Opinion

Stories I’d like to see

Picking government contractors, high-flying Dubai, and a dubious drug on the market

By Steven Brill
November 26, 2013

1. Who picks the contractors?

In the wake of the failed launch of Healthcare.gov there has been some spectacular insider coverage, particularly by the Washington Post and New York Times, of the failure of the private contractors to deliver what they promised when they won the assignments to build the federal insurance exchange. But while there has been some mention of problems with the contract procurement process itself (focusing on the notion that in Washington the IT providers who win the contracts are better at winning IT contracts than at doing cutting-edge IT), one piece of the story has so far been missing: Who actually decided to award the Healthcare.gov contract to CGI and the others who shared the work? And on exactly what basis?

We know the winners had invested heavily over the years to get on a list of pre-qualified companies who could bid on contracts like this one, a tortuous process that the best and brightest technology companies outside the Beltway typically don’t bother with because they have too much more rewarding work to do in the private sector, where the bidding process is more straightforward. But we still haven’t gotten a good picture of who in the government runs these processes.

I know from some reporting I’ve done recently that in Kentucky, to take one example, the contractor that won the job to build that state’s Obamacare website was chosen by a committee that did not include the person who was actually in charge of building the Kentucky exchange. In other words, the person who would supervise the outside vendor, and whose career depended on whether the contractor did a good job, had nothing to do with picking the contractor. In fact, I’m told that the official in charge of the website didn’t meet the leader of the contracting team until after the choice was made.

It turns out that the lead Kentucky contractor — Deloitte Consulting — did a great job, and its team worked perfectly in synch with the state officials supervising them. But that seems to be more a matter of good luck than a procurement process designed to produce teamwork and accountability. Imagine a private corporation picking a supplier to work on a key project without the executive supervising the project being allowed to meet the supplier’s team leader first.

I’m assuming that’s what happened in Washington at the Department of Health and Human Services. As with most states, federal procurement regulations require a walled-off selection process intended to prevent corruption by having mid-level civil servants rather than higher-ranking officials, who are often political appointees, make these big-money choices.

Is that what happened? Who chose these contractors and how?

2. Dubai follies:

According to this article in the November 18th Wall Street Journal, Boeing and rival Airbus announced an astounding $150 billion worth of aircraft sales to Middle East-based airlines at the Dubai Air Show that opened the weekend before last.

So, how about some comprehensive stories about how airlines like Emirates make their purchasing decisions and negotiate discounts? The Journal reported that Emirates is “already the world’s largest international carrier by capacity” and that it bought 150 Boeing jets with a total list price of $76 billion at the air show.

More generally, what are the details behind the obvious plans for world domination by the Middle East’s airlines, and how are international air hubs like London’s Heathrow responding to what the Journal says is the Middle East states’ strategy to overtake Europe as the leading crossroad for international travel? According to the Journal, “Dubai’s existing airport is set to overtake London Heathrow as the world’s busiest international hub, and it has added a second, the new Dubai World Airport that is hosting this week’s show.”

How will the West be able to respond? And are there international trade issues related to the fact that much of the funds behind the Middle East push are coming from competition-skewing subsidies from these oil-rich governments?

Beyond that important but relatively dry stuff, I bet there’s also a fun lifestyle story here. With all that money on the line last weekend at the Dubai conclave, how about a report from the party scene?

3. Who let this drug on the market?

Lately, we’ve been bombarded by TV ads for something called AndroGel, apparently an underarm-applied drug for men that purports to boost testosterone. But it’s hard to tell what it really does because most of the ad talks about its scary side effects.

About fifty seconds of the 90-second ad  warns first of the horrible things that can happen to women or children who have any contact with the gel and then what might happen to men who use it: “worsening of enlarged prostate, possible increased risk of prostate cancer, low sperm count, swelling of ankles, feet, or body, enlarged or painful breasts, problems breathing during sleep, and blot clots in the legs.”

Earlier this month, CBS News (which clearly doesn’t worry about offending advertisers) reported on the air and on its website that “A major study published Tuesday in the Journal of the American Medical Association looked at older men, most with heart disease, in the Veterans Affairs system who had low testosterone levels. There was a 29 percent increased risk of heart attack, stroke or death in those given testosterone.”

So why is this drug allowed to be sold?

“Now I feel the way I should feel,” says one patient interviewed by CBS extolling the drug — and reflecting the new lease on life offered to men in the other 40 seconds of the AndroGel ad.

But the potential downsides are so threatening that, as a doctor interviewed by CBS puts it, “before you start treating millions of Americans with testosterone, you probably ought to think twice.” It would seem that the AndroGel ads would be a good hook for a story examining not only the process by which the Food and Drug Administration approved it for sale, but also the United States’ uncommonly loose rules when it comes allowing TV ads for drugs, even those with such dicey cost-benefit profiles.

PHOTO: United Arab Emirates’ Prime Minister and Ruler of Dubai Sheikh Mohammed bin Rashid al-Maktoum (front R) comes out of an Airbus 319 aircraft after touring it during the Dubai Airshow November 17, 2013.  REUTERS/Ahmed Jadallah 

 

Comments
2 comments so far | RSS Comments RSS

Actually, the lead Kentucky contractor didn’t do the good work on the state’s Obamacare website. Deloitte Consulting subcontracted the marketplace website to CGI, the same company working on the federal system.

Posted by 2MW747 | Report as abusive
 

speaking of loose advertising laws, something should be done about the supplement industry.

Posted by zotdoc | Report as abusive
 

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