In his effort to assemble an administration that can go to war against the “deep state,” Trump has nominated Robert F. Kennedy Jr. to head the Department of Health and Human Services. Kennedy’s views on the crisis of American public health are highly confused. But like Trump’s rhetoric generally, it taps into a widespread distrust of the “establishment.” Take, for instance, Kennedy’s endorsement speech for Trump, in which he stated:
The FDA, the USDA, CDC, all of them are controlled by giant for-profit corporations … Pharma executives and consultants and lobbyists cycle in and out of these agencies. With President Trump’s backing, I’m going to change that … We’re going to stop subsidizing the worst foods with our agricultural subsidies. We’re going to get toxic chemicals out of our food. We’re going to reform the entire food system. And for that, we need new leadership in Washington, because unfortunately, both the Democrats and the Republican parties are in cahoots with the big food producers, Big Pharma and Big AG, which are among the DNC’s major donors.
In a country with an abysmally bad healthcare system and skyrocketing chronic disease, it’s no wonder that this kind of rhetoric can get an echo. But Kennedy and Trump’s “marriage of convenience” will not result in an improvement of public health.
Chronic disease crisis
Kennedy presents his base with a number of undeniable facts about the deplorable state of public health in the world’s richest country. No one could disagree with him on these grounds. As a 2024 CDC report explains:
An estimated 129 million people in the US have at least one major chronic disease (e.g., heart disease, cancer, diabetes, obesity, hypertension) as defined by the US Department of Health and Human Services. Five of the top 10 leading causes of death in the US are, or are strongly associated with, preventable and treatable chronic diseases. Over the past two decades, prevalence has increased steadily, and this trend is expected to continue. An increasing proportion of people in America are dealing with multiple chronic conditions; 42% have two or more, and 12% have at least five.
Observing these trends, Kennedy proposes a number of different measures, such as banning certain dyes and other ingredients in food, removing ultra-processed food from school lunches, removing fluoride from tap water, ending direct-to-consumer advertising for prescription drugs, questioning vaccination schedules and regulation policies, and abolishing “entire departments” at the FDA and USDA. All things being equal, many of these measures would likely be beneficial if implemented. However, since he limits himself to tinkering within the limits of capitalism, his entire outlook misses the forest for the trees.
The most effective measures to help prevent chronic disease are the simplest and most well known. The problem is a lack of implementation. A 2016 CDC study looked at the prevalence of five key behaviors for preventing chronic disease: never smoking, getting regular physical activity, consuming no alcohol or only moderate amounts, maintaining a normal body weight, and obtaining daily sufficient sleep. After analyzing data on 395,343 people, it found that just 6.3% of the US population regularly engages in all five behaviors.
To be truly healthy, one must have adequate time for sleep, exercise, cooking, socializing, and relaxing. Realistically, only a small layer of better-paid workers have all of this. / Image: Ed Yourdon, Flickr
This is not for lack of information or a lack of desire to be healthy. The problem is that the structure of capitalist society makes these measures virtually unattainable for most people. To be truly healthy, one must have adequate time for sleep, exercise, cooking, socializing, and relaxing. One also requires access to affordable and nutritious food, parks, gyms, etc. And of course, access to high-quality healthcare services when needed. Realistically, only the capitalists and a small layer of better-paid workers have all of this, all of the time.
Most workers are forced to live lifestyles that are more or less atrocious for human health. The simple lack of time and money, as well as the enormous stress of life under capitalism, leads to disastrous health outcomes for millions of people. Due to the relative scarcity and affordability of healthy food, 60% of caloric intake comes from ultra-processed food, while 90% of Americans do not meet the recommended daily allowance for vegetables. The average step count in the US is just 3,000 to 4,000 per day. One-in-three Americans are sleep-deprived.
Meanwhile, certain elements of the capitalist class are consciously working against human health in order to make profits. Ultra-processed food companies have spent millions of dollars researching how to make food products that override natural satiety signals, while Netflix CEO Reed Hastings observed plainly to shareholders in 2017:
“You know, think about it, when you watch a show from Netflix and you get addicted to it, you stay up late at night. We’re competing with sleep, on the margin.” And there’s no need to mention the disastrous outcomes and horror stories that result from the for-profit health insurance industry.
Socialist planned economy
All of this goes to show that the driving force for sustaining workers’ lives under capitalism is not human need or health, but simply keeping them “alive enough” to show up at work and create surplus value for their boss for as long as is profitable. The capitalist class as a whole does not care if the general population is chronically sick and miserable, as long as there is a sufficient supply of labor power. Workers do not need to be in pristine health in order to keep profits flowing.
Only a socialist planned economy can improve human health on a mass scale. A 20-hour workweek will give everyone the necessary time to look after their health and well-being. City planning motivated by human need, not profit, will allow everyone to have access to excellent dining halls, supermarkets, gyms, and parks. Everyone will have access to high-quality healthcare, free at the point of service, and billions of dollars will be poured into medical research and development unhindered by the profit motive. On this basis, human health will flourish in a way never before seen in human history.