Is the MAHA movement’s political influence waning? On “The Opinions,” the Times Opinion science editor Alexandra Sifferlin, the columnist and sociologist Tressie McMillan Cottom and the Opinion science writer David Wallace-Wells explored this question in a live event at the Brooklyn Public Library. They discussed the impact of Robert F. Kennedy Jr.’s tenure as secretary of health and human services and what a counternarrative to MAHA should look like.
Below is a transcript of an episode of “The Opinions.” We recommend listening to it in its original form for the full effect. You can do so using the player above or on the NYTimes app, Apple, Spotify, Amazon Music, YouTube, iHeartRadio or wherever you get your podcasts.
The transcript has been lightly edited for length and clarity.
Alexandra Sifferlin: To start, I thought we would talk about what MAHA is, because it can sometimes be a little hard to define. Is it a grass-roots movement with real political power? Is it branding for R.F.K. Jr.?
I’m curious how you guys think about what MAHA is and what influence it has or doesn’t have. Tressie?
Tressie McMillan Cottom: OK, sure. Let’s start with me. I think the easy answer is yes to everything that you just listed. Much like the MAGA movement overall, what you’ve got is this sort of uneasy alliance of a lot of populist groups with a sprinkling of performative political factions.
And that is exceptionally true with MAHA because there’s a much longer history there of what we call populist health communities. It’s drawing heavily on ecofascism, whatever might be left over of a sort of libertarian environmental movement. I don’t think you can overstate the role of the emergence of the mommy-blogger-to-health-influencer pipeline.
It’s also worth saying — particularly because it’s branded as being a female-heavy section of MAGA: It’s easy to pick out the low-hanging fruit of performative politics and populism — dangerous populism, in fact. But there is also a real thread there of people who have a longstanding, and defensible, position that our health systems and our health ecology does not create the conditions for them to make good, healthful choices.
Now, we may disagree on what ends they then come to, and the conclusions that they draw based on that, but I do think it’s worth pointing out that there is also a real contingent of people for whom health, especially the idea of health, is deeply tied to concerns about the environment and climate change. The climate crisis is, for some people, a single-voting issue. And some of those people also get lumped into MAHA.
Sifferlin: David, what do you think?
David Wallace-Wells: Well, you used the word “branding,” and in my less charitable moments I think of it as a fiction. Because the coalition that I see, which draws on a lot of pre-existing groups — many of whom are full of great conviction and passion — it doesn’t feel to me like a natural or workable political alignment.
What we’ve had is a sort of opportunistic branding, which has made what was maybe eternal, maybe growing, features of the libertarian fringe in America start to draw on some of the frustrations you were talking about: the food system and the failure of the health care system to deliver what Americans want from it. It’s been presented as a political force growing in strength, maybe even sufficient to catapult R.F.K. Jr. to the presidency after Donald Trump is gone — a kind of successor movement, even as it’s also a parallel movement to MAGA.
Cottom: You sound concerned.
[Audience laughs.]
Wallace-Wells: If you look around today in 2026, you see how much it really has been revealed to be a fiction. Or, at least, a coalition of convenience full of contradictions, which could not be sustained over the long haul.
Many of the people who R.F.K. brought in have already left the H.H.S. Of those who remain, there are those who believe that medicine has been overregulated in this country, and those who believe that medicine has been underregulated.
There are people who believe that nothing is sufficient to license a drug unless you’ve got a rock-solid, randomized control trial, and people who think that anecdotal evidence should allow you to license any new drug. There are people who think that we should be able to volunteer to take part in a clinical trial. There are people who believe that the world is poisoning us, and then there are people in the administration who are literally poisoning themselves with off-label supplements and meds.
And all of this, to me, suggests some basic fragmentation and fracturing in what seemed a year or so ago to be an ascendant coalition. But on the core point: This is a movement that has been mobilized on behalf of, or I should say against, what was basically settled vaccine science. That’s how most of the country sees its threat — as a threat against vaccines.
I’m left thinking: We passed through this fever dream. We thought that the country had turned against science and public health and vaccines in the aftermath of the pandemic. For some people, that was true. But to the extent that we believe that it was this mass movement that was laying a claim on the American political future, it doesn’t seem to be bearing out.
Sifferlin: Interesting. So just to stick with that vaccine point a little bit, because it is a little hard to make sense of what’s happening — there’s a lot of conflicting threads: We have rising vaccine skepticism. At the same time, we have pockets of measles outbreaks happening in places where they weren’t before.
But as David points out, the vast majority of Americans are still vaccinating their children. A lot of Kennedy’s specific vaccine policies are really unpopular. So it does raise this question: Is what we’re seeing just a social contagion that’s actually just going to be a bit of a blip, or is it the beginning of something potentially really dangerous?
Cottom: I’m afraid this is going to be a theme, but it’s possible that it’s a bit of both. I agree with David that part of what we saw was a mobilization of a message, and not necessarily a political mobilization. And I think especially early on in Trump’s rise to power, those of us who are just not used to politicians being particularly popular were a little slow to realize that there was a difference between a person garnering a lot of attention and someone actually being able to mobilize people.
