Republicans Should Run Against Medicare for All

National Review Online

Tuesday, September 15, 2026

 

Democrats are partying like it’s 2019.

 

Coming off a successful midterm election year and convinced that socialism was where the energy of the party would be, Democratic presidential candidates lined up that year to embrace a government takeover of the health-care system they branded as “Medicare for All.” But in relatively short order, questions about the staggering cost and massive disruptions associated with the idea helped sink the candidacies of Elizabeth Warren and Kamala Harris, and ultimately helped catapult Joe Biden (who endorsed more incremental expansion of government-subsidized health insurance) over Bernie Sanders.

 

This year, Medicare for All has reemerged. Democrats have nominated a number of candidates who support the idea, including in two of the most competitive Senate races — Abdul El-Sayed in Michigan and Troy Jackson in Maine.

 

The pitch for Medicare for All starts off quite simply. We’re the richest country in the world, we spend all sorts of money on weapons, we should be able to afford to provide free health care to everybody. The promise is of a paradise in which there is no more dealing with being denied care by insurance companies or struggling to pay for prescription drugs.

 

Yet once anybody examines the details, the sales pitch becomes much less appealing. To start, there is the incredible cost. Back in 2019, the progressive Urban Institute estimated that a Medicare for All system along the lines of what Sanders proposed would cost about $34 trillion over ten years. To be clear, that was not the total cost of the program, but how much it would be expected to increase federal spending on top of the trillions a year we already spend on health-care programs. After seven years of inflation, the number is certainly higher today. An updated analysis from Stephen Parente of the right-leaning American Action Forum estimated that the cost of such a system over the next decade would be $47.4 trillion.

 

The immense cost of health care doesn’t disappear when it’s absorbed by the government — it just is paid in the form of taxes and debt rather than premiums. At the time, the Committee for a Responsible Federal Budget estimated that a $30 trillion increase in health-care spending could not be financed through simply taxing the rich, and would actually require the equivalent of a 32 percent increase in payroll taxes or doubling all income tax rates — actions that could shrink annual economic output by over 7 percent.

 

Efforts to contain costs by denying care do not go away — the only difference is that in socialist systems like the U.K. and Canada, it is a government bureaucrat saying “no.”

 

Lately, Sanders has been pointing to an analysis done by Medicare for All–supporting authors from the Yale School of Public Health last month claiming that implementing such a system would save lives while reducing health-care spending by $1 trillion a year. But the assumptions required to get that estimate are ridiculous. For instance, under the current system, doctors and hospitals earn less money from treating Medicare patients, which they are able to do by shifting costs onto privately insured patients. But the Yale analysis assumes that the new program would be paying Medicare rates for all Americans — which would be financially unsustainable for medical providers and would reduce access for Americans, especially at more cash-strapped rural hospitals. The analysis also assumes a 51 percent reduction in costs for prescription drugs, without any discussion of how that would impact research and development.

 

In addition to the costs and disruption to health-care access, a true Medicare for All system would necessitate the elimination of private health insurance, meaning most Americans, including the 161 million Americans who obtain insurance through their employers and the 36 million seniors who have chosen Medicare Advantage plans, wouldn’t be able to keep their coverage, even if they liked it. There was a massive backlash when Americans realized they wouldn’t be able to keep their plans under Obamacare, and that was a comparatively small few million people.

 

Republicans, facing headwinds in the midterms, would be wise to spend this fall making a sustained case against Medicare for All.

The Shallow Iconoclasm of HHS Leadership

By Grayson Logue

Thursday, September 10, 2026

 

Robert F. Kennedy Jr. and his allies at the Department of Health and Human Services (HHS) are tired of talking about measles. In the weeks before and after the controversy over the recent measles-associated deaths in Lancaster County, Pennsylvania, HHS officials were characterizing the focus on the spread of the world’s most contagious disease as a campaign by media and Democrats to distract from the toll of chronic disease.

 

“The media and certain demagogic politicians are constantly trying to scare us about infectious disease,” Kennedy said in a town hall last month with Fox News. “And we take the attention away from the chronic disease that is being caused by powerful entities, by big food companies, by big pharmaceutical companies!” He referred to the two measles fatalities as “so-called” measles deaths. While there was uncertainty about whether one infant infected with measles had died due to complications from the virus, the Lancaster County coroner announced last Friday that a second infant, a 6-week-old baby, had died from the disease.

 

Despite leading a sprawling department responsible for overseeing the nation’s federal public health agencies, Kennedy continues to operate like an outsider, railing against the very system he administers. Faced with growing outbreaks, Kennedy and his allies alternate between claiming the spread is insignificant, solely the fault of their predecessors, or being sensationalized to distract from the MAHA agenda. They consistently fall back on amplifying institutional distrust, but the refrain betrays a lack of progress in fighting both infectious and chronic disease.

 

Downplaying outbreaks.

 

Calley Means, a senior adviser at HHS, is a prominent MAHA influencer who helped connect the Kennedy and Trump campaigns in 2024 prior to Kennedy’s endorsement of the GOP presidential candidate. Before the announcement of the Pennsylvania deaths, Means had spent recent weeks decrying any focus on measles outbreaks, comparing measles deaths to annual childhood drownings or the toll of chronic diseases. “[Zero] Americans have died this year of measles. 300 per year died before invention of vaccine. The U.S. is managing the current Fauci measles outbreak better than any other country. Over 1 million Americans will die this year of preventable chronic diseases tied to our food system. Any medical influencer only talking about measles and not talking about chronic disease is a political hack, not someone who cares about public health,” Means posted on X last month.  

 

While deaths from measles outbreaks since the start of the Trump administration have been few, the U.S. has seen a 35-year high in cases—more than 5,300 since January 2025—and nearly 500 hospitalizations, including 280 teenagers and young children. But Means’ suggestion that the pre-vaccine measles toll was insignificant isn’t supported by estimates from the Centers for Disease Control and Prevention (CDC): In that era, the country experienced between 3 million and 4 million cases each year, 400 to 500 deaths, and 48,000 hospitalizations.

 

Means had made similar arguments about recent foodborne illness outbreaks. Responding to Fox News host Jessica Tarlov’s criticism of the administration’s response to measles and cyclospora outbreaks, Means wrote, “These imbeciles like  @JessicaTarlov are gleeful that there are a couple cases of diarrhea that they can blame on RFK.” The U.S. has struggled with foodborne illness for years, and outbreaks have been common across administrations, though the Trump administration also cut a range of programs and funding aimed at improving food safety. Regardless, there have not just been “a couple cases of diarrhea.” The country has experienced the largest cyclospora outbreak in history, with more than 19,500 confirmed cases and more than 9,000 additional cases that have yet to be confirmed in a lab. More than 1,000 people have been hospitalized, and two have died.

 

Means has falsely claimed food recalls are at a multiyear low, after apparently confusing data on total product recalls (which include everything from medical devices to drugs and tobacco products to food). The number of food recalls in fiscal year 2025 was the highest since 2018, and this year’s recalls are on pace to exceed last year’s.

 

Oversimplifying chronic disease.

