It’s not physicians that are running public health. Maybe I have a vested interest in making that statement, but it’s true.
It’s the master of public health awardees who are running public health. An MPH is a two-year degree which does not require you to have any prior training in health, in biology, or in medicine. It’s primarily focused on the use of big data and statistical analysis, often to optimize single variables, which is consistent with the idea that we have narrow—I would use the term siloed—sectors within the federal bureaucracy.
These bureaucratic structures tend to drive toward optimization of those parameters that they believe are within their domain to the exclusion of impacts on other domains and other parameters. As a matter of fact, this is one of the big challenges in bureaucracy. They’re often fighting over the boundaries between their silo and adjacent silos, and who has the right to control those boundaries and how those resources are allocated across those silos.
The practice of medicine has a centuries-long history of rejecting and ridiculing innovators and dissenters. It’s no surprise that all of this follows a narrative that we have seen played out over the centuries, where physicians, who are taught to assimilate a set of truths without question, and to implement and regurgitate those truths, are extremely resistant to change. They view change as heresy. In many ways, what we have in modern public health and medicine more closely resembles a religion than it resembles anything that we might call science. In our books, we refer to this as scientism, and we assert that scientism has been substituted for religion in modern political action and thought. So, this religion of belief in a set of endorsed scientific truths, or pseudoscientific truths, is scientism, and it has a high priesthood.
MAHA and MAGA
Now I’d like to talk and specifically focus on this new dialectic that exists between Make America Healthy Again (MAHA) as a movement and Make America Great Again (MAGA) as a movement.
They’re actually two separate things, and they have different constituencies and different drivers. In many ways, they resolve into proregulatory big government initiatives versus promotion of deregulation and small government. In theory, Make America Great Again is more aligned with libertarian principles. Make America Healthy Again, in my opinion, is much more aligned with big government and regulation.
Within that, we can discern some real tensions that are playing out in real time, and will continue to play out over the next four years. And I can’t predict what the outcome is going to be.
It’s worth noting that the MAHA movement exists outside of Robert F. Kennedy Jr. and the government, and encompasses many societal issues outside of the focus of the Trump administration. For example, homesteading, medical and personal sovereignty, and personal responsibility for healthcare choices. These may all be outside of the MAHA whole-of-government approach. Remember, this is a presidential directive now, the MAHA Commission. It has specific objectives, goals, requirements, and deliverables that are separate from MAHA as a movement.
For this discussion, I’m primarily concerned with the MAHA directives within the government, but MAHA is much bigger than that. I just want to make that key point: it’s bigger than Robert F. Kennedy Jr. It’s been going on for years. And in many ways, it was Calley and Casey Means, through a series of interviews, including, I think, four hits on Tucker and one on Rogan, that really brought this to the fore. In their logic, for example, Big Food and Big Ag have been contaminated with the money from Philip Morris that was required to be moved out of Big Tobacco and was moved into Big Food. And in Calley and Casey Means’s thesis, Big Food and Big Ag applied the marketing strategies and approach that had characterized Big Tobacco, making for an addicted consumer base, as a great business model. When you see a lot of the activities that are associated with Big Food and Big Ag, it’s hard to escape the underlying truth of that metaphor.
The Origins of MAHA
Now, MAHA as we know it now has emerged mainly from the left out of frustration with the Democratic Party’s corruption and rejection, and it has embraced the center-right.
Bobby wasn’t originally talking about making America healthy again. He assimilated that agenda as it began to build momentum during the election and made it his own. But in so doing, he was coming from the left. Remember, Kennedy’s thesis was that there existed a population of what he called Kennedy Democrats that we could really call New Deal Democrats. They are the Democrat Party of the ’60s—pre-Reagan, pre-Carter, pre-Clinton. Those are the people that Bobby thought would come back to him within the Democratic Party. That thesis failed for a variety of different reasons.
So MAHA has emerged mainly from the left, out of frustration, and has been enthusiastically endorsed by MAGA center-right populists, including many formerly associated with the Tea Party movement, in part because MAHA was rejected by the Left.
Bobby’s inability to gain any traction within the Democratic primaries, where he was locked out, kind of forced him into this position. And at one point, some of you may be aware, there was active outreach to Bobby from the Libertarian Party, which could have enabled Bobby to be on the ballot in all 50 states without having to have this enormous campaign funded by Nicole Shanahan. But Bobby didn’t want to do that. He didn’t want to position himself as a libertarian. In the end, he ran as an independent. That failed.
The arc of the presidential campaign of RFK Jr. closely adheres to this narrative. Bobby started out seeking the Democratic Party nomination representing Kennedy Democrats, but the Democratic Party of today bears little resemblance to that of his father and uncle’s time.
There were the changes in national political thought on both left and right wrought by Carter and Reagan. And then there was the succession of the military-industrial corporatist Bushes, the Clintons, Obama, and Biden on the left, and to no one’s surprise, apparently other than Bobby and his team, today’s Democratic Party makes it abundantly clear that there’s no room for a Kennedy—this Kennedy—in this tent.
