RIP Health

With the new Trump administration there has been a flurry of activity that does not bode well for healthcare. Not all these things may come to pass, but I’ll comment on some of them.

Federal scientific meetings were cancelled, and federal health officials were told to refrain from all public communications, including publications and speaking engagements, until approved by a presidential appointee or designee. It includes email lists and social media posts. It prevented the C.D.C from publishing the Morbidity and Mortality Weekly Report on 1/23/25, that was to include information on the spreading bird flu affecting poultry and cows, as well has humans. It prevented meeting, such as advisory committees on health issues, and funding for research at the National Institute of Health (NIH). Scientific and medical information should be managed by scientists and medical professionals, not politicians. That didn’t work out well at the beginning of the COVID-19 pandemic, when political messaging took precedence, and advice was rendered that led some infected patients to drink bleach. That lesson doesn’t seem to have been learned.

There was a haphazardly announced (and probably illegal) federal funding freeze that at least temporarily (until parts were rescinded or blocked by a judge) affected such things as Medicaid, funding for doctors and nurses at Veteran’s Administration (VA) hospitals hired to start in February (some who had already moved their families), VA suicide prevention lines, disaster relief to places such as Los Angeles (fires) and North Carolina (floods), and medical research.

Robert F. Kennedy Jr. has been nominated to be the Secretary of Health and Human Services. Although he has some views about food that I might agree with, there are many reasons he is completely unsuitable for the job. Over the years he has repeatedly questioned the safety of vaccines, including measles and polio. These are devastating illnesses that we rarely see nowadays, thanks to vaccines. At a talk in November he said 48% of (American) teens are diabetic. It’s less than 1% at that age. He also seemed to mix up pre-diabetes, which is brought on by diet, with juvenile (Type 1) diabetes, that is not. He falsely said that the flu shot does not prevent hospitalizations and that it increases the risk of spreading it to others. He falsely said the pertussis vaccine (part of Tdap) causes brain injury.

Two days ago the administration ordered health organizations in other countries to stop distributing HIV medications purchased with U.S. aid. This was part of a freeze in PEPFAR overseen by the State Department. This program has been estimated to have saved 25 million lives worldwide. Besides the importance of being a good global citizen, it indirectly benefits U.S. citizens. The less cases in the world, the less likely Americans will get infected one way or the other. If patients go off HIV medications temporarily, it increases the risk they will develop drug resistant HIV, which could then spread worldwide. Providing such a benefit is soft diplomacy that buys good will and decreases the chances that other countries that are not friendly to us will be able to influence them. When countries do poorly, they are also more like to develop terrorists. Yesterday the administration at least temporarily allowed the distribution to resume.

There have been a number of initiatives that adversely affect transgender people, including healthcare.

Did I leave anything out? That’s just a little over the first week!