Medical Conservatism Is the Antidote to MAHA

The recent confirmation hearings for Robert F. Kennedy, Jr., President Trump’s pick to lead the Department of Health and Human Services, before the Senate Committee on Health, Education, Labor and Pensions were a missed opportunity to look beyond Kennedy’s contentious views on American public health and to analyze the alternative model of healthcare he represents. Specifically, this should have been a moment to place the Make America Healthy Again (“MAHA”) movement, Kennedy’s sharp critique of America’s approach to health and wellness, under a congressional microscope.

While his confirmation appears probable, Kennedy is likely to come before Congress and, by extension, the American public again. When that opportunity inevitably arises, hopefully, those dedicated to exposing the flaws in Kennedy’s outlook will adopt a new framework to assess our relationship to healthcare. A viewpoint known as medical conservatism is well-suited for this task.

But before discussing this, it is important to recognize that Kennedy and his worldview are gaining traction. This is why regurgitating the same criticisms that have been leveled against him for decades failed during the confirmation hearing—and will only continue to do so. Specifically, many opposed to Kennedy cite his vaccine skepticism as disqualifying. While I agree that that alone should be enough to bar him from serving in a president’s cabinet, his nomination and growing influence suggest this is inadequate.

This is why any future confrontations with Kennedy and MAHA must first recognize that his conclusions about the state of health in America are difficult to dispute. His speech last summer endorsing Trump for president encapsulates why his views have gained popularity. At that time, he stated that “two-thirds of American adults and children suffer from chronic health issues”; “74 percent of Americans are now overweight or obese,” including 50 percent of American children; and there has “been an explosion of neurological illnesses” like autism, ADHD, and Tourette’s Syndrome in the last few decades. Kennedy clearly knows these are his strongest arguments, because he reiterated these points during the opening statements of his confirmation hearing.

One may quibble with some of Kennedy’s arguments or point to recent improvements in other areas of healthcare, such as the decline in tobacco use and advances in cancer treatments. But to do so ignores that what he articulates is clearly visible to millions of Americans. 

Existing lines of attack against Kennedy’s theories are now ineffective because, fundamentally, they operate within the framework of the very system so many Americans now distrust. After all, the existing medical establishment bungled the response to COVID-19, contributed to the opioid epidemic, and regularly flip-flops on dietary guidelines, all the while managing a system of ballooning healthcare costs coupled with deteriorating public health outcomes. 

So while the criticisms offered by Kennedy and his MAHA movement are valid, it is important to understand why his worldview should be rejected. At its core, MAHA rests on the beliefs that those in charge are malicious and that what is natural is good. This first belief is self-defeating for any serious movement, because to effectuate change, a movement must strive to take charge. 

The second belief, while containing some insight, ignores that most human progress depends on our ability to alter the natural world for our betterment. Sunlight is natural and sunscreen is not, but that doesn’t make one inherently good and the other bad.

Since Kennedy offers legitimate complaints, a successful inoculation to MAHA must come from outside the existing medical establishment. This is where medical conservatism comes in.

A conservative view of medicine has been around as long as healthcare itself, but its current iteration is best explained by authors of the 2019 essay “The Case for Being a Medical Conservative,” published in The American Journal of Medicine. The essay argues that medical conservatism “is pragmatic about human nature and the prevailing business model of medical science.” Given this, the medical conservative understands “that our knowledge and best models only rarely predict the success of a new intervention” and that medical progress is “slow and hard, in large part because nature has provided the human body with inherent healing properties.”

This fits within the larger tradition of philosophical conservatism that President Lincoln eloquently examined during his 1860 address at the Cooper Union when he asked, “What is conservatism? Is it not the adherence to the old and tried, against the new and untried?”

In much the same way, medical conservatism is humble and able to admit ignorance or failure. It makes incremental progress by building on advancements that result from decades of trial and error. It does not overpromise, suggest easy solutions are readily available, or rely on a belief that our health could be quickly improved if only the right people were in charge. This is the opposite of the MAHA ideology and the existing establishment its adherents wish to thwart.

To demonstrate this point, consider what Kennedy wants: to replace the regime of prolific pharmaceutical prescriptions, surgical interventions, medical testing, and industrial farming with supplements (including testosterone), psychedelics, new therapies, and clean eating. In other words, he wants to replace one hubristic scheme with his own. If one opposed to Kennedy promotes a conservative view of medicine during Kennedy’s tenure, this adoption will expose Kennedy’s desired medical establishment as no different from what Americans currently face: a system that overpromises and underdelivers while lining the pockets of those that most enthusiastically promote it.

As an example of this hypocrisy, Kennedy was set to profit from ongoing litigation against a pharmaceutical company over which he will have power should he be confirmed as Secretary of HHS. After facing pressure, he promised to divest from his interest in the litigation and turn over any potential proceeds to his adult son, as though that were a meaningful concession. 

This demonstrates that Kennedy has no principled objection to those that intertwine their personal financial interests and public health policy. This is the behavior that MAHA is supposed to find so abhorrent.

However, a conservative standpoint should not aim to diminish what draws throngs to Kennedy and MAHA, since it detects many of the same problems. Instead, it reminds Americans that solutions to our healthcare challenges are not simple, and that those that suggest otherwise are misguided, have ulterior motives, or both. In exposing Kennedy, we should not further alienate those who find his message appealing.

Kennedy and the MAHA movement survived their most high-profile airing before the American public during the Senate confirmation hearing. This unsatisfactory outcome should remind those who see Kennedy as a charlatan that his diagnosis of America’s approach to health cannot be simply dismissed. When the next opportunity arrives, it should be used as an opportunity to demonstrate that Kennedy promises the same outcomes as the existing regime, just with different medicine. And if we want to finally cure ourselves of our failing model of health and wellness, we should start with a dose of medical conservatism.

Image by Katherine Welles and licensed via Adobe Stock.