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Donald Trump nominates RFK Jr. to be Secretary of Health and Human Services.
I am not naturally sympathetic to criticizing policy or personnel decisions on the grounds that they "embolden" the wrong people, but I am going to make an exception here. The sheer magnitude of human suffering prevented by vaccines and antibiotics is hard to comprehend. Due to complex structural and psychological reasons, the developers of these treatments capture a miniscule fraction of the total utility surplus created.
Enter the pharma skeptics: I do not know what RFK Jr.'s specific stance on vaccines is, besides "more skeptical than the liberal establishment will accept", but I do know how Twitter works. Twitter is real. It affects real events in actual reality, up to and including the US presidential election. Trans issues are getting dumped from the mainstream Democratic Party agenda because of how much it gets dunked on on Twitter.
In this Twitter thread, the entire concept of rewarding companies for treating disease is getting dunked on like it's a Lia Thomas podium. This is of course not the only example I could have pulled, but it shocked me both because of it's location (Alex Tabarrok's feed), and because of the sheer intensity of what can only be described as concentrated stupid.
But perhaps the most alarming implications are for democracy itself. RFK's endorsement likely won Trump the election, not least because it paved the way for the Rogan endorsement. Republicans won by increasing their share of the stupid vote. Indeed, no party can win a national election without winning large swaths of the stupid vote. There simply aren't enough smart people to win. Perhaps this explains the modern political environment. The decision between Democrat or Republican boils down to a decision on which party's concession to the stupid vote will do the least amount of damage.
I don't know that I want to stan RFK here, but the status quo isn't inherently better: public health generally has a lot of egg on its face, not just from the pandemic. Attempts at COVID vaccine mandates seem pretty ham-handed in hindsight given their lack of long-term immunity. The FDA approved, over the advice of its own scientists, a very expensive drug for Alzheimer's that wasn't even found to be effective. Literally the current assistant secretary of HHS was found to have put political pressure on WPATH to remove age limits from gender medicine in its guidelines at a time when many Western countries have reviewed the literature and are questioning the practice for youth.
I get where you're coming from, but I find myself questioning whether putting RFK in charge will actually make things worse. At least he'll get push-back against crazy policies.
Agreed. If we're going to go with the "a purpose of a system is what it does", then the US public health apparatus is awful. We spend by far the most money in the world and get the life expectancy of (checks notes) Turkey, Ecuador, and Albania.
It would probably help if Americans drove less, exercised more, were less fat, did fewer drugs, and stopped shooting each other and themselves. However, the public health interventions needed to address these cultural and lifestyle issues are fairly unpopular.
Let's see what RFK can do. Maybe we'll start directing dollars towards effective interventions and away from ruinously expensive and ineffective ones.
I agree that America should be more like Europe and Asia by harshly prosecuting violent crime and refusing to tolerate drugs. We should probably also adopt European food standards where breakfast cereal has 5 simple ingredients instead of 20 unpronouncable ones.
Can you to be more specific about what effective interventions you're thinking about? The main causes of the European-American life expectancy gap is not a mystery, and I promise you it's not tripotassium phosphate or excessive vaccinations.
Like, stricter regulations on microplastics or whatever would be great, but the effects on life expectancy are going to be completely swamped by obesity, drugs, car accidents, and suicides. (Not to mention, the GOP traditional stance on environmental and health issues makes me think there's not going to be much appetite for imposing additional standards on industry).
The US prosecutes violent and drug crimes far more harshly than Europe, as I'm sure you are well aware. Tolerance is not the issue.
A focus on reducing obesity and preventing sickness would be a welcome change. Will it dramatically increase life expectancy? Maybe not at first, but it's a start. And it might at least stem the rapid increase in costs. We're getting very little for our expensive medical system.
What changes would you propose? Cities like Chicago and DC have done literally everything that establishment figures say is good, and look at the results. These are intractable problems. The state can't simply snap its fingers and will away problems. Except crime. That can be made much less via mass incarceration.
I am not aware. Here in Seattle open air drug markets are tolerated and people who have been arrested for dozens of crimes (including violent crimes) are frequently released onto the streets without trial. It's hard to imagine a more lenient system.
Perhaps the argument could be made that we can in fact throw the book hard at drug offenders, and that we have indeed done so to the point that DAs, lacking a less-harsh punishment, choose not to punish at all.
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