 

Kennedy and Means say they want to shift attention to chronic disease, specifically conditions like obesity and diabetes that are linked to food and lifestyle choices, because those conditions are responsible for more death and suffering than infectious disease. As a matter of raw numbers, they are right: Chronic disease is the greatest healthcare burden on the country, in terms of both deaths and cost. A large portion of this burden can be attributed to poor diet and lack of exercise, but shifting Americans’ lifestyles in a better direction at scale is a complex public policy and cultural challenge involving deeper and broader issues than media attention and narratives.

 

HHS officials have spent a great deal of time talking up efforts to remove food dyes and provide inspiration in the form of cooking shows and workout videos, but the administration has so far fallen short on broader reforms to food and agriculture policy. For example, officials are still struggling to come up with a regulatory definition for ultraprocessed food, months after Kennedy had promised results; food industry executives reportedly nixed the public release of the definition last month. Pushing states to remove sodas and sugary drinks from SNAP benefits is a step in the right direction, according to some nutrition policy analysts, but it’s unclear whether the administration’s overall SNAP policies will be a net win for healthier eating after taking into account the significant cuts to the program Congress passed last year.

 

The administration has also been comparatively quiet on chronic disease factors that are unrelated to food, such as smoking and alcohol consumption. The CDC’s Office on Smoking and Health, which ran a longstanding and effective antismoking ad campaign and funded state smoking cessation programs, has been shuttered since April 2025. The administration’s new dietary guidelines, released this January, included a mix of improvements upon the previous guidance and revised suggestions with little data to back them up. They substituted recommended daily limits on alcohol consumption with a vague admonition to “consume less alcohol for better health.” Smoking and drinking were not addressed in last year’s MAHA Commission report on causes and solutions to the childhood chronic disease crisis.

 

The complexity of chronic disease and the administration’s mixed record haven’t stopped Kennedy and Means from trying to claim credit for any positive shifts. “The Trump administration will see the largest declines in diabetes and obesity in modern American history - as a direct result of its policies,” Means claimed earlier this summer. “Yet all the media can talk about is measles.” Obesity rates have been falling, but that decrease tracks closely with increased use of GLP-1 weight-loss drugs. The Trump administration’s attempts to lower the cost of drugs like GLP-1s have been a mixed bag. What’s more, both Means and Kennedy voiced opposition to the use of GLP-1s because they see it as a pharmaceutical solution to a problem that should be addressed through diet and wellness changes, though they’ve softened their tone since joining the administration.

 

Promoting distrust.

 

The administration has claimed it is restoring trust in the public health system, but Kennedy and Means spend a good deal of time encouraging distrust. “Americans distrust of the media and medical system is rational. Why should you trust institutions that relentlessly lied (and never apologized) on so many other topics like COVID,” Means posted last week. Trust in the CDC’s public health recommendations declined from 77 percent last spring to 50 percent a year later, according to a poll by Harvard University and the de Beaumont Foundation. Other polls have documented similar declines across federal health agencies.

 

As a direct result of this administration’s promotion of vaccine hesitancy, primary care doctors and pediatricians are having to spend more and more of their time fielding questions about vaccines. That’s a direct trade-off with time spent discussing other health priorities. “There will never be a day where mothers ask less questions about the pharmaceutical products they put in their children’s bodies,” Means said last month. “And that’s a good thing.” In Means’ estimation, skepticism isn’t just a salutary means to improve the healthcare system; it’s an inherent good. Doctors are facing the knock-on effects of this broadening skepticism in trends like increasing refusals of vitamin K shots for newborns. For his part, President Donald Trump described the measles, mumps, and rubella vaccine last month as possibly “quite lethal.”

 

Much of the media attention paid to infectious disease has come in reaction to Kennedy’s unilateral overhaul of longstanding vaccine recommendations and his promotion of false claims about vaccination in the midst of the outbreaks. If the secretary had done what he pledged to do during his confirmation hearing and checked his anti-vaccine priors at the door, Means’ media criticism might hold more weight. “As HHS secretary, he has selectively cherry-picked many of his longstanding interests and their purported causes (often contrary to scientific evidence) and framed his narrative under the header of chronic disease,” Dr. Anand Parekh, a former HHS official in the Bush and Obama administrations who worked on chronic disease issues, including nutrition and infectious disease response, argued in an essay last month. “This tunnel vision carries a very high opportunity cost. We have spent the first year of Kennedy’s tenure having to talk about vaccines, raw milk, acetaminophen, peptides, and fluoride instead of sodium, tobacco, added sugars, alcohol, adverse childhood experiences, and other established chronic disease risk factors.”

 

Only since the 2024 presidential campaign has Kennedy focused his advocacy intently on diet and nutrition. For years before, he argued that vaccines are one of the biggest drivers of chronic disease. “He believes falsely that vaccines are causing chronic diseases, and he sees these outbreaks as a very, very small price to pay for his war against vaccines, which he believes are a major cause of chronic diseases,” Dr. Paul Offit, who directs the Vaccine Education Center at the Children’s Hospital of Philadelphia and has followed Kennedy’s anti-vaccine advocacy for years, told The Dispatch. “The problem is vaccines don’t cause what he’s claiming them to cause. The only outcome of this is these massive outbreaks, [and] not just measles. We had almost 300 children die of influenza last year. We had close to 200 die this year.” Kennedy has canceled public campaigns promoting flu vaccination, removed the universal recommendation for childhood flu vaccination, and suggested publicly in January that it would be better if fewer children got the vaccine.

 

While Kennedy presents the media and Democrats as using infectious disease to distract from chronic disease, his beliefs about vaccines have long promoted a false dichotomy between the two health issues. Though some public health leaders agree that the work of preventing and fighting infectious disease outbreaks strains limited health resources, that’s a reason to work toward getting outbreaks under control, not to downplay them. “You cannot effectively focus on chronic diseases while you’re being repeatedly overwhelmed by acute infectious outbreaks,” Dr. Jerome Adams, surgeon general during the first Trump administration, argued last month. “Uncontrolled salmonella, cyclospora, measles and the next emerging threat won’t step aside so we can concentrate on diabetes or hypertension. Those illnesses disrupt lives, strain hospitals, erode trust and make longer-term prevention far harder.”

 

At this point, it’s certainly plausible to argue that Kennedy’s HHS tenure will be characterized not by a significant reversion of chronic disease rates, but by atrophying public health programs and systems and a worsening trust crisis that has fueled the resurgence of vaccine-preventable diseases. Contrary to Means’ and Kennedy’s claims, Adams believes the damage to outbreak surveillance and response and plummeting public trust will be the enduring legacy. “What makes me sad isn’t the argument,” he wrote Monday. “It’s the ledger we’re handing our kids: lower trust, fewer people who can count cases, and diseases we had already beaten coming back.”

Trump Is the Real Vaccine Skeptic in His Administration

By Grayson Logue

Monday, August 10, 2026

 

President Donald Trump held his most recent televised Cabinet meeting at Camp David last month, going around the room to hear updates from department secretaries on various policy fronts. When Robert F. Kennedy Jr’s turn to speak came, he talked up the progress the administration had made on drug pricing policies. The president nodded along, but after his health and human services secretary finished, he inquired about progress on another issue. “How are you doing on the autism research? Because that’s so important,” Trump asked. “We will have an answer for you,” Kennedy replied.