I don’t think we have any strong evidence that everybody who self-identifies as MAHA, even if they say they voted, that they voted necessarily because of Trump or because of R.F.K. I think the more likely outcome is that you probably have a lot of disaffected voters, but that doesn’t necessarily mean that they could be mobilized. I’m not even entirely sure that Trump has ever tried to actually mobilize them in any significant way.
Now they do, however, have an infrastructure to drive a lot of attention, and a lot of media narrative, which I think gave us the impression, especially coming out of Covid — it’s hard, at this point, to overstate the shock that was to our public consciousness. If you’ve got any narrative coming out of an event like that, to help people make sense of it — for a lot of people, it was very difficult to make sense of what was happening.
Especially during a moment when we started to see the fracturing of institutions that had really just atrophied after decades of disinvestment — or they were institutions that people just never really had to think about before, the C.D.C. being a very good example of that. It was easy to mistake the clarity of the message — that conspiratorial: Here’s what they don’t want you to know.
If there is anything that’s holding that group together, it is that underlying sentiment of: I’m unsure about what is happening. There is a lot of change, and there are a lot of unknowns. There is declining trust in our institutions. And what we know — from just about every conspiracy that has ever captured the public imagination — is that a message of clarity will solve that problem for people.
For a lot of people, if you tell them: This is what they don’t want you to know — there were many individuals who were able to use that to leverage, again, attention, and political proximity in some cases. But that is not a very good framing for turning things into actual policy, which is one of the reasons why I think we see pretty ineffective, or chaotic, policy-making based on MAHA’s agenda — to the extent that they have a single agenda. To David’s point, a lot of it is very contradictory.
But that’s the thing about conspiratorial thinking: It is inherently contradictory. It is not a very good framework from which to come to a consensus, which is what you need to move policy along. So the people exist, but I’m not sure that it is a coherent political group. And even if it were, since the main thing that adheres the group together is thinking that someone is out to get them, then perversely, solving their problem politically just lowers their trust in the political system.
It’s not a very good mechanism for someone who wants to organize people and turn it into political mobilization. The biggest lesson from this, however, is that the problem remains: There are a lot of people for whom the health care system, or healthful choices, or living in a healthy environment, are either inaccessible or unaffordable.
More so than whether or not the Republicans can hold the MAHA coalition together, to me, is the question of who is competing for that voter for whom that matters. Do we have a competing vision on the other side? As of yet, we don’t really have a clear one, and that’s more of a longstanding political problem than whether or not people have faith in R.F.K. Jr. to help them live forever.
Wallace-Wells: Taking this seriously as a social question, I would throw a few other ingredients into the mix with a longer view. One is that it’s really important, when we talk about vaccine hesitancy and the decline of vaccination rates, to think about the fact that we no longer deal with infectious disease. And we haven’t, depending on how long you want to count, for 60, 70 or 80 years.
There are very few people around who have meaningful memories of what it was like to have to deal with those diseases, and who therefore have a real appreciation for the benefits of vaccination. A lot of people talk about: Once the World War II generation died, people stopped worrying enough about World War III, and it may bring us there.
There’s something similar happening with vaccines. The people who grew up in a world with vaccination and much more limited disease spread can take for granted the basic safety of the world around them. They can think to themselves: It’s relatively safe for me not to vaccinate my child because around me, I don’t see any of this disease. Forgetting is a really big part of this story.
It also helps to keep in mind that, while there are partisan valences to this social movement — and over the last few years they’ve been channeled into one particular partisan direction — a lot of these sentiments are pre-political, and exist in populations across the spectrum. It’s kind of a cliché to talk about the left-wing vaccine skeptic, but those people have been there for a long time. In fact, R.F.K. was one of those people not very long ago.
But it’s also the case that even those who are relatively more conservative are not necessarily engaging with this set of questions through their politics directly. When you think about the measles outbreak in Texas last year, or the one in South Carolina this year, both of those outbreaks were in religious communities.
Cottom: I was about to say, religion plays a significant role.
Wallace-Wells: A huge part, yeah. But, of course, even those two communities responded really differently. In Texas, the community as a whole did not decide to get vaccinated en masse in response to the measles outbreak, even though it resulted in a tragic death.
In South Carolina, they did take a turn and did much more to get vaccinated. And that has to do with the very particular backgrounds of those communities — the people who were there and why they were saying no — which is all to say that this is incredibly complex terrain, in which most people probably have felt some affinity for the stated causes of MAHA.
If you say: Do you want our kids to be healthy? Do you want to end chronic illness? Do you want people to eat healthier? — who’s going to say no to all of that? The question is how those sentiments, which are pre-political, get appropriated and channeled into politics.
I don’t think that the last few years are going to be that satisfying to many people, and when they’re tallying up the wins and the defeats a few years from now, they’re not going to feel like their side changed the world.
Cottom: Agree.
Sifferlin: Yeah. This raises this question: Has MAHA emerged from a genuine institutional failure, or has it emerged from a perception of institutional failure that’s been propagated by — Tressie, you mentioned some of these wellness influencers, or people who have an ax to grind. You mentioned the fiction. How much of this is real and has tapped into something that a lot of Americans have felt, and how much of it is our backlash mechanism?
