I hate to say it, however I’m feeling a way of déjà vu, besides on steroids. After Donald Trump gained the Presidency in 2016, I watched the Presidential transition course of with a way of rising dread. Particularly, I used to be frightened about whom President-Elect Trump would identify to employees key medical and public well being coverage positions, akin to Secretary of the Division of Well being and Human Providers (HHS), the FDA, and the CDC. For HHS, Trump picked Dr. Tom Worth, an orthopedic surgeon unqualified to run such an enormous group who had been referred to by the ever-great Charles Pierce in 2015 as as “certainly one of Georgia’s wingnut sawbones” and described by Stephanie Mencimer as certainly one of The Tea Celebration’s Favourite Medical doctors, partly as a result of his membership within the Affiliation of American Physicians and Surgeons (AAPS). This can be a group that I’ve characterised because the “John Birch Society” of drugs as a result of its rabid antivax views, HIV/AIDS denial, and basic right-wing conspiracy mongering. For the CDC, the decide was not nice both; though Dr. Brenda Fitzgerald was usually pro-vaccine, she was a quack in different methods, having offered anti-aging nonsense. Worse, the trio of finalists for FDA Commissioner included males acceptable to Peter Thiel, certainly one of whom advocated changing these pesky medical trials with a Yelp! or Uber for medicine. And don’t even get me began on Trump assembly with antivax crank Robert F. Kennedy, Jr. to dangle a place as chair of a “vaccine security fee” in entrance of him.
This quick forwards me to 2024. Whereas it’s true that Donald Trump has not gained the Presidency once more and there nonetheless stays a good probability that he’ll lose, I’m feeling worse than déjà vu proper now, on condition that RFK Jr., who had been operating for President because the nominee of the Pure Regulation Celebration, suspended his marketing campaign a few weeks in the past and endorsed Donald Trump, to the purpose of campaigning with Trump. Worse than that, there does seem like a particular quid professional quo, with Trump apparently having promised RFK Jr. a cabinet-level place in return for his endorsement. Even worse, it’s wanting seemingly that the place Trump promised RFK Jr. is HHS Secretary, as described in an article in The Hill entitled Alarm grows over attainable RFK Jr. function at HHS if Trump wins (as effectively it ought to):
The potential for Robert F. Kennedy Jr. turning into Well being and Human Providers (HHS) secretary if former President Trump wins has rankled Democrats and the general public well being neighborhood as he good points affect inside the former president’s transition crew.
Hypothesis about Kennedy’s future function has grown after Nicole Shanahan,who was Kennedy’s operating mate earlier than he suspended his marketing campaign final month, stated lately that he would do “an unbelievable job” at HHS ought to Trump win in November.
Whereas the previous president has not stated what, if any, Cupboard place he would supply Kennedy, the prospect of the previous impartial candidate taking the reins of HHS is already drawing pushback from well being specialists essential of Kennedy’s anti-vaccine rhetoric.
“We are able to solely hope that he could have no place within the administration, as a result of somebody who thinks like that, who simply has these beliefs which are immutable regardless of how a lot proof is in opposition to them, isn’t the form of particular person you need ready of authority,” stated Paul Offit, director of the Vaccine Schooling Heart on the Kids’s Hospital of Philadelphia.
I’m with Dr. Offit (as normal) on this, however I strongly suspect HHS Secretary is precisely the worth that RFK Jr. required to droop his marketing campaign and throw his weight, akin to it’s, behind Trump. Once I first heard that Trump and RFK Jr. have been speaking, I first suspected that possibly Trump would supply RFK Jr. the publish of FDA Commissioner (for which RFK Jr. is unqualified) or maybe CDC Director (for which RFK Jr. can also be unqualified), however behind my thoughts was at all times the worry that HHS is what RFK Jr. wished and what he would possibly get. The explanations are apparent and described in The Hill story:
Shanahan sparked speak of a attainable HHS secretary function for Kennedy throughout a latest dialog on a podcast with vitamin entrepreneur Tom Bilyeu.
“It oversees a large portfolio,” she informed Bilyeu. “Bobby in a job like that will be wonderful.”
