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Comment by misswaterfairy | Hacker News Reader

> McKinsey also advised Purdue and Endo on how to target the U.S. Department of Veterans Affairs for sales of their products, according to documents made public through the firm’s settlements with state and local governments. This advisory work occurred while McKinsey was simultaneously working as a consultant for the VA itself. McKinsey has said that it advised the VA on matters unrelated to opioid procurement.

Conflicts of interest are rife in utilising these consulting companies for government services.

Australia has an ongoing saga with a similar theme[1], where a consulting company, PwC, played both sides to the advantage of corporate friends, and got caught.

[1] https://en.wikipedia.org/wiki/PwC_tax_scandal

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It's a dirty secret in a lot of governments that internal expertise has been systematically swapped out for consultants to ever increasing levels for decades. They allow governments to "move quickly" and "act strategically", which pretty much always means ignore those pesky regulations or people who are employed in a specific way to not face political reprisal for telling politicians that their idea/plan is bad or wrong-headed. The Canadian government has had bad PR lately for the same reasons. Whole parts of the civil service are infested with consultants who have produced not much of anything useful, yet extracted enormous fees.

I strongly suspect that weaseling their way into government agencies and then using that to launder influence over the bureaucracy is a key selling point for management consultants.

Regulatory capture as a service.

The VA and VA healthcare are somewhat separate but they are in a unique position to be able to detect something along the lines of, "Given an increase in opioid prescriptions what is the relative increase in homelessness and substance use disorder services saught by members."

I also have a somewhat petty comment to make while juxtaposing this with this: https://www.publichealth.va.gov/marijuana.asp

It’s a federal law and the VA is a federal agency. What would you propose? VA offers multiple “edgy” therapies like ketamine therapy but there’s just no room for that for MJ.

Don’t like the law? Lobby to change it.

Also, frankly I’ve worked in states with legal and not legal status and nobody really cares. Maybe the pencil pushers and disability raters are different. Don’t know.

This discussion is much larger than these comments but ultimately my point is the VA should absolutely never ever ever decide to become a legislative branch. God help us if the VA becomes some quasi chevron deference pretend legislative arm of the federal government and decides to interpret and/or disregard federal laws.

Kind of an aside, but it takes a lot of energy to respond to rants like this. Maybe that's on me, but if you're a vet then I'd assume you'd know how difficult it is to get anything changed at the VA much less lobbying to change an incorrectly scheduled drug.

What my point was is that it's incredibly hypocritical for the VA to have a history of denying veterans medical care over marijuana and then they were caught with their hands in the cookie jar with McKinsey about opioids - an epidemic that they had plenty of data on from the DOD. When I got out in 2012 the DOD base hospitals were chalk full of addicts that their hospital system had created due to over prescription and then subsequently processing people out. I postured whether they had an even bigger picture because it's also the VAs job to track people when they get out; the exception I made was that healthcare and the VA are somewhat separate but related entities.

I do realize the marijuana policy has changed drastically, but it's not reason to forget the last decade.

Serving both sides is expected by all parties. Failure to implement internal firewalls like in this PWC example is a serious failure of internal controls.

Exactly. It's the risk management system that a company implements. Tech companies also serve customers who are in competition with each other. No company is above this. It's all about how you handle these tricky situations. I have yet to see concrete evidences saying that the internal firewall was breached. I'll wait and see.

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