Archives for category: Health

President-Elect Trump made another off-the-wall nomination, which is sure to demoralize the scientists and doctors who work in public health for the federal government.

The Boston Globe reported:

President-elect Donald Trump has chosen health economist Dr. Jay Bhattacharya, a critic of pandemic lockdowns and vaccine mandates, to lead the National Institutes of Health, the nation’s leading medical research agency.

Trump, in a statement Tuesday evening, said Bhattacharya, a 56-year-old physician and professor at Stanford University School of Medicine, will work in cooperation with Robert F. Kennedy Jr., his pick to lead the Department of Health and Human Services, “to direct the Nation’s Medical Research, and to make important discoveries that will improve Health, and save lives.”

“Together, Jay and RFK Jr. will restore the NIH to a Gold Standard of Medical Research as they examine the underlying causes of, and solutions to, America’s biggest Health challenges, including our Crisis of Chronic Illness and Disease,” he wrote.

The decision to choose Bhattacharya for the post is yet another reminder of the ongoing impact of the COVID pandemic on the politics on public health.

Bhattacharya was one of three authors of the Great Barrington Declaration, an October 2020 open letter maintaining that lockdowns were causing irreparable harm.

The document — which came before the availability of COVID-19 vaccines and during the first Trump administration — promoted “herd immunity,” the idea that people at low risk should live normally while building up immunity to COVID-19 through infection. Protection should focus instead on people at higher risk, the document said.

“I think the lockdowns were the single biggest public health mistake,” Bhattacharya said in March 2021 during a panel discussion convened by Florida Gov. Ron DeSantis.

The Great Barrington Declaration was embraced by some in the first Trump administration, even as it was widely denounced by disease experts. Then- NIH director Dr. Francis Collins called it dangerous and “not mainstream science.”

Timothy Snyder, professor of history at Yale University, is the author of On Tyranny. He writes and speaks frequently on television about the importance of defending our institutions against authoritarianism and resisting Putin’s quest to reclaim the Soviet Union.

He posted:

Each of Trump’s proposed appointments is a surprise.  It is comforting to think that he is simply a vengeful old man, lashing out this way and that.  This is unlikely.  He and Musk and Putin have been talking for years. And the whole idea of his campaign was that this time he had a plan.

We should be wary of shock, which excuses inaction.  Who could have known?  What could I have done?  If there is a plan, shock is part of the plan.  We have to get through the surprise and the shock to see the design and the risk.  We don’t have much time. Nor is outrage the point. Of course we are outraged. But our own reactions can distract is from the larger pattern.

The newspapers address the surprise and the shock by investigating each proposed appointment individually.  And we need this.  With detail comes leverage and power.  But clarity must also come, and quickly.  Each appointment is part of a larger picture.  Taken together, Trump’s candidates constitute an attempt to wreck the American government.  

In historical context we can see this.  There is a history of the modern democratic state.  There is also a history of engineered regime change and deliberate state destruction.  In both histories, five key zones are health, law, administration, defense, and intelligence.  These people, with power over these areas of life, can make America impossible to sustain.

The foundation of modern democratic state is a healthy, long-lived population.  We lived longer in the twentieth century because of hygiene and vaccinations, pioneered by scientists and physicians and then institutionalized by governments.  We treat one another better when we know we have longer lives to lose.  Health is not only the central human good; it enables the peaceful interactions we associate with the rule of law and democracy.  Robert F. Kennedy, Jr., the proposed secretary of the Department of Health and Human Services, would undo all of this.  On his watch, were his ideas implemented, millions of us would die.  Knowing that our lives will be shorter, we become nasty and brutish.

A modern democratic state depends upon the rule of law.  Before anything else is possible, we have to endorse the principle that we are all governed by law, and that our institutions are grounded in law.  This enables a functional government of a specific sort, in which leaders can be regularly replaced by elections.  It allows us to live as free individuals, within a set of rules that we can alter together.  The rule of law depends on people who believe in the spirit of law.  Matt Gaetz, the proposed attorney general, is the opposite of such a person.  It is not just that he flouts law himself, spectacularly and disgustingly.  It is that he embodies lawlessness, and can be counted upon to abuse law to pursue Trump’s political opponents.  The end of the rule of law is an essential component of a regime change.

The United States of America exists not only because laws are passed, but because we can expect that these laws will be implemented by civil servants.  We might find bureaucracy annoying; its absence, though, is deadly.  We cannot take the pollution out of the air ourselves, or build the highways ourselves, our write our Social Security checks ourselves.  Without a civil service, the law becomes mere paper, and all that works is the personal connection to the government, which the oligarchs will have, and which the rest of us will not.  This is the engineered helplessness promised by Elon Musk and Vivek Ramaswamy, who are to head a black hole named after a cryptocurrency.  There are already oversight instruments in government.  DOGE is something entirely different: an agency of destruction, run by people who believe that government should exist for the wealthy or not at all.