“I’d like to see the state of science go uncensored,” Shanahan added.
And:
Kennedy has lengthy courted controversy for pushing the debunked concept that vaccines trigger autism, a message championed and amplified by the nonprofit he based, Kids’s Well being Protection. He has now broadened his focus to the rise of childhood continual illness, one thing he additionally attributes to vaccinations.
As he appears to be like to assist Trump defeat Vice President Harris, Kennedy has been telling voters that the forty fifth president will “make America wholesome once more.” Earlier than suspending his marketing campaign, he was operating adverts on social media asking, “Is America sicker than it’s ever been?”
The Democrat-turned-independent has been lobbying Trump for a job in his attainable subsequent administration, and one ally of Kennedy stated he would seemingly have a place that “impacts one thing in public well being.”
“Bobby has the community of specialists, attorneys and leaders able to step up and do battle,” the ally stated.
Trump stated lately throughout a rally in Arizona that he would ask Kennedy to work on a panel that will examine “the decades-long enhance in continual well being issues, together with autoimmune problems, autism, weight problems, infertility and plenty of extra.”
The previous president’s feedback come as Kennedy continues to attract scrutiny over his views on the general public well being sector. Kennedy has vowed to get rid of company corruption from public regulatory companies, such because the Meals and Drug Administration (FDA) and the Nationwide Institutes of Well being (NIH), which he says are managed by massive company pursuits.
HHS oversees 13 separate companies, and Kennedy has lengthy argued they’re in determined want of reform.
As a lot as a number of the companies that fall beneath the umbrella of HHS would possibly want reform, the types of “reform” that they may want isn’t what RFK Jr. is prone to work on, ought to Trump win. That, in fact, is what frightens public well being advocates, physicians, and scientists. I additionally notice that certainly one of these companies overseen by HHS, Facilities for Medicare & Medicaid Providers (CMS), is the entity that oversees the huge Medicare and Medicaid applications. The HHS Secretary thus has monumental energy to affect Medicare and Medicaid insurance policies, laws, and reimbursement for providers.
As an indication of simply how “all-in” this partnership between RFK Jr. and Trump has gone, Trump’s marketing campaign has began to undertake an RFK Jr.-inspired variation of Trump’s outdated slogan. As an alternative of “make America nice once more” (MAGA), RFK Jr. has been claiming that he and Trump would “make America wholesome once more” (MAHA):
In fact, I can’t assist however snort on the considered a President who has been about something however wholesome consuming “making America wholesome once more.” Some well-known pictures come to thoughts:
Far be it from me to be too judgmental of somebody for liking quick meals. Personally, I’ve been recognized to indulge within the occasional Huge Mac or Kentucky Fried Hen meal myself, though relating to fried rooster I undoubtedly want Lee’s Well-known Recipe Hen. Nonetheless, Donald Trump’s penchant for greasy quick meals seems to transcend the occasional self-indulgence, making his embrace of “make America wholesome once more” quite jarring, no less than to me.
Who is aware of, although? Possibly Donald Trump, at age 78, has had a “come to Jesus” second and is now all in regards to the wholesome way of life, together with nutritious diet. I doubt it, however, regardless of the cause for this risible “MAHA” second, I did marvel what, precisely, RFK Jr. needs to do if Trump wins once more and he will get his most fervent want to run one of many largest cabinet-level departments within the federal authorities, in essence having monumental management over federal well being and public well being coverage and funding. Thankfully (or sadly) I didn’t have to attend lengthy for him to publish his intentions on the editorial web page of The Wall Road Journal—the place else?—entitled Trump Can Make America Wholesome Once more. The subtitle? “Continual illnesses have reached disaster proportions, and Kamala Harris appears uninterested within the situation.”
I significantly eyerolled. It’s, in fact, all about the way you outline being within the situation, and we all know from lengthy historical past what RFK Jr. means about continual illnesses.
