It's been a rough week for the Defense Contract Audit Agency, home to the Pentagon beancounters charged with insuring the goverment doesn't get robbed blind by military contractors. They are supposed to be doing that, at least. Recently, though, there have been questions about how effective the agency has been in protecting billions in taxpayer dollars from falling prey to waste, fraud, and abuse. On Tuesday, the Commission on Wartime Contracting—which has a former DCAA deputy director as its co-chair—blasted the problem-plagued DCAA, along the Defense Contract Management Agency, for failing to provide adequate oversight. Today, in tandem with a Senate hearing on the DCAA, the Government Accountability Office followed with a report [PDF] that found big time flaws with the agency's audits and operations. How big? Well, let's put it this way: Of the 69 audits and cost-related reviews the GAO looked at, it determined that every single one of them had problems— and the majority of them had "serious" ones. The GAO explains the heart of the issue:

A management environment and agency culture that focused on facilitating the award of contracts and an ineffective audit quality assurance structure are at the root of the agencywide audit failures we identified. DCAA’s focus on a production-oriented mission led DCAA management to establish policies, procedures, and training that emphasized performing a large quantity of audits to support contracting decisions and gave inadequate attention to performing quality audits. An ineffective quality assurance structure, whereby DCAA gave passing scores to deficient audits compounded this problem.

Flawed audits are just the half of it. An earlier GAO report [PDF], in July 2008, found abusive work environments at two DCAA field offices, including auditors who were threatened with disciplinary action if they refused to change audit findings or draft favorable reports. Today, the Pentagon's Inspector General, Gordon Heddell, told [PDF] the Senate homeland security committee that an investigation by his office had centered on one senior DCAA official in particular, the deputy director responsible for the agency's west coast operations. Heddell said his office concluded that she "improperly directed changes" to one audit that "could have allowed Boeing to recover $271 million in unallowable costs."

In the past, committee member Claire McCaskill (D-Mo.)—a former auditor herself—has demanded changes at the DCAA, saying in 2008 that "somebody needs to be fired this." The "the top of my head is about to pop off" she tweeted during today's hearing, remarking on the "unbelievable" problems at the agency. "In the world of auditing," she said later, "what has been committed here is a capital crime."

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I like kids. They think their bellybuttons are hilarious and can zone out to a screensaver. So I wanted to learn how to avoid consuming products made by kids when I heard about the new Department of Labor report on international child labor. Unfortunately, the 194-page report (PDF) is essentially useless to consumers. It doesn't tell you which companies are producing goods with child labor abroad, and doesn't even commit that the goods listed are absolutely produced by children. Instead, the report just lists "Bangladesh: Footwear" and "China: Cotton" as products that could possibly be made with child labor. Or possibly not. On page 29 the report states:

"It is important to understand that a listing of any particular good and country does not indicate that all production of that good in that country involves forced labor or child labor... There may be firms in a given country that produce the good in compliance with the law... Labor conditions may differ widely in different regions of the country, among other variables. The identity of specific firms or individuals using child labor or forced labor was beyond the statutory mandate."

Fantastic. Not only will the DOL not tell me which Ecuadoran banana packers use child labor, they can't even tell me that all or most Ecuadoran companies use kids to pick bananas. So what's the point of the report? The report lists so many items (cotton from 15 countries, rice from 8) that it's impossible to avoid them all. Basically, this report just makes me feel guilty about buying everything from Ghanian cocoa to Argentinian grapes, while leaving me no tools or information to counter it. Since I'm in California, I'll at least try to make sure all my fruit and vegetables are local. I can definitely avoid the disturbingly child-produced "pornography" from Colombia, Mexico, Philippines, Russia, Thailand, and Ukraine. But beyond that, I'll just have to look for a better report, one that actually gives American consumers specific information on child-produced goods.

On Monday, a small corner of the Internet exploded with reports that Martin Nisenholtz, Senior Vice-President of digital operations at The New York Times Co., had credited Twitter with 10 percent of NYTimes.com traffic. That would be roughly 2.8 million people redirected from the micro-blogging website to NYTimes.com every month. 

Fortunately, at least one blogger did his homework, noting that NYT spokeswoman Diane McNulty would confirm only that: “At its current growth rate, Twitter is, or will soon move into, the top 10 in terms of referrals to NYTimes.com.” To those not versed in Google Analytics, that means Twitter probably brings in a much smaller piece of the Gray Lady's pie than speculated. But it's growing! And, importantly, skewing toward that oh-so-elusive younger audience the NYT and other papers have been chasing.

