Archives for category: Health

Of all of Trump’s choices for his Cabinet, the most dangerous by far is Robert F. Kennedy Jr.

Kennedy has a long and well-established record as a vaccine opponent. The media usually refer to him as a vaccine “skeptic,” but he is far more than a skeptic. He has claimed that vaccines cause autism and that vaccines cause the very diseases they are supposed to prevent.

He opposes fluoridating the water, despite established evidence that fluoridated water dramatically improves dental health.

He has been quick to reject science, although he is neither a doctor nor a scientist.

He promised the senators that he would not oppose vaccines, but promises mean nothing as compared to decades of anti-vaccine advocacy.

Did he have a conversion experience? Did he wake up on the morning of his Senate hearings and decide that he had been wrong for 30 years?

After the lies about abortion told to the Senate by Kavanaugh, Gorsuch, and Barrett, you would think the Senators would refuse to be fooled again. Not so.

If Kennedy resumes his hatred of vaccines, if he cancels clinical trials and research, people will die.

He was the worst possible choice for secretary of Health and Human Services.

Eating healthy foods is great.

Taking on the political power of Big Pharma is great.

Denying access to vaccines is madness.

“It will be a disaster for public health,” said Dr. Paul Offit, an infectious disease physician at Children’s Hospital of Philadelphia. “He has fixed, immutable, science-resistant beliefs. This country will suffer under his leadership.”

Mitch McConnell, a polio survivor, was the only Republican to vote against RFK.

McConnell said polio vaccines have saved millions of lives and their proven value shouldn’t be relitigated. 

HHS “deserves a leader who is willing to acknowledge without qualification the efficacy of lifesaving vaccines and who can demonstrate an understanding of basic elements of the U.S. healthcare system,” McConnell said.

Kennedy has blamed autism on vaccines, though many studies have found there isn’t a link. He has said the Covid-19 vaccines were the deadliest ever made. 

After it emerged he could hold a prominent health role in a Trump administration, Kennedy moderated his statements about the shots, saying he didn’t want to take them away. 

Of course he wouldn’t take them away, but he might make them voluntary, which would not halt the spread of epidemics.

He told many senators during meetings that he isn’t antivaccine but simply wants good data to support shots.

He “wants good data” means that he is not yet persuaded, despite decades of evidence, that vaccines protect children against many communicable diseases. The data is good enough for doctors who know far more than Kennedy. What will it take to persuade him?

Sen. Bill Cassidy (R., La.), a medical doctor, said he agreed to vote for Kennedy in exchange for a commitment to keep current federal vaccine recommendations, among other pledges.

The senators have learned nothing. They believe that a leopard can change its spots. They have been fooled again and again.

Many federal government websites went dark after Trump took office. Medical and scientific professionals were concerned when websites containing research were shut down. One reason for the lights out was the Trump administration’s determination to remove any research that contained language that referred to diversity, equity or inclusion and any research that related to sexuality, especially references to transgender or bisexual or any LGBT issues. The Trump administration has stated that there are only two genders–male and female–and that’s it.

The news was reported by The Washington Post:

The Centers for Disease Control and Prevention removed or edited references to transgender people, gender identity and equity from its website Friday, racing to meet a late-afternoon deadline imposed by the federal Office of Personnel Management.

Whole pages about HIV testing for transgender people, guidelines for use of HIV medication and information on supporting LGBTQ+ youth health were no longer available late Friday. The page that lists vaccines recommended by the CDC’s vaccine advisory committee was also no longer available. The vaccine to protect against mpox virus is recommended for groups including transgender, nonbinary or gender-diverse people.

By Saturday, the page of vaccine-specific recommendations was back online, with no mention of the mpox vaccine.

The blog Inside Medicine reported on the pall of censorship by the feds across the scientific community. Its report included the words that triggered the DEI censors.

In the order, CDC researchers were instructed to remove references to or mentions of a list of forbidden terms: “Gender, transgender, pregnant person, pregnant people, LGBT, transsexual, non-binary, nonbinary, assigned male at birth, assigned female at birth, biologically male, biologically female,” according to an email sent to CDC employees (see below).”

A screenshot of a CDC email shared with Inside Medicine of a list of terms that must be removed from any CDC-authored manuscript being seriously considered or “in press” (but not yet online or in print) at any medical or scientific journal.

An expansion of an emerging censorship regime at the CDC. 

