care to listen to from people who went to a hospital with an injury that wasn’t immediately life threatening and were billed some outrageous amount. They could have gone to their normal doctor to have their broken bone set for a couple hundred dollars, but they instead have to pay thousands for the ambulance ride, thousands for the hospital bed, thousands for consultations with doctors whose names they don’t remember, etc.

Now it is true that in situations like this it is difficult to go back in time and replay history with different choices, so I admit that this is not all as obvious to people as I make it sound. There is plenty of scope for disagreement about causes and effects.

However, there is another source of evidence. Instead of going back in time and making different choices, we could do an A–B test. Have one group of people go with ubiquitous health insurance and another group avoid it, then compare the outcomes. You might think that this would be hard to arrange, but it actually happened! The Amish arranged their own lives to avoid most of the complications of modern life and high technology, and apparently that includes insurance as well. As I understand it, their health care is still very inexpensive; they haven’t had the same continual rise in prices that the rest of us have had.

How effective was medicine before WWII? How complex was it? How many instruments for extensive tests were there? Labs that would run analysis to find out what is wrong with you so that doctors could figure out how to best cure you?

Sure, the current system is preposterous and prices are way higher that necessary, but we can't just compare with the past unless you also want a service like the one you'd got in the past, which is probably still quite affordable.

You don't need to compare with the past. Just compare with other countries, where you can pay 300 a month and have all your family fully covered privately. No copay. No public health. Although you can skip the payment and get public health. Or even have both and decide when to go private and when public. All in much less powerful economies.

Sure. The let's make that comparison and not construct an argument using pre WWII data as a reference, which was what I was replying to.

I think OP was pointing to a potential starting point of the raise in prices and decoupling it from the actual services rendered. Something I think is very likely given that now there are a lot of examples where things are comparable quality with much lower prices. It might not be exactly WWII, but it certainly was caused by some factors not tied directly to the quality of the services.

Right, I never tried to say that there was only one cause for prices going up. However, note that technology has vastly decreased costs across all industries too. Faster communications, faster billing and payments, digital images instead of film that has to be developed, etc, etc. It’s not immediately obvious that the rising quality of healthcare would necessarily make it more expensive, given the vast cost reductions happening at the same time.

Technology has vastly decreased the cost of things that existed.

Technology also vastly increased the cost of things that didn't exist.

Prior to the invention of video games, nobody spent a dime on video games. People today spend a lot of money in air travel while before WWII very few people spent money on air travel. Etc

Yes, but videogames cost roughly the same all around the world.

Developed never really has the meaning that you think it has, imho. In Europe, during a long time, it really meant "like us" without thinking that each European country have a lot of different country. Looks at the difference in the Health system between Belgium and the Nederlands.

Actually the terminology shifted in some organizations as a continum of Low to High income countries (set by the World Bank). It is far from perfect but it frames the differences and terminology differently in your mind.

Going further off topic, inspired by the US single mother story. There's a joke in Japan about a group of old people sitting in the waiting room at a doctors office. One of them asks, "Hey, where's Tanaka-san?" Another one answers, "She couldn't make it. She's sick."

When it comes to classifying countries, "developed" does not mean "equal access".

US healthcare system is arguably one of the most advanced (if not the most) in the world.

It's just not affordable for a good chunk of their population.

The people who talk about protecting themselves from a tyrannical government are usually the ones who lick the boot the hardest

The US citizens wouldn't be able to stand up to the military anyhow

> The US citizens wouldn't be able to stand up to the military anyhow

To what military? The one made of US citizens?

Yea and the government made of US citizens. Have you really forgotten about the polarization of the US or are you just going to treat the 300M+ people as one homogeneous group?

What's your point

> What's your point

Open a history book. Two important events you’ll find:

- the US government trying to use military against citizens resulted in a civil war and military fighting military.

- the Iraq, Afghanistan, and Vietnam wars have demonstrated quite clearly that armed insurgents cannot be eradicated by a massive power imbalance alone. People making IEDs out of stuff you can find at a Home Depot and randomly attacking military from within civilian populations using small arms was significantly effective.

“But muh gubment has fancy planes so people shouldn’t have guns” is about the dumbest argument you can make.

