O'Beirne's staff posed blunt questions to some candidates about domestic politics: Did you vote for George W. Bush in 2000? Do you support the way the president is fighting the war on terror? Two people who sought jobs with the U.S. occupation authority said they were even asked their views on Roe v. Wade.

‘Loyalist’ replaces public health expert
The hiring of Bremer's most senior advisers was settled upon at the highest levels of the White House and the Pentagon. Some, like Foley, were personally recruited by Bush. Others got their jobs because an influential Republican made a call on behalf of a friend or trusted colleague.

That's what happened with James K. Haveman Jr., who was selected to oversee the rehabilitation of Iraq's health care system.

Haveman, a 60-year-old social worker, was largely unknown among international health experts, but he had connections. He had been the community health director for the former Republican governor of Michigan, John Engler, who recommended him to Paul D. Wolfowitz, the deputy secretary of defense.

Haveman was well-traveled, but most of his overseas trips were in his capacity as a director of International Aid, a faith-based relief organization that provided health care while promoting Christianity in the developing world. Before his stint in government, Haveman ran a large Christian adoption agency in Michigan that urged pregnant women not to have abortions.

Haveman replaced Frederick M. Burkle Jr., a physician with a master's degree in public health and postgraduate degrees from Harvard, Yale, Dartmouth and the University of California at Berkeley. Burkle taught at the Johns Hopkins School of Public Health, where he specialized in disaster-response issues, and he was a deputy assistant administrator at the U.S. Agency for International Development, which sent him to Baghdad immediately after the war.

He had worked in Kosovo and Somalia and in northern Iraq after the 1991 Persian Gulf War. A USAID colleague called him the "single most talented and experienced post-conflict health specialist working for the United States government."

But a week after Baghdad's liberation, Burkle was informed he was being replaced. A senior official at USAID sent Burkle an e-mail saying the White House wanted a "loyalist" in the job. Burkle had a wall of degrees, but he didn't have a picture with the president.

Haveman arrived in Iraq with his own priorities. He liked to talk about the number of hospitals that had reopened since the war and the pay raises that had been given to doctors instead of the still-decrepit conditions inside the hospitals or the fact that many physicians were leaving for safer, better paying jobs outside Iraq. He approached problems the way a health care administrator in America would: He focused on preventive measures to reduce the need for hospital treatment.

He urged the Health Ministry to mount an anti-smoking campaign, and he assigned an American from the CPA team -- who turned out to be a closet smoker himself -- to lead the public education effort. Several members of Haveman's staff noted wryly that Iraqis faced far greater dangers in their daily lives than tobacco. The CPA's limited resources, they argued, would be better used raising awareness about how to prevent childhood diarrhea and other fatal maladies.

Haveman didn't like the idea that medical care in Iraq was free. He figured Iraqis should pay a small fee every time they saw a doctor. He also decided to allocate almost all of the Health Ministry's $793 million share of U.S. reconstruction funds to renovating maternity hospitals and building new community medical clinics. His intention, he said, was "to shift the mind-set of the Iraqis that you don't get health care unless you go to a hospital."

But his decision meant there were no reconstruction funds set aside to rehabilitate the emergency rooms and operating theaters at Iraqi hospitals, even though injuries from insurgent attacks were the country's single largest public health challenge.

Haveman also wanted to apply American medicine to other parts of the Health Ministry. Instead of trying to restructure the dysfunctional state-owned firm that imported and distributed drugs and medical supplies to hospitals, he decided to try to sell it to a private company.

To prepare it for a sale, he wanted to attempt something he had done in Michigan. When he was the state's director of community health, he sought to slash the huge amount of money Michigan spent on prescription drugs for the poor by limiting the medications doctors could prescribe for Medicaid patients. Unless they received an exemption, physicians could only prescribe drugs that were on an approved list, known as a formulary.

Haveman figured the same strategy could bring down the cost of medicine in Iraq. The country had 4,500 items on its drug formulary. Haveman deemed it too large. If private firms were going to bid for the job of supplying drugs to government hospitals, they needed a smaller, more manageable list. A new formulary would also outline new requirements about where approved drugs could be manufactured, forcing Iraq to stop buying medicines from Syria, Iran and Russia, and start buying from the United States.

He asked the people who had drawn up the formulary in Michigan whether they wanted to come to Baghdad. They declined. So he beseeched the Pentagon for help. His request made its way to the Defense Department's Pharmacoeconomic Center in San Antonio.

A few weeks later, three formulary experts were on their way to Iraq.

The group was led by Theodore Briski, a balding, middle-aged pharmacist who held the rank of lieutenant commander in the U.S. Navy. Haveman's order, as Briski remembered it, was: "Build us a formulary in two weeks and then go home." By his second day in Iraq, Briski came to three conclusions. First, the existing formulary "really wasn't that bad." Second, his mission was really about "redesigning the entire Iraqi pharmaceutical procurement and delivery system, and that was a complete change of scope -- on a grand scale." Third, Haveman and his advisers "really didn't know what they were doing."

Haveman "viewed Iraq as Michigan after a huge attack," said George Guszcza, an Army captain who worked on the CPA's health team. "Somehow if you went into the ghettos and projects of Michigan and just extended it out for the entire state -- that's what he was coming to save."

Haveman's critics, including more than a dozen people who worked for him in Baghdad, contend that rewriting the formulary was a distraction. Instead, they said, the CPA should have focused on restructuring, but not privatizing, the drug-delivery system and on ordering more emergency shipments of medicine to address shortages of essential medicines. The first emergency procurement did not occur until early 2004, after the Americans had been in Iraq for more than eight months.

Haveman insisted that revising the formulary was a crucial first step in improving the distribution of medicines. "It was unwieldy to order 4,500 different drugs, and to test and distribute them," he said.

When Haveman left Iraq, Baghdad's hospitals were as decrepit as the day the Americans arrived. At Yarmouk Hospital, the city's largest, rooms lacked the most basic equipment to monitor a patient's blood pressure and heart rate, operating theaters were without modern surgical tools and sterile implements, and the pharmacy's shelves were bare.

Nationwide, the Health Ministry reported that 40 percent of the 900 drugs it deemed essential were out of stock in hospitals. Of the 32 medicines used in public clinics for the management of chronic diseases, 26 were unavailable.

The new health minister, Aladin Alwan, beseeched the United Nations for help, and he asked neighboring nations to share what they could. He sought to increase production at a state-run manufacturing plant in the city of Samarra. And he put the creation of a new formulary on hold. To him, it was a fool's errand.

"We didn't need a new formulary. We needed drugs," he said. "But the Americans did not understand that."

So no one has any opinion on this?

How about this one?

No shit.