RFK Jr.’s 12-point plan: Introduction
As is commonly the case with cranks like RFK Jr., the issues that he identifies vary from the affordable (regulatory seize of some companies and conflicts of curiosity)—a few of which, he mischaracterizes or exaggerates, in fact—to the nonsensical (e.g., not sufficient various medication in medication). Principally, RFK Jr.’s proposal is rather a lot like “integrative medication” in that he “integrates” a variety of quackery and pseudoscience into some semi-reasonable coverage proposals. Once more, nobody would argue that continual illness isn’t an enormous public well being downside, as described:
Amongst American teenagers, near 30% are prediabetic. Greater than 18% of younger adults have nonalchoholic fatty liver illness. Greater than 40% of adults 22 to 44 are overweight, based on a 2023 examine. In 2020, 77% of younger adults didn’t qualify for the navy primarily based on their well being scores, forcing the navy to decrease its requirements.
Six out of 10 adults in America live with a continual sickness. Seventy-four p.c of American adults are chubby or overweight. Charges of kidney illness and autoimmune circumstances are going up. Most cancers charges among young people are rising. This is despite Americans spending more and more to treat many of these conditions. U.S. life expectancy is markedly lower than in every other developed country, with wide disparities between income classes.
As you can see, RFK Jr. starts with a very predictable gambit (at least predictable to those who have been following him for a long time, as I have), laying out a variation of what he has long touted through his antivax organization Children’s Health Defense, namely the idea that somehow today’s children represent the “sickest generation” (and a lot of it is due to—cough, cough—vaccines). As I described, although no one—least of all I—would argue that chronic illness is not a problem among children, RFK Jr.’s version both exaggerates the scope and mischaracterizes the causes.
RFK Jr. pivots to a common quack mantra. While it is true that there is some merit to this complaint, as you will see (I hope), as always the devil is in the details and the spin:
This crisis is the product of broken incentives. There is nothing more profitable for much of the healthcare system than a sick child. Americans with chronic conditions are often put on medications or treatments for the rest of their lives. Nearly 30% of teens have reportedly used prescription drugs in the past 30 days, according to data from the prescription discount service SingleCare.
Mr. Trump has made reforming broken institutions a cornerstone of his political life. He has become the voice of countless Americans who have been let down by our elites.
I must admit that I laughed out loud at the sycophancy of that last line. Trump “has made reforming broken institutions a cornerstone of his political life”? Seriously? As for “elites,” it’s hard to imagine anyone more “elite” than a billionaire reality show star who has hobnobbed with celebrities and powerful politicians all of his adult life before being elected President. (Sorry, I couldn’t resist.)
RFK Jr.’s 12-point plan: Ranging from the semi-reasonable to advocacy for quackery
Now let’s look at the specific “proposals.” Again, they range from semi-reasonable to not so reasonable, and even the semi-reasonable ideas are tainted with some rather odd rhetoric and exaggeration. The first three proposals are not particularly objectionable, depending on your interpretation of what they mean and how such “reforms” might be implemented, although they could be debated, starting with the first one:
Reform the Prescription Drug User Fee Act. Pharmaceutical companies pay a fee every time they apply for a new drug approval, and this money makes up about 75% of the budget of the Food and Drug Administration’s drug division. That creates a barrier to entry to smaller firms and puts bureaucrats’ purse strings in the hands of the pharmaceutical industry.
The FDA has long been funded mostly by user fees, but it was not always so. Interestingly, the move to funding the FDA more through user fees began with the HIV/AIDS epidemic and pressure from patient advocates, who felt that the FDA was not moving fast enough and that more funding was required:
In 1992, in response to intense pressure, Congress passed the Prescription Drug User Fee Act. It was signed into law by President George H.W. Bush.
With the act, the FDA moved from a fully taxpayer-funded entity to one funded through tax dollars and new prescription drug user fees. Manufacturers pay these fees when submitting applications to the FDA for drug review and annual user fees based on the number of approved drugs they have on the market. However, it is a complex formula with waivers, refunds and exemptions based on the category of drugs being approved and the total number of drugs in the manufacturers portfolio.
