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"Either this nation shall kill racism, or racism shall kill this nation." (S. Jonas, August 2018)
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"How do you spell ICE in German? GESTAPO."
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First, they came for the socialists, and I did not speak out because I was not a socialist.
Then they came for the trade unionists, and I did not speak out because I was not a trade unionist.
Then they came for the Jews, and I did not speak out because I was not a Jew.
Then they came for me and there was no one left to speak for me. Pastor Martin Niemoller (c. 1946)
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On her Substack of Sept. 3, 2025, Dr. Jennifer Margulis (as she notes, an award-winning journalist and a senior fellow at the Schuster Institute for Investigative Journalism at Brandeis University), a supporter of the policies of Robert F. Kennedy, Jr., Secretary of Health and Human Services, posted the following observations on health and health care in the United States:
"My point is that Americas health is in the toilet. I love this country.Andwe are a nation full of overweight, endocrine-disrupted ,cancer-ridden, diabetic,brain-injured, unhappy,digitally addicted humans.
"We also have a for-profit greed-motivated healthcare system in this country, one that benefits every day from keeping its citizens fat, sick, and nearly dead.
"The status quo has been doing a very good job making Americans sick and keeping them that way.
"RFK Jr. wants to heal our nations health.
"Those 1040 employees can go work for the vaccine and drug manufacturers. I'm sure they'll be welcomed with open arms.
[SJ Note: The "1040" here refers not to an income tax form, but to the number of career professional and staff employees of the Department of Health and Human Services Centers for Disease Control who have been fired apparently because they worked with what I regard as the long-established science and practice of protecting the public's health through the use of vaccination and a wide variety of other public health measures, an understanding and perspective with which Sec. Kennedy obviously disagrees.]
"In the meantime, there are over 340 million Americans whose health will benefit from RFKs initiatives.
"Including me. [That is, Dr. Margulis.]"
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And now to my commentary on the text above. I have spent my career in public health/preventive medicine and the academic field of health care delivery system analysis, retiring in 2014 after 43 years as a Professor of Preventive Medicine at the Renaissance School of Medicine, Stony Brook University, NY. As it happens, in the late 1970s I created the first textbook ever on the structure and functions of the U.S. health care delivery system. It is currently in its 13th ed.
Among other subjects, I have also done work (including a book) on the substance-addiction problem (which of course begins with tobacco and alcohol use), as well as having authored, co-authored, and edited a number of books on healthy living in general, and regular exercise (including triathlon/duathlon racing) and healthy eating in particular. I find myself largely in agreement with both the health risks list and the critique of the US health care delivery outlined above. However, as a career public health physician and health care delivery systems analyst, my recommendations for the changes needed in the U.S. health care delivery system in order to help the U.S. become at least healthier, is somewhat broader than the one outlined above by Dr. Margulis.
What a True National Health and Illness Care Program Would Look Like
As it happens, I have looked at the Secretary's recommendations for change in the US system, but have not (yet, at least) found the following items which collectively would do much to reduce the high morbidity/mortality numbers for the U.S. population (as noted by Dr. Margulis), in addition to reducing the profit motive for providing (or not providing) health care services.
- A comprehensive national health insurance program (if not a national health service, and there is a difference), not income-based. The US is the only industrialized nation in the world that does not have one.
- A comprehensive long-term care insurance program, not income based.
- A comprehensive program to deal with two of the major killers in the U.S., tobacco and alcohol use. (As it happens, I have written a book on that subject too [see further below].)
- A comprehensive program to promote healthy eating and exercise. (As it happens, I co-authored the American College of Sports Medicine's book on that subject, plus [as noted] several books on triathlon/duathlon racing. [As it also happens, I did 257 triathlons and duathlons myself, including 3 Ironman-distance finishes over a 36-year period, starting when I was in my mid-40s.] Plus, I co-authored several books focusing on healthy eating and weight management.
- A comprehensive, life-long, cancer screening program, available at no or low cost.
- A comprehensive national program for healthy eating in all schools.
I do look forward very much to seeing the details of RFKJ's plans to promote the health of and health-care for the U.S. population. Those plans, of course, would be aimed at dealing with the well-done, extensive, and correct, morbidity/mortality list that Dr. Margulis has put together.
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An Addendumon dealing with the morbidity and mortality related to the use of Recreational Mood-Altering Drugs, esp. in re Fentanyl. One could deal with the Drug War at great length (and indeed, as noted, I have done so, in my book on the subject, End the Drug War; Solve the Drug Problem: The Public Health Approach).
Briefly, here is a list of the important facts concerning and characteristics of recreational drug-use in the United States, if its mortality and morbidity are to be significantly reduced. First, supply does not create demand. Demand for the recreational drugs (e.g., nicotine in tobacco products, ethyl alcohol in alcoholic beverages, heroin, cocaine, fentanyl) comes from those who want to use them. It is not created by the suppliers (except of course by the advertising in the marketplace for the two most prominent legal drugs). Second, as noted above, by far-and-away the two major drug killers in the U.S., both regulated-but-legal, are indeed smoking/using [in one form or another] tobacco products (around 400,000 deaths per year [yes, you read that right]), and alcoholic beverages (around178,000 deaths per year.)
Fentanylover-dose (not fentanyl per se) is responsible for about 75,000 deaths per year. Many overdose-related fentanyl deaths are the result of the user not knowing just how much fentanyl they are consuming (unlike in the use of tobacco and alcohol). Thus a program designed to deal with the very real problem of fentanyl-overdose related death must recognize that reality. Yes indeed, the bottom line here is that in the case of tobacco and alcohol-related deaths, the dosage is known to the user. In fentanyl it isn't. And yes indeed, if fentanyl were sold legally, from what used to be called "package stores," with the dosage printed on the label, the death rate from its use would likely be much lower than it is presently.
(Article changed on Nov 01, 2025 at 11:21 AM EDT)
(Article changed on Nov 01, 2025 at 1:26 PM EDT)
(Article changed on Nov 03, 2025 at 10:46 PM EST)
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