Sunday, December 22, 2019

CAPITALISM’S CONSIGLIERE: MCKINSEY’S WORK FOR INSURANCE COMPANIES, ICE, DRUG MANUFACTURERS, AND DESPOTS







December 18 2019, 5:01 a.m.



THE POWERFUL GLOBAL consulting firm McKinsey is facing scrutiny over its work for a wide range of shady governments and companies. This week on Intercepted: Former senior health insurance executive-turned-whistleblower Wendell Potter explains McKinsey’s role in our insurance nightmare and how Democratic presidential candidate Pete Buttigieg is using industry talking points to attack Medicare for All. Potter also discusses his career working for insurance giants, soaring medical costs in the U.S., and his role in killing Hillary Clinton’s health care initiative in the 1990s. ProPublica reporter Ian MacDougall discusses McKinsey’s relationship with the Saudi regime, its work for Rikers Island, and how it helped push opioids to doctors and patients. MacDougall also lays out his reporting on how McKinsey’s work for Immigration and Customs Enforcement in detaining and deporting immigrants disturbed career immigration officials.
Also, the Justice Department’s inspector general blasted the FBI over its lies and omissions in obtaining a secret Foreign Intelligence Surveillance Act warrant to spy on Trump campaign operative Carter Page. Intercept co-founder Glenn Greenwald discusses how the report vindicates civil liberties activists and serves as a striking rebuke of the bipartisan love affair with law enforcement and intelligence agencies.

Narrator: How the Grinch Stole Christmas by Dr. Seuss. The Grinch hated Christmas, the whole Christmas season.
Donald J. Trump: The impeachment is a hoax. It’s a sham. It’s impeachment, the whole impeachment thing.
Narrator: That’s one thing he hated.
DJT: The impeachment thing is a total hoax. And people behind my back are trying to do a subversion of government, think of that.
Narrator: Which was something that Grinch couldn’t stand in the least.
DJT: These people are sick. They’re sick.
Narrator: The more the Grinch thought I must stop this whole thing.
DJT: To use the power of impeachment on this nonsense is an embarrassment to this country.
Narrator: But you know, that old Grinch was so smart and so slick. He thought up a lie and he thought it up quick.
DJT: I like transparency here and I’m the most transparent president in history, the most transparent president. God bless you. God bless Israel. And God bless the United States. Thank you very much.
[Music interlude.]
Jeremy Scahill: This is Intercepted.
[Music interlude.]
JS: I’m Jeremy Scahill, coming to you from the offices of The Intercept in New York City. And this is episode 111 of Intercepted.
Amy Goodman: McKinsey proposed cuts to spending on food, medical care and supervision of people in immigration jails.
Ryan Hampton: You know, Purdue and we learned this last week, hired McKinsey, the PR firm to figure out a strategy to combat the message of, the messages of these parents who had lost their children and their grief.
Steve Inskeep: McKinsey and Company was paid millions for a new anti-violence strategy and a ProPublica investigation finds that strategy failed which McKinsey obscured with bogus numbers.
JS: The powerful global consulting firm, McKinsey and Company, has found itself in the news quite a bit this year. The company has been around for nearly a century and it has been a significant player in reorganizing the way both governments and corporations operate. McKinsey’s central goal is increasing profits and eliminating what it perceives to be impediments to securing that bottom line and the interests of the shareholders and executives. In essence, they are capitalism experts. But when it comes to corporations or government agencies that can directly impact the health, safety and very livelihood of human beings, the stakes are incredibly high and McKinsey’s work for health insurance companies, drug manufacturers, prisons, immigration authorities and repressive governments around the world is finally receiving some of the scrutiny that it has long deserved.
CNBC: Its alumni control some of the largest and most powerful companies in the world, and have also been involved in some of corporate America’s most sensational scandals.
JS: McKinsey was a major player in the drive toward privatizing U.S. government services at the height of the Cold War. It now works for governments across the world, including the antidemocratic and murderous Saudi regime.
After the execution of Washington Post columnist Jamal Khashoggi on October 2, 2018, The New York Times published a report on some of McKinsey’s work for the kingdom. Specifically, a report that identified Saudi social media accounts that were attacking the kingdom’s economic austerity measures. In its report, McKinsey highlighted three critics whose commentary was gaining traction on Twitter. One of these people was later arrested, while a second Twitter user said that two of his brothers were arrested in Saudi Arabia. Twitter apparently shut down the account of the third person that was identified by McKinsey.
Christine Burke: Now the report went on to identify specific individuals that were driving the conversations on Twitter and the New York Times has reported that that report fell into the hands of the Saudi Arabian government and was used to then punish those specific individuals.
