I also push back against your framing that MAHA and Kennedy are the only people who are thinking about this problem and other issues with the American medical system. I have personally written about the side effects of birth control, for example, and how I think pharmaceutical advertising should be banned, which Kennedy agrees with. The genius of this movement is that they frame themselves as uniquely skeptical or truth-telling, when they’re not. I would say the biggest problem in terms of health polarization is social media, and how Kennedy and the Children’s Health Defense, the organization that he helped found and run, science-wash their statements to make them seem like they have a veneer of official medical knowledge.
Wallace-Wells: On some level I am inclined to see Kennedy as a good-faith actor on this — deluded and conspiratorial, yes, but operating consistently over a long period of time. What worries and depresses me more is the support he’s won from people like Jay Bhattacharya, the new director of the National Institutes of Health, and Marty Makary, the new head of the Food and Drug Administration — good, serious scientists who in my view went through the Covid rabbit hole and came out the other side with a new set of standards for themselves and for science. How can Bhattacharya say with a straight face that scientists are scared to look into the link between vaccine and autism? It’s absurd.
Douthat: I definitely don’t think Kennedy is the only person thinking about these problems, and I think it’s unfortunate that the specific claim about a link between vaccines and autism — which as far as I can tell has no real evidence behind it — has become a kind of condensed symbol of the entire establishment-outsider debate. I do think, though, Jess, that while working scientists are often very skeptical and good at self-criticism and offering caveats, doctors and public health officials, in somewhat different ways, feel pressure to project often unwarranted certainty about their own expertise, in a way that their outsider rivals then imitate and mirror.
To your points about diagnostic inflation, David, I think two things can be true at once: There is a set of difficult conditions, some congenital and some probably related to infection, where existing medical investigations have hit something of a wall in understanding the origins and proposing effective therapies, and there’s also a tendency to overdiagnose. Social media contagion makes it hard to tell how fast any of these conditions are actually increasing — and that creates a feedback loop where skeptics become more dismissive of the real problems because they assume that if you say you have certain chronic conditions you must just be a hysteric.
Wallace-Wells: I agree that both things are true. I also think we’ve developed an unfortunate tendency — not just in the world of MAHA but even in institutions like ours — to lay quite a lot of blame on the failure of establishment actors to comprehensively address questions like these, and much less blame on those simply setting fire to the institutions. This marks me as quite a normie liberal, I know, but I just can’t look back on the pandemic and think, the problem here is that Anthony Fauci and Rochelle Walensky, the former director of the Centers for Disease Control, slightly oversold the ability of vaccines to entirely stop spread, rather than the numbers of pretty high-profile people circulating video compilations of sudden vaccine death.
