AAmong the cast of characters about to join the Trump administration, none is as annoying, polarizing or potentially dangerous as Robert F Kennedy Jr. But in a twist emblematic of our times, no nominee has the potential to do so much good. for the American people.
Please bear with me. RFK Jr was right nailed to the pillory for promoting a litany of theories linking vaccines to autism, chemicals in the water supply to gender identity, how people contract AIDS and saying the Covid-19 vaccine, which will in fact halt the deadliest pandemic of our lifetimes shouted at, yourself “the deadliest vaccine ever made”. He claimed that Covid-19 was intended to target certain ethnic groups, black people and white people, while sparing Asians and Jewish people.
In normal times, these views would be disqualifying. Making unfounded scientific claims is harmful to a functioning democracy. It weakens the bonds of trust in our public institutions and fuels the right-wing narrative that all government is illegitimate. This is why, writing in the Guardian in September this year, I dismissed the prospect of RFK Jr, saying his ‘anti-vaccination work will probably cause America to get the measles again’.
But these are not normal times. RFK Jr is Donald Trump’s choice to lead our nation’s Health and Human Services Department. He will have a huge impact on our broken, expensive and largely ineffective healthcare services. How will we deal with this?
On the one hand, RFK Jr.’s anti-vaccine viewed its beyond the pale. To win Senate approval, I believe he will have to reject the unproven claim that the Covid-19 vaccine was harmful, and embrace the scientific reality that vaccines against measles, smallpox, coronavirus and other infectious diseases are in fact are modern medical miracles that have spared humanity. where hundreds of millions of people live. And here I will say goodbye to many of my Trump-fighting friends: as RFK Jr. were able to give up his numerous conspiracy theories about vaccines, he could be the most transformative Secretary of Health in our country’s history.
This is because RFK Jr has articulated what our Democratic and Republican leaders have largely ignored: our healthcare system is a national shame hiding in plain sight. He recognizes the outsized control the pharmaceutical and food industries have over health care policy, and the revolving door that exists among congressional staffers, pharmaceutical lobbyists and corporate executives. In testimony during hearings chaired by Republican Senator Ron Johnson last September, Kennedy offered a lucid analysis of what makes America metabolically ill; He lambasted big pharmaceutical companies and the big food industry, drawing connections between the damage that ultra-processed foods, such as seed oils and sugars, do to our health and the food industry’s efforts to invent chemicals that make these foods addictive.
He advocates ban pharmaceutical advertising on television, and wants to curb the industry’s ties with federal agencies such as the Food and Drug Administration and the National Institute of Health. (As far as I know, he hasn’t spoken out against the enormous costs of life-saving drugs or the unequal access to medical treatment, but hopefully he gets around to that.)
We spend $4 trillion in healthcare annuallyand leading the world in spending over $12,000 per person, 50% more than Switzerland, which is the second largest per capita spender. American doctors dominate the Nobel Prizes in medicine, and our medical schools are considered the best in the world. Yet we seem unable to contain the epidemic of chronic diseases. A staggering one 73% of us suffer from obesity or overweight and more than 38 million people suffer from diabetes.
This issue affects me as I was diagnosed with severe type 2 diabetes in 2021 and – after receiving terrible medical advice to rely on insulin and metformin – reversed my condition by following a low carb diet. This year I published a ‘follow the money’ series for the Guardian, Death By Diabetes, highlighting the major influence of big pharmaceutical companies and big food on the American Diabetes Association (ADA). The ADA is a so-called patient advocacy group that sets the standard of care for diabetes management in this country, yet accepts money from food companies like the makers of Splenda and Idaho potatoes – two products that have been found to improve people’s health. risk of developing diabetes.
Then I wrote about amputations and the reality that African Americans with diabetes are four times more likely to endure that grim procedure than white people. I view nutrition and metabolic health as an issue of racial and economic equity. I think I’m clear on the serious public health risks posed by RFK Jr’s baseless anti-vaccine views. But as long as we still have a voice and can find a glimmer of hope in these terrible times, I think we should try to direct policy towards the common good wherever possible. To that end, here is the game plan I think RFK Jr should pursue.
