
Robert F. Kennedy Jr.’s MAHA movement has reshaped the public health debate. But if the coalition behind it begins to fracture, what comes next?
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Tressy
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Host/Announcer
This is the Opinions, a show that brings you a mix of voices from New York Times opinion. You've heard the news. Here's what to make of it.
Alexandra Sifrilin
I'm Alexandra Sifrilin, a science editor at the New York Times. I recently hosted a live event at the Brooklyn Public Library to talk about the state and future of the Make America Healthy Again movement. I was joined by opinion science writer David Wallace Wells and columnist Trustee McMillan. We discussed how Robert F. Kennedy, Jr. Is reshaping our healthcare system, our preparedness for future pandemic, and what vision, if any, Democrats have for what public health should look like for the nation. Thank you. All right, so to start, I thought we would talk about what MAJA is because it can sometimes be a little hard to define. Is it a grassroots movement with real political power? Is it branding for RFK Jr? I'm curious how you guys think about what Maha is and what influence it has or doesn't have. Maybe Chessy.
Tressy
Okay, sure. Let's start. Make sure. Okay, go for it. I think the easy answer is yes to everything that you just listed. I think much like the MAGA movement overall, what you've got is this sort of uneasy alliance, a lot of populist groups with a sprinkling of performative political factions. And I think that is exceptionally true with Maha because there's a much longer history there of sort of what I would call like populist health communities. Right. It's drawing heavily on like eco fascism, whatever might be left over of a sort of libertarian environmental movement. Then you've got, I don't think you can overstate the role of the emergence of like the sort of mommy blogger to health influencer pipeline. So you've got all of that. But then there's also, I think it's worth saying, I think it's kind of easy, particularly because it's branded as being a female heavy section of maga. I think it's easy to sort of pick out the low fruit of like, performative politics and populism. Dangerous populism, in fact. But there is also a really real thread there of people who have a long standing and I think defensible position that our health systems and our health ecology does not create the conditions for them to make good healthful choices. Now, we may disagree on what ends they then come to and the conclusions that they draw based on that. But I do think it's worth pointing out that there is also, I think, a real contingent of people for whom health, especially the idea of health, deeply tied to concerns about the environment and climate and climate change and climate crisis is a, for some people, a single voting issue. And some of those people, I think, also get lumped into Maha David.
Alexandra Sifrilin
What do you think?
David Wallace Wells
Well, I mean, you use the word branding and you know, in my less charitable moments, I think of it as a fiction because the coalition that I see, which draws on a lot of, you know, pre existing groups, many of whom are full of great conviction and passion, don't feel to me like a natural or workable political alignment. And so I think what we've had is a sort of an opportunistic branding which has made what was maybe eternal, maybe growing features of the sort of libertarian fringe in America, drawing on some of the frustrations you were talking about about the food system and the failure of the healthcare system to deliver what Americans want from it presented as a political force growing in strength, maybe even sufficient to catapult RFK Jr to the presidency after Trump has gone, a kind of successor movement, even as it's also a parallel movement to maga.
Tressy
You sound concerned.
David Wallace Wells
Well, but I think actually if you look around today in 2020, you see how much that really was or has become a fiction, has been revealed to be a fiction or at least a coalition of convenience, full of contradictions which could not be sustained over the long haul. I mean, you know, many of the people who RFK brought in have already left the, you know, hhs. Those that remain there are those who believe that medicine has been overregulated in this country and those who believe that medicine has been under regulated in this country. There are people who believe that, that nothing is sufficient to license a drug unless you've got a rock solid randomized control trial. And people who think that anecdotal evidence should allow you to license any new drug. There are people who think that we should be able to volunteer to take part in a clinical trial. There are people who believe that the world is poisoning us. And then there are people in the administration who are literally poisoning themselves with off label supplements and meds. And all of this to me suggests some basic fragmentation, fracturing in what seemed a year or so ago to be an ascendant coalition. But on the core point, this is a movement that has been mobilized on behalf of, or I should say against what was basically settled vaccine science. That's how most of the country sees its threat as a threat against vaccines. So I'm left thinking like, we passed through this fever dream. We thought that the country had turned against science and against public health and against vaccines in the aftermath of the pandemic. For some people, that was true. But to the extent that we believe that it was this mass movement that was laying a claim on the future, on the American political future, it doesn't seem to be bearing out.
Alexandra Sifrilin
Interesting. So just to stick with that vaccine point a little bit, because it is a little hard to make sense of what's happening. So there's a lot of conflicting threads. So we have rising vaccine skepticism at the same time, and we have pockets of measles outbreaks happening in places where they weren't before. But as David points out, most Americans are still. The vast majority of Americans are still vaccinating their children. A lot of Kennedys specific vaccine policies are really unpopular. So it does raise this question, is what we're seeing just a sort of social contagion that's actually just going to be a bit of a blip, or is it the beginning of something potentially really dangerous?
