Why MAHA Needs Public Health

I went to that swampy, terrible city again. But this time to talk to some people from Public Health. I thought I might be up against some headwinds, but I realized something very different.

Last Wednesday morning, I made my way to Denver International Airport to board a plane bound for Washington. My wife and I were on the front end of the power outage that turned the nation’s second busiest airport into a scene from a market in Marrakesh, but we made it out just in time. I’m not usually thankful for a flight on Frontier — their terminal is the worst one at DIA, and every time I’m down there I whistle Elvis’s song “In the Ghetto.” I found myself grateful, however, because their terminal was the only one that had power, and we were able to take off in time to get to DC. Parenthetically, the disruptions at the airport always remind me of how fragile the whole system of American society actually is. Disruptions seem to come more consistently these days as we see under the patched-together veneer, a very tenuous machine that is struggling to keep itself on the tracks. It wasn’t lost on me either that the reason for my travel was to discuss how the Make America Healthy Again movement is interfacing with public health; another system that is struggling with its footing. It has become apparent that nothing we know of our “systems” seems to be immune to the crumbling. Even movements like MAHA are realizing that idealism collides harshly with the reality of the Empire’s ferocity.

The last few weeks have been nothing but discouraging for those of us who are watching the generational political coalition that Donald Trump gathered together in the election of 2024, be dismantled by a war, a silly executive order on glyphosate, and a myriad of other mistakes, blunders and undoings that the Trump administration seems to be either fumbling their way through or willfully marching toward. I’d be lying if I said that my heart hasn’t been bent towards repentance for my part in the whole thing. I helped champion Bobby Kennedy as a campaign volunteer, and when he joined up with Trump, I reluctantly, yet calculatingly, decided that the tradeoffs were worth what I believed Mr. Kennedy could advocate for within the walls of a Trump White House.

I will always adore Bobby Kennedy for his scrappy presidential run. From the moment he signed on as a Democratic candidate, I was overwhelmed with a want and desire to help him win the presidency. I thought he was the only way to restore a sane approach to the democratic process, and after the Democrats trounced him out of the primary process, his independent candidacy gave him the most runway to tell people the truth about what he thought would be the best fixes for a very sick and broken nation. Yet, the last few weeks and months have been hard to muster up a smile about what is going on. I have hung on to Mr. Kennedy’s words at his campaign suspension event that he wanted the chance to argue and debate robustly with President Trump, especially on the things they disagreed about, but I was the fool for thinking the American bafoonery of thespianism, that supposedly passes for the governance of a nation, would ever allow for such a dynamism.

So, when I was asked to head into the citadel of arrogance, which adores itself more than any other city on the planet, I was more than a little reluctant. I’m not sure what going to Washington as an average citizen is ever going to accomplish. The machine, which uses democracy as a placating illusion, is a beast unto itself, and I have little hope that any “dialogue” will ever do much to change the trajectory of an avalanching empire. But my friend Brinda Adhikari called one afternoon a few months ago and said I should go “do this thing in DC with the gang from Why Should I Trust You,” the podcast I’ve been fortunate enough to be a guest on a few times over the last year. “This thing” was a conference called the Association of Schools and Programs of Public Health. It was their annual meeting to “share and discuss new strategies and tools to strengthen education, practice, and research.” I have enjoyed my interactions on Why Should I Trust You with others from the public health space, so I signed on.

Our arrival at the hotel had me wondering if I had made the right choice. These were the adversaries I had found frustrations with during the pandemic. Add to it that I’m a small government guy who would be in a room with people who depend on government for their work, and I became unsure that what I was going to say would be received very well. Despite my frustrations with the Trump administration on a host of issues, I still believe that MAHA is a good movement and that public health and healthcare in general need a wholesale revision if they are ever to become trusted institutions again. My fears also heightened, realizing that many in this room were likely the unfortunate recipients of the cuts that the Trump administration, under RFK Jr.’s leadership, had implemented.

That fear comes from the functional reality of how politics works in America. As citizens, we are masters of blaming our neighbors for the issues in government rather than the government itself. For most of us, we assign the blame to our neighbor who voted for Joe Biden or the plumber who wears a MAGA hat, and say their voting choices are the root of our own misfortune. Rarely, if ever, do we see the government and its spidery web of bureaucracy as the entity that is to blame. And that habit of American politics is why I felt an uneasiness about standing up in front of a room that, in all likelihood, saw my advocacy for RFK Jr. as part of their own moment of tumult. I snuck away to my room with my wife to hide out until the conference started the next day. I made plenty of excuses to myself about being tired and travel troubles, but the reality was that my fear of the moment was probably greater than I would ever want to let on.