In a modern democratic state, the armed forces are meant to preserve a healthy, long-lived people from external threats.  This principal has been much abused in American practice.  But never before Donald Trump have we had a president who has presented the purpose of the armed forces as the oppression of Americans.  Trump says that Russia and China are less of a threat than “internal enemies.”  In American tradition, members of the armed forces swear an oath to the Constitution.  Trump has indicated that we would prefer “Hitler’s generals,” which means a personal oath to himself.  Pete Hegseth, Trump’s proposed secretary of defense, defends war criminals and displays tattoos associated with white nationalism and Christian nationalism.  He is a fundraiser and television personality, with a complicated sexual past and zero experience running an organization.  

In a world of hostile powers, an intelligence service is indispensable.  Intelligence can be abused, and certainly has been abused.  Yet it is necessary to consider military threats: consider the Biden administration’s correct call the Russia was about to invade Ukraine.  It is also necessary to counter the attempts by foreign intelligence agencies, which are constant, to harm American society.  This often involves disinformation.  Tulsi Gabbard, insofar as she is known at all, is known as a spreader of Syrian and Russian disinformation.  She has no relevant experience.  Were she to become director of national intelligence, as Trump proposes, we would lose the trust of our allies, and lose contact with much of what is happening in the world — just for starters.  We would be vulnerable to all of those who wish to cause us harm.

Imagine that you are a foreign leader who wishes to destroy the United States.  How could you do so?  The easiest way would be to get Americans to do the work themselves, to somehow induce Americans to undo their own health, law, administration, defense, and intelligence.  From this perspective, Trump’s proposed appointments — Kennedy, Jr.; Gaetz; Musk; Ramaswamy; Hegseth; Gabbard — are perfect instruments.  They combine narcissism, incompetence, corruption, sexual incontinence, personal vulnerability, dangerous convictions, and foreign influence as no group before them has done.  These proposed appointments look like a decapitation strike: destroying the American government from the top, leaving the body politic to rot, and the rest of us to suffer.

I do not defend the status quo. I have no doubt whatsoever that the Department of Defense and the Food and Drug Administration require reform.  But such a reform, of these or other agencies, would have to be guided by people with knowledge and experience, who cared about their country, and who had a vision of improvement.  That is simply not what is happening here.  We are confronted instead with a group of people who, were they to hold the positions they have been assigned, could bring an end to the United States of America.  

It is a mistake to think of these people as flawed.  It is not they will do a bad job in their assigned posts.  It is that they will do a good job using those assigned posts to destroy our country.

However and by whomever this was organized, the intention of these appointments is clear: to create American horror.  Elected officials should see this for what it is.  Senators, regardless of party, should understand that the United States Senate will not outlast the United States, insist on voting, and vote accordingly.  The Supreme Court of the United States will likely be called upon.  Although it is a faint hope, one must venture it anyway: that its justices will understand that the Constitution was not in fact written as the cover story for state destruction.  The Supreme Court will also not outlast the United States.

And citizens, regardless of how they voted, need now to check their attitudes.  This is no longer a post-electoral moment.  It is a pre-catastrophic moment.  Trump voters are caught in the notion that Trump must be doing the right thing if Harris voters are upset.  But Harris voters are upset now because they love their country.  And Harris voters will have to get past the idea that Trump voters should reap what they have sown.  Yes, some of them did vote to burn it all down.  But if it all burns down, we burn too.  It is not easy to speak right now; but if some Republicans wish to, please listen.

Both inside and outside Congress, there will have to be simple defiance, joined with a rhetoric of a better America.  And, at moments at least, there will also have to be alliances among Americans who, though they differ on other matters, would like to see their country endure.

Governor DeSantis hired Dr. Joseph Ladapo as Florida’s Surgeon General because he wanted a doctor who took a contrarian view on COVID: to support those who were anti-vaccine, anti-mask, and unwilling to follow public health guidelines. In other words, in the world of people who care about science, a quack.

Now, Dr. Ladapo is calling for the end of fluoridating the drinking water of Florida. He’s taking cues from the nation’s leading medical crackpot, Robert F. Kennedy.

The Washington Post reports:

The top health official of the nation’s third-largest state called Friday for a halt to adding fluoride to Florida’s water, citing controversial studies that suggest the widely hailed public health practice poses a risk to developing brains.

Surgeon General Joseph A. Ladapo issued a recommendation citing “the neuropsychiatric risk associated with fluoride exposure, particularly in pregnant women and children,” and noting the availability of alternative sources of fluoride intoothpaste and mouthwash.

“It is clear more research is necessary to address safety and efficacy concerns regarding community water fluoridation,” Ladapo said in a statement.“The previously considered benefit of community water fluoridation does not outweigh the current known risks, especially for special populations like pregnant women and children.”

Ladapo’s announcement comes three weeks after Robert F. Kennedy Jr., who is President-elect Donald Trump’s choice to lead the Department of Health and Human Services, said the Trump administration plans to issue a similar recommendation nationwide next year. Kennedy’s remarks drew rebukes from public health experts who say that the practice has helped protect Americans’ teeth, particularly in vulnerable communities where children might not regularly brush their teeth.

