Robert F. Kennedy Jr. is wrong about many things in public health. Vaccines do not cause autism. Raw milk is more dangerous than pasteurized milk. Also, it has not been proven that cell phones cause brain tumors. But the basic idea behind his efforts to “make America healthy again” is correct. America is not healthy and our current system is not solving the problem.
Joe Biden took office promising to “defeat” the coronavirus pandemic, cure cancer and give more people access to health care. Perhaps no one on the planet speaks more passionately about funding cancer research than Mr. Biden. Biden’s son Beau died of brain cancer in 2015, and in 2022 he announced an effort to cut cancer deaths in the United States by half over the next 25 years. Mr. Biden’s FDA Commissioner, Robert Califf, was particularly vocal in arguing that the FDA must play a role in reversing the “catastrophic decline” in American life expectancy, saying that “diet-related chronic He has repeatedly warned that the spread of the disease will not stop. , cardiovascular disease and type 2 diabetes. A 2019 study found that only 12 percent of Americans are considered metabolically healthy based on waist circumference, blood sugar levels, blood pressure, and cholesterol.
Of course, the Biden White House never eradicated cancer or obesity in four years. But many of those policies barely scratched the surface of America’s broader health problems. For example, despite Mr. Khalif’s dramatic words about the nation’s dietary problems, the FDA’s efforts to improve the situation have largely focused on providing Americans with more information about healthy foods. It has revolved around.
The public health bureaucracy the Trump administration inherits is focused and skilled at treating America’s health problems rather than preventing them. Despite billions of dollars being spent each year on these agencies, their shortcomings have so undermined public health agencies’ credibility that Kennedy is now Donald Trump’s nominee for Secretary of Health and Human Services. . Marty McCulley, President Trump’s nominee to head the FDA, has similarly become well-known both in the United States and abroad for his willingness to accept “medical dogma” at face value. Additionally, former Congressman Dave Weldon, who was nominated by President Trump to lead the CDC, has criticized the CDC’s vaccine policies and attempted to block vaccine safety research, claiming it was a conflict of interest. A group of men who have spent their careers distrusting the established medical establishment may soon be empowered to try to blow it up.
To be fair, the Biden administration had less time to address America’s more serious health problems because it had to deal with at least some disasters. Much of Biden’s term has been spent getting the country out of the pandemic. Overall, his administration has met most of its COVID-19 goals. President Biden has offered free coronavirus testing to Americans and launched a vaccination campaign that has resulted in more than three-quarters of the nation being vaccinated. Still, with the pandemic, the CDC has been dogged by claims that it has been both too slow and too aggressive in its efforts to combat the virus. During President Biden’s term, the agency promised It aims to “share science and data faster” and “translate science into practical policy,” but it is struggling to respond to the continuing spread of bird flu. Public health experts have accused the CDC of not sharing enough information about the spread of the virus, including a human case that emerged in Missouri earlier this year, and farmers are worried that sick cattle could be passed on to humans. are reluctant to implement CDC recommendations to prevent the spread of the virus.
Some of these disasters were self-inflicted. The FDA is tasked with ensuring the safety of food and drugs and typically detects problems as soon as they occur. But for months, the FDA failed to act on whistleblowers alerting regulators to dire conditions at infant formula factories, ultimately leading to a national formula shortage and the deaths of two infants. caused it. The FDA is also supposed to decide what tobacco products can be sold, but it has not been able to crack down on the illegal market for e-cigarettes such as Zyn or nicotine pouches. And the government said,Science and Truth” The White House appears to have bowed to political pressure and abandoned plans to ban menthol cigarettes in the final stages of a lengthy rulemaking process. Over the past four years, it has become clear that important parts of the agency’s mission, particularly tobacco and food system oversight, have been ignored by agency leadership. In 2022, an independent review of the FDA’s Food and Tobacco Center found that both lacked clarity in mission and goals.
At the same time, the regime has not been able to achieve its lofty ambitions. Biden has quietly dropped some of his bolder ideas, including a campaign promise to create a public option insurance system. The Health Advanced Research Projects Agency, a new government agency that funds high-risk, high-reward research and is critical to Biden’s cancer goals, is still in its infancy, and Republicans in Congress are already eager to cut its budget. is. And some pledges, such as Mr. Biden’s grand goal of helping transform the way Americans eat, are being approached as trivial pursuits.
For example, the administration touted the 2022 Conference on Hunger and Nutrition as the largest and most important gathering on nutrition policy since the Nixon administration. This conference in the 1960s made school meals available to millions of children and established the Special Supplemental Nutrition Program for Women, Infants, and Children, which provides food to approximately 6 million Americans each month. (WIC)” was established. The Biden administration’s summit ended with a pledge to end hunger and improve the U.S. diet by 2030, but it will also take steps to address those goals, including developing a plan to put warning labels on unhealthy foods. The measures taken were modest. And all the agency has done so far for this project is conduct research on potential designs for the label. The FDA has also committed to reducing sodium in foods, but the goals set for the food industry are completely voluntary.
These efforts are understandably cautious and bureaucratic. The agency’s cautious approach to warning label design comes amid threats from the food industry to sue over labels deemed unfair. Indeed, in the U.S. legal system, regulators have a hard time forcing companies to do most things without being branded as unconstitutional. But given the scope of America’s health problems, the Biden administration’s efforts appear comically inadequate.
RFK Jr. promises to challenge the status quo. This is not to say he has a better plan if confirmed as health secretary. Most of his ideas are simply declarations that Trump will take drastic action as soon as he becomes president. The reality is that many of these initiatives will take months, if not years, to implement, and some may not be possible at all. For example, he suggested he would clean up the FDA’s food center, despite rules against arbitrary firings of government officials. He has also promised to ban certain chemicals from food, which he claims are shortening the average life expectancy of Americans. But all chemicals banned by the FDA must go through a lengthy regulatory process that will likely be challenged in court by food companies. President Kennedy’s initiative to drastically change the fee structure that drug companies pay the FDA to review their products is likely to plunge the agency into a budget crisis.
If Kennedy is confirmed to head HHS, governing is a slow and tedious process, even with an impatient leader like Trump at the helm, and big, bold ideas. You’ll soon have to face the reality that it’s not in your favor. Early in his first term, Trump declared war on drug companies, claiming they were “getting away with murder” because of their high prices. For the next four years, President Trump’s then-Secretary of Health Alex Azar would require drug companies to list prices in TV ads, import drugs from Canada, tie U.S. drug prices to drug prices in other countries, and eliminate rebates. I tried some drastic solutions. Intermediaries negotiating with insurance companies. But each idea was bogged down in bureaucracy and litigation. President Trump’s early attempts to contain the coronavirus by shutting down international air travel also did so, despite claiming at the time that the policy “saved us” from a widespread outbreak. did little to keep the virus out of the United States.
Biden benefited from Operation Warp Speed’s rapid vaccine development push, but it was his team of technocrats who ultimately distributed the vaccines. And in the end, it also lowered drug prices in a much simpler way than Trump had proposed. But technocracy has also failed to address our most pressing and most visible health problems. Trump’s picks have little experience navigating the Rube Goldberg challenges of American bureaucracy. They’re certainly not afraid to try something new, but we’ll see how far that takes them.
