Title: Inside RFK Jr's MAHA Report on Childhood Health

[MUSIC]

Brian: It's The Brian Lehrer Show on WNYC. Good morning, everyone. We have Harvard historian and New Yorker staff writer Jill Lepore coming up later in the show. I know we have a lot of Jill Lepore fans out there, especially those of you who read The New Yorker, but also her books. She's got a new book, A New History of the US Constitution. She and, apparently, Bugs Bunny, who gets the first quote in the book, want the Constitution to be easier to amend.

We'll ask her if that's a good idea in today's political climate from her point of view. We'll also give you the chance to call in and say what, if you could have your way, would be the 28th Amendment to the Constitution. We have 27 now. We'll ask Jill for hers. I think she's got a short list of a few, and we'll invite yours as we talk with Jill Lepore coming up.

We start with our Health and Climate Tuesday section of the show. We don't always lead with it, but we're leading with it today because RFK Jr is out with his promised analysis of children's health in the United States, which he describes as a chronic disease crisis. The report describes rising rates of asthma, diabetes, obesity, and anxiety among children. Most of you know these things. It blames ultra-processed foods and what it calls the overuse of prescription drugs.

The report is called Make Our Children Healthy Again, part of Kennedy's larger Make America Healthy Again agenda. It does zero in on food, chemicals, and medication as causes, but it leaves out some of the biggest threats to kids' health that are also real: gun violence, smoking, vaping, and access to health care itself. Now, taken together, the omissions and the focus on individual lifestyle changes reveal a lot about how this health department is thinking about children's health and where it wants to steer the conversation and steer policy.

We should say on the policy level that, for all its urgency of tone and for all RFK is associated with this in general before, now during his tenure, the document is light on details. It gestures at big changes, but says almost nothing specific about how to make them happen. That's where the next round of public health politicking will begin. We'll pick it up there with Julie Rovner, chief Washington correspondent for KFF Health News and host of the What the Health? podcast and former NPR health reporter, as some of you know, to break it down. Hey, Julie, welcome back to WNYC.

Julie: Hi. Thanks for having me.

Brian: Listeners, we can open up this to you right away. Pediatricians, parents, teachers, anybody working with children, living with children, working on children's health professionally, you can help us report this story, and opinions welcome as well. What do you see as the biggest threats to children's health right now? Do you worry more about food, chemicals, anxiety and depression, medications that are supposed to help them with things, at least theoretically, vaccines, which we haven't mentioned by name yet, or about the things this report leaves out, guns, smoking, vaping, access to health care? What do you think at a policy level should be done about your main concerns? 212-433-WNYC, 212-433-9692.

If we're going to invite people later with Jill Lepore to propose constitutional amendments, we'll invite you right now to propose a piece of children's health policy for America. 212-433-WNYC, 433-9692, call or text with Julie Rovner. Julie, the report is fairly short, but it makes sweeping claims about why kids are getting sicker. How would you flesh out a little bit that short list that I gave in the intro?

Julie: I thought you did a wonderful job of summarizing it. Remember, this is part two of-- The first part was saying why our kids are so chronically ill. This was supposed to be the strategy for helping that. As you say, it's kind of light on details and more stronger on moral suasion, if you will. Some of its goals, it says, are to realign incentives, foster collaboration with the private sector, and increase public awareness, which I guess we are doing right now this morning.

Often, these reports will say Congress should pass this law or the administration will change these regulations, and it doesn't do a whole lot of that. It's not entirely clear how this administration is going to go about achieving these goals. We do already know that Secretary Kennedy has proposed this major restructuring of HHS, which would require congressional approval, and Congress hasn't shown much of an inclination to do that at this point.

Brian: It does point to ultra-processed foods, chemical exposures, overprescribing, it uses that word. How much does that diagnosis match what you're reporting over many years now would say public health research actually shows?

Julie: A lot of those things are, I think, everybody would agree, serious problems, but as you say, it leaves out some of the biggest threats to children's health. You didn't mention climate change as a threat. Also, as you say, tobacco and vaping, gun violence. This is, as you say, mostly looking at personal behavior and family behavior rather than systemic societal problems. Clearly, it's both, and I think that most researchers would agree that it's both, that most of the things that they're looking at here are important things to look at, but they're not the be-all and end-all. Helping these issues are not going to necessarily make our children healthy again.