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Lose the conspiracies and stick to science. RFK Jr is right, and there is more than enough research to focus on the harmful impact of sugars and seed oils. Following the money has always been a valuable strategy. Let’s start there.
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Lean on the vast ecosystem of dedicated researchers, physicians and writers who have dedicated their careers to promoting metabolic healtheven while knowing they would lose access to government and pharmaceutical subsidies. Many of these mavericks come from the best medical schools, but within their faculties they are a decided minority. They include doctors such as Georgia Ede, Mariela Glandt, Tony Hampton, Eric Westman, scientists such as Benjamin Bikman, Ravi Kampala, Cate Shanahan and writers such as Gary Taubes, Nina Teicholz and Casey Means. These are heroic people who, as I got to know them and read their work, I discovered that they are intellectually honest health professionals.
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Appoint a diabetes czar to put forward proposals to put an end once and for all to this deadly and completely reversible disease. I choose this particularly chronic condition because it is ubiquitous, terribly expensive, a disease that disproportionately affects the poor, is closely linked to our obesity epidemic, and completely reversible through diet. Wouldn’t it be great if we could finally reverse type 2 diabetes in our lifetime?
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Increase federal funding for nutrition studies. Historically, the FDA and NIH have shifted the scale of research in favor of studies that could potentially yield the next blockbuster drug. In reality, we still don’t understand why we get fat and why we have seen an increase in chronic (non-communicable) diseases such as diabetes, Alzheimer’s and Crohn’s.
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Strictly regulate the ability of cereal companies to market their sugary products to children, and the ability of pharmaceutical companies to bombard the rest of us with advertising. Will a Republican-controlled Congress allow more government regulation – even if it saves lives?
The rise of RFK Jr poses a difficult issue for people like me, who strongly supported the election of Kamala Harris. Healthcare is far from the only issue I am committed to, and I am disgusted by the Trump administration’s plans to deport millions of undocumented immigrants, its attack on democratic institutions, and its possible abandonment of Ukraine and the NATO alliance. While I disagreed with Liz Cheney on many, if not most, issues, I also embraced her defection when it came to the election. I stick to the approach of not interrupting people you disagree with while they are doing the right thing.
After writing something unkind about RFK Jr in the days leading up to the election, I received a private note from Jan Baszucki, a prominent metabolic health advocate whom I have come to admire over the past year. “With all due respect,” she wrote. “I’m a big fan of your coverage of type 2 diabetes. But your comments about RFK Jr. are not furthering the cause of metabolic health, which is only on the national agenda because he put it there.”
Leading up to the election, I believed RFK Jr was fair game. I was and remain particularly concerned that his fringe ideas on vaccines and toxins would be conflated with his excellent views on metabolic health and that this would hurt the cause. Now I think we have to be constructive where we can promote the common good.
The increased demand beyond RFK Jr.’s term. hanging as HHS secretary is whether Donald Trump will support him as he takes on the pharmaceutical and food industries. The health of the US is not an issue in which the president-elect has shown interest in the past. And his embrace of corporate leaders like Tesla’s Elon Musk suggests that crony capitalism could be the dominant theme of the second Trump administration. But if we know anything about what makes Trump tick, we know that he responds to positive reinforcement.
After all, it was criminal justice advocates like Van Jones and Trump’s son-in-law Jared Kushner who led him to support the First Step Act, a key part of criminal justice reform (and one that Trump is now abandoning). As the founder of the Marshall Project, the nonprofit journalism organization covering America’s criminal justice system, I believe that criminal justice reform should also be a matter of national urgency, but at the time I was ambivalent about efforts to work with the government to work. . In retrospect, whatever damage Trump might have otherwise done, I would say we are a better country for the First Step Act.
We find ourselves in a similar dilemma today when it comes to healthcare: the system is terribly expensive and inhumane. If there is someone in government who wants to make things better, let us not interrupt him.
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Neil Barsky, former reporter and investment manager for the Wall Street Journal, is the founder of the Marshall Project