Health
The People Cheering Brian Thompson’s Murder Can’t Have the Medical Utopia That They Want
Whether private or public, third-party payment for health care is a huge problem.
Evoking a collective scream of despair from socialists and anti-corporate types, police in Pennsylvania arrested Luigi Mangione, a suspect in the murder of UnitedHealthcare CEO Brian Thompson. Thompson, they insist, stood in the way of the sort of health care they think they deserve and shooting him down on the street was some sort of bloody-minded strike for justice.
The assassin’s fans—and the legal system has yet to convict anybody for the crime—are moral degenerates. But they’re also dreaming, if they think insurance executives like Thompson are all that stands between them and their visions of a single-payer medical system that satisfies every desire. While there is a lot wrong with the main way health care is paid for and delivered in the U.S., what the haters want is probably not achievable, and the means many of them prefer would make things worse.
“Unlimited Care…Free of Charge”
“It is an old joke among health policy wonks that what the American people really want from health care reform is unlimited care, from the doctor of their choice, with no wait, free of charge,” Michael Tanner, then of the Cato Institute, quipped in 2017.
The problem, no matter how health care is delivered, is that it requires labor, time, and resources that are available in finite supply. Somebody must decide how to allocate medications, treatments, physicians, and hospital beds, and how to pay for it all. A common assumption in some circles is that Americans ration medicine by price, handing an advantage to the wealthy and sticking it to the poor.
“Today, as everyone knows, health care in the US can be prohibitively expensive even for people who have insurance,” Dylan Scott sniffed this week at Vox.
The alternative, supposedly, is one where health care is “universal,” with bills paid by government so everybody has access to care. Except, most Americans rely on somebody else to pay the bulk of their medical bills just like Canadians, Germans, and Britons. And while there are huge differences among the systems presented as alternatives to the one in the U.S., third-party payers—whether governments or insurance companies—do enormous damage to the provision of health care.
Third-Party Payers, Both Public and Private, Raise Costs
“Contrary to ‘conventional wisdom,’ health insurance—private or otherwise—does not make health care more affordable,” Jeffrey Singer, a surgeon and senior fellow with the Cato Institute, wrote in 2013. “The third party payment system is the principal force behind health care price inflation.”
In the U.S., the dominance of third-party payment, whether Thompson’s UnitedHealthcare, one of its competitors, Medicare, Medicaid, or something else, makes it difficult to know the price for procedures, medicines, and treatments—because there really isn’t one price when third-party payers are involved.
Several years ago, the first Trump administration required hospitals to publish prices for services. My local hospital offers an Excel spreadsheet with wildly varying prices for procedures and services, from different categories of self-pay, Medicare, Medicaid, and negotiated rates for competing insurance plans.
“A colonoscopy might cost you or your insurer a few hundred dollars—or several thousand, depending on which hospital or insurer you use,” NPR’s Julie Appleby pointed out in 2021.
That said, savvy patients paying their own bills can usually get a lower price than that paid by insurance.
“When government, lawyers, or third party insurance is responsible for paying the bills, consumers have no incentive to control costs,” Arthur Laffer, Donna Arduin, and Wayne Winegarden wrote in the 2009 paper, The Prognosis for National Health Insurance. After all, the premium or tax is already paid, right?
Other Countries Struggle With Similar Issues
Concerns about rising costs, demand, and finite resources apply just as much when the payer is the government.
“State health insurance patients are struggling to see their doctors towards the end of every quarter, while privately insured patients get easy access,” Germany’s Deutsche Welle reported in 2018. “The researchers traced the phenomenon to Germany’s ‘budget’ system, which means that state health insurance companies only reimburse the full cost of certain treatments up to a particular number of patients or a particular monetary value.” Budgeting is quarterly, and once it’s exhausted, that’s it.
Last year in the U.K., a Healthwatch report complained: “We’re seeing a two-tier system emerge, where healthcare is accessible only to those who can afford it, with one in seven people who responded to our poll advised to seek private care by NHS [National Health Service] staff.” Britain’s NHS remains popular, but it has long struggled with the demand and expense for cancer care and other expensive treatments.
And Canada’s single-payer system famously relies heavily on long wait times to ration care. “In 2023, physicians report a median wait time of 27.7 weeks between a referral from a general practitioner and receipt of treatment,” the Fraser Institute found last year. “This represents the longest delay in the survey’s history and is 198% longer than the 9.3 weeks Canadian patients could expect to wait in 1993.”