Tressy
I'm afraid this is going to be a thing, but I think it's possible that it's a bit of both. I agree with David that part of what we saw was a mobilization of a message and not necessarily a political mobilization. And I think especially early on in sort of Trump's rise to power, I think those of us who are just not used to politicians being particularly popular, we were a little slow to realize that there was a difference between a person garnering a lot of attention and someone actually being able to mobilize people. And I'm not exactly sure, and I don't think that we have any strong evidence that everybody who self identifies as Maha, even if they say they voted, that they voted necessarily because of Trump or because of rfk. Right. I think the more likely outcome is that you probably have a lot of disaffected voters. Right. But that doesn't necessarily mean that they could be mobilized. I'm not even entirely sure that Trump has ever tried to actually mobilize them in any significant way. Now, they do, however, have an infrastructure to drive a lot of attention, a lot of media narrative. Right. Which I think gave us, yes, the impression, especially coming out of COVID which was just. It's hard to, at this point, to overstate the shock that was, I think, to our public consciousness. And if you've got any narrative coming out of that, that helps you make sense of something that for A lot of people, it was just very difficult to make sense of, especially during a moment of when we start to see the sort of fracturing of institutions that it really just kind of atrophied after decades of either disinvestment or institutions that people just never really had to think about before. The cdc, I think, being a very good example of that. I think it was easy to mistake the clarity of the message. That conspirator, here's what they don't want you to know. And I think if there was anything that's kind of holding that group together, it is that underlying. I'm unsure about what is happening. There is a lot of change and there are a lot of unknowns. There is declining trust in our institutions. And what we know from just about every conspiracy that has ever sort of captured the public imagination is that that will solve that problem for people. For a lot of people, if you tell them this is what they don't want you to, there are a lot of people then were able to use that to leverage again, attention and I think political proximity in some cases. But that is not a very good framing for turning things into actual policy. Which is one of the reasons why I think we see pretty ineffective or chaotic policymaking based on Maha's agenda. To the extent that they have a single agenda, to David's point, a lot of it is very contradictory. But that's the thing about conspiratorial thinking. It is inherently contradictory. It is not a very good framework from which to come to consensus, which is what you need to move policy along so the people exist. I'm not sure that it is a coherent political group. And even if it were, because one of the things, the main thing that adheres that group is thinking that someone is out to get them. Perversely solving their problem politically just lowers their trust in the political system is not a very good mechanism for someone who wants to organize people and turn it into a political mobilization. I think the biggest lesson, however, from this is that the problem remains that there are a lot of people for whom the health care system or healthful choices or living in a healthy environment is either inaccessible or unaffordable. And more so than whether or not the Republicans can kind of hold the Maha coalition together to me is the question of who is competing for that voter for whom that matters. Right? Do we have a competing vision on the other side? And as of yet we don't really have a clear one. And I think that's more of a, a long standing political problem than Whether or not people have faith in RFK Jr. To help them live forever.
Alexandra Sifrilin
Yeah.
David Wallace Wells
I mean, taking seriously this as a social question, I would throw a few other ingredients into the mix with a sort of longer view. One is that I think it's really important when we talk about vaccine hesitancy and the decline of vaccination rates, just to think about the fact that we no longer deal with infectious disease and we haven't. For depending on how you want to count, 60, 70, 80 years, which means there are very few people around who have meaningful memories about what it was like to have to deal with those diseases and therefore have a real appreciation for the benefits of vaccination. I think a lot of people talk about, you know, once the World War II generation died, people stopped worrying enough about World War III and it may bring us there. There's something similar happening with vaccines that people who grew up in a world with vaccination and much more limited disease spread can take for granted. The basic safety of the world around them can think to themselves, it's relatively safe for me not to vaccinate my child because around me I don't see any of this disease. And that forgetting, I think, is a really big part of this story. I think it also helps put us in mind that this is. While there are partisan valences to this social movement, and over the last few years they've been channeled in one particular partisan direction. A lot of these sentiments are kind of pre political and exist in populations across the spectrum. Yeah, it's a kind of a cliche to talk about the left wing vaccine skeptic, but that those people have been there for a long time. In fact, RFK was one of those people not very long ago. But it's also the case that even those who are relatively more conservative are not necessarily engaging with this set of questions through their politics directly. So when you think about the measles outbreak in Texas last year or the one in South Carolina this year, both of those outbreaks were in religious communities.
Tressy
Let's say religion plays a.
David Wallace Wells
But of course, even those two communities responded really differently. In Texas, there was not a large, you know, the community as a whole did not decide to get vaccinated en masse in response to the measles outbreak, even though it resulted in a tragic death in South Carolina. Actually, they did take a turn and do much more to get vaccinated. And that has to do with the very particular backgrounds of those communities. The people who were there, who, why they were saying no, which is all Just to say that this is an incredibly complex terrain in which most people probably have some felt affinity for the stated causes of Maha. If you say like do you want our kids to be healthy? Do you want to end chronic illness? Do you want people to eat healthier? Who's going to say no to all that? The question is how those sentiments, which are kind of pre political, get appropriated and channeled into politics and. Yeah, I mean, I don't think that the last few years are going to be that satisfying to many people. And I don't think when they're tallying up the wins and the defeats a few years from now they're going to feel like their side changed the world.
Tressy
Yeah, agree.
Alexandra Sifrilin
I guess this raises this question about has maha emerged from a genuine institutional failure or has it emerged from kind of a perception of institutional failure that's been sort of propagated by Tressy? You mentioned some of these like wellness influencers or people who kind of have an ax to grind. You mentioned like the fiction. I mean how much of this is real, has tapped into something that a lot of Americans have felt and how much of it is like this is kind of our backlash mechanism for.
