With the election decided and over, Americans are looking at Republicans to make good on their campaign promises.
One important promise to voters was to make America healthy again.
But what does this agenda entail?
And what impacts can we expect to see in healthcare?
In this episode of CareTalk, David E. Williams and John Driscoll discuss the framework of Make America Healthy Again, covering what they have right, what they have wrong, and how it is set to change healthcare.
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Episode Transcript:
David E. Williams: Republicans made Make America Healthy Again a key part of their closing argument, and voters seemed to like it. A major part of the focus is chronic disease. Does this agenda make sense, and what actions and concrete impacts can we expect?
Welcome to Care Talk, America's home for incisive debate about healthcare business and policy. I'm David Williams, President of Health Business Group. And I'm John
John Driscoll: Driscoll, Senior Advisor at Walgreens.
David E. Williams: Well, John, before we get started, I want to take a moment to thank my extended family for making the effort to get together on Thanksgiving, traveling from places near and far.
Because this month is all about gratitude. And along with my family, there's someone else that we don't thank enough. That's ourselves. It's sometimes hard to remind ourselves that we're trying our best to make sense of everything. And in this crazy world, that is not easy. So here's a reminder to send some thanks to the people in your life, including yourself.
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That's better help H E L P. com slash CareTalk. Well, John, we want to make grateful
John Driscoll: for you, Dave. I just want you to know that I really appreciate all of the good work you've done here. And you know, that gratitude practice that you're talking about couldn't be more powerful, but I'm not so sure. I'm grateful about the new Trump administration, at least from a healthcare perspective.
David E. Williams: Well, there's this concept, John, of making, make America healthy again, and maybe let's start with a positive. I mean, I think health is great. What does make America healthy again? Get right. Must be something.
John Driscoll: If we step back a second, you know, RFK Jr. has trafficked in a lot of conspiracy theories. Around organized the organized medical establishment, particularly preying on people's fears about vaccines, but it's not like just because he's wrong on some of the big things he's wrong in total.
He's pointed out a number of things around the industrialization of food and how processed food is really a threat to people's health. And the way we think about food and consume it Is is obviously a problem. We've got an obesity epidemic, which he's pointed out, but where he his conspiracy, I think, theories might be right is around how the United States has industrialized the food business so that we prioritize things like sugar based snacks and salty snacks at a time when we've got a diabetes epidemic, even in Children.
And I think that's where, when you think about ways where we might agree that America's failing on a healthcare metric and could improve, I think, I think RFK Jr. has a point.
David E. Williams: So I would agree, John, there, you know, there's a lot of chronic disease, not as much as what RFK Jr. says, and especially, I think, the fixation on children is probably not quite, Correct.
Environmental risks are important contributors and there's too much just if you could, if you could pause there, David,
John Driscoll: I mean, he's, he talks about these statistics. 6 percent of children had chronic disease under my uncle, Jack always wants to pull in his, his, his family name and 60 percent of kids, 60 percent of kids today are not suffering from chronic disease.
And in fact, In many ways from a healthcare perspective, whether it's heart disease or smoking cessation, we're actually making a lot of, have made generationally profound progress. And since Jack Kennedy, we actually have done a better job at extending life and managing chronic illness. We're failing on obesity.
We're failing on addiction. But in many other areas, the areas that were the, you know, primary you know risks of death, you know, heart coronary heart disease and cancer, we've really turned into manageable diseases. And he, he conveniently skips over those facts to then say, again, kind of blame it on the kids.
David E. Williams: Yeah. Well, John, I'd like to you know, the former CDC director, Tom Frieden, had a good framework that he just put out last week as well as a reminder for people interested in chronic disease. What are we, what should be the way we do it? He divided it into three areas. There's some things that we know cause chronic disease.
There's some things that might. And there's some things that are proven not to. So for the things that are known to cause chronic disease, which is tobacco, alcohol, junk food, you put in that, and air pollution, well, we should go after those with programs that work. They're not sexy. And by the way the Biden administration has actually done a pretty good job on a number of these areas.
For the things that might have be causing chronic illness. And those are like these forever chemicals like P fast. We should be investigating there. And there's some things that are proven not to cause chronic illness, namely vaccines. And so those should not be denigrated. And should not be, people should not be calling into question.
So what's interesting to me partly is that, you know, some of this will go great with the new administration, but there's some other things like air pollution, John, which I'd like to just throw in the idea about you know, so like air pollution and, and Junk food are, you know, things that are a concern and a problem.