You have to wonder what those so furious at Brian Thompson that they would applaud his murder would say about the officials managing systems elsewhere. None of them deliver “unlimited care, from the doctor of their choice, with no wait, free of charge.” Some lack the minimal discipline imposed by what competition exists among insurers in the U.S.
We Need Less Government Involvement in Medicine
“Policymakers need to understand that the key to ‘affordable health care’ is not to increase the role of health insurance in peoples’ lives, but to diminish it,” Cato’s Singer concluded.
My family found that true when we contracted with a primary care practice that refuses insurance. We pay fixed annual fees, which includes exams, laboratory services, and some procedures. My doctor caught my atrial fibrillation when he walked me across his clinic hall on a hunch to run an EKG.
The Surgery Center of Oklahoma famously follows a similar model for much more than primary care. It publishes its prices, which don’t include the overhead and uncertainty of dealing with third-party payers.
Those examples point to a better health care system than what exists in the United States—or in most other countries, for that matter. They’re probably not the whole answer, because it’s unlikely that one approach will suit millions of people with different medical concerns, incomes, and preferences. But making people more, rather than less, responsible for their own health care, and getting government and other third-parties as far out of the matter as possible, is far better than cheering the murder of people who supposedly stand between us and an imaginary medical utopia.
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CDC Cuts Total Doses in Alignment with the rest of most of Western Civilization. I suspect we found evidence within CDC supporting.
The CDC’s January 2026 childhood vaccine schedule realignment is not a retreat from science—it is its restoration. By aligning the U.S. with international norms, reclassifying low-benefit vaccines, and preserving universal access, the policy reasserts informed consent, parsimony, and scientific integrity as central to public health. This editorial evaluates the evidence, clarifies common misinterpretations, and outlines the stakes of institutional credibility in the era of collapsing trust.
Ending the Era of Maximalism
In January 2026, the CDC issued a long-overdue correction to the American childhood vaccine schedule. Despite headlines framing this move as a rollback or retreat, not a single vaccine was removed from access or coverage. The change was not reductive—it was clarifying. It replaced one-size-fits-all mandates with a proportional, transparent structure based on international norms, current evidence, and a sobering admission of what science does not yet know. This was not a political maneuver. It was a governance correction, rooted in the principles of informed consent and institutional legitimacy.
The real story is not what was removed, but what was realigned—and why. The revised architecture reflects a basic truth: trust cannot be coerced. It must be earned. That is the starting point of science. And the endpoint of policy.
The CDC Recognizes Its Schedule as a Coercive Instrument
For decades, the CDC’s “routine recommendation” has operated less as guidance and more as soft mandate. Once a vaccine was recommended for all children, it cascaded through state school-entry requirements, insurance policies, quality metric scoring, and pediatrician compliance programs. Families who opted out often faced dismissal from care. Physicians faced insurer incentives tied to vaccination quotas. In this ecosystem, choice was technically permitted—but penalized.
The CDC’s own assessment acknowledges this explicitly: “Instead of implementing vaccination mandates, most peer nations maintain high childhood vaccination rates through public trust and education” (CDC, 2026, p.3). The updated policy aims to dismantle this coercive scaffolding—not by withdrawing vaccines, but by restoring clarity to what is essential, what is conditional, and what is contextual.
Comparative Overreach: America as an Outlier
The United States was not just a global leader in pediatric vaccination. It was a statistical outlier. According to the CDC’s comparative review (2026, Table 2), the U.S. schedule in 2024 recommended vaccines against 17 diseases, requiring 84 to 88 total doses delivered across 57 to 71 injections. By contrast:
- Denmark covers 10 diseases with 30 doses and only 11 injections.
- UK uses fewer doses but retains near-universal MMR uptake.
- Canada varies by province but aligns closely with European practice.
Importantly, many peer nations refrain from recommending routine use of hepatitis A, influenza, meningococcal B, and rotavirus for all children. These are not poor or negligent countries. They are scientifically robust, and they achieve high uptake by preserving credibility, not enforcing compliance.
The report introduces the ethical principle of clinical equipoise—the acknowledgment of uncertainty in the face of professional disagreement. When peer nations with equivalent disease burdens and health infrastructures diverge in recommendations, it signals unresolved evidence gaps, not ignorance.
