The Kennedy Prescription
It's Time to Excise Government from Healthcare
Robert F. Kennedy, Jr. (RFK), is President-elect Trump's new pick for Health and Human Services secretary. He is a firebrand and ready to take radical action. He argued Saturday that the incoming Trump administration should “act fast” to implement massive changes at the National Institutes of Health, including replacing as many as 600 people at the federal agency.
What else might he do? If we want to "Make America Healthy Again", we have to get to the root cause of what’s making America unhealthy in the first place.
First and foremost, American healthcare is largely administered by a legally-protected cartel. The American Medical Association (AMA) is a private, member-supported labor union which successfully lobbied the U.S. government for carte blanche power to regulate medical schools in the United States (which also teach physicians across much of the world). All schools not approved by the AMA’s Council on Medical Education were closed in the early 20th century. The AMA controls undergraduate medical education, graduate medical education, continuing medical education, and professional development curricula, accreditation, admissions, and graduation standards. They also control state boards of licensing, limiting the number of new doctors allowed to practice medicine. The mission of the AMA is to protect the interests of member doctors, which includes managing competition so as to keep salaries and fees as high as possible.
Next, medical textbooks are out of date virtually as soon as they're published. A 2012 analytic survey of newest edition online textbooks (which could theoretically be kept continuously up-to-date) found that between 23% and 60% of topics discussed offered different treatment recommendations than the newest published journal research in those topics.
And it's not just medical textbooks. According to the National Institute for Health and Care Excellence (NICE), a public health guidance arm of UK's NHS, the majority of clinical guidelines go out of date within three years of publication. A similar study in Spain and an earlier study of the ACP Journal Club came to similar conclusions.
The Dean of Harvard Medical School, Charles Burwell, once told students, "Half of what we are going to teach you is wrong, and half of it is right. Our problem is that we don't know which half is which."
Dave Sackett, the father of evidence-based medicine, repeated the same warning:
Half of what you'll learn in medical school will be shown to be either dead wrong or out of date within five years of your graduation; the trouble is that nobody can tell you which half.
This is now accepted as a truism and backed by evidence such as I quoted above regarding textbooks and clinical guidelines.
Perhaps worse still, the scientific basis for medical procedures is also largely absent or very poor quality, contrary to public expectations. An analysis by the Mayo Clinic in 2011-2012 of every article published during the prior 10 years in the prestigious New England Journal of Medicine (NEJM) found that, of articles that tested an existing medical practice, 40.2% determined it to be ineffective compared with a previous standard of care or its omission. That's 146 standards of treatment in 10 years that at best do not improve outcomes. A further 79 (27.3%) were inconclusive. Only 38% of new medical practices were upheld as superior to previous standards. The problem is that virtually all of the “experts” have financial ties to benefit from the positive outcome of their “research”.
Marcia Angell MD, editor of NEJM for over two decades, said:
It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines.
Richard Smith, 25 year editor of another top-tier journal, the British Medical Journal (BMJ), echoed the same sentiment:
…most of what appears in peer-reviewed journals is scientifically weak.
Likewise with pharmaceuticals, despite a very lengthy and expensive FDA approval procedure, and similar regulations in other countries, the safety and efficacy of drugs is a crap shoot. A 2016 systematic review of world literature found that 462 pharmaceutical products were withdrawn from the market between 1950 and 2014 due to adverse drug reactions. That's more than seven approved drugs per year that had to be pulled. Drugs that were as likely to harm people as help them while they were being prescribed. At least 80 of those drugs caused human deaths.
Expert medical advice is routinely based on legal liability avoidance. SOPs to avoid malpractice have significant inertia, steered by political interests, and do not change easily. The legal standard for negligence is whether the physician was acting according to his or her training and whether any other reasonably competent doctor would have done similarly. This inhibits the adoption of new or different methods, even if they prove superior, until the medical schools and entire body of practicing doctors do likewise.
Mandated continuing education (controlled by the AMA, remember) has been shown to have no significant impact on changing physician behavior or improving patient outcomes either. Whether that’s because it’s just more AMA indoctrination or because they use out-of-date textbooks or because they base it on bad research, it’s hard to know for sure.
According to a 2005 national survey, 55% of physicians say their religious beliefs influence their practice of medicine.
So what Americans and most of the world believe to be cutting-edge, science-based, highly-educated medical advice is little more than very expensive voodoo. Perhaps that’s why Johns Hopkins estimates that medical “error”, or should we just say SOP, is the third leading cause of death in America, with between 250,000 and 400,000 killed by doctors every year. This doesn’t even include the fact that the first and second leading causes of death -- heart disease and cancer -- are preventable diseases that are not being appropriately addressed by the medical establishment. Most heart disease and probably cancer is a result of the “war on fat” dietary guidelines published and promulgated by the mainstream healthcare industry for the past 40 years.
Greek philosopher Hippocrates famously said that "all disease begins in the gut". This is because the gut plays a central role in many aspects of health, including:
Digestion: The gut breaks down food and absorbs nutrients or anti-nutrients, which either builds and fuels the body or else toxifies it.
Immunity: The gut contains about 70–80% of the body's immune system.
Hormones: The gut contains most of the body's serotonin.
Barrier defense: The gut acts as a barrier to prevent harmful substances from entering the bloodstream.
Over the past half century or so, the federal government has been captured by the sugar, corn, soy, and seed oil industries, promoting unhealthy processed foods high in empty calories, unbalanced nutrients, and anti-nutrients. Meanwhile, these same industries pay for so-called peer-reviewed research promoting these foods as healthy when they are anything but. Diet-related diseases are the leading causes of death in the U.S. A poor diet may lead to cardiovascular disease, diabetes, obesity and even psychological conditions like depression and anxiety.
In a research article, The State of Nutrition Education at US Medical Schools, it was discovered in a survey of 133 US medical schools that on average, medical students received just 14.3 hours of education about nutrition. In a 2023 survey of more than 1,000 U.S. medical students, about 58% of respondents said they received no formal nutrition education while in medical school for four years. As a result, doctors are woefully incapable of providing nutritional advice to their patients for the purposes of maintaining health or addressing disease.
Kennedy said he'd work to ensure members of the Dietary Guidelines Advisory Committee have no connections to food or drug companies. He also wants to reform farm subsides, cutting back on corn and soy.
Kennedy also said he'd push for more coverage of functional medicine, and devote 50% of the National Institutes of Health budget to "preventive, alternative and holistic approaches to health."
He also wants to end the “revolving door” of government employees who have previous history working for pharmaceutical companies or who leave government service to work for that industry.
Kennedy has claimed that the FDA is battling a "war on public health" and is suppressing the use of anything "that advances human health and can't be patented by Pharma." On X, he wrote that the FDA is pursuing “aggressive suppression of psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunshine, exercise, nutraceuticals”. He warned that “If you work for the FDA and are part of this corrupt system, I have two messages for you: 1. Preserve your records, and 2. Pack your bags.”
Those are great first steps! But we also need:
abolition of the American Medical Association (AMA) monopoly
total overhaul of the academic journals to weed out conflicts of interest and enforce highly-critical peer review
more independent medical schools competing to turn out more doctors and to teach them nutrition
more freedom for nurses, paramedics, and other providers to be allowed to practice medicine more widely
more free market forces in general regarding dietary advice, nutrition counseling, holistic medicine, pharmaceuticals, emergency care, and pretty much every other aspect of preserving wellness and treating illness.
Over a hundred years of union monopoly and captured regulators is far too much!
I really hope that RFK, Jr., is able to be confirmed as HHS Secretary and succeeds in radically transforming the American healthcare system. It’s long overdue.