Making America Healthy

US Politics 7 Minutes

Dr. Nicole Saphier is a Fox News medical analyst. Her book “Make America Healthy Again” was published on April 21, 2020. The title likely draws inspiration from the political slogan “Make America Great Again.” Therefore, the “again” is more political rhetoric, aiming to evoke a sense of nostalgia or urgency for improving current health standards rather than referencing a specific historical period.

Dr. Saphier’s book emphasizes personal responsibility for health, arguing that lifestyle changes can prevent many diseases. Saphier critiques government healthcare policies for not holding individuals accountable and suggests that reducing healthcare costs requires individuals to adopt healthier habits. Her focus is more on personal lifestyle changes rather than systemic policy reforms.

Historically, the United States has excelled in certain health-related areas, particularly in medical research, innovation, and technology. For much of the 20th century, the U.S. was a leader in developing new medical technologies, pharmaceuticals, and procedures, which contributed to significant advancements in healthcare globally.

The U.S. has had periods of strong performance in specific health metrics, such as:

  1. Cancer Survival Rates: The U.S. has often reported higher survival rates for certain types of cancer compared to other countries, largely due to early detection, advanced treatment options, and significant investment in cancer research.
  2. Cardiovascular Treatments: Advances in the treatment of heart disease, including surgical techniques and pharmaceuticals, have been areas where the U.S. has excelled, contributing to improved outcomes for patients with cardiovascular conditions.

However, when it comes to broader health indices such as life expectancy, infant mortality, and overall healthcare access, the U.S. has not consistently led the world. In fact, the US has often lagged behind other high-income countries in terms of universal healthcare coverage and equitable access to healthcare services. The complexity and cost of the U.S. healthcare system have been ongoing challenges that have impacted its overall ranking in global health indices.

International comparisons of countries’ health are often based on several key health indices, including:

  1. Life Expectancy: Measures the average number of years a person is expected to live based on current mortality rates.
  2. Infant Mortality Rate: The number of deaths of infants under one year old per 1,000 live births.
  3. Maternal Mortality Rate: The number of maternal deaths per 100,000 live births, reflecting the risk associated with pregnancy and childbirth.
  4. Prevalence of Diseases: Rates of diseases such as HIV/AIDS, tuberculosis, and malaria, which can indicate the burden of infectious diseases.
  5. Healthcare Access and Quality Index (HAQ Index): Assesses the quality and accessibility of healthcare services.
  6. Disability-Adjusted Life Years (DALYs): A measure of overall disease burden, expressed as the number of years lost due to ill-health, disability, or early death.
  7. Health Expenditure: The percentage of GDP spent on healthcare, indicating the financial resources allocated to health services.
  8. Body Mass Index (BMI) and Obesity Rates: Used to assess the prevalence of obesity, which is a risk factor for many chronic diseases.

These indices help provide a comprehensive view of a country’s health status and are used by organizations like the World Health Organization (WHO) and the World Bank for global health assessments.

https://www.commonwealthfund.org/publications/fund-reports/2024/sep/mirror-mirror-2024

As of 2024, the United States ranks last among 10 high-income countries in terms of healthcare performance, according to a report by the Commonwealth Fund. This ranking is based on several factors, including access to care, health equity, administrative efficiency, and health outcomes. Despite spending nearly double on healthcare compared to other nations, the U.S. struggles with issues like high costs, inequitable access, and poor health outcomes.

Historically, the U.S. has consistently ranked low in international health comparisons. Previous reports have also placed the U.S. near the bottom, highlighting persistent challenges in achieving universal healthcare coverage and addressing social determinants of health. The country’s healthcare system is often criticized for its complexity, high out-of-pocket costs, and disparities in access and quality of care.

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The U.S. continues to be in a class by itself in the under performance of its health care sector. While the other nine countries differ in the details of their systems and in their performance on domains, unlike the U.S., they all have found a way to meet their residents’ most basic health care needs, including universal coverage.

Commonwealth Fund Report (2024)

In healthcare system analyses, individual clinical care and public health services are two major components. Individual clinical care focuses on personal medical services provided to patients, while public health services aim to protect and improve the health of populations through preventive measures, health education, and policy initiatives.