I received a text early the next morning from Dr. Craig Spencer. He and I have forged a genuine friendship over the last year. We don’t come from the same background; he has a lot more letters behind his name than I do, and in any normal circle of the world, we likely would never have intersected. But I was thrilled to see a friendly name in my messages: “Tom and I are grabbing coffee in the lobby if you want to join.”

“Great,” I thought, “at least I will have a friendly shield.”

On my way down to the lobby, I walked past Francis Collins. I recognized him instantly and couldn’t help but trace my thoughts to COVID and all of the nefarious stories I associated him with. For a moment, the scenes of lockdowns and vaccine mandates all flashed in my head. I felt sadness about it. I had no interest in an Alex Jones-like confrontation with the man, but seeing him was a firm reminder that the art of medicine is another broken machine. I didn’t belong at this conference, and in America, we have proven through harsh treatment of one another that we are only safe inside our own bubbles of like-mindedness.

From across the lobby, I saw Craig and Tom, and as I approached, we immediately jumped into a conversation as if we had been lifelong friends. We lightly discussed what we were going to try to do on the panel and what questions Tom should try to ask based on the topic for the forum, but we mostly caught up about life and the last few weeks of time that had passed since we had last spoken on the podcast with one another. Both Tom and Craig are people who live in completely different worlds than I do, and in hindsight, that is what has made being on the podcast so unique. All of us have forged real relationships simply by having to tackle the hard questions that we face on the show — especially the ones we disagree about. I have a lot of respect for the people I have met and exchanged ideas with through the process of dialogue on the show. They seem to value me as well, and that is unique amongst people who have spent their lives in academia. My interactions with the diploma elite have rarely been positive. I am a country bumpkin to most of them. I have a two-bit theology degree from a no-name school in Alberta. Any interactions are always from the perspective of defending my lack of education. I hated school because of the arrogance it bathed itself in. The formal hoop jumping and I never lived in much simpatico, and it has eliminated me from too many conversations to count. But Craig and Tom never asked me about my education. They simply listened to what I said and found value in it. That simple act has endeared me to them.

The panel we were participating in was the plenary session of the afternoon, and as things started, I sensed something really amazing. The room wanted to listen to what we had to say. I am certain that the skeptics were scattered amongst the masses, but as we spoke and discussed the challenges of public health interfacing with MAHA and the Kennedy leadership at HHS, the room seemed earnestly willing to hear what it was that was being said. It wasn’t a debate, and I wasn’t there to convince anyone that what I was saying should become the new gospel of health, but I could see in the eyes of many in the crowd an acknowledgement that what had happened over the past decade, particularly because of the pandemic, needed to be addressed.

We spoke for an hour, and when it was over, many gathered around the stage to talk to us and find out more. I was thrilled to see it. No angry, in-your-face, Twitter-like battles were instigated. There was a real sense that we should be learning from one another in this moment, rather than building our bulwarks. In my most honest of moments, what I want from the medical community is the chance to trust it again. We need medicine to function in all the glory of its artistry. Patient care is one of the most necessary and humane interactions in all of humanity. So its politicization has been the worst possible outcome to a choose-your-own-adventure that never had to find its way down paths of distrust. I’m not anti-medicine, but the last few years have made me highly skeptical of it. But I live in the reality that my oldest son was born three weeks early, and without the brilliance of doctors and the care of nurses, twenty-four hours a day, seven days a week, for the first month of his life, I most certainly would have been burying my child instead of celebrating his ever-flourishing life.

I know we need medicine and medical caregivers as a functional and good society. I also know we have a very broken system that seems, as an outsider looking in, beyond repair. But it was in that room that I realized something that was deeply moving. The doctors and educators in that place are interested in the care and health of all with whom they interface. They aren’t interested in being pill pushers or happy that our country is morbidly obese and our life expectancies are slipping. They see the same issues I do, and want them to be better. It’s the people in power, and not the B-grade actors in Congress or in the appointed heads of departments, but the ones who work behind the scenes lobbying with money and influence to make their corrupt system work, who want us all to fight about the unresolvable problems. The corporate interests and beneficiaries of the current version of medicine love it when we argue about vaccines and Big Pharma, because it means they get to keep on keeping on — doing exactly what they have always done. Meanwhile, medicine gets less trustworthy, and groups like MAHA get more incensed that nothing ever changes.

But that room I was in was filled with the people who can make the outcomes what all of us want. They are the ones who are interfacing with the most downtrodden of our society, with the emergencies of bad choices, and the extraction that our mercantile system perpetuates and celebrates in its boardrooms.

Those advocates are the ones who have to sit with a forlorn woman from Mississippi and try to help her understand what is happening to her body, and why she’s feeling sick. They are the ones who have to try to educate people about junk food and processed fillers that are destroying their metabolisms and impeding their full flourishing capabilities. They are the ones who have to try to explain why it is their Medicare or Medicaid won’t help them pay for the preventive measures they would benefit from, but only will allow them the money they need for a pill or a procedure once the disease has progressed too far. These are the ground troops for a war that must be won, and MAHA needs them.