See, my point was that the government has been growing increasingly tyrannical and a good portion of the population has gone along with it whole-hog

Police have been increasingly militarized and its used against citizens on a regular basis

Which portion of the population felates the police on a regular basis and says they can do no wrong? The boot has been licked, brother. You can thank hyper nationalism

I never said anything about gun rights

Have you ever heard of someone in US revenge killing a cop after said cop killed/shot a baby?

Quick google ~one year back brings plenty of victims.

https://edition.cnn.com/2021/03/16/us/houston-police-shoot-b...

https://www.wlox.com/2021/05/05/coroner-infant-died-after-ca...

https://www.nj.com/mercer/2022/02/cop-charged-with-killing-h...

https://en.wikipedia.org/wiki/Killing_of_Aiyana_Jones

No revenge. Turns out people capable of killing either are already part of Police force, and/or are too insane to think logically and lash out at innocents.

I always thought if I was about to die in poverty due to the state of our screwed up "health care" system I'd self immolate on the steps of a health insurer's CEO or corporate headquarters.

The armed revolution is very likely to bring up violent tyranny and very unlikely to strengthen democracy and bring justice.

Also, succesful revolutions require organization and tons of money.

Several mass shooter manifestos have made references to the parties you’re talking about… but they end up killing their families, school children, or shopping centers full of minorities instead.

I suspect it’s because most mass shooters are ultimately cowards and those organizations are big, scary, and often located in “intimidating” areas like major cities. That, and there’s tons of racist conspiracy theories that make it sound like a bunch of working class Muslims, Blacks and Latinos are somehow playing for the same team as Jamie Dimon.

US has spent a lot of time dividing the working class and poor so that they fight their neighbor more than the capitalist or state

As I told every college freshman who just took poli sci 101, if you have a better system than capitalism, we're all ears.

They are all around us, no one wants to admit they bought the lie though.

I know it feels very self-righteous to dunk on college students but this reasoning is kind of like traveling back to the middle ages and telling a knight "if you have a better system than feudalism, we're all ears".

Just like a King is going to do anything in their vast amount of power to uphold the monarchy; so does capitalism. In both cases, the current powers that be will always seem entrenched

unless you have traveled back from a future in which a better solution exists, then not really.

You could make that same argument to the hypothetical knight. Capitalism in the modern sense has only been around for 200 years. Just because you are unable to imagine a different future doesn't mean that one doesn't exist. What you are doing is no different than an appeal to tradition. You are sacrificing the virgin to the mountain god every year for reasons you can't fully grasp.

you're right that I have not imagined a different and better future syste,, but in the hypothetical someone does know of a different and better future system (assuming that we agree capitalism is better than feudalism), goes back to the past, and lies and says there is not a better system.

Second of all I admit I don't know of a different better system, I do not say I like the present system especially, although I get the feeling you must think that I do not being able to think of a better one.

>You are sacrificing the virgin to the mountain god every year for reasons you can't fully grasp.

and you are evidently good at insulting people and feeling superior when they admit they don't know of a better way without providing any concrete arguments for a better system. Must be nice.

> "if you have a better system than feudalism, we're all ears".

But we did have a better system.

Sure if you are so confident that the existing system is maximally good, you’d be interacting with professors of economics, history, and sociology, not college freshmen since a bunch of people 18 year olds aren’t exactly most equipped to answer these questions.

To be clear, you are implying civilization was better off during feudalism?

No. I am saying that complaining about "every college freshman who just took poli sci 101" is not an effective way of engaging in discussion about the merits of capitalism.

And assuming I am "confident that the existing system is maximally good" is equally as bad of footing to begin a discussion. I think nothing of the sort.

>But we did have a better system

1. You can only make that assertion in hindsight.

2. The adoption of that "better system" wasn't sunshine and roses.

1. Ok

2. Yes revolution is bad, violent, and dark times in the short term. More of an argument to reform our current system rather than listen to romantic ideas of ditching capitalism as a whole.

A better system than capitalism is a better capitalism.

Capitalism is not boolean. Anything can be good for the economy of somebody but we don't need to accept school mass shootings, or drug trafficking, or massive wildfires, or millions of people jailed for minor offenses, just because somebody benefits of it

It does not matter how is called

You’re looking for “a better system than US politics”. The rest of the capitalist world doesn’t have these things.

> A better system than capitalism is a better capitalism.