So he decided to make a run as an independent. Nicole Shanahan stepped up to bankroll it, and amazingly, they managed to get on the ballot in all 50 states. But it became clear that, once again, an independent run would primarily function as a spoiler. Now I know this because I was very close to the campaign at this point in time and was very aware of all the discussions that were going on. What should Bobby do? What are his options?
The pivotal moment was when RFK Jr. placed a sympathetic phone call to Donald Trump after the assassination attempt, which still reeks of a deep state operation, much like what happened to Bobby’s uncle and father. And Bobby did so in a spectacular manner, with a ringing endorsement, a speech that will live on through the ages. I think many of you have heard and seen this.
So, MAHA originates from the left, but the appeal crosses all party lines. Who does not want to be more healthy? The MAHA mandate from President Trump is to demonstrate measurable improvements in the health of US citizens within 12 to 18 months, with a particular focus on chronic disease and children’s health. One aspect of this effort will involve refocusing Health and Human Services on health promotion and deemphasizing disease-specific treatment. It’s the largest branch of the US government, by the way, and exceeds the size of the DOD by budget, at least the visible budget.
At its core, MAHA is predominantly proregulation. Let that sink in. The logic is that we must use regulatory authority to improve transparency and eliminate that which leads to unhealthy outcomes. Examples include drugs with side effects that, when considered in whole, do not have a strongly favorable risk-benefit ratio, an example being glyphosate (or Roundup) contamination of our grain and soybeans. Of course, recently, we have the removal of food dyes. However, there’s also a deregulatory aspect to the MAHA movement. For example, is unpasteurized milk really a health risk? What health-promoting properties are associated with unpasteurized milk?
Similarly, there is the move toward backyard poultry and eating locally slaughtered grass-fed beef, and reexamination of the widespread US policy of fluoridating municipal water supplies. These are all pushes against big government mandates. There’s also an investigational research aspect. For example, what are the drivers behind the explosion of autism, obesity, and other childhood chronic diseases? This is the explicit mandate coming from Donald Trump through the MAHA Commission. To date, the MAHA movement has primarily focused on things that big government can do to promote improved health. This is where MAHA is going currently.
Who isn’t for improved children’s health? Who isn’t for improved food purity? There are 10,000 petroleum-based compounds that are authorized by the FDA for inclusion in our food supply right now. And there has been absolutely no investigation, long term, of any of these because the way the system works is once the bureaucracy makes a decision, they rarely, if ever, go back and revisit that decision. And that is rampant through the entire HHS structure. It is the reason why these food dyes took so long to be banned. The data have been there for decades. The information about the role of these dyes in ADHD in children has been known for a very long period of time, is exceedingly well documented, and yet the FDA did nothing because their policy is that once a decision is made, they never go back and look at it. The CDC and FDA tend to not set up any processes where they revisit past decisions.
And this also, by the way, can be seen in the vaccine enterprise.
Short-term data was acquired, in the case of many of the pediatric vaccines, during the ’60s using rules, regulations, policies, and clinical trial research norms that are long since obsolete.
But those limited data from back then allowed the FDA at that point in time to make a “go” decision on authorizing those vaccines for the pediatric vaccine schedule, and they’ve never gone back and revisited that with new data. It’s just not in the structure. The whole structure of the approval process is driven by approving the thing in front of them right now, not going back and looking at whether or not there’ve been interactions between any of these drugs or compounds or vaccines, whether or not that decision was a good decision, or whether or not they missed some long-term safety signal because they were only looking at short-term data. It’s not done because that is kind of fundamental to the nature of bureaucracy. Once they make a decision, they don’t ever want to revisit it. It becomes locked in stone, and they move forward from that.
A derivative of this is that behind the potential of the MAHA initiative to improve our lives, and, importantly, improve childhood chronic disease, is the threat that if this gets institutionalized and bureaucratized, it will morph into another overbearing set of state mandates. There is no way to avoid that.
The Regulatory Impulse Behind MAHA
And, basically, my talk here is a plea to you folks, who are kind of at the tip of the spear concerning bureaucracy and the administrative state. We need you. We need your intellectual input to help set the boundaries and parameters around the MAHA initiative. It’s not being done right now. Nobody’s talking about what the proper boundary should be. We seem to have a consensus that this is necessary. That actually is debatable, but that is the current consensus. But no one is talking about what happens once the administrative state gets its teeth into this initiative.
Let’s say there’s a person who loves McDonald’s hamburgers, consumed with sugary Coca-Cola. Should the state mandate that such a person not eat these things with clear-cut health risks? Should the state outlaw cigars? What about regulating foods? Where should MAHA draw the line? What principles should guide these decisions? What is the proper role of small government in food and drug regulation? This is unexplored territory as far as I’m concerned, and it needs intellectual input. It needs guidance. It needs informed discussion. Where are the boundaries? And if we don’t set those boundaries, I guarantee that the administrative state will continue to just expand and run rampant as it assimilates the MAHA initiative and begins to institutionalize it and exploit it. This really involves the boundaries between individual sovereignty, libertarianism, Murray Rothbard’s anarcho-capitalism, and the utilitarian socialist logic of modern public health.