Brian: Let's look at some of the categories in a little more detail that are in the report, and maybe even distinguish, based on what you just said, between individual changes that individuals or families can make and potential systemic ones on food. What kind of changes does it suggest for school lunches and SNAP benefits? Because that's in there a little bit, right?

Julie: It is, and this is one of those cases where this strategy goes against what other things are happening in this administration. It wants to get sugary drinks and candy and basically empty calories out of the SNAP program, more healthy products into the SNAP program. Of course, the big budget bill that passed earlier this year takes a huge chunk out of SNAP. They may be changing what SNAP will and won't cover, but fewer people are going to get it. That's just one of the many contradictions in this report.

Brian: I know one of the arguments against that proposal for SNAP is that even poor people deserve to have dessert, and so it shouldn't be that those items are categorically prohibited, critics would say. There should be education or whatever that addresses the whole population, because by this telling, if it's just for SNAP and there's nothing systemic that goes after the processed food industry, the sugary drinks industry, et cetera, then all the more affluent people are at risk as they ever were.

Julie: Also, it's more than just poor people deserve to have dessert, too. I've seen posts from people who have relatives who have diabetes who, sometimes, if they're in a blood sugar crisis, need something quick and sugary. There can be medicinal reasons to drink something sugary or eat some candy. Obviously, not all the time, and obviously, better education as to what types of foods are appropriate is something that I think everybody agrees on, but the actual banning of some of these from being eligible for people who have SNAP benefits is something that maybe deserves a longer look.

Brian: Let's take our first phone call from a CUNY professor who I think has been at it for a while and sees trends over time of the health of his 18-year-old freshman. Jim in the South Bronx, you're on WNYC. Hey, Jim, thanks for calling today.

Jim: Good morning. Thank you for taking my call. I've been in the CUNY system now for a good 30 years, and I cannot believe how out of shape and really, quite frankly, how bad the incoming 18-year-olds in my undergraduate classes and intro classes look. It's really remarkable, and it's getting worse and worse. Again, I see it year after year. My recurring joke is that every year the 18-year-olds get younger, [chuckles] but it's remarkable what is going on in this culture that young people at that age are so out of shape, so unhealthy, look so bad, quite frankly. I have to admit that I'm looking at it from the perspective of someone who's been very much into fitness my entire adult life. I'd like your guest to tell us what she thinks.

Brian: Jim, let me ask you a follow-up question first. First of all, I'll say, yes, the 18-year-olds get younger every year. I remember thinking that when I was a college junior. Like, "Did I really look like a baby two years ago, like those freshmen do?" I don't think you're a public health professor or science professor. Correct me if I'm wrong.

Jim: Not at all. I'm a historian.

Brian: Do you have your own theory about why this is happening, that they're coming in looking more out of shape?

Jim: Obviously, it's because they're inactive. Young men in particular, their commitment to gaming and essentially a sedentary life from a very, very young age, apparently, is driving some of it. The bad food, of course, fast food is a lot cheaper and a lot more available than it was when I was that age. You have a Wendy's, a McDonald's, or whatever, almost in every corner in a place like New York.

I guess it's also the convenience culture, because again, there's all kinds of processed food you can easily get. Again, maybe it's my own perspective as a kind of fitness guy, it's the real inactivity, the sort of sedentary life that they, so many of them, not everybody, of course, seem to be committed to. They just don't want to move. They just don't want to exercise, do sports, or whatever. They just don't want to do it.

Brian: I guess we can say the word phones and the word screens in relation to that. Jim, thanks a lot. Julie, how would you answer his question? Does the research back his theories as to what's going on, or does the RFK Jr report get into him?

Julie: I don't think there's any question that-- I think you put your finger on it, it's screens. It's not that kids don't want to move, it's that the kids don't have to move. When I was a little kid, I could read a book, but other than that, I pretty much had to go outside and play, and that was true for generations. It's not necessarily true anymore that kids can be fully mentally stimulated without ever getting up, and that is a problem. I don't think anybody suggests that it's not.