JS: Now McKinsey subsequently claimed that the report was an internal company document and that it wasn’t used by the Saudis. But what we do know is that the murder of Khashoggi did not deter McKinsey from continuing to work for Saudi Arabia or Mohammed bin Salman. Coming up on the show, we are going to take an in-depth look at what McKinsey does and who they do it for, including helping to push opioids on doctors and patients. But first, we are going to focus in on how McKinsey has made its way into the Democratic presidential primaries.
McKinsey has been in the news recently because Democratic presidential candidate Pete Buttigieg, the mayor of South Bend, Indiana, worked at McKinsey from 2007 to 2010. And among the clients he worked for was the health insurance company Blue Cross/Blue Shield. Now, Buttigieg has tried to downplay his role at McKinsey and has suggested that there is nothing in his time at the firm that should reflect negatively on his presidential run.
Pete Buttigieg: This is my first job out of school. It’s not like I was the CEO. I was making a lot of spreadsheets and powerpoints but people ought to know from somebody who proposes to be the president of the United States: What’s in your past?
JS: At the same time he is saying all of this, Pete Buttigieg is running as a corporate Democrat and he has emerged as a major attack dog against the popular movement for Medicare for all.
PB: Medicare for all who want it — trusting you to make the right decision for your health care and for your family and it can be delivered…
Marc Lacey: Thank you, mayor. Senator, your response?
Elizabeth Warren: So, let’s be clear, whenever someone hears the term Medicare for all who want it, understand what that really means. It’s Medicare for all who can afford it.
JS: Mayor Buttigieg has tried to distance himself from the layoffs of 1,000 people that occurred at Blue Cross Blue Shield after his time at McKinsey, saying he had nothing to do with it. But at a forum back in 2011, Buttigieg appeared to suggest that he actually did. In fact, he said, “One of the things I did for a living was just that.”
PB: One of the things I did for a living was just that. I remember one client organization that was a large insurance firm that had grown in such a way that there was a great deal of duplication. Some people didn’t even know what the people working for them were doing.
Former McKinsey and Health Insurance Industry Insider, Wendell Potter, on How the Industry is Killing Health Care and Why the fight for Medicare For All Matters
JS: As the revelations about Pete Buttigieg’s work for McKinsey have begun to come to public light, a former senior health insurance executive has emerged as one of the presidential candidate’s major critics. Wendell Potter worked more than two decades in the health insurance industry, first at Humana and then at the $70 billion health insurance giant Cigna. Wendell Potter helped crush Hillary Clinton’s health care initiative in the early 1990s. He was serving as head of corporate communications for Cigna when he left after what he called a “crisis of conscience” in 2008.
Wendell Potter: When I got to the fairground, I saw something that just changed my life entirely. I saw people who were standing in long lines, soaking wet because it had rained that morning and I noticed that a lot of those lines lead to barns and animal stalls on this fairground site.
JS: Wendell Potter is the author of “Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans,” as well as “Nation on the Take: How Big Money Corrupts Our Democracy And What We Can Do About It.” He is the president of Businesses for Medicare for All and the founder of Tarbell, an investigative journalism nonprofit that aims to “put the power back in the hands of citizens.” And Wendell Potter joins me now. Wendell, welcome to Intercepted.
WP: My pleasure, Jeremy. Thank you.
JS: So recently, you had a Twitter thread that dealt with Pete Buttigieg, health care, and McKinsey.
WP: I wanted people to understand what McKinsey does for health insurance companies and for corporations generally. The sketchy information that he had put out initially was just that he had done some work for a nonprofit health insurance company in Michigan and it sounded relatively benign, but I know there aren’t a lot of nonprofit health insurance companies in Michigan. I started just poking around making really the assumption it probably was the very big and dominant health insurance company in Michigan, Blue Cross Blue Shield of Michigan. And I found that not long after his work, the company laid about 1,000 workers off and hiked premiums for its members, significantly, double-digit rate increases for its health insurance members. I thought it was an opportunity one, to highlight the work that McKinsey does which is almost invariably aimed at in one way or another boosting profits or the bottom line, and also just how the health insurance industry really operates. Regardless of tax status, that they often routinely, year after year, raise rates on their customers to the point that many people drop out — they can’t afford insurance anymore — also routinely lay people off. He’s talked about the jobs in the insurance industry. I’ve witnessed it and was a part of it in my old days in the industry of having to lay people off because of the work that McKinsey had recommended to executive management.
JS: Pete Buttigieg, of course, when you, in part, he was responding to you and he appeared on Rachel Maddow.
PB: Well, I was assigned to a team that was doing analysis on the overhead costs that they had. Nothing to do with claims or what they do with patients, but kind of as an organization — buildings, rent, utilities, travel, that kind of thing. I certainly saw how big and complicated an insurance company could be. Now, it was my very first study. So honestly, most of the time, I was just figuring it out how to do my job and perfecting my powerpoint skills, but it at least gave me a sense of what that world is like, and it’s one of the reasons—
JS: What’s your response?
