One of twelve units of the U.S. Department of Health and Human Services [3] is contemplating outsourcing [4] its communications office, reports O'Dwyer's. The Agency for Healthcare Research and Quality [5] is collecting "proposals from PR firms that can handle its public affairs, publishing, research and web operations." The firm would replace the agency's Office of Communications and Knowledge Transfer, which employs 32 full-time staff. (Current staff would be offered the "'right of first refusal' to outsourced jobs for which they are qualified.") The agency's move follows Office of Management and Budget [6] guidelines, which say "'commercial activities' performed by government workers should be subject to competition when possible." The agency carries out an annual report on healthcare quality in each U.S. state, and recently reported that alcohol abuse-related problems cost $2 billion a year in hospital costs.