There are other problems that this report doesn't get into, and that I assume we're not going to get into today, with internet culture in general and gaming. It is definitely an issue that there needs to be more physical fitness. The question is, do you want to fix that by bringing back the presidential physical fitness test, which is something that this report suggests, and it's something that certainly traumatized a lot of young people, myself included, because it was actually extremely difficult. You had to be extremely fit to pass it, and it was kind of demoralizing.

There may be ways to address this, but the idea of having this discussion is obviously a good one. There are a lot of things in this report, as I said at the top, that a lot of people agree with, like doing more about ultra-processed foods. One of the technical things in this report is closing a loophole that allows food manufacturers to add things that are "generally recognized as safe," which is not necessarily true. There are some action items that I think would have broad bipartisan support.

Brian: Oh, tell us more about that. What is this category under the law, I guess, generally recognized as safe?

Julie: That's right. These are things that predate the regulation of food and, to some extent, drugs. There's a similar thing on the drug side that-- Basically, you're allowed to use things that are generally recognized as safe, but there's an awful lot of things that are under this category that might not be as safe as maybe we thought they were 10 or 20 or 50 or 100 years ago.

Brian: Does generally recognized as safe just mean they haven't been tested for toxicity or other harmful effects?

Julie: It means that they've qualified to be on a list. That's why they call it the grass loophole, that they've basically been designated as generally recognized as safe.

Brian: Before we get off food and onto some of the other categories in this RFK Jr report on children's health and what to do about it, Listener writes, "Is there anything in there to help people that are in food deserts?" Listener says, "That's why a lot of kids buy snacks because there's no apples or bananas in their neighborhood."

Julie: That's right. There's mention of it. This is one of those places where, as you said at the top, it's light on specifics. It acknowledges that there are food deserts, that there is difficulty getting healthy food to a lot of people, but it's not entirely clear how it would go about addressing that.

Brian: One text on things that aren't mentioned in the report, as we mentioned in the beginning of our conversation, listener writes, "Firearms are the leading cause of death for children 1 to 19 years old, full stop." Do you know if that's an accurate stat? We always have to fact-check stats when listeners write them in. Do you know if that's an accurate fact? Firearms are the leading cause of death.

Julie: I believe that it's accurate. I'm not positive. I know that gun violence, including accidental shootings, are way up there. The listener is correct that this report does not address that.

Brian: We're going to look that up and get the actual number from what's out there because that's worth confirming and expanding on to some degree, even though it's not in this report. Let's go to another category, that is, chemicals and the environment. On environmental health, the report, I think it's fair to say, is soft on pesticides, but tough on fluoride in drinking water. Can you explain more about the categories there or that contrast in particular?

Julie: There was a leaked version of this report, and the pesticide industry was very nervous about what it might recommend. I've seen claims that basically what the report now includes are the pesticide industry's own talking points. It does seem to lighten up a bit on the pesticide industry, and that is to the distinct unhappiness of a lot of the MAHA supporters who thought that it goes too lightly on things like pesticides.

Brian: Why would he do that?

Julie: Probably because he was told from his higher-ups. Remember, this report includes a lot of things that are not under the auspices of the Department of Health and Human Services. That's why the department, the agriculture secretary, and the head of the Environmental Protection Agency were at the launch for this report, because a lot of those things come under the auspices of those departments and not HHS. Pesticides is one of them.

Brian: Here, by the way, is a stat on the question that we left open from the Bloomberg Johns Hopkins School of Public Health, a report just last year based off of 2022 data. It says firearms remain leading cause of death for children and teens and disproportionately affect people of color. It says for the third straight year, firearms killed more children and teens ages 1 to 17 than any other cause, including car crashes and cancer. There's that from Johns Hopkins.

Some of you know Michael Bloomberg, who did have a reputation as the public health mayor when he was in office in New York City. Also, I guess, through a big donation, got the naming rights quite a while ago to the School of Public Health at Johns Hopkins, so that from the Bloomberg Hopkins School of Health, and that listener apparently was correct. Staying on chemicals in the environment, PFAS in particular, microplastics, air pollution, anything on those in any detail?

Julie: I would say, again, mentioned, important. A lot of these things are already happening. There's a lot of research already on these forever chemicals and the likely harm that they do, microplastics. This is already ongoing, and I think this is part of an effort in this report to just use moral suasion to push that along. Again, as you say, it's difficult because the administration can't do a lot of things it might like to do. It would need Congress to do those, and Congress may or may not be interested in picking up the ball here.

