Robert F. Kennedy Jr., President Donald Trump’s recently-confirmed pick to lead the Department of Health and Human Services (HHS), is infamous for peddling a wide range of anti-science lies: that vaccines cause autism, that unpasteurized milk is healthy, and that HIV does not cause AIDS, among others.
Kennedy has cultivated a strong supporter base of quacks and fringe extremists, and thousands of doctors have spoken out against his incompetence and “actively dangerous” agenda. But even people I know who think critically about medical science have often said to me: “Sure, RFK is nutty, but the healthcare system is broken.”
Indeed, our country’s healthcare system has monumental flaws. The United States has overwhelmingly worse health outcomes than other wealthy countries despite spending far more on healthcare per capita. There are plenty of real problems harming Americans’ health, from bankruptcy-inducing hospital bills to dire physician shortages to poor health education, and the list goes on.
The trouble is, Kennedy’s “Make America Healthy Again” (MAHA) marketing campaign barely even acknowledges the biggest problems weighing on the healthcare field, let alone plans to solve them.
By far the biggest concern of the American public when it comes to healthcare policy is medical debt and affordability – a health issue as well as an economic one. According to the health policy nonprofit KFF, two out of every five Americans have debt from medical or dental bills, and one in four have avoided seeking healthcare they needed because of the cost.
Furthermore, many Americans cannot afford to take time off work when they are ill, let alone have the free time and money to make healthy lifestyle choices as MAHA believers propose. Poverty and stressful working conditions are among the major social determinants of health that contribute to preventable disease; according to scientific reviews published by the American Heart Association and American Diabetes Association, chronic illnesses like high blood pressure and Type 2 diabetes are exacerbated by socioeconomic disparities, not just “lifestyle choices” like diet.
So what has Kennedy said about making healthcare more affordable for Americans? Not much, it turns out, and certainly nothing encouraging from a public health perspective.
Asked by Vermont Senator Bernie Sanders in the confirmation hearings whether healthcare is a human right, Kennedy replied, “I can’t give you a yes or no answer” – in other words, no, but saying so outright would probably not sit well with the millions of Americans who suffer from limited access to healthcare.
Kennedy then proceeded to implicitly victim-blame people with chronic illnesses, as though unhealthy behaviors like smoking and physical inactivity – which are often made in a context of poverty, stress, poor education and other systemic factors – are a personal moral failing that mean you forfeit the right to receive care or empathy.
Kennedy has criticized pharmaceutical companies for financial corruption – while he himself has financially benefited from lawsuits against vaccine manufacturers – and MAHA has stated plans to examine the role of “corporate influence” and “over-utilization of medication” in making Americans sicker. But neither the campaign nor Kennedy have acknowledged the complex system of economics responsible for impeding access to care.
For instance, while the Trump administration has been launching a McCarthyist-like campaign against diversity, equity and inclusion (DEI), Kennedy has been oddly silent on another type of “equity” – private equity and its role in reducing access to healthcare. A week before inauguration, the HHS itself released a report highlighting the impact of healthcare consolidation and private investors.
“Provider consolidation leads to higher prices and less access for patients,” reads one of the “themes” taken from over 2,000 public comments submitted on the matter. “People are dissatisfied with private health insurers, especially vertically integrated insurers,” reads another, because patients are often denied coverage of healthcare for arbitrary and likely profit-related reasons.
If MAHA truly cared about making Americans healthier, socioeconomic factors like these should be a priority. But Kennedy couldn’t even get the facts straight about Medicare and Medicaid during his hearing, so needless to say, it is unlikely that ensuring equitable access to healthcare is on the MAHA agenda.
Considering the Trump administration’s unstable “shock and awe” strategy, it is hard to predict what Kennedy will actually accomplish with his new position, but there is unfortunately not much cause for optimism. Kennedy has consistently ignored real problems in favor of tilting at windmills ranging from seed oils to Wi-Fi, and he has already moved to dismantle actual public health infrastructure like vaccines and federal health employees within his first week as HHS Secretary.
In a cruel irony, Kennedy’s confirmation coincided with an ongoing measles outbreak in Texas that has sickened at least 58 people and hospitalized 13 – the vast majority of whom were unvaccinated. Contrary to anti-vaccine rhetoric, the measles, mumps and rubella (MMR) vaccine is not only safe and effective, it’s also exponentially cheaper than a hospital stay for such a devastating disease.
By discouraging prevention of infectious diseases and willfully failing to ensure access to treatment, MAHA is doing the exact opposite of making Americans healthy. It’s time we see past the smoke and mirrors of “lifestyle choices” and confront the real factors contributing to our country’s healthcare crisis.