The modern “public health enterprise” seeks the greatest good for the greatest number and is driven by narrow analysis of large data sets to identify, regulate, promote, and mandate specific healthcare interventions, such as vaccines, while often disregarding other related issues, including long-term unanticipated or difficultto- predict consequences. It is a “public health enterprise” that seeks to optimize collective health outcomes rather than optimizing health opportunities coupled with respect for individual autonomy and choice—which is what I advocate. It is a “public health enterprise” that has repeatedly used top-down management via government, insurers, and health management organizations to require and deploy preapproved treatment protocols rather than to promote individually optimized healthcare management and promotion reflecting each patient’s complexities. In other words, what I’m saying is the practice of modern medicine, particularly under Obamacare, has come down to protocoldriven application of modules.
If you are tested and answer questions that can now be interpreted by AI quite efficiently, you will be binned into one of these categories, and then you will be subjected to a preapproved protocol.
Modern physicians—I’m not defending my caste; it’s just a fact—don’t have a lot of operational latitude under the current structure. They have to implement the policies, procedures, and protocols that they’re given; otherwise they lose their jobs.
And when you’re sitting with the chains of a quarter, a half, or three-quarters of a million dollars in debt at high interest rates—so you basically have a couple of mortgages—you don’t have any choice.
Consider seat belt mandates. Like many big government initiatives that stand on the top of slippery slopes, there’s a general consensus that it’s right and proper for government to mandate that seat belts be installed on cars. But is it right to legally require their use when driving?
Next comes motorcycle helmets. Same issues, slightly less clear. Cigarette smoking.
In all three cases, the argument is made that irresponsible health behaviors by individuals cost all of society due to increased healthcare and insurance costs, including publicly subsidized costs and loss of person years. The same logic can then be applied all the way down to whether or not the state should mandate your dietary choices, which is why I used the McDonald’s hamburger example.
Should we allow citizens to experiment with nutraceuticals and health supplements that are not officially endorsed by the FDA? What rights do they have to do that? They may be costing the public health enterprise money.
They may be costing us tax dollars that are avoidable. This is the logic that we confront. This is where we risk going with the MAHA initiative. And there we go, straight to nanny state medical fascism.
But seat belts save lives. Air traffic controllers save lives most of the time. You get my point. The greatest good for the greatest number has become a logical fallacy. For a while, it seemed to work, but when you look at the twenty-first-century incarnation in particular, it has become badly corrupted. The history and reality behind vaccines is perhaps the best example in modern times, but the entire edifice of “public health” as it’s practiced today needs to be deconstructed.
Public health is good when the objectives are clear, they make sense to everyone, and their implementation is transparent and their results measurable. We have wonderful examples: clean water, sanitation, modern sewers, sewage treatment, waste management (which, by the way, has had the biggest impact on the decline in infectious disease. It’s not vaccines. Credit where credit’s due), clean air in places with local air pollution, antibiotics, advanced surgical procedures. We can go on and on and on.
This is the history of public health in the twentieth century, but things seem to go downhill from there, particularly with allopathic Western medicine. It’s morphed into monetized “sick care” and then monetized sickness in all its aspects.
If MAHA is to transition from merely a populist uprising and a set of immediate grievances to a new and sustainable set of public health policies, we need to take some time to think—to think about and define acceptable limits on the role of the state in promoting and advancing public health, and in some cases, mandating limits on the infringement of individual sovereignty and autonomy.
Immediate short-term interventions are absolutely necessary, and I applaud the use of both the bully pulpit as well as executive orders. But if MAHA is to become more than just a populist uprising, if it’s to result in sustainable, positive, long-term policy changes, it’s also important to take the time required to examine, define, and develop public support for the boundaries between the proper role of a constitutional republic–based federal government and the constitutional role of individual states— which are structurally responsible for regulating the practice of medicine, not the federal government—and both the sovereign rights of the individual and the global right to truly informed consent to medical interventions.
I’m going to close with this to drive home this final point. As a component of his commitment to no longer, “walk on eggshells,” the US secretary of defense, Pete Hegseth—I think it was two days ago—recently stated that the covid genetic “vaccines” were experimental products, that the vaccine mandates were illegal. These mandated experimental products were associated with severe adverse events, including myocarditis, stroke, and death. They were mandated, and the US bureaucracy actively suppressed the ability of those who either were forced to accept or willingly accepted these products to obtain informed consent.
These actions were violations of the Nuremberg accords. You cannot shirk that anymore. It’s in your face. With Pete Hegseth’s statement, this is now out in the open. There must be accountability and consequences. In close, I challenge the Mises Institute to work to help establish appropriate limits on the federal bureaucracy and to insist that these limits, like the Nuremberg accords, be enforced. If we don’t have enforcement, we will see the same things recapitulated because, as was eloquently said in the prior talk, this is the nature of bureaucracy.
