Merck

The Shift from Sick Care to Health Care For decades, the American medical establishment has operated under a model that Robert F. Kennedy, Jr. identifies as **sick care**. This distinction is not merely semantic; it represents a fundamental misalignment of incentives where the primary economic drivers reward the management of chronic conditions rather than their prevention or cure. As the Secretary of Health and Human Services, Robert F. Kennedy, Jr. argues that HHS has historically presided over a declining state of national health despite possessing the largest budget in the federal government. The United States spends more per capita on healthcare than any other nation, yet it maintains the highest chronic disease burden in the developed world. The current crisis is most visible in the health of American youth. Kennedy points to staggering statistics: 77% of American children cannot qualify for military service due to health issues, and autism rates have climbed from 1 in 10,000 in 1970 to 1 in 31 today. In California, the rate is even more alarming at 1 in 19. Juvenile diabetes, once a rarity for pediatricians to encounter in a 40-year career, now affects or threatens nearly 40% of teens. This "existential" threat to the nation's future is driven by a system that extracts profit from illness. Reversing this requires a complete realignment of the economic incentives that currently reward hospitals, insurance companies, and pharmaceutical firms for keeping a population in a state of perpetual, managed sickness. Industrialized Fraud in Medicaid and Medicare One of the most immediate challenges facing the reform of the HHS is the eradication of pervasive, industrialized fraud within the Medicaid and Medicare systems. Kennedy estimates that at least $100 billion is lost annually to blatant fraudulent operations. This isn't just a matter of bureaucratic error; it is a sophisticated criminal industry often exploited by foreign entities. For example, investigators found a single hotel in Florida where every one of the 129 rooms served as a shell company for durable medical equipment like wheelchairs and knee braces that never existed. These operations buy patient identification numbers on the black market and bill the federal government for millions in non-existent services. Historically, the effort to maintain program integrity was severely diminished. Kennedy claims the Biden administration reduced the program integrity office from hundreds of employees to just six, shifting the focus exclusively to new enrollments. This lack of oversight created "pervious guardrails" that allowed organized crime syndicates to exploit well-intentioned programs, such as those that pay family members to provide home care. In Minneapolis, a program intended to support kids with autism saw its costs balloon from an expected $3 million to over $400 million a year due to wholesale fraud. By integrating AI to audit state spending, the current administration is forcing states to adopt corrective actions or face the withdrawal of federal reimbursements, a move that has met resistance from several blue-state governors who see the crackdown through a partisan lens. Transparency as a Market Force The medical industry thrives on "information chaos," a state where consumers have no access to the true cost of services until after those services are rendered. To combat this, Robert F. Kennedy, Jr. is championing price transparency as a primary tool for market correction. He notes that the price of having a baby can range from $1,300 to $22,000 in the same square mile of Manhattan, or from $5,000 to $60,000 in Detroit, for the exact same quality of care. Without a price menu, there is no functional market, and therefore no competition to drive costs down. The administration is currently finalizing regulations that mandate hospitals and providers post their prices on a centralized website. This approach mirrors successful reforms in Australia, where price transparency was the single most effective lever in improving care quality and reducing expenditure. By making these prices public and providing consumers with tools to compare costs, the government intends to shift the public into the role of "CEO of their own health." This empowerment extends to pharmaceutical access via initiatives like Trump RX, which allows individuals to access medications at the lowest developed-world prices by bypassing the middlemen and pharmacy benefit managers who typically inflate costs. The Nutritional Revolution and Food Policy The American diet is the primary driver of the chronic disease epidemic, with 70% of children's calories coming from ultra-processed foods. Kennedy describes the previous Food Pyramid as a document written by lobbyists rather than scientists, famously placing sugary cereals like Froot Loops as high-priority recommendations. The administration’s new dietary guidelines focus on nutrient-dense whole foods and eliminate the "mercantile impulses" that formerly dominated nutritional policy. This includes returning whole milk to school lunches and removing federal subsidies for soda and candy through the SNAP program. A central component of this strategy is the "Make America Healthy Again" (MAHA) initiative, which seeks to use the government's massive purchasing power to shift the market. By changing the requirements for military meals and school lunches, the administration is creating an immediate demand for real food. Chef Robert Irvine has demonstrated that providing fresh, locally sourced meals at military bases is actually cheaper—costing $10 