You can see that there is a legitimate policy argument to be had here, although some data suggest that prescription drug user fees (PDUFs) actually benefit the public in terms of enhancing the balance between safety and speed of approval. One problem that I see with moving to Congress funding the FDA in its annual appropriations is one that RFK Jr. perhaps has not considered. If Trump retakes power, coming along with him will be a contingent of ideologues inspired by Peter Thiel and other radical “libertarians” who think that the FDA is not needed because, according to them, it kills more people than it saves, invoking as the reason the vastly exaggerated descriptions of the regulatory burden on “innovators” producing “cures” supposedly face in their quest to develop all sorts of diseases. These are exactly the people who want to decrease the authority and reach of The FDA as much as possible, with the possible exception of when it comes to approving new vaccines. One way to accomplish that goal of defanging The FDA is to decrease its funding.
Moreover, drug approval is not the only function of the FDA. Food and drug safety monitoring is another key function, and, arguably, while user fees have made the drug approval process now relatively well-funded, funding for the FDA’s other functions is insufficient for it to fulfill its other functions. (The case of Stanislaw Burzynski is one good example.) Any consideration of weaning the FDA from user fees is incomplete without making sure that the FDA is fully funded for all of its critical functions, not just drug and medical device approval.
Next up:
Prohibit members of the U.S. Department of Agriculture Dietary Guidelines Advisory Committee from making money from food or drug companies.
I was curious about what was meant by a “conflict of interest.” I have long been of the mind that COIs do matter, but undisclosed COIs are far more pernicious than those that are disclosed. I looked at the study cited by RFK Jr. concluding that 95% of all members of a USDA panel charged with updating dietary recommendations had a COI. What this study suggested to me, more than anything else, is that more rigorous disclosure requirements are needed. Again, the optimal amount of rigor in reporting and disclosure of COIs is a legitimate area of debate. However, one problem with barring anyone on any of these committees from “making money from food or drug companies” is that the scientists and physicians with the most expertise almost invariably have had some contact with pharmaceutical and food companies in their careers, because they can be sources of research funding and/or a means for turning a discovery into a product that can benefit the public (e.g., a new drug). If anyone who’s received any funding ever from a food or drug company is excluded from such panels, all that will be left are activists like RFK Jr., which introduces an entirely different form of bias, one that RFK Jr. no doubt wants to promote.
Next up:
Review direct-to-consumer pharmaceutical ad guidelines. The U.S. and New Zealand are the only countries that allow pharmaceutical companies to advertise directly to the public. News channels are filled with drug commercials, and reasonable viewers may question whether their dependence on these ads influences their coverage of health issues.
This is one of the rare areas where I have little or no conflict with RFK Jr. Direct-to-consumer pharmaceutical ads have been a boon to pharmaceutical companies and a bane to physicians trying to promote evidence-based care for their patients. I suspect that a lot of physicians agree with me here. Again, this is an example of one reasonable proposal sprinkled into RFK Jr.’s list to make the rest seem equally reasonable. Ditto RFK Jr.’s proposal to address the disparity in how much US patients pay for prescription drugs relative to how much patients in, say, Germany or other countries pay in part by allowing the federal government to do what most other countries do and negotiate prices with drug companies paid by federal payors.
Other reasonable to semi-reasonable ideas that I will mainly only mention in passing include:
- “Reform crop subsidies. They make corn, soybeans and wheat artificially cheap, so those crops end up in many processed forms. Soybean oil in the 1990s became a major source of American calories, and high-fructose corn syrup is everywhere. Our subsidy program is so backward that less than 2% of farm subsidies go to fruits and vegetables.” (Maybe. Again, this is a very contentious issue and devilishly complex; so I file it under the possibly semi-reasonable.)
- “Issue new presidential fitness standards. My uncle John F. Kennedy was right in 1960 when he wrote, ‘The physical vigor of our citizens is one of America’s most precious resources.’ The Presidential Fitness Test that President Obama ditched should be reinstated.”
- “Increase patient choice by giving every American a health savings account. HSAs are a bipartisan healthcare policy that saves Americans money and gives them financial support in healthcare outside insurance. In many cases, food and exercise interventions are clinically the best medicine. With an HSA, a pre-diabetic can choose with his doctor whether to devote medical dollars to a drug like metformin or a root-cause intervention like a gym membership.”