“It’s madness,” said Kurt Ferré, a retired Portland, Oregon, dentist and longtime pro-fluoridation activist. He said Florida’s seniors especially benefit from fluoride because of the oral health issues that come with age and medical care for older adults.

The Centers for Disease Control and Prevention has long recommended putting fluoride in Americans’ drinking water, hailing it as one of the 10 great public health achievements of the 20th century and citing data that the practice reduces cavities by about 25 percent in children and adults. The water systems of more than 200 million Americans are fluoridated, according to CDC data.

Fluoridation has been a key public health strategy for decades, and proponents have pointed to studies showing oral health problems declining in cities that added the mineral and rising in communities that removed it.

Trump announced the appointment of Dr. David Weldon, a former Congressman from Florida, as director of the Centers for Disease Control. He has unorthodox views, to say the least. But we can always count on the Secretary of Health and Human Services, to maintain the integrity of our premier public health agency.

Oh, wait, Trump’s nominee for Secretary is the noted conspiracy theorist Robert F. Kennedy, Jr.

Is Trump trying to gut our public health agencies? How many career physicians who are noted authorities in their field will quit rather than work for know-nothings?

The New York Times reported about Dr. Weldon:

President-elect Donald J. Trump chose Dr. David Weldon, a former congressman, on Friday to serve as the director of the Centers for Disease Control and Prevention.

Dr. Weldon, 71, is a native of Long Island and earned a medical degree in New York before moving to Florida to practice. Starting in 1995, he served seven terms in Congress, representing the 15th District of Florida, before forgoing re-election and returning to his medical practice.

As a member of Congress, Dr. Weldon pushed the false notion that thimerosal, a preservative compound in some vaccines, had caused an explosion of autism — a hypothesis that experts say has no evidence. He also introduced a “vaccine safety bill” that aimed to relocate most vaccine safety research from the C.D.C. — which he said had an “inherent conflict of interest” — to a separate agency within the Department of Health and Human Services.

Mr. Trump’s choice signals yet again his commitment to reforming the role of federal health agencies in radical ways. Though Dr. Weldon is an internist, his skepticism of vaccine safety and concern about C.D.C. overreach echo those of other nominees, including Robert F. Kennedy Jr.

“In addition to being a Medical Doctor for 40 years, and an Army Veteran, Dave has been a respected conservative leader on fiscal and social issues,” Mr. Trump wrote in a statement released Friday night, saying that Dr. Weldon would “restore the CDC to its true purpose.”

“Americans have lost trust in the CDC and in our Federal Health Authorities, who have engaged in censorship, data manipulation, and misinformation. Given the current Chronic Health Crisis in our Country, the CDC must step up and correct past errors to focus on the Prevention of Disease.”

As a member of congress, Dr. Weldon also authored the so-called Weldon Amendment, which barred the Department of Health and Human Services from funding federal or state programs that “discriminated” against health insurance plans that did not cover abortions.

He unsuccessfully sought a Senate seat in 2012 and a Florida House seat in 2024.Dr. Weldon also served as president of the Alliance of Health Care Sharing Ministries, a trade group for Christian organizations that offered an alternative to traditional health insurance.

The groups have come under scrutiny for potentially misleading people into thinking the groups had some legal obligation to pay their medical claims. Dr. Weldon has said that the members of his association were clear that they were not offering insurance, which is subject to strict regulations.

For the first time, the incoming C.D.C. director will need Senate confirmation. If Dr. Weldon is successful, he will sit at the helm of an agency with a budget of more than $15 billion, which has historically been used to track and respond to infectious disease outbreaks.

But Mr. Trump’s choice to lead its parent agency, the Department of Health and Human Services, is Mr. Kennedy, who has been outspoken about his plans to deprioritize communicable disease research in favor of preventive medicine.

If Mr. Kennedy, too, is confirmed by the Senate, the mission and focus of the C.D.C.’s work may change.

Reed Abelson contributed reporting.

Trump has promised to eliminate the U.S. Department of Education. He needs Congressional approval to do it. Trump made this promise during the campaign. The details are spelled out in Project 2025. The elimination of ED is step one. Then right wingers approve their dream, which is to “block grant” all the big funding. That means that the money goes to states without limits on how it is spent. They can spend it as they wish, without federal oversight. But then comes the kicker: the federal government stops funding Title 1, Special Education, and other “categorical programs,” and the states have to fund it themselves. This works for the well-off states, because they currently pay more than they receive. But the poor states, which voted overwhelmingly for Trump, are screwed. They receive more from the federal Department of Education than they pay in. Tough justice. Bad for kids.

What about the U.S. Department of Education?

Heather Cox Richardson wrote:

One of President-elect Trump’s campaign pledges was to eliminate the Department of Education. He claimed that the department pushes “woke” ideology on America’s schoolchildren and that its employees “hate our children.” He promised to “return” education to the states. 

