The Scott Gottlieb example

Since former FEMA Director Mike Brown’s background came to public light, there’s been considerable discussion about cronyism in the Bush administration — the only people who seem to get jobs are those who are reliable political allies, and they’re given jobs whether they deserve them or not.

Since the Brown example, critics have not hurt for examples. David Safavian and Julie Myers made headlines shortly thereafter for the same reason.

Time magazine moves the ball forward this week — asking “How many more Mike Browns are out there?” — explaining that cronyism dominates the executive branch at nearly every level.

The Office of Personnel Management’s Plum Book, published at the start of each presidential Administration, shows that there are more than 3,000 positions a President can fill without consideration for civil service rules. And Bush has gone further than most Presidents to put political stalwarts in some of the most important government jobs you’ve never heard of, and to give them genuine power over the bureaucracy. “These folks are really good at using the instruments of government to promote the President’s political agenda,” says Paul Light, a professor of public service at New York University and a well-known expert on the machinery of government. “And I think that takes you well into the gray zone where few Presidents have dared to go in the past. It’s the coordination and centralization that’s important here.”

It’s an important point. Every president is going to fill sought-after vacancies with political allies and generous contributors. Bush not only does it more than his predecessors, he also, apparently, sees this as integral to how the executive branch should function. Loyalty above competence, allegiance to ideology over commitment to public service. We’ve all heard the phrase “it’s not what you know; it’s who you know,” but with the Bush White House, it’s reached a ridiculous level.

If Bush were simply filling ambassadorial posts with high-donor “Rangers,” I doubt anyone would be terribly surprised or outraged. But the real scandal here is the specific jobs, with important public responsibilities, being filled with those who have little or no qualifications in their field.

Mike Brown, unfortunately, was just the beginning. Meet Scott Gottlieb.

Internal e-mail messages obtained by Time show that scientists’ drug-safety decisions at the Food and Drug Administration (FDA) are being second-guessed by a 33-year-old doctor turned stock picker.

The FDA’s deputy commissioner for medical and scientific affairs is not exactly some random bureaucrat. When Gottlieb was given the job, he was burdened with the responsibility of reviewing accuracy in medical research on, as Time put it, “everything from new vaccines and dietary supplements to animal feed and hair dye.” It’s the kind of job in which Americans need to rely that a qualified specialist, free of influences from politics and special interests, has their best interests in mind.

And while the 33-year-old Gottlieb does have a medical degree, his bio raises a few eyebrows considering his high-ranking post.

What the bio omits is that his most recent job was as editor of a popular Wall Street newsletter, the Forbes/Gottlieb Medical Technology Investor, in which he offered such tips as “Three Biotech Stocks to Buy Now.” In declaring Gottlieb a “noted authority” who had written more than 300 policy and medical articles, the biography neglects the fact that many of those articles criticized the FDA for being too slow to approve new drugs and too quick to issue warning letters when it suspects ones already on the market might be unsafe. […]

[Donald Kennedy, Jimmy Carter-era FDA Commissioner, a former Stanford University president and now executive editor-in-chief of the journal Science said]Gottlieb breaks the mold of appointees at that level who are generally career FDA scientists or experts well known in their field. “The appointment comes out of nowhere. I’ve never seen anything like that,” says Kennedy.

OK, so there are questions about Gottlieb’s qualifications. But has he proven himself on the job?

Behind the scenes, however, Gottlieb has shown an interest in precisely those kinds of [scientific and medical] deliberations. One instance took place on Sept. 15, when the FDA decided to stop the trial of a drug for multiple sclerosis during which three people had developed an unusual disorder in which their bodies eliminated their blood platelets and one died of intracerebral bleeding as a result. In an e-mail obtained by Time, Gottlieb speculated that the complication might have been the result of the disease and not the drug. “Just seems like an overreaction to place a clinical hold” on the trial, he wrote. An FDA scientist rejected his analysis and replied that the complication “seems very clearly a drug-related event.” Two days prior, when word broke that the FDA had sent a “non-approvable” letter to Pfizer Inc., formally rejecting its Oporia drug for osteoporosis, senior officials at the FDA’s Center for Drug Evaluation and Research received copies of an e-mail from Gottlieb expressing his surprise that what he thought would be a routine approval had been turned down. Gottlieb asked for an explanation.