per day compared to the $18 spent on low-quality frozen options—while significantly increasing soldier satisfaction. Furthermore, the FDA is fast-tracking the removal of harmful synthetic dyes, such as Red Dye 40, and transitioning the industry toward vegetable-based alternatives that do not carry the same neurodevelopmental risks associated with ADHD and other behavioral disorders. Pharmaceutical Innovation and Domestic Production For decades, the United States has served as the primary profit engine for global pharmaceutical companies, paying significantly higher prices for the same drugs sold in Europe. Kennedy highlights the case of Ozempic, which retails for $1,350 in the U.S. but can be purchased for $88 in London, despite being manufactured in the same New Jersey factory. To resolve this, the administration leveraged the Most Favored Nation (MFN) agreement, ensuring that Americans pay the lowest price available in the developed world. This was achieved not through price caps alone, but by threatening tariffs and using the massive leverage of Medicare to bring 16 of the 17 top pharmaceutical firms to the negotiating table. A critical part of this deal involves the "onshoring" of drug production. During the COVID-19 pandemic, the vulnerability of the American supply chain became clear as the nation ran out of Active Pharmaceutical Ingredients (API) primarily sourced from overseas. As part of the new agreements, companies like Eli Lilly, Pfizer, and Merck are building massive new facilities in the U.S. to ensure that the country remains the center of global innovation and production. This strategy aims to combine affordability for the consumer with national security for the country, making the U.S. self-sufficient in life-saving medicine. Regenerative Agriculture and the Future of Farming The American agricultural system is currently "addicted" to chemical inputs, specifically Glyphosate (Roundup). Kennedy, who spent 40 years litigating against Monsanto, acknowledges the paradox of the current administration’s support for domestic glyphosate production. While he views pesticides as poison, the reality is that 98% of American soy and corn production is currently dependent on them. Banning these chemicals overnight would collapse the food system and leave the U.S. vulnerable to China, which currently controls 99% of the glyphosate supply. The long-term solution lies in creating an "off-ramp" for farmers through technology and Regenerative Agriculture. New technologies, such as laser-equipped tractors that identify and incinerate weeds without harming crops or soil, offer a path forward. These machines can reduce pesticide costs from $1,500 per acre to $300 while increasing yields and soil health. Farmers like Will Harris of White Oak Pastures have shown that it is possible to restore the soil's microbiome and eliminate runoff, but the transition requires time and significant investment. The administration is committing billions to help farmers scale these organic and regenerative practices, aiming for a future where American food is once again free from the persistent chemical burden that characterizes the modern industrial farm. Mental Health and the Psychedelic Frontier The crisis of mental health in America, particularly among veterans and those suffering from PTSD, has prompted the administration to explore non-traditional interventions. Kennedy expresses strong support for the therapeutic use of psychedelics, including Psilocybin, MDMA, and Ibogaine. These substances have shown remarkable success in "rewiring the brain" and breaking the cycle of addiction and depression, often with a much higher success rate than traditional SSRIs. The VA is currently conducting over 20 studies into these treatments, recognizing that soldiers who have sacrificed for the country should not have to travel to Mexico to receive life-changing care. While Kennedy emphasizes the need for strict clinical guidelines to prevent "the Wild West" of unregulated use, he views these substances as transformative tools that can address the root causes of trauma rather than merely masking symptoms. This bipartisan interest—supported by figures ranging from Rick Perry to Bernie Sanders—marks a significant shift in drug policy, moving away from the "war on drugs" mentality and toward a focus on human flourishing and mental wellness. Conclusion: A Bipartisan Path to Wellness The fundamental challenge to these reforms is the deep-seated tribalism and partisanship that currently defines American life. Kennedy laments that many blue states refuse to participate in fraud detection or nutritional improvements simply because they view the initiatives as being tied to Donald Trump. He argues that health, food quality, and the prevention of fraud should be universal concerns that transcend political affiliation. The goal of the MAHA movement is to reunite Americans around the basic right to be healthy and to live in a system that values human life over corporate profit. As the administration moves into the coming years, the focus remains on incremental but rapid change: cleaning up the food supply, lowering drug costs, and making the medical system transparent. By realigning the economic incentives of the world’s largest health agency, the hope is to finally end the "mass poisoning" of the American public and restore the nation’s health for future generations. The success of this mission depends not just on policy changes in Washington, but on a cultural shift where Americans take back control of their own health and demand a system that truly serves them.