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Thursday, November 7, 2024

What a Trump presidency can mean for health care

 by Vinay Prasad

Trump has won a decisive victory and most Americans think the country is on the wrong track. RFK Jr and Casey and Calley Means have been called in to help advise Trump about health care. While some have expressed concern about past statements by Mr. Kennedy, there are several avenues of reform that I believe everyone can agree with.

  1. Conflict of interest has to go. One reason the American health care system is so broken is doctors take money from Pharma, FDA officials go to work for Pharma, Big agriculture lobbies congress.

Rules limiting the revolving door. An expansion of the Sunshine act to include prohibitions against taking pharma money and serving on FDA committees or working for compendia would be great ideas.

  1. The CDC is an abject failure. The agency— to this day— says that 2 year olds need to wear masks, and that babies need covid boosters. These recommendations lack randomized data and are wrong. The CDC should be split into 2 agencies. One in charge of tracking statistics, and the other with a policy advisory role. The agency needs to lose ~10000 employees, as it is bloated and needing a hair cut.

  2. The NIH is a failure. It has never tested how to give grant money. We have no idea if the current system is better than modified lottery or other proposal. It has no interest in data transparency, publishing in timely fashion, and reproducibility. The agency also needs a hair cut, and a leader who understands these concerns.

  3. The FDA is a failure. It rubber stamps too many useless products. It needs to either remove itself from the picture, or demand randomized trials measuring appropriate endpoints.

  4. CMS should stop paying for things that don’t work. 5% of the CMS budget should be to run randomized trials to identify interventions that don’t work.

  5. Children’s nutrition. RFK Jr is correct. Children are served dog food in school. They need to be be served good, nutritious food ala Japan and France.

  6. Processed food. I tend to agree that America eats too much processed food, and merely removing subsidies could change these habits. The Means discuss this well.

  7. Repeal vaccine indemnification. Alex Berenson is 100% right here

  1. Fire Peter Marks at FDA. He was responsible for the departure of Gruber and Krause and has displayed a reckless attitude to drug regulation. He is actively trying to lower the bar for gene therapy.

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