The Times seems to be throwing its weight behind the Twitter phenomenon. @nytimes has nearly 2 million followers, which is nothing to sneeze at even if Twitter does slough half of its new users, and given that plenty of profiles are inactive. But not every Twitter profile in the Times-iverse was created equal: Maureen Dowd's @NYTimesDowd has a meager 1,500 followers, compared to Nicholas Kristof's @nytimeskristof, which has more than 600,000. 

Not an @nytimes follower? May I humbly suggest @sewell_chan, the powerhouse behind the paper's City Room blog. Chan's mere 3,000 followers and relative obscurity in the world of the Times belies a feed full of pointed questions and tantalizing tidbits.

The Rise of Glenn Beck

From Vinnie Penn, Glenn Beck's partner in the late 90s, when both were Top 40 jocks at KC101 in New Haven, Connecticut:

He always knew how to work people and situations for attention. He could pick the most pointless story in the news that day and find a way to approach it to get phones lit up. That was his strong point — pissing people off. He was very shrewd on both the business and entertainment sides of radio. He's built his empire on very calculated button pushing.

This is from part 3 of Alexander Zaitchik's terrific profile of Beck at Salon.  If you're looking for an antidote to the Beck dreck that Time magazine recently passed off as journalism, this is it. Read part one here and part two here.

When you get right down to it, it’s hard to believe Republicans want to run against health care in next year’s midterm elections. But that does seem to be the road they’ve chosen, as Dana Milbank’s report in the Washington Post makes clear. You’ve got Sen. Jim Bunning of Kentucky complaining how the Baucus bill "tramples on American freedom and liberties," (before nodding off to sleep). There’s John Kyl sounding like a broken record: "This bill is a stunning assault on liberty." In fact, the Republican contribution to the "debate" in the Senate Finance Committee on Tuesday had little to do with health care reform at all.

But that’s not to say the GOP has nothing to contribute to the subject. The Republican Study Committee, an alliance of more than 100 self-identified fiscal conservatives headed by Tom Price, has issued a slew of health care proposals, surely intended to protect members on the stump in 2010.

The Real Cost of Medmal

In his column today, David Leonhardt makes a point about medical malpractice that doesn't get enough attention:

The fear of lawsuits among doctors does seem to lead to a noticeable amount of wasteful treatment. Amitabh Chandra — a Harvard economist whose research is cited by both the American Medical Association and the trial lawyers’ association — says $60 billion a year, or about 3 percent of overall medical spending, is a reasonable upper-end estimate. If a new policy could eliminate close to that much waste without causing other problems, it would be a no-brainer.

At the same time, though, the current system appears to treat actual malpractice too lightly. Trials may get a lot of attention, but they are the exception. Far more common are errors that never lead to any action.

After reviewing thousands of patient records, medical researchers have estimated that only 2 to 3 percent of cases of medical negligence lead to a malpractice claim.

This deserves more attention.  We can argue about the costs of defensive medicine forever. But I'm willing to tentatively accept $60 billion as a conversation starter.  It's never going to be possible to get a precise answer anyway since, as Leonhardt says later, virtually every incentive in our medical system is to do more.  Trying to isolate and quantify the blame for each particular unnecessary test just isn't possible.

Still, $60 billion is a reasonable enough guess, and trying to reduce that cost is, as Leonhardt says, a no-brainer.  Unfortunately, the real problem with our medical malpractice system isn't that it costs too much.  The real problem is that it's a lottery.  Some people get money they don't deserve because it's cheaper to settle with them even if their claims are frivolous.  But far more people who are victims of genuine malpractice never sue and never get a dime.  A genuinely fair reform, one that cut frivolous malpractice suits but also did a better job of compensating everyone who was genuinely injured, would almost certainly end up costing us more, not less.

Here's a little-known fact that helps to make this clearer.  If you're injured in a hospital, how do you know if you're the victim of malpractice?  After all, not every surgery has a positive outcome.  If yours didn't work out, that doesn't mean the doctor was negligent.

The answer is: you don't.  Unless you sue.  Most hospitals refuse to release their internal records unless you sue them and force disclosure via discovery or a subpoena.  This means two things.  First, lots of suits that look frivolous (because they're dropped quickly) aren't.  They were merely attempts to see the actual records of a case.  If there were an easier way to do that, the suit would never have been filed in the first place.