Cottom: I’ve been reading a lot lately — trying to get my arms around understanding — whether or not this era of populism has anything distinct to it.
You can’t overstate the role of how mass communication has changed, for example. The availability of information and of misinformation — that seems to be distinct, and I suspect both of those things are playing into this issue. There is this pre-existing populism, to David’s point — any moment in time when there is yawning economic insecurity and uncertainty about the future, you tend to see a populist response.
However, that is in response to real changes in people’s material conditions: Yes, my health care costs too much. Yes, they keep dropping the medication I need. Yes, it is harder and harder to get a primary care physician. Yes, somehow it seems easier to get medical aesthetics than to get lifesaving care in a lot of communities. Yes, there are rural and urban health divides.
Those things are real, material conditions that show up in people’s lives. But that doesn’t necessarily mean that that is what is driving the populist response at this moment in time. It can be a real vein of concern, but to David’s point, that doesn’t necessarily explain how people get mobilized through this larger concept of whether or not I am pro-Trump, or I’m a Republican, or I’m a Democrat — how it gets funneled into our pre-existing partisan divides.
To understand that, you’ve got to understand how this populism is a bit different, and I think it is because it is mixing two things: people who are having real, material insecurities, and then people who just perceive that they are having real, material consequences. And when those things get conflated, you’ve got both. A consequence of this disease of privilege, of never having had to deal with a health threat — or really any threat that is larger than you — is part of what people were responding to during Covid.
Covid was a great equalizer. Everybody was vulnerable. For some people, being vulnerable was a new experience. And the perception of that certainly made some people feel like their material conditions had changed, but that does not mean that they had the same risk and the same vulnerabilities of people who, for example, are living with decades of environmental toxins in their communities. Or communities that don’t have clean water.
But for a moment in time, if there is enough anxiety, if there’s a big enough external shock — which arguably Covid was — it can give a sense of a greater populist movement than what is actually true on the ground. So yes, there’s real concerns, but MAHA doesn’t respond to them. What you don’t see are a lot of systemic responses, or even arguments for those. In fact, that tends to be antithetical to the belief. What you see is a lot of doubling down on individual choice, which suggests to me that it is more about people wanting to manage their individual risk.
And again, that’s just going to be a really difficult thing to do with policy, and that’s even assuming that that is what R.F.K. Jr. and Donald Trump are interested in doing. So far, they have not shown that they are interested in actually solving a material problem, or really a perceived problem, either.
Wallace-Wells: That focus on individual risk is really important, and it is one of the main ways that MAHA has organized itself, especially in the aftermath of Covid. And it’s really destructive.
There’s a huge amount that we miss, and ways that we fail to protect one another, if we reduce all of public health and human flourishing to matters of individual choice. The pandemic itself illustrates that very neatly. And here we are, six years after the start of the pandemic, and there is still some lingering resentment. Especially, it seems, among the people whom Trump has appointed to run the country’s public health systems.
What’s really interesting is that when you look a little bit more deeply into the data, it doesn’t really seem, to me, that there’s so much widespread anger, resentment or frustration about the ways that we burdened one another, and protected one another, during the pandemic itself.
In survey after survey, when you ask people, even in retrospect, if they agree with the mitigation measures that were implemented, if they agree with mask mandates and school closures, there are some people who say no, but you’re talking about 70 to 80 percent of the country saying that they supported the policies that were implemented at the time.
And that is just so divergent from the messaging, not just that we get from H.H.S. and R.F.K. and Donald Trump, but honestly from establishment liberals, too, who say that we really bungled this pandemic — we mismanaged it, we alienated the trust of the public. And I’m not entirely sure that’s true.
Cottom: I think that’s a great point.
Wallace-Wells: What worries me most is it makes me wonder: If we have a change of the page, if we have a change of political leadership, what are the leaders on the other side going to be thinking about public health?
Are they going to be thinking we need to rebuild the value of solidarity, or are they going to be thinking we need to learn the lessons of the pandemic, by which they mean that we overreached and went too far and need to have a lighter touch in our messaging? I worry that we’re going to head down that second path.
Sifferlin: Yeah. It’s interesting — this idea about public health as this important collective endeavor kind of feels like it’s gone away, though I don’t know, maybe not. But this very individual health focus: It seems to have evolved beyond a response to Covid to now this obsession with — Tressie, you’ve written about personal health, the aesthetics of health. Where do you think that’s coming from now? And is it still related to Covid, or is it evolving into something else?
Cottom: There are a couple things happening, but the most macro trend in all of the data that you see about people’s shifting political position vis-à-vis health decisions — really the biggest answer there is that gender matters a lot.
There’s this wonderful sociological data that followed women, particularly mothers, across Covid and a couple of years after. And one of the things I found fascinating was that a lot of what we would think of as vaccine hesitancy among moms — if you just asked them on a survey whether or not they had questions about vaccines, you would conclude: Oh, they’re vaccine-hesitant. But then they’re liberal, or they’re well educated. You’d have these questions, and it would make it seem like there was this growing anxiety about vaccines.