Except that is never the conclusion of anyone that makes it a point to criticize how terrible everything is, without the context that everything is better today than it ever has been.

I think that's an extremely reductive and academically dishonest question.

Adam Smith didn't propose some new system (and nor did Marx, really). Modern economists understand at least they work based on observation of human behavior and policy to influence or react to it, not a "system" from first principles that solves all problems perfectly.

I don't think you read Marx, because what you're saying about his work ain't true: he absolutely had a systemic thinking and within it for sure perfection could be achieved, by means of superceding the division of classes. Nevertheless, most people who cite Marx didn't actually read Marx, but a rehashed version from someone else. Or perhaps only a small, incomplete, subset of his work, from a very specific perspective. Marx's writings in particular have been falsified many times, for a multitude of reasons.

Marx didn’t propose a new system of government though, Marx proposed a theory of history (“history as class struggle”) in which the inevitable outcome was communism.

How about actual capitalism rather than the government-enforced pro-major-corporations environment we have now? When businesses can lobby government to change the rules in their favor any sort of free market is impossible...

The only way to get Adam Smith style markets is to forbid, and enforce the prohibition, corporations that are a large fraction of the market. No Walmart, no Amazon, no Tesco, Sainsbury's, Morrisons, no IBM, no ARM, no Toyota, VW, or Ford.

Ownership structures that hide the actual owners would have to be rooted out.

That way we might get slightly closer to markets where both suppliers and customers have a choice as to who to deal with.

In most of the modern world it's not capitalism Vs communism but rather how we define freedom and democracy.

Live is a lot better here in Switzerland, but we are just as capitalistic, and nearly as gun loving as the US

Things can change though. For decades rich disgusting guys were abusing young girls and women, without repurcussions, until the #metoo movement sent the Weinsteins, the R‘Kellys, the Epsteins and their helpers and others to jail.

Those are all limited hang outs. Abuse is endemic in Hollywood, Weinstein and Bill Cosby were scapegoats. I’m sure things have continued as they did before a few people went to jail.

Similarly with Epstein. Prince Andrew, Bill Clinton, Trump, Gates. None of them will ever face consequences.

> None of them will ever face consequences.

If this is how we decided it is, they will not. Sadly an awful lot of people already decided that this is an unchangable law of nature — and by doing so they are complicit.

If #metoo movement really brought up meaningful changes who would be in jail is clinton, trump, gates, not weinstein and rkelly…

What would Clinton, Gates, and Trump be guily of related to metoo?

Their activities on epstein island, but the judge on ghislaine maxwell's case found it prudent to redact the information that surfaced.

https://www.thedailybeast.com/judge-allows-ghislaine-maxwell...

Clinton and Trump have also faced a string of sexual misconduct allegations going back decades.

The Daily Beast article you linked to is a blurb from https://lawandcrime.com/high-profile/judge-rules-some-ghisla...

That article is talking about a ruling a judge made. The ruling is available here (https://www.scribd.com/document/499328774/G-Maxwell-Ruling-3...).

"Clinton" or "Trump" does not appear anywhere in the ruling or article.

IF things change, which clients of convicted sex trafficker Maxwell we’re also charged and convicted after being named in the public courtroom that the world is watching instead of celebrity court?

> the Epsteins and their helpers

Still waiting for even one of their clients to be charged.

"Consequences are only for Julian Assange and Snowden."

wtf kind of bizarre comment from a new account

What’s with the value judgement? People who had accidents and get addicted to pain killers are “weak” and “at the bottom of the food chain”? And “food chain” implies that humans are supposed to prey on each other, which would make what those people are doing OK.

Those same people are now in the rehab business bilking the healthcare system for money

And the cycle of wealth extraction continues.

Dopesick is a great series. Worth a watch!

The same applies to online betting and most of the mobile-game industry of today (which is basically also betting). Outside of FAANG-like companies there’s where lots of money is when it comes to being a programmer/IT person, I would personally not touch that industry for almost anything in the world, but there are many amongst us (programmers/IT people) who don’t have those scruples.

I wouldn't touch a FAANG-like company and more than an online casino. In fact, FAANG developers are worse because they're ignorant to the harm they do.

The high salaries are there so you don't look any deeper!