The administration is filled with Scott Gottliebs, in offices most people have never heard of, running the executive branch (usually) free of intense public scrutiny.

So, for every high-profile controversy over a Bush nomination (Ashcroft, Rumsfeld, Rice, Gonzales), remember there are many more mundane presidential appointments that may be doing just as much damage, if not more.

What I want to know is how many of these posts are Senate confirmed. Maybe there should be a complete overhaul of the process, so that the Senate could have more time to scrutinize every nominee thoroughly.

Brownie got in unanimously. This can’t happen again.

  • Sounds just like the state of Illinois under D or R administrations.

    Cronyism from top to bottom within Illinois makes it one of the most difficult states to get straight, correct, and legal answers from whether it is obtaining a fishing license to filing for food stamps or Medicaid.

    Ignorant, careless workers abound. Beware.

  • Maybe it’s all part of the grand plan, to use government incompetence as the rationale to minimize government. Stranger things have happened.

  • When Carpetbagger speaks of Schedule C cronies being given “real power over the bureaucracy,” I am reminded of the comical struggles between Paul Hacker, the Minister for Administrative Affairs in the YES, MINISTER tv series, and Sir Humphrey, the lifetime civil servant who tries to derail Hacker’s grandiose plans for reform. Bureaucracy is a necessary evil in any complex society, and political superintendence of that bureaucracy is a necessary evil in a democracy. The key difference between someone like Hacker (who is fictional) and someone like Brown (who is all too real) is that Hacker, a British minister, is an elected official who has to defend his policies before the voters, whereas Brown and other American federal administrators are presidential appointees accountable only to the president (who is in turn accountable only to God). I don’t think we’re ever going to get a system of Parliamentary government in this country similar to that in Britain, but maybe it’s time to think about having biennial elections for Cabinet and Cabinet-rank officials, so that there’s some way of throwing the bums out when they screw up.

  • The key to understanding all this is that Bush is, himself, the least qualified human being to ever hold the office of the President. Looking down his resume, you’ll see lots of puffed up corporate positions that friends helped him get where he didn’t really do anything (or ran the company into the ground while breaking laws) – followed by an extremely short stint as one of the country’s least powerful Governors (as per their state constitution).

    It makes perfect sense that all of these dangerously underqualified people are appointed by the penultimate example of that sort of thing gone awry.

  • The president (whoever he is) has the right to select who he thinks will
    be best for the job. He has to balance loyalty to the administration’s objectives with personal competence in the people he selects.
    This can lead to the gross distortions of this privilege we are seeing under
    Bush’s leadership.
    But this can also result in some inspired choices. Remember John
    F. Kennedy chose his own brother Robert for Attorney General and
    his brother -in-law Sargeant Shriver to head the Peace Corps. These
    were certainly great choices to lead crucial areas of the administration in
    spite of the obvious nepotism involved.
    Of course, governing is as much of an art as it is a science. We are
    at the mercy of our leaders to do what is best for us and have to hope
    they will put the interests of the whole country ahead of petty, partisan
    gain. That clearly did not occur in this sorry administration. Congress
    should look into reforming this to find ways to best serve everyone.

  • Sheldon Bradshaw is another FDA newbie, coming over from DOJ. Evidently, he’s treating Big Pharma with the same kid gloves and moist lips as his predecessor, Daniel Troy.

    I’ve been looking into the slightly odd Brigham Young/Utah connections in the Bush administration – it’s, shall we say, incestuous.

  • Comments are closed.