But when you did the qualitative analysis and you followed up with them, what you’d find is that they felt increasingly responsible for their children’s health in every way imaginable, and wholly unprepared to manage it: If my child has autism, nobody’s blaming the father — why didn’t I do X?
A lot of what you were seeing was an undue amount of expectation, specifically on motherhood, to manage the fracturing of our health care system. And women who were educated enough to know what they didn’t know and were trying to ask questions in a system that is not set up to treat women seriously. In that conundrum, it looked like women were vaccine-hesitant, when in fact it was just that they were never supposed to be managing the vaccine schedule or the biological future of their children. This was never supposed to be an individual endeavor.
That has probably impacted women’s understanding of health as being something that they are personally, morally responsible for. And then you add onto that all of the status benefits of looking healthful, of looking like you are making the right moral health choices for yourself and for your family.
Then we do what we always do — an economy appears to help you solve that problem. It’s not enough to be healthy; you have to look healthy. And then it’s not enough to look healthy; you have to look like you’re trying to be healthier. And then you need to have really healthy children who also care about health, and they also have to look healthy.
Again, these are not things that, by and large, we are asking of men. We are asking this mostly of mothers, and that then becomes a thread through how all of our medical decisions are understood — not just as individual consumer choices, but as individual responsibility.
Wallace-Wells: Not only all that. You also have to sell something to your audience.
Cottom: That’s right.
Wallace-Wells: So that they can live as beautifully and healthily as you live.
Cottom: That’s exactly it. Don’t forget that part. [Chuckles.]
Wallace-Wells: But there is also, as you mentioned earlier, there is the male side of it. You were just talking quite beautifully and profoundly about the way that pressures on women through this period have produced some of this social pathology. On the male side, it’s really quite clear: It’s like these people are playing a game of social Darwinism. They do not care for the weak. They’re happy to see the weak die.
Then, when you look at the genuine male avatars of MAHA, it is not about looking healthy. It’s looking like ——
Cottom: What is that look?
[Audience laughs.]
Wallace-Wells: I mean, it’s professional wrestling. [Audience laughs.]
Truly. I made a crack about it earlier, but the fact that R.F.K. Jr. puts himself forward as an icon of health — have you seen a photo of him at 40? He did not look like that 30 years ago. He has completely remade his body in ways that strike me as quite off-putting. If you see him in jeans in a hot tub, even more so.
Cottom: I actually had forgotten that image. And I don’t appreciate being reminded.
Wallace-Wells: But he’s also — I mean, I don’t want to rag too much, but he can’t even lift that much weight. He just looks really huge.
[Audience laughs.]
Cottom: I actually think we should say that more.
Wallace-Wells: But the story that’s being told by his body, and by the body of many men like him, is not about fitness, even. It’s about monstrousness. These people are meant to be threatening. They are meant to be intimidating.
And that is an aesthetic value that has grown much more powerful over the last decade as, in the Trump era, the right wing has gotten much more explicitly acquisitive, competitive and unapologetic about its claims on the rest of the world and resources, etc. It’s a very, very dog-eat-dog worldview, and the way that descends on the individual is to coach them to be warriors in a time of — they would say, like, soy boys.
Cottom: Yeah. I just read some reporting about R.F.K. Jr. wanting to create a men’s health initiative, as if the majority of medical science had not been developed for the health and well-being of men. [Chuckles.]
But by which he meant, it was to make testosterone more freely available. To David’s point, it’s this very limited, narrow view of male health as just performative aesthetics — of, I love this, of monstrosity.
It is very different from what is happening on the other side with women, and we conflate the two in a way that hides what might be the most strident fissure of the MAHA movement. One side may be going about managing their health risk in a way that is not pro-social, but the other is quite actively trying to destroy the idea of social in its performance of health.
And along the way, they are making it virtually impossible for the women of their own camp to do what it is they’re charged to do — to perform motherhood effectively. To my mind, it’s a coalition that cannot hold, but it’s also a coalition that they are not very devoted to, either. I don’t think that the men of MAHA are very devoted to the female faction.
Sifferlin: Interesting.
Wallace-Wells: Well, one way of combining them would just be to say: That’s patriarchy. [Chuckles.]
[Audience laughs.]
Cottom: That’s right.
Wallace-Wells: The men are supposed to be warriors and the women are supposed to be beautiful, eternally youthful wives.
Sifferlin: Yeah. You talked about testosterone and the things that Kennedy is personally into. I was hoping you could help me make sense of this pushback against more established medications and treatments, like vaccines, and this embrace of unregulated substances, like peptides, that people are buying online from places like China. They don’t really know what’s in them, but they’re willing to inject themselves with these substances.
Wallace-Wells: Yeah, we can’t buy E.V.s from China, but we’ll buy gray-market peptides.
Sifferlin: What is going on?
Cottom: I think of it as the merger of what I call everyday eugenics — which is this idea that you can retroactively self-select your genetic superiority — and the nihilism of where individual choice will lead a person. That there is something inherently superior about me choosing to do it that overrides all of the unknowns, that overrides all of the risks.