Tressy
Yeah, yeah. So I think, you know, I've been reading a lot lately about trying to get my arms around understanding whether or not this era of populism has anything distinct to it. Right. You can't overstate the role of how mass communication has changed, for example, the availability of information and of misinformation that seems to be distinct. And I suspect both of those things are playing into this issue which is there is the, you know, there is this pre existing populism to David's point, which you, you come in any moment in time when there is yawning economic insecurity and uncertainty about the future. You tend to see a pop response. However, that is in response against real changes in people's material conditions. Yes, my healthcare costs too much. Yes, they keep dropping the medication I need. Right. Yes, it is harder and harder to get a primary care physician. Yes, somehow it seems easier to get medical aesthetics than to get life saving care in a lot of communities. Yes, there are rural and urban health device like those things are real material conditions that show up in people's lives. But that doesn't necessarily mean that that is what is driving the populist response in this moment in time. I think that it can be a real vein of concern. But to David's point is that doesn't necessarily explain how people get mobilized through this larger concept of Whether or not I am pro Trump or I'm a Republican or I'm a Democrat, how it gets funneled into our sort of pre existing partisan divides. I think to understand that, you've got to understand how this populism is a bit different. And I think it is because it is mixing two things who are having real material insecurities and then people who just perceive that they are having real material consequences. Right. And when those things get conflated, you've got both a consequence, I think, sort of like this disease of privilege of never having had to deal with a health threat or really any threat that is larger than you, which is part of what people were responding to during COVID Covid was a great equalizer. Everybody was vulnerable. For some people, being vulnerable was a new experience. And the perception of that certainly made some people feel like their material conditions had changed. But that does not mean that they had the same risk and the same vulnerabilities of people who, for example, are living with decades of environmental toxins in their communities. Right. Or communities that don't have clean water. But for a moment in time, if there is enough anxiety, if there's a big enough external shock, which arguably I think Covid was, I think it can give the sense of, of a greater populist movement than what is actually true on the ground. So, yes, I think there's like a real thing. But Maha doesn't respond to that. Right. What you don't see are a lot of systemic responses or even arguments for those. In fact, that tends to be antithetical to the belief. What you see is a lot of doubling down on individual choice, which suggests to me that it is more about people wanting to sort of, you know, manage their individual risk. And again, that's just gonna be a really difficult, difficult thing to do with policy. And that's even assuming that that is what RFK Jr and Donald Trump are interested in doing. And so far they have not shown that they're interested in actually solving a material problem or really a perceived problem either.
David Wallace Wells
I mean, I think that that focus on individual risk is really important, and it is one of the main ways that Maha has organized itself, especially in the aftermath of COVID And. And I think it's really destructive. I think that there's a huge amount that we miss and fail to, you know, ways that we fail to protect one another if we reduce all of public health and human flourishing to matters of individual choice. And I think the pandemic itself actually illustrates that very neatly. And, you know, I Think. Here we are, six years after the pandemic. There is still some. Some lingering resentment, especially, it seems, among the people whom Trump has appointed to run the country's public health systems. But I think what's really interesting is that when you look a little bit more deeply in the data, it doesn't really seem to me that there's so much widespread anger and resentment and frustration about the ways that we burdened one another and protected one another during the pandemic itself. In survey after survey, when you ask people, did they agree, even in retrospect, did they agree with the mitigation measures that were implemented, do they agree with mask mandates? Do they agree with school closures? There are some people who say no, but you're talking about 70 to 80% of the country saying that they supported the policies that were implemented at the time. And that is just so divergent from the messaging, not just that we get from HHS and RFK and Donald Trump, but honestly from establishment liberals, too, who say that we, we really bungled this pandemic, we mismanaged it, we alienated the trust of the public. And I'm not entirely sure that that's really true.
Tressy
Yeah, I think it's a great point.
David Wallace Wells
What worries me most about it is it makes me wonder, what does it mean if we have a change of the page, we have a change of political leadership, what are the leaders on the other side going to be thinking about public health? Are they going to be thinking we need to rebuild the value of solidarity, or are they going to be thinking we need to learn the lesson of the pandemic? By which they mean that we overreached and went too far and need to be lighter touch in our messaging. And I sort of worry that we're heading, we're going to head down that second path.
Alexandra Sifrilin
Yeah, I mean, it's interesting. This sort of the way that this idea about public health is, this important collective endeavor has kind of feels like it's gone away, though. I don't know. Maybe not. But this very individual health focus, it seems to have evolved beyond a response to Covid to now. This sort of obsession with Tressy. You've written about personal health, the kind of aesthetics of health. Where do you think that's coming from now? And is it still related to Covid or is it kind of evolving into something else?
Tressy
I think the easiest way to answer, I think there are a couple of things happening, but I think the most macro trend in all of the data that you see about people's, you know, Shifting political position vis a vis health decisions. Really, the biggest answer there is that gender matters a lot. There's this wonderful sociological data that followed women, particularly mothers, across Covid and a couple of years after. And one of the things I found fascinating in this was that a lot of what we would think of as like, vaccine hesitancy among moms, if you just ask them on a survey whether or not they had questions about vaccines, you would say, oh, they're vaccine hesitant, but then they're liberal or they're well educated. And then you'd have these questions, and it would make them. It seem like that there was this sort of like, growing anxiety about vaccines. But when you did the qualitative analysis and you followed up with them, what you found was that they felt increasingly responsible for their children's health in every way imaginable and wholly unprepared to manage it. If my child has autism, nobody's blaming the father, right? Why didn't I do? And that a lot of what you were seeing was an undue amount of expectation, specifically on motherhood, to manage the fracturing of our health care system and women who were educated enough to know what they didn't know, trying to ask questions in a system that is not set up to treat women seriously. And so in that conundrum, it looked like you were vaccine hesitant, when in fact it was just that you were never supposed to be managing the vaccine schedule or the biological future of your children. Right. That this was never supposed to be an individual endeavor. I think that that has probably impacted women's understanding of helping something that they are personally morally responsible for. And then you add onto that all of the status benefits of looking healthful, of looking like you are making the right moral health choices for yourself and for your family. And then we do what it is we always do, which then is an economy, appears to help you solve that problem. Right. It's not enough to be healthy. You have to look healthy. And then it's not enough to look healthy. You have to look like you're trying to be healthier. And then you need to have really healthy children who also care about health and that they also look healthy. Right. And again, these are not things that by and large, we are asking of men. Right. We are asking this mostly of mothers. And I think that then becomes a thread through how all of our medical decisions then become to be understood not just as individual consumer choices, but individual responsibility.
