It sure seemed like Robert F. Kennedy Jr. had a cold on Wednesday. During his Senate hearing as Donald Trump's nominee to head the Department of Health and Human Services, Kennedy snuffled, cleared his throat, coughed, blew his nose and, most painfully for those forced to listen, wheezed heavily into a perplexingly unmuted microphone while others spoke. I'm not his doctor, of course, and cannot diagnose him. I'm just saying that even the most stalwart believer that COVID-19 is a hoax might nonetheless be reluctant to sit next to their fellow conspiracist. For a man who claims it's time for a "break" in medical research into infectious disease, it was likely an irritating irony to present such a compelling reminder of the validity of germ theory.
(No, I'm not referring to Kennedy's vocal disorder, which causes his voice to shake. It doesn't cause the phlegm-fest he struggled to contain on Wednesday.)
Despite his apparent malady, Kennedy stuck to his shtick of reframing health as a matter of private virtue rather than public concern. Over the course of the hearing, it became clear why this lifelong Democrat has switched to the GOP. His view that sick people did it to themselves and deserve what's coming to them offers a nifty justification for Republicans' long-standing desire to deny health care to millions of Americans. Kennedy may dress this up as "prevention" or concern for children, but the message came through loud and clear: Medical patients are parasites who suck up resources from better, more responsible people.
Kennedy noted in his opening statement that the U.S. spends "far more on health care" than other developed nations, but declined to note the obvious reason: No other nations is so deeply committed to a for-profit insurance system. He dismissed that objection with a red herring: "Shifting the burden around between government, corporations and families is like rearranging the deck chairs on the Titanic," he said, evading reams of proof that different entities have different scales of cost-effectiveness in health care delivery.
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Instead, Kennedy blamed "chronic disease," a vague category that encompasses a cornucopia of ailments like "autoimmune diseases, neurodevelopmental disorders, asthma, Alzheimer’s, ADHD, depression, addiction" and, with special emphasis, diabetes. I'll leave it to the experts and fact-checkers to explain how badly he misrepresented the diverse causes of these conditions. What matters here is the rhetorical purpose "chronic disease" plays: Blaming the victims, and creating the pretext for taking their health care away.
Kennedy has spent decades as an anti-vaccine conspiracy theorist, and his training as a B.S. artist was on full display at Wednesday's hearing. He waxes poetic about the importance of "prevention." to the point where even those of us who know he's full of it can get sucked in, at least until we remember that he rejects the single most important form of preventive care ever developed. (Vaccines, duh.) But as the hearing went on, it became clear that "prevention" was just an RFK code word for victim-blaming.
When asked how he would implement "prevention" for Medicare and Medicaid patients, Kennedy replied that it was about "making them accountable for their own health care, so they understand the relationship between eating and getting sick." He argued that people on food assistance should have their options reduced so they can't buy processed foods. That's designed to sound vaguely positive while doing nothing to help people. No living person believes that Oreos are better for you than apples. Lecturing them about it and restricting their food budget will do nothing to reduce their medical costs, but it does creates an excuse to deny health care by claiming that they made themselves sick.
When Sen. Bernie Sanders, I-Vt., asked whether health care is a right, Kennedy got closer to showing his true colors by refusing to answer the question.
SANDERS: Do you agree healthcare is a human right? RFK Jr: I can't give you a yes or no answer
— Aaron Rupar (@atrupar.com) January 29, 2025 at 12:18 PM
Under prolonged badgering, Kennedy all but admitted he thinks care should be denied if your past behavior wasn't "healthy" enough. "Free speech doesn't cost anybody anything, but in health care, if you smoke cigarettes for 20 years and you get cancer you are now taking from the pool. Are you guaranteed the same right?" Kennedy snapped at Sanders.
On its surface, that may sound fair. Most people don't have much sympathy for smokers these days. But this must be seen in the larger context of Kennedy's constant refrain: Most illnesses are a result of what people eat, so almost any health problem can be blamed on "personal choices," especially when you're as divorced from scientific facts as Kennedy is.
There's an entire "wellness" industry, which Kennedy is deeply plugged into, that sells the idea that "clean" food and healthy living will prevents every kind of ailment. We saw this in operation during the pandemic, when influencers like Joe Rogan peddled the idea that diet and exercise were superior "prevention" to the vaccine. In other cases, it's more complicated: There's no question that diabetes has both diet and genetic factors. But it's not a huge leap to move from false or dubious claims about personal health practices to blaming sick people for not taking your advice.
Kennedy's eagerness to slash access to health care burbled up repeatedly during the hearing, most comically when he offered computer software as an alternative to doctors. When asked about provider shortages in rural areas, he raved about an article he read describing "an AI nurse that you cannot distinguish from a human being, that has diagnosed as good as any doctor." I don't know what's scarier: replacing doctors with chatbots, or the fact that Kennedy wants upend the medical system based on a half-remembered article.
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On a more serious note, Kennedy repeatedly nodded at the long-standing Republican dream of slashing Medicare and Medicaid. He hyped Medicare Advantage, a privatization scheme set up to cannibalize Medicare, even though studies repeatedly show it raises patient costs without improving care. There was an especially telling exchange with Sen. Thom Tillis, R-N.C., who sneered at people who consider Medicaid "sacrosanct" and declared that the program, which covers nearly one in five Americans, "is not producing positive outcomes."
That is a lie, since 83% of people on Medicaid rate the program positively, which is slightly higher than ratings for remployer-provided insurance. But Kennedy couldn't agree quickly enough, declaring, "We're spending $900 billion. People are getting sicker every year." No doubt Republicans were pleased, since they are proposing massive cuts to Medicaid to fund yet another tax cut for the wealthiest Americans.
Kennedy uses his status as a former Democrat as a shield to seem "reasonable" despite his decades of conspiracy theory-mongering, but what he dished out on Wednesday was the same glib right-wing nonsense we've heard forever. Kennedy implied that health care spending is doing nothing to help people, and may even make their situation worse. In reality, lower-income people have worse health outcomes in no small part because they have sporadic or incomplete access to medical care, and Medicaid — which is mainly an insurance program, not a provision program — can do little to address that. Taking away whatever access people now have will not compel them to bootstrap their way to better health. Kennedy and his new Republican bosses know this, which is why they've got their excuses lined up when health outcomes get even worse: Sick people are to blame.
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