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Tuesday, October 29, 2024

'Could RFK Jr. Really Become HHS Secretary?'

Former president Donald Trump's rhetoric during his rally at Madison Square Garden last weekend about letting Robert F. Kennedy Jr. "go wildopens in a new tab or window" on health, medicine, and food may be more than just bluster.

Indeed, several news organizations -- including the Wall Street Journalopens in a new tab or window (WSJ) and Politicoopens in a new tab or window -- have reported that Kennedy will be considered for a role in any future Trump administration.

That includes the role of secretary of the Department of Health and Human Services (HHS), WSJ reported.

"Trump has committed to considering Kennedy for any job in his administration, a person familiar with the matter said, including Health and Human Services Secretary," according to WSJ. "The post oversees more than 80,000 federal employees, a budget that tops $3 trillion, and a swath of federal policy."

Kennedy has made no secret of his disdain for the agencies under the HHS Secretary's purview. In a videoopens in a new tab or window for the Make America Health Again (MAHA) initiative that he leads, Kennedy said his "big priority will be to clean up the public health agencies like CDC, NIH, FDA and U.S. Department of Agriculture."

"Those agencies have become sock puppets for the industries they're supposed to regulate," Kennedy said in the video. "President Trump and I are going to replace the corrupt industry-captured officials with honest public servants."

Late last week, Kennedy lashed out at the FDA in a post on Xopens in a new tab or window: "FDA's war on public health is about to end. This includes its aggressive suppression of psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunshine, exercise, nutraceuticals and anything else that advances human health and can't be patented by Pharma. If you work for the FDA and are part of this corrupt system, I have two messages for you: 1. Preserve your records, and 2. Pack your bags."

So, how likely is it that Kennedy would be nominated for HHS secretary, and be able to carry out his plans to dismantle the nation's premier health agencies?

Health Policy vs Health Behavior

Think-tank experts interviewed by MedPage Today essentially said it was unlikely Kennedy would pull off that kind of demolition job, but that they also said they've come to expect the unexpected from a Trump administration.

Peter Nelson, JD, senior policy fellow at the Center of the American Experiment who worked within the first Trump administration, told MedPage Today that the team was "willing to go against the special interests. The status quo was not something we were concerned with protecting under the prior administration."

But Nelson questioned whether Kennedy would even want the job of HHS secretary, since it "involves a lot of work on the ins and outs of federal Medicare and Medicaid policy."

He pointed out that Kennedy is more interested in health behaviors.

"There's a lot of discussion missing in that area," Nelson said. "We do have health issues in America that are very much tied to a lack of healthy behaviors. To the extent that someone can step into a leadership position in [Washington] and move the needle on America's health behaviors, that would be an incredibly positive thing. I can see him doing that in a way other people couldn't."

He noted, however, that advocacy would have to happen "alongside all these other more procedural things that are constantly needing attention. There's a lot of rulemaking at HHS and it's a big job for anybody to oversee all of it."

Joseph Antos, PhD, of the American Enterprise Institute, told MedPage Today that Kennedy might fit better in a role like the special advisor to the secretary.

"You'll have several layers between him and the president," Antos said. "It'll be a nice position; he'll have a nice office. He'll be able to release press statements, give talks, and it really won't affect the operation of the government very much."

"Having somebody as an official scold on healthcare wouldn't be a terrible idea for the public," Antos added.

Rodney Whitlock, PhD, a vice president at McDermott+ Consulting, said that while Kennedy becoming HHS secretary isn't impossible, people who have worked in Washington for a long time may be more comfortable with a known entity, like former Louisiana Gov. Bobby Jindal.

"People look at Jindal and say, 'I can work for him, I know who he is, what he's worked on,'" Whitlock told MedPage Today. "I'm not certain if folks would look at RFK [Jr. and say the same]."

Whitlock added that the Trump administration could have a string of consultants who can act as "czars" of various initiatives, as Elon Musk has been floated as an "efficiency czar" under Trump.

"RFK might realize there's a lot of stuff you have to do as HHS secretary that isn't any fun," Whitlock added. "[He] wants to do the stuff he likes. Is that ultimately the type of role he's looking for? I don't think healthcare is the only area you might see that happen."

'Tread Very Carefully'

Physicians and healthcare professionals, on the other hand, haven't warmed to the idea of Kennedy being in a healthcare leadership position.

Trump's former Surgeon General Jerome Adams, MD, MPH, said during the American Public Health Association meetingopens in a new tab or window in Minneapolis earlier this week that having Kennedy in healthcare leadership would "further erode people's willingness to get up to date with recommended vaccines, and I am worried about the impact that could have on our nation's health, on our nation's economy, on our global security."

"I would advise Republicans to tread very carefully in this world of allowing vaccine confidence to continue to be eroded and for us to go backwards on one of the number one public health achievements made in the last 50 to 75 years in this country," Adams said.

Paul Offit, MD, director of the Vaccine Education Center at the Children's Hospital of Philadelphia, told The Hillopens in a new tab or window that "[S]omeone who thinks like that, who just has these beliefs that are immutable no matter how much evidence is against them, is not the kind of person you want in a position of authority."

Michigan oncologist David Gorski, MD, PhD, wrote on his blog Science Based Medicineopens in a new tab or window, that Kennedy's tirade against the FDA was hypocritical.

"A lot of what is in RFK Jr.'s list is not 'natural,'" Gorski wrote. "Certainly extracting and isolating stem cells and injecting them into the bloodstream is not 'natural,' nor are chelation therapy and hyperbaric oxygen -- and especially ivermectin, hydroxychloroquine, peptides, and psychedelics, all of which are manufactured drugs."

"What 'health freedom' really wants is the freedom for quacks to ply their grift without interference from the government," Gorski wrote.

https://www.medpagetoday.com/special-reports/exclusives/112639

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