Brian: Let's take another phone call. Here's Lila in Miami. You're on WNYC. Hi, Lila.

Lila: Hi, Brian. I'm a virologist that went to the dark side. I'm in pharma now, and I call on pediatricians from Jupiter down to the Keys, so I see all kinds of situations. I just think that the bigger cause that we have is poverty, and nobody wants to say it. It's poverty. People are going into poverty. The children suffer. Complaining about the sugars, complaining about the pharma, complaining about everything else, but we're not doing anything for the health of the children. They should be taken care of. I lived in Germany for six years, and it's a totally different system. Yes, it's socialism, it's not communism. This capitalism has gone bad.

Brian: Lila, thank you very much. Does the RFK Jr report measure, I think this is a talk about toxicity, this is a toxic term in the Trump administration, disparate impact on children's health based on poverty?

Julie: Not a lot. This is a big concern, and I think the caller is absolutely right. You mentioned this at the top, that one of the things that really it doesn't get into is access to health care. Obviously, according to RFK Jr, one of the problems with children's health is what they call the over-medicalization, that children are getting too much medical care, but certainly, there is a huge problem of children not getting enough or not getting any medical care, and a lot of it does come back to poverty.

The US has done a lot in the last 20 or 30 years. It started the Children's Health Insurance Program, which dramatically increased insurance coverage for children. We started the Vaccines for Children Program in the 1990s to make sure that children that didn't have health insurance could still get vaccines without out-of-pocket costs. There were a lot of efforts to address this. This administration is not fans apparently of most of those.

Brian: We're going to take a break and then continue with Julie Rovner from KFF Health News, who's breaking down the new report on children's health and what to do about it from Health and Human Services Secretary RFK Jr. We'll take more of your theories about why children are getting sick in the ways that they are, being unhealthy in the ways that they are, and what to do about it. We're going to get into more of the categories in the actual report. Yes, we will touch on vaccines, but more generally, as soon as we come back, the larger category of medication, which is very much in RFK Jr sites. Stay with us. Call up with your analysis or proposals for improving children's health in the United States, 212-433-WNYC, 212-433-9692. You can call or you can text.

[MUSIC - Marden Hill: Hijack]

Brian: Brian Lehrer on WNYC as we continue to look at the new RFK Jr report, his promised analysis of children's health in the United States, which he describes as a chronic disease crisis, and his initial suggestions about what to do about it, some of them controversial for what they do suggest, some of them-- We could say the report is also controversial for what it omits. We're talking about all this with Julie Rovner from KFF Health News, former NPR health reporter, as you may remember, and she hosts KFF's What the Health? podcast.

Before we move on from food to medication, here's a text that says to the previous listener who said there are no bananas and apples at the bodegas, so we need to address food deserts. Listener writes, "The idea that kids aren't eating healthier because there aren't enough bananas in their neighborhood is bananas. Junk food has been engineered to be addictive, not to mention there are bananas at basically every bodega. It's the food industry and how they process and market junk food that is largely to blame." Julie, does RFK go there at all with respect to what the listener calls the addictive engineering, or that junk food is engineered to be not just tasty but addictive?

Julie: That's what the whole issue is with ultra-processed foods, or one of the main issues with ultra-processed foods. They don't go as explicitly, and I confess I have not read every page of this report, although I've skimmed all of it. I think both of those things can be true, that junk food is more attractive to not just kids, to adults, often, too, than fruits and vegetables. Also, there is a lack of available fruits and vegetables, and I think that it's both our problems.

Brian: Medication. The report puts ADHD medication in the spotlight. The numbers that I'm seeing are about 5% of kids are on ADHD medication at this point. What does RFK say about ADHD itself and ADHD medications?

Julie: This is part of his claim of over-medicalization that too many kids are on ADHD medication, too many kids are on SSRIs, that being hyperactive or anxious is part of growing up, I guess, and kids should just deal with it. This is obviously a fairly controversial take. This comes back to the vaccines. Just because something is being overused doesn't mean that perhaps the answer to it is to ban it.

RFK Jr was at a hearing a couple of weeks ago where he responded very angrily to claims that he has made the COVID vaccine unavailable by just changing the parameters of who it's approved for. Doesn't seem to understand that by creating all of those barriers, he has made it unavailable for a lot of people. There's a concern that perhaps even if we are overusing some of these medications, that we may end up underusing these medications.