Alexandra Sifrilin
Right.
David Wallace Wells
I mean, not only all that, you also have to sell something to your audience.
Tressy
That's right.
David Wallace Wells
So that they can live as beautifully.
Tressy
That's exactly it.
Host/Announcer
Yes.
Tressy
Don't forget that part.
David Wallace Wells
But there is, as you mentioned earlier, also there is the male side of it. Right. So you were just talking, I think, quite beautifully and profoundly about the way that pressures on women through this period have produced some of this pathology. So the social pathology on the male side, I think it's really quite clear. It's like these people are playing a game of social Darwinism. They do not care for the weak, they're happy to see the weak die. And then when you look at the genuine avatars of Maha on the, you know, the male avatars, it is not about looking healthy. It's looking like, what is that look? It's, I mean, it's professional wrestling. Right. And I mean, truly, it is like I sort of made a crack about it earlier, but the fact that like RFK Jr puts himself forward as an icon of health. Have you seen a photo of him at 40? He does not look like that. He did not look like that 30 years ago. He has completely remade his body in ways that strike me as like, quite off putting, but the, I mean, if you just see him in like jeans, in a hot tub, even more so.
Tressy
I've actually forgotten that image and I, I don't appreciate being reminded.
David Wallace Wells
Yeah, but he's also, I mean, you know, I don't want to like, rag too much. It's like he can't even lift that much weight. He just looks like really huge.
Tressy
I actually think we should say that more.
David Wallace Wells
But, you know, the story that's being told by his body and by the body of many men like him is not about fitness even.
Tressy
Yeah.
David Wallace Wells
It's about monstrousness. Like these people are meant to be threatening, they are meant to be intimidating. And that is a aesthetic value that has grown much more powerful over the last decade. As I think in the Trump era, the right wing has gotten much more explicitly acquisitive, competitive, unapologetic about its claims on the rest of the world, any resources, et cetera. It's a very, very dog eat dog worldview. And the way that that descends on the individual is to coach them to be warriors in a time of, you know, they would say, like, whatever. Soy boys.
Tressy
Yeah, yeah, yeah. I just read about, you know, RFK Jr. Wanting to create a men's health division as if the majority of medical science had not been developed for the health and well being of men. But by which he meant it was to make testosterone more freely available. Right. To David's point, that this very limited, narrow view of male health is just performative aesthetics of, I love this, of monstrosity. Whereas I think it is very different what is happening on the other side with women. And we conflate the two, I think in a way that hides what I think might be the most strident fissure of the Maha movement, which is that one may be going about managing their health risk in a way that is not pro social, but the other is quite actively trying to destroy the idea of social in its performance of health. And along the way are making it virtually impossible for the women of their own camp to do what it is they're charged to do, to perform motherhood effectively. And to my mind, it's a coalition that cannot hold, but it's also a coalition that they are not, not very devoted to either. I don't think that the men of Maha are very devoted to the female faction.
David Wallace Wells
Well, one way of combining them would just be to say that's patriarchy.
Tressy
Yes.
David Wallace Wells
Yeah, I mean the men are supposed to be warriors and the women are supposed to be beautiful, eternally youthful wives.
Alexandra Sifrilin
You know, you talked about the things like testosterone and you know, the things that Kennedy is personally into. I was hoping you could help me make sense of this sort of push back against more established medications and treatments like vaccines and this embrace of unregulated substances like peptides that people are buying online from places like China. They don't really know what's in them, but they're willing to inject themselves with.
David Wallace Wells
Yeah, we can't buy EVs from China, but we'll buy.
Tressy
But
Alexandra Sifrilin
what is going on?
Tressy
I mean, I think of it as the merger of what I call everyday eugenics, which is this idea that you can kind of retroactively self select your genetic superiority and then just the nihilism of where I think individual choice will lead a person. Right. That there is something inherently superior about me choosing to do it, that overrides all of the unknowns, that overrides all of the risk that the real problem a lot of people have, I think in particular men have with a vaccine schedule, is that it was decided by someone else. It is a locus of external control and that. No, but if I choose the peptide right, then it is obviously superior despite the fact. So again, it is flattering to one's sense of self as being able to make complex scientific decisions. There are these wonderful studies about people where they talk about. I do my own research, Listen, people I love are among those groups of people. I won't name them but hello, mother, you know, who are very proud of having done their own research, Right. And then. But then you get down to them, what was their research process?
Alexandra Sifrilin
Right.