I think one of the most egregious examples of this is Snapchat Inc's official mission statement being:

We contribute to human progress by empowering people to live in the moment

From my own observations of how snapchat makes people behave in the moment I couldn't think of a statement any more ironic

I have found very few people have morals when it comes to money.

I would gander 1 out of 100 refuses to do something when faced with loosing money.

Psychiatrists=Most know antidepressants don't work, but they still prescribe them. (Irving Kirsch)

Lawyers=Happliy take that retainer knowing you will be found guilty.

Chiropractors/Osteopaths=Subluxation does not exist, unless in a bone bending accident.

Religious Leaders=Most mouth the words, and collet the money.

My point is most people can't afford to have morals. If it's not illegial; 99% of you will follow along the money trail.

Who ever speaks up at a FANG that isn't independently wealthy when they see something slimey. How many people spoke up over the NSA?

> most people can't afford to have morals

Your examples suggest the opposite, all of those people could very much afford to take the moral high ground. Let's not excuse people's greed by pretending that they would otherwise starve.

I actually served on a Federal jury (as an alternate) for a trial against a pill mill doctor. I wasn't there for the deliberations but the doctor ended up being found guilty and sentenced to jail. From testimony, the owners were nailed as well as support staff like nurses.

It was eye opening how blatant this was, the doctor was starting people on 160 mg/day of oxycodone which is absolutely insane.

Clearly what the US needs is a strong, broad Anti-Predation Act. With teeth in the form of regular detailed reporting, close scrutiny, and immense personal and financial penalties starting at the top. Since trafficking people is worth a 20-year sentence, then each death must certainly match that. $100,000 a day, up to 100 days, after which the business and all of its assets are forfeit ... as well as all of the assets of the principals. That oughta work.

Is there literally anything good that these consultancy/auditing enterprises do?

Are there any businesses that do anything good?

There are. The problem is that there are many corrupted businesses and authorities out there, and the ones who are evil usually suck every resource in to be even more powerful.

I know genuinely good, small companies which, well, stay small and you don't hear about them, as the bigger something grows, there is more controversy around it. And those small ones just "give back" to the community and get crushed by the ones who don't give back, in the competition.

Ok well those ones that you like have consultants and auditors

Not necessarily. And even if they have, I'm talking about the ones that always lobby up the corporate ladder, be close to the government, and fill their own pockets with no actual productivity involved (e.g. Big Four, McKinsey, or any equally enterprise BS). Not talking about small indie non-enterprise consultancy companies who genuinely share their domain knowledge.

Many. I think that the company I spent the latter 30 years of my career working for (ABB) has left the world better off than if it had not existed. It did have its ups and downs though and benefited from being held to account by competition authorities.

And they probably had consultants and auditors

Generally speaking if you are an authoritarian government or rogue company and can afford a company like McKinsey, they will take your money to consult and provide legitimacy. Scruples are overrated in this industry.

Related: all the VPN companies paying big consulting firms for “no log” audits. Example: https://www.tomsguide.com/news/independent-audit-confirms-no...

PwC is primarily an audit firm, which does some consulting, and not the other way around.

Sacklers got to keep their billions right?

They have to pay a fine, but it appears to be structured in a way that gives them time to pay the fine with the interest/investment income from their I’ll gotten gains.

That’s clever and very sick at the same time.

On a more general note, I sometimes hate this world, not for the fact that people like the Sacklers exist, there will always be bad people around, but because of the system itself, it looks so methodical, so homo economicus. There’s no escape out of that.

Will we ever become homo conscious?

its probably made up to not scare "unscrupolus productive" people too much

For a brief time.

Trillion dollar debtors.

> In 2019, McKinsey cut ties with opioid manufacturers

So up until then, they were fine with it. In fact, abetting it. Now they're apologizing.

If ever there were an argument for the corporate death penalty, this is it.

Or if not, their work for 43 of the 100 largest global polluters [0] or illegal corruption in Africa? [1]

[0] https://www.nytimes.com/2021/10/27/business/mckinsey-climate...

[1] https://www.nytimes.com/2018/06/26/world/africa/mckinsey-sou...

I hate it when "studies" assign pollution to the company that pulled the oil from the ground. It's so dishonest, and perhaps even worse, it provides zero valuable insight. If I go joyride in a private jet, I'm the polluter, not Exxon Mobil for pulling the oil from the ground.