I agree. Now, the Biden administration has actually tried to do certain things on this, but you can see how the politics come around on air pollution. There's a famous thing you'll see, you know, gas stoves that was picked up upon. The Inflation Reduction Act has incentives to For people to put in electric appliances as opposed to gas, because gas stoves can actually contribute to asthma and this has been taken, obviously, by some of, from the, the Trump folks as you know, what, what is it?
God, gas stoves and guns. That's going to be there. Oh,
John Driscoll: no. It's a, I mean, the challenge that I mean, if you really look, if you really want to make America healthy again. David, we've got to deal with this epidemic of of gun violence. And maybe there's some middle ground around tying sensible gun safety legislation and regulations to.
A focus on mental health because apparently the Republicans only agree with dealing with issues of gun violence if we're talking about issues of mental health, but that's a place to build. I think that the challenge that RFK Jr. is going to run into on the industrialization of food, obesity, and sugary and salty snacks is that America loves Yeah.
Making those choices. And frankly, sugar and salt are addictive. Yeah. And you're going to take my Pepsi away.
David E. Williams: John? Along in the I want it Listen. Bloomberg tried. Yeah. Yeah. And the thing is, it actually places the tax sugary drinks. They actually, they actually do better and keep them out of this, out of the school.
So, but yeah, you can imagine the, you can imagine coming from the other side, right? They're going to take my Coke and Pepsi and my Big Mac.
John Driscoll: America, America has look, we are the land of the home of the, of the free. There's not a great track record of government. Either incenting, regulating, or prohibiting things that people really want, with the exception of taxing the bejesus out of tobacco, which has had an impact in regulating access to tobacco.
The temperance movement failed around alcohol one of the best public health Politicians ever Bloomberg who was, you know, universally elected three times as mayor of New York really failed around his Taxing the big gulp and sugar sugary snacks, but was successful with Tom Frieden in banning smoking in restaurants Which was a massive massive public health win So I guess the lesson from regulations and regulators past is to find the few big levers to Where you might be able to actually improve public health, but I don't think taking things away is something that we could expect to be easily, to easily happen, in a, in a country that that sort of celebrates the live free or die ethos and a party that's built its identity around that.
David E. Williams: Yeah. Well, John, and I think, you know, some of these things like RFK wants, Junior wants to steer the NIH away from research on infectious disease toward chronic disease, presumably, or maybe just cut the budget and pandemic, you know, getting rid of the office of pandemic preparedness, which you know, is going to, going to happen as well.
There's a lot of contradictions built in. And I guess what we're going to see is whether. The populace gives a darn about that or not, John, or whether it's okay if there's contradictions as long as it's coming from a certain party. Well, I think, I think what's it's what's tricky right now
John Driscoll: and why we've got to be a little bit careful is we don't really know what we're going to get till we get it and personnel in this in this particular.
Well, in, in every administration, but personnel will, will turn into policy. And I don't think that RFK Jr. is going to have a, an administrative role that requires anything close to Senate confirmation. As he said, there's so many skeletons in his closet, they don't fit. Yeah. That, that, that, so that I don't think on the administrative roles, it's more, how does the, how might.
The Trump administration start to lean into some of the concerns that Bobby has about you know the food tying to obesity. And that's actually, I think, a rich area that, honestly, the Democrats have not been willing to lean in on. There's the Farm Bill comes up next year. The Farm Bill is the biannual congressional bill that drives subsidies or structures the subsidies for agriculture and farming in the U.
S. And to a large degree, it incents. larger farms over smaller ones less traditionally organic and local and more national. And it really subsidizes corn and other sugary-based insulin driving food production. And I think that if, if, if there's a really If they, if the Trump administration really wanted to go at the health of America, particularly the obesity epidemic, it would align with some of the more thoughtful players in Congress around reducing the subsidies for producing what we shouldn't eat and improving the subsidies for things that we should eat.
And I think that's the way to make America healthy again. It'll be really interesting. It's very detailed in the weeds. Kind of thing, but that's that that's where I'd look at. Does he appoint at in the Department of Agriculture and HHS and CDC and NIH People who could support that kind of an initiative because that actually could have an impact?
David E. Williams: Well John, there's plenty of work, to be done and some of the things point in a direction That could be positive and different from what we've seen In the past and I think we should if not provide the benefit of the doubt at least leave the Option open and the opportunity to see good things done and we should encourage those and cheerlead for them on our show Well, that's it
John Driscoll: Cheerlead for the things we agree with we're going to criticize the ones we don't David.
David E. Williams: That's fair John Well, that's it for yet another episode of care talk we are giving some coaching to the new administration on what they can do about chronic disease. I'm David Williams, president of Health Business Group.
John Driscoll: And I'm John Driscoll, senior advisor at Walgreens. If you like what you heard or you didn't, we'd love you to subscribe on your favorite service.
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