Among the cast of characters ready to join the Trump administrationNo one is as annoying, polarizing or potentially dangerous as Robert F Kennedy Jr. But in a twist characteristic of our time, no single nominee has the potential to do so much good for the American people.
bear with me RFK Jr was right destroyed for promoting a series of theories linking vaccines to autism, chemicals in the water supply to gender identity, how people get AIDS and saying the Covid-19 vaccine, which in fact caused the deadliest pandemic of our lifetime, was self “the deadliest vaccine ever made”. He claimed Covid-19 was intended to target certain ethnic groups, Black people and Caucasians, while sparing Asians and Jewish people.
In normal times these ideas would be disqualifying. Expressing unfounded scientific claims is corrosive to a functioning democracy. It weakens the bonds of trust in our public institutions, and feeds the right-wing narrative that all government is illegitimate. This is why, writes in the Guardian this September I dismissed the prospect of RFK Jr saying his “anti-vaccine work is more likely to make America get measles again”.
But these are not normal times. RFK Jr is Donald Trump’s pick to run our nation’s Department of Health and Human Services. He will have a massive impact on our broken, expensive and largely inefficient delivery of healthcare services. How are we going to deal with it?
On the one hand, RFK Jr’s anti-vaccine views is beyond the pale. To win Senate approval, I think 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 modern medical miracles are what live hundreds of millions of people. And this is where I part ways with many of my Trump-fighting friends: should RFK Jr. be able to drop his numerous conspiracy theories about vaccines, he could be the most transformative health secretary in our nation’s history.
That’s because RFK Jr articulated what our Democratic and Republican leaders have largely ignored: our health care system is a national disgrace hiding in plain sight. He acknowledges the disproportionate control of the pharmaceutical and food industries 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 this past September, Kennedy offered a clear analysis of what is making America metabolically ill; he spoke out against big pharma and big food, and drew connections between the damage ultra-processed foods like seed oils and sugars do to our health, as well as the food industry’s efforts to come up with chemicals that make these foods addictive.
He advocates bans pharmaceutical advertising on television, and wants to limit corporate ties to federal agencies such as the Food and Drug Administration and National Institute of Health. (To my knowledge, he hasn’t spoken out against the outrageous cost of life-saving drugs or unequal access to medical treatment, but hopefully he’ll get that right, too.)
We spend $4tn annually in health careand leads the world in spending over $12,000 per person, 50% more than Switzerland, which is the second largest spender per capita. American doctors dominates the Nobel Prizes for medicine, and our medical schools are considered the best in the world. Yet we seem unable to stem the epidemic of chronic disease. An astonishing 73% of us are obese or overweight and more than 38 million people suffer from diabetes.
This issue hits home for me as I was diagnosed with severe type 2 diabetes in 2021 and – after receiving terrible medical advice to rely on insulin and metformin – vice versa my condition by adopting a low-carbohydrate diet. This year I published a “follow the money” series for the Guardian, Death by Diabetesin which I highlighted the huge influence of big pharma 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 treatment in this country, yet it accepts money from food companies such as the makers of Splenda and Idaho potatoes—two products that have been found to increase people’s risk of getting diabetes.
I then wrote about amputations, and the reality of African Americans with diabetes four times more likely to endure that grim procedure as white people. I view nutrition and metabolic health as a matter of racial and economic equity. I think I’m clear-eyed about 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 drop of hope in these terrible times, I think we should try to tilt policy towards the public interest where we can. To that end, here is the game plan I believe RFK Jr. should follow.
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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 adverse 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, clinicians and authors who have dedicated their careers to advancing metabolic healtheven while knowing that they will lose access to government and pharmaceutical grants. Many of these volunteers come from top medical schools, but they are a definite minority on their faculties. This includes clinicians such as Georgia Ede, Mariela Glandt, Tony Hampton, Eric Westman, scientists such as Benjamin Bikman, Ravi Kampala, Cate Shanahan and authors such as Gary Taubes, Nina Teicholz and Casey Means. These are heroic people who, by getting to know them and reading their work, have found them to be intellectually honest health practitioners.
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Appoint a diabetes czar to come up with proposals to fix this deadly and totally reversible disease once and for all. I choose this particular chronic ailment because it is ubiquitous, devastatingly expensive, a disease that disproportionately affects the poor, closely linked to our obesity epidemic, and completely reversible through diet. Wouldn’t it be great if we could finally stop type 2 diabetes in our lifetime?
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Increase federal funding of nutrition studies. The FDA and NIH have historically tipped the research scales in favor of studies that could produce the next blockbuster drug. In reality, we still don’t understand why we get fat and why we’ve seen an increase in chronic (non-infectious) diseases like diabetes, Alzheimer’s and Crohn’s.
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Strictly regulate the ability of cereal companies to market their sugary wares 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?
RFK Jr’s rise represents a difficult issue for people like me who strongly supported the election of Kamala Harris. Health care 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 people, its attack on democratic institutions, and possible abandonment of Ukraine and the NATO alliance. While I disagreed with Liz Cheney on many, if not most, issues, I also embraced her apostasy when it came to the election – I like the approach of not interrupting people you disagree with, while doing the right thing.
After I wrote 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 I’ve come to admire over the past year. “With all due respect,” she wrote. “I’m a big fan of your reporting on type 2 diabetes. But your comments about RFK Jr… are not helpful to the cause of metabolic health, which is only on the national agenda because he put it there.”
Before the election I believed RFK Jr was fair game. I was, and remain, especially concerned that his rants about vaccines and toxins would be confused with his excellent perspective on metabolic health, and hurt the cause. Now I think we have to be constructive where we can promote the public interest.
The bigger question hanging over RFK Jr.’s tenure as HHS secretary is whether Donald Trump will back him as he takes on the pharmaceutical and food industries. America’s health is not an issue in which the president-elect has shown an interest in the past. And his embrace of corporate executives like Tesla’s Elon Musk suggests that social 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 lured him to support the First Step Act, a significant piece of criminal justice reform (and one that Trump now rejects). As founder of the Marshall Project, the nonprofit journalism organization that covers the U.S. criminal justice system, I believe criminal justice reform should also be a matter of national urgency, but at the time I was ambivalent about efforts to work with the administration. . In retrospect, whatever damage Trump has done otherwise, I’d say we’re a better country for the First Step Act.
We are in a similar dilemma with health care today: the system is devastatingly expensive and inhumane. If there is someone in the administration who wants to improve things, let’s not interrupt them.
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Neil Barsky, a former Wall Street Journal reporter and investment manager, is the founder of the Marshall Project
