OPINION:
Robert F. Kennedy Jr. was sworn in last week as secretary of health and human services. With it, President Trump has given Mr. Kennedy the keys to America’s health care megastore, which includes the National Institutes of Health, the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, and the Food and Drug Administration. That’s quite a portfolio.
Despite the dire reporting, we must ask one important question: Is this a moment for panic? Absolutely not. It’s time for focus and change. The two key ideas for the American health care ecosystem are Smart Engagement and smart leadership. Smart leadership from the secretary’s sixth-floor perch atop the Humphrey Building can bring down bureaucratic barriers, driving a new and elegant design for more efficient use of taxpayer dollars while improving Americans’ health.
Five years ago, our country was quickly entering the COVID-19 pandemic. Can anyone who has paid attention to the past five years realistically say that our public health agencies don’t need a shake-up? It’s time for some real creative destruction.
As I’ve written, Mr. Kennedy has an opportunity to add a lane or two to the American health care superhighway. Political rhetoric, regardless of where you are on the linguistic pronoun spectrum, should play zero role in advancing 21st-century regulatory science.
The department’s public health tree needs pruning. The NIH, for example, has more than 18,000 employees — only half of those are scientists — but it’s not just about head count; it’s about addressing mission creep and institutional focus.
Narrowing the focus to these agencies’ core missions will help ensure that Americans receive the best medical information and services the government can provide.
Job one for Mr. Kennedy is rebuilding trust in America’s public health institutions by reversing the public’s loss of confidence, which will require aggressive transparency. The bad news is that the status quo hates transparency. The good news is that the elusive public health administration era is over.
What will the Trump FDA look like? With a new sheriff in town, we can expect and should embrace more targeted, regular and collegial friction. That’s a good thing. Meaningful and respectful change can help grease the skids of 21st-century regulatory reform. A little creative destruction can go a long way. It’s not even early days yet, but, as I said at January’s J.P. Morgan Healthcare Conference in San Francisco, “Ladies and Gentlemen, fasten your seat belts and start your engines.”
There are caveats. News reports of mass firings and resignations may be premature. The president’s picks for FDA commissioner, Dr. Marty Makary; NIH director, Dr. Jay Bhattacharya; CMS administrator, Dr. Mehmet Oz; and CDC director, Dr. Dave Weldon, haven’t even had their Senate confirmation hearings yet. Strategic pruning is needed at all these agencies, but it would be wise for the chief gardeners to be in place. Haste is not the solution to waste. Haste causes waste, and an indiscriminate buzz seen by these world-class agencies would do more harm than good.
A good place to start is with an honest appraisal process that embraces the basic premise of trust through transparency.
Smart leadership from Mr. Kennedy can break bureaucratic barriers, shake up the status quo and drive innovative design for a more efficient, egalitarian and impactful use of taxpayer money. That’s what “making America healthy again” means.
• Peter J. Pitts, a former Food and Drug Administration associate commissioner, is president of the Center for Medicine in the Public Interest and a visiting professor at the University of Paris School of Medicine.
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