The policy goes beyond the previously reported pause of the CDC’s own publications, including Morbidity and Mortality Weekly Report (MMWR), which has seen two issues go unreleased since January 16, marking the first publication gap of any kind in approximately 60 years. Emerging infectious Diseases and Preventing Chronic Disease, the CDC’s other major publications, also remain under lock and key, but have not yet been affected because they are monthly releases and both were released as scheduled in January, prior to President Trump’s inauguration. The policy also goes beyond the general communications gag order that already prevents any CDC scientist from submitting any new scientific findings to the public.

The National Science Foundation was directed to screen papers submitted for funding; it uses a list of words to flag papers that might offend the new administration.Being flagged means that the research needs a closer review to be sure that the topic is inoffensive.

Here is the NSF list:

Judd Legum and Rebecca Crosby of the blog “Popular Information” reported on censorship at the National Secutity Agency.

They wrote:

A memo distributed by NSA leadership to its staff says that on February 10, all NSA websites and internal network pages that contain banned words will be deleted. This is the list of 27 banned words distributed to NSA staff:

Anti-Racism
Racism
Allyship
Bias
DEI
Diversity
Diverse
Confirmation Bias
Equity
Equitableness
Feminism
Gender
Gender Identity
Inclusion
Inclusive
All-Inclusive
Inclusivity
Injustice
Intersectionality
Prejudice
Privilege
Racial Identity
Sexuality
Stereotypes
Pronouns
Transgender
Equality

The memo acknowledges that the list includes many terms that are used by the NSA in contexts that have nothing to do with DEI. For example, the term “privilege” is used by the NSA in the context of “privilege escalation.” In the intelligence world, privilege escalation refers to “techniques that adversaries use to gain higher-level permissions on a system or network.”

Heather Cox Richardson points out that Trump’s desire to cut the federal budgets threatens to undermine cancer research. Cutting cancer research? Yes. Is cancer research a “Marxist radical lunatic” or DEI activity?

Cancer research is important for all of us, regardless of our political views, or lack thereof. Why in the world would Trump want to cut its funding?

Yesterday the National Institutes of Health under the Trump administration announced a new policy that will dramatically change the way the United States funds medical research. Now, when a researcher working at a university receives a federal grant for research, that money includes funds to maintain equipment and facilities and to pay support staff that keep labs functioning. That indirect funding is built into university budgets for funding expensive research labs, and last year reached about 26% of the grant money distributed. Going forward, the administration says it will cap the permitted amount of indirect funding at 15%.

NIH is the nation’s primary agency for research in medicine, health, and behavior. NIH grants are fiercely competitive; only about 20% of applications succeed. When a researcher applies for one, their proposal is evaluated first by a panel of their scholarly peers and then, if it passes that level, an advisory council, which might ask for more information before awarding a grant. Once awarded and accepted, an NIH grant carries strict requirements for reporting and auditing, as well as record retention.

In 2023, NIH distributed about $35 billion through about 50,000 grants to over 300,000 researchers at universities, medical schools, and other research institutions. Every dollar of NIH funding generated about $2.46 in economic activity. For every $100 million of funding, research supported by NIH generates 76 patents, which produce 20% more economic value than other U.S. patents and create opportunities for about $600 million in future research and development.

As Christina Jewett and Sheryl Gay Stolberg of the New York Times explained, the authors of Project 2025 called for the cuts outlined in the new policy, claiming those cuts would “reduce federal taxpayer subsidization of leftist agendas.” Dr. David A. Baltrus of the University of Arizona told Jewett and Stolberg that the new policy is “going to destroy research universities in the short term, and I don’t know after that. They rely on the money. They budget for the money. The universities were making decisions expecting the money to be there.”

Although Baltrus works in agricultural research, focusing on keeping E. coli bacteria out of crops like sprouts and lettuce, cancer research is the top area in which NIH grants are awarded.

Anthropologist Erin Kane figured out what the new NIH policy would mean for states by looking at institutions that received more than $10 million in grants in 2024 and figuring out what percentage of their indirect costs would not be eligible for grant money under the new formula. Six schools in New York won $2.4 billion, including $953 million for indirect costs. The new indirect rate would allow only $220 million for overhead, a loss of $723 million.

States across the country will experience significant losses. Eight Florida schools received about $673 million, $231 million for indirect costs. The new indirect rate would limit that funding to $66 million, a loss of $165 million. Six schools in Ohio received a total of about $700 million; they would lose $194 million. Four schools in Missouri received a total of about $830 million; they would lose $212 million.

