How the Kakistocracy Became a Quackistocracy

Corruption is a germ’s best friend

Childhood vaccination is one of public policy’s greatest success stories. People who view the 1950s through rose-colored glasses, seeing them as an era of American greatness, miss many ways in which life was much worse then than now, ranging from gross racism and sexism to high poverty rates among the elderly. One often-overlooked feature of the “good old days” was that many children contracted, and some died from, infectious diseases that have now been almost eliminated — or had been almost eliminated, until today’s right-wing anti-vaccine agitators set the stage for their comeback.

In many ways the Trump administration’s hostility to vaccines is similar to its hostility to clean energy, which I wrote about yesterday. Both policy swerves will kill Americans. If Trumpists succeed in forcing the U.S. to burn more coal, thousands will die from air pollution. Only a year into the Trump 47 administration, there is already a resurgence in almost conquered diseases due to the anti-vax MAGA crusade. Both these sudden policy serves are economically destructive: A 2024 report from the Centers for Disease Control estimated that each dollar spent on childhood vaccination has saved around $11 in societal costs.

Moreover, the Trumpists aren’t content with just cutting off federal funding — they’re determined to stop anyone else from doing the right thing. The Trump administration has imposed a blockade on privately funded wind and solar projects, while RFK Jr.’s allies are pushing to prevent states from implementing childhood vaccine mandates.

And the damage from the assault on vaccines continues to widen. Last week the Food and Drug Administration refused to review Moderna’s new mRNA-based flu vaccine. They didn’t reject it based on evidence; they wouldn’t even look at it, in line with RFK Jr.’s evidence-free, dogmatic assertion that mRNA technology, which gave us Covid vaccines, is useless and harmful. Pharmaceutical companies, understandably, are retreating from vaccine development.

The motivations behind the crusade against clean energy and the crusade against vaccines are also similar. The conspiracy-theorizing hostility to science and expertise in general that underpins both movements also predisposes people to become right-wing extremists, which means that their movements are now in power. The headline on a 2023 article in The Guardian captured this perfectly: “ ‘Everything you’ve been told is a lie’: Inside the wellness-to-fascism pipeline.”

Last but by no means least, in both cases it’s crucial to follow the money.

It may seem strange to think of the wellness industry as a corrupt and corrupting force comparable to the fossil-fuel sector. But wellness is big business. McKinsey estimates that U.S. spending on wellness is running at around $500 billion a year, while spending on nutritional supplements alone was close to $70 billion last year.

And sellers of nutritional supplements, unlike companies selling pharmaceuticals, are effectively allowed to make false, outlandish claims about what their products do. Here’s how the National Institutes of Health summarized the law:

Dietary supplement labels may include certain types of health-related claims. Manufacturers are permitted to say, for example, that a supplement promotes health or supports a body part or function (like heart health or the immune system). These claims must be followed by the words, “This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.”

In other words, it’s OK to peddle snake oil with false medical claims as long as you mumble some content-freeboilerplate.

And where do the snake-oil salesmen peddle their wares? Largely on right-wing media. After all, that’s where they can find customers who have the right mix of anti-intellectualism and disdain for experts. And the snake-oil purveyors are, in turn, a key part of the extreme right’s financial ecosystem.

I wrote about this almost five years ago. The relationship between quack medicine and right-wing extremism has a long history. As the historian Rick Perlstein has documented, extremists have been marketing medical snake oil, and snake oil purveyors have been financially supporting extremism, since the days when misinformation had to be disseminated through paper newsletters. This mutually beneficial relationship continued through the eras of talk radio, cable TV, and now podcasts.

But now we have entered a new era. As many observers have noted, the Trump administration is a kakistocracy: rule by the worst. A history of personal corruption is no longer a bar to high office — it’s practically a requirement.

Under Trump 47, people who have enriched themselves by peddling medical misinformation are no longer just influencing policymakers. They have become policymakers. Robert F. Kennedy, Jr., who appears to have made millions in salary and book royalties thanks to his anti-vaccine screeds, is now the secretary of health and human services. Dr. Oz is running Medicare and Medicaid.

In short, the kakistocracy is also a quackistocracy.

And the reign of the quacks will condemn thousands, perhaps millions of Americans — many of them children — to gratuitous illness and in some cases death.

MUSICAL CODA