I prefer addressing issues at the source. Mental gymnastics are for the guilty.

Right, the source here being the jet where the fuel is actually burned for energy.

Wrong. The jet is a matter of convenience. The fuel (source) being sufficiently inconvenient (expensive, illegal) would force alternative decisions.

Takes two to tango in this case.

The source is still where the fuel came from. You're talking about the sink it's ending up in.

do you know oil has a lot of uses that are not pure transportation/electricity/heating related and necesssary for the modern civilization ?

Yeah, like the plastics that kill our environment on another vector.

Stop apologizing for oil companies. Your brain power would be better spent solving how to stop literally pouring gas on the fire.

Why not both?

Half a million people died and they get away with a slap on the wrist. Mckinsey should be dismantled and its members involved in the opoids promotion sued and tried.

The owners of the company should he sent to prison for more than 10 years

That is horribly inhumane. Just have each of them be forced to take the average prescribed dose of their product for one year, and then forced not to from then on.

But the entire point of OxyContin is to induce opioid withdrawals every single day by lying claiming that the release formula is effective for 12 hours, but making it cease dosing at 8 hours. Regular removal of opioid availability from a patient has the pernicious effect of creating a excessively of desire for a normalizing dose but removing all base levels to zero puts the brain and body through another cycle of low and high experience and so OxyContin makes immediate junkies out of everyone unfortunate enough to be prescribed.

I was prescribed it recently after surgery. Took it for around 5 days and then stopped with no ill effect (and several left). I don’t think your statement holds in the short term (and certainly not “immediate”), though over a longer period it seems to.

Possibly, but I have had Oxy prescribed and wasn't an immediate junkie. It worked for my pain is as much that I would pass out soon after taking one. This would have been in the 2008/2009 period, and my doctor was very careful with dosage.

Also note, I hated the way I felt while taking them.

Yeah Oxycontin was a 13th amendment violation.

And calls into question every number in Western Medicine.

> its members involved in the opoids promotion sued and tried.

definitely sounds like they would be liable for tortious offenses due to this.

The timing is eerie. Declared public health emergency in 2017 and most media coverage and high profile lawsuits was in 2017-2019. Insiders like McKinsey knew about the dangers much earlier, perhaps better than anyone.

> Consultancy McKinsey and Company agreed to pay $573 million to 47 state governments to settle claims it advised "Purdue Pharma and other drug makers to aggressively market opioid painkillers."

That was in 2021.

At all levels the true service that McKinsey provides is responsibility diffusion. Whether it's a manager that doesn't want the bad rap for a stupid or unpopular decision to profiting from creating the opioid crisis, the role of McKinsey is to come in, tell you what you wanted to hear, and then walk away bearing a good chunk of the blame for whatever happens.

The blame is meaningless to them and has zero negative consequences (in fact it has positive consequences), they just perform the part of "evil" management consults. It's an important part in making sure no one takes too big of a responsibility hit.

This is what makes McKinsey so vile. It's not that they actually put these ideas in the heads of their clients, but that they perform a necessary part in making sure that even the most banal of evil actions to the most horrendous can remain ultimately consequence free.

> The blame is meaningless to them and has zero negative consequences

I would imagine this many government ties helps a little bit when it comes to consequences: https://en.wikipedia.org/wiki/List_of_former_employees_of_Mc...

This I think is the reality of it all. There's a subtle hint of extortion in their work. A tone of "oh, you need to lay off thousands of workers because your business isn't doing as well as it sounds? That's a shame. That sounds a lot like securities fraud to me. We have the commissioner's daughter on our payroll, so if you let us advise on the layoffs, maybe you can avoid charges."

No, it’s not nor is it solely responsibility diffusion. The real trick of McKinsey is being everywhere. If you are a corporate strategist, you can try to do the best you can with what your analysts tell you and your own data. But if you hire McKinsey you are sure their advice will be at least as good as the one they are giving your competitors. Of course they don’t make it obvious. They have internal shielding, privacy protection, the whole shebang. But you might get invited to be part of the benchmark which matters and their internal documentation pulls cleverly from all their cases. It’s subtle but hiring them is the closest you can get to a cartel without crossing the line. That’s why they are so expensive.