 

“We’ll be talking about that—we’ll be having something of interest,” Trump added.   

 

Much scrutiny and reporting has rightfully focused on how Kennedy has used his position at the Department of Health and Human Services to promote vaccine skepticism and to try to roll back long-standing immunization recommendations. But the man who tapped Kennedy for the post has long maintained his own strain of vaccine skepticism, which seems to have reemerged in recent weeks as a force driving policy.

 

The Cabinet meeting exchange followed reporting from the Wall Street Journal a few days earlier that Trump had begun pressuring Kennedy to do more to try to establish a connection between vaccines and autism—numerous studies over decades have found no link—as well as reduce the number of vaccines that children receive, and the secretary appeared to confirm the reporting in an interview with CNN earlier this month. During a May meeting at one of his golf courses, Trump reportedly ribbed Kennedy for the lack of progress on eliminating vaccines, telling him that he had the yips. Last Thursday, several media outlets reported that the White House is preparing a new executive order on childhood vaccines and autism, though the details are not yet clear.

 

Throughout last year, Kennedy appeared to have free rein to pursue his own anti-vaccine agenda, and at times, Trump joined in the effort, including last September when the president went even further than Kennedy in misrepresenting the science around possible associations between Tylenol taken during pregnancy and autism. The president also endorsed Kennedy’s effort in January to unilaterally rewrite the childhood vaccine schedule under the guise of mirroring other peer nations’ recommendations. The resulting cuts to routine vaccine recommendations did not, in fact, approximate other peer countries.

 

But by the beginning of this year, senior advisers in the White House had reportedly put the brakes on Kennedy’s efforts, worried about polling showing that vaccine skepticism would hurt Republicans in the midterm elections. A court decision in March froze the changes to vaccine recommendations and the childhood shot schedule that Kennedy had carried out unilaterally and pushed through an advisory committee at the Centers for Disease Control and Prevention. Throughout the spring, Kennedy largely stopped talking about vaccine issues in public and emphasized less controversial aspects of his MAHA agenda like healthy eating, even launching his own cooking show.   

 

Trump’s reengagement on issues related to vaccines suggests that attempts to restrain Kennedy came from White House staff but not the president. In late May, the same month Trump reportedly started pressuring Kennedy on vaccines, the president issued an executive order taking another swing at the peer-country shift that the court had put on hold for failing to consult the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP). In December, the president issued a brief presidential memorandum directing Kennedy to align the childhood schedule with peer-countries’ recommendations. The May order seemed structured to provide a more solid legal footing for the administration to make a second attempt at cutting the number of routine vaccine recommendations.

 

The president is not as broadly anti-vaccine as Kennedy and often says he’s generally supportive of vaccines, particularly the polio vaccine—an immunization the HHS secretary has falsely claimed killed more people than the disease itself. “No, I believe in vaccines,” Trump said in a May interview. “But I don’t believe you have to have a mandate for all of them. The polio vaccine [is] amazing, you know—wiped it out.”

 

But Trump has maintained for decades that the concentration and total number of vaccines recommended for children are unnecessary and cause autism. In that same May interview, Trump detailed his feelings:

 

I believe in vaccines, but I think we’re up to 88 vaccines, and I really feel that vaccines, if they were given in smaller quantities. …  They want to cut some out, and that’s good too, I agree with that. Eighty-two is too many. If you look at Denmark and other countries, you have 12, 14, I think 17, and we have like 82. But I look at these beautiful little babies and they get like a vat, a big glass of stuff pumped into their bodies, and I think it’s a very negative thing to do.

 

He added that his beliefs are independent of Kennedy’s vaccine views: “I’m not doing that in terms of Bobby or not. I hope they agree with that, but that’s just my opinion. I would love to see much smaller shots, like four visits to the doctor, and I think you would have a much better result with the autism.”

 

Trump incorrectly conflated the number of diseases targeted by routine immunization—18 in the U.S.—with the total number of vaccine doses a child is recommended to receive in the first 18 years of life. The White House has promoted the false claim that the U.S. vaccine schedule recommends that babies receive 72 injections. You can arrive at that number by totaling doses—getting a COVID and flu shot every year until age 18 accounts for half of that total—but not injections, since some vaccines are delivered via combination shots. None of the peer countries highlighted by the administration, including Denmark, recommend fewer than 30 total doses. Public health observers have argued that fearmongering about injections harming babies has contributed to a decline in infants receiving vitamin K shots at birth. Those injections are not vaccines and are administered to eliminate the risk of severe bleeding from vitamin K deficiency.

 

What’s more, the number of diseases protected against by the childhood schedule has increased over the decades, but improvements in vaccine technology have resulted in a significant decrease in the number of proteins and molecules, known as antigens, required to trigger a sufficient immune response. Put simply, today’s shots are easier on the immune system. The entire modern vaccine schedule includes a total of 165 antigens, lower than the number in a single vaccine of previous eras. For comparison, babies and young children encounter anywhere from 2,000 to 6,000 antigens in their natural environments every day.

 

A mountain of studies has failed to establish a link between childhood vaccines and autism, or the idea that combination shots like the measles, mumps, and rubella (MMR) vaccine cause autism. A study published last month examined a cohort of 2.5 million American children and found that receiving an MMR vaccine dose before age 2 had no association with autism.

 

The idea of spreading out the vaccines a child receives has gained acceptance among some parents because it sounds intuitively safer, even though the scientific data indicate that delaying immunizations increases the risks of a child contracting potentially harmful diseases. It’s also the kind of gut, intuitive belief that Trump is known for, not unlike his belief that tariffs benefit the U.S. economy. As far back as 2007, Trump promoted the belief that the quantity of injections caused autism. “When I was growing up, autism wasn’t really a factor,” he said. “And now all of a sudden, it’s an epidemic. Everybody has their theory. My theory, and I study it because I have young children, my theory is the shots. We’ve [been] giving these massive injections at one time, and I really think it does something to the children.”

 

In 2014, he posted on social media, “Healthy young child goes to doctor, gets pumped with massive shot of many vaccines, doesn’t feel good and changes - AUTISM. Many such cases!” He also wrote at the time, “If I were President I would push for proper vaccinations but would not allow one time massive shots that a small child cannot take - AUTISM.”

 

While Kennedy has been the face of the modern anti-vaccine movement, the vaccine skepticism flowing from the administration is not simply the result of Trump installing an attorney whose career centered on suing vaccine manufacturers as the federal government’s top health official. It’s also emanating from the president’s proclivities and his insistence on risking the country’s health in an attempt to validate his personal opinions.

The FDA Does a Very Good Thing

By John R. Puri

Thursday, August 06, 2026

 

Despite what RFK Jr. says, mRNA-based vaccines have the potential to be groundbreaking. It came as a pleasant surprise this morning to see that one more will soon be available, with possibly lifesaving consequences.

 

From the New York Times:

 

The Food and Drug Administration on Wednesday approved the first mRNA flu vaccine, enabling use of a technology that will make it easier to rapidly target a widely prevalent or particularly virulent strain of the virus.

