President Donald Trump’s nomination of Casey Means to be surgeon general stalled in the Senate this week after a quartet of Republican senators grumbled about her qualifications and temperament. Here’s an easy way to break the impasse: Eliminate the position entirely.
Americans often think about the surgeon general as the “nation’s top doctor,” but that’s an invention of Washington. In reality, the surgeon general has become a mouthpiece for every White House’s health agenda, which often involves hectoring the public — in uniform — on what they should and should not be consuming. Essentially the surgeon general has become the head nurse of the nanny state.
Yes, the role comes with managing the Public Health Service Commissioned Corps, which employs about 6,000 uniformed medical professionals who can deploy to various federal agencies. Yet that little-known agency could be easily managed by a civil servant, if it really needs to exist at all. That’s why the actual job rarely came up during Means’s confirmation hearing.
Instead, senators prodded her about positions she’s espoused as a star in the “Make America Healthy Again” movement. That includes, for example, her claim in 2024 that the dose of the hepatitis B vaccine given at birth is a “crime” and her flirtation with the falsehood that immunizations cause autism.
Means repeatedly insisted at her hearing that she supports vaccines, but she declined to endorse specific shots. She also refused to acknowledge the consensus that they don’t cause autism. Instead, she said, “we should not leave any stones unturned” in researching the condition.
Why, exactly, does America really need another taxpayer-funded scold? No doubt, some previous surgeons general produced serious reports for the public, including warnings about the dangers of smoking. But often they fixate on ideological projects based on flimsy research, such as Surgeon General C. Everett Koop’s fearmongering in the 1980s that video games make kids more violent.
Vivek Murthy, who held the job under Joe Biden and Barack Obama, championed gun control, declared loneliness an “epidemic” and went on TV around the Christmas holidays to urge Americans to drink less.
The federal government has plenty of other ways to inform consumers about health risks. That includes many agencies at the Department of Health and Human Services that are staffed with medical doctors, who are in a better position to produce rigorous scientific reviews.
The value of the Commissioned Corps is iffy, too. Defenders say the agency provides surge capacity to meet government needs during a crisis. Yet a 2010 report from HHS estimated that employing officers from the agency costs 15 percent more than simply hiring civilians to perform the tasks they carry out.
Even if Congress cannot get behind eliminating the Commissioned Corps, why would they want it to be led by someone who sees their primary job as a flack? That’s bad enough in ordinary times; it’s worse when that person has a history of vaccine skepticism.
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