A little different take on DOGE
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Another different take. Very insightful about the sources of inefficiency in a large bureaucracy which will resonate with many here.
Give it a read.
https://www.eatingpolicy.com/p/bringing-elon-to-a-knife-fight
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I’ll dig into both of these articles more in depth a little later, but I think one basic point that both authors are kind of missing is that most of our institutions these days are set up to reward mediocrity and even failure and punish success.
Let’s start with procurement and budgets. Departments are punished for coming in under budget. If they find that they are under the projected budget at the end of the year, they are punished by having their budget cut. Divisions that come in over budget often have their budgets increased as they cry that they were underfunded. There are no repercussions for defense contractors that come in over budget. You need another $5B for the F35s, damnit! Here you go. In procurement, large and successful companies that have a higher number of employees can easily lose out to small companies with less manpower to accomplish the job, but because they have the SWaM designation they get bonus points, even if their prices are substantially higher. Almost any company with a small staff will routinely have higher overhead… On top of that, the process of managing your SAM accounts and GSA schedules is so Byzantine that there are companies that are entirely dedicated to managing your accounts at a cost of tens of thousands of dollars per year. More overhead. There used to be one piano company with a GSA Schedule based out of Texas. Their prices were at full retail…
So the small companies have difficulty fulfilling government contracts, and almost by necessity come in higher, but are given priority…
Want to know a dirty little secret of why there are so many women CEO’s and in ownership stakes now? Because if a company can’t get the S (small) designation, they want the W (women) or M (Minority) designation.
Then there’s the whole subcontracting thing in acquisitions. Any time a bid comes out that we’re eligible for, I’ll get 5 contacts from different companies that want me to sell through them. I used to kindly explain to them that I was bidding on the same item and it would be unlikely that they would be able to match my price as they need to add their own markup… It’s ridiculous, but it’s obvious that it works for them or they wouldn’t be in business…
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@jon-nyc said in A little different take on DOGE:
Another different take. Very insightful about the sources of inefficiency in a large bureaucracy which will resonate with many here.
Give it a read.
https://www.eatingpolicy.com/p/bringing-elon-to-a-knife-fight
First comment is worth the article. That guy nails the court's participation in promoting inefficiency.
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Talk about burying the lede. CNN strikes again. Read at least the first few paragraphs, then the last one. THIS is CNN (Communicate No News)
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Somewhat related: Mark Cuban gives feedback on healthcare inefficiencies.
I don’t know cars or rockets, but I know how to land healthcare in a net that saves millions of people an un quantifiable amount of money. Without legislation.
Cuban laid out seven major issues with typical PBM agreements that affect not only companies like Musk's Tesla and SpaceX but also their employees and families:
No control over claims data: Companies don't get full access to the data about what's being billed or paid.
Restricted formularies: PBMs control which medications are covered, often prioritizing profits over health.
Overpriced “Specialty Drugs”: These are often marked up without justification.
Rebates come at a cost: "Rebates" paid by pharmaceutical companies ultimately increase employee deductibles and co-pays, hitting the sickest and oldest the hardest.
Harming independent pharmacies: PBMs often reimburse small pharmacies less than the cost of brand-name drugs, driving many out of business.
No manufacturer collaboration: Companies can't directly work with drug manufacturers to create targeted wellness programs.
Opaque contracts: Many PBM agreements include NDAs, making the system inefficient and increasing prices nationwide.
"All of this allows the big PBMs to continue to distort the pharmacy market for literally EVERYONE," Cuban emphasized.
