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New SF public health chief was part of McKinsey opioid-marketing operation

• AlexandrB 2y ago
  Say something spicy on Facebook: lose your job. Make a living pushing prescription painkillers triggering an opioid epidemic: awww shucks guys, he deserves another chance. This quote at the end is particularly funny cope: > "Just like [Tsai] distributed the drugs, maybe he can distribute the solution to the drugs,” Beal said. “Hopefully, he can use the knowledge he has from helping to create the monster to figure out how to solve it." Yeah, ok. I guess this is also why we usually hire people arrested for carjacking to head police task forces on auto theft. /s
  • ketzo 2y ago
    I mean — the best cybersecurity experts are often former black- or gray-hat hackers. Hiring people with intimate knowledge of Bad Thing to try to fix Bad Thing is not necessarily a bad strategy. Just need them to have very legible incentives. That’s less clear to me in this case.
    • daeken 2y ago
      The reason we hire established hackers for pentesting/red teaming is because the work is the same no matter which side you're on. This isn't the case with drug distribution or whatnot; like doesn't cure like when it comes to most problems. To me, this is akin to hiring a mass shooter to solve gun violence.
  • DevKoala 2y ago
    I have never seen an SF news publication being truly critical of the politicians that lord over the city and state. These publications will criticize the situation and blame factors, but never individuals and their actions. Never expect accountability from them.
    • mmooss 2y ago
      Isn't this article highly critical and in a news publication?
      • DevKoala 2y ago
        You are right. I guess I went off past articles I’ve read from SFGate. This one is very unbiased.
        • mmooss 2y ago
          In my experience people think 'the media' is biased, etc., but when they examine a particular article (from a quality source) they think it's good. That seems to be human nature: Politicians are corrupt but I like my local representative. Obamacare is terrible but I like my ACA health insurance.
          • edmundsauto 2y ago
            Abortions are wrong, but my circumstances were exceptional and it was fine.
        • hindsightbias 2y ago
          This guy would never have an agenda https://en.wikipedia.org/wiki/Michael_Moritz https://en.wikipedia.org/wiki/Michael_Moritz
• Swizec 2y ago
  This looks bad of course, but isn’t he also someone who knows about how this stuff works and has lots of relevant experience building messaging strategies to achieve a goal? Sounds like the guy you’d want handling the opioid epidemic.
  • mszyndel 2y ago
    I know this type of comment is frowned upon here, but you should consider quitting opioids mate.
  • jazzyjackson 2y ago
    Maybe as a part of a work release program from prison, sure
  • anigbrowl 2y ago
    Do you seriously think that marketing opioids to doctors means he's going to be a good communicator with opioid addicts and their street dealers?
    • Swizec 2y ago
      No idea but at least he knows where to find the doctors who are overprescribing and knows how to talk to them right?
      • anigbrowl 2y ago
        Illegal drug markets are a bit more complex than you seem to believe they are. Please read more deeply on the topic, it's not something I can just inform you about in a HN comment.
• mszyndel 2y ago
  [flagged]
• stouset 2y ago
  I hate regulatory capture as much as anyone, but this makes for a more damning-sounding headline than it actually is. To steal a comment from Reddit[1] user NewInThe1AC: > It's a lot less concerning if you actually think about what he specifically did, and what information he would've had access to at the time > He was 23 and working on an early career project. Given how consulting teams are structured, he was not an architect of any grand scheme or plan, and was just executing the work ahead of him. Based on the evidence cited in the article, this was run of the mill business research -- interviewing experts about how pharma sales works and how to segment doctors, summarizing and framing to get to recommendations, and editing PowerPoints > It's only bad when you consider that the product was opioids, but keep in mind that the scientific literature he would've had access to at the time would not have suggested they were especially harmful. If anything, there were compelling reasons for a 3rd party at the time to actually believe that more widespread use of these products would improve wellbeing. If it was so obvious to everyone how bad these things were, we wouldn't have ended up with the crisis we did [1] https://old.reddit.com/r/sanfrancisco/comments/1ipgwcm/sfs_new_public_health_chief_tasked_with_fighting/mcs0a53/ https://old.reddit.com/r/sanfrancisco/comments/1ipgwcm/sfs_n...