Brian: Listener texts to this point in a broad way. We were just talking about ADHD medication, and I know you started to put it more broadly. Listener writes, "Do experts agree that too many pharmaceuticals are being prescribed for young people? Because you don't have to be RFK, you don't have to be a conspiracy theorist to think that may be the case."

Julie: Yes, I think this is still an ongoing debate. Are there kids who are prescribed ADHD medication because their teachers don't want to deal with them in class? Most likely. Are there kids who do extraordinarily well because they get the ADHD medications? Yes. Like every medical indication, there are risks and benefits. I don't think there's a consensus on the over-medicalization that this report talks about. That's something that RFK Jr and his MAHA allies have adopted.

Brian: We're getting some pushback on the idea that junk food should be available to people with SNAP benefits. One listener texts, "You say that junk food is addictive, and then you want it to be paid for by tax dollars because poor people have a right to eat dessert. Give me a break." I think also to this point, Avi in Brooklyn, you're on WNYC. Hello, Avi.

Avi: Hey, good morning. How are you doing? First of all, thank you, RFK Jr, for speaking your mind and bringing this conversation to the forefront. What a brave guy. I think there are two solutions. First of all, not a single piece of sugar processed or regular should be given out by government. They've snapped people by all sorts of sodas and junk, and then we want to give them all free insurance. It's crazy.

Number two, you have to link the cost of insurance to people's weight. If you're 25 pounds overweight, your insurance goes up. If you're 50 pounds overweight, your insurance goes up more, like car insurance. You'll see how quickly people get healthy, and that should include government insurance. If you're on government insurance, if you're skinny, you get the free insurance. If you're overweight, I don't have to pay for you because you're 75 pounds overweight, eating Snicker bars and drinking Coke.

Brian: Avi, let me ask you one thing before we talk about the weight and a curve for insurance costs. Do you think government, in support of your health, should also limit how much junk food you can take in, not just those on SNAP? DR.

Avi: No, but I should have to pay for it myself. If I want to be fat and I want to eat any junk I want, eat it all you want. You could die at 45 if you want, but you should pay the insurance cost. Government certainly shouldn't give out food that way. Government certainly shouldn't put it on SNAP. No freedom. You can eat yourself to the grave. I don't care, but I don't want to have to pay for it, and we all pay for it because insurance is a shared risk. We're all paying for it for these people who eat like pigs. Why should I be paying for it?

Brian: Avi, thank you very much. Obviously, when he says these people who eat like pigs, I'm going to interpret that as generously as possible in saying only those who do "eat like pigs or overeat among SNAP benefits," not to characterize SNAP recipients in general that way, please. The underlying idea of Avi's call, Julie, is that by metrics he cites weight, and weight isn't everything. We know you can be "fat and fit," as they say, but obesity is an indicator of risk for diabetes, for cancer, for early death. What about the whole idea of, like car insurance, he says, based on your record, which could be your metrics at your physical exam, an individual should have to pay more for insurance because society bears the cost?

Julie: I think one of the things that medicine has realized, I think, over really just the last decade is that a lot of people don't have control over their weight. That's why these weight loss drugs work so well. People aren't necessarily fat because they're drinking Coke and eating Snickers. They're fat because they have biochemical imbalances. It doesn't help, as we said earlier, that a lot of these foods are made to be highly palatable and very high-calorie, and somewhat addictive.

This got debated during the Affordable Care Act when there was so much more of the government's going to help pay for people's health insurance than there had been previously. In the end, it was decided that tobacco use could be used to raise premiums, and that was it, because at that point, there seemed to be medical ways to stop tobacco use. Perhaps now that there are medical ways to help people lose weight, we'll rethink it and have a discussion of it, but then you're going to have to help people pay for those, at the moment, very high-cost drugs that help people lose weight.

Brian: In fact, here is Deborah in Jersey City, who just called in and wants to respond to the previous caller. Deborah, you're on WNYC. Hello.

