Over my career, I have worked as a primary care physician, a professor at Harvard Medical School, and an executive at CVS Health. So by all means, yes, let’s Make America Healthy Again. But if that’s truly the goal, then the Trump administration’s approach, led by Robert F. Kennedy Jr., is a farce.
Despite lofty slogans, there is no clear or coherent health policy coming out of this administration. Instead, we are seeing a patchwork of marginal reforms paired with sweeping changes that ultimately do more harm than good.
Kennedy, along with figures like Centers for Medicare and Medicaid Services Administrator Mehmet Oz, National Institutes of Health Director Jay Bhattacharya, and FDA Commissioner Martin Makary, may hold political and medical credentials, but their worldview is steeped in grievance — particularly over how their views were sidelined during the COVID-19 pandemic.
Unfortunately, that resentment — more than science, compassion or public health expertise — appears to be shaping national policy.
Some initiatives, at face value, seem reasonable. Encouraging Americans to eat less processed food? Great. Eliminating artificial dyes from products? Sure. But these measures are meaningless when paired with cuts to nutrition assistance programs that help low-income families afford healthy food in the first place. You can’t claim to care about clean eating while gutting the very systems that make nutrition accessible.
And while removing certain food additives may make headlines, let’s not ignore the more urgent threat: environmental pollutants. The same administration that wants credit for minor food reforms is actively dismantling the Environmental Protection Agency. Toxins in our air, water and soil kill far more Americans than Red Dye No. 3 ever will.
The administration’s interest in rising autism diagnoses is another example of misplaced focus. Research into autism's causes is welcome. But linking it — even subtly — with a rollback of vaccine requirements is not just irresponsible but dangerous. Vaccines are among the most effective public health tools we’ve ever had. Undermining public confidence in them won’t reduce autism rates; it will bring back deadly, preventable diseases we thought we’d left behind.
Perhaps the most dangerous contradiction lies in access to care. Here, the administration has correctly identified a real problem: primary care doctors are underpaid and undervalued. Proposed changes to Medicare and Medicaid reimbursement structures could help fix that. More support for primary care would improve health outcomes and lower long-term costs — there’s no serious debate about that.
But these small improvements are being completely undercut by broader efforts to dismantle access to care. Medicaid eligibility is being slashed. Premium subsidies for plans under the Affordable Care Act are on the chopping block. Taken together, these changes could strip health insurance from more than 20 million Americans. That means fewer patients able to afford care — even from the very primary care doctors the administration now claims to support.
For decades, there’s been bipartisan consensus that access to health insurance — and by extension, health care — is a public good. That consensus is being dismantled in real time. And the cost, measured in lives, could be staggering. Credible analyses estimate that tens of thousands of Americans will die prematurely due to lack of access to care — deaths that could have been prevented with early diagnosis, regular screenings and affordable medications.
Recent research I have conducted — including visits to dozens of primary care clinics — has put a human face on the statistics. Even when physicians are willing to treat uninsured patients, they and their nurse practitioner colleagues are often unprepared for the reality of caring for people who can’t afford hospitals, specialists or basic tests. Doctors are forced into heartbreaking compromises, knowing the right course of action but unable to pursue it because the patient can’t pay. For patients, it is worse: the agony of knowing something is wrong, but being priced out of care. In a country as wealthy as ours, no one should have to face that reality.
This is the core of Make America Healthy Again. The rhetoric is bold, but the reality is brutal. Behind the slogans lies a health agenda fueled more by ideological vendettas and populist distrust than evidence, empathy or strategy. MAHA may claim to stand for medical independence, but it ultimately abandons the very people it purports to serve — whether it’s a child left unprotected from measles or an adult suffering a fatal heart attack due to unaffordable care.
Unless the direction changes soon, we can expect more slogans, more symbolic gestures, and more policy decisions that undermine public health. The question is no longer whether this approach will work — it won’t. The real question is: how many lives will be lost before we change course?
Troy Brennan, M.D., is an adjunct professor at the Harvard School of Public Health and a former executive at CVS Health.
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