Can RFK add something positive?

An attempt to present a somewhat objective viewpoint on RFK, which is still full of potential clashes with an ever-moving WH strategy and multiple Congressional factions.

Women are the often-unrecognized default Chief Medical Officers for their immediate and extended families and half of the neighborhood. Women Untamed was started to thank you and and to support that role. While there are many issues that immediately impact women’s health, changes made by the Secretary of Health and Human Services (HHS) will impact all of us eventually—if not today, certainly tomorrow.

I have two degrees in nursing. I was raised in traditional healthcare and I wouldn’t consider not being vaccinated—pretty much the same way I wouldn’t consider strolling into a gunfight on the belief that God will save bullets from hitting me. But dad was a journalist and editor; objectivity was drummed into me from birth. It’s particularly easy to fall into ranting about RKF. There’s so much on record that’s cringe-worthy, from adolescent stunts when he was 60 to claims Lyme disease was developed by the military as a bioweapon and the initial H1N1 outbreak in 2006 never happened.

Many very smart, well-respected people have done everything they could to alert Congress and the country to the dangers of approving inexperienced Cabinet members. With outright control of two branches of government (arguably three), so far Republicans in office have shown absolutely no inclination to not back their president. RFK was almost certainly getting approved, particularly after Congress pushed back early and hard on Gaetz.

It’s important to think ahead now, as we’re going to need a lot more energy later. If you follow Generations theory, someone like Trump getting elected in 2024 was predictable: America was looking for “strong leadership.”¹ In our current Fourth Turning chaos, the election was the second phase of the Turning. What comes next is a lot uglier. We’ll need every voice and far more action for that.

Are we screaming from inside a glass house?

Besides, not many would say US healthcare is working well. We rank 10th out of 10 peer nations in healthcare system performance while spending 50% more than peer nations with much better outcomes. Or you could skip the data and look at the shooting of the CEO of the largest US health insurance company—a company that had reportedly owned a claims denial rate of over 30%, nearly twice as high as the nearest competitor, at a time Americans are paying more for healthcare than ever before. [UHC investors are now asking about delays and denials. Fear of being shot apparently outweighs lower ROI.]

And that’s at the macro level. That doesn’t get anywhere near issues like why millions of Americans—myself included—relied on something we can’t even pronounce, Oscillococcinum, to work better than a crucifix and holy water at warding off the COVID vampires. American medicine, of course, doesn’t believe in that; never mind the billions of doses that continue to be grabbed off the shelves at CVS and Walgreens. For four years, I flew all over the US gripping my N95s and Oscillococcinum. I never got diagnosed with COVID while everyone around me did. Try convincing me the O stuff didn’t work, even if I still can’t say it.

Various sources are able to describe, or at least sound enlightened about, WH strategy. But we’ve been here before. We know that one thing that delights half of America while simultaneously appalling the other half is what I call the ‘idea of the morning,’ which I imagine originates early in the Residence master bathroom and often tweeted (X’d?) right then…the new great idea that dominates all conversations for the day no matter the original agenda and throws yesterday’s strategy out the window, sometimes for a day and occasionally for eternity.

Is it possible for RFK to actually make positive changes? To not do too much damage? Will he beat Musk to join Vance under the bus?

[Current standings in the race to be thrown under the bus: JD Vance is in first place.]

RFK has a million ideas. Like his boss, RFKs ideas right now seem all over the place—anywhere but on an issue increasingly worrying many of us, what Bloomberg says is the “lethal spread” of the H1N1 bird flu that Bloomberg also calls a big threat we need to act on. (Bloomberg’s opinion is important here; financial news outweighs science expertise in the current era.) During hearings two weeks ago, Kennedy said he would support development of a bird flu vaccine; he quickly changed that to his standard that he’d “have to see the science.” Silence on H1N1 since.

It’s important to note Kennedy is just this week’s brand-new-no-training-never-done-this-before Cabinet member to be approved in the middle of a four-alarm fire. Whether it’s Treasury (DOGE), State (Greenland, Ukraine, Canada, Panama, etc.), VA (getting rid of 1000 employees in already-understaffed vet health care), USDA (bird flu), or Transportation (multiple plane crashes), RFK and the other secretaries are going to be very, very busy, particularly as DOGE simultaneously paints targets on their staff. And in echoes of December 2019, we’re not seeing any indication yet that the WH is concerned about bird flu—so be thankful Bloomberg is.