I wholeheartedly disagree. I have never heard of a single instance where they provided actual, useful, cutting edge actionable advise. I however have seen them payroll dozens of unremarkable yet politically connected people. You are repeating the narrative they pitch out loud, but whenever they make this pitch, they also make sure you hear the extortion angle as well.

In the instance of this very article, what makes more sense? McK offered competitive advise that sold more product. Or, given that at all the companies they advised, employees knowingly murdered hundreds of thousands of people and escaped any legal culpability, that the fees went to paying off politicians to protect them from investigation/prosecution?

It is a small step between enabling pill mills and helping herd undesirables into the showers. It truly is time that we demand better of corporations, and time to prosecute immoral and unethical management.

The "undesirables" comment is a little harsh. You're taking about people who are foolish enough to trust that doctors have their best interests at heart, and get addicted.

No, I am not. You might recall the adage “Those who forget their history are doomed to repeat it.”

Here’s some light reading for you: https://en.m.wikipedia.org/wiki/IBM_and_the_Holocaust

The parallels should now be obvious.

Maybe I'm confused. Are you calling the addicts undesirables?

You're confused. They're not calling the addicts undesirables.

McKinley advising and assisting Purdue is not entirely unlike IBM advising and assisting Germany’s 1933 NSDAP government in its execution of a thorough ethnic census of its peoples, and then “facilitating the regime's generation and tabulation of punch cards for … military logistics, ghetto statistics, train traffic management, and concentration camp capacity.”

I see upon reading my OP that I did not identify IBM as a co-guilty party paralleling McKinley. My apologies.

another side to this is -- now that your eyes are open, you have a unique choice, to build social systems that thrive from mutual benefit and actually implementing those, and to bear witness to that. Profit is useful for force certainly, but not the only factor for making change over time. The ugly spectacle of Big Pharma here is not the only path forward.

> the role of McKinsey is to come in, tell you what you wanted to hear, and then walk away bearing a good chunk of the blame for whatever happens

This is the role of nearly all consultants.

how would a corporation death penalty work? probably with company closure ( equity destruction ), banning the brand and force all ill involved managament to not work in that specificindustry for 5-10 years.

McKinsey used to be very respected but over the last 10 years or so has gone from scandal to scandal. McKinsey used to be the the place top graduates wanted to go, but today the best no longer seem interested in going there. What caused things to break down so badly? Did they just get too big and lost control of the culture?

Quite ironically they seem to need some serious advice on how to fix their own company.

I work(ed) for McKinsey. Happy to chat about it to some extent. I’ll start by saying that this is not accurate at all. It’s still extremely competitive. Big tech is probably the most attractive place but you’ll still see large percentages of top programs trying to get in.

There's this strange dichotomy in thinking around drugs.

On the one hand, you have people saying we should decriminalize drugs.

On the other hand, you have examples like this of what happens with drugs when they are distributed in a decriinalized way.

There’s a bit of truth in that perhaps, but I don’t think anyone is advocating legalizing free sales of opioids. Apart from scumbags.

> examples like this of what happens with drugs when they are distributed in a decriinalized way

People were told, by pushers in white coats, that these opioids were not addictive. The issue was not with the availability of those drugs (heroin is more available and much cheaper, like most addicts eventually discovered) but with disinformation from persons in positions of authority.

I mean, if 2004– is the timeline, seems mostly opportunistic. The opioid stuff started in the mid 90s. “Pain is the fifth vital sign” and all that. You were made to feel like a shitty doctor if you didn’t get on board.

"I don't have to sell nuthin'. This shit here? It sells itself."

These scumbags are the reason I changed my mind on the death penalty.

Unfortunately most consultancies like McKinsey play minimal roles, if any, from the companies that engage them. They are often used as excuses for things the company was already going to do. That way management says “look at McKinsey presentation” or “McKinsey says raise prices” and passes the buck to them in a very expensive way.

May be true in general but if you’ve followed and read through all the articles published by NyT and others, McKinsey deserves far more blame in propagating the opioid epidemic than not.

If you hire a hitman to kill somebody, both you and the hitman are guilty.

Is this true with Purdue? It was a family owned private company, so there shouldn't be much need to get the shareholders on board. They probably just wanted their expertise.

mckinsey or other big consultancy with any ethical conduct code shoud report (even informally) blatant frauds (enron) or (human rights) violations

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