Tressy
And of course, they don't mean what we mean by the scientific method and debate and falsifiability and et cetera. They mean they read lots of things. But it is very flattering to one's sense of self, I think, especially if you feel like you don't have a lot of control, to think that if you just read enough, if you read a summary of those complicated studies, that you can draw meaningful inferences that are not much different from a scientist or a medical doctor. And then, so you add that to, I think, the egotism of looking smarter, having the superior genes and the superior physical strength or power or looks maxing or whatever it is at any given point in time. And then you go, well, yeah, I did my research and I chose the peptide.
David Wallace Wells
I agree with all that. A couple small things I would add. One is that I think one thing that people find offensive about vaccines, but also anything that you'd compare them to is that everybody gets the same one.
Tressy
That's right. It's the DMV principle.
David Wallace Wells
You are equal before the vaccine.
Tressy
That's right.
David Wallace Wells
And if the principle of equality offends you.
Tressy
Yep.
David Wallace Wells
You will rebel. And I think that is one big part of what has happened here, is everybody wants a personal advantage because they can't tolerate being told they are just like everybody else, vulnerable like everybody else, and only entitled to the same protection as everybody else, not more. It's also the case that we're not just seeing individuals striking out on their own. We're seeing them withdraw trust from one set of people and then extend them to another set of people. If you think about what, like, the wellness influencer universe is, that's not a map of distrust. It's just a map of distrust to people who work at the New York Times. It's not, you know, it's like people trust Andrew Huberman, like, quite a lot and so much that they're willing to take drugs that are not approved by any regulatory body, but they're willing to forego all of that, overlook all of that, because they trust the person who sent them there. And so I think we sometimes get into a little bit of a tangle when we talk about this question in terms of the decline of trust, when, in fact, what we're really seeing is something more like trust transference. And that may be in certain ways scarier, because it's not just about Drawing individuals back into the fold they are already allied with. With a whole new knowledge system which operates according to a completely different set of principles, which is to say, often like entrepreneurial principles.
Tressy
Yeah, I was. Yeah. And when you start talking about them, we talked about this before, but when you start talking about withdrawing trust and transferring it to another entity, what you're talking about is a market. And what is fundamentally beneath wellness influencers, I think in particular, is that you don't solve people's problems, you create a new market for them. Right. Well, that market is not just competing with the other wellness influencers. It is also competing with the cdc. Right. I think it's important to keep in mind that what is being done here is, for most people, is being done for profit. That means there is no profit in solving the problem and saying, well, the CDC has figured it out. Right. We got this great vaccine schedule, or this is how we address high blood pressure, or, hey, everybody doesn't need a testosterone shot. Right. That forecloses on a market. Right. So, yeah, it's not just the moving the trust from one to the other. It is doing it to maximize whether it's attention or it is profit seeking. And these days, they are roughly the same.
Alexandra Sifrilin
Yes. I wanted to talk just a little bit about Robert F. Kennedy, Jr. The man.
Tressy
Oh, the myth, the lantern.
Alexandra Sifrilin
I'm curious if you guys think of him as sort of a true believer in his causes or as more of a sort of politically or otherwise motivated figure.
Tressy
What do you think?
David Wallace Wells
You know, I guess I. I think that if he really believed that vaccines in particular were as damaging as he was saying three and six and eight years ago, before he was really in public life, if you really believe that they were as damaging as he was saying then, and he was put in a position of this centrality and power and only did as much as he has done to diminish our faith in vaccines and attack the vaccine schedule, that would be a huge failure for him. And so I think the fact that he has accommodated himself to this political moment, navigated the landscape and solved the contradiction. The contradiction being he believes vaccines are bad, the country believes vaccines are good. The fact that he has solved that contradiction by vaguely raising doubts, suppressing vaccine uptake by a couple of percentage points, that, to me, suggests someone who is more a grifter than a true believer. I do think he believes in his core that institutions are corrupt, elites are paid off, and Big Pharma and Big AG don't have the interests of Americans in their heart. I think he believes that, but I believe that. I mean, it's not a weird set of things to believe. The thing that I don't believe is that vaccines cause autism and we shouldn't be giving hep B vaccines to children. And those are the things that he purports to believe. But if he really believed them and it only achieved as much as he had achieved, he'd have to be shrinking from D.C. as a miserable failure rather than someone who's trying to hold together a shape shifting coalition with every ounce of political capacity that he has.
Tressy
Yeah, I think all of it and all of them are scam artists. And I mean, I was looking for an exception and I don't have many. And I also, like, I tend to, you know, I've got this like, ontological position on whether or not, you know, I don't know does it. I don't know if I care so much about what he believes in because should he have stayed just, you know, RFK Jr. If he'd done whatever it is the Kennedy thing is you're responsible for doing, meaning a quasi private person with a public family institution behind him and believed whatever he wanted, I might think it's somewhat interesting to try to figure out whether or not he really believes it at the moment. He becomes, however, a political actor and his decisions impact other people's ability to make good decisions for themselves. Right. Then I think the only thing that matters is what has he been willing to do? And what he's been willing to do is to further ideas, questions, doubts that fundamentally make us weaker and more vulnerable and some of us sicker and more likely to die. I don't even really care too much about what he actually believes because the stakes of that tribe more seriously are so high that even if he were a true believer, it would make him more monstrous, not less. And so. Yeah, but I tend to just think it's mostly a scam artist.
Alexandra Sifrilin
Yeah.
David Wallace Wells
One more thing I'd add just quickly about him and his character and his, you know, public character is, I think a lot about how different the world we'd be living in right now and how different this conversation would be on stage tonight if Trump had made RFK Jr. The head of the EPA.
Tressy
Uhhuh, yeah.
