President-elect Donald Trump campaigned on a platform of shaking up the federal government, including an inefficient and often ineffective healthcare system. His nominations on the healthcare side show that he is intent on doing just that.
Leading this effort will be Robert F. Kennedy Jr., Trump’s nominee to lead the Department of Health and Human Services (HHS), and whose “make America healthy again” platform has engendered a wide range of responses, from fear to hopeful optimism.
Much of the alarm surrounding RFK Jr. specifically comes from his noted skepticism of vaccines, which some worry will expose Americans – particularly children – to diseases that vaccines have largely eradicated.
This is particularly worrying for diseases such as smallpox, for which there are scientifically validated vaccines which have long proven safe and effective.
Given the power afforded to the HHS and other public health authorities, it is critical that those leading the agencies recognize that the first job of the government and public health officials must be to keep communities safe, including requiring preventative vaccinations on certain occasions.
On the other hand, many Americans are optimistic that RFK Jr.’s emphasis on eliminating ultra-processed foods and removing artificial chemicals from our food supply will have a positive impact on the epidemic of diet-related cardiovascular disease and obesity.
Further, there are hopes that by increasing transparency in both the healthcare system and food industry, RFK Jr. will restore Americans’ trust and confidence in those institutions.
Put another way, there are genuine potential positives and negatives to the “make America healthy again” agenda specifically, and Trump’s approach to the country’s healthcare generally.
It is important to note that despite a history of authoring and promoting debunked claims surrounding vaccines, RFK Jr. has said that, as the head of HHS, his focus would be on giving people the freedom to make their own choices.
Speaking to NBC News, RFK Jr. said, “If vaccines are working for somebody, I’m not going to take them away. People ought to have a choice, and that choice ought to be informed by the best information.”
To be clear, it is in the public’s interest that RFK Jr. and other health authorities stick to that pledge and do not crusade against vaccines generally. Where vaccines have been proven to be safe and effective, such as for polio or smallpox, vaccination should be required.
While RFK Jr., Dave Weldon, Martin Makary – Trump’s nominees for the Center for Disease Control (CDC) and Food and Drug Administration (FDA), respectively – hold unorthodox views on healthcare, it is fair to ask if the country will benefit from their perspectives, assuming they do not endanger public health.
Indeed, following the Covid-19 pandemic, Americans’ trust in healthcare professionals declined significantly, as many health guidelines and mandates were either seen as politically motivated or based on incomplete science.
Between April 2020 and January 2024, trust in doctors declined from 72% to 40% according to a survey conducted by Massachusetts General Hospital.
Similarly, a 2023 Gallup poll showed that just one-third (32%) of Americans trust the medical system generally, just three-points higher than the institution’s all-time low.
In itself, the considerable erosion of trust in America’s doctors can be considered a public health crisis.
How RFK Jr. and Trump’s other nominees to lead the CDC and FDA approach this will go a long way in either curing – or exacerbating – this issue.
To that end, RFK Jr.’s opposition to the revolving door between the FDA and “Big Pharma” may bolster trust by removing perceptions that physicians and government bureaucrats have ulterior motives in how they regulate the industry.
In that same vein, an op-ed RFK Jr. penned in 2019 slammed the “conflicts of interest” that nearly 10,000 federally funded health researchers had, including owning stock in companies that “may benefit from the outcome of research.”
These are genuine issues that have contributed to the erosion of trust in our healthcare system, and if RFK Jr. can truly eliminate these conflicts of interest, Americans stand to gain from his reforms.
However, the biggest impact of the “make America healthy again” platform is likely to be felt in what Americans eat and drink.
Fighting to eliminate ultra-processed foods filled with added fats and sugars has been a longstanding campaign for RFK Jr., particularly in school lunches. At a rally for Trump ahead of the election, he declared, “We are betraying our children by letting (food) industries poison them.”
Unlike his stance on vaccines, the push to overhaul the FDA and America’s food system enjoys relatively broad support.
It was praised by Colorado’s Democratic Gov. Jared Polis, and Dr. Peter Lurie, executive director at the Center for Science in the Public Interest – a non-profit food safety advocacy group –applauded RFK Jr.’s efforts to remove certain dyes and other chemicals like seed oils from the food we eat.
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With roughly 4-in-10 (43%) Americans considered obese according to the World Health Organization, any effort to combat this growing epidemic should be encouraged.
Of course, it remains to be seen just how effective RFK Jr. can be here, as there are legal constraints on the agency’s powers, and the certain pushback from the deep-pocketed food and agricultural industries.
Ultimately, while there are legitimate questions over Trump’s appointees to oversee our healthcare and food agencies, it is evident that Robert F. Kennedy Jr and the other nominees will inherit institutions that Americans broadly do not trust to keep us healthy nor safe.
It is my hope that RFK Jr. and others shake things up in a positive way.
If they commit to supporting long-proven safe vaccinations while increasing transparency and freedom to make choices on newer vaccines, they stand a good chance of rebuilding America’s trust in our medical institutions.
Douglas Schoen is a longtime Democratic political consultant