One of the sure signs of an authoritarian regime is a passion to censor unwanted information, research, ideas, and history. The Trump administration is busy deleting scientific research at the Centers for Disease Control. Any studies that include data about LGBT+ people, women, or others whose existence is anathema to Trump and his Merry Band of Bigots is being purged. During the first Trump term, research about climate change was given the heave-ho, and scientists rushed to archive their work. Again, climate change is being buried in the archives of the EPA. Now the new Enemy of the State is DEI.

The Washington Post wrote about the censorship at the CDC here:

The Centers for Disease Control and Prevention removed or edited references to transgender people, gender identity and equity from its website Friday, racing to meet a late-afternoon deadline imposed by the federal Office of Personnel Management.

Whole pages about HIV testing for transgender people, guidelines for use of HIV medication and information on supporting LGBTQ+ youth health were no longer available late Friday.
The material removed or edited includes extensive sets of data collected and used by researchers around the world, according to two employees who spoke on the condition of anonymity out of fear of retaliation. The data’s removal will have implications for researchers who have relied for decades on the comprehensive material collected by the vaunted public health agency.

One example of a set of data taken down was a survey by the Youth Risk Behavior Surveillance System, conducted every two years to assess the health behaviors of high school students. The landing page for data about the survey was dark Friday afternoon and read: “The page you’re looking for was not found…”

Agency staff members were given a list of about 20 words and phrases to be used as a “guide,” according to a screenshot shared by one employee. The words include: gender, transgender, pregnant person, pregnant people, LGBT, transsexual, nonbinary, assigned male at birth, biologically male, biologically female, he/she/they/them. All references to DEI and inclusion are also to be removed.

The new regime is moving fast to obliterate inconvenient science writes TCinLA at his Substack blog, which is called “That’s Another Fine Mess.”

There is a scene toward the end of Act Two in “Rollerball” (the first release, starring James Caan, the one worth watching) in which “Jonathan E” is allowed to go to Geneva, where the computer that runs the world is housed, to ask questions of it. He finds that the computer is systematically “losing” history and data. The Librarian tells him that “He’s already lost the entire Twelfth Century.” Jonathan E realizes that there will never be a way to rebel against the corporate overlords who run the world in which he lives, because the people will never know any other alternative.

Or as George Orwell put it in “1984″: “Who controls the past, controls the future; who controls the present, controls the past.” In that novel – which it seems some people are adapting now as a user’s manual – the information Big Brother’s government didn’t want people to access ended up in “the memory hole.”

As bad as we thought things would be with the second coming of Cletus J. Dumbass’s Maladministration, the reality is far worse. We are only at day 12 of this maladministration, and the assault on historical knowledge and information is well underway.

The Theocrats who created Project 2025 know what Orwell knew, what the screenwriter of Rollerball knew, what those who study authoritarian movements know: if people do not have access to information, they have no way to separate lies from truth. They can then be ruled without fear of revolt.

Information at the Centers for Disease Control is disappearing as you read this. The agency has already removed all scientific data from public view.

On Thursday night, word began to spread through the scientific community that researchers should go to the CDC website and download their data immediately, because such data was about to disappear from the website, or be altered to comply with Maladministration II’s ongoing plan to remove from federal agencies any mention of gender, DEI, or accessibility. Scientists were up throughout the night, working to download information they needed for their continued work on such crucial issues as tracking viral outbreaks. (Remember back in 2020, at the outbreak of the pandemic, when Cletus said he wished they would stop testing people and reporting the results because “It doesn’t look so good for me”?)

Already, the data from the CDC’s Youth Risk Behavior Surveillance System has disappeared. The data from the Agency for Toxic Substances and the Disease Registry’s Social Vulnerability Index and the Environmental Justice Index are gone. The landing page for HIV data has vanished. The AtlasPlus tool, which holds 20 years of CDC surveillance data on HIV, hepatitis, sexually transmitted infections, and tuberculosis, is no longer available. The new “leaders” at the CDC have directed employees to scrub any mention of “gender” from the data it shares at the website, replacing it with “sex.”

The purge’s full scope is still unclear. The Atlantic obtained a document that revealed the government – as of Thursday evening – planned to target and replace several “suggested keywords” – including “pregnant people,” “transgender,” “binary,” “non-binary,” “gender,” “assigned at birth,” “cisgender,” “queer,” “gender identity,” “gender minority,” and “anything with pronouns” These terms represent demographic variables researchers collect when tracking the ebb and flow of diseases and health conditions across populations. If they are reworded, or even removed entirely from data sets to comply with the Executive Order issued the night of Enshittification Day, researchers and health-care providers will have a much harder time figuring out how diseases affect specific communities.