 

The vaccine, developed by Moderna, proved more effective than flu vaccines currently on the market in clinical trials:

 

The company enrolled nearly 41,000 people who were 50 to 64 years old in a major study that found that the vaccine was effective but had more side effects than a vaccine manufactured with older technology. In the study, about 21,000 people took the Moderna vaccine and about the same number took the comparator vaccine. Within six months, 411 of the Moderna recipients got the flu compared with 557 of those who took the other flu shot. That translated to a relative efficacy of about 27 percent.

 

There are drawbacks, unfortunately, as with any alternative drug. Those taking Moderna’s vaccine were twice as likely to experience minor side effects, such as injection-site pain, fatigue, and headache. Out of 21,000 recipients, there were three cases of serious medical reactions linked to the shot. (None resulted in death.)

 

These are risks worth considering against the benefits of increased immunization. But they are far better considered by doctors and patients, on a case-by-case basis, than by bureaucrats who make a one-size-fits-all determination. The FDA’s job is to ensure a baseline level of safety and efficacy and then allow individuals to judge for themselves. Approving the vaccine was the right call — especially because it sets the precedent that future mRNA drugs, targeting much worse diseases than the flu, will get a fair shake.

 

Incredibly, however, Moderna’s application almost didn’t receive even a cursory review:

 

Initially the F.D.A. had refused to even review Moderna’s application for approval earlier this year, but quickly reversed course after a public outcry. The flu kills more than 300,000 people worldwide each year and was particularly harsh in the 2024-25 season, with an estimated 45,000 deaths in the United States, including at least 297 reported cases in children, according to the Centers for Disease Control and Prevention.

 

That decision “came from the desk of Dr. Vinay Prasad, who at the time was the head of the agency’s vaccine division.” He isn’t there anymore. Amazing things can happen when Bernie Sanders acolytes step away from regulatory positions.

 

As for why Prasad held such an important job in the first place, we can thank the boss at the Department of Health and Human Services. Hopefully no one has told him about the Moderna approval.

Liars and Loons

By Nick Catoggio

Thursday, July 30, 2026

 

You know populism is having a good week when the White House Correspondents’ Dinner isn’t the most self-discrediting elitist spectacle of the past seven days.

 

That came on Wednesday, when COVID pope Anthony Fauci was hauled before a Senate committee to explain why some of his public statements during the pandemic didn’t jibe with the thoughts he recorded in the private diary he was keeping at the time. Modern congressional hearings unfailingly generate far more heat than light, and this was no exception. But the heat was enough to melt a meaningful chunk of what’s left of Fauci’s reputation.

 

On the advice of counsel, to avoid the risk of perjury charges that might arise from his testimony, Fauci invoked his Fifth Amendment right to refuse to answer questions no fewer than 111 times. A man who spent seemingly every waking moment of 2020 and 2021 chattering into microphones suddenly had nothing to say.

 

It’s true, of course, that pleading the Fifth isn’t proof of wrongdoing, no matter what Josh Hawley might tell you. But it’s also true that it’s a tactic that the public associates with criminal lowlifes like gangsters, or the president. Fauci will never fully recover.

 

Just as embarrassing was the habit revealed by his diary of the doctor squeeing like a teenage TikTok influencer about how famous he was becoming during the pandemic, replete with name-checking the celebrities who had reached out to him. The eternal populist critique of the ruling class is that its highest priority is enhancing its own prestige, and now here was apparent confirmation in Fauci’s own words.

 

“Reading this, I truly worried about someone who would take a call from Dionne Warwick to talk about vaccines in a moment when the country really needed him to be a bit more focused,” The Atlantic’s Gal Beckerman sniffed of the diary entries.

 

And then, to round matters off, there was the matter of the blanket pardon Fauci received from Joe Biden during the final hours of the former president’s term. Biden would say that he did that to shield the doctor, a longtime MAGA hate object, from being unfairly harassed by a renegade Trump Justice Department. (A reasonable concern, to be sure.) But it had the effect of immunizing Fauci from any crimes he really did commit between 2014 and 2025—like, say, perjury in the testimony he gave to Congress during the pandemic.

 

So Fauci is untouchable legally—living proof that Trump and the right haven’t quite cornered the market on granting clemency to ideologically aligned cronies and shielding them from public accountability. Fauci will never need to explain whether he deliberately undersold the possibility that COVID leaked from a Chinese lab when, it turns out, he was privately agnostic about its genesis early on. Or whether his public skepticism of the lab-leak theory had to do with the fact that his own agency helped fund the Wuhan lab that was carrying out the sort of research that might plausibly have produced a Frankenvirus.

 

The political script here writes itself. You can’t trust the experts. They’re drunk on their own power and will lie to protect it. They care more about their own press than they do about your life. As I say, a good week for populism.

 

But not as good as it might have been.

 

No reckoning.

 

“It’s a real shame that the country cannot have an honest conversation, with the benefit of hindsight, about the many mistakes that were made six years ago,” the Washington Post wrote in an editorial about yesterday’s dismal Fauci hearing. “America has never fully grappled with the causes and consequences of COVID.”

 

My editor made a similar point this morning. In the past, he noted, major national failures typically generated serious inquiries into finding out what went wrong. Sometimes, as with segregation, those inquiries were informal matters of cultural reflection and debate. But with acute episodic crises—the Kennedy assassination, September 11, Nixon-era abuses by federal intelligence agencies—Congress opened bipartisan fact-finding investigations that ended with recommendations for reform.

 

Not the pandemic, though. Even if Fauci had agreed to answer the committee’s questions, it’s hard to imagine yesterday’s hearing producing anything more illuminating than Republican members telling him that he belongs in prison and Democratic members asking him how it feels to be a hero. Why is that? Why can’t America do a fruitful, thoughtful examination of what everyone agrees was a mismanaged once-in-a-lifetime calamity?

 

The easy answer is that the same bitter hyperpartisanship that’s made presidential landslides a thing of the past has made earnest nonpartisan problem-solving a thing of the past too, at least in matters as intensely politicized as COVID. Consider this: Unlike with most major national failures, the two sides can’t even agree on what the failure during the pandemic was.

 

The Warren Commission probed the government’s failure to detect an assassin and to protect the president from him. The 9/11 Commission probed the government’s failure to sniff out and foil a terrorist plot. The Church Committee probed the government’s failure to keep intelligence bureaus from being turned against the public those bureaus were supposed to protect.

 

Which failure would a “COVID Commission” probe? The failure to limit transmission of a virus that ended up killing more than a million Americans? Or the failure involved in locking down schools and businesses and imposing mandates for masks and vaccines?

 

The divide over how America failed during COVID is less an ideological “disagreement” than it is a divorce. It’s why, to borrow a term my editor used, Fauci has become a “totem” of sorts for both sides. In a country where each party increasingly regards the other’s continued viability as a threat to the American experiment, politics is less a shared struggle toward national improvement than a battle for dominance to crush an incompatible worldview. Each worldview reflexively polarizes around sources of authority, and so Fauci became an angel to the left and a devil to the right.

 

That also explains why idiot socialists are still masking in 2026. It’s not because they’re terrified of COVID. It’s because they’re keen to signal their allegiance to a worldview in which the state is empowered to take draconian measures in the name of “safety”—as leftists define it, at least. Masks are totems too.

