What does RFK Jr mean for healthcare?

Many people don't understand how bad the status quo is

I have read and heard many accounts of what RFK Jr will mean for healthcare. “He will ban the MMR vaccine.”. “ He will take Fluoride out of water” “He will approve ivermectin”. Is this possible or science fiction?

I have spent hours listening to him on long form podcasts and have some thoughts:

First, in my opinion, it is possible that he will be sidelined. Although he supported Trump and Trump has said he has a place at the table, his exact role is unknown. He is anti-corporation and that doesn't earn you friends in Washington. I can see him being pushed out, easily. Many pharmaceutical firms will spend massive capital to do so.

Two, he has stated repeatedly that he will not ban vaccination, but work against policies that make it compulsory. He will try to undo legislation that indemnifies makers.

Let's talk about indemnification. The logic to protect vaccine makers from suits is that vaccines don't earn a lot of cash and some suits will be frivolous. The former is not true anymore. Moderna and Pfizer made 100 billion +. They can afford to be sued.

Furthermore, currently in America, we can litigate drugs and that system has not been chaotic. Some drug makers have been sued. Some frivolous suits, dismissed. Extending that to vaccines is straightforward. These companies should be sued for myocarditis and VITT (J&J). Particularly by young men and families of young women (dead from VITT). Schools that mandated these products should also be sued. This is the only way to protect the public from cronyism and corruption masquerading as public health. Make no mistake: vaccine mandates for young people was just that.

Let's talk about compulsion. Some external rules can be good to encourage target vaccination rates for vaccines that halt transmission and I don't think the MMR vaccine is linked to autism with OR 1.02 or greater. But, you can never prove the null in medicine. And, current safety detection is actually very bad in America. There are lots of safety signals we are unaware of.

The compromise to RFK should be: let's make a new vaccine and drug safety system.

The US did not detect VITT or myocarditis. We may be missing many other concerns for common drugs and vaccines. We need better randomized trials. Extension cohorts. And better active reporting systems. These cannot be designed in partnership with Pfizer. RFK Jr should channel these energies into productive policy.

Moreover, let's be honest, the current system is corrupt. FDA employees routinely go to work for Pharma. They are not successful in demanding appropriate studies from Pharma. Just consider what they did with the sickle cell drug, voxeletor. They approved it based on a flimsy 1g Hg rise (at the time, experts doubted that would help), and had to withdraw it later when it caused deaths and vaso-occulsive disease. At the time of the approval nothing supported a 1 pt Hb endpoint. They just made it up to make the company rich. It would be a great thing to get more studies to assess the efficacy and safety of products. And to have these done in an unbiased fashion.

Now let's talk about some of the things in the above post.

Ivermectin. As a cancer doctor, I know one thing: Ivermectin doesn't work for cancer. Why? Nearly every single drug that works in cancer is capable of shrinking the tumor when given to people by itself. That's called single-agent drug activity. This drug has 0% activity. It doesn't work. It's also cheap, and has a mostly decent safety profile. It's probably safer to take than most cancer drops.

If RFK Jr approved this product, most doctors would never get it, and most people would never take it. Some people would take it, of their own choosing. They'll take it the same way people take vitamins and supplements. None of that stuff will make a difference. It probably won't do too much harm. It's probably pretty cheap.

Cancer drugs that don't work and cost $200,000 are way worse. Personally, I doubt RFK would approve ivermectin. He might first ask for a large trial and that will be negative along side metformin and stations, other fools errands that are popular in the ‘ drug repurposing crowd.’ Put another way: Anyone who thinks ivermectin would be a bad approval, doesn’t understand how bad things are right now.

Raw milk has small risks, and this is discussed nicely by Emily Oster. She concludes this risk is one on par with other risks healthy adults take.

I will return to fluoride and water in a future post.

Now let me say one thing RFK Jr is profoundly correct about. This was retweeted by him.

The current system is profoundly broken. Drug regulators like Bob Califf have up lied. He said, “misinformation is the leading cause of death,” which was and remains a lie . He lied about the ability of vaccines and paxlovid to lower long COVID. He approved Exondys against the advice of the primary reviewers. When he left the FDA, he immediately worked for a company in the biopharma space. He is a sell-out, in the classic sense of the term.

Both Bob Califf and RFK Jr promote some things that don’t work. Califf promotes costly, branded pharmaceutical drugs that don’t work and then works for pharma, where RFK seems to promote low cost medications that don’t work, and has not gone to work for those companies.

US Healthcare is broken. RFK is an unpredicable and chaotic force. With the right direction, he may do what has been unthinkable: a deep reform of the system.

Instead of attacking him, we should acknowledge what he is right about and give guidance. Here are some of mine.

And this post

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