The legislative “explicit purpose” of CDC data is to guide researchers to places and people who most need attention. It is hard to understand how this decision benefits health, but it does benefit an ideological decision to delete the entire topic of transgender.

When questioned about this today, an HHS spokesperson said that “all changes to the HHS website and HHS division websites are in accordance with President Trump’s January 20 Executive Orders” on gender and DEI.

The government understands these changes could have scientific implications since the document directing a review of CDC content suggests some work could be altered without “changing the meaning or scientific integrity of the content;” any such changes should be considered “routine.” Changing other content, would require review by an expert since any alterations would risk scientific integrity.

However, the document does not specify how data would be sorted into the two categories, or who would make such decisions.

The fear among researchers is that entire data sets could be taken down, reappearing with demographic variables removed or altered to conform with the DEI restrictions, losing entire sections of data. Since the Executive Order defines sex as binary, this means transgender people and nonbinary people could be erased. Such data could include facts such as gay men have higher rates of STIs, but lower rates of obesity and that transgender women have higher rates of HIV, but lower rates of prostate cancer, or how various demographic subsets of Americans are most at risk from conditions including adolescent depression, STIs, and sex-specific cancers

At this time, groups of researchers are rushing to archive the CDC website in full.
An example of what is at stake: Mpox – popularly known as “Monkey Pox” – affects people differently, with men who have sex with men being the primary group likely to be infected with the disease. Possessing that knowledge allowed medical authorities to more efficiently allocate resources, including vaccines, bringing the epidemic under control before it affected Americans more widely.

Scrubbing data such as this would change how the government allocates funds for long-standing threats to public health; this will widen health-equity gaps, or reverse progress in combating such diseases. The rates of STIs have recently started to plateau in the U.S., after decades of steady increase. Altering data that focus interventions on transgender populations, or men who have sex with men, would undo those gains. If there is no data to prove a health issue is concentrated in a particular community, that gives the government justification to cut funding.
Since much of the data on the CDC website comes from states, once it becomes known this data-scrubbing is happening, some states (blue states) may become reluctant to share information with the federal government while other states (red states) might not collect that important information at all. This would make what information the government does have unreliable, creating a skewed picture of reality.

It is shocking to realize how Project 2025 amounts to a war against modern society. Those reading this who are older than 75 can remember what life was like without the polio vaccine, without the measles and mumps vaccines. I escaped polio, but I came down with both measles and mumps before age 5, and I can still remember how difficult dealing with those was. The only thing I can compare those events to was coming down with COVID two years ago, which I survived only because I immediately obtained Paclovid for early treatment. Knowing to do that was because information about the disease and its effect on older people was made public by the CDC. Without that information, I and a lot of other older people who came down with COVID then would literally not be here now.

Maladministration II has to be seen as the all-out attack on modern society that it is. It has to be opposed by all means available. These Enemies of America are a minority. Every poll shows that significant majorities – over 66% – of Americans oppose every single action Project 2025 plans to take in this assault.

I admit that in my wildest nightmares of this coming to pass, I didn’t think of such things as an all-out attack on modern science, as is happening now. But this clearly demonstrates the nature of the threat we face. They are The Enemy. In all things, in all ways.

Winston Churchill warned his people in a speech given on June 18, 1940 that they were threatened by “a new Dark Age made more sinister, and perhaps more protracted, by the lights of perverted science.” We actually face that situation now.

The one fortunate thing is that, so far, the enemy has proven themselves largely incompetent to carry out successfully their plans to destroy modern civilization. That doesn’t make them less dangerous, but we can resist them.

We have to.

Robert F. Kennedy Jr., one of the most famous vaccine skeptics in the U.S., tried to distance himself from his decades of anti-vaccine sentiment during his Jan. 29 hearing to be confirmed as secretary of the U.S. Department of Health and Human Services (HHS). If confirmed, Kennedy would oversee agencies including the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the National Institutes of Health.

“News reports have claimed that I am anti-vaccine or anti-industry. I am neither. I am pro-safety,” Kennedy said in his opening statement before the Senate Committee on Finance, prompting a protester to shout, “He lies!” Kennedy added that all of his children are vaccinated—a decision he has previously said he regrets—and said vaccines “play a critical role in health care.”