Second, despite our famously litigous nature, suing is a lot of work.  Most people don't want to do it just on the chance that there might have been some malpractice.  And most people don't.  Which means that lots of cases of malpractice are never discovered.

We could fix this pretty easily by making it much easier for patients to see the records of their own cases.  If we did, that would cut down on "frivolous" lawsuits and it would increase the number of justified lawsuits.  That would be fairer for everyone, but it probably wouldn't cut medical malpractice costs.  It would increase them.  That's why the medmal warriors never talk about this.  They like the idea of cutting back on frivolous suits, but they're much less keen on admitting that there's also a lot of genuine malpractive that goes completely unnoticed.

Even if we eliminated medmal suits entirely, the cost savings would be pretty modest.  Genuine reform, on the other hand, would likely cost us money.  That's why you never hear much about it.

As I noted yesterday, the new book on Bill Clinton, based on taped conversations he had throughout his presidency with Taylor Branch, a Pulitzer Prize-winning author and FOB, is loaded with intriguing and juicy passages about the Clinton years (like Hillary Clinton dumping on Sally Quinn because Quinn was spreading the rumor the First Lady had been caught trysting with a female veterinarian in a White House bedroom). But perhaps the most fascinating subplot of the 707-page tome is the relationship between Clinton and Al Gore. The book details the now-famous conversation the two had after the 2000 election, an encounter that was both heated and weird, with each man caught in a different view of reality about that election and other matters.

Now that I've had more time to peruse the book, I've come across other passages that illuminate the tensions and affections these pols shared.

* Describing one interview in which Clinton was evaluating Gore's campaigning during the 2000 election, Branch writes, "Gore lacked confidence in a light touch. Whenever he tried to be aggressive, said Clinton, Gore could come off ponderous and harsh, like Mussolini." Mussolini? That's harsh.

* During a "stressful consultation" between the two men when Gore was running for president, Gore, as Clinton recalled to Branch, told Clinton that "he, Gore, was a good politician, elaborating that he meant good on the policy, and also good on the politics, but admitted that he did not instinctively blend the two. Gore said he had to think about it, and Clinton thought this was pretty close to the bone. As a policy person, and a government person, Gore would make wise choices. He had the stuff to be a great president."

So Clinton compared his veep to a fascist Italian dictator, but believed he could be a great president, and Gore realized that his major deficit was integrating the policy wonk and the politician within him. What I'd like now is to see Gore's side of the tale. Or perhaps a book just on what went on between these two guys. Mr. Vice President, where are your memoirs of the Clinton years?

You can follow David Corn's postings and media appearances via Twitter.

News on Blue Marble-ish subjects from our other blogs and around the Web you might have missed.

Baucus Bill Changed: Baucus says he'll change the bill to favor middle-income Americans.

Green Girl: Model Gisele Bundchen becomes a goodwill UN ambassador for climate. [Environmental News Service]

Save Me, Will Ferrell!: New video by Ferrell worries about fate of healthcare company execs.

Hot Seat: In speech, Obama says US is making strides in fighting climate change.

Junk Science: New bill would sponsor study of junk food marketing in schools. [Consumerist]

Adios, Cloves: Clove cigarettes, beloved by drama geeks everywhere, shut down by the FDA.

An Afghan National Army soldier stands ready with his patrol vehicle’s crew-served weapon outside of Camp Shimshod, Helmand province, Afghanistan. Many ANA soldiers are provide forward or rear security while on patrol with International Security Assistance Forces personnel. (US Marine Corps photo by Cpl. Michael Curvin.)

Today's must-reads are still glad we #hiredkatesheppard:

  • Obama Considering Strategy Shift in Afghanistan (NYT)
  • ACORN Worker in "Pimp" Video Told Police (AP)
  • Health Care Progress May Not Be Possible for Two Weeks (TPM)
  • PG&E Quits Chamber of Commerce Over Climate Change (MoJo)
  • Pentagon office overseeing contracts has 14 people working in it. That must make Blackwater very happy (MoJo)
  • Clinton on Gore: "I Thought He Was In Neverland" (MoJo)
  • Arpaio Targeting ACORN (MoJo)
  • Congress Defunding Blackwater? (MoJo)
  • Q&A With Historian Rick Perlstein on the ACORN Flap (Columbia Journalism Review)
  • Kennedy Seat To Be Filled By Appointment (MoJo)
  • What Obama Told the UN (MoJo)
  • "I'm pretty sure I have never—before today—yelled at NPR's Robert Siegel in my car." (Obsidian Wings)

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