The real problem a lot of people — in particular, men — have with a vaccine schedule is that it was decided by someone else. It is a locus of external control. But if I choose the peptide, and it is obviously superior, despite the fact — again, it is flattering to one’s sense of self as being able to make complex scientific decisions. There are these wonderful studies of people talking about doing their own research. Listen, people I love are among those groups of people. I won’t name them, but hello, Mother.
[Audience laughs.]
They’re very proud of having done their own research. But then you ask them: What was their research process? And, of course, they don’t mean what we mean by the scientific method and debate and falsifiability, etc. They mean they read lots of things. But it is very flattering to one’s sense of self, especially if you feel like you don’t have a lot of control, to think that if you just read enough — if you read a summary of those complicated studies — that you can draw meaningful inferences that are not much different from a scientist or a medical doctor.
Add that to the egotism of looking smarter, having the superior genes and the superior physical strength or power or looksmaxxing — or whatever it is at any given point in time — and then you go: Well, yeah, I did my research and I chose the peptide.
Wallace-Wells: I agree with all of that. A couple small things I would add: One thing that people find offensive about vaccines, but also anything that you’d compare them to, is that everybody gets the same one.
Cottom: That’s right. It’s the D.M.V. principle.
Wallace-Wells: You are equal before the vaccine. And if this principle of equality offends you, you will rebel. And that is one big part of what has happened here — is everybody wants a personal advantage because they can’t tolerate being told they are just like everybody else — vulnerable like everybody else — and only entitled to the same protection as everybody else, not more.
It’s also the case that we’re not just seeing individuals striking out on their own. We’re seeing them withdraw trust from one set of people and then extend it to another set of people.
If you think about what the wellness influencer universe is, that’s not a map of distrust. It’s just a map of distrust to people who work at The New York Times. People trust Andrew Huberman quite a lot, and so much so that they’re willing to take drugs that are not approved by any regulatory body. But they’re willing to forgo and overlook all of that, because they trust the person who sent them there.
So we sometimes get into a little bit of a tangle when we talk about this question in terms of the decline of trust, when in fact, what we’re really seeing is something more like trust transference. And that may be, in certain ways, scarier, because it’s not just about drawing individuals back into the fold. They are already allied with a whole new knowledge system, which operates according to a completely different set of principles — which is to say, often, entrepreneurial principles.
Cottom: Yeah. We talked about this before, but when you start talking about withdrawing trust and transferring it to another entity, what you’re talking about is a market. And what is fundamentally beneath wellness influencers, in particular, is that they don’t solve people’s problems; they create a new market for them.
Well, that market is not just competing with the other wellness influencers; it is also competing with the C.D.C. It’s important to keep in mind that what is being done here is, for most people, being done for profit. That means there is no profit in solving the problem and saying: Well, the C.D.C. has figured it out — we got this great vaccine schedule, or this is how we address high blood pressure, or, hey, everybody doesn’t need a testosterone shot. That forecloses on a market.
So yes, it’s not just moving the trust from one to the other. It’s doing it to maximize either attention or profit-seeking, and these days they are roughly the same.
Sifferlin: I wanted to talk just a little bit about Robert F. Kennedy Jr. — the man, the myth.
[Audience laughs.]
Cottom: The legend.
Sifferlin: I’m curious if you guys think of him as a true believer in his causes, or as more of a politically or otherwise-motivated figure?
Cottom: What do you think?
Wallace-Wells: I think that if he really believed that vaccines, in particular, were as damaging as he was saying three and six and eight years ago, before he was really in public life — if he really believed that they were as damaging as he was saying then, and he was put in a position of this centrality and power, and only did as much as he has done to diminish our faith in vaccines and attack the vaccine schedule, that would be a huge failure for him.
And so the fact that he has accommodated himself to this political moment, navigated the landscape, and solved the contradiction — the contradiction being he believes vaccines are bad, and the country believes vaccines are good — the fact that he has solved that contradiction by vaguely raising doubts and suppressing vaccine uptake by a couple of percentage points — that to me suggests someone who is more a grifter than a true believer.
I do think he believes in his core that institutions are corrupt, elites are paid off and Big Pharma and Big Agriculture don’t have the interests of Americans in their hearts. I think he believes that. I believe that. [Laughs.] It’s not a weird set of things to believe.
The things that I don’t believe are that vaccines cause autism, and I don’t agree we shouldn’t be giving HepB vaccines to children — those are the things that R.F.K. Jr. purports to believe. But if you really believe those things and have only achieved as much as he has achieved, he’d have to be shrinking from D.C. as a miserable failure, rather than someone who’s trying to hold together a shape-shifting coalition with every ounce of political capacity that he has.
Cottom: Yeah. I think all of it, and all of them, are scam artists. I was looking for an exception, and I don’t have many.
I’ve got this ontological position on whether or not — I don’t know if I care so much about what he believes in, because: Should he have stayed, just, R.F.K. Jr.? If he’d have done whatever it is the Kennedy thing is that you’re responsible for doing — meaning, be a quasi-private person with a public family institution behind him — and believed whatever he wanted, then I might think it’s somewhat interesting to try to figure out whether or not he really believes it.