In fact, the Department of Education does not set curriculum; states and local governments do. The Department of Education collects statistics about schools to monitor student performance and promote practices based in evidence. It provides about 10% of funding for K–12 schools through federal grants of about $19.1 billion to high-poverty schools and of $15.5 billion to help cover the cost of educating students with disabilities.

It also oversees the $1.6 trillion federal student loan program, including setting the rules under which colleges and universities can participate. But what really upsets the radical right is that the Department of Education is in charge of prohibiting discrimination on the basis of race and sex in schools that get federal funding, a policy Congress set in 1975 with an act now known as the Individuals with Disabilities Education Act (IDEA). This was before Congress created the department.

The Department of Education became a stand-alone department in May 1980 under Democratic president Jimmy Carter, when Congress split the Department of Health, Education, and Welfare into two departments: the Department of Health and Human Services and the Department of Education. 

A Republican-dominated Congress established the Department of Health, Education, and Welfare in 1953 under Republican president Dwight D. Eisenhower as part of a broad attempt to improve the nation’s schools and Americans’ well-being in the flourishing post–World War II economy. When the Soviet Union beat the United States into space by sending up the first  Sputnik satellite in 1957, lawmakers concerned that American children were falling behind put more money and effort into educating the country’s youth, especially in math and science. 

But support for federal oversight of education took a devastating hit after the Supreme Court, headed by Eisenhower appointee Chief Justice Earl Warren, declared racially segregated schools unconstitutional in the May 1954 Brown v. Board of Education decision. 

Immediately, white southern lawmakers launched a campaign of what they called “massive resistance” to integration. Some Virginia counties closed their public schools. Other school districts took funds from integrated public schools and used a grant system to redistribute those funds to segregated private schools. Then, Supreme Court decisions in 1962 and 1963 that declared prayer in schools unconstitutional cemented the decision of white evangelicals to leave the public schools, convinced that public schools were leading their children to perdition. 

In 1980, Republican Ronald Reagan ran on a promise to eliminate the new Department of Education.

After Reagan’s election, his secretary of education commissioned a study of the nation’s public schools, starting with the conviction that there was a “widespread public perception that something is seriously remiss in our educational system.” The resulting report, titled “A Nation at Risk,” announced that “the educational foundations of our society are presently being eroded by a rising tide of mediocrity that threatens our very future as a Nation and a people.”

Although a later study commissioned in 1990 by the Secretary of Energy found the data in the original report did not support the report’s conclusions, Reagan nonetheless used the report in his day to justify school privatization. He vowed after the report’s release that he would “continue to work in the months ahead for passage of tuition tax credits, vouchers, educational savings accounts, voluntary school prayer, and abolishing the Department of Education. Our agenda is to restore quality to education by increasing competition and by strengthening parental choice and local control.”

The rise of white evangelism and its marriage to Republican politics fed the right-wing conviction that public education no longer served “family values” and that parents had been cut out of their children’s education. Christians began to educate their children at home, believing that public schools were indoctrinating their children with secular values. 

When he took office in 2017, Trump rewarded those evangelicals who had supported his candidacy by putting right-wing evangelical activist Betsy DeVos in charge of the Education Department. She called for eliminating the department—until she used its funding power to try to keep schools open during the covid pandemic—and asked for massive cuts in education spending.

Rather than funding public schools, DeVos called instead for tax money to be spent on education vouchers, which distribute tax money to parents to spend for education as they see fit. This system starves the public schools and subsidizes wealthy families whose children are already in private schools. DeVos also rolled back civil rights protections for students of color and LGBTQ+ students but increased protections for students accused of sexual assault. 

In 2019, the 1619 Project, published by the New York Times Magazine on the 400th anniversary of the arrival of enslaved Africans at Jamestown in Virginia Colony, argued that the true history of the United States began in 1619, establishing the roots of the country in the enslavement of Black Americans. That, combined with the Black Lives Matter protests in 2020, prompted Trump to commission the 1776 Project, which rooted the country in its original patriotic ideals and insisted that any moments in which it had fallen away from those ideals were quickly corrected. He also moved to ban diversity training in federal agencies. 

When Trump lost the 2020 election, his loyalists turned to undermining the public schools to destroy what they considered an illegitimate focus on race and gender that was corrupting children. In January 2021, Republican activists formed Moms for Liberty, which called itself a parental rights organization and began to demand the banning of LGBTQ+ books from school libraries. Right-wing activist Christopher Rufo engineered a national panic over the false idea that public school educators were teaching their students critical race theory, a theory taught as an elective in law school to explain why desegregation laws had not ended racial discrimination. 

After January 2021, 44 legislatures began to consider laws to ban the teaching of critical race theory or to limit how teachers could talk about racism and sexism, saying that existing curricula caused white children to feel guilty.

When the Biden administration expanded the protections enforced by the Department of Education to include LGBTQ+ students, Trump turned to focusing on the idea that transgender students were playing high-school sports despite the restrictions on that practice in the interest of “ensuring fairness in competition or preventing sports-related injury.” 