I know I said I’d mention these mainly in passing, but I can’t resist responding to that last proposal thusly: Why not just propose that insurance companies include gym memberships in health insurance plans when indicated? Oh, wait, a lot of health insurance plans already subsidize low-cost (or sometimes even no-cost) gym memberships. As for health savings accounts, I remain agnostic regarding their relative value in health care, although I do note that HSAs can function to siphon tax-sheltered HSA dollars to pay for quackery, mainly because HSA accounts don’t require the treatments they pay for to be safe and effective. Far more valuable would be some sort of government-subsidized or funded universal health insurance, just like nearly every other wealthy country provides for their citizens. Funny how RFK Jr. doesn’t propose anything like that, but instead advocates a program that, in addition to its legitimate uses to help pay for healthcare needs, can facilitate funneling tax-sheltered funds to pay for quackery.
Now, let’s look at the ideas and proposals that drift out of the reasonable or semi-reasonable and into the realm of RFK Jr. quackery:
Change federal regulation so that NIH funds can’t go to researchers with conflicts of interest. A 2019 ProPublica analysis of disclosures going back to 2012 found that over 8,000 federally funded health researchers reported significant financial conflicts of interest.
Again, what constitutes a “conflict of interest” for an NIH-funded researcher? Again, many of these researchers are trying to translate their findings into actual products that benefit patients. To do so, they often either have to form companies themselves or partner with existing companies to develop their findings into an FDA-approvable, marketable product. There are even NIH grant mechanisms specifically designed to assist this process, like the Small Business Innovation Research (SBIR) and Small Business Technology Transfer (STTR) programs, collectively the Small Business Programs, also known as America’s Seed Fund. No one, least of all I, will likely argue that COIs shouldn’t be reported, and the NIH does require its investigators to report any financial COI that involves more than $5,000/year, but if the goal of NIH-funded research is to lay the groundwork for drugs, treatments, and devices that are ultimately turned into products it is counterproductive to ban NIH funds from going to anyone who has a financial interest with a pharmaceutical, medical device, or food company. One can reasonably argue about policies designed to minimize harmful influences due to financial COIs, but to ban researchers with interest in a company related to the research that they are carrying out would likely have the unintended consequence of hampering further research. The issue is, of course, complex, predictably RFK Jr. has presented an oversimplified version of it designed to imply that most NIH researchers are in the pocket of big pharma.
This next one will sound familiar to readers of the blog:
Devote half of research budgets from the NIH toward preventive, alternative and holistic approaches to health. In the current system, researchers don’t have enough incentive to study generic drugs and root-cause therapies that look at things like diet.
I note that the NIH already has a fairly well-funded center to examine these questions, the National Center for Complementary and Integrative Health (NCCIH), formerly the National Center for Complementary and Alternative Medicine (NCCAM). Of course, research into the “preventative, alternative, and holistic approaches to health” funded by NCCIH includes rank quackery such as acupuncture and highly dubious treatments like chelation therapy for cardiovascular disease. This proposal sounds as though RFK Jr. wants to expand NCCIH to take up half of the NIH budget, which would, of course, be a disaster for public health. One also notes that one of the most efficacious and safe preventative approaches to health is vaccines. I’d love it if the NIH put more resources into vaccine research, but somehow I suspect that RFK Jr. isn’t including vaccines in the category above.
Unsurprisingly, related to the above proposal, RFK Jr. suggests:
Require nutrition classes and functional medicine in federally funded medical schools. Today, 7 out of 10 of the leading killers of Americans are chronic diseases that are preventable, sometimes through improved eating habits. Yet about 80% of medical schools don’t require a course in nutrition.