Trust Collapse and Its Operational Consequences
Trust in U.S. health authorities fell precipitously between 2020 and 2024—from 71.5% to 40.1% (CDC, p.3). This collapse had measurable consequences. Uptake of the MMR vaccine, one of the most effective vaccines in the consensus schedule, dropped from 95.2% to 92.7% nationally. Sixteen states fell below the 90% threshold, increasing the risk of outbreaks.
Indeed, in 2025, the U.S. experienced 49 measles outbreaks—88% of the 2,065 reported cases were outbreak-associated (CDC, 2026). This wasn’t due to vaccine rejection. It was due to trust rejection. The report directly links trust erosion to coercive COVID-era policies, including mask mandates, school closures, disregard for natural immunity, and overstated claims about sterilizing immunity. The CDC writes, “The distrust of public health agencies during the pandemic has spilled over to other recommendations, including those with respect to vaccines” (p.3).
This trust decay wasn’t isolated. Countries like Denmark explicitly warned against adding low-benefit vaccines to their schedules, citing risks of degrading public confidence. Their prediction came true here. The U.S. attempted to do more—and got less.
Schedule-Level Science: Gaps Finally Acknowledged
The most important admission in the report may be this: “The effects of the overall schedule have never been fully evaluated” (CDC, p.12). That sentence should haunt anyone who defends the status quo. Despite decades of schedule expansion, there has been no comprehensive evaluation of the long-term safety, synergy, or cumulative immunologic impact of the entire pediatric vaccine regimen.
While individual vaccines like MMR, Hib, and IPV have robust pre-licensure data, many others were approved without large-scale placebo-controlled trials. Post-marketing systems such as VAERS, VSD, and BEST have identified acute risks—e.g., intussusception with rotavirus, febrile seizures with MMRV, myocarditis with mRNA vaccines—but are underpowered for delayed or systemic effects.
A 2023 VSD study found a dose-dependent association between cumulative aluminum exposure from vaccines and persistent asthma (HR = 2.0) (Daley et al., Academic Pediatrics, 2023). This is not conclusive proof of harm—but it is definitive proof of the need to study schedule-level interactions.
The CDC now calls for exactly that: randomized timing trials, long-term cohort studies comparing health outcomes across exposure strata, and formal evaluation of interaction effects, adjuvant loads, and timing differentials.
A New Ethical Architecture
The revised schedule distinguishes three recommendation types:
1. Recommended for all children — reserved for vaccines with demonstrated benefit across the population and international consensus.
2. High-risk group recommendations — for children with defined medical or exposure risks.
3. Shared clinical decision-making — for vaccines where the population-level benefit is uncertain, or where individual risk–benefit may vary.
This framework already exists in CDC language, but it had been underutilized and obscured by the dominance of routine recommendations. The new policy makes it operational.
Crucially, no vaccines are removed from coverage. The document reiterates: “All immunizations recommended by the CDC at the end of 2025—and covered by insurance at that time—should remain covered without cost sharing” (CDC, p.3). Denmark, the UK, and Switzerland use similar stratified systems. The U.S. has now caught up—not by doing less, but by doing what works.
HPV One-Dose: An Evidence-Based Pivot
The decision to shift from two doses of HPV vaccine to one is a model for evidence-responsive policy. The CDC cites multiple studies demonstrating non-inferiority of a single dose:
– Kreimer et al., NEJM 2025
– Watson-Jones et al., Lancet Global Health 2025
– Basu et al., Lancet Oncology 2021
Peer nations including the UK, Ireland, Australia, and Canada had already adopted this strategy. One dose achieves near-identical protection against vaccine-targeted HPVs with lower burden and fewer adverse events. The CDC’s alignment here is not a retreat—it’s a data-driven upgrade.
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Refined “Recommended for All” List
The CDC now limits routine universal recommendations to vaccines with:
– Strong international consensus
– High demonstrated public health value
– Well-characterized safety and efficacy profiles.
These are:
– Measles, mumps, rubella (MMR)
– Diphtheria, tetanus, pertussis (DTaP/Tdap)
– Polio (IPV) – Haemophilus influenzae type B (Hib)
– Pneumococcal conjugate (PCV)
– Human papillomavirus (HPV), now reduced to a single-dose schedule
– Varicella (chickenpox), retained due to U.S.-specific epidemiology
Many parents have questions about the efficacy of the measles and mumps portions of the MMR given that asymptomatic transmission of measles is an established but little-discussed fact, and before COVID-19, mumps outbreaks in fully vaccinated schools in the US was well-documented.