Some Republican senators accepted Kennedy’s pro-vaccine comments at the hearing. But many senators—including Oregon’s Ron Wyden, a Democrat—pressed Kennedy on discrepancies between his past public statements—in which he has repeatedly questioned the safety and necessity of vaccines and said they are linked to autism and chronic diseases—and his sanitized comments during the hearing. “Mr. Kennedy, all of these

Christina Jewett wrote in The New York Times that Robert F. Kennedy Jr. tried to block the release of all COVID vaccines in 2121, at the height of the pandemic.

In the past, I have referred to Mr. Kennedy as a crackpot. I was wrong. He’s more than a crackpot. He’s a dangerous man, whose non-scientific ideology has the potential to kill thousands of people. He should not be confirmed as Secretary of Health and Human Services. His views are lethal. If a new form of COVID or some other contagious disease were to emerge, we would all be in danger.

Robert F. Kennedy Jr., President-elect Donald J. Trump’s choice to lead the nation’s health agencies, formally asked the Food and Drug Administration to revoke the authorization of all Covid vaccines during a deadly phase of the pandemic when thousands of Americans were still dying every week.

Mr. Kennedy filed a petition with the F.D.A. in May 2021 demanding that officials rescind authorization for the shots and refrain from approving any Covid vaccine in the future.

Just six months earlier, Mr. Trump had declared the Covid vaccines a miracle. At the time Mr. Kennedy filed the petition, half of American adults were receiving their shots. Schools were reopening and churches were filling.

Estimates had begun to show that the rapid rollout of Covid vaccines had already saved about 140,000 lives in the United States.

The petition was filed on behalf of the nonprofit that Mr. Kennedy founded and led, Children’s Health Defense. It claimed that the risks of the vaccines outweighed the benefits and that the vaccines weren’t necessary because good treatments were available, including ivermectin and hydroxychloroquine, which had already been deemedineffective against the virus.

For-profit healthcare companies, many of which are owned by private equity, are aggressively expanding their efforts to trick seniors into abandoning their enrollment in traditional Medicare and joining for-profit Medicare Advantage plans.

About half of all seniors are now enrolled in Medicare Advantage. The pitch for MA plans is seductive. They offer bells and whistles that are not part of Medicare. If you enroll in a MA plan, you will get free gym membership, prescription drug coverage, dental coverage, and a variety of other attractive benefits.

What’s wrong with MA? It’s great when you are not sick. It’s very bad when you have a serious illness.

When you have surgery or other serious illness, Medicare and your secondary pays almost all of your medical costs. MA may or may not. MA has panels to decide whether to pay your bills. You may be denied and stuck with huge bills.

Privatization produces worse service because the corporation must turn a profit. Make no mistake: MA is privatization.

How does MA make a profit? By denying the claims of patients.

I had open heart surgery in 2021. I was hospitalized for a month. I spent a week in the ICU (intensive care unit). When the total hospital bill arrived many weeks later, I almost had a stroke: it was over $839,000! After Medicare negotiated with the hospital, the actual cost to me was $300. That’s a miracle. Why give up that kind of coverage?

The Lever reports that the federal government has been complicit in tricking people to abandon Medicare and switch to Medicare Advantage.

It begins:

A new Medicare privatization scheme developed under President Donald Trump and now being expanded under President Joe Biden is forcing hundreds of thousands of seniors onto new private Medicare plans without their consent.

The development represents a troubling new dimension in the fight by corporate interests to privatize Medicare, the federal health insurance program for people 65 or older. Medicare Advantage, which allows for-profit health insurers to offer privatized benefits through Medicare, already results in unexpected costs for routine procedures and wrongful denials of care. Private plans have cost Medicare an astonishing $143 billion since 2008, and are now drivingsome health insurers’ record profits.

The new Direct Contracting Entity (DCE) program similarly adds a private-sector third party between patients and Medicare services. Medicare allows these intermediary companies to offer unique benefits, like gym membership coverage. But as for-profit operations ranging fromprivate insurers to publicly traded companies to private equity firms, these intermediaries are incentivized to limit the care that patients receive, especially when they are very sick.

While Medicare Advantage patients choose to sign up for private insurance plans, patients are being enrolled in these DCE health care plans without their informed consent. As Rep. Pramila Jayapal (D-Wash.) noted in a January op-ed, “Seniors in traditional Medicare may be ‘auto-aligned’ to a DCE if any primary care physician they’ve visited in the past two years is affiliated with that DCE. That means Medicare automatically searches two years of seniors’ claims history without their full consent to find any visits with a participating DCE provider as the basis for enrollment.”