WP: He still hasn’t been very forthcoming about the work that his team did. Maybe it was, as he says his first job and his first assignment at McKinsey, but I would find it very hard to believe that he was not aware of what the client hired McKinsey to do, and what the work he was doing, how it contributed to the objectives of the assignment.
JS: Let’s separate the minutiae of what Pete Buttigieg is talking about in terms of his time at McKinsey, and talk in the bigger sense about what McKinsey and consulting firms like McKinsey do for large health care corporations.
WP: They’re paid a lot of money, first of all. One of the companies that I worked for I know that the chief financial officer had McKinsey and Company on retainer to the tune of about $50,000 a month and that’s just to be on retainer. Much of what McKinsey does results in downsizing of organizations and it’s also very prevalent in the insurance business, health insurance business, not only to lay jobs off but to ship them overseas. But that’s basically you know, what the company does it is to in one way or another figure out ways for the company to boost the bottom line and more often than not, they work for for-profit corporations. And the ultimate objective is to enhance shareholder value, to improve the profitability, improve the chances that the company can meet Wall Street’s financial earnings per share estimate as an example. It’s all about the money.
Rachel Maddow: Was your work part of what led to those lay-offs?
PB: I doubt it. I don’t know what happened in the time after I left that was in 2007 when they decided to shrink in 2009. Now, what I do know is that there are some voices in the Democratic primary right now who are calling for a policy that would eliminate the job of every single American working at every single insurance company in the country.
JS: Specifically, this notion that Buttigieg has floated that eliminating these private insurance companies all together would be a great job killer.
WP: And that’s straight out of the health insurance industry’s playbook. The cards that my former colleagues play consistently whenever there is reform that’s proposed they don’t like is to play the tax card and the jobs card. And they want people to believe that any kind of reform that’s being proposed that they don’t like will result in job eliminations, people losing their jobs. And there’s no doubt because of the way our health care system has developed, we have hundreds of thousands of people who are involved in work one way or another. More often than not, within the insurance industry, there are barriers to care. The reason that we spend $3.6 trillion on health care in this country is because so much of that is eaten up by administrative costs caused by our multi-payer system. Hospitals and doctors have to hire people who don’t deliver care but day in and day out are on the phone or on their computers dealing with insurance company bureaucrats trying to make sure that they’re being paid adequately, and that the patients they’re treating are hopefully going to get the care that they need. So, that’s one thing.
The other is he’s floating an idea that is just fallacious. There is even if you remove the private insurance industry from our health care system and the role that they’re playing now, those companies will not dry up and blow away. Over the years, those companies have diversified significantly to the point that a lot of their profit centers now have nothing to do with providing patient care or providing insurance. The other thing that he is not saying which I think is deceptive is that in both of Sanders bill and the bill in the House, the lead sponsor of whom is Congresswoman Pramila Jayapal, there is a provision that would set aside a lot of money to retrain people whose jobs would be eliminated. A lot of the people who work for these insurance companies are caregivers, or at least they were in their original careers, who do paperwork, who are in many cases, carrying the title of denial nurse that means that their primary responsibility is to check someone’s eligibility for benefits and make a determination as to whether or not someone’s going to get the care that the doctor recommends.
JS: How much of Pete Buttigieg’s language on health care is lifted straight from the insurance lobby’s playbook?
WP: I recognize a lot of it and sometimes specific words. I mean, just what we were talking about, the suggestion that every single job in the insurance industry would disappear. I mean, that’s what the industry wants someone to say, someone who has a national platform like he does to scare people and all these are precisely what Buttigieg is doing. And one part of that, one part of the playbook is to get candidates and elected officials to carry your water for you, to recite your talking points. It’s hard to get at least Democrats to sing the praises of health insurance companies, but you can get them to talk about taxes and jobs in ways that bolstering are the insurance industry’s agenda.
JS: Now, I know that you haven’t endorsed any candidate, and you say that you don’t plan to. So, with that independent spirit in mind, let’s talk about some of the health care plans being floated by Democratic presidential candidates. In your estimation, when it comes to health care, whose ideas or stated policy positions do you see as most dangerous to the average American when it comes to health care?
WP: Well, I think anything quite frankly, that leaves the basic structure in place is dangerous to every American regardless of whether they have insurance now or what kind of insurance policy they might have. And I will add to that that those who are now saying that let’s open up the Medicare program for all who want it, which is one of Buttigieg’s platform elements, would not serve the American public well. Now, 10 years ago, I was among those who was saying that the Affordable Care Act as it was working its way through Congress, that it should have contained the provision that would have created a public option. Back then, it was the best option that we could have gotten. There was no real debate at that time. It was actually shut down. There were no real hearings in Congress on the idea of moving to a single-payer or Medicare for all type of system back then.
