The recently installed leadership of the various agencies within the Department of Health & Human Services (DHHS) is surrounded by very powerful forces seeking to derail virtually everything that the Trump administration has charged them with accomplishing. The usual suspects are well known, and consist of powerful cartels that include Big Pharma, Big Food/Agriculture, Big Chemical, Big Media, and Big Tech/Data.
Less well known are the inputs by public health professionals, healthcare providers, and the organizations that claim to represent them. As I will describe, this has caused a level of chaos and confusion within the general population that will only serve to further erode the level of trust in the medical profession, as if its reputation hasn’t taken enough of a hit over the past five years!
I am of the belief that the Covid response disaster of the past five years, which I strongly suggested could legitimately be called a Holocaust in my previous Brownstone post, has revealed a number of other problems in healthcare that need to be examined and overhauled. I believe that the new leadership of the various agencies within DHHS is asking the right questions, and each of them has the will and the expertise to obtain answers.
Given this state of confusion, you’d think that public health professionals, healthcare providers, and the organizations representing them would be fully onboard with the new DHHS initiatives. Sorry to say, but you’d be dead wrong! These groups have sought to derail these efforts as vigorously as the cartels.
My years of work in public health, most prominently as a 10-year member of the NYS Dept of Health AIDS Institute Quality Advisory Committee from 2008-18, and my 19 years of rural primary care medical practice as a Board Certified internist from 1980-99 has provided me with the requisite training, knowledge, and experience to provide a roadmap as to how this destructive state of affairs came to be.
Let’s begin with the public health agencies that fall under the umbrella of DHHS. They were responsible for issuing guidance, directives, and mandates throughout the 5-year Covid pandemic response. Despite the fact that much of what these agencies did is generally known to have been based on cherry-picked or fraudulent data, and outright lies, many public health professionals still defend these actions. Here’s my take on how that happened.
The largest public health organization in the country is the American Public Health Association (APHA), of which I was a member from 2005-21. For all of those years, I was affiliated with the Alcohol, Tobacco and Other Drugs (ATOD) Section, and I gave a number of oral and poster presentations of research done at the institution where I was employed. From 2011-21, I was a member of the ATOD Program Committee, and I was charged with making sure that all ATOD oral presentations were approved for continuing education credit.
While the ATOD Section was one of the larger sections within APHA, it seemed like it was an orphan. That’s because our section provided solid research documenting the health risks of substance use and abuse, yet most of the other sections, when given the opportunity, were solidly in favor of legalizing virtually all drugs.
There were other areas where I personally felt like I was living in another dimension. This extended to their journal, the American Journal of Public Health (AJPH), a well-respected peer-reviewed publication. For example, Dr Fauci was treated like a rock star, and was a frequent contributor of articles. Need I say more?
Eventually, the situation became so untenable that I decided to leave APHA in 2021, and resigned from the ATOD Program Committee. Here is the letter (only slightly edited) that I sent to the Program Committee leadership:
October 29, 2021
Now that the 2021 APHA Annual Meeting & Expo has ended, I will be stepping down from the ATOD Program Planning Committee.
While I will no longer be actively involved in any of the month-to-month and day-to-day work of the Program Planning Committee (including abstract reviews, abstract selection, and compiling session offerings); I’ll continue to be available to answer any questions you or other members of the team may have. I believe that you have a team that is fully capable of carrying-on the work, such that the goals of ATOD for the annual meeting (compiling high quality oral and poster sessions, and obtaining CEUs for oral presentations) will continue to be met.
My decision to step down is not due to any issues with the ATOD section, but rather with the direction of APHA in general. I’ve stated any number of times on our Zoom calls that ATOD has consistently allowed the research science to guide the political science (which is how it should be), while I’ve known for a long time of APHA’s overall left-wing bias, where, too often, political science is controlling. However, since the Biden administration assumed power; I feel that the association has become nothing but a Marxist PAC that does public health almost as an afterthought. This became most obvious when reading the COVID-related articles in AJPH. As someone with experience in direct patient care (as a Board Certified internist who provided rural primary care for 19+ years), public health (including the advisory committee of the NYS Dept of Health AIDS Institute), and clinical research; I believe I’m well qualified to know garbage when I see it. As a result, I let my APHA membership lapse.