During the 2024 political campaign, Trump brought the longstanding theme of public schools as dangerous sites of indoctrination to a ridiculous conclusion, repeatedly insisting that public schools were performing gender-transition surgery on students. But that cartoonish exaggeration spoke to voters who had come to see the equal rights protected by the Department of Education as an assault on their own identity. That position leads directly to the idea of eliminating the Department of Education.

But that might not work out as right-wing Americans imagine. As Morning Joe economic analyst Steven Rattner notes, for all that Republicans embrace the attacks on public education, Republican-dominated states receive significantly more federal money for education than Democratic-dominated states do, although the Democratic states contribute significantly more tax dollars. 

There is a bigger game afoot, though, than the current attack on the Department of Education. As Thomas Jefferson recognized, education is fundamental to democracy, because only educated people can accurately evaluate the governmental policies that will truly benefit them.

In 1786, Jefferson wrote to a colleague about public education: “No other sure foundation can be devised for the preservation of freedom, and happiness…. Preach, my dear Sir, a crusade against ignorance; establish and improve the law for educating the common people. Let our countrymen know that the people alone can protect us against [the evils of “kings, nobles and priests”], and that the tax which will be paid for this purpose is not more than the thousandth part of what will be paid to kings, priests and nobles who will rise up among us if we leave the people in ignorance.”

Laura Helmuth recently resigned as Chief Editor of Scientific American after expressing her outrage online about Trump’s election. I can understand her anger because she knew that Trump would appoint completely unqualified people to take charge of federal agencies overseeing the health of the American people. But I wish she hadn’t expressed it online!

She posted this information on BlueSky about the importance of vaccines:

The measles vaccine has saved 94 million lives over the past 50 years, and it plus vaccines against 13 other pathogens have cut infant mortality by 40 percent and saved 154 million lives.
154 MILLION LIVES
🧪
Anti-vaxxer RFKJ is a menace to global health

If RFK Jr. has his way, vaccines will be voluntary. Among the unvaccinated, disease will run rampant. Even the vaccinated may be at risk. It will be dangerous to attend public events or go anywhere that is crowded.

Robert F. Kennedy Jr. visited in Samoa in 2019. While there, he proselytized on the dangers of vaccines. After he left, the number of people getting vaccines declined. 83 people died of measles, many of them children. They were not vaccinated. RFK is not merely a “vaccine skeptic,” he’s an opponent of vaccines.

The Washington Post reported:

Health officials around the world are alarmed over the likely impact of Robert F. Kennedy Jr. — a longtime vaccine skeptic who was tapped for the health secretary role this week — on global health. Experts from Samoa have been particularly vocal in sounding the alarm, citing the destructive impact of Kennedy’s rhetoric on the tiny Polynesian island nation.


Warning that Kennedy will empower the global anti-vaccine movement and may advocate for reduced funding for international agencies, Aiono Prof Alec Ekeroma, the director general of health for Samoa’s Health Ministry told The Washington Post that Kennedy “will be directly responsible for killing thousands of children around the world by allowing preventable infectious diseases to run rampant.”


“I don’t think it’s a legacy that should be associated with the Kennedy name,” Ekeroma said in an email Friday.


Ekeroma recalled a disastrous epidemic in 2019, when measles spread rapidly across the small Pacific Ocean country. Of Samoa’s population of 200,000, more than 5,700 were infected and 83 died, many of them young children. Hospitals were overrun, and the nation declared a state of emergency. To stop the outbreak, Samoa launched a massive vaccination campaign, and unvaccinated families were asked to hang red flags outside their homes.

The island nation already had a lagging measles vaccination rate of only about a third of infants, plummeting from 90 percent in 2013. Health experts attributed that drop in part to a public health scandal in which two nurses improperly mixed the measles vaccine with the wrong liquid, resulting in the deaths of two infants. Both nurses were sentenced to five years in prison, and the vaccination program was temporarily suspended — but the accident also opened the door to a wave of vaccine misinformation, including from Kennedy and his anti-vaccine nonprofit.


Kennedy had visited Samoa only four months before the outbreak and met with anti-vaccine advocates. He later characterized the outbreak in Samoa as “mild.”

Trump put Elon Musk and Vivek Ramaswamy in charge of a “Department of Government Efficiency” and told them to have fun cutting the federal budget. A billionaire and a millionaire who know nothing about government programs will start hacking away.

The Washington Post helpfully assembled a list of programs that are prime targets.

Jacob Bogage wrote:

Trump government efficiency advisers Elon Musk and Vivek Ramaswamy have pledged not to bring a chisel to government spending, but rather “a chainsaw.” The particular approach Ramaswamy has in mind could threaten dozens of programs that tens of millions of Americans rely on each day.


Ramaswamy floated on social media a proposal to eliminate programs that Congress funds but where specific spending authorization has lapsed. That may sound like an easy source of savings, but it would ax veterans’ health-care programs, drug research and development, opioid addiction treatment — even the State Department.