So, that was the best we could do. The Democrats decided to go along with the lobbyists for the insurance industry and the hospital industry and the drug industry to create that bill in ways that would enhance profitability of all those sectors of health care. Ten years later, I certainly do not think that having a public option is the way to go because the problem is the basic structure of our health care system. We have a system that really is driven by and controlled by health insurance companies. They are the entities that are the barriers to care or the gatekeepers, if you will, and they figured out ways to profit handsomely from the status quo. And they also do not control health care costs. Nor do they really have any incentive to do that because as health care costs go up on the delivery side, because they’re the only game in town, they can increase premiums just as much as they want to. Costs keep going up, more and more people are being shifted into high deductible plans, they can’t get the care that they need even if they have insurance. Increasingly, thousands if not millions of Americans are in the category of the underinsured. They have coverage, but they have such high deductibles, they can’t use their coverage. So they’re resorting to Go Fund Me to raise money to pay for the care that they need, but they don’t have the money to pay for.
JS: One statistic that you cited regarding the Affordable Care Act, Obamacare, that I think is just so important for people to understand is that when the ACA was passed, we were spending about $2.5 trillion on health care in this country. Now, it’s $3.5 trillion. And it may, since you said that, it may have even gone up. So, what you’re saying is that the Affordable Care Act has increased how much consumers have to spend to get basic health care in addition to what the federal government is spending?
WP: That’s exactly right. What we have been seeing is that over the course of those years, not only have people been having to pay higher premiums — even if they get their coverage through their workplace and their employers subsidize it — workers are having to pay a higher percentage or higher amount of money every paycheck to pay for health insurance. That money is money that otherwise could go into their paychecks in forms of a raise or a bonus, but instead, it’s being sent to insurance companies. The formal name is the Patient Protection and Affordable Care Act, but it is not the Affordable Care Act and we’ve got now 10 years of evidence to show that it has not control health care costs. The reason is that Democrats back then — and that includes the Obama administration — knew that we had problems both of cost and access. We had at the time that the bill was passed about 50 million people who did not have insurance. So, they just said, well, let’s tackle the access issue. Let’s try to get more people insured without doing very much of anything to control health care costs. They cut deals with drug companies, and the hospital association and insurance companies to make sure that they would continue to get their big piece of the pie and do no damage to their bottom line. So, that’s what we’ve seen. And as a consequence, these health care prices keep going up and the people who are paying for them are average Americans.
JS: I recently had a personal experience with this. A member of my family had a very frightening accident happen that required a little under two weeks in the hospital, and it was you know, fairly routine stuff, scary to the individual family. But in terms of the issues that were raised, it was pretty run of the mill, basic health emergency. But what I’m in the middle of right now, Wendell is dealing with getting ping-ponged between the hospital, the doctors, and the insurance company over erroneous bills, double bills, surcharges, mistakenly categorized procedures or personnel as out-of-network. It’s like a full-time job. If you have a loved one who ends up in a medical emergency, and they go to the hospital. First of all, you have to fight in the hospital to not be neglected. And then secondly, you are constantly on the phone or sitting in waiting rooms to argue with a billing department that couldn’t care less about what’s going on in your life that you have to now spend all this time arguing about your bill. And then you’re introduced to the world of co-insurance, co-payments, deductibles. Oh, you didn’t hit your out-of-pocket max yet. Well, it was hit for this person but not that person. I don’t remember this being the case 10 or 15 years ago at the level that we’re seeing it right now. But it seems like they find every way to take a pound of flesh out of already suffering people and force you into a bureaucracy that grinds you totally into the ground.
WP: And that’s by intent. Our health care system has grown so confusing and complex, and that plays right into the hands of the industry because they know that people are just really incapable in many cases of fighting back. And just imagine if you’re a patient and you don’t have anyone in your family who can do that for you, and you’re sick, you’re trying to recover. It’s almost an impossible undertaking. And we get these EOBs — the explanation of benefits statements — from our insurance companies and they’re indecipherable. It takes a lot of effort and time. You’re right, almost like having a full-time job, just to try to sort through it and to figure out: Was this service actually provided? The health insurers will often point the finger of blame at hospitals and drug companies for rising health care costs. They actually work very cooperatively behind the scenes to push back against any reform they don’t like because the system with this complexity, benefits all of them. And all the rest of us are greatly disadvantaged, and in many cases winding up in bankruptcy, even if we have insurance because of all that we are now having to pay out of our own pockets for care that, you know, at one point, used to be covered by insurance companies. But since the advent of high deductible plans, more and more of us can’t even, we don’t have enough money in our bank account to cover our deductibles.