What changed: HPV was reduced from 2–3 doses to 1. Several vaccines previously listed as universal are now reclassified. The new universal list more closely mirrors countries like Denmark, the UK, and Ireland.
Reclassification of Non-Consensus Vaccines
Vaccines such as:
– Hepatitis A
– Hepatitis B (birth dose only if mother is HBsAg-negative)
– Rotavirus
– Influenza
– COVID-19
– Meningococcal B and ACWY
– RSV monoclonal antibody (not a vaccine)
have all been moved to either:
– High-risk group recommendations (e.g., Hep A for travelers, Hep B for infants of positive/unknown mothers)
– or Shared clinical decision-making pathways
This model mirrors European governance practices, where vaccines with uncertain population-wide benefit are discussed individually between provider and parent/guardian.
What changed: These vaccines are no longer recommended for universal administration but remain fully covered and available to all families through Medicaid, CHIP, VFC, and private insurance.
Policy Emphasis on Schedule-Level Science
For the first time, the CDC acknowledges:
– The full schedule has never been rigorously studied for cumulative, synergistic, or long-term effects
– Many vaccines were approved without randomized placebo-controlled trials in children
– Post-licensure surveillance (e.g., VAERS, VSD) is underpowered to detect long-latency effects or rare but serious chronic sequelae
The CDC now explicitly calls for:
– Randomized trials using timing-based designs
– Long-term cohort studies comparing vaccinated vs unvaccinated children
– Safety studies on combined vaccine administration, adjuvants, and spacing.
This is a seachange: Scientific uncertainty is now acknowledged and embedded into the policy framework, triggering a new research mandate.
Elimination of Implicit Coercion via Schedule
While the policy does not change state-level school mandates, it removes the federal “routine” label from lower-priority vaccines, reducing pressure on providers to dismiss non-compliant families or tie insurer bonuses to rigid adherence.
In its place: a structured, choice-respecting pathway that centers parental informed consent.
What changed: The policy restores consent as a governing principle, removes schedule inflation, and distinguishes between access and recommendation.
This is a systemic reform, not a minor tweak. The policy shift restores proportionality, science-based prioritization, and institutional humility—while safeguarding coverage and access. It is a reassertion of legitimacy in the aftermath of a trust crisis.
What the Policy Rejects
This policy formally rejects several assumptions that had ossified into doctrine:
– That more vaccines necessarily equal better health.
– That mandates are required to ensure compliance.
– That high-volume schedules are scientifically complete.
– That dissent is misinformation.
– That informed consent is a formality, not a right.
The CDC explicitly names coercion as a failed tool and calls for its replacement with personalized, risk-aligned care.
What the Policy Preserves and Strengthens
This is not a deregulation agenda. It is a realignment. The policy preserves:
– Universal access to all covered vaccines.
– Full coverage under Medicaid, CHIP, and VFC.
– Trust-based compliance mechanisms.
– Ethical clarity: recommendations reflect both evidence and respect for autonomy.
– Institutional epistemic humility: public health must now justify, not presume.
The result? Less friction, more uptake—of the right vaccines, in the right populations, for the right reasons.
Anticipating and Answering the Critics
No, the liability protections were not removed. This policy does not increase vaccine risk—it increases institutional honesty.
No, measles will not surge because of this schedule. MMR remains fully recommended. The drop in uptake happened under maximalist policy.
No, international comparison is not cherry-picking. It is the standard for identifying clinical equipoise. Denmark, Germany, Ireland, and Switzerland offer leaner schedules, fewer mandates, and stronger vaccine trust.
Those who call this “anti-science” misunderstand science. This is science doing what it must: confronting uncertainty, not denying it.
The Schedule Is the Signal
The CDC’s January 2026 reform is not the dismantling of public health. It is its restoration. Trust cannot be coerced. Compliance must be earned. And scientific legitimacy must be updated to reflect both what we know—and what we still don’t.
The vaccine schedule is not just a list. It is a social contract. And for the first time in decades, it has been revised to reflect mutual respect, rather than managerial force.
The signal has changed. And for the health of children and the credibility of science, that is exactly what was needed.
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CDC SHRINKS ROUTINE CHILDHOOD VACCINE SCHEDULE BY ~55 DOSES
Today, the CDC formally adopted a revised childhood and adolescent immunization schedule, following a Presidential Memorandum directing alignment with international best practices.