“We can & should save hundreds of billions each year by defunding government programs that Congress no longer authorizes,” Ramaswamy wrote.


The approach from President-elect Donald Trump, Musk and Ramaswamy’s out-of-government “Department of Government Efficiency,” or DOGE, demonstrates a fundamental misunderstanding of Congress and federal spending, experts say.


Though Ramaswamy suggested that programs Congress no longer authorizes are prime targets for cuts, in reality, many programs where Congress has let authorization lapse are covered by funding bills that policy wonks call “self-authorizing.”

In other words, instead of needing two laws — one to approve funding for an agency and another to actually allocate the money — Congress only passes one: the allocation, which intrinsically gives a department authority to spend its funding. It is Congress’s way of making legislative work more efficient, and its legality has been confirmed by numerous government studies.


There is plenty of room for policymakers to uncover and eliminate excess federal spending, experts say, an issue made even more serious by the country’s deteriorating financial health. The national debt is expected to eclipse $36 trillion in the coming days; Trump’s first-term policies accounted for $8.4 trillion of that amount, according to the nonpartisan Committee for a Responsible Federal Budget.


It just might be more difficult than DOGE’s backers suggest.


“It is obviously important for the government to be good stewards of taxpayer dollars. There’s real bipartisan areas where people agree there’s stuff to be done. But what Elon and Vivek and Trump are going for is not that,” said Bobby Kogan, an analyst at the center-left think tank Center for American Progress. “They don’t even get the basics right. They get the size of the budget wrong. They named it after a meme. In no way are they actually taking this seriously.”

Musk and Ramaswamy beg to differ, and have called the DOGE commission the United States’ next Manhattan Project.


“There’s a new sheriff in town. Donald Trump’s the president. He has mandated us for radical, drastic reform of this federal bureaucracy with the learnings of that first term,” Ramaswamy said on Fox News. “And look, Elon and I — Elon is solving major problems of physics. I came from the world of biology. What we’re solving here now is not a natural problem. This is a man-made problem, and when you have a man-made problem, you better darn well have a man-made solution. That’s what we’re bringing to the table.”
Trump transition officials did not immediately return a request for comment.


The programs without separate spending authorization that Ramaswamy would do away with represent more than $516 billion, according to the Congressional Budget Office. The 10 largest make up $380 billion. Here’s a look at what some of those programs do.

Veterans’ health care


A 1996 law set eligibility requirements for military veterans to receive hospital, medical and nursing home care and authorized spending for those services and patient enrollment. That law has not been renewed, but Congress regularly allocates additional Department of Veterans Affairs funding and allows benefits to increase automatically based on inflation. VA provides medical care to more than 9.1 million enrolled veterans, according to the agency.
Drug development and opioid addiction treatment.


Most of this spending relates to the bipartisan 21st Century Cures Act of 2016. That law provided money to the National Institutes of Health and Food and Drug Administration to modernize pharmaceutical research and medical trials. It funded research for cancer cures and state-level grants for opioid addiction and other substance abuse treatment.


State Department


In 2003, Congress passed the Foreign Relations Authorization Act, which set policy priorities and created spending authority for the State Department. That law has not been renewed, but Congress every year since has passed annual funding bills for the department, which Trump has announced he’ll nominate Sen. Marco Rubio (R-Florida) to run.


Housing assistance


President Bill Clinton in 1998 signed the Quality Housing and Work Responsibility Act, which overhauled federal housing assistance policies, including voucher programs and other antipoverty assistance. The Department of Housing and Urban Development and other agencies continue using this law to implement federal housing programs.


Justice Department


In 1994, Congress passed the landmark Violence Against Women Act and has renewed it multiple times since. In 2006, lawmakers packaged a VAWA renewal with authorizing legislation for the Justice Department. As with the State Department, Congress has not approved new authorizing legislation for the Justice Department since, but it has funded the agency — and even authorized hundreds of millions of dollars more for a new FBI headquarters — every year.


Education spending


The 2015 Every Student Succeeds Act delegated power to state and local education officials to set primary and secondary education achievement standards. It gives billions of dollars in federal grant money to state and local education officials to fund schools and school districts. Those standards are still used by the Education Department, even though the legislation has not been reauthorized. Trump has suggested he’d like to eliminate the entire department.


NASA


Stripping funding for NASA, which was last reauthorized in 2017, could spell doom for Musk’s commercial spaceflight firm, SpaceX. The company has contracts worth more than $4 billion — including for return trips to the moon and retiring the International Space Station — linked to programs approved in the 2017 law.
Health-care and student loan programs
What’s known as the Affordable Care Act, or Obamacare, was actually passed in two separate bills in 2010. The Health Care and Education Reconciliation Act represents the second bill, which included some tax revisions and technical changes to the ACA. The law has not been reauthorized since, but the Department of Health and Human Services reported in March that more than 45 million people have health insurance coverage backed by the Affordable Care Act.