Deborah: Hello. Good morning. I was listening to the show, and I really want to clap back at this other caller. I have been overweight, probably since I was about 14. I gained the weight because I lost my mother very young, and nobody did therapy then, so I guess I ate. As I've gotten older, I've become somebody that does a lot of walking. I walk upstairs, just do a lot of physical activity, but I just couldn't lose the weight. My philosophy is to keep from gaining, and that has served me well since I was 14 and I am now 68.

Since I've been on Medicare, instead of going to the gym, I exercise in my house, but sometimes I don't do structured exercise. Like today is housework day, so I'm actually in the middle of cleaning the bathroom, mopping, and vacuuming the whole house. Anybody that has done housework knows how much physical activity. I climbed up the ladder about 16 times between Sunday and yesterday because I had to change curtains, change shades, and change dresser scarves.

I get tired of people body-shaming everybody. I usually weigh between 180 and 185, and I'm supposed to weigh about 140, but I make sure I go to the doctor. As I've learned over the years, I've tried to get better at eating and cooking a little more healthy. I don't really do a lot of junk food. I try to turn everything into a physical activity, whether it's walking to the doctor, sweeping around my building, everything. My 185, 190-pound self just went tandem skydiving two weeks ago.

Brian: [chuckles] Yes, there we go.

Deborah: You know what, I'm tired of people clapping back, and that's the second time I've done it, and I tend to do it every year. I'm just tired of people clapping back on other people because you don't know why they gained weight. Thyroid issues run in my family. I just had mine checked. It runs in my family, and it caused my mother to gain-- She had the one where her thyroid made her gain a lot of weight. She gained weight in the hospital.

You know what, I'm tired of people clapping back at people. People are doing the best they can. I didn't learn about healthiness when I was younger. I'm older now, and I'm trying to do it, but I'm not trying to lose weight. My philosophy is don't gain anymore. That's what I work on. I'm really tired of people like this guy. Really.

Brian: Deborah, thank you very, very much. Couldn't be a better example if we made one up, Julie, of-

Julie: Absolutely well said.

Brian: -the notion that weight is not necessarily a reflection of how hard you try to be healthy.

Julie: That's right. We've heard this before, and I thank the caller for being so blunt and so personal. I think that this ship has mostly sailed from the earlier caller, this whole idea of behavior, certainly of adult behavior. This report is talking about children, and certainly, there are ways to help children eat better and learn more about nutrition. There is discussion of teaching more nutrition to doctors in medical school, though I've had a lot of doctors clap back at that. It's not that we don't learn it, [chuckles] it's not that the system is structured so that we don't have time to counsel our patients about it. There are a lot of problems with our inherent in the way our health system works that makes all of this more difficult.

Brian: Getting back to the medication, and I'll say broadly that category could include vaccines, as things that for medical purposes we put in our bodies that are produced by the pharmaceutical industry. This part of the RFK Jr report on children's health and what to do about it. On vaccines, the report seems to hint at possible changes ahead, obviously, including to the hepatitis B vaccine schedule, which seems to be elevated to some prominence in this report. Why hepatitis B? We usually hear about COVID vaccines, measles vaccines as controversial in that world. Why hepatitis B?

Julie: Because hepatitis B is a vaccine that's given at birth, and because it's a sexually transmitted disease. People who oppose it say, "Newborns are not having sex." It's like, yes, but their mothers might have, and giving the vaccine at birth is a way to prevent the mother-to-infant transmission of hepatitis B, which has been a big problem. That's just not just me saying it, but Senator Bill Cassidy, the chairman of the HELP Committee, who's a doctor, who has been pushing back very hard on this.

This is something that's likely to come up. It's on the agenda this week for the Advisory Committee on Immunization Practices. That's the newly configured by RFK Jr advisory committee that makes recommendations on vaccines. I think there were stories just today that they're going to look at perhaps delaying that vaccine until age four rather than giving it at birth, which would obviously be okay in terms of the sexually transmitted for that individual, but not for the mother-to-child transmission. We'll see how that all plays out.

Brian: What else with respect to vaccines?

Julie: One of the things that the report calls for is a redoing of the vaccine injury compensation system. We don't know how. This was something created in the late 1980s and early 1990s that basically kept vaccine makers in the business of making vaccines because their liability concerns were threatening to make them stop doing it altogether. This is a government program where, if you can show that you were injured by a vaccine side effect, you can get compensation. It is not clear yet how RFK Jr wants to change that program.

