{ "docId": "019dd923-5ca1-7489-b639-45501f4b359b", "docSlug": "158df8627a0b9aca", "documentTitle": "Opioid Conflicts Majority Staff Report", "authorId": "McKinsey", "authorName": "U.S. House Committee on Oversight and Reform", "documentKindSlug": "consulting-deck", "documentKindLabel": "Consulting deck", "sourceTypeSlug": "strategy_consulting", "sourceTypeLabel": "Strategy consulting", "presentationDate": null, "orientation": "portrait", "aspectRatio": 0.773, "pageNumber": 42, "pageCount": 53, "prevPage": 41, "nextPage": 43, "slideType": "appendix_disclosure", "function": "other", "density": "dense", "nDataPoints": 0, "notes": "This appears to be a page from a formal investigative report or legal document, indicated by the footnote citations.", "elementsJson": [ "paragraph", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-5ca1-7489-b639-45501f4b359b/42", "deckHref": "/decks/019dd923-5ca1-7489-b639-45501f4b359b", "deckJsonHref": "/decks/019dd923-5ca1-7489-b639-45501f4b359b.json", "deckAnchorHref": "/decks/019dd923-5ca1-7489-b639-45501f4b359b#slide-42", "components": [ { "bbox": null, "kind": "callout", "text": "Given the conflicts between the Industry and what the Secretary of HHS might want to do we should tread carefully eg I would be careful about people who serve Opioid Manufacturers.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd951-cdec-74db-b49d-df924745f75e", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.22, "w": 0.78, "x": 0.11, "y": 0.57 }, "kind": "paragraph", "text": "The next morning, Senior Partner Navjot Singh wrote that given “conflicts between McKinsey should “tread carefully” with respect to the memo. He cautioned: Given the conflicts between the Industry and what the Secretary of HHS might want to do we should tread carefully eg I would be careful about people who serve Opioid Manufacturers (sorry Martin [Elling] and Arnie [Ghatak]) influencing the opioid section. Perfectly fine to share wisdom but maybe let people who are at a distance take the pen who maybe our HHS colleagues [sic].204 An additional response by Mr. Singh was redacted by McKinsey, but Mr. Singh added that he would be “[h]appy to discuss this live.”205", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "3d50a603-1590-4789-ab47-38a8af9ae60e", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.22, "w": 0.78, "x": 0.11, "y": 0.34 }, "kind": "paragraph", "text": "McKinsey began preparing the memo to Secretary Azar prior to his confirmation. On January 17, 2018, Stephanie Carlton, the partner who co-leads McKinsey’s Center for US Health System Reform, wrote to two senior McKinsey partners in the pharmaceutical practice, both of whom had previously served opioid manufacturers, noting that McKinsey was sending a transition memo to incoming Secretary Azar, and seeking their input.201 Ms. Carlton wrote that another McKinsey partner “is sending a transition memo to Alex Azar (as soon as the full Senate vote happens). The full memo is attached, but 2 sections in particular I wanted to flag for you: drug prices and opioids.”202 That evening, another McKinsey partner forwarded the memo to other McKinsey consultants serving opioid clients for their feedback.203", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "bc93074d-6417-4868-a1a4-acb13ff67384", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.22, "w": 0.78, "x": 0.11, "y": 0.11 }, "kind": "paragraph", "text": "consultants had prepared a similar memo for former President Trump's first HHS Secretary, Tom Price to address “several operational perspectives for HHS.”197 Based on internal McKinsey emails, the transition memo to Secretary Azar was reviewed or edited by consultants working for opioid manufacturers.198 McKinsey noted in the Secretary Azar memo that, “McKinsey is a non-partisan firm; we do not provide policy advice or recommendations. Accordingly, we provide only our perspectives on the potential ramifications of various policy options, including for the private sector.”199 However, the memo prepared for Secretary Azar contained “strategic priorities” that appear to be functionally identical to recommendations, and noted policy-oriented “actions” that HHS “might consider.”200", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "f72b729d-33d6-4854-b9db-0139243d6088", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "Given the conflicts between the Industry and what the Secretary of HHS might want to do we should tread carefully eg I would be careful about people who serve Opioid Manufacturers (sorry Martin [Elling] and Arnie [Ghatak]) influencing the opioid section. Perfectly fine to share wisdom but maybe let people who are at a distance take the pen who maybe our HHS colleagues [sic]. — Navjot Singh", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd951-cdec-74db-b49d-e340b88fbd1d", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.15, "w": 0.35, "x": 0.11, "y": 0.81 }, "kind": "source-note", "text": "197-205 citations", "attrs": { "numbered": true }, "subkind": null, "toolName": null, "toolSlug": null, "confidence": null, "componentId": "d0720140-5e55-4cc2-85ba-8e30d0294ca0", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [ { "to": 53, "from": 29, "beatId": "1170eac2-9202-4b41-a53c-edbd934ded10", "arcName": "Problem-Agitate-Solution", "arcSlug": "problem-agitate-solution", "beatName": "Impact & Next Steps", "beatSlug": "consultants-gambit-impact-next-steps", "evidence": "The document concludes with implications of McKinsey's actions and potential next steps for regulatory action.", "position": 2, "confidence": 0.8, "parentBeatName": "Resolution", "parentBeatSlug": "resolution" } ], "loops": [ { "to": 53, "from": 1, "name": "Cost Of Inaction", "slug": "27-cost-of-inaction", "bestFor": "Urgent budget requests, compliance, risk mitigation", "matchId": "ee9686db-f8b5-4bc9-bf6e-2d29966ee033", "evidence": "The document implies the cost of inaction through its presentation of McKinsey's conflicts of interest and their potential impact on the opioid epidemic.", "position": 0, "objective": "What is the cost of inaction in addressing McKinsey's conflicts of interest?", "structure": "The Status Quo -> The Hidden Costs Accumulating -> The Future State of Inaction -> The Tipping Point", "confidence": 0.7, "description": "Quantify what happens if the audience does nothing" } ], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }