The MAHA Report, Part Two: Putting health needs over politics.

“The pharmaceutical industry, from 1999 to 2018, spent $4.7 billion on lobbying expenditures at the federal level, more than any other industry. In addition, 9 out of the last 10 FDA commissioners—and approximately 70% of the agency’s medical reviewers—have gone on to work for the pharmaceutical industry. Over 80% of clinical departments and teaching hospitals at U.S. medical schools receive some degree of pharmaceutical funding, while half of the total costs for continuing medical education (CME) is funded by industry…. In the United States, private industry funds five times as many clinical trials than all U.S. Federal agencies combined including the NIH. Since 1999, 97% of the most frequently cited clinical trials received funding from industry.”

-MAHA Report, 2025

This past week Robert Kennedy released his first MAHA Report, focusing primarily on the health of children.  The above graph, which is part of the report, says it all: we are the sickest country in the industrialized world and pay the most for it. The Report can be found by clicking here, and the first few pages summarize his policy objectives.  In reading the entire report and having come to similar conclusions in our book Return to Healing, it is clear that Kennedy seeks to make substantive and essential changes to both the healthcare system and the food industry, changes that will clearly (and have already) incite vitriol from both parties.  The Democrats have attacked it mostly because it emanated from the Trump Whitehouse and Kennedy, and the Republicans (including some in the Trump administration) have attacked it because it is an assault on corporate America, but it’s important to understand both what the report says and what it leaves out.

Here are the basic points from the report itself:

• “Aggregation of Environmental Chemicals: Children are exposed to an increasing number of synthetic chemicals, some of which have been linked to developmental issues and chronic disease. The current regulatory framework should be continually evaluated to ensure that chemicals and other exposures do not interact together to pose a threat to the health of our children.

• Lack of Physical Activity and Chronic Stress: American children are experiencing unprecedented levels of inactivity, screen use, sleep deprivation, and chronic stress. These 6 factors significantly contribute to the rise in chronic diseases and mental health challenges.

• Overmedicalization: There is a concerning trend of overprescribing medications to children, often driven by conflicts of interest in medical research, regulation, and practice. This has led to unnecessary treatments and long-term health risks.

• Poor Diet: The American diet has shifted dramatically toward ultra-processed foods (UPFs), leading to nutrient depletion, increased caloric intake, and exposure to harmful additives. Nearly 70% of children’s calories now come from UPFs, contributing to obesity, diabetes, and other chronic conditions.”

Having studied our own healthcare system and the health habits of Americans, it is hard to argue with any of this.  We are over-medicated and little attention is given to diet and to the pesticides and other poisons with which our foods are infested.  We don’t study this as a nation, spending almost all of our dollars engaging in pharmaceutical and device studies paid for and often engineered by drug companies.  Kennedy seeks more study and more regulation over aspects of both the drug and food industries, putting people over profits.  How he will accomplish this, especially over the protests of many Republicans and the power of industry, is not well delineated by this report.

Kennedy has long been an opponent of the pharmaceutical industry’s penetration into every tentacle of our healthcare infrastructure, and he is not alone in that belief.  Many more liberal analysts have come to the same conclusion, and in our book we lay out the bare facts about how deep their hold is on medical research, on media positions, on national agencies (being the primary funders and leaders of both the FDA and CDC), on patient advocacy groups like the American Cancer Society and American Diabetes Association, on academic research and education, on Congressional action, and on the protocols and calculators that doctors use to treat their patients and get paid.  In his recent book No More Tears, award-winning New York Times journalist Gardiner Harris makes the same claims, showing how the FDA, academia, the media, and much of the medical establishment (including doctors) are bought off and influenced by Big Pharma.  The fact that Kennedy ascribes blame to industry in creating a profitable but lethal mess, especially for children, is hardly novel, but the report says little about how to address it.  We in several articles, including a recent one in Dow Jones Market watch, do provide a plan, and it is likely Kennedy’s team will as well, but it’s tough to fight the money and power in the Medical Industrial Complex, especially given how much financial largesse they provide across our medical, political, and media landscapes.

In the report Kennedy writes: “A BMJ analysis found that industry spent over $60 billion on drug, biotechnology, and device research in nutrition science; by comparison, the government spends an estimated $1.5 billion on nutrition research. Concerningly, industry-funded nutrition research may bias conclusions in favor of sponsors’ products. Government funding for nutrition research through the NIH is only 4-5% of its total budget.”  As we have stated, health insurances (including Medicare) spent $35 billion last year on specious and barely studied weight loss drugs that easily slipped by the FDA’s regulatory eyes, while they spend almost nothing on nutrition and exercise programs.  Kennedy seeks to change that paradigm, pushing more federal dollars into programs that target nutrition and exercise, and financing more studies that look at the pervasive effects of our poor and highly contaminated diets.  Again, it seems strange that anyone other than those seeking to profit from the current system would argue against that.

He also talks about over-medicalization, especially of children.  He writes: “The overmedicalization of American children, characterized by escalating prescription rates, unwarranted interventions, and declining health outcomes, signals a critical policy failure where corporate profitability supersedes the health of children.”  Again, who could argue against that other than those who make money by convincing people to use medicines that are either useless or harmful?  Our drug epidemic, as the Lown Institute and so many other healthcare analysts (on both sides of the political aisle) have argued, is due to physician overprescribing.  Doctors often take their orders from drug company studies and protocols, and few studies have examined the detrimental effects of this medicine overload until it’s far too late.  It’s rare that doctors truly understand the risks and benefits of drugs they insist their patients must take, something demonstrated by many studies.  Harris in his book estimates the death toll of all these dangerous medicines to be in the many millions, and we as doctors have seen its effects on quality of life and longevity among all our patients, young and old.  That Kennedy seeks to address this is laudable and necessary, and it requires a complete exorcism of drug company money and influence from public agencies, Congress, the media, and academia, again something that is in line with what people like Harris say too.  It’s time to end drug company ads, drug company gifts, drug company sponsorship of research and of the FDA and CDC, and turn toward a focus on lifestyle interventions.  That’s where the money should flow, and Kennedy’s report does provide a blueprint for how to do this.

Many liberals assail his anti-vax position, but as our previous piece on Kennedy’s views stated, his position is far more nuanced than the media suggests.  In the report he states: “Vaccines benefit children by protecting them from infectious diseases. But, as with any medicine, vaccines can have side effects that must be balanced against their benefits. Parents should be fully informed of the benefits and risks of vaccines.”  Are there too many vaccines for kids and even the elderly?  Is it dangerous to give them all at once, as the CDC has advised, without providing any data to substantiate its position?  Should we be studying vaccines instead of merely accepting the accusations made by drug companies and their media/academic allies that merely questioning vaccines amounts to being labeled an anti-vax nutjob?  Vaccines play a tiny role in this report, and the message about them is hardly anti-vax or anti-science, but it is likely that some people will harp on this one issue and ignore everything else.

The report is not complete, and we expect more to come.  In past statements Kennedy emphasized his intent to reform physician reimbursement and extant rules that help buttress specialty care and procedural-oriented care at the expense of a dying primary care infrastructure, something crucial to any effective healthcare reform.  He has talked about removing drug company ads from the media, which too is not explicitly discussed in the report.  And of course in this report he talks very little about adults, especially older adults, who are equally put at risk by the perfidy of the industrial penetration of their medical lives.

Our healthcare system has been coopted by those who seek to profit by disseminating fictive narratives that scare patients into diving into a medical morass that only makes them sicker.  Whether the message is spread by specialty physician societies or the media or drug/device companies or hospitals or academics or mega-farmers and players in the food industry, so much profit is derived by making people sicker that we must do something to curb their influence.  We spend 4 trillion dollars on a healthcare system that has made us among the least healthy and shortest-lived nations in the world, and almost as much providing food that makes us sick, and Kennedy seeks to change that calculus.  He is not alone, and many on both sides of the aisle have raised the same clarion call.  But it does mean fighting an entrenched system of money and power that also exists on both sides of the aisle.  The question his report truly brings up is whether we want to be a healthier nation that spends less and achieves more, or whether we want to continue to enrich those who profit from us being sicker and more miserable.  And of course, the devil is in the details; we still don’t know how this will all be done.