At the moment he becomes, however, a political actor, and his decisions impact other people’s ability to make good decisions for themselves, then I think the only thing that matters is: What has he been willing to do? And what he’s been willing to do is to further ideas, questions and doubts that fundamentally make us weaker and more vulnerable, and some of us sicker and more likely to die.
I don’t even really care too much about what he actually believes, because the stakes of that, more seriously, are so high that even if he were a true believer, it would make him more monstrous, not less. But I tend to just think it’s mostly a scam artist.
Wallace-Wells: One more thing, quickly, about him and his public character. I think a lot about how different the world would be that we’d be living in right now, and how different this conversation would be onstage tonight, if Trump had made R.F.K. Jr. the head of the E.P.A. Or even the head of the F.D.A., or the head of the Department of Agriculture.
Those would’ve been causes in which he had conspiratorial views — he has, I think, nonscientific perspectives — but his instincts are more in line with science and much more in line with public opinion on those causes. And so it wouldn’t have been nearly as politically difficult for him to, at least on the public side of things, achieve real concrete gains that he might have been celebrated for.
Instead, Trump made the opposite choice and put him in a kind of impossible situation, trusting that Bobby could navigate his way out of it. And ultimately, as always, Trump miscalculated: He made a short-term decision that he thought would benefit him, and it’s coming at a long-term cost to his own political popularity.
Sifferlin: There’s been a lot of attention paid to the hantavirus outbreak. And while there’s a lot of uncertainty — and I’m not saying it’s going to be a huge thing — it is raising this question of what might happen should Kennedy be in a position where he does actually have to lead the country through something like a serious pandemic, or some kind of novel virus.
I’m curious if this is keeping you up at night?
Wallace-Wells: I should say as a first note that I don’t think that the hantavirus is likely to take off in the ways that have animated our nightmares since Covid. There are too many reasons to think that it will be spreading too slowly for anything like a global takeover to happen. So what we’re dealing with is a public health threat of a distinctly smaller scale.
Which is nevertheless quite scary, because the strain that we’re dealing with kills somewhere between 30 and 40 percent of those people who are infected. And because at no point along the timeline of the last month has any public health official — whether in America or internationally — done a very good job of communicating about the risk, or building a set of protocols or infrastructure that would allow us to really contain it.
I think we’re in a really bad spot there. I don’t think that we have control over this disease. I think it’s likely to continue spreading, and ultimately killing more people, and that those infections and those deaths were avoidable. The degree to which that’s an international problem or an American problem — I think there’s a lot of blame to go around. I don’t think the W.H.O. has handled itself very well here.
But I will say that we are, as a country, staring this down so ill equipped. I mean literally, the health cabinet is bare. Marty Makary just quit today. There’s no head of the C.D.C. There’s no head of the F.D.A. ——
Cottom: What’s been done to the C.D.C. alone ——
Wallace-Wells: Thousands of people fired. And the person who’s nominally in charge of the American public health response is actually not R.F.K. — he’s not really been paying much attention. It’s Jay Bhattacharya, who’s the head of the N.I.H. and technically the acting director of the C.D.C. And this is a man who, last fall, wrote an essay in The City Journal in which he said that the United States should scrap its pandemic playbook because the best pandemic preparedness was to make America healthy again.
Now, I would like to see Americans cut their B.M.I. I would like to see us have less chronic disease. But that is not the job of the N.I.H. or the C.D.C. or H.H.S. in the face of a new virus. And I don’t think any of these people take their role seriously because, again, they think of the world in social Darwinist eugenicist terms.
Cottom: They think they will survive.
Wallace-Wells: Now, I don’t think that means that any of these people want to see 10 million Americans die, but I also don’t think that they care that much if a few more people die that didn’t need to die, if the logic of that was that they were allowing more able-bodied people to move around more freely and unencumbered.
These are people who take that deal, after generations of public health officials would have insisted on the opposite deal. And that’s not comforting in the least.
Cottom: When you think about what has happened at the C.D.C., which I do think about quite a lot, it’s not just the pushing out of the head of the C.D.C. It is what has happened to the two tiers of scientists and institutional knowledge below the executive level, and how that has been gutted in the same way you see other government institutions gutted.
But in science — because science is so path-dependent, and it is so cumulative — when you lose that, you’re not just losing basic human power or labor power. You really are losing the consensus upon which science has a system to refine. And what those scientists will tell you, many of whom have become, for the first time in their professional lives, advocates — or think of themselves now as having to be far more radical than they’d ever thought they would have to be — what they would tell you is that it is not a matter of if we will have another pandemic event. It is a matter of when.
And so the question becomes: What is our risk tolerance, politically, for having people who not only don’t believe in the science, but don’t believe in the institutional production of any sort of public knowledge — but also have an overinflated sense of themselves, or belief in themselves. What does it mean, then, to face down that risk? My risk tolerance for that is quite low. I think there are some other people, again, who think that they can navigate through individual choices: I’m healthy. I won’t have these problems.
