Crémieux Profile picture
Feb 12 • 10 tweets • 4 min read • Read on X
The biggest news of the day should once again be about DOGE.

A new Executive Order was passed a few minutes ago.

It empowers DOGE to spearhead the complete reorganization of the federal government🧵 Image
The first part of this Order is simple:

The OMB will put out a plan to make the federal workforce smaller and more efficient, including a stipulation that agencies must remove four existing employees for each new hire, with some exceptions. Image
The second part is meatier.

New hires have to be approved by newly-installed DOGE Team Leads in each agency. These Team Leads will report what goes on in the agency they're assigned to on a monthly basis.

But that's not even the big part yet. Image
Third, agency heads will prepare for a massive reduction in the federal workforce.

This workforce reduction will apply to employees not performing necessary and statutorily mandated functions, so if Congress isn't protecting your job, you're likely leaving. Image
Fourth, suitability judgments about the excepted service will be expanded.

People who do not meet certain legal obligations, people who do not certify NDA compliance, and people who steal or misuse government resources are deemed no longer suitable for employment in it. Image
Here's the really big part of this order. It's kind of buried down deep, but it's very important:

Agencies are ordered to develop a comprehensive reorganization plan that identifies offices that can be purged because they lack statutory protections, and offices to consolidate. Image
Putting this all together, what the Order entails is a massive reorganization of the federal workforce and the streamlining of the civil service to make its operation line up with the goals of DOGE.

Not only that, but it empowers DOGE by embedding Team Leads for oversight.
Couple this with the February 4 OPM memo on CIOs, and what we have is staggering:

The federal government will be centralized, stripped down, and more intimately controlled by the President and his delegates, with control enhanced via DOGE.

This is the biggest news of the day, and it's hard to overstate just how big it is.

Because the federal government has grown so unwieldy that no one can provide you with a semblance of an outline of it, measures like this may just be needed to tame the beast.

Get ready!
You can read the EO here: whitehouse.gov/presidential-a…

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More from @cremieuxrecueil

Mar 12
Manhattan is arguably America's most iconic city, and more arguably, its only 'real' city.

But its own laws have made the buildings that make it so iconic illegal to build more of🧵 Image
Many of the existing buildings in Manhattan that you couldn't make today are too tall by current standards. Image
Many of the existing buildings in Manhattan that you couldn't make today have too many apartments by current standards. Image
Read 9 tweets
Mar 11
President Trump just sent a hugely important memo to all agency heads.

It instructs them to inform courts filing injunctions against them that, per the law, plaintiffs have to post a security equal to the potential costs of the injunction to the Federal Government. Image
So, if you, a plaintiff demand the government make good on a payment of $2 billion that they were going to cancel, you must post $2 billion, just in case it's later found that the injunction was wrongful.

This means the injunctions will stop.
Activists groups are trying to get injunctions against the government to force massive payments to continue.

They will lose many of these battles, but now the battles probably won't even take place in most cases, because these securities are enormous and they won't make them.
Read 5 tweets
Mar 11
Proposed DOGE target:

In 1992, Congress told the FDA to approve generic drugs within 180 days of submitting Abbreviated New Drug Applications (ANDAs).

Since 2006, they've failed, and generic drug approvals lag badly. Getting back to 180 days would save hundreds of billions. Image
There really is no good excuse here for doing this slowly, because

1. Generic drugs are drugs that are already in use. We know they're OK to approve!

2. Generic drugs make it possible for the healthcare system to save so much money that fast approval can pay for itself.
Read 5 tweets
Mar 10
On the left, you can see child autism diagnoses.

On the right, you can see states with policies that give schools more money when their students are diagnosed with autism.

When these policies pass, autism diagnoses increase by almost 25%! Image
Incentives really do matter for autism diagnoses.

For example, people on SSI receive larger payouts if they're diagnosed with autism.

After the economic downturn in 2008, the most heavily impacted age group started getting diagnosed with autism at an incredible rate: Image
Similarly, because laws in many places mandate providing more resources to autistic children, parents have sought to get their mentally retarded children diagnosed as autistic.

Using California as an example, more than a quarter of the rise 1992-2005 was due to this: Image
Read 12 tweets
Mar 10
The U.S. reports a higher maternal mortality rate than many peer nations like Canada, the United Kingdom, and France.

But the key word there is "reports".

How America classifies maternal mortality varies from peer nations, and this matters🧵 Image
If you go based on the official reports, America's maternal mortality has actually increased since about 1999.

Rising maternal mortality is a disgrace and a tragedy.

But that's if it's really rising. America's rise has more to do with this checkbox on death certificates. Image
The U.S. used to code maternal deaths as any deaths during childbirth or the immediate postpartum period, under the old ICD-9 classification.

When they switched to ICD-10, the classification expanded to any deaths during pregnancy, childbirth, or 42 days of the end of pregnancy.
Read 22 tweets
Mar 5
During Bernie's second set of questions in today's Senate confirmation hearing, @DrJBhattacharya came very close to describing the U.K.'s RECOVERY trial and arguing that the U.S. should emulate that sort of pragmatic clinical trial.

Bernie cut him off, but he shouldn't have🧵 Image
The RECOVERY Trial was the in-patient equivalent to the community-level PRINCIPLE Trial.

Both were trials run in the U.K. to figure out what works for keeping people off of serious treatments like ventilators and out of the morgue after they've been infected with COVID-19. Image
RECOVERY was an amazing success, but it can't be done in the U.S., because America's healthcare resources are not aligned like they are in the U.K.

In Britain, the NHS and the country's death index (how deaths are tracked) enable people to be easily signed up and tracked. Image
Read 11 tweets

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