Again, it would take an act of Congress, most likely. He also wants to change something called VAERS, the Vaccine Adverse Events Reporting System, which we are now hearing they might use to suggest that the COVID vaccine was responsible for the death of 25 children. That adverse event reporting system is not really that scientifically certain. It's made as an early warning to suggest that these things might be connected. You might want to look at it. It's not that these things are connected and that there's something wrong. There's a lot of concern about the misuse of that data.

Brian: People in the RFK camp may have heard your last answer and thought, "Wait, if the pharmaceutical companies were at risk of bankruptcy or at least enough financial damage that they wouldn't even produce a lot of vaccines because people were successfully suing them for damage to their health from vaccines, then that doesn't make the news very much." Maybe there's more of a there there than mainstream medicine might like to think about the risk from vaccines.

Julie: This is why you always have to sign a consent form. Every vaccine has risks. It's all about the risk-benefit ratio. In the case of most vaccines, the benefits so much outweigh the risks that the few people who are harmed by the vaccines do deserve some compensation. Pretty much whenever you go into surgery, every medical intervention has some risk, and vaccines are no different.

Brian: Listener writes, "Advertising on TV, start the day with sugar cereal. When I was young," writes a listener, "there was not so much choice for foods with extra sugar." That listener must be very old because [laughs] sugary cereal commercials on TV, I think they go way, way, way, way back to about the beginning of television. Does he get into any kind of media restrictions? We could ask that about pharmaceuticals, too.

I know that Kennedy has spoken in the past skeptically about the fairly recent change in the law that allowed pharmaceutical companies to start advertising prescription drugs on TV. Now we see those ads all the time. In either category, unhealthy foods or other products, advertisements, and pharmaceutical advertisements, do either of them make this report?

Julie: No, but I will say that the same day this report came out, the administration, the president and the FDA said that they were going to move to basically get rid of the loophole that allows those drug ads to be on TV, which is to say that they can say, to see all of the potential side effects or contraindications, you can go to this website, or they have it in little tiny print that nobody could possibly read, that basically that is what allows these to be on TV, because when you get a drug and you look at the drug insert, it's pages and pages long. It is possible that they are going to move to eliminate drug ads. Again, I don't know how unpopular that would be.

On the other hand, the Supreme Court has been very, very firm about freedom of speech, about even commercial speech. You would expect that the drug manufacturers who spend a lot of money on these ads and presumably get a lot of payback from spending the money on these ads would be very quick to go to court to challenge that. That's what I'm expecting.

Brian: We're going to run out of time soon. Are there parts of the report that mainstream medical experts actually find constructive, even if the overall document, with what's in it and what's not in it, is controversial?

Julie: Oh, yes, a lot of it. As I said, there's a lot of emphasis right now and concern about ultra-processed foods, about pesticides, about forever chemicals, about kids' sedentary lifestyles, about screen time. There's a lot of this that is, a, very popular and, b, very bipartisan. I think the concern from a lot of people is maybe the emphasis on some of the things that maybe aren't the biggest problems, or as I said earlier, the contradictions of "Oh, let's fix the SNAP program," while we're busy cutting the SNAP program.

Brian: What might we expect to see next in conclusion? If this is kind of a general statement of what RFK Jr thinks should be done with respect to children's health, what kind of specific policy proposals, funding, regulation, political fights ahead, any way to project?

Julie: Certainly, RFK Jr himself seems to be pushing ahead on the vaccine front. That's we're seeing. He's just replaced basically all of the members of this vaccine advisory panel, their meeting. The new surgeon general appointee is an RFK Jr ally. We're still waiting to see her-- She has not yet been approved by Congress, nor has had a hearing yet, but we're seeing a lot of movement, I think, on the vaccine front. As I said, a lot of the food and pesticide issues are not under the purview of HHS anyway. They're under the agriculture, the EPA. We seem to be seeing mostly on the vaccine front what we're going to right now.

Brian: Julie Rovner, chief Washington correspondent for KFF Health News and host of their What the Health? podcast. Thanks for this.

Julie: Thank you.

 

Copyright © 2025 New York Public Radio. All rights reserved. Visit our website terms of use at www.wnyc.org for further information.

New York Public Radio transcripts are created on a rush deadline, often by contractors. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of New York Public Radio’s programming is the audio record.