For more than 30 years I have watched our health care system become increasingly more politicized. As a physician I have become concerned with the direction it has recently taken.
Until the early 20th century healthcare was mostly private, and medical expenses were out of pocket. Early calls for national health insurance began with labor organizations and were quickly joined by progressive politicians. President Franklin Roosevelt wanted to include health insurance in the Social Security Act of 1935 but was unable to get it passed. President Harry Truman also proposed a National Health Insurance program in 1945, but it was denounced as socialized medicine. All these efforts were opposed by business interests, conservative politicians — particularly southern— and surprisingly, the American Medical Association.
Finally in the 1960s as part of his “Great Society” programs President Lyndon Johnson pushed for the passage of both Medicare and Medicaid. Rising costs of health care under President Richard Nixon led to the introduction of Health Maintenance Organizations (HMOs) as an attempt to encourage cost efficiency. President Ronald Reagan reduced federal health care spending and pushed for more privatization. In the 1990s President Bill Clinton attempted to introduce universal health coverage but it was met by fierce opposition from the insurance industry, business, and the Republican Party who labeled it as government “overreach”. Finally in 2010 President Obama’s Affordable Care Act (ACA) also called “Obamacare” became the most significant health care reform since Medicare and Medicaid. It also faced legal challenges and political resistance with the Republicans consistently attempting to repeal it. During his first term, President Donald Trump reduced ACA funding and repealed the individual mandate penalty that had required people who did not maintain health insurance to pay a fee. The elimination of the penalty weakened the law and reduced the number of people who sought coverage. We can expect further efforts to weaken the provisions of the ACA but given that it is well entrenched in the US healthcare system now is unlikely that it will be completely repealed.
While early health care programs faced significant controversy and strong debate, progress in providing expanded coverage and improved care was continuous. I’m concerned that we’re about to enter an era where many of our gains in public health are going to be reversed. The United States remains unique among wealthy nations as the only one without universal health care and I fear that we will begin to lose what gains we have made over the past several decades.
I’ve written previously about my concerns with vaccine resistance and the elimination of vaccination requirements for school children. I believe that this is an impending public health disaster and I’m afraid there are even greater disasters on the horizon.
Robert F. Kennedy Jr has been nominated by President Trump to be the secretary of Health and Human Services and by the time you read this he may well have been confirmed. During his confirmation hearings Kennedy has made a few positive statements. He’s expressed an intent to increase focus on chronic diseases such as diabetes and obesity. He has indicated support for rural hospitals. He would like to increase training for physicians in addiction care and increase access to treatment programs. He is also indicated plans to improve American diet by targeting ultra processed foods, contaminants in food, and placing restrictions on food additives. He also has proposed reforms to include stricter FDA oversight of the food supply.
However, there are several very troubling aspects to his nomination. He has a history as a vaccine denier although he is currently denying that denial. He said he is not anti vaccine but is pro safety. He has stated he will support polio and measles vaccines and that all his children have been vaccinated. (In 2020, while speaking on the podcast of his nonprofit organization Children’s Health Defense, Kennedy said that he would do anything, pay anything to be able to go back in time to avoid giving his children the vaccines that he gave them.) Given his history of anti vaccine statements and the fact that he profits from anti vaccine litigation it’s likely he will return to previous anti vaccine positions once confirmed.
He has proposed significant changes to both the CDC and the NIH including significant staff changes. He has proposed redirecting funding to preventative/alternative medicine.
Most troubling is his poor understanding of Medicare and Medicaid programs. During questioning he showed a lack of understanding of the funding sources and statutory requirements of the two programs.
The Centers for Disease Control (CDC) faces considerable threat. House Republicans have proposed a $1.8 billion cut (22%) to CDC’s budget. These budget cuts target programs that address opioid overdoses, firearm injuries and food safety monitoring. This budget conflicts with Kennedy’s statements about his priorities and it remains to be seen how this will be resolved. The Heritage Foundation’s Project 2025 has advocated splitting the CDC into two separate entities: one for data collection and another for limited public health guidance. The intent is to reduce its influence on social policies. The administration has already imposed communications restrictions, requiring that CDC announcements, social media posts and scientific reports undergo political review. There is currently a proposal to reduce the in-house reviews of medical research; there is even a proposal to “deputize the public” to challenge scientific findings used in regulations. This would leave medical research open to review by the least qualified. Unfortunately, he current nominee for CDC director, David Weldon, a physician and former republican congressman, has signaled his intent to narrow the agency’s scope and his support for administration policies.
Highly contentious issues such as gender affirming care and reproductive health have already been severely restricted. It is likely that these areas will come under continued attack by the current administration.
This administration also poses a threat to global health. By executive order the US was withdrawn from the World Health Organization. Additionally, the US Agency for International Development (USAID) has been significantly reduced with all major programs placed on hold. Not only does USAID support foreign aid programs, but it is also a major player in global health.
