RFK Jr. and the MAGA Death Trip

The war on science is turning deadly

In a better world Donald Trump’s musings about taking back the Panama Canal would lead him or people around him to study the canal’s history. They won’t, of course. But if they did they’d learn some important lessons.

One is that America gave up the canal, not out of a spirit of generosity or wokeness, but because U.S. occupation of the Canal Zone had become a strategic liability rather than an asset. By the 1970s changes in transportation patterns had greatly diminished the canal’s economic importance; its military value was almost nil. At the same time, U.S. occupation of the zone had become a flashpoint for anti-Americanism, and it was obvious that defending the canal against sabotage and potential guerilla warfare would be difficult if not impossible.

Trying to take the canal back would be as stupid and self-destructive as, to give a wild example, trying to occupy Gaza.

But there’s also a lot to be learned by asking how we managed to build the canal in the first place. Yes, it was a spectacular feat of engineering. But even more important, it was a triumph of medical science and science-based policy. To build the canal, America first had to conquer yellow fever and malaria. This meant understanding how these diseases were spread, then implementing widespread preventive measures that ranged from isolating infected patients with mosquito netting to eliminating sources of standing water in which mosquitoes could breed.

The success of these measures was an extraordinary achievement. But then, for much of the 20^th century America led the world both in medical research and in the application of that research to public policy. This one-two punch of knowledge and knowledge-based action led to an incredible decline in the rate of death from infectious disease:

Source: Centers for Disease Control

But that was the America that was.

Now Robert F. Kennedy Jr., a crank who rejects vaccines in particular and medical science in general, is on track to become the Secretary of Health and Human Services. The National Institutes of Health have effectively been shut down. The Centers for Disease Control and Prevention have stopped releasing crucial data. If you go to CDC’s website, there’s a banner across the top reading “CDC’s website is being modified to comply with President Trump’s Executive Orders,” which mainly means purging anything that hints at concern over social inequality.

I don’t know this for sure, but my prediction is that the current purge of language will eventually turn into a purge of people, with the administration firing anyone suspected of being more loyal to science than they are to Donald Trump.

And all of this is highly likely to lead to many preventable deaths — hundreds of thousands, maybe millions.

How did this happen? Gradually, then suddenly.

What many people don’t understand about science is that it isn’t a set of Truths handed down from above. It is, instead, an attitude and a method. The attitude is that the world should be understood through observation and evidence, interpreted via hard thinking. The method involves formulating hypotheses and testing them against the facts.

Since someone will ask: Does economics qualify as a science? Well, sometimes. Much of the field involves deductive reasoning from a priori assumptions, hence the old joke that ends with the economist saying “Assume a can opener.” I’d say that such exercises can be useful, but then I would say that, given that it describes a lot of my own work. Beyond that, however, there has been a “credibility revolution” in economics in recent decades, with much greater efforts to ground the field in solid evidence.

But back to science in general: Because it’s a method rather than a set of declarations from on high, you can’t consume it a la carte, rejecting scientific results you dislike for political, cultural or religious reasons. Reject evolution, and you undermine the basis for much of biology, and hence medical science. Reject the case for climate change, and you undermine the physics and chemistry that underly that case.

And Republican politicians have been rejecting science they don’t like for a long time. Remember that Ronald Reagan called for schools to teach creationism alongside the theory of evolution. He also initially rejected the scientific consensus on the causes of acid rain, and prohibited the National Academy of Sciences from studying the issue. In the first case he was catering to the religious right, in the second to industry groups, but in both he was saying that he wouldn’t accept science he didn’t like, an attitude that is now almost universal on the right.

In addition to rejecting science he didn’t like, Reagan did all he could to undermine belief that government can be a force for good. This is a real problem for health policy, because most of the long-term decline in deaths from infectious disease has been the result of collective action, from ensuring access to clean water to promoting childhood vaccination at rates sufficient to prevent diseases from spreading.

Notably, the Reagan era is also when U.S. life expectancy began falling significantly below life expectancy in other advanced countries:

While much has been made of the fact that America is richer than its peers, with higher levels of per capita consumption — and that is definitely an important observation — the ultimate point of economic growth isn’t to increase consumption, it’s to improve the quality of life. And if you ask me, one important factor in the quality of life is not being dead.

Anyway, there are presumably multiple reasons for high U.S. mortality, including high rates of death from both guns and motor vehicles. But refusal to believe in medical science, which should be seen as part of the rejection of science in general, was probably a factor even before Covid.

And then Covid came. Until vaccines were developed, all we could do involved precautionary measures, especially masking. And the thing about masking was that while masks can to some extent protect the wearer, what they mostly do is protect other people. Yet the modern Republican party is deeply hostile to the idea of making sacrifices, or even incurring some minor inconvenience, in order to help others.

Then came the vaccines, which were a medical miracle. But who was telling you that vaccines could save your life? Why, scientists and government officials — two groups that the modern right has been told never to trust. So misinformation and conspiracy theories, fanned by prominent figures and politicians like Ron DeSantis, ran wild, leading many Americans — disproportionately conservative Republicans — to refuse the vaccines. The result was that many Americans refused to be vaccinated, and a large number — perhaps several hundred thousand — died unnecessarily.

Where does RFK Jr. fit into all of this? The political scientist John Sides, drawing on work by Eric Oliver and Thomas Wood, argues that the deepest divide in America isn’t between left and right, it’s between “rationalists” who focus on facts and reason, on one side, and “intuitionists,” who rely on their feelings, on the other.

This divide has always been there, although I suspect that the internet, which makes it easy to find people telling you what you want to hear, has increased the reach of intuitionism. What is relatively new is that these two kinds of people have sorted themselves along partisan lines. Oliver and Wood write that

Intuitionists have become the dominant force in the conservative movement and Republican Party politics.

And RFK Jr., although he holds some views at odds with conventional conservatism, fits right in.

What comes next? As far as I know, there are no examples of modern nations turning their backs on medical science. But there’s every reason to expect the consequences to be ghastly. We can expect to see a resurgence of infectious diseases like measles and polio that had almost been eliminated. When — not if — the next pandemic strikes, we can expect the federal response to be even worse than it was when Trump confronted Covid.

The thing is, not all Republican senators are stupid. Some of them have to know that putting a crank like RFK Jr. in charge of public health will effectively condemn many of their fellow citizens to unnecessary death. Yet they’ll vote to confirm him anyway, out of sheer personal cowardice. And when they do, they’ll have blood on their hands.

MUSICAL CODA