JS: Just describe your background in the health care industry and how you ended up being a former executive who now is talking to me on this show.
WP: I’ve spent about 25 years in health care. I was vice president of Corporate Communications for Cigna. My job responsibilities included handling financial communications to the media for the company. My name was on every earnings release. And I also worked with my peers across the industry in Washington at our trade association and coalitions or front groups that we would set up to craft communication strategies to push back against reform. My team was responsible for equipping our lobbyists with talking points. My team handled the political action committee giving so I know how these companies dole out campaign cash to candidates on both sides of the political aisle. And because of that job that I had handling financial communications, I had to know how these companies make money, where it comes from and where it goes. So, I know what motivates these companies and these executives because I was a part of it for over two decades.
JS: Describe your role in trying to crush the Clinton health care reform in 1993.
WP: The industry initially thought that the Clintons, you know, they might create a health care plan that the industry would like but they ultimately decided — and it wasn’t just the insurance industry, it was the drug companies and the hospitals — that altogether the Clinton plan would change the health care system in ways that might threaten profits. As often happens, the insurance companies, the big hospital companies, and drug companies, and medical device manufacturers began to pool their resources to throw money at a central place. And at that time, it was through an organization called the Healthcare Leadership Council. We operated a war room. We churned out press releases that back then were sent to media and staff on Capitol Hill via fax. It was just churning out propaganda day in and day out. Again, once again based on the principles of fear, uncertainty, and doubt to get to the public and policymakers in the media to believe that what the Clintons were proposing would not be good for the country.
Bill Clinton: Our work has just begun. Many Americans still haven’t felt the impact of what we’ve done.
Announcer: There will be rationing. Waiting lines will develop. You will have to settle for one of the low budget health plans selected by the government. Selecting the hospital you think best will be even harder. A giant social experiment, the Clinton health plan, everything good about your health care is at risk.
JS: Who were Harry and Louise?
WP: Harry and Louise were a fictional couple. They started showing up on our TV screens during the Clinton years in ’93 and ’94.
Harry: I don’t get it. Congress isn’t passing the health care reform America wants.
Louise: The problem is they don’t get it.
Harry: We’ve been clear about the reforms we want.
Louise: Private health insurance we can all have even if we’ve been sick. Coverage we can keep even if we change or lose our jobs. Coverage we can afford.
Harry: Why can’t Congress write a law like that?
WP: They were created by an advertising firm called Goddard Claussen at the time that was hired by the Health Insurance Association of America, paid a lot of money. And Harry and Louise would be seen sitting around their kitchen table worrying about what the Clinton plan might do.
Harry: Well, I’m glad the President’s doing something about health care reform.
Louise: He’s right. We need it.
Harry: Some of these details.
Louise: Like a national limit on health care?
Harry: Really?
Louise: The government caps how much the country can spend on health care and says, that’s it.
Harry: So what if our health plan runs out of money?
WP: And it was all based on misleading information and the whole effort was to scare people to think that the Clinton plan was something that would not be good for them or for the country.
Harry: Well, government should police the plans. Keep everyone honest, but I’m not comfortable with government-run health care.
Louise: That’s not the reform we want and Congress needs to get that message. What can we do?
WP: And it worked. People bought into the propaganda. They really weren’t paying a lot of attention as to who was behind it. But every penny of it came from the insurance industry.
JS: Describe the moment where a crisis of conscience hit you and your departure from that industry and your entry into now fighting the fight that you are engaged in today.
WP: I flew back home to visit family and this was in July of actually 2007 and I read in my local newspaper while I was down there about something called a health care expedition that was being held a few miles away at a county fairground. People were expected to drive from hundreds of miles away to get care in a small little Appalachian town. I decided to borrow my dad’s car and drive up there to just check it out. I was at the time writing a white paper for the industry to try to make people think that the problem of the uninsured was not such a big deal, to try to make people think that people who were uninsured were that way by choice.
When I got to the fairground, I saw something that just changed my life entirely. I saw people who were standing in long lines soaking wet because it had rain that morning. And I noticed that a lot of those lines lead to barns and animal stalls on this fairground site. And it just was stunning to me. I knew immediately it was, I never imagined I would have anything that I would ever refer to as an epiphany. But I woke up that day and I realized that when I was doing for a living contributed to people having to get care that way. And I knew that what I was writing for that white paper was just misleading to the point that one of the things I was obviously supposed to obscure in that white paper was the fact that many thousands if not millions of people were uninsured because insurance companies refused to sell them coverage because of a pre-existing condition.
JS: How could we change this current system? I mean, is it realistic that we could get to a system that takes profit entirely out of the administering of health care in this country?