I think, though, that if you ask most Americans more soberly, when we are facing something — which may or may not be the next pandemic event, but something that could be — when they’re actually thinking about what’s really possible and probable, I think their sense of risk changes.
And that becomes, potentially, a political problem for this administration. The difference between imagined risk and real risk has a way of clarifying some people’s own susceptibility to risk. But that is not the way you want to do a political means test. To David’s point, it’s not just that people will be sick and people will die. It is the sheer possibility of the scale on which that might happen. But I worry that that is the sort of political means test it might take.
Sifferlin: Totally. So, we have some great reader questions, but I just had one more future-looking question that I know was of interest to both of you: What should be the response from the other side — from Democrats — to all of this? What does a Democratic public health vision look like, let’s say, in 2028 potentially?
Cottom: That’s a great question.
Wallace-Wells: You want to go first?
Cottom: I think it is part and parcel of the larger project that the Democrats — and listen, I really resist this thing where we tell the Democratic Party what it needs to do. It’s not my job. And also, I’m not particularly sure they’re interested in what I think they should do.
However, having said that, our concerns about our health system are part of our larger set of concerns, which is — I think David said this: Well, you either believe in a social compact or you do not. And as a party, you need to lay out a clear vision: Listen, the other side thinks that — and it took the Democrats quite a while to even come to consensus about how to talk about what was happening in the Republican Party, and they’ve roughly settled on a consensus: They’ve decided to throw the F-bomb out once in a while or something, I don’t know. [Chuckles.]
But what you don’t see is a more affirmative, coherent argument about what they do believe in, and the issue of health is just an example of that more broadly. Like, is this still the party that believes in public administration or not? And how much do they think we should have? Is this an administration that believes that economic security is part of the government’s responsibility to citizens? And if so, how are they going to enact that? They’re still kind of trapped in the cycle of trying to accurately describe what Trumpism is.
And as it comes down to health, the Republicans have a narrative about the Democrats — their most recent big legislative win, of course, was Obamacare, which they’re not all equally comfortable running on. But it is a set of benefits that most Americans have become comfortable with having, and it means something to them, and it has the possibility of being a political wedge issue.
But I’m stunned that they have not drawn a bigger story about health. It’s not just that you have access to the Affordable Care Act, but we want to make it possible for you to make a range of good, healthy choices. On the fringes, Bernie Sanders talks about it. Cory Booker recently was talking about organic food and vegetables, that kind of thing. But no, the Democratic Party right now does not have a clear vision on that, and does not seem to be competing for voters for whom that is a concern.
I think there are a couple reasons for that. Some of them are still smarting about what happened to Michelle Obama when she tried to lead on school lunches and that kind of thing. But I also think there’s this sense that the other side is bungling it so bad, and why get in the way of your enemy shooting themselves in the foot? And maybe that is good politics, but it is not a good narrative for how, or why, we should trust you to lead us out of this era of political dysfunction.
Wallace-Wells: Yeah. Like Tressie, I see this as part of the bigger dilemma for Democratic politicians. I also see this as: The war on public health is a war on the social safety net. Many of these measures that have been drawn back are things that were extended to protect the most vulnerable in society, and they’ve been withdrawn.
But looking beyond health, I see a party that seems comfortable to wait for the Trump administration to self-immolate. And I see the challenges ahead looming quite large. I’m worried that a Democratic public health administration will be divided, as I was saying earlier, between those who basically want to restore faith in public health and extend the principle of health solidarity, and those who want to retreat from those principles in order to demonstrate that they learned some lessons and they heard some criticism during Covid.
I see that on foreign policy. The Democrats are very happy right now criticizing Trump’s foreign policy. But what is the post-Trump, Democratic vision for America’s role in the world? I think it’s extremely open-ended. And you see people who are very hawkish, even in the Biden administration, now singing an extremely dovish tune.
I don’t know if there’s a possibility out there that a future Democratic president could even try to regain the world stage the way that Joe Biden tried to regain the Obama position when he came in in 2021. And I see that in domestic policy and fiscal policy. Do I really think that the Democratic Party is capable of raising money via taxes sufficient to actually deliver services to their voters and the country as a whole? It seems quite hard.
They seem like they really want to just raise taxes on the very rich, and there’s a kind of justice argument to that. But I’m not sure that the party’s actually serious about doing what it needs to do to deliver meaningful victories there. And on that point, I think I’m inspired by the model of our mayor in New York, Zohran Mamdani, who has really taken ——
[Audience applauds.]
Wallace-Wells: Yeah, please applaud. I’m not here to make a personal endorsement, but I think it’s really inspiring in the sense that he is an ideological actor who nevertheless takes extremely seriously the need to do the job well, and demonstrate that the system itself works for people.
And he seems, actually, much more than was apparent even during the campaign, to believe that that’s the first job of governance: to demonstrate attentiveness to the needs of the people. And once you’ve established that trust, you can go further ——
Cottom:Aand do bigger things ——
Wallace-Wells: And make ideological gains.