Notice how RFK Jr. yokes a relatively unobjectionable idea (depending on the specifics, of course) that increasing the teaching of nutrition in medical schools might be desirable to the pure quackery that is functional medicine. As I like to point out, functional medicine can best be characterized by the defining feature of its practitioners, reams of useless tests in one hand and a huge invoice in the other. As for nutrition, the complaint that there isn’t a specific class on nutrition in many medical schools is a bit deceptive. There are a lot of topics that we covered in medical school for which there is no specific class; rather, the topic is covered in multiple classes, with a lot of time dedicated to it in different contexts. This is particularly true now with the “organ-systems” approach to medical education used in many medical schools, in which the curriculum is divided into organ systems and, for example, nutrition’s effect on each organ system would not be covered as a single class but rather as a segment in each class dedicated to each organ system. Again, designing a medical school curriculum is a hellaciously complex endeavor in which, it seems, one topic or another will be shortchanged in the eyes of some, but here RFK Jr. is simply amplifying the deceptive narrative that medical schools don’t teach nutrition.
Next up, fear-mongering about glyphosate:
Revisit pesticide and other chemical-use standards. As of 2019, the U.S. allowed 72 pesticides that the European Union bans. We also allow chemicals in food and skin care that the bloc doesn’t. Some of these chemicals are quite common to our daily lives. Though glyphosate isn’t currently banned EU-wide due to disagreement between member states, it’s approved for use only through the end of 2033, when the issue will be revisited. Meanwhile in the U.S. the University of California, San Francisco, in 2015 found the chemical in 93% of the urine samples it studied.
Again, different countries have different standards, and the regulatory bodies of different countries might reasonably conclude that certain pesticides are or are not safe and effective in the context of the needs of the country. As for glyphosate, even though it is quite safe it has become the boogeyman to people like RFK Jr. because of its association with genetically modified organisms (GMOs) and all the imaginary harm that he and others attribute to them. It’s also another appeal to “chemicals” as somehow inherently dangerous, when (1) everything is made of chemicals; (2) the identity and toxicology of the individual chemicals are what matters; and (3) even for “toxic chemicals” (like some of the ingredients in vaccines, the dose makes the poison and low doses are very much safe.
Notable omissions
After finishing RFK Jr.’s MAHA manifesto, I noticed at least three glaring omissions in RFK Jr.’s litany of health woes among children (and adults). First is gun violence. Firearms are currently the leading cause of death among children and teens, but nary a word about this public health catastrophe is to be found in RFK Jr.’s MAHA manifest. To me, this is very telling about just how much RFK Jr. has subsumed his previous “progressive” and “liberal” beliefs to bend the knee to the culture war shibboleths of the right. (So is his opposition to gender-affirming care for gender dysphoria and trans adolescents.) Any health policy that does not address the number one cause of death among children and teens is, to me at least, automatically profoundly unserious, given that it ignores the single largest cause of preventable death among children today, one that claims more lives than even trauma from vehicular collisions.
The second glaring omission is not unexpected: Vaccines. Nowhere in his MAHA manifesto does RFK Jr. mention vaccines, not even once. In one way, you might be surprised at this given his history of rabid antivax fear-mongering dating back to at least 2005, when he published the antivax ur-conspiracy theory of the 20th century (at least in the US), that mercury in the thimerosal preservative used in some childhood vaccines until 2001 was responsible for an “epidemic” of autism. It is very clear that RFK Jr. wants to flee the “antivax” label that he has so richly earned over the last two decades, to the point where he doesn’t mention his central animating purpose over the last two decades, namely portraying vaccines as dangerous, the cause of autism and America’s children being the “sickest generation” at all. No one is fooled. Certainly I am not, and Steve Kirsch, as much as he liked most of RFK Jr.’s plan noticed that not once did RFK Jr. mention vaccines, which is why he “helpfully” added some points that he’d like to see, such as:
- Get rid of the liability protection for vaccine manufacturers.
- Revoke the medical license for any doctor in America recommending any vaccine
- End the mandates. Make it illegal to require vaccination as a requirement to attend school or work.
- Replace the head of the CDC and FDA with someone who recognized the dangers early
- Hold regular public debate forums inviting qualified scientists on both sides of an issue to debate to help resolve important questions like whether vaccines cause autism
- Compensate victims of vaccine injury.
- Criminally prosecute the people at the CDC who ordered William Thompson to destroy the evidence linking vaccines and autism and those who went along with the fraud. They should be locked up for the rest of their lives for what they did. We need to send a message that people will be held accountable for clear scientific fraud.