Dr. Spencer asked for a show of hands during the discussion.

“Who wants to eliminate processed foods for their children?”

“Who wants toxins to be out of our water and food supply?”

“Who wants good access to healthy, whole foods?”

There wasn’t a hand that didn’t raise. The people of MAHA want that too. They don’t want Bobby Kennedy relegated and boxed in to a corner, simply playing with his food dyes. They want a cooperative effort at seeing his life’s work of fighting against pollutants and toxins to be celebrated by a community, that if we could all get past our politics, could work together to fix the troubles out there that we agree on. The people of MAHA actually want a government that acts as a watchdog against the enrichment of corporations by the extraction of human capital through their cycles of drug-chasing-drug remediation. The grassroots people, who worked to try to help elect RFK Jr. to the Presidency, aren’t interested in the corporate excuses that donors get to perpetuate on the people so they can continue to spray our food supply with who knows what kind of witch’s brew. They reject the idea that the administration gets to tiptoe around the ongoing perpetuation of a broken system with a lengthy tweet in order to justify industrialized farming. The glimmer of hope from the people in public health at this conference made me wonder what this could all be like if we actually came together on the things we know we could easily tackle. If we allowed ourselves the dignity to ignore our politics, the pressure to fix the brokenness of medicine would actually be overwhelming.

American false choice politics is awful. It solves very little other than the comfort of the politicians and mercantilists’ lives. This made the event a brighter harbinger of something better than the “vote harder” system we subject ourselves to. What I had the pleasure of being a part of at the conference allowed me to think outside the Washington-solves-everything box and recognize that both Public Health and MAHA have a chance to work together to start to try and fix this crumbled mess of brokenness. What if both groups said they wanted to work on the things they know would have mass support from both the MAHA gang and the Public Health warriors, and ignore the small-minded prison of petty politics?

What if both groups agreed that the government should be a stopgap for a lack of funding for research and testing, and eliminate the conflicts of interest that the current system is plagued by? What if they asked the government to do the thing it is instituted to do: protect against mercantilism instead of manifesting it as it currently does?

What if MAHA and leaders in Public Health said that Medicare and Medicaid should disproportionately reverse their spending habits and focus on preventive care and access to great food?

What if they said that public health should be about educating people about debt and money, so that the impoverished and disenfranchised could understand how to escape the tyranny of a devaluing dollar?

What if those on both sides of the divide made education compelling instead of an advanced daycare for parents who have to work perpetually to afford the Jack In The Box junk fest for the evening dinner? What if that same education system taught kids how to cook good food and grow a garden, even on the balcony of a tenement apartment? What if they said that our society should see public health and education as synonymous endeavors, where what the society teaches our kids is just as much about how to take care of themselves as it is to study calculus?

And what if MAHA and Public health agreed that being a whole person, spiritually, mentally, physically, and emotionally, was the job of our society?

On our way back from dinner after the event yesterday, we drove by the Jefferson Memorial. I have always laughed at how the planners of Washington DC put his memorial on the far outskirts of town, as if to say, “Thanks for your letter…we’ll take it from here. We have little use for much else of yours.” I remain convinced, however, that if we had a little more understanding of the man and his visions for the republic he and his cohorts wanted to build, we might see the possibilities they dreamed of. A favorite quote, that seems to capture the divide we find ourselves in, comes from a letter that Jefferson wrote to William Charles Jarvis in 1820:

“I know of no safe depository of the ultimate powers of the society but the people themselves; and if we think them not enlightened enough to exercise their control with a wholesome discretion, the remedy is not to take it from them but to inform their discretion.”

Trust was shattered because our system is wired to isolate us from debate. Both sides have lost sight of Jefferson’s maxim: that we must inform the discretion of the citizen. Those whose motives were not for the betterment of the people, and who saw profit and control as the highest ethic, decided that taking our capacity for thought and self-determination was the only way to make the people behave and “be enlightened enough.” But that isn’t the sentiment of the workers in the field of labor in public health. The doctors and nurses from public health who hold the hands of a sick child or give hope to a person whose health has debilitated their physicality and their spirits aren’t the ones with whom MAHA should be adversaries. Instead, they should work together. To build a bridge between the two groups to put the people back in their rightful place at the head of the republic. A place where their discretion is informed, where they are self-caring, where they have the capacity to take care of themselves and their fellow man. Public Health is a key ally in this next phase of a healthy people. Perhaps both camps, who were once trained to be at war with one another, are realizing they have been fighting the wrong enemy.