David Wallace Wells
Or even the head of the FDA or the head of the Department of Agriculture. Yeah, Those would have been causes in which he had conspiratorial views. He has, you know, I think non scientific perspectives, but, but his instincts are more in line with science and much more in line with public opinion. And so it wouldn't have been nearly as politically difficult for him to at least on the public side of things, achieve real concrete gains that he might have been celebrated for. Instead, Trump made the opposite choice and put him in a kind of impossible situation, trusting that, that Bobby could navigate his way out of it. And I think the ultimate, as always, like Trump, miscalculated, made a short term decision that he thought would benefit him, and it's coming at a long term cost to his own political popularity.
Alexandra Sifrilin
So there's been a lot of attention paid to the hantavirus outbreak. And while there's a lot of uncertainty, and I'm not saying it's going to be a huge thing, it is raising this question, I think, of what might happen should Kennedy be in a position where he does actually have to lead the country through something like a serious pandemic or some kind of novel virus. And I'm curious if this is keeping you up at night.
David Wallace Wells
I mean, I think I should say as like a first note that I don't think that the hantavirus is likely to take off, off in the ways that have animated our nightmares since COVID There are too many reasons to think that it will be spreading too slowly for anything like a global takeover to happen. So what we're dealing with is a public health threat of a distinctly smaller scale, which is nevertheless quite scary because the strain that we're dealing with kills somewhere between 30 and 40% of those people who are infected. And because at no point along the timeline of the last month has any public official, public health official, whether in America or internationally, I think, really done a very good job of communicating about the risk or building a sort of set of protocols or infrastructure that would allow us to really contain it. I think we're in a really bad spot there. I don't think that we have control over this disease. I think it's likely to continue spreading and ultimately killing more people and that those infections and those deaths were avoidable. The degree to which that's an international problem or an American problem, I think there's a lot of blame to go around. I don't think the WHO has handled itself very well here, but I will say that we are, as a country staring this down, so ill equipped. I mean, literally, the cabinet, literally like the health cabinet is bare. Marty Macri just quit today. There's no head of the cdc. There's. There's no head of the FBI.
Tressy
What's been done to the cdc, I
David Wallace Wells
mean, alone, thousands of people fired. I mean, it's Completely, you know, and the person who's nominally in charge of the American public health response is actually not rfk, really. He's not really been paying much attention. It's Jay Bhattacharya, who's the head of the NIH and technically the acting director of the cdc. And this is a man who last fall wrote an essay in the City Journal in which he said that the United States should scrap its pandemic playbook because the best pandemic preparedness was to make America healthy again. Now, I would like to see Americans cut their bmi. I would like to see us have less chronic disease. But that is not the job of the NIH or the CDC or HHS in the face of a new virus. And I don't think any of these people take their role seriously because again, they think of the world in social Darwinist eugenicism.
Tressy
They think they will survive. That's right, yeah, yeah.
David Wallace Wells
Now, I don't think that means that any of these people want to see 10 million Americans die, but I also don't think that they care that much if a few more people die that didn't need to die. If the logic of that was that they were allowing more able bodied people to move around more freely and unencumbered. These are people who take that deal after generations of public health officials would have insisted on the opposite deal. And that's not comforting in the least.
Tressy
No. When you think about what has happened at the cdc, which I do think about quite a lot, it's not just, you know, the pushing out the head of the cdc. It is what has happened to like the two tiers of scientists and institutional knowledge below the sort of executive level and how that has been gutted in the same way. You see other government institutions gutted in the same way, but in science, because science is so path dependent. Right. And it is so cumulative that when you lose that, you're not just losing sort of like basic human power, labor power, you really are losing sort of the consensus upon which science has a system to refine. And what those scientists will tell you, many of whom have become for the first time in their professional lives, advocates or think of themselves now as having to be far more radical than they'd ever thought they would have to be. What they would tell you is that it is not a matter of if we will have another pandemic event, it is a matter of when. Right. And so the question becomes, what is our risk tolerance politically for having people who do not only, who not only don't believe in the science, but don't believe in the institutional production of any sort of public knowledge. Right. But also have an over inflated sense of themselves and belief in themselves. Right. What does it mean then to face down that risk? And my risk tolerance for that is quite low. I think there are some other people who again, who think that they can sort of navigate through individual choices. I'm healthy, I won't have these problems. And I think though that if you ask most Americans more soberly, like when we are facing which may or may not be the next pandemic event, but something that could be, and when they're actually thinking about what's really possible and probable, I think their sense of risk changes. And I think that becomes potentially a political problem for this administration. The difference between imagined risk and real risk has a way of clarifying some people's own susceptibility to risk. But that is not the way you want to do a political means test. I mean, to David's point, it's not just that people will be sick and people will die. It is the sheer possibility of the scale of which that might happen. But I worry that that is the sort of political means test it might take.
Alexandra Sifrilin
So we have some great reader questions, but I just had one more future looking question that I know was of interest to both of you too, is so what should be the response from the other side, from Democrats to all of this? What does a Democratic public health vision look like, let's say in 2028, potentially?
Tressy
That's a great question.
David Wallace Wells
Wanna go first?