Open the link and continue reading.

Don’t be fooled.

Alexandra Petri is the resident humorist at The Washington Post. She has the knack of taking wacky ideas in the world of politics and exposing them as bizarre. In this post, she shows the absurdity of sanewashing extremism in the guise of finding a “middle ground” with crackpot ideas. The “middle ground,” she cautions, may actually mean “giving ground” to very bad and deadly ideas. Sometimes there is no middle ground between a good idea and a dangerous idea.

She writes:

“As a Democratic member of Congress, I know my party will be tempted to hold fast against Mr. Trump at every turn: uniting against his bills, blocking his nominees and grinding the machinery of the House and the Senate to a halt. That would be a mistake. Only by working together to find compromise on parts of the president-elect’s agenda can we make progress for Americans who are clearly demanding change in the economy, immigration, crime and other top issues.”

— “Let’s Try Something Different in How We Deal With Trump,” Rep. Tom Suozzi (D-New York), in a New York Times op-ed


Look, some people are still naive enough to believe that polio is, for lack of a better word, “bad.” And recent signs haven’t been encouraging! It seems like the disease wants to do exactly what it did last time: cripple children and put them in iron lungs. But what if instead of fighting it, we … didn’t?

When I look at how people voted this election, I am forced to conclude: Some of you want polio. Who am I to stand against that desire? Someone with values?

Do I think polio is good? No! Of course not. But some people do, and I just think it would be a mistake not to give them the opportunity to set the course of vaccine policy for the next four years. Which, again, isn’t what I want. But compromise is important. That was why people voted for me, someone who said he didn’t like polio, so that I could surprise them by wanting to hear polio out. That’s just good politics.

It’s not only polio. Everywhere you look, there are battles that once felt existentially important in which you can just surrender, as I’m sure Donald Trump is eager to tell Ukraine. And I am ready to start doing that work — first on polio, then on everything else.

Listen, I’m not naive. I know that every indication so far has been that only one side is willing to compromise on anything. That gives us bargaining power! Or is it the other side that gets the bargaining power … ? Hang on, let me go look this up. This feels important to get right! Well, let me keep going with my argument, but I will come back and look this up. Don’t let me forget!

Where was I? Right: Having core values means that sometimes you have to stand up for them, even when it feels like an uphill battle. For instance, the belief that trans people deserve protection from those who would legislate them out of public spaces and eliminate their right to medical self-determination — a bottom line that I would never budge on, except to completely throw away that principle if I ever decide it’s politically expedient. Which I think I might just have done! Whoops!

But, hey, that’s what principles are: inconvenient. Except for my bedrock principle: that those who want the opposite of what I stand for and who refuse to work with me on any issue probably know something that I don’t, and I should listen to them. That I will never abandon.

When I see someone who wants to put polio back on the map, I just see one more opportunity for compromise. Why, if enough of us say, “You know what, in all that ranting about fluoride, I heard one word that made a kind of sense! Say more! I bet we can find common ground!” maybe the other side will stop believing what they believe and change their entire worldview! Isn’t that what happened to Scrooge? It’s not? Well, never mind.

If I just listen hard enough and agree to find common ground, I am certain the other party will be the one to change. That’s usually what makes people change: when you give up defending your position completely! Then they budge. I hope! That’s certainly what I’m counting on for the next four-plus years!

When I read the sentence “Unless enough people find the spine to oppose his appointment, Robert F. Kennedy Jr. will soon be in charge of the Department of Health and Human Services,” what I see is not a call to find some spine (impossible) and remind others of the stakes of not doing so. When has anyone found a congressional spine, except RFK Jr. while out on one of his weekly Hikes in Search of Surprising Things to Put Into His Freezer?

No, what that sentence means is: We need to start thinking of ways to compromise now! Compromise public health, compromise public safety, compromise all of our principles! Because that’s what the country needs: more things to be compromised.

And I, for one, am excited.

Whooping cough is one of the diseases that had been virtually eliminated thanks to the development of effective vaccines. But with the rise in vaccine skepticism, whooping cough is on the rise. If RFK Jr. is confirmed as the nation’s Secretary of Health and human Services, we can expect the return of many once-vanquished diseases.

Sabrina Mali of The Washington Post reported a dramatic increase in cases of whooping cough:

Whooping cough continues to surge in the United States, with reported cases soaring to more than 32,000 this year — nearly five times the 6,500 cases recorded during the same period last year — marking the highest levels in a decade.
Health experts cite as main culprits for the increase waning vaccination rates and a loss of broad immunity tracing to coronavirus lockdown protocols.