  • anigbrowl 2y ago
    It's been widely understood since the 1970s, if not longer, that opioids have a high potential for addiction and that long term use tends to be harmful. Sure, he seems to have been quite a junior employee, but I knew opioids were a high risk category of drugs when I was in high school. I don't think he's the worst guy in the world, but I do think McKinsey style consulting and this experience in particular is a net negative.
    • asdff 2y ago
      Potential for addiction yes but we are looking at it from the lens of a post Purdue media bias. People abuse plenty of drugs that aren't opioids and we aren't say seeing a big push against Xanax for example because that wasn't in any crosshairs of media spectacle. People die on Xanax but it doesn't seem to matter because people write them off as combining with alcohol or that they were addicts. And indeed most drugs of this sort are not particularly harmful if they are used within recommendations. At a certain point a doctor can't control what you chose to do at home with your prescription and that doesn't mean you shouldn't have people who would use it responsibly not receive it even if it means some will abuse it.
• sweeter 2y ago
  The people doing the bulk of the corruption here in the US just decided to stop even trying to hide it. Why would they hide it at this point? They aren't even worried about the optics anymore, they are sending a clear message imo. There's like a handful of people in high positions who aren't corrupt, and all of the ire is aimed at low level employees. I wish I could say that I didn't know why, but it is pretty clear. Even then, it seems like this headline is a little sensationalist. But optically, not good. Even then, this is something that everyone should be aware of. It is easy to jump to conclusions, but we should also do our due diligence here to verify these connections. This can end similar to how Bernie Sanders was painted as a health industry "shill" when in reality it was just the way political donations are categorized. Nurses and such had donated X amount of dollars to his campaign and that was twisted as him taking money from "the healthcare lobby" when in reality he is basically one of the 3 people in government who don't accept super pac and lobbying money, proving that you can indeed survive off of grassroots donations. So we have to be careful here. Optics is not enough to make a conclusion, and people will try to use that against you.
  • xyst 2y ago
    What I am concerned about is the increasing number of bean counters and MBA-flunkies filling positions where technical or medical expertise should be required. Just based on his resume he shouldn’t be managing state/federal medical resources. He should be managing a franchise of fast food chains. He has no medical background. LinkedIn only mentions graduating from Harvard. Out of college he joins the parasites at McKinsey. Then fails upward from there. Current administration is doing this across all departments.
• xyst 2y ago
  This guy is a classic example of failing upward. Goes from parasitic consultant at McKinsey. Consulting/devising strategy to market opioids to masses. Then to _medical_ director at MassHealth. Then to director of Medicaid and CHIP. And now a public health chief. No medical degree or scientific background. Background reads like an accountant from McDougal & McDouglass (w/e firm that took over Boeing). It’s no wonder people have no confidence in our health system. It’s filled with nepo babies and neoclassical economic types that min/max cost.
  • ricksunny 2y ago
    (I believe the firm you're referring to is the aerospace company McDonnell Douglass which in hindsight may be being seen as having brought a more financial accounting orientation to Boeing) ..and o/w your point is well-taken, thank you for the instructive comment.
    • btilly 2y ago
      Things may be seen in many ways. I see it as, "Destroyed an engineering safety culture."
  • cubecul 2y ago
    Where does it say he was "medical director" at MassHealth?