The law that made those final tweaks to the ACA also overhauled the Education Department’s student loan program. Where some schools relied on private lenders to issue federally backed loans, with this law, the government itself became the lender. That change has since enabled President Joe Biden to offer student loan debt relief, though many of his most ambitious policies have been blocked by the courts. Student loans are generally funded through mandatory spending — similar to social safety net programs such as Medicare and Social Security — and not subject to annual spending laws.


International security programs


The 1985 International Security and Development Cooperation Act bundled together authorizations for a number of international security programs, including funding and regulations for arms sales to allies, economic aid for developing countries, airport security, anti-narcotics-trafficking policies, the Peace Corps and more. This Reagan-era law continues to be foundational to congressional funding and federal policy.


Head Start


Head Start provides preschool education for children from low-income families. In the 2023 fiscal year, more than 800,000 children enrolled in Head Start programs, according to the National Head Start Association. The program also helped place more than 530,000 parents in jobs, school or job-training programs. It was last authorized in 2007.

The article contains a graphic of programs that are on the chopping block, along with their appropriations. I can’t copy it. If you subscribe to the Washington Post, please open the link and post the graphic in your comment.

https://www.denverpost.com/2024/11/14/jared-polis-rfk-jr-trump-hhs-endorsement-tweet/

Colorado Gov. Jared Polis holds up a copy of Project 2025 as he speaks during the Democratic National Convention Wednesday, Aug. 21, 2024, in Chicago. (AP Photo/J. Scott Applewhite)
Colorado Gov. Jared Polis holds up a copy of Project 2025 as he speaks during the Democratic National Convention Wednesday, Aug. 21, 2024, in Chicago. (AP Photo/J. Scott Applewhite)

Colorado Gov. Jared Polis on Thursday cheered anti-vaccine advocate Robert F. Kennedy Jr.’s nomination to lead the nation’s top public health agency, highlighting the controversial nominee’s stances on “big pharma” and “corporate ag.”

Polis, a Democrat, faced quick pushback on social media after he said he was “excited” by President-elect Donald Trump’s selection, and he posted againan hour later to clarify his thoughts. A spokesman for the governor then further walked back Polis’ support for Kennedy in a statement to The Denver Post.

Trump, a Republican, nominated Kennedy to lead the U.S. Department of Health and Human Services. In the presidential race, Kennedy initially had sought the Democratic nomination, then ran as an independent. A member of the dynastic Kennedy family, he later abandoned his presidential campaign and backed Trump.

Kennedy has pushed a number of public health conspiracies, most prominently around vaccines, and has advocated for other positions that are generally out of the mainstream, such as more availability of unpasteurized milk. He has said he wants to remove fluoride from the American water supply, and when he ran for president, he said he wanted to pause research into pharmaceuticals and infectious diseases for at least eight years.

He has falsely suggested that COVID-19 was “ethnically targeted” to “attack” certain groups and that mass shootings have been caused by prescription drugs, among other debunked conspiracy theories.

Kennedy has adopted some mainstream health positions, such as limiting ultra-processed foods and the use of pesticides in growing crops. Polis, citing specific quotes by Kennedy, focused on those latter views in his first post Thursday afternoon on the social platform X.

“‘In some categories, there are entire departments, like the nutrition department at the (Food and Drug Administration) that are — that have to go, that are not doing their job, they’re not protecting our kids,” Polis quoted Kennedy as saying, then added himself: “YES! The entire nutrition regime is dominated by big corporate ag rather than human health and they do more harm than good.”

Polis — who’d previously criticized Kennedy’s anti-vaccine stances this summer — acknowledged those positions in his posts Thursday but urged his 136,000 X followers to hold off on mocking or disagreeing with Kennedy.

He said Kennedy had “helped us defeat vaccine mandates in Colorado in 2019.” He was referring to a defeated legislative measure that would have made it harder for parents to opt out of vaccine mandates for public schools.

Polis wrote that he hoped Kennedy would make vaccines a matter of choice, not about bans or requirements.

Polis’ comments drew swift backlash. Outgoing state Rep. David Ortiz, a Littleton Democrat, called the governor’s endorsement “pathetic pandering.” Rep. Javier Mabrey, a Denver Democrat, quipped on X: “Yikes.” Shad Murib, the chair of the Colorado Democratic Party, tweeted “Welp” shortly after Polis’ comments, and he subsequently criticized Kennedy’s conspiratorial history in a Thursday evening statement from the party.

Sen. Kyle Mullica, a Thornton Democrat and emergency room nurse, was blunter.

“This is just complete bullshit,” he said in an interview, and then repeated that point for emphasis. 

Mullica rejected Polis’ suggestion that state officials had sought vaccine mandates in the past. He said legislators worked to improve immunization rates through medical exemption reform and through education. Polis previously supported parents’ ability to opt out of vaccinations — drawing support from anti-vaccine advocates — despite the state’s poor rankings for pediatric immunization.