Tressy
I think it is part and parcel of sort of the larger project. And listen, I really resist this thing where, you know, tell the Democratic Party what it needs to do. It's not my job. And also I'm not particularly sure they're interested in what I think they should do. However, having said that, I think that our concerns about our health system are part of our larger set of concerns, which is, I think David said as well, you either believe in a social compact or you do not. And as a party you need to lay out a clear vision of listen, the other side thinks that. Which it took the Democrats quite a while to even, I think, come to consensus about how to talk about, about what was happening in the Republican Party. And they've roughly settled on sort of a consensus. Right. You know, they've decided to throw the F bomb once in a while or something, I don't know. But what you don't see is a more affirmative, coherent argument about what they do believe in. And I think the issue of health is just an example of that more broadly. Like, is this still the party that believes in public administration or not, and how much do they think we should have? Is this an administration that believes that, you know, economic security is kind of part of government's responsibilities as citizens, and if so, how are they going to enact that? Right. I think that they're still kind of trapped in the cycle of trying to accurately describe what Trumpism is. And as it comes down to health, you know, they've got a narrative about the Democratic, you know, this sort of big, most recent big legislative win, of course, is, you know, Obamacare, which they're not all equally comfortable running on. But it is a set of benefits that most Americans have become comfortable with having and it means something to them. And it's a particular, you know, has the possibility to be a political wedge issue. But, like, I'm, I'm stunned that they have not drawn a sort of bigger story of that about health. Right. Like, it's not just that you have access to the Affordable Care act, but like, we want to make it possible for you to make a range of good, healthy choices. You know, there's some, you know, on the fringes. You know, Sanders talks about it. Cory Booker recently was talking about organic food and vegetable, that kind of thing. But, but no, the Democratic Party right now does not have a clear vision on that, does not seem to be competing for voters for whom that is a concern. And I think there are a couple of reasons for that. Some of them are still smarting about what happened to Michelle Obama when she tried to lead on school lunches and that kind of thing. But I also think there's this sense that the other side is bungling it so bad and why get in the way of your enemy shooting themselves in the foot and that maybe that is good politics, but it is not a good, good narrative for how, why we should trust you to lead us out of this era of political dysfunction.
David Wallace Wells
Yeah, like trustee, I see this as part of the bigger dilemma for Democratic politicians. I also see this as, you know, the war on public health is a war on the social safety net.
Alexandra Sifrilin
Yes.
David Wallace Wells
Many of these measures that have been drawn back are things that were extended to protect the most vulnerable in society and they've been withdrawn. But looking beyond health, I see a party that seems comfortable to wait for the Trump administration to self immolate.
Tressy
Right.
David Wallace Wells
And I see the challenges ahead looming quite large. So, yeah, I'm worried that a Democratic public health administration will be divided as I was saying earlier, between those who basically want to restore faith in public health and the principle, extend the principle of health solidarity, and those who want to retreat from those principles in order to demonstrate that they learned some lessons and they heard some criticism during COVID I see that on foreign policy, the Democrats are very happy right now criticizing Trump's foreign policy. But what is the post Trump democratic vision for America's role in the world? I think it's extremely open ended and you see people who are, were very hawkish even in the Biden administration now singing an extremely dovish tune. I don't know if there's a possibility out there that a future Democratic president could even try to regain the world stage the way that Biden tried to regain the Obama position when he came in in 2021. And I see that in domestic policy and fiscal policy. Do I really think the Democratic Party is capable of. Of raising money via taxes sufficient to actually deliver services to their voters and the country as a whole? It seems quite hard. They seem like they really want to just raise taxes on the very rich. And there's a kind of justice argument to that. But I'm not sure that the party's actually serious about doing what it needs to do to deliver meaningful victories there. And on that point, I think I'm sort of inspired by the model of our mayor here, Zora Namdani, who. Who has really taken. Yeah, please applaud.
Tressy
Yeah,
David Wallace Wells
you know, I'm not here to make a personal endorsement, but I think really inspiring in the sense that he is an ideological actor who nevertheless takes extremely seriously the need to do the job well and demonstrate that the system itself works for people and seems actually much more than was apparent even during the campaign. And to believe that that's the first job of governance is to demonstrate attentiveness to the needs of the people and that once you've established that trust, you can go further and make ideological gains. At the moment, it seems to me like there are few leaders at the national level in the Democratic Party who are thinking in those terms. And to the extent that they are, their impulses run against one another. And so I don't know where we're going to end up, although I do think we're going to end up with a Democratic president in 2020 that.
Alexandra Sifrilin
Okay, all right. I think we have time for some reader questions. How do we productively respond to mistrust of corporations, like in agriculture, food producers within Maha? How can we question what we're being sold while rebuilding social trust if I
Tressy
understand the question correctly, and I may not, but I think what we're. What what you're asking for there is meaningful regulation, meaning how do we regulate the corporations that are charged with the manufacturing and distribution of most of our sort of meaningful resources, so things like food. One of the problems we have is that we're in an era where people are questioning whether or not regulation is sufficiently muscular enough to do that job. And we're also doing that after like, you know, 40 years of just sort of like actively chipping away at some regulations. Some people would say, and then. And then actively making it more complex. Others would say, depending on what industry you're talking about. But I think what people are really responding to there isn't necessarily the degree of regulation, but the transparency of the regulation. I think one of the issues that we have is that when so much is provided by the private sector, there is not a meaningful feedback loop for people to respond to what's being done and to feel like they understand what is being done. And so I think one of the things that people are really asking for when we talk about regulation, whether they think it's too much or too little, I think we confuse that with public accountability. Just recently, speaking with someone about how we bring the sense of accountability in the public feedback loop to things like labor policy, for example, and she had come up, that's how she cut her professional teeth. And she was talking about ways that she tried to do that at the federal and the state level and how hard it was. She said, yeah, it was hard. She was like, but when we got it right, people's trust in the system was off the charts. And to your point about Mamdani, and when you develop trust in one area, you were able to translate it into another area. It is hard work. I think it's going to be even harder with the way that so many of our institutions have atrophied. But I think it is fundamentally what people are asking for, which is public accountability. It can be done. People are going to have to demand it and a lot of political forces are going to have to align. But yeah, I think it's the way forward.
