Public health policy in the US
There is controversy regarding Casey Means' nomination for surgeon general.
She's only 38 years old, and has a lot of crackpot-like controversial views regarding medicine, vaccine, and health. She is in agreement with RFK Jr regarding a lot of his health theories, and that's presumably the reason Trump nominated her.
She's practices "functional medicine", which is similar to alternative medicine, utilizing unproven and disproven methods to treat and prevent disease.
Like RFK Jr, she believes ultra-processed foods, environmental factors, lack of sunlight, and lack of exercise are responsible for many of America's health issues. In that, she has somewhat of a point. It is likely that highly processed foods with increased additives might be causing obesity, cancer, and some other ailments. Environmental factors can always impact health, though those have improved over the years. Low vitamin D is often either undetected or untreated in adults, especially those 40+, and can lead to all kinds of health problems. Americans get much less exercise than they used to, and that's bad.
However, she takes these beliefs one step too far. She thinks that these factors are the basic cause of nearly ALL disease, and that they're all branches of metabolic dysfunction. There is no credible evidence to show this, and in fact the "single cause of most health problems" research has always failed to show any validity upon scrutiny.
She has also oddly embraced raw milk (which is unsafe), criticized childhood vaccines, and believes that medical error and medication is the third cause of death in the US (which isn't true).
Suffice to say that her beliefs do not align with many highly studied scientific findings, and many of them would put us decades back in public health. There is no question that modern medicine has improved with every passing year, and we should not put those in power who reject a lot of it.
That's not to say she doesn't have a few good points. In addition to the desire to push an emphasis on exercise, proper vitamin D levels, and less processed foods (all positives for health), it is true that big pharma has too much influence, and probably is pushing vaccines and medications onto the public which do more harm than good. It's also true that some otherwise valuable medications are overprescribed due to incentives from big pharma to doctors. If she chose to mainly focus upon these areas, she could be a good pick.
However, she's just plain wacky, and often discards proven science for hunches, theories, and trends. That's not what we want for a surgeon general, and of course these same criticisms also apply to RFK Jr.
This is what frustrates me about Trump this term. He has the chance to think out of the box and appoint people who will break molds and make positive change, but instead he goes too far and appoints whack jobs.
Good public health policy would be as follows:
- Embrace all time-tested, well-proven vaccines, and re-explain to the public why they are essential
- Do not push any dumb or unproven theories (such as vaccines causing autism)
- Aggressively push to the public the value of exercise (even moderate exercise) and maintaining a healthy weight
- Strongly push for change in food processing to make them healthier, and put pressure on the FDA to change their requirements
- Push the importance of a yearly blood test for those over 40, and the need to treat whatever is found abnormal. This is actually huge and overlooked by many. Not going to the doctor for at least a blood test once a year when 50 is a huge difference than not doing so at 30 (where the latter isn't necessary).
- Push to disconnect big pharma from any influence, and ban them from providing gifts or incentives to doctors
- Push to close loopholes in insurance billing which provides huge incentives to doctors to prescribe expensive (and sometimes harmful) tests
- Educate the public on the real risks of vaccines and medications, make it easy for them to get this information, while at the same time pushing their benefit
- Make people over 50 aware they should get a colonoscopy, and have them start at 45 with any family history of colon cancer or polyps
Some of these are not directly under the authority of a surgeon general, but they can have influence in all of these areas.
I have run into many people my age who haven't had a blood test in a decade, simply because they don't realize how important it is. Bad.
I have run into many people my age who have no idea that colon cancer can be mostly prevented, and if not, it's a fairly common deadly cancer, even for middle-aged people. Bad.
I have run into many people my age who think they can diet or exercise out of all health issues, and that meds are never necessary. Bad.
Trust in public health authorities has taken a harsh beating since the COVID fiasco. Dr. Fauci and all of his media sycophants, combined with right wing conspiracy theorists, have made half the country believe that public health officials are selfish, evil, dishonest tools of big pharms. That's very bad, and it's one of the big reasons I was stating that the left/media COVID dishonesty was doing LONG TERM harm to trust in health officials. They were inadvertently validating all of the crackpot conspiracy theorists whenever these officials were caught lying.
The time is now to put a responsible but transparent/honest surgeon general in place, who will give it straight to Americans, challenge norms, while at the same time staying aligned with proven science.
