McKinsey Advised Purdue Pharma How to ‘Turbocharge’ Opioid Sales, Lawsuit Says

I'm not dodging anything. I'm pointing out that when I bother to read their articles, they repeatedly get things wrong. The whole point of the Gell-Man effect is: "I read things I'm an expert on. They get those things really wrong. I am skeptical when they continue to write (on that topic) and (other topics), because why would they get other things any more right?"

I'm not an expert on the nuances of the pharma payout reporting. I am an expert on health care policy, health insurance, and clinical practice. Everything they write related to that, that I have read, tends to be off-base. If they regularly get healthcare stuff wrong, then yes, I apply skepticism to them writing about closely related topics which I may not have the same expertise in.

> If the medical industry requires reams of context to understand its practices and pricing, it's largely because pharma, insurers, medical groups, and individual providers often go to obscene lengths to obscure their practices and pricing.

(a) Any data of any complex, multi-component system requires reams of context to understand. This is why "domain expertise" is considered one of the key components of a competent data scientist.

(b) Our system is complex in part because >60% of our healthcare dollars derive from either federal programs, state programs, or an intersection of the two, which means they come with piles of regulatory things that complicate the issue.

(c) Our system is complex in part because we have a free market system, which is a fractured, multi-actor system (as opposed to a single-party-system). This means cash-flow gets complicated by the fact that reimbursement flows to lots of different interacting groups with dis-aligned interests.

(d) Our system is complex because we have a privatized insurance system, which puts a for-profit actor between the consumer and the physician - and one who, in partnering with certain provider groups, specialty pharmacies, etc. effectively channels the demands of the consumers into preferred paths - preferences determined by negotiated rates.

(e) Pricing tends to lack transparency because the vast majority of healthcare dollars are via these third-party insurers, who each negotiate separate rates with providers. Everyone involved in these negotiations has an incentive to not let their negotiated rates become widely public.

If your need to point a finger of blame undermines your willingness to understand the complexity of the system, you only do a disservice to yourself. The system doesn't get simpler just because you don't like its outcomes - and attempting to modify it without understanding the interacting components is doomed to massive unintended consequences. Or, in short, don't tear down the fence until you understand why it was built.

>I'm not going to waste skepticism on ProPublica that could better directed at the American medical-industrial complex.

That's a false dichotomy.

People providing inaccurate reporting that is critical of an industry don't become more accurate because you are also critical of that industry. That's just rationalization: "these guys must be above criticism because they validate beliefs I already hold."

You could be skeptical of both parties. You could be skeptical of the medical industry and shitty reporting on the medical industry. You could be skeptical of FB and NYT's recent obsession with it. You could be skeptical of etc. etc.

Not to discredit any individual points, but the targeting seems odd.

“It was that year that Craig Landau, then Purdue’s chief medical officer and now its chief executive, had an email exchange that included a McKinsey consultant about how to counter mothers whose teenagers had overdosed on OxyContin. The solution: bring in patients to emphasize how the drug helps to relieve pain.“

This really does not feel malicious. It’s not discrediting the losses at all.

Doctors control our right to live. It's contrary to life, liberty, and the pursuit of happiness, because we must get your permission to live.