Robert F. Kennedy Jr. has his confirmation hearing to be Donald Trump’s next head of the Department of Health and Human Services (HHS) today.
Opposition to his confirmation will almost certainly be focused on his record of making strange and conspiratorial claims about vaccines and the Covid-19 pandemic. Kennedy’s defenders paint him as merely a civil libertarian critic of heavy-handed lockdowns or someone with reasonable concerns about the approval process for the Covid vaccines. But as recently as 2023, he went on “Fox & Friends” and reiterated the long-debunked idea that “autism comes from vaccines.” The same year, a video emerged of him speculating at a private event that the coronavirus was engineered as an “ethnically targeted” bioweapon and that this is why it had so little effect on “Ashkenazi Jews and Chinese.”
Kennedy isn’t ‘anti-establishment’ in any way that would actually help working-class people at the expense of wealthy plutocrats.
All this is enough to make respectable public health officials shudder. But some critics of America’s health care status quo might be inclined to welcome Kennedy’s nomination. After all, a great many ordinary Americans are so disenchanted with our health care system that they were willing to openly cheer for the assassination of a health insurance executive on the streets of Manhattan. Clearly, the status quo isn’t working. However kooky some of RFK Jr.’s views may be, aren’t we overdue for an “anti-establishment” figure to take the helm and shake things up?The problem is that Kennedy isn’t “anti-establishment” in any way that would actually help working-class people at the expense of wealthy plutocrats. He might be an enemy of Big Pharma in the sense that he spreads bizarre conspiracy theories about some of the medicine they sell. But he doesn’t dispute their right to reap massive profits for their shareholders by selling that medicine at extortionate prices.
In the spring of 2023, when RFK Jr. was still challenging President Joe Biden for the 2024 Democratic presidential nomination, he was interviewed by left-leaning journalist Krystal Ball and her conservative-leaning co-host, Saagar Enjeti. Ball asked Kennedy whether he agreed that the root of the problem with America’s health care system was a “health insurance industry and a hospital industry and a pharmaceutical industry” in which “the bottom line is the bottom line,” and he responded that that just sounded like “human nature.” Ball clarified that she was talking about the “profit motive,” and Kennedy shrugged off the distinction.
“The profit motive,” he said, “is human nature.”
But there’s nothing “natural” about the way the United States ties health care to the profit motive. As far as I know, America is the only country in the developed world where cash-strapped diabetics sometimes die because they resort to rationing out their insulin. In many other nations around the world, health care is treated as a basic right, funded by taxation and provided free at the point of service. No one in Canada or Britain or Norway or Sweden, for example, has to stay in a job they hate because of fear of losing their employer health insurance. No one in these countries stays in a bad marriage for fear of losing their spousal health insurance. No one grieving for a dead parent has to spend half their life on the phone arguing about unpaid hospital bills. But all of these things are routine parts of American life.
In his runs for president in 2016 and 2020, Sen. Bernie Sanders, I-Vt., proposed a single-payer “Medicare for All” system that would be similar to the systems in those countries. Debate over the merits of this proposal dominated the 2020 race on the Democratic side. As a candidate, Joe Biden rejected Medicare for All, though he split the difference with a “public option” proposal under which a government-run plan would be offered alongside various private plans. (He stopped talking about this idea after the election.)
RFK Jr. could never really bestir himself even to push for a public option.
Sanders supporters like me thought this was a much worse idea than Medicare for All. A public plan that you could buy into, however cheaply, would replicate at least some of the big problems with private health care. People who missed a payment or two would be out of luck in medical emergencies, for example, and (much like Medicaid under the current system) it’s likely that many doctors and clinics wouldn’t take the public plan. A public option would be better than what we have now, but it would still be two-tiered health care for the rich and the poor.RFK Jr., though, could never really bestir himself even to push for a public option. The best he’d do, as in the Ball/Enjeti interview, was to say that his first choice would be a system with a public option, if only it were “politically realistic.” Nor has he shown much enthusiasm for the government’s directly providing Americans with affordable prescription drugs. When Ball asked him if he’d be in favor of nationalizing pharmaceutical companies or even, if the private companies stayed in place, at least manufacturing generic drugs in the public sector, he dismissed this without a second’s thought, saying, “No, I don’t think that’s the right thing,” and immediately changing the subject.
And that was when he was challenging Biden for the Democratic nomination and he had a powerful incentive to present himself as a progressive candidate. It’s a safe bet that, serving in the Cabinet of a Republican president, he would be even less inclined to interfere with the profit motive he sees as nothing more than an extension of “human nature.”Our health care system is a nightmare. But we need to be able to distinguish between diametrically opposed critiques of it. Is the problem that rent-seeking private companies stand between suffering people and the health care they need, or is it that the medicine itself doesn’t work and everyone just needs to get more sunshine and go for a jog (or maybe try ivermectin)?
Championing the first perspective puts you on the right side of history. The second one just makes you a crank.