WP: It’s a matter of when not if, Jeremy, that we get to a Medicare for all type of system because businesses, and doctors, and hospital administrators, and many others, as well as regular folks are seeing that the system is built on a foundation that is crumbling. The employer-based system is crumbling. More and more people who get coverage through the workplace are not taking their employers up on the offer because they can’t afford even their share of the premiums. And I think more and more policymakers are going to be waking up to that as well too, but it’s going to take money. But the thing is, they have more money than we’ll ever raise, but we’ve got people. You will see a real groundswell of support at the grassroots level for change that we’ve never seen before.
JS: We’re going to leave it there, Wendell. Thank you so much for joining us on Intercepted.
WP: Thank you, Jeremy.
JS: Wendell Potter worked more than two decades in the health insurance industry, first at Humana and then at Cigna. He’s the author of “Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans.” He’s also the president of Businesses for Medicare for All.
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Reporter Ian MacDougall on the Far-Reaches of McKinsey & Company’s Influence on the Public and Private Sector, From the U.S. to Saudi Arabia
Kevin Sneader: One of the great strengths of our firm in the past was its sense of mystery. In fact, I remember one of the first articles that covered us when I joined the firm was the McKinsey Mystique.
JS: That mystique Kevin Sneader, McKinsey’s global managing partner, is referring to has helped make them one of the most powerful and influential management consulting firms in the world. Operating in some 65 countries and more than 130 cities, McKinsey sells its ideas without taking credit. As Duff McDonald, the author of “The Firm,” a book about the company’s influence on American business, puts it:
Duff McDonald: They take no credit. They take no blame.
JS: But the 90-plus-year-old company has had a hand in shaping business trends in that time, promoting the wonders of efficiency in the 1920s and the privatization of programs like NASA in the 1950s and ’60s. Legitimizing mass lay-offs and the widening CEO-to-worker pay gap can also be traced in part back to McKinsey. Today that ratio stands at about 278 to 1.
McKinsey alumni include people like Facebook COO Sheryl Sandberg, former Boeing CEO James McNerney, Chelsea Clinton, and, as we just discussed, Pete Buttigieg. Questions regarding Buttigieg’s time at McKinsey have thrust the company back into the spotlight and directly at its ethical track record. McKinsey has been involved in some major business scandals including Enron and Purdue Pharma.
Andrew Ross Sorkin: McKinsey has faced a slew of negative press over the past year from troubles in South Africa, potentially profiting on the outcome of Puerto Rico’s debt crisis, taking heat for its work with Saudi Arabia, at one point the firm was called the new Facebook and it was likely not intended as a compliment.
JS: To discuss how McKinsey operates around the world in both public and private sectors as well as its influence, I’m joined now by lawyer and journalist Ian MacDougall. For ProPublica, he has reported on McKinsey and its work with the Trump administration to detain and deport immigrants, its work at Rikers Island, and its ongoing relationship with some repressive regimes. Ian MacDougall, welcome to Intercepted.
Ian MacDougall: Thank you for having me.
JS: So, let’s start from the biggest possible picture, explain what McKinsey and Company is.
IM: It’s a global management consulting company that’s been around for nearly 100 years. It began and still is chiefly devoted to the kind of work you’d expect management consultants to do. So, working with U.S. Steel or other, you know, big kind of traditional companies to do things like cut costs, streamline supply chains, that sort of thing.
KS: At McKinsey, we’ve always been guided by our mission. In fact, it keeps us focused on the reasons we exist of which there are two: to help our clients create change that really matters, and to develop a place for exceptional people.
IM: Increasingly recently, they’ve moved not only into doing more work for governments at home and abroad, but also all kinds of other work that’s quite different from what they traditionally do.
JS: In researching this, doing some reading about their time during the Cold War, and when the arms race started, and the case of McKinsey’s work with NASA, for instance, was really interesting. If you go back and look at some of the proposals, they were really pushing a privatization agenda early on for government services, military services, etc.
IM: They were very much as you’re saying involved in setting up the contractor-industrial state, but advising NASA and then increasingly other parts of the government to rely heavily on contractors rather than developing internal competence. They then ended up leaving the public sector in the U.S. almost altogether in the early 70s after this scandal actually involving the New York City government, and have only begun to come back into it really, in the last 10 to 20 years. It more or less began with Bob Mueller when he was the head of the FBI asking to help the FBI reorganize as its priorities changed after 9/11.
JS: You wrote that “As the Cold War’s end opened new markets worldwide, McKinsey reoriented its priorities toward aggressive expansion between 1989 and 2019. The firm vastly enlarged its global footprint from offices in 44 cities across 23 countries to offices in more than 130 cities spread across 66 countries today.” McKinsey reported $10 billion in revenues last year. Talk about some of the countries and projects that McKinsey currently works on.