 

In my darker moments (which are most moments, admittedly), I’d go further and hypothesize that Americans aren’t clamoring for a “COVID Commission” because they simply no longer expect national problems to be addressed seriously, let alone solved. In May, Pew Research Center published a poll in which it asked respondents whether they thought the country’s best days are behind it or ahead of it. Across all parties and all races, majorities answered “behind.” An America that continually stumbles into wars it can’t win, that remorselessly amasses a national debt it knows it can’t sustain, and that twice elected a character like Donald Trump is plainly incapable of dealing conscientiously with challenges.

 

We’re in our “managed decline” phase as a nation, and most of us know it. So why go through the motions of pretending that a “COVID Commission” might be productive?

 

There’s another reason that a thoughtful bipartisan investigation into the pandemic is impossible, though. One of our two major parties is beholden to populists, and “populism” and “thoughtfulness” are basically a contradiction in terms.

 

The lesser evil.

 

The two lessons I gleaned from yesterday’s hearing and the right-wing commentary around it are (1) Fauci isn’t very trustworthy, and (2) if you’re forced to choose between letting him set your scientific policy and letting Republicans do it, take Fauci every time.

 

That’s what I meant when I said above that the hearing was a missed opportunity for populism. Having effectively discredited the expert di tutti experts, the GOP should have been teed up to assert itself as the superior choice for Americans on public health. It … did not do that.

 

When I say that Wednesday’s “right-wing commentary” about COVID wasn’t reassuring, I’m not talking about crank randos on social media. I’m talking about Republican lawmakers. Sen. Ron Johnson babbled at the hearing about an alleged epidemic of suicides among people who’ve been “injured” by the COVID vaccine. Rep. John McGuire complained to Newsmax that Americans had been urged to take a vaccine that includes “human fetus baby parts” when they could have simply used ivermectin instead. Then Sen. Tommy Tuberville topped both of them by accusing Fauci of having been responsible for no fewer than 9 million deaths.

 

Granted, not every Republican in Congress is a lunatic. But they all answer to lunatics, which is how we ended up with Bill Cassidy, M.D., feeling obliged to support the most infamous anti-vaccine advocate in the country to be head of the Department of Health and Human Services. In a declining America, you can have Fauci spearheading pandemic policy in between signing autographs—or you can have Robert F. Kennedy Jr. presiding over an unfolding disaster in American vaccine uptake with potentially dire long-term consequences. Take Fauci.

 

QAnon chronicler Mike Rothschild captured the absurdity of populist strains of thought about COVID with what’s at best a half-joke: “The overwhelming right-wing sentiment is that COVID was an engineered bioweapon that was also harmless. Trump overreacted to it by shutting down the country, then engineered a drive to create a vaccine that was the real bioweapon that killed millions, and it’s Joe Biden’s fault.” Another Twitter user flagged a dispute between two populists, one insisting that the virus leaked from a Chinese lab and the other insisting that the virus never existed, with the caption “the diversity of right-wing thought on display.” Those are the impulses that congressional Republicans somehow have to navigate.

 

How could they possibly conduct a serious pandemic investigation under the circumstances?

 

What about Ron DeSantis? you might say at this point. The governor of Florida is very much a populist, and he had a thoughtful COVID policy in the early days of the pandemic, back when Democrat Andrew Cuomo was seeding contagion in nursing homes across New York. DeSantis is the exception that proves the rule, though: Having boldly defied the left-wing lockdown consensus and followed the facts initially, he began meekly pandering to right-wing anti-vax paranoia as he prepared to run for president in 2024. At last check he was busy pushing his state legislature to repeal certain vaccine mandates for schoolchildren.

 

Not every Republican politician is a lunatic. But they all answer to lunatics.

 

The supreme tragicomic example is Trump, of course, who’s never been free to celebrate his momentous achievement in helping to bring the COVID mRNA vaccine to market during his first term. He spent months after leaving office in 2021 urging supporters to take the vaccine, only to discover that this is one matter in which their loyalty to him isn’t absolute. By 2024 he had stopped mentioning it altogether; “I’m not allowed to talk about it,” he said, not a little resentfully, “because I’m a Republican.”

 

Two years on, though, he seems to have finally caught up with his own base. Reportedly, Trump approached Kennedy recently to ask why he wasn’t moving faster to reduce the number of childhood vaccinations recommended by the federal government. The president is now more eager than his fanatically anti-vax deputy to scale back immunizations. Once again, for emphasis: Take Fauci.

 

Brain worms.

 

Even thoughtful right-wing commentators, when writing about left-wing pandemic failures, rarely reckon seriously with the fact that they’re allied with a faction of witch-doctor lunatics who’d rather spend money studying whether ivermectin cures cancer than encouraging mRNA research.

 

In noting that, I don’t mean to imply that, because the right is crazy, it’s acceptable for Fauci to lie or for Democratic policymakers to take dictation from the teachers unions on opening schools. But if we’re going to critique the expert class usefully, with an eye to convincing readers to trust it less blindly, we should probably be more forthright about pointing out that the main alternative to Faucism in modern America has brain worms. Literally.

 

Nor should we excuse populist derangement over the pandemic as an understandable or even defensible reaction to the expert class’ deceptions. It’s doubtless true that Fauci’s deceit about masking and revisionism about herd immunity piqued skeptics’ mistrust in the science bureaucracy, but right-wing mania over COVID was already raging long before Fauci became an Enemy of the People. As early as April 2020, just a month after the virus began spreading aggressively, the FDA had to debunk the populist craze over hydroxychloroquine as a pseudo-folk remedy against it.

 

You can have Fauci telling “noble lies” about masks to try to protect the supply available to hospital workers, or you can have the president musing about bleach injections and his fans praising the magical healing powers of a deworming medication. Only a doomed, decadent country would put itself in a position of having to choose between the two, but if we do have to choose—and most right-wing critiques of Fauci implicitly invite us to do so—the choice is clear. “The experts are untrustworthy” does not rationalize brain-worms populism.

 

And that’s the only kind of populism there is in practice, I suspect. Even when it has valid grievances, even when it’s led by obviously intelligent figures like DeSantis, the intense pressure populism is under to affirm and ventilate the suspicions of its supporters—whether those suspicions are reasonable or not—will lead it inevitably toward crankery. To its own detriment.

 

It’s why DOGE, led by the richest man in history and driven by an obviously legitimate belief that government is too wasteful, ended up cutting federal programs so vindictively and indiscriminately that Elon Musk himself recently admitted that he’d gotten carried away. It’s why Trumpists, despite enjoying strong popular support for measures like mandatory voter ID, can’t resist framing calls for better election security in terms of ludicrously paranoid conspiracies to rig elections. Populism could and should win on those issues, just as it should win its case against Fauci.

 

But the brain worms always find their way in.

 

Maybe we’ll eventually see a form of it that’s better suited to governing responsibly. (Leftists might point to the New Deal or the Great Society as examples, although you can imagine what an anti-statist conservative like me thinks about that.) “Populism, but smart” is the implied warranty of J.D. Vance 2028; a brilliant Ivy-trained mind like his can deliver the sober, reality-based people power that skeptics are waiting to see, his fanboys would insist. Could be—but remember that the vice president has also “been a conspiracy theorist for a decade,” according to the White House chief of staff. Even in a brain as formidable as his, the worms are stirring.