USAID sponsored programs identify and monitor disease outbreaks, provide treatment and preventive measures for local populations and provide global disease alerts that help protect United States citizens. We are already seeing the beginnings of a worldwide humanitarian healthcare emergency. Not only will this affect healthcare systems but eventually the economic systems in countries who have lost their access to modern medical assistance. We will lose the advanced notice about disease outbreak and spread. Without this remote surveillance, it is possible that we may be caught unaware by the next pandemic until it is ravaging our population.
This administration claims to support “the average American” yet it seems to be intent on destroying all our health.
When Evidence Isn’t Enough: The Crisis of Science in Public Life
By John Turley
On September 23, 2025
In Commentary, Politics
While I would never call myself a scientist, as a physician my whole professional life is built on the belief in and the trust of science. I am distressed that so many people have chosen to disregard trust in science in favor of misinformation.
Throughout history, scientific discovery has been humanity’s most reliable guide to progress. From the germ theory of disease to space exploration, science has reshaped how we live and what we believe possible. Yet in recent years, the very foundation of this methodical pursuit—evidence, observation, and experimentation—has come under sustained political, cultural, and economic attack. This struggle is often described as “the war on science,” a phrase that captures how debates once rooted in policy have shifted into battles over truth itself.
The numbers tell a stark story. The National Science Foundation has terminated roughly 1,040 grants that would have awarded $739 million to researchers and has awarded only 52 undergraduate research grants in 2025, compared to about 200 annually since 2015. The proposed cuts are staggering. Trump will request a $4 billion budget for the NSF in fiscal year 2026, a 55% reduction from what Congress appropriated for 2025.
At the heart of the conflict lies mistrust. Science requires patience since answers evolve as new data emerge. But in a world driven by instant communication and ideological certainties, that evolving nature is often cast as contradiction or weakness. Critics dismiss changing conclusions not as hallmarks of rigorous inquiry, but as evidence of unreliability. The result is a dangerous fracture; science depends on trust in evidence, while many segments of society increasingly place trust in ideology or anecdote or even outright falsehoods.
Climate change is one of the most visible fronts in this battle. Virtually every major scientific body worldwide affirms that human activities are driving global warming. Yet climate scientists are routinely accused of bias or conspiracy, their data questioned, and their motives impugned. What is often overlooked in the controversy is not the complexity of climate systems—scientists have long acknowledged uncertainties—but the political and economic interests threatened by the solutions science prescribes. When climate scientists publish evidence of global warming, their research doesn’t just describe weather patterns—it challenges powerful industries built on fossil fuels.
Public health provides another stark example. During the COVID-19 pandemic, scientific guidance became subject to fierce political polarization. Masking policies, vaccine safety, and even simple social distancing rules morphed into partisan symbols rather than matters of medical evidence. Scientists found themselves vilified, their professional debates distorted into talking points. The losers in this exchange were not the scientists themselves but the broader public, denied clear trust in institutions that are dedicated to safeguarding health.
Underlying these conflicts are powerful currents. Some industries resist regulation by casting doubt on findings that threaten profit. Certain political movements thrive on skepticism of expertise, channeling populist distrust of “elites” toward scientists. And in the swirl of social media, misinformation spreads more rapidly than peer-reviewed studies, eroding the influence of evidence before consensus can take hold.
What makes this particularly concerning is the timing. America’s main scientific and technological rivals are rising fast. In terms of federal Research and Development funding as a percentage of GDP, U.S. investment has dropped for decades, and the lead that the U.S. enjoyed over China’s R&D expenditure has largely been erased.
While the war on science is often treated as a distinctly modern dilemma, born of political polarization, mass media, and cultural distrust of expertise, its roots stretch back centuries. Galileo was silenced for challenging religious dogma. Early physicians were scorned when they argued that invisible germs, not miasmas or curses, caused disease. During the Enlightenment of the 17th and 18th centuries, thinkers faced their own version of this struggle—a battle between dogma and reason, authority and evidence, tradition and discovery. In every case, vested interests—whether theological, cultural, or economic—feared the disruption that scientific truth carried. Understanding those earlier conflicts provides valuable context for our challenges today.
The stakes today, however, feel higher. Our era’s challenges—climate change, pandemics, artificial intelligence, genetic engineering—demand unprecedented reliance on scientific understanding. To wage war on science is, in effect, to wage war on our own best chance for survival and responsible progress. If truth becomes negotiable, then evidence loses meaning, and with it, the possibility of reasoned self-government. That is why the war on science cannot be dismissed as a technical squabble—it is a philosophical contest echoing the Enlightenment battles that shaped modern civilization.
Ultimately, the struggle is less about data than about values. Do we commit to curiosity, openness, and the willingness to change our minds? Or do we cling to certainties that soothe but endanger us in the end? The war on science will not be won by scientists alone. It can only be resolved if society restores trust in evidence as the most reliable compass we have—however unsettling the direction it may point. There may be alternative opinions but there are no alternative facts.