This marks the largest rollback of routine childhood vaccination in U.S. history.
After reviewing peer-country schedules and the scientific evidence underlying them, federal health leadership acknowledged that we are hyper-vaccinating our children.
The result is a dramatically smaller routine childhood vaccine schedule, cutting approximately 55 routine doses.
This is a major victory — even as serious safety concerns remain for the vaccines that continue to be recommended.
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The Key Change: ~55 Routine Doses Eliminated
Previous U.S. routine schedule (2024)
- 84–88 routine vaccine doses
- Targeting 17 diseases
- (18 if RSV monoclonal antibody is included)
New CDC routine schedule (2026)
- ~30 routine doses
- Targeting 10–11 diseases
- Based on international consensus
Net change: approximately 54–58 routine doses removed, commonly summarized as ~55 routine doses.
Importantly, this reduction applies only to vaccines previously labeled “routine for all children.” No vaccines were banned or removed from availability.
What Was Removed from the Routine Schedule
The following vaccines are no longer recommended for all children by default:
- COVID-19
- Influenza
- Hepatitis A
- Hepatitis B (including removal of the universal birth dose if the mother is HBsAg-negative)
- Rotavirus
- Meningococcal ACWY
- Meningococcal B
These vaccines account for nearly the entire ~55-dose reduction.
What Remains Routine
The CDC now limits routine childhood vaccination to the following vaccines:
- Measles, Mumps, Rubella (MMR)
- Diphtheria
- Tetanus
- Pertussis
- Polio
- Haemophilus influenzae type B (Hib)
- Pneumococcal disease
- Varicella (chickenpox)
- Human Papillomavirus (HPV), reduced from two doses to one
This is still not “safe by default”
These vaccines remain:
- Insufficiently studied for long-term outcomes
- Untested in placebo-controlled trials
- Never evaluated as a cumulative schedule
- Inducers of over 20 chronic diseases
Adverse events such as febrile seizures, severe neurological injury including autism, ADHD, tics, autoimmune disease, asthma, allergies, skin and gut disorders, ear infections, and a long list of other chronic diseases have been documented across multiple vaccines on this list:
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Reducing the schedule does not equal proving safety. It simply reduces exposure. Nonetheless, that reduction alone is quite meaningful.
Where Those Vaccines Went
Non-consensus vaccines were reclassified, not banned:
Shared Clinical Decision-Making
- COVID-19
- Influenza
- Hepatitis A
- Hepatitis B
- Rotavirus
- Meningococcal ACWY
- Meningococcal B
High-Risk Groups Only
- RSV monoclonal antibody
- Hepatitis A (travel, outbreaks, liver disease)
- Hepatitis B (HBsAg-positive or unknown maternal status)
- Dengue
- Meningococcal vaccines for defined risk groups
All remain available and fully covered by insurance. However, given entrenched institutional habits and ideological adherence to maximal vaccination, many clinicians are likely to continue promoting shared clinical decision-making vaccines as de facto routine unless families are informed and assertive.
Why This Is Still a Massive Win
For decades, the childhood vaccine schedule expanded without:
- Schedule-level safety trials
- Long-term outcome data
- Meaningful public debate
- Informed consent
This decision reverses that trajectory. It:
- Shrinks routine exposure dramatically
- Restores parental agency
- Forces future decisions to confront risk-benefit reality
Most importantly, it breaks the false premise that “more vaccines is always better.”
Conclusion
The CDC has eliminated every non-consensus vaccine from the routine childhood schedule, cutting routine exposure by approximately 55 doses—an implicit admission that the safety of the expanded schedule was never adequately established.
This decision does not end the problem. The vaccines that remain routinely recommended are still largely untested in long-term, placebo-controlled trials, are administered during critical periods of neurodevelopment, and continue to pose serious safety concerns. As a result, a substantial number of autism cases and other chronic conditions will continue to occur.
However, by sharply reducing cumulative exposure during early childhood, this change marks the first credible step toward reversing the trajectory. The burden of neurodevelopmental injury should begin to decline—not disappear, but diminish.
Even with its limitations, this action represents the most consequential course correction in U.S. pediatric vaccination policy in modern history. It breaks the assumption that an ever-expanding schedule is inherently safe, restores proportionality, and opens the door to long-overdue accountability, transparency, and real safety science.
Epidemiologist and Foundation Administrator, McCullough Foundation
Support our mission: mcculloughfnd.org
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