HHS has 90,000 employees, including many scientists who are more than slightly skeptical of RFK. Its 13 agencies include huge ones that determine virtually everything that happens to us in in healthcare, like the NIH, CDC, FDA and CMS. That’s not a quickly-turned ship. Depending on how the poll winds are blowing, voiced WH strategies can change overnight. There’s a lot of daylight between many of RFK’s well-documented prior positions and those of his boss and/or Congress.

In an effort to consider the idea that RFK could add something positive in the long run, I searched for and uncovered two relatively objective stories, one from Kiplinger and another from Time.² Here’s what they think; I’ve added some of my own commentary and would really like to hear yours—just comment below.

Kiplinger focused on impact on seniors and thinks Kennedy

• Will stay away from major changes to Medicare, and possibly “better integrate” dual eligibles. What happens with Medicare Advantage—of which RFK was a member—is uncertain; it’s popular but more costly than traditional Medicare. Trump has said he won’t touch Medicare. However, the hard right contingent in the House is focused on cutting costs, and Medicare and Medicaid are in both their sites. The battle between saving our young or our elders may well show up in this administration.

• Not change Medicare vaccine coverage for now…but given his prior statements on vaccines, in the long run that could change. There’s no better way to discourage vaccination than to stop paying for it.

• Will continue to push his goals of drug reform, including lower prices. However, the first place RFK will have trouble with that is Trump’s support of Big Pharma. The day he took office, Trump revoked Biden’s EA authorization of Medicare to negotiate more drug prices like the 2024 reduction in insulin costs, and Big Pharma put $16M into the Republican cause last cycle.

Time safely defaulted to a recap of Fox News host Laura Ingraham’s interview of RFK post-confirmation. In that interview, Kennedy

• Said he wants to focus on “diseases of isolation” at the same time as everything else. That’s going to be a longer sell than dealing with bird flu; most Americans haven’t yet clearly identified isolation as an issue, even though the data clearly indicates it is. And those who have may not understand what is has to do with RFK and HHS. When Biden’s Surgeon General took a swing at it last fall, it fell flat.

• Said he won’t “take away anyone’s Twinkies,” but does want to target food stamps and school lunches for less ultra-processed foods and sugar. Hard to argue with that—at least until we see the details.

• Said he wouldn’t “take away people’s vaccines.” However, he wants to “make people more aware of side effects,” which many scientists believe is code for discouraging use, and not the traditional public health perspective of “protect thy immune-compromised neighbor.” Worse, when Ingraham asked him if he thought the COVID vaccines were safe, Kennedy’s response was, “We don’t have good data on it. And that is a crime.” So far, that means he just doesn’t agree with the data.

• Agreed he has a list of staff he will get rid of, particularly those who have made “bad decisions”—in other words, those who don’t share his definition of good science.

• Danced when asked about marijuana and abortion. He’s on record against high incarceration rates of low level marijuana offenders—further than Republicans have been willing to go—and his lifetime views on abortion couldn’t be further from the current Republican stance. For now, he says he’ll follow Trump’s lead on abortion, to default to the states—politically safe at the federal level.

Words of wisdom on navigating through the storm

Katelyn Jetelina, PhD is an internationally-recognized and -followed epidemiologist who speaks science in a way everyone can understand. In her new post on RFK, she has great tips for navigating the storm:

1. Recognize top-down doesn’t work anymore with science.

2. Meet people where they are.

3. Tell stories…to which I’d add that often in my own career, I’ve seen stories in focus groups result in health system policy changes overnight with huge surveys could create change.

4. Recognize trust isn’t declared—it’s demonstrated.

5. Don’t turn anger into shaming others.

6. Keep telling the truth.

Bus watch

Finally, back to the bus. Nothing bad that happens is ever the fault of RFK’s boss, and most bad results are defined by rapidly changing public opinion. Including abortion, there are multiple potential issues for RFK that could fit into that ‘bad’ category, but the biggest one is management of bird flu. If it goes away, Kennedy and everyone around him will breathe a huge sigh of relief. If it blows up, the space under the bus will get crowded; although the secretary of agriculture might provide some temporary cover. If we’re placing bets, I suspect Kennedy is probably still ahead of Musk on seeing the undercarriage of the bus; Musk has a lot more money.

What do you think will happen next? Comment below!

1. Phases of Fourth Turnings (see sources at bottom of slide)

2. MediaBiasFactCheck.com rates Kiplinger as highly factual and least biased, and rates Time as highly factual with a left-center lean.