• GIVEDADDYABYTE 2y ago
  I'm reading a book on McKinsey now titled "When McKinsey Comes To Town". Given the firms track record finally coming to light it's amazing that working at McKinsey is a career booster instead of a black mark. Hopefully more people start to realize that putting the most ruthless business minds in charge of public healthcare leads to poor outcomes. I'd recommend reading the book, it is a bit of a downer though
  • deleted 2y ago
    [deleted]
  • pembrook 2y ago
    Calling the 20-somethings who choose the MBA route and all start their career in consulting “the most ruthless business minds” is giving them wayyy too much credit. The majority of McKinsey employees are fundamentally risk-averse kids choosing a safe brand name instead of doing anything entrepreneurial. To write books about them as if these PowerPoint jockeys are doing anything more than providing political cover for executives on a prostitution billing model is beyond funny. I wish people would stop building the McKinsey brand by falling for their own marketing BS. Experts in business don’t need sell non-scalable human labor in hourly chunks, they create successful businesses themselves. An addictive painkiller has product market fit by default and is possibly the easiest product to sell on the planet. You don’t need evil geniuses to get the opioid epidemic, it was an inevitability given the US model.
    • uoaei 2y ago
      You're acting as if the 20-somethings were holding the reins. They absolutely were not -- they were looking to the higher-ups for guidance and authority. The term 'banality of evil' comes to mind in regard to the limited knowledge the underlings had and how firmly they were held under control by those directing their actions.
      • pembrook 2y ago
        The “higher-ups” you speak of are just the top PowerPoint jockeys who get promoted extremely fast — all professional services firms are highly incentivized to give people fancy titles so they can bill them at higher rates. Even the senior management have never actually done or accomplished anything other than Googling stuff and pasting it on PowerPoint slides. Consulting firms like this are a one way street for young grads, up or out. It’s not like McKinsey is recruiting successful founders or corporate executives with actual business acumen to sell PowerPoint slides by the hour. There is no there there. Ironically, the scandals they're supposedly "behind" only serve to build their brand. It gives cover to the morally bankrupt executives at the actual company, while signaling to other executives that McKinsey will take the fall for you.
• mmooss 2y ago
  The interesting question is why the mayor is sticking with him. That seems like a major change in the embrace of corruption recently. What does the mayor gain politically by sticking with this guy?
  • umeshunni 2y ago
    > That seems like a major change in the embrace of corruption recently This is San Francisco we're talking about where the former mayor was funneling bribes to her boyfriend(?), pressuring to get her brother out of jail early and had her buddies managing diversity programs funnel millions elsewhere.
• SoleilAbsolu 2y ago
  SFDPH in general has been moving in a more corporate/consulting-BS direction in last several years, guessing that will accelerate with this individual. Their transition to Epic EHR across the system has heralded a new era of squeaky-clean product/project managers who sling massive Agile jargon but don't actually understand the technical/compliance processes involved that affect orgs like mine who have to integrate with their systems (basics like not understanding the limitations of numerical precision in Excel data types affecting .CSVs, Unix vs. Windows line endings, BOMs, leading zero truncation, demanding tons of excess PHI in billing records for de-duplication). Their response to our issues is kindly, gently strong-arming us to ditch our EHR to join the Epic monopoly if we want to keep our contracts. And this when last time I went to SFDPH in person I literally had to step over junkies shooting up on the street a couple blocks away. On the bright side, Epic seems more functional than the Avatar system it replaced (made national headlines for its botched implementation, SFDPH made it even worse when they completely borked their internal Avatar server migration around 2019 because they didn't know how to properly load-balance using NGINX, maybe 1 in 200 access attempts would succeed).
  • hindsightbias 2y ago
    You can always go to Cerner and buy Larry a new yacht.
• throwaway984393 2y ago
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• nielsbot 2y ago
  Rather than debate the finer points of whether this guy has a conflict of interest, why not just find a public policy expert?
  • SpicyLemonZest 2y ago
    As the article describes, he is a public policy expert with long experience running Medicaid programs, which is precisely why the city wants him.
    • nielsbot 2y ago
      Ok, thanks
• dkkergoog 2y ago
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