Alexandra Sifrilin
Last question. I think this could go to either of you. Is there anything RFK could do to alienate the Maha base? Or is any escalation, no matter how ridiculous, excused as anti establishment heroism?
Tressy
Yeah, there is a lot of anti establishment impulse there that will drive people to follow the personality as opposed to any sort of political activity. However, we are already seeing some fracturing of those coalitions you know, one of the problems that RFK has is the same problem that like Donald Trump has, and I think sort of like Trumpism writ large is that it is pretty effective at mobilizing people whose beliefs are transactional. It really struggles with people who truly believe. And so some of what you see, for example, are, you know, what moms across America who had really led this fight against, like Roundup, weed killer and feeling deeply betrayed by this administration's supposed interest in health. When Trump signs the executive order, sort of defending the corporate interests against many in his base who are actively saying he has lost my support because of this. Not yet seeing many of them willing to organize on the other issue. But being disaffected is a political choice, much like voting is a political choice. And I think the real possibility of that particular fissure anyway is that those were a lot of people who were mobilizing for Donald Trump, at least, certainly online, some of them even offline. And I think you can lose some of that energy when they decide that they are no longer supporting RFK Jr. And so you're already seeing some of that emerge. Everybody, however, is not a true believer. Right. It becomes a problem and then the question becomes how many of them them are. But for those who actually really believe rfk, genius almost, you know, wholesale inability to deliver them anything other than like symbolic victories, his smarting with a lot of people.
David Wallace Wells
Yeah, Just to pick up, pick up briefly on the anti establishment point. I mean, I do think it's worth remembering that, you know, come 2028, 2029, we will have been living in Donald Trump's America effectively for at least 12 years. And there was an interim period where we had basically an invisible president, but in the kind of collective period American imagination, Donald Trump has been running this country for a very long time. And there are things about Democrats picking up the mantle of anti establishmentarianism that make me worried and make me uncomfortable. I'm, you know, I'm the kind of person who works at the New York Times. I obviously have establishmentarian values, but I also think that there are some political opportunities there. And if you think on the food front, you compare the objection to Michelle Obama is making us eat healthy food. Compare that to Donald Trump was in bed with all the big ag companies and he's feeding us poison. One of these actually is a much more potent message. I don't know exactly to what degree the Democratic Party as a whole will feel comfortable playing that card, but it is available at least to some members of the coalition. And I suspect that one of the things that's going to happen over the next few years is that at least some figures, if it's Graham Platner or whoever, are striking that note to national effect, even if the party itself is not singing the same tune.
Alexandra Sifrilin
That's great. David and Tressy, thank you so much.
Tressy
Thank you. Thank you, guys.
David Wallace Wells
Thanks to the library, too.
Host/Announcer
If you like this show, follow it on YouTube, Spotify or Apple. The opinions is produced by Derek Arthur Vishaka Darba, Victoria Chamberlain and Gillian Weinberger. It's edited by Gillian Weinberger, Jasmine Romero and Kari Pitkin. Mixing by Pat McCusker. Original music by Isaac Jones, Sonia Herrero, Pat McCusker, Carol Sabaro, Efim Shapiro and Amin Sahota. The fact check team is Kate Sinclair, Mary Marge Locker and Michelle Harris. The head of operations is Shannon Busta. Audience support by Christina Samulewski. The director of opinion shows is Annie Rose Strasser.
Tressy
A vacation rental shouldn't come with surprises. It should come with Verbocare and 24. 7 Life Support. If the hot tub's broken, that's a verbo care thing. If my teenager starts calling me Leslie, that's a family thing. Leslie. Verbo Care and 24. 7 Life Support. If you know you Verbo terms apply. See verbo.comtrust for details.
Host: Alexandra Sifrilin, The New York Times Opinion
Guests: David Wallace-Wells (Opinion Science Writer), Tressie McMillan (Columnist)
Recorded: Brooklyn Public Library, May 21, 2026
This episode explores the state and future of the Make America Healthy Again (MAHA) movement—a prominent, yet fractious, force in post-pandemic American politics tied to RFK Jr. and, in part, Trumpism. The guests dissect the origins, makeup, influence, and contradictions of MAHA, the underlying crisis of trust in public health institutions, and the political ramifications for both the Republican and Democratic parties. Discussions are candid, sociopolitically astute, and reflect on institutional decline, populist health politics, gendered dynamics, and the fragmentation of public consensus around health and medicine.
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The conversation is incisive, skeptical about political and health movements’ motives, and focused on the collision of individual anxieties and collective well-being. Both guests call for a rejuvenation of public institutions and a renewed democratic vision that centers solidarity and systemic reform, rather than fragmented, market-driven responses to health crises. The tone combines critical analysis with flashes of sardonic wit and real concern for the functioning of American democracy and public health.
Skip ahead to specific moments above for discussions on the fragility of political coalitions, the gendered burdens of health management, and suggestions for how Democrats (and the public) might rebuild a trustworthy, inclusive public health agenda in the future.