At the moment, it seems to me like there are few leaders at the national level in the Democratic Party who are thinking along those terms, and to the extent that they are, their impulses run against one another. I don’t know where we’re going to end up, although I do think we’re going to end up with a Democratic president in 2029.
Sifferlin: OK. I think we have time for some reader questions.
How do we productively respond to mistrust of corporations — in agriculture, food producers — within MAHA? How can we question what we’re being sold while rebuilding social trust?
Cottom: If I understand the question correctly — I may not — but I think what you’re asking for there is meaningful regulation. Meaning, how do we regulate the corporations that are charged with the manufacturing and distribution of most of our meaningful resources — so, things like food.
One of the problems we have is that we’re in an era where people are questioning whether or not regulation is sufficiently muscular enough to do that job, and we’re also doing that after 40 years of just sort of actively chipping away at some regulations, some people would say, and then actively making it more complex, others would say, depending on what industry you’re talking about.
But I think what people are really responding to there isn’t necessarily the degree of regulation, but the transparency of the regulation. One of the issues that we have is that when so much is provided by the private sector, there is not a meaningful feedback loop for people to respond to what’s being done and to feel like they understand what is being done. And so I think one of the things that people are really asking for when we talk about regulation, whether they think it’s too much or too little, I think we confuse that with public accountability.
I was just recently speaking with someone about how we can bring a sense of accountability in the public feedback loop to things like labor policy, for example. That’s how she had cut her professional teeth, and she was talking about the ways that she tried to do that at the federal and the state level, and how hard it was. She said: Yeah, it was hard. But when we got it right, people’s trust in the system was off the charts. And to your point about Mamdani: When you develop trust in one area, you are able to translate it into another area.
It is hard work. It’s going to be even harder with the way that so many of our institutions have atrophied, but I think it is fundamentally what people are asking for, which is public accountability. It can be done. People are going to have to demand it, and a lot of political forces are going to have to align, but I think that’s the way forward.
Sifferlin: Last question, I think this could go to either of you: Is there anything R.F.K. could do to alienate the MAHA base? Or is any escalation, no matter how ridiculous, excused as anti-establishment heroism?
Cottom: Yeah, there is a lot of anti-establishment impulse there that will drive people to follow the personality as opposed to any sort of political axis. However, we are already seeing some fracturing of those coalitions.
One of the problems that R.F.K. has is the same problem that Donald Trump has, and Trumpism writ large: It’s pretty effective at mobilizing people whose beliefs are transactional, but it really struggles with people who truly believe.
And so some of what you see — for example, moms across America who had really led this fight against Roundup weed killer, and feeling deeply betrayed by this administration’s supposed interest in health when Trump signed the executive order defending the corporate interests against many in his base, who are actively saying: He has lost my support because of this.
We’re not yet seeing many of them willing to organize on the other issue, but being disaffected is a political choice, much like voting is a political choice. And the real possibility of that particular fissure, anyway, is that those were a lot of people who were mobilizing for Donald Trump, at least certainly online — some of them even offline — and you can lose some of that energy when they decide that they are no longer supporting R.F.K. Jr.
And you’re already seeing some of that emerge. Everybody, however, is not a true believer. It becomes a problem. And then the question becomes: How many of them are? But for those who actually really believe, R.F.K. Jr.’s almost wholesale inability to deliver them anything other than symbolic victories is smarting with a lot of people.
Wallace-Wells: Just to pick up briefly on the anti-establishment point: I do think it’s worth remembering that, come 2028 and 2029, we will have been living in Donald Trump’s America, effectively, for at least 12 years. And there was an interim period where we had basically an invisible president, but in the collective American imagination, Donald Trump has been running this country for a very long time.
There are things about Democrats picking up the mantle of anti-establishmentarianism that make me worried and make me uncomfortable. I’m the kind of person who works at The New York Times; I obviously have establishmentarian values, but I also think that there are some political opportunities there.
And on the food front, if you compare the objection to Michelle Obama making us eat healthy food — compare that to Donald Trump being in bed with all the Big Ag companies and the notion that he’s feeding us poison. One of these actually is a much more potent message.
I don’t know exactly to what degree the Democratic Party as a whole will feel comfortable playing that card, but it is available, at least to some members of the coalition. And I suspect that one of the things that’s going to happen over the next few years is that at least some figures, if it’s Graham Platner or whoever, are striking that note to national effect, even if the party itself is not singing the same tune.
Sifferlin: That’s great. David and Tressie, thank you so much.
[Audience applauds.]
Wallace-Wells: Thank you, guys. Thanks to the library, too.
Thoughts? Email us at [email protected].
This episode of “The Opinions” was produced by Derek Arthur. It was edited by Kaari Pitkin. Mixing by Pat McCusker. Original music by Carole Sabouraud, Aman Sahota and Pat McCusker. Fact-checking by Lori Segal and Kate Sinclair. Audience strategy by Shannon Busta and Kristina Samulewski. The deputy director of Opinion Shows is Alison Bruzek. The director of Opinion Shows is Annie-Rose Strasser. Special thanks to the Brooklyn Public Library.
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