The disease, caused by the bacterium Bordetella pertussis, is highly transmissible from person to person through the air. Because of their immature immune systems, infants younger than 1 year old are at highest risk of contracting whooping cough — also known as pertussis — and are at most significant risk of severe illness.

Vaccination rates with the DTaP shot — which protects against diphtheria, tetanus and pertussis — declined from March through September 2020 at the height of the coronavirus pandemic. But because people were following pandemic protocols such as masking and social distancing, cases did not soar. Some children who missed getting their shots during that period may never have received them, experts have said…

Health experts worry that the incoming administration could impede efforts to increase vaccination rates among vulnerable populations.

Robert F. Kennedy Jr., whom President-elect Donald Trump selected to lead HHS, will have significant influence over vaccine production and safety. Kennedy has been a longtime anti-vaccine activist, and many health experts express concerns that he could contribute to waning vaccination rates.

Although he has said he is not anti-vaccine, Kennedy has criticized the recommended list of childhood vaccines and promoted debunked claims about autism and vaccines.

In a recent issue of The New Yorker, physician Dhruv Khullar writes about what happened to the practice of medicine when private equity began buying up hospitals and group practices. The result of privatization of healthcare was not surprising: the desire for profit became more important that the drive to improve patients’ health. Private equity was very successful in squeezing handsome profits out of community hospitals, but all too often those hospitals went bankrupt, leaving the communities without a hospital. Dr. Khullar says we are now in “the Gilded Age” of medicine, where wealth and corporate power are in charge.

Dr. Khullar is a physician and associate professor of health policy and economics at Weill Cornell Medical College.

Dr. Khullar wrote:

In 2010, a private-equity firm called Cerberus Capital Management, which is named for the three-headed dog that is said to guard the underworld, bought six Catholic hospitals in Massachusetts and christened the chain Steward Health Care. The state’s attorney general blessed the deal on multiple conditions, including that, during a five-year review period, the hospitals stayed open and their workers stayed employed. A few months after the period ended, however, Steward started selling the land on which the hospitals stood. A $1.25-billion-dollar deal, in 2016, helped to finance more acquisitions. Many facilities, asked to pay rent on land they’d previously owned, struggled.

According to a recent report published by Massachusetts Senator Ed Markey’s office, which covers the period between 2017 and 2024, some Steward facilities had to forgo key investments in staffing, surgical equipment, elevator repairs, and even clean linens. Patients increasingly languished in emergency rooms; many left without receiving care; and mortality rates for common conditions climbed sharply. (Steward has argued that its death rates were better than expected, given the underlying health status of the patients it cared for.) A hospital in Florida developed a bat infestation, and another, in Texas, was cited for placing potentially suicidal patients in rooms with materials with which they could hang themselves. Employees at Steward’s Carney Hospital, in Massachusetts, began calling their workplace “Carnage” hospital. (Cerberus’s ownership ended in 2020, and the firm claims that the quality issues at Steward are “overwhelmingly related to the post-Cerberus ownership period.”)

In May, Steward filed for bankruptcy. It has closed two hospitals and plans to sell thirty-one others. Steward’s C.E.O., Ralph de la Torre, who in 2011 purchased a forty-million-dollar superyacht, was subpoenaed by a Senate committee but failed to show up; he was held in contempt of Congress and resigned from his position. (De la Torre, in turn, sued the committee for violating his right against self-incrimination.) Nonetheless, Cerberus realized a profit of seven hundred and ninety million dollars from its investment in Steward. Meanwhile, in some places in the U.S., private-equity firms now own more than half of all medical practices within certain specialties. “We are being picked clean by private equity,” a New Jersey-based radiologist said at a recent meeting of the American Medical Association. “There are people who don’t know where their next paycheck is even going to come from because their groups have been flipped so often.”

2024 was arguably the year that the mortal dangers of corporate medicine finally became undeniable and inescapable. A study published in JAMA found that, after hospitals were acquired by private-equity firms, Medicare patients were more likely to suffer falls and contract bloodstream infections; another study found that if private equity acquired a nursing home its residents became eleven per cent more likely to die. Although private-equity firms often argue that they infuse hospitals with capital, a recent analysis found that hospital assets tend to decrease after acquisition. Yet P.E. now oversees nearly a third of staffing in U.S. emergency departments and owns more than four hundred and fifty hospitals. In some of them, patients were “forced to sleep in hallways, and doctors who spoke out were threatened with termination,” according to Jonathan Jones, a former president of the American Academy of Emergency Medicine.

