Despite dropping out of the race for president in August, Robert F. Kennedy, Jr. is turning up the volume on reforming national health care and drug policy and attracting attention to what role he might play in an administration depending on the outcome of the November election.
Kennedy has endorsed former president Donald Trump, and Trump has hinted that there could be a role in his second Trump administration.
Kennedy, who founded the safety advocacy group Children’s Health Defense, recently revealed the scope of his health care recommendations through his “Make America Healthy Again” agenda. Trump named Kennedy to his transition team and pledged to establish a panel of experts to work with Kennedy to investigate the increase of chronic health problems and childhood diseases in the United States (see related articles, pages 8,9).
In a September 5 op-ed in The Wall Street Journal, Kennedy laid out his 12-point Make America Healthy Again plan. Some of the ideas include reducing conflicts of interest at federal health agencies, implementing drug price caps, setting chemical and pesticide standards, requiring nutrition classes in medical school, redirecting money toward preventative care, rereleasing a presidential fitness standard, and expanding health savings accounts.
Boundary Crossing
Over the years, Kennedy has not hesitated to express his opinions, many of which have challenged long-held positions of the public health establishment on issues from vaccines and childhood obesity to the role of big pharmaceutical companies.
Kennedy’s stances cross ideological boundaries. His support of a single-payer national health care system conflicts with free-market opinions on the right, and his criticism of big-government bullying alienates the left. The nation’s painful experience with the measures taken to stem the spread of COVID-19 has attracted attention to Kennedy’s health care opinions in the wake of his forceful criticisms of those policies.
In a wide-ranging interview with Preferred Health magazine in June, Kennedy lambasted the lockdowns and the people he says profited from them.
“The people who came into the pandemic with a billion dollars, the Bill Gates, the Mark Zuckerbergs, the Bloombergs, the Jeffery Bezos, increased their wealth on average by 30 percent,” Kennedy told the publication.
“The lockdowns were a gift to them, the super-rich,” said Kennedy. “Jeffery Bezos, the richest or second-richest man in the world, was able to close down all of his competitors, 3.3 million businesses, and then give us a two-year training course about how to never use a retail outlet again in our lives. Forty-one percent of the black-owned businesses will never reopen. And he was instrumental because he was censoring the books that were critical of the lockdowns, including one that I wrote.”
Insider Advantage
Kennedy’s criticisms appeal to Craig Rucker, president of the Committee for a Constructive Tomorrow (CFACT).
“Kennedy, by virtue of his family name, is an insider, but his unorthodox views make him a provocative outsider,” said Rucker. “The public-health establishment, against which he has railed for years, failed miserably during the coronavirus pandemic. The ties between HHS and Big Pharma are far too cozy, and we have good reason to believe public health suffers as a consequence. A free spirit like his could be just what the doctor ordered.”
NIH Reform Call
Echoing his criticisms of the pandemic response, Kennedy says he wants to overhaul federal health care agencies, beginning with the National Institutes of Health (NIH).
The NIH suppressed the use of ivermectin and hydroxychloroquine during the early stages of the pandemic, in favor of, first, remdesivir and later the COVID vaccines through emergency use authorization, Kennedy argues. Saying the NIH “has been transformed into an incubator for the pharmaceutical industry,” Kennedy recommends removing much of the NIH’s funding for virology.
“It has stepped away from rigorous, evidence-based science, evidence-based medicine, into kind of a magical world,” Kennedy told Preferred Health. “It needs to have scientific discipline reimposed on the entire field of virology. We ought to be funding the study of the etiology of chronic diseases in our universities.”
Focus Shift
Kennedy has also spoken widely on chronic childhood diseases, some of which he has attributed to vaccines. Kennedy has called for public health authorities to shift their focus from infectious diseases such as COVID and influenza to devote more attention to diabetes, obesity, environmental toxins, and other longer-term concerns.
Kennedy has also cited large-scale factory farming and processed food as contributing to the nation’s health problems.
Peter Pitts, president and co-founder of the Center for Medicine in the Public Interest, says Kennedy brings a fresh perspective to public health debates.
“RFK Jr.’s penchant for not taking things at face value could go a long way toward forcing government public-health agencies to argue on behalf of their beliefs rather than simply relying on a ‘because I said so’ defense,” said Pitts.
Surprising Endorsements
Texas Agriculture Commissioner Sid Miller, a Republican, praised Kennedy’s efforts in a September 26 op-ed for Fox News.
“The role of Big Food, much like Big Pharma, is to prioritize their profits over our health,” wrote Miller. “I enthusiastically support RFK Jr.’s campaign to hold these industries accountable by reforming our food and medicine approval and patenting systems. In this he is uniquely qualified: the $1.7 trillion pharmaceutical industry has unfairly maligned him for decades, and he’s still standing strong.”
In a move that raised eyebrows, Robert Redfield, who headed the Centers for Disease Control and Prevention (CDC) under Trump from 2018 to 2021, endorsed Kennedy’s reform efforts in a Newsweek op-ed in September.