 

I’ll believe “populism, but smart” when I see it. In its current incarnation the movement is a purely adversarial force, unequal to the challenge of governing effectively and not even very interested in doing so. It won’t pursue an inquiry like “What went wrong with COVID?” because it won’t risk having to reach conclusions that challenge the inviolable suspicions of its supporters. If populists were more intellectually honest and civically virtuous, Wednesday’s Fauci disaster would have been the first chapter in an earnest effort to improve America’s scientific bureaucracy. As it is, the book is closed.

 

 

So Sorry, It’s Not ‘Your’ NHS, Gents

By Andrew Stuttaford

Friday, May 29, 2026

 

“Our” NHS, the envy of the world, etc., may be on the edge of taking a step that, if approved, will act as a deadly reminder of how brutal health care rationing can be within Britain’s National Health Service.

 

The Daily Telegraph:

 

The UK performs worse than many European countries on prostate cancer survival, ranking 17th of 28 countries in one league table.

 

Almost every country in Europe is now planning or piloting some form of prostate cancer screening.

 

But on Thursday, the UK National Screening Committee (NSC) – which advises ministers – ruled that the vast majority of men should be denied screening.

 

Only men with a cancer-causing form of the BRCA2 gene and a family history of breast, ovarian, pancreatic or prostate cancer should be eligible, the guidance states.

 

How many would qualify? It’s hard to say, apparently. A “few thousand” is the estimate given by the committee’s chairman.

 

If that recommendation is followed, the consequences will be lethal. Early-stage prostate cancer can be symptomless or associated with other problems that are not necessarily evidence of cancer. Either way, that increases the case for routine screening after a certain age (which will vary). If someone turns out to have prostate cancer, early detection can pave the way for early intervention, which can often amount to no more than increased surveillance. Early detection, as I know from my own family’s experience, can save lives.

 

Part of what lies behind this move is concern that early detection will prompt some men, understandably alarmed at a diagnosis that includes the word “cancer,” to press for more radical treatment than their situation calls for. But the idea that the way to address this issue is to deliberately keep people in the dark by discouraging or denying screening is at best paternalistic nonsense, at worst an attempt to provide a “medical” excuse for cost containment that may even end up failing at that.

 

The U.K. has no national prostate-cancer-screening program, a bizarre state of affairs given how common the disease is. Could it be that its dismal prostate-cancer survival rankings reflect that, at least in part?

 

Yes, that is a rhetorical question.

MAID Gone Mad in Canada

National Review Online

Thursday, May 28, 2026

 

Encouraging doctors to get involved in people killing themselves in a society with socialized medicine and declining religiosity has ghastly consequences. Who knew? Canadians can’t say that nobody warned them.

 

Social conservatives are often accused of being overwrought in predicting a parade of horribles from each step down the proverbial slippery slope of social “progress.” By the time those horribles materialize — and in most cases, sooner or later, they do — we are on to the next cause, or we’re told that people are just accustomed to this now.

 

After all, who wants to settle for slow progress when one can enjoy the swift forward momentum of jumping out the window?

 

The antiseptic acronym MAID, for Medical Aid in Dying, is almost too perfect in how it evokes the modern nanny state: a nice lady who just tidies things up for you. It was sold, as it has been sold in nations such as Britain and American states such as Oregon and New York, as compassion for those suffering terribly at the very end from incurable ailments that robbed them of their minds, their movements, and their dignity.

 

That was the teaser rate. Now, the real bill is due. As has happened in other jurisdictions, Canada started with strict criteria in 2016 and then loosened them in 2021 to apply to anyone considered to be suffering gravely, whether or not they were close to the grave. On a per capita basis, Canadians today are more likely to die of MAID than Americans are to die of gun violence.

 

Now, MAID in Canada has its own poster boy: Dr. James MacLean. If MacLean’s case is not as sensationally grisly as, say, that of Kermit Gosnell’s abortion clinic or as flamboyant as the euthanasia crusading of Jack Kevorkian, it nonetheless underlines the banality of evil at work in Canada.

 

As reported this week by the Toronto Globe and Mail and the National Post, two of MacLean’s MAID cases in 2024 have come under scrutiny following public complaints. In one, MacLean signed off on the death of a 45-year-old man with Crohn’s disease. Crohn’s, which involves inflammation of the bowels, is chronic and frequently painful, entails expensive medical care, and can lead to an early death, especially if not properly treated. But it is a far cry from the kinds of immediate end-of-life situations MAID was billed to address; many people live with it for years and years.

 

As the Cleveland Clinic observes, “Crohn’s disease isn’t usually life-threatening. Life expectancy is generally normal. But ongoing inflammation can increase your risk of colon cancer and cause other complications. . . . Treatment can help manage irritation and reduce symptoms. Most people with Crohn’s disease can live full, active lives.” At least in America, that is.

 

The National Post tells us the basis upon which Dr. MacLean thought it appropriate for the man to be put down: “because of his illness, didn’t have an active social network, had difficulty maintaining a job, found personal relationships difficult and was dependent on family for housing and financial support. He had a history of mental illness, previous bouts of suicidal thinking and on-going alcohol and opioid misuse that cost him his driver’s licence.” His family told the Globe and Mail that “he was still able to pursue hobbies such as skydiving and maintain friendships. They said the isolation of the COVID-19 pandemic and loss of work as a timber framer sent him into depression and alcohol abuse.” Think how many lives this describes, and what sort of mentality deems them worth ending at 45, with no hope of a redeeming second act.

 

In a cavalier twist that seems almost parodically Canadian, MacLean performed his entire assessment of the man outside of a Tim Hortons coffee shop. Six months later, meeting again outside of the coffee shop after communicating with the patient by text, MacLean drove the man to the “industrial-like facility” for MAID after the man refused to ride there with his sister. His family objected to the death and was not consulted in the assessment. As MacLean texted the man, “Do they think it is going to negatively impact them? It is not about them.”

 

In the second case, MacLean tried and failed to kill a 67-year-old cancer patient who had previously consented to MAID; MacLean was called in when the man lost consciousness. When the doctor wasn’t able to obtain a fresh kit from the pharmacy — pause here for a second to think of a pharmacy playing executioner’s handmaid — he simply grabbed one off the shelf that turned out to be missing the drug that was supposed to paralyze the man’s muscles to stop his breathing. MacLean gave him a powerful sedative and pronounced him dead anyway when his heart stopped, then left before his breathing resumed.

 

The doctor’s excuse was that “he believes the stress of the situation, including the last-minute and urgent request for his attendance and the substantial number of people present with significant tension amongst them, contributed to initial failed provision of MAID.” Doctors endure stress and time pressures routinely, but this sounds like the small voice of conscience, not quite stilled, in the “significant tension” over using medicine to kill rather than heal.