“The biggest thing is — look, science matters, man,” Mullica continued. “And with all the disinformation and misinformation that’s being put out by people like RFK Jr. and the internet, we need leaders who can stand up, follow the science, understand it and (make) sure we are making decisions based on evidence and science.”

Asked why Polis endorsed Kennedy in light of his often-conspiratorial stances, a spokesman for the governor responded by referring to a subsequent Polis social media post. The spokesman, Eric Maruyama, then issued a statement distancing the governor from the controversial figure he had just backed.

Maruyama wrote that Polis “does not endorse actions that would lead to measles outbreaks and opposes unscientific propaganda.”

“Governor Polis has not changed his view as a whole on RFK Jr. or on the Governor’s previously stated concerns regarding some of  RFK Jr’s positions,” Maruyama wrote. “While opposed to RFK’s positions on a host of issues, including vaccines and banning fluoridation, (Polis) would appreciate seeing action on pesticides and efforts to lower prescription drug costs and if Trump is going to nominate someone like him then let them also take on soda, processed food, pesticides and heavy metals contamination.”

Trump knows that there is a strong possibility that some of his nominees for his Cabinet are so unqualified that they may not be approved by the Republican majority of the Senate. The Senate typically advises and gives its consent to high-level appointments. But Trump is trying to exercise a relatively obscure provision of the Constitution to bypass the Senate.

Since we know that Trump never read the Constitution, it’s certain that one of his creative lawyers planted the idea.

Trump’s selection of Matt Gaetz, who faces allegations of sex-trafficking minors and drug abuse, as Attorney General, produced shock and disbelief among some Republicans. So has Tulsi Gabbard, whom Trump would elevate to the highest position in the American intelligence community. So has Robert Kennedy Jr., the anti-vaccine advocate, to head the Department of Health and Human Services. Medical and scientific experts are appalled. So has Trump’s choice of Pete Hegseth, FOX talk show host, to lead the department of Defense.

But Trump could give them “recess appointments” and have no scrutiny or review by Senators. And avoid the risk that some or all might be rejected.

We know that Trump doesn’t care about norms, traditions or laws that constrain his power. If the Senate abandoned its role to please Trump, he would be empowered to trample the rule of law at every turn. That is most definitely a threat to our democracy.

Senate Majority Leader John Thune says “all options are on the table,” and has neither accepted or refuted the scheme.

Edward Whelan, a prominent conservative lawyer, criticized Trump’s devious route in this op-ed in The Washington Post.

He wrote:

President-elect Donald Trump is threatening to turn the Constitution’s appointment process for Cabinet officers on its head. If what I’m hearing through the conservative legal grapevine is correct, he might resort to a cockamamie scheme that would require House Speaker Mike Johnson (R-Louisiana) to play a critical role. Johnson can and should immediately put an end to this scheme.

The Senate’s power to approve or reject a president’s nominees for Cabinet positions is a fundamental feature of the Constitution’s system of checks and balances. As Alexander Hamilton explained in the Federalist Papers, that power “would tend greatly to prevent the appointment of unfit characters,” including those “who had no other merit than that … of possessing the necessary insignificance and pliancy to render them the obsequious instruments of [the president’s] pleasure.” Almost as if Hamilton were describing Matt Gaetz, Trump’s pick for attorney general.

To be sure, the Constitution also provides a backup provision that allows the president to make recess appointments — “to fill up all Vacancies that may happen during the Recess of the Senate.” But as Hamilton put it, this “auxiliary method of appointment” is “nothing more than a supplement” to the “general mode of appointing officers of the United States” and is to used “in cases to which the general method was inadequate.”

It appears that the Trump team is working on a scheme to allow Trump to recess-appoint his Cabinet officers. This scheme would exploit an obscure and never-before-used provision of the Constitution (part of Article II, Section 3) stating that “in Case of Disagreement” between the houses of Congress, “with Respect to the Time of Adjournment,” the president “may adjourn them to such Time as he shall think proper.”

Under this scheme, it appears that the House would adopt a concurrent resolution that provided for the adjournment of both the House and the Senate. If the Senate didn’t adopt the resolution, Trump would purport to adjourn both houses for at least 10 days (and perhaps much longer). He would then use the resulting intrasession recess to appoint Gaetz and other Cabinet nominees.

Ten years ago, Supreme Court Justice Antonin Scalia labeled the president’s recess-appointment power an “anachronism” because “modern forms of communication and transportation” make the Senate always available to consider nominations. Along with three of his colleagues, Scalia also argued that the president’s power to make recess appointments is limited to intersession recesses and does not apply to the intrasession recess that the Trump scheme would concoct. The justice, who died in 2016, would be aghast at the notion that a president could create an intrasession recess for the purpose of bypassing the Senate approval process for nominations.

Mike Johnson should not be complicit in eviscerating the Senate’s advice-and-consent role. He should promptly make clear that the House will abide by its usual schedule of recesses and will not attempt to engineer a recess of the Senate.

Edward Whelan is a distinguished senior fellow of the Ethics and Public Policy Center, where he holds the Antonin Scalia chair in constitutional studies.