Erin Fuse Brown, a professor at the Brown University School of Public Health, told me that private-equity firms have learned that they “don’t have to make things better or make them more efficient. You can just change one small thing and make a ton more money.” They are hardly the only corporations to learn this lesson. Increasingly, health insurers, private hospitals, and even nonprofits are behaving as though they aim first to extract revenue, and only second to care for people. Patients often are viewed less as humans in need of care than consumers who generate profit.

In 1873, Mark Twain co-wrote the novel “The Gilded Age: A Tale of Today,” which satirized an era that was marked by inequality, greed, and moral decay but was painted in a veneer of abundance and progress. Industrialists made fortunes in oil, steel, and shipping even as millions suffered poverty and exploitation. Today, health care is where the money is. New technologies and treatments sustain the impression that patients have never been healthier, but corporations and conglomerates wield immense power at the expense of the people they’re meant to serve. Welcome to the Gilded Age of medicine.

In recent years, health-care corporations have embraced an approach that can only be described as gamification. In the U.S., all seniors over sixty-five are entitled to health insurance through Medicare, and, for several decades, private companies have offered plans through programs such as Medicare Advantage. The government pays insurance companies a fixed sum based partly on how sick those patients are. The sicker the patients, the bigger the potential payments. But who’s to say, really, how sick a patient is? Let the games begin.

This year, the health-news site STAT revealed that UnitedHealth, the country’s largest private insurer, had set up dashboards for practices to compete on how many conditions they could diagnose in patients. Doctors who completed the most appointments with seniors in Medicare Advantage were eligible for ten-thousand-dollar bonuses, and patients were offered seventy-five-dollar gift cards for getting checkups at which their medical histories could be recorded. At the height of the covid-19 pandemic, an e-mail sent to one practice told clinicians that documenting chronic illnesses was the “#1 priority.”

Insurance companies have even started to scour medical records for possible diagnoses, and to send nurses to patients’ homes to perform “health-risk assessments.” These strategies rack up so many additional diagnoses that, in 2023 alone, the federal government made $7.5 billion in “overpayments” to insurers, according to the U.S. Office of the Inspector General. Insurers are “pouring tremendous resources into developing the capacity to code patients in a way that nets more money from Medicare,” Donald Berwick, a former head of the Center for Medicare & Medicaid Services, told me. “That’s taxpayer money being siphoned away from people who need it.”

Berwick said that his own physician’s practice had recently been acquired by UnitedHealth. One day, he asked his doctor, “Anything different now?”

“Two things,” the doctor replied. “I have to see more patients each day. And my patients have new diagnoses that I didn’t put there.” Many patients with atrial fibrillation, for example, were now coded as having another condition known as “hypercoagulable state”—which was technically accurate, but didn’t change patients’ care in any way. It did, however, generate higher payments from Medicare. Ask not what your insurer can do for you—ask how much revenue you can generate for your insurer.

The insurance companies in Medicare Advantage tend to argue that they’re simply recording diagnoses, not making them up; that they offer vision and dental benefits that traditional Medicare doesn’t offer; and that they rein in unnecessary care, such as by requiring prior authorization for certain tests and procedures. But according to the Medicare Payment Advisory Commission, a nonpartisan agency that counsels Congress, private Medicare Advantage plans will cost the federal government eighty billion dollars more per year than if those patients had been in the traditional Medicare program. “You might as well flush most of that eighty billion dollars down the toilet,” Berwick told me.

On December 4th, after I drafted this piece, Brian Thompson, the C.E.O. of UnitedHealthcare, was fatally shot in midtown Manhattan. In the days that followed, the public response was not just one of shock but also of frustration and even rage against the health-insurance industry. Someone posted in a subreddit for nurses, “Honestly, I’m not wishing anyone harm, but when you’ve spent so much time and made so much money by increasing the suffering of the humanity around you, it’s hard for me to summon empathy that you died.” The comedian Bill Burr compared C.E.O.s like Thompson to gangsters. “It’s a dirty game,” he said. “Health care—dirty game.” I was saddened by the callousness of these comments. Thompson had become a symbol of a broken system; people who devalued his life, it seemed to me, were engaging in a version of the dehumanizing behavior that they found objectionable within the health-care industry.

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