IM: A big one is their work in the Saudi government. Others have reported that I think it went from one project in 2010 to something in the hundreds a few years later, and they’re still there. It’s a major source of revenue for them. They’re working hand in glove with lots of parts of the government dealing with economic issues, trying to sort of overhaul aspects of the economy there.
Fahd Al Rasheed: The government of Saudi Arabia is thinking about what does government look like in the 21st century in terms of delivery to citizens of the private sector, and they’ve implemented that.
IM: Evidently, the planning ministry is referred to as the Ministry of McKinsey there because of how suffused with McKinsey consultants it is. And it’s gotten them to raise some real questions about whether they ought to be doing work there and other places like that, that have authoritarian regimes in place. In this case, MBS — Mohammed bin Salman — who effectively runs the country is you know, quite close as I understand it with them. And then obviously, after the murder of Jamal Khashoggi raised a lot of even more questions, put it that way.
JS: Soon after that killing happened, The New York Times did a pretty significant story that I’m sure shook the power structure at McKinsey. As best as we can tell from that reporting, it had to do with McKinsey doing work on profiles for Saudi Arabia of externally important individuals or issues. In a statement that McKinsey put out after this happened, the company said that the Saudi state had not commissioned it to create a report that identified critics and this is the McKinsey quote, “In our work with governments McKinsey has not and never would engage in any work that seeks to target individuals based on their views. The document in question was a brief overview of publicly available information looking at social media usage.”
ARS: When you find out that your client is a murder you do what?
KS: You walk.
ARS: You walk?
KS: If your client is a murderer, and that’s why when we think about where —
ARS: OK, so let’s talk about Saudi Arabia, then.
KS: Sure.
ARS: What happened?
KS: Well, what we’re doing and what we’ve been very thoughtful about is the kind of work that we take.
What was your sense of how that played out, the New York Times report and then the way McKinsey responded to it?
IM: I’ve seen the document and in fairness to McKinsey, it does look like an internal document. When McKinsey does work for their clients — this is in part to preserve their secrecy or plausible deniability, or whatever you want to call it — the client’s name is usually the only one that shows up on those slides. So, McKinsey’s name often won’t be on it at all. This one says McKinsey and Company on every page. It looks like these internal knowledge documents. It’s an analysis of the reaction and sentiment among Saudis to austerity measures. And so it names these three individuals as three of the most prominent critics of the austerity measures.
JS: The recent piece that you did “How McKinsey Helped the Trump Administration Detain and Deport Immigrants,” explain first of all, how McKinsey ended up working for ICE. This didn’t start under Trump. It started under Obama, and what exactly they did and why ICE was even concerned about the pace that McKinsey was recommending.
IM: They began the work under the Obama administration in March 2016 really, as kind of analyze where they’re inefficiencies? After the Trump administration came into office, the president signed these two executive orders, which were meant to put into motion his promised crackdown on illegal immigration.
DJT: We are going to get the bad ones out, the criminals and the drug deals, and gangs, and gang members and cartel leaders. The day is over where they can stay in our country and wreak havoc.
IM: McKinsey was already there working on efficiency issues and procurement for detention centers principally. And so in that sense, when McKinsey says nothing changed at that highest level. I guess that’s true. But both documents and interviews with people who worked on it from the ICE side and from the McKinsey side say it changed dramatically to be really focused just on figuring out how to, on one hand, hire the 10,000 new immigration officers that one of these executive orders directed ICE to hire. The other part of it was how to handle what they expected to be a large influx of detainees, how to keep costs down at detention centers.
The parts that really troubled, I should say some people at ICE, not everybody, because on some level, they were channeling a certain level of kind of thinking within but the recommendations that really troubled folks at ICE were things like cutting, you know, essentially pennies on food costs, medical care, maintenance at quite decrepit facilities.
JS: You write McKinsey, the firm’s presentation show pursued “detention savings opportunities in blunt ways. The consultants encouraged ICE to adopt a longer-term strategy with operational decisions to fill low-cost beds before expensive beds. In practice, that meant shunting detainees to less expensive and sometimes less safe facilities often rural county jails.”
IM: Those kinds of things left a lot of these ICE staffers quite wary that you know, a couple of them independently of one another said that it felt like McKinsey was approaching this issue as if it was dealing with how to best price widgets. There was a detachment from the humanity of what they were looking at.
JS: Let’s talk about your work on Rikers. You also wrote about how McKinsey consultants worked with Rikers’ jail officials to skew the outcomes of report on violence prevention strategy that it implemented at the notorious jail. Why was the report misleading?