Historically, the U.S. healthcare system has been heavily influenced by market-driven approaches, which have often been promoted by conservative (Republican) administrations. This market-driven model emphasizes private sector involvement, competition, and consumer choice, which can lead to innovations and efficiencies but also tends to result in disparities in access and coverage.

Republican administrations have generally favored policies that reduce government involvement in healthcare, oppose mandates for universal coverage, and promote private insurance markets. This approach contrasts with efforts to establish universal healthcare coverage, which typically involve more government intervention and are often championed by more liberal (Democratic) administrations. The lack of universal healthcare coverage in the U.S. is partly due to these ideological differences, leading to a system where many individuals remain uninsured or underinsured.

Robert F. Kennedy Jr.’s “Make America Healthy Again” (MAHA) proposal emphasizes private personal medical care services, thinly disguised as reforming health care and food systems to combat chronic diseases. The proposal includes ideas like expanding health savings accounts and promoting alternative health care options, such as functional medicine, which focuses on nutrition and exercise over pharmaceuticals.

However, the MAHA proposal does not explicitly address universal health care coverage, which the 2024 Commonwealth Fund Report identifies as a major deficiency in the U.S. health system. Instead, the proposal seems to focus more on individual health choices and reducing corporate influence in health care, rather than expanding public health services or ensuring universal coverage. This approach aligns with a more market-driven model, which has historically been associated with conservative policies that prioritize private sector solutions over government-led universal health care initiatives.

While a focus on preventive health is commendable, there are valid concerns regarding his regulatory approach and skepticism towards scientifically validated public health measures, including vaccines.. Health experts warn that his methods could dismantle essential public health infrastructure and reduce trust in health agencies. 

Kennedy aims to create an environment where preventive health measures are prioritized, which does sound reasonable. However, what is excluded from his proposal is who will cover — or at least share — the costs for providing personal preventive services. Private insurance has historically been reluctant to assume such costs. Most likely, Kennedy’s proposal would add out-of-pocket expenses for personal health care while reducing the public health budget, the aim of all conservative administrations.

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Most concerning is Robert F. Kennedy Jr.’s history of promoting numerous instances of blatant health misinformation over the years.

  1. Vaccines and Autism: He has repeatedly claimed that vaccines, particularly the MMR (measles, mumps, and rubella) vaccine, cause autism, a theory that has been thoroughly debunked by scientific research.
  2. COVID-19 Misinformation: Kennedy has described COVID-19 vaccines as “the deadliest vaccine ever made” and suggested they were developed to control people via microchips, both of which are false.
  3. Fluoride in Water: He has advocated for the removal of fluoride from drinking water, falsely claiming it causes various health issues, despite scientific consensus that fluoride is safe and effective in preventing dental cavities.
  4. Antidepressants and Violence: Kennedy has suggested a link between antidepressants and school shootings, a claim not supported by evidence.
  5. Raw Milk: He promotes the consumption of raw milk, which poses significant health risks due to potential pathogens that pasteurization eliminates.

These examples, among many others, highlight his history of spreading misinformation, which has raised concerns among public health experts about his potential influence on health policy. How can we place our trust in a conspiracy theorist who aligns with the MAGA ideology to lead the much-needed reform of the American healthcare system?

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Ten Great Public Health Achievements — United States, 1900-1999

  • Vaccination
  • Motor-vehicle safety
  • Safer workplaces
  • Control of infectious diseases
  • Decline in deaths from coronary heart disease and stroke
  • Safer and healthier foods
  • Healthier mothers and babies
  • Family planning
  • Fluoridation of drinking water
  • Recognition of tobacco use as a health hazard

https://www.cdc.gov/mmwr/preview/mmwrhtml/00056796.htm

Ten Great Public Health Achievements — United States, 2001–2010

  • Vaccine-Preventable Diseases
  • Prevention and Control of Infectious Diseases
  • Tobacco Control
  • Maternal and Infant Health
  • Motor Vehicle Safety
  • Cardiovascular Disease Prevention
  • Occupational Safety
  • Cancer Prevention
  • Childhood Lead Poisoning Prevention
  • Public Health Preparedness and Response

https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6019a5.htm

Ten Great Public Health Achievements — Worldwide, 2001–2010

https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6024a4.htm

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Published by Jose Becerra

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