The pandemic has also highlighted how the pharmaceutical industry has engaged in activities that are similar to the activities of the tobacco and alcohol industries that ATOD has correctly called out. Unfortunately, in the case of the pharmaceutical industry, APHA, along with other public health agencies, has shifted its stance towards the pharmaceutical industry like a weathervane, depending on the prevailing political agenda.
I raise the foregoing issues, not out of any animus or feelings of being slighted. As a right-leaning (to say the least) conservative, I’m used to being a member of what I’ll describe as an “exclusive club” within the academic community. The reason I raise these issues is because I believe the Other Drugs members of ATOD are facing, and will continue to face, a challenge that the leadership of APHA will not touch. With the de facto open border policy that is in place in the US, the amount of fentanyl entering the country has increased to where there’s enough to kill every man, woman, and child. While drug overdose deaths decreased for the first time in at least 20 years during the 2018-19 timeframe, overdose deaths have once again increased to record levels, largely due to the influx of fentanyl. Given my belief that the APHA leadership supports having an open border, and is in favor of decriminalizing and eventually legalizing just about everything; efforts by ATOD to develop policies to address this matter in any meaningful way will hit a brick wall. In good conscience, I can’t support an association (APHA) that is of that mindset, as it is contrary to my entire work effort over the past 20 years. Further, as a grandfather of 4; these issues take on even greater urgency.
Apologies for the length of this communication, but I believe I bring a perspective that you probably have not heard, but is worth looking at going forward.
Thank you for the privilege of being able to serve the ATOD section for the past dozen years.
Sincerely,
Steve
Steven Kritz, MD
I received responses the same day from two members of the ATOD Program Committee leadership, both of whom had previously been Program Committee chairpersons. Here’s the first response (again, only slightly edited):
October 29, 2021
Hey Steve
The email makes me a bit sad, but it is clear that you have given this a bunch of thought.
I want to begin by saying that your participation in the section has been an enormous contribution.
I want to thank you for saying the kind words about the section. I think that you are right—I think that the section has tried to pursue the science……we have not always gotten it right, but we have tried.
I know that we occupy different places on the political spectrum, but you have always been deeply respectful, collegial and funny. You should know that your assistance with the opioid section of the program this past spring was a tremendous help. For reasons that I won’t get into, my bandwidth was not what it usually is and I needed the help.
Steve- thanks very much. I have learned a ton from you over these many years that we have worked together and your commitment to quality sessions and a robust section has set a very high bar. I am deeply grateful.
Here’s the second response (unedited):
Steve, On behalf of the ATOD Section and from me personally, I want to thank you for all that you’ve done over the years. Your dedication and depth of knowledge has been such an asset. You’re one of the reasons that we’ve consistently presented such a strong scientific program.
I appreciate you sharing your thoughts about APHA and your willingness to answer any questions from the program committee if they come up.
I wish you all the best. Thanks again for everything you’ve done for the ATOD Section.
From the foregoing, it should not be surprising that APHA has vigorously opposed everything that RFK, Jr. and his agency heads are trying to do. Not a week goes by that Georges Benjamin, MD, who has been Executive Director of APHA since 2002, doesn’t issue a press release warning of the deadly consequences of the work of DHHS. The recent removal of the entire FDA Advisory Committee was especially irksome to Dr Benjamin.
Let me now turn to the healthcare providers, who appear to be ignoring the current activities of DHHS. I’ll begin by stating that it looks like the worst damage from ObamaCare was that it forced virtually all practicing physicians in the country to become employees of huge healthcare organizations, with resultant loss of autonomy. I’ve come to believe that this was the government’s plan from the beginning. In other words, physicians in this country have been castrated. They do what their employers tell them to do!
For more than a decade, I have been a regular reader of the American Journal of Medicine (AJM, AKA, The Green Journal), a well-known (at least among internists) peer-reviewed publication that is now totally online. Most articles are freely available without a subscription. In the July 2025 issue that was posted in mid-June, I read three consecutively placed articles in the Commentary section that were the true impetus for writing this article.
The first article is entitled, Make America Healthy Again as a Clinical Practice Guideline: Let the Recommendation Classification System Speak for Itself.