 

Just imagine how the botched execution of a mass murderer caused by the failure to administer the correct sequence of drugs would be received: as a moral stain on the entire “cruel and unusual” enterprise and grounds to force the pharmaceutical companies to discontinue the toxic drugs. But when the state approves this sort of thing for people who committed no crime besides illness and despair, we get what happened here: a “caution” for Dr. MacLean and an order that his practice be better supervised for six months. He can’t be taken off his rounds, after all, because those Canadians just won’t kill themselves.

Is Bill Cassidy’s Loss a MAHA Win?

By Grayson Logue

Tuesday, May 26, 2026

 

Sen. Bill Cassidy of Louisiana lost his bid for reelection in the Republican primary earlier this month. He came in third behind a Trump-endorsed challenger, Rep. Julia Letlow, and Louisiana State Treasurer John Fleming, who advanced to a June runoff. Political observers have portrayed Cassidy’s defeat as proof of President Donald Trump’s continued grip over the GOP and a cautionary tale of faltering, principled dissent.

 

Cassidy broke with Trump over the January 6 riot, voting for his impeachment during his Senate trial, but the two-term senator also voted to confirm the face of the modern anti-vaccine movement, Robert F. Kennedy Jr., as the Department of Health and Human Services (HHS) secretary. 

 

The president and Make America Healthy Again (MAHA) advocates cheered Cassidy’s defeat, but both parties have now lost whatever political leverage they once held over the senator. Cassidy, a physician who chairs the Senate Health, Education, Labor and Pensions (HELP) Committee, could be a particular headache as the administration tries to fill vacancies in key Senate-confirmed positions at HHS, including Food and Drug Administration (FDA) commissioner, Centers for Disease Control and Prevention (CDC) director, and surgeon general.

 

One way to read Cassidy’s defeat is a sign of MAHA’s electoral power. MAHA Action, an advocacy group, endorsed Letlow, the leading Cassidy challenger, and MAHA PAC donated $580,000 to her campaign, according to recent Federal Election Commission filings. That’s certainly the story that MAHA PAC and MAHA Action leader Tony Lyons want to tell. “This is a powerful indication that MAHA is a gift to the Republican Party,” he said the day after the primary.

 

Another telling is that MAHA, grasping for relevance in the midterm cycle and struggling for funds, rode the coattails of Trump’s effort to sink Cassidy. At the most proximate level, the reason why Cassidy didn’t make it to the runoff is because Louisiana Gov. Jeff Landry pushed through a change to the state’s primaries. Previous primaries had been open to any voters regardless of party affiliation, but only registered Republican voters were eligible to cast ballots in this year’s primary. Unaffiliated moderates and Democrats couldn’t vote for Cassidy unless they changed their registration. Louisiana’s Republican lieutenant governor, who opposed the change, suggested earlier this year that the primary rules were switched with the express goal of ousting Cassidy. MAHA advocates had nothing to do with the change. Fleming, a MAGA Republican that MAHA didn’t endorse, also secured more of the vote than Cassidy.

 

While the White House seems more than happy to pay lip service to MAHA goals while the midterms still loom, Cassidy’s new lame duck status comes at a time when the administration has also pivoted away from vaccine issues and ignored several of the movement’s priorities, including on herbicide use. The question for the movement following Cassidy’s loss is how influential MAHA will be for the administration in 2027 if Democrats secure a wave victory this November. What will the White House’s appetite for iconoclastic HHS leaders and appointees or more vaccine disruptions be after such a loss? In the interim, White House and MAHA will be stuck with Cassidy helming the Senate’s health committee. 

 

Cassidy unbound.

 

Cassidy joked with a reporter last week about possibly being “unbound” since his loss, and he’s wasted little time taking advantage of his newfound freedom. In the 72 hours following his primary loss, Cassidy came out against Trump’s ballroom project and the Justice Department’s recently announced $1.8 billion “anti-weaponization” slush fund. He vocally defended his January 6 impeachment vote, a subject he’d been quiet about for years, and last Tuesday, he joined Democrats and three of his Republican colleagues in advancing a war-powers resolution to end the Iran war unless the president secured congressional authorization for the conflict. 

 

He has also signaled a readiness to push back on Kennedy and HHS policies he disagrees with. “Absolutely, I’ll hold him accountable, not to be destructive, no, but to be constructive,” Cassidy said Monday when asked about oversight of the health secretary. He also emphasized that the administration has “had some bad policies regarding vaccinations.” Cassidy could use his power as chair to put Kennedy back in the hot seat or hold hearings to scrutinize any undue political influence on scientific decision-making, as he did after Kennedy fired CDC Director Susan Monarez last summer.

 

The administration will need Cassidy and the HELP committee’s cooperation to fill a lengthy list of vacancies at HHS, as well as key posts in other departments, including the commissioner of the Bureau of Labor Statistics. Trump falsely claimed that a lackluster jobs report last summer was “rigged” and promptly fired the previous commissioner.

 

Even before the primary, Cassidy had shown some willingness to push back on White House picks for CDC director and surgeon general. The administration has had to withdraw previous HHS nominees after it became clear they wouldn’t make it through the HELP committee, including Dave Weldon for CDC director and, more recently, Casey Means for surgeon general. “If you look at the HELP committee, there’s already been some back and forth regarding nominees,” Cassidy told NOTUS last week. “Am I going to deliberately push back on things? No. I’m going to do what’s good for my country and my state.”

 

Setbacks for MAHA.

 

In April, the president announced Dr. Erica Schwartz, the deputy surgeon general in his first administration, as his new nominee for CDC director and Dr. Nicole Saphier, a radiologist and a frequent Fox Business contributor, for surgeon general. A HELP spokesperson told The Dispatch that the committee is still waiting on paperwork on Schwartz and Saphier from the Office of Government Ethics to begin consideration of their nominations.

 

Sean Kaufman, an infectious disease specialist and biosecurity consultant, was also nominated last month to lead the health department’s public health emergency response agency, which has been without a permanent leader since Trump took office. The White House has yet to name a nominee to replace Marty Makary as FDA commissioner.

 

MAHA activists castigated Cassidy over the failure of the Means nomination, but the movement’s influence on HHS appointments could continue to suffer as a result of Cassidy’s loss. Schwartz and Saphier are much more traditional picks than a figure like Means. The American Public Health Association endorsed Schwartz as qualified for the post.

 

Both Schwartz and Saphier are broadly supportive of vaccines, though Saphier has signaled openness to making changes to the childhood vaccine schedule and opposes vaccine mandates. But she has also vocally defended vaccines as critical tools to prevent illness and infectious disease and criticized the way Kennedy changed federal vaccine guidance.

 

“I did think the original CDC vaccine schedule was somewhat bloated,” Saphier said on her podcast in March. “I thought we could scale back on certain things. Some of the things RFK Jr. has done, you know, I wasn’t staunchly opposed to, but the way that it has been communicated makes it seem that changes are being done because they found new evidence showing it’s not safe or it’s not effective, and that’s just not true.” She also publicly criticized Trump over his claims about the dangers of Tylenol for pregnant women and how the administration is handling a forthcoming assessment about the country’s measles elimination status, suggesting the study was purposefully delayed until after the midterm elections.

