OPINION: Make America healthier again: Not a chance

Destruction of the public health system: Under Secretary Robert F. Kennedy’s Health and Human Services reorganization, about 10,000 positions have been eliminated — including roughly 3,500 at the Food and Drug Administration and 2,400 at the Centers for Disease Control and Prevention (about 20% each), and 1,200 at the National Institutes of Health — all part of a broader reduction of nearly 20,000 people from an 82,000-person department. 

The cuts included scientists, epidemiologists, regulatory specialists and laboratory experts — whose work underpins surveillance systems — drug and device review, and infectious disease preparedness. These actions leave us unprepared for the next pandemic. Entire research laboratories across the country have been shuttered, and the scientists who staffed them dismissed. These laboratories are the incubators of medical progress, where basic discoveries slowly evolve into transformative therapies — GLP-1 agents, cancer treatments and potential interventions for neurodegenerative disease — an innovation process that takes, on average, more than two decades from concept to clinical reality. When funding collapses, that pipeline collapses with it.

Kennedy’s positions on vaccines have been devastating for our country. We can no longer trust the CDC to provide us evidence-based scientific guidance. Promulgating disproven relationships between vaccines and chronic disease and autism has confused the public. Vaccination programs function on consistency and trust. When long-standing recommendations are weakened, reframed or publicly questioned without compelling new evidence, the impact is behavioral. Parents hesitate and their kids don’t get vaccinated and the country sees a needless resurgence of measles.

Under the January 2026 revision to the CDC childhood immunization schedule, several vaccines that had previously been recommended routinely for all children were shifted to the high-risk or shared clinical decision-making categories. In addition to influenza, the vaccines no longer universally recommended include hepatitis A, hepatitis B, rotavirus, respiratory syncytial virus immunization for infants, COVID-19 and meningococcal vaccines. These changes were made without that guidance from infectious disease societies and the American Academy of Pediatrics. The academy strongly opposed the revision and would not follow the non-scientific based revisions. The organization was punished for the opposition. Following that disagreement, federal health officials terminated certain cooperative agreements and grant funding streams that had previously supported AAP-led public health initiatives, including programs related to vaccine communication and pediatric health outreach

Nutritional advice has been turned upside down. The “Make America Healthy” dietary recommendations begin with advice that few physicians would dispute: eat more fruits and vegetables, reduce added sugars and cut back on highly processed foods. Those principles are firmly grounded in decades of nutrition science. Diets centered on whole, minimally processed foods are consistently associated with lower rates of obesity, type 2 diabetes and cardiovascular disease. The stronger language on added sugars is particularly welcome, as sugar-sweetened beverages and refined carbohydrates drive insulin resistance, fatty liver disease and metabolic dysfunction. To the extent that these recommendations encourage Americans to move away from packaged, ultra-processed products and toward real food prepared at home, they reflect sound medical evidence.

Beyond that narrow foundation, however, the guidance departs from established science. To simply label food as “real” does not make it heart healthy. Nutritional quality depends on composition — fiber content, unsaturated fats, added sugars, sodium levels and overall dietary pattern — not on whether a food appears natural or minimally processed, and the emphasis on “real food” is misleading. The visual and rhetorical elevation of such real foods like red meat, butter and full-fat dairy stands in direct conflict with overwhelming evidence that saturated fat raises LDL cholesterol and that elevated LDL is causally linked to atherosclerotic cardiovascular disease. There has been no new scientific breakthrough overturning this biology. Recasting these foods as central to a healthy diet ignores metabolic data, clinical trials and decades of cardiovascular research. Similarly, promoting higher protein intake without clinical indication disregards the fact that most Americans already consume adequate protein and derive no cardiovascular benefit from excess intake. The failure to provide a clear, evidence-based guidance on alcohol — despite accumulating data that even modest consumption carries measurable health risks — further underscores the problem. Encouraging fruits and vegetables is evidence-based. Much of what surrounds that message is not.

If making “America healthy” means dismantling our valued public health system, defunding or closing scientific laboratories doing important research, bringing back measles and polio and encouraging people to eat butter with their steaks, then the effort ignores scientific nutritional science. We can reflect on the changes over the past year and change the name to Make America Sick Again.

Barry W. Ramo, M.D., is a New Mexico cardiologist who has practiced for more than 55 years.