IM: The report itself said that there was a reduction in violence in these pilot units where they were piloting the reforms by 50 percent. What had happened was very early when they were starting that pilot project in a small subset of cellblocks they had decided to keep out folks who jail officials who corrections officers knew to be unruly or troublemaking or might cause violence numbers to go up. In part, because they were trying to fine-tune their process and they didn’t want someone stabbing someone on the first day. But what ended up happening is they presented the outcome of those cellblocks — where violence went down dramatically and stayed quite low — publicly into oversight boards as if it was a cross-section, representative cross-section of the population. And when they handed that process off to jail officials using this new algorithm they’d created to assign housing units to detainees, the jail officials said hey, look, before we were keeping these guys out, numbers were staying down, city hall was staying off our back. Let’s keep doing it. And they did.
The idea that those pilot projects, the reforms caused 50 percent or 70 percent, the number reported in different ways, different places, reductions in violence. As one person said to me, maybe that was from the reforms but how can you say when cherry-picking who was in there?
JS: Wasn’t there evidence to suggest that the violence actually increased after McKinsey started working on it?
IM: It absolutely has. There was a recent report in October, just as the city council voted to close Rikers that said, essentially the use of force issues — and this is from a federal monitor as part of a civil rights settlement — that said the use of force there has gotten worse and worse and worse, and we just don’t see things getting any better and that was part of what McKinsey was supposed to help deal with.
JS: McKinsey also worked with Purdue Pharma. Your colleague David Armstrong wrote that “From 2009 until at least 2014, McKinsey helped Purdue shape its message for selling OxyContin and overcoming concerns about addiction and overdoses… The consultant told Purdue in a slide presentation that it could increase prescriptions by convincing doctors that opioids provide ‘freedom’ and ‘peace of mind’ and give patients ‘the best possible chance to live a full and active life.” Is this telling, or an example that’s helpful to look at when you’re wondering like how McKinsey operates as a corporation?
IM: Yes, this is a good example of where a partnership like any frankly for-profit partnership or corporation exists to make the partners money or the shareholders money. That’s really why that exists and they may say otherwise. But you know, when they say we’re doing good in the world — it comes up to a point where it’s like it was gonna cut into the bottom line, they become less enthusiastic for that. This is the kind of stuff that’s happening behind that facade of being a, you know, benevolent steward of capital or whatever you want to call themselves. They’re working now on trying to, you know, reduce opioid addiction, find strategies for states to basically undo what they helped do in the first place.
JS: The journalist and author of the book “The Firm: The Story of McKinsey, and Its Secret Influence on American Business,” Duff McDonald has said the following about McKinsey: “I think, by the very nature of the business, they are mercenaries. They will work for anyone.” He then went on to say, “I don’t mean they’ll work for a murderer, but they’re for hire.” In all of these pretty damning cases, covering the way that the company has worked with businesses or government agencies or foreign governments has McKinsey ever faced any actual accountability?
IM: The closest they’ve had recently is in South Africa, which The Times has written about it at some length, where there have been quite serious investigations by various authorities into the work they did for an energy company or energy utility there that they worked alongside this local company that had ties to the Gupta family which is involved in this big corruption scandal with the former president of South Africa. And there they’ve, you know, had to appear before legislative committees and reveal the work that they did there and both publicly and to authorities with power to do something about if there was criminality. They haven’t been charged. So there hasn’t been anything like that, that’s happened.
KS: Illegality or unethical behavior in any guise has no home in McKinsey. I welcome everything that has been done by public leaders and the authorities to piece together and halt state capture. We will continue to cooperate with all relevant authorities or investigations.
IM: But beyond that they’ve been pretty lucky. They were deeply embedded in Enron. When it collapsed, Jeffrey Skilling, the CEO was a McKinsey partner before he went over there, and they sort of skated away from that one. No one’s ever found evidence that they were involved in the illegal stuff that happened at Enron. But they were certainly everywhere in a company that was, you know, heading towards collapse long before it actually collapsed.
JS: I mean, stepping back from the specifics of what you’ve reported, and I’m just asking you as a reporter who’s now spent some time digging pretty deeply into McKinsey. What is the overall impact that McKinsey and firms like it have on the way that government entities function in this country, and businesses interact with the government?
IM: I think a big part of it is to focus almost all of the attention on things like efficiency and agility and things like that which are I suppose neutral in some way and could be quite good, depending on how it’s applied, but the way in which it has been deployed, especially when it comes to government misses some of the points that, you know, government despite what some people say isn’t a business and it doesn’t look like one generally and it’s not supposed to. And so sometimes a lot of the things that are not susceptible to certain kinds of technocratic solutions that would be used within corporations, you know, they’ve certainly helped get those applied more broadly in government often to the detriment of people the government [is] meant to serve.
JS: All right, well Ian, I want to thank you very much for joining us.
IM: Thank you for having me.
JS: Ian MacDougall’s a journalist at ProPublica. He has written about crime, criminal justice and legal affairs for Harper’s, The Atlantic, Slate, and The Guardian. You can find him on Twitter @i_m_m.
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