Here’s the first paragraph:
Something disconcerting is happening to health care and the way scientific evidence is used to guide treatment decisions in the United States (US)—the same can be said for the approach to public health. Historically, data from rigorously conducted studies, collectively forming a scientific evidence base, has been used as the primary driver for clinical decision-making and public health policy. This apolitical approach has been extremely effective in advancing medicine and public health, improving both quality of care and outcomes. It seems we have begun to deviate from a model driven by an evidence base founded on scientific inquiry. Specifically, we have entered an era of unprecedented scientific politization. It appears this new era was ushered in during the coronavirus disease 2019 (COVID-19) pandemic, where vaccine hesitancy was driven by unfounded, politically driven information that was contrary to the scientific evidence supporting vaccine safety and efficacy. This, unfortunately, led to higher COVID-19 mortality rates in US regions with lower vaccination rates, where politically motivated vaccine hesitancy was an important factor. While the US and the rest of the world have moved past the COVID-19 pandemic, the politization of science appears to have persisted, creating a new threat to medicine and public health.
The rest of this Commentary goes on to defend the development of clinical practice guidelines over the past 50 years. I’ll just paraphrase the second half of the title of this Commentary, and what any decent plaintiff attorney used to say during malpractice trials where a surgeon left a foreign object in a patient’s abdomen: Res ipsa loquitor, which means that the thing speaks for itself!
I’ll move on to the next Commentary, Turning Fate into Choice: Patient Self-Determination and Life Extension, which promotes scientific efforts to preserve life for those wishing to do so, and laments that this type of medical research is not being pursued more vigorously. Given what we have experienced with the fallout from gain-of-function research over the past several years, this Commentary seemed absolutely ghoulish. I’ll also point out that one of the authors is from Australia, where enforcement of lockdowns, social distancing, and mask mandates during the Covid pandemic were as draconian as anywhere in the world, with the possible exception of China! If this author was living in Australia during the height of the Covid pandemic, I’m willing to cut him some slack, given the toll that the country’s concentration camp environment took on everyone’s psyche.
The third and final Commentary is entitled, Los Angeles Wildfires: Getting to the Heart of It, which was co-authored by the Editor-in-Chief of AJM, a physician with whom I’ve had very pleasant email interactions over the past five years…except when I challenged an article written in January of 2022 extolling the virtues of the original Covid response, and the need to maintain those interventions. Things got a bit testy, but I decided it was better not to push too hard, so I backed off!
Here’s the first paragraph of the Commentary:
The January 2025 Los Angeles wildfires resulted in unprecedented destruction, burning nearly 60,000 acres, leveling entire neighborhoods, and claiming 29 lives. These events serve as a stark illustration of global climate change, highlighting the escalating frequency, intensity, and duration of wildfires in many regions worldwide.
The article then goes on to talk in a scholarly way about the adverse cardiac consequences of breathing in particulate matter generated by wildfires. Had the authors stuck to the healthcare issues, it would have been of value, but apparently, they couldn’t help themselves and had to enter the world of climate science, of which they clearly know very little, if anything. I guess that forest management is beyond their scope of knowledge as well, since it’s never mentioned!
In sum, public health professionals and healthcare providers in the US have been bought and paid for, and have become too willing to follow whatever shiny objects their professional organizations or paymasters place before them without question. Is it any wonder that the efforts of the new DHHS regime have been met with such fierce backlash? Going forward, those of us who recognize what’s being done need to continue supporting DHHS so that the professionals within the various agencies can put their heads down and plow ahead.
Steven Kritz, MD is a retired physician, who has been in the healthcare field for 50 years. He graduated from SUNY Downstate Medical School and completed IM Residency at Kings County Hospital. This was followed by almost 40 years of healthcare experience, including 19 years of direct patient care in a rural setting as a Board Certified Internist; 17 years of clinical research at a private-not-for-profit healthcare agency; and over 35 years of involvement in public health, and health systems infrastructure and administration activities. He retired 5 years ago, and became a member of the Institutional Review Board (IRB) at the agency where he had done clinical research, where he has been IRB Chair for the past 3 years.
https://brownstone.org/articles/public-health-professionals-and-healthcare-providers-vs-dhhs/