I love how people like Kirsch claim that they are “not antivaccine” but then argue that the medical license of any doctor who recommended any vaccine should have their medical license revoked and parrots the “CDC whistleblower” conspiracy theory. (Hint: There is no evidence that any data were destroyed, much less at the orders of anyone at the CDC.)
Of course, RFK Jr. is trying to “prove” to the electorate that he is not an antivax conspiracy theorist, even though he very much is about as antivax to the core as a human can be. Kirsch, on the other hand, is free to let his antivax freak flag fly high. Still, given the elephant in the room, I was nonetheless somewhat surprised that RFK Jr. didn’t at least mention vaccines in seemingly less objectionable ways still coded so that they serve as antivax dog whistles, such as saying that he wants “more rigorous testing” before approving new vaccines or questioning whether children get too many vaccines too soon, you know, “just asking questions.” He did not.
The third notable omission is even odder, given recency bias. Nowhere in RFK Jr.’s MAHA manifesto is there a mention of the most important public health incident of (arguably) the last century, namely the COVID-19 pandemic. RFK Jr., besides being antivaccine, soon joined with the anti-“lockdown” and antimask crowd that opposed basically all non-voluntary public health interventions to slow the spread of COVID-19, in favor of the death-ridden “natural herd immunity” approach favored by contrarian physicians and scientists.
Instead he ends by sucking up to Donald Trump:
Mr. Trump has told me he wants to make ending this chronic-disease calamity a key part of his legacy, while Kamala Harris has expressed no interest in this issue. His political courage and moral clarity about the danger of our compromised institutions give us the best opportunity in our lifetimes to revive America’s health.
First of all, it’s not true that Kamala Harris has “expressed no interest in this issue.” It’s just that she, as far as I can tell, has not supported expanding quackery like “functional medicine” to do that. One also can’t help but wonder if the above statement is just sour grapes, given that RFK Jr. approached the Harris campaign with a similar deal to the one he ultimately took with Trump, a cabinet position in return for his dropping out and endorsing the Harris-Walz ticket. Her appropriate refusal of RFK Jr.’s feelers regarding such a possible deal does not mean that she has “expressed no interest in this issue,” just that she has expressed no interest in having RFK Jr. be the point man for this issue in her administration if she wins.
I realize that there are those among our readers who don’t think that we should be political at SBM, but we have always been so. After all, advocating for the highest level of science in government policies with respect to healthcare and the regulation of medicine and physicians is inherently political. In other words, we do not try to be apolitical, but rather nonpartisan. (Just look at the opprobrium we heaped on Democratic Sen. Tom Harkin for basically creating NCCIH and using his power to pressure it to “validate” quackery.) I realize that it’s sometimes a fine line, but in this case I would argue that it’s nowhere near that.
As Sarah Jones at The Intelligencer puts it:
There’s no evidence that Trump has gone completely anti-vaxx. But he doesn’t have to in order to agitate his base and pull in Kennedy’s small voting bloc at the same time. “Make America healthy again” is a way for Trump to pretend yet again that he’s invested in the common good — as he promotes language and policy that would undermine it. The former president’s health gambit is a ruse. His voters won’t care, but the rest of us should.
Precisely, and RFK Jr. is Trump’s useful idiot to help him do that.
The first Trump administration was in general a disaster for health care policy and public health, concluding, as it did, with his utter mismanagement of a once-in-a-century pandemic. That was true even though his worst impulses had been checked and he did not appoint RFK Jr. to chair a “vaccine safety commission” or put the “Uber for drugs” guy in charge of the FDA. This time around, though, Trump and RFK Jr. are, at least in appearance, the best of buds, with RFK Jr. on track if Trump wins to be put in charge of the federal government’s health apparatus. If that doesn’t scare proponents of science-based medicine and vaccine policy, I don’t know what will. If Trump wins in November, the guardrails will be gone, and it’s likely that his second administration would do damage to public health that won’t be repaired in a generation, if it’s ever repaired at all.