OPINION: U.S. health care will backslide under Kennedy

So Robert F. Kennedy Jr. has been confirmed as secretary of Health and Human Services. He is a trial lawyer with no medical experience — or even management experience — and now leads one of the biggest departments of the federal government.

Food safety, medication safety and effectiveness assessment, Medicaid, Medicare, federal public health response and all the scientific and clinical research of the federal programs are under his aegis: the Centers for Disease Control and Prevention, the Food and Drug Administration, the Center for Medicaid and Medicare Services and the National Institutes of Health. Heck, I have more experience in health care, health financing, public health and personnel and organizational management than he has. But in the current government, expertise is not as valued as fealty.

Most are aware of his history of vaccine nihilism and of his conspiracy theories that fly in the face of clinical data. Many are also aware of his admitted history of chemical dependence, mercury poisoning and parasitic infection of his brain.

I point all of this out to help prepare readers for some of the foreseeable outcomes of this appointment.

First, I expect to see an ax taken to the public health infrastructure and information. Already the CDC has pulled down data sets from its website and “paused” widely relied upon communications such as such as the Weekly Morbidity and Mortality Report. The pause is to allow changes to conform to the administration priorities, a spokesperson says. So it’s not about scientific fact or actual world health conditions. More to come, I’m sure.

We have also withdrawn from the World Health Organization, the international body that helps identify diseases and stops their spread from country to country. With all the international trade and travel that occurs, do people think germs respect borders?

There has been another “pause,” this one in NIH grants and funding for research at hospitals and educational institutions. These were grants already awarded funding clinical and scientific research. People have been hired and equipment has been purchased. Now what?

I am likewise concerned with health care financing. The GOP has a target on Medicaid, the financial assistance and health care insurance for the poor, disabled and elderly. I expect rural hospitals and senior centers to struggle or close, for emergency rooms to increase their uninsured burden and county budgets to be expected to pick up the burden.

Republicans in the Idaho Legislature have targeted Medicaid as well, trying to repeal the coverage expansion passed by popular vote in 2018, even though repeated analyses have shown the increased costs to the state if Medicaid eligibility is taken back to prior levels. Your federal tax dollars will then flow to other states and the burden will remain on the taxpayers of Idaho.

I remember the county indigent Catastrophic Fund (CAT Fund) receiving appropriations each year to pay for the uninsured and how a set of uninsured premature twins, a non-Medicare chemo patient or a bad automobile accident could bankrupt a county budget.

And the GOP leadership is pushing this to give another income tax break to the affluent.

There was a time when the Centers for Disease Control and Prevention and Center for Medicaid and Medicare Services would put a damper on the wild ideas of the Idaho Legislature. But now, if there is no vaccine requirement for kids, no ability to quarantine when necessary, no international cooperation or national health data reporting and a public health/vaccine skeptic at the wheel in Washington, D.C., I expect that the Idaho and American public will be harmed.

I hope I am wrong. But I expect the rules of science, of epidemiology and arithmetic will hold true.

Rusche, of Clarkston, is a retired physician who served six terms in the Idaho House.