“If the next president prioritizes the National Institutes of Health (NIH) to identify which exposures are contributing to the spike in chronic disease in children, we will finally find out and end what is slowly destroying our children,” wrote Redfield.
Bonner Russell Cohen, Ph.D., ([email protected]) is a senior fellow at the National Center for Public Policy Research.
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After the Smith government recently announced its shift to a new approach for funding hospitals, known as “activity-based funding” (ABF), defenders of the status quo in Alberta were quick to argue ABF will not improve health care in the province. Their claims are simply incorrect. In reality, based on the experiences of other better-performing universal health-care systems, ABF will help reduce wait times for Alberta patients and provide better value-for-money for taxpayers.
First, it’s important to understand Alberta is not breaking new ground with this approach. Other developed countries shifted to the ABF model starting in the early 1990s.
Indeed, after years of paying their hospitals a lump-sum annual budget for surgical care (like Alberta currently), other countries with universal health care recognized this form of payment encouraged hospitals to deliver fewer services by turning each patient into a cost to be minimized. The shift to ABF, which compensates hospitals for the actual services they provide, flips the script—hospitals in these countries now see patients as a source of revenue.
In fact, in many universal health-care countries, these reforms began so long ago that some are now on their second or even third generation of ABF, incorporating further innovations to encourage an even greater focus on quality.
For example, in Sweden in the early 1990s, counties that embraced ABF enjoyed a potential cost savings of 13 per cent over non-reforming counties that stuck with budgets. In Stockholm, one study measured an 11 per cent increase in hospital activity overall alongside a 1 per cent decrease in costs following the introduction of ABF. Moreover, according to the study, ABF did not reduce access for older patients or patients with more complex conditions. In England, the shift to ABF in the early to mid-2000s helped increase hospital activity and reduce the cost of care per patient, also without negatively affecting quality of care.
Multi-national studiesontheshift to ABF have repeatedly shown increases in the volume of care provided, reduced costs per admission, and (perhaps most importantly for Albertans) shorter wait times. Studieshavealsoshown ABF may lead to improved quality and access to advanced medical technology for patients.
Clearly, the naysayers who claim that ABF is some sort of new or untested reform, or that Albertans are heading down an unknown path with unmanageable and unexpected risks, are at the very least uninformed.
And what of those theoretical drawbacks?
Some critics claim that ABF may encourage faster discharges of patients to reduce costs. But they fail to note this theoretical drawback also exists under the current system where discharging higher-cost patients earlier can reduce the drain on hospital budgets. And crucially, other countries have implemented policies to prevent these types of theoretical drawbacks under ABF, which can inform Alberta’s approach from the start.
Critics also argue that competition between private clinics, or even between clinics and hospitals, is somehow a bad thing. But all of the developed world’s top performing universal health-care systems, with the best outcomes and shortest wait times, include a blend of both public and private care. No one has done it with the naysayers’ fixation on government provision.
And finally, some critics claim that, under ABF, private clinics will simply focus on less-complex procedures for less-complex patients to achieve greater profit, leaving public hospitals to perform more complex and thus costly surgeries. But in fact, private clinics alleviate pressure on the public system, allowing hospitals to dedicate their sophisticated resources to complex cases. To be sure, the government must ensure that complex procedures—no matter where they are performed—must always receive appropriate levels of funding and similarly that less-complex procedures are also appropriately funded. But again, the vast and lengthy experience with ABF in other universal health-care countries can help inform Alberta’s approach, which could then serve as an example for other provinces.
Alberta’s health-care system simply does not deliver for patients, with its painfully long wait times and poor access to physicians and services—despite its massive price tag. With its planned shift to activity-based funding, the province has embarked on a path to better health care, despite any false claims from the naysayers. Now it’s crucial for the Smith government to learn from the experiences of others and get this critical reform right.
Officials at the the National Institutes of Health and the Centers for Medicare & Medicaid Services announced a partnership Wednesday to research “root causes of autism spectrum disorder.”
As part of the project, NIH will build a real-world data platform enabling advanced research across claims data, electronic medical records and consumer wearables, according to the agencies.
“We’re using this partnership to uncover the root causes of autism and other chronic diseases,” said HHS Secretary Robert F. Kennedy Jr. “We’re pulling back the curtain – with full transparency and accountability – to deliver the honest answers families have waited far too long to hear.”
CMS and NIH will start this partnership by establishing a data use agreement under CMS’ Research Data Disclosure Program focused on Medicare and Medicaid enrollees with a diagnosis of autism spectrum disorder or ASD.
“This partnership is an important step in our commitment to unlocking the power of real-world data to inform public health decisions and improve lives,” NIH Director Dr. Jay Bhattacharya said. “Linking CMS claims data with a secure real-world NIH data platform, fully compliant with privacy and security laws, will unlock landmark research into the complex factors that drive autism and chronic disease – ultimately delivering superior health outcomes to the Americans we serve.”
Researchers will focus on autism diagnosis trends over time, health outcomes from specific medical and behavioral interventions, access to care and disparities by demographics and geography and the economic burden on families and healthcare systems, according to a news release.