 

Of course, any tempering influence Cassidy exerts will end when he leaves the Senate in January, and Sen. Roger Marshall, a Kansas Republican, is reportedly angling to take over the HELP chairmanship if the GOP keeps control of the Senate. Marshall is an OB-GYN and a MAHA ally who disagreed with Cassidy on vaccines, particularly over whether the hepatitis B vaccine should be given at birth. He’s also been a Kennedy defender, saying during the secretary’s nomination hearing, “I think that you are the person to lead HHS to make America healthy again, that God has a divine purpose for you.” 

 

But the senate-confirmed HHS vacancies will more than likely be filled by then, and MAHA’s influence over the administration’s health policy and personnel appears on a downward trajectory. The administration is continuing to replace HHS appointees allied with Kennedy and backed by MAHA. Earlier this month, the administration fired Tracy Beth Høeg, the FDA’s top drug regulator and the co-author of a report justifying Kennedy’s overhaul of the childhood vaccine schedule earlier this year.

I’m Not a Pundit, I Just Play One on TV

By Christian Schneider

Thursday, May 07, 2026

 

In the early 20th century, John R. Brinkley gained national fame and international notoriety by surgically transplanting goat testicles into human men. Known as the “goat-gland doctor,” he made a fortune doing this, claiming it cured sexual dysfunction and other ailments, ranging from dementia to flatulence (a wide array of maladies, but not mutually exclusive). Despite the disapprobation of the medical community, he operated clinics and hospitals in several states and continued practicing “medicine” for almost two decades. He eventually ran for governor of Kansas. He nearly won.

 

The “trust me, I’m a doctor” halo is apparently quite durable.

 

The white coat is so imbued with authority that society has historically treated it as a kind of secular papal vestment. Wear one and you can tell people to ingest almost anything. Throughout history, doctors have recommended cocaine for toothaches, whiskey for essentially everything, and radium — actual radioactive radium — for “vigor.” Radithor, a popular 1920s health tonic of radium dissolved in water, killed its most famous enthusiast so thoroughly that when scientists exhumed him 33 years later, his bones were still radioactive. They had to reseal him in a lead-lined coffin.

 

A medical degree is a credential but does not make its holder an oracle. The lesson each generation refuses to learn is that doctors are subject to the same ideological fashions, motivated reasoning, and spectacular wrongness as everyone else. They just look smarter with a stethoscope around their neck.

 

Yet in recent years, the medical profession has endured a thorough battering, with doctors exposing themselves as just as misinformed and politically motivated as the general public.

 

Nowhere has this provided more comedy than in President Donald Trump’s attempt to fill the spot of U.S. surgeon general in his administration. Trump is now on his third choice for the position in little over a year, and his health secretary, Robert F. Kennedy Jr., insists on rolling out a parade of quacks to fill the slot.

 

First, Trump nominated Janette Nesheiwat, a Fox News medical commentator, who appears to have embellished her medical credentials. (For instance, she received her medical degree from American University of the Caribbean in Saint Maarten, but her online résumé claimed an M.D. from the University of Arkansas.)

 

After Nesheiwat bailed, Trump nominated Casey Means, a wellness influencer who peddled crackpot theories about vaccines causing autism. She never completed her medical training and did not have a license to practice medicine, yet still hawked unproven supplements on her podcast. A chapter of her book is titled “Trust Yourself, Not Your Doctor” — an interesting position for a doctor asking the American people to trust her advice as surgeon general. Soon, she, too, dropped out of consideration.

 

Which brings us to Nicole Saphier, a radiologist, another Fox News contributor and the Trump administration’s latest nominee for surgeon general, who has managed to position herself against nicotine pouches — specifically, against the demonstrated harm-reduction principle that a product orders of magnitude less dangerous than cigarettes should be encouraged as a substitute for cigarettes. Saphier was appalled when she watched RFK Jr. use a nicotine pouch during his Senate confirmation hearing, calling it an example of “platforming” an addictive product. (Groups such as the Campaign for Tobacco-Free Kids condemn nicotine pouches, despite the fact that nicotine has nothing to do with tobacco.)

 

Never mind that the FDA itself authorized the marketing of Zyn nicotine pouches based on a determination that they offer benefits to population health greater than the risks they pose, or that Sweden, by openly embracing harm reduction through pouches and snus, is now on track to become the world’s first smoke-free nation, with smoking-related diseases having plummeted as a result. The science, in other words, points in one direction. Saphier points in another, having given in to political pressure. Her credentials, however, remain intact and impressive-sounding.

 

Radiology, her specialty, is not pulmonology, not addiction medicine, and not public health policy. Her opposition to nicotine pouches is based not on evidence but on a moral stance that she has dressed in a white coat and presented as medicine. She described RFK Jr.’s use of the product as evidence that even those “championing health can be ensnared by the allure of nicotine’s addictive nature,” which is a very elaborate way of saying she finds it distasteful. Distaste is a legitimate human response. It is not a public health policy. And it is certainly not a reason to deny smokers a product that the FDA itself has determined helps them quit doing something that can kill them.

 

All this has led Jeffrey Singer, an esteemed doctor with the Cato Institute, to wonder why the U.S. even has a surgeon general. “The surgeon general has drifted from an apolitical public health role into a politicized platform,” Singer recently wrote, adding that recent surgeons general have been “weighing in on issues far beyond [the role’s] proper scope — from gun control to social policy — thereby undermining trust in legitimate health functions.”

 

All this is true. Progressives regularly bend their medical advice to fit their ideological causes. Everyone remembers that while Covid-19 was killing Americans by the hundreds of thousands, physicians across America decided the virus wasn’t a threat to the enormous crowds packed into tight areas to protest George Floyd’s death. The American Medical Association long supported gender-reassignment surgery for minors but now counsels against it. As a nominee to the surgeon general position, Vivek Murthy told senators that he wouldn’t use the office to push gun control, but he ended up doing just that. And as Singer has noted, the surgeon general’s office has expanded its reach to hold court on issues such as media violence, pornography, education, poverty, guns, inequality, parenting, labor, loneliness, and social media overexposure.

 

The diminishment of the medical profession by a wannabe political physician class has real-world consequences. It leads to vaccine skepticism and reliance on artificial intelligence to recommend cures. It means more parents rejecting safe but vital vitamin K shots for their newborns, leading more babies to bleed to death.

 

Naturally, not every physician is as soft-headed as an Oberlin freshman — real science and meaningful advances happen every day. But this is the thing about expertise: it has limits. It ends at the boundary of the discipline in which it was earned, and often quite abruptly. A brilliant cardiologist who ventures opinions about macroeconomics is just a person with opinions about macroeconomics who happens to know how to wield a syringe. The white coat does not travel.

 

But the coat has done a lot of work throughout history, granting status to people who are just as petty, emotional, and gullible as the rest of us. As Dr. Evil says in Austin Powers: International Man of Mystery, “I didn’t spend six years in Evil Medical School to be called ‘Mister,’ thank you very much!” The coat has sold cigarettes, prescribed cocaine, implanted goat gonads, and (in the case of brilliant neurosurgeon but amateur Egyptologist Ben Carson) stored imaginary grain in solid rock pyramids.

 

The white coat can likely survive one more nominee who confuses ideology for medicine, but the real mystery is why the federal government even bothers anymore.