To gauge the speed of America’s third-world-ization, economist Noah Smith pointed out, consider just the past few weeks. Generalissimo Trump deployed troops to the capital, moved to seize power over setting interest rates, partially nationalized another American corporation, purged a few more high-ranking military and intelligence officials, issued a decree purporting to ban flag burning (sort of), and watched the FBI he commands search the home of one of his political nemeses for reasons that may or may not turn out to be justified.
He also put a henchman on the federal bench, instigated an irregular redistricting push to weaken the opposition’s chances of reclaiming power, and fired the federal bureaucrat in charge of calculating employment numbers because the July data made him look bad. His choice to replace her is exactly the type of person you’d expect.
Those are things that happen routinely in “sh-thole countries,” to borrow the president’s preferred terminology. Draw your own conclusion about America in 2025 from the fact that they’re happening here.
Still, despite his and his team’s best efforts, superpowers don’t turn into sh-tholes overnight. Our courts still enjoy some authority and our elections remain scheduled. The imbecile faction persists, for now, in denial about the magnitude of its error last November because we haven’t yet fully arrived at a third-world political culture. We’re still transitioning.
That was also true of the CDC until Wednesday night, when it took a quantum leap toward sh-thole status.
Lysenkoism.
For the same reason that swing voters supported Donald Trump at the ballot box, wary Senate Republicans supported Robert F. Kennedy Jr.’s nomination to lead the Department of Health and Human Services. They didn’t believe he’d act on his worst impulses when handed the awesome responsibility of power over life and death.
Admittedly, that wasn’t the only reason. It took an immense amount of political cowardice for senators to sell out American public health to a God-tier anti-vax creep because they feared the president would primary them in their next race if they didn’t.
But I do think the Republicans who gave Kennedy the benefit of the doubt earnestly believed he could and would be restrained. Bill Cassidy, a medical doctor and thus the most notorious GOP vote in favor of confirming RFK, said as much in a floor speech in which he pledged to do the restraining himself if necessary:
I will use my authority as Chairman of the Senate Committee with oversight of HHS to rebuff any attempts to remove the public’s access to life-saving vaccines without ironclad, causational scientific evidence that can be defended before the mainstream scientific community and before Congress. I will carefully watch for any effort to wrongfully sow public fear about vaccines between confusing references of coincidence and anecdote.
To this day, I have no idea what he meant by that. Trump’s administration operates on the principle that, once the votes are counted, it’s no longer accountable to anyone. True to form, Kennedy seemed to stop caring about Bill Cassidy’s opinion the moment the tally on his confirmation was announced in the Senate.
Again and again and again since February, despite the senator’s warnings, RFK has targeted the public’s faith in and/or access to vaccines. The only thing Cassidy has done to stop him is derail the confirmation of Dave Weldon, another vaccine skeptic, to lead the CDC. Weldon’s more credible replacement, Susan Monarez, was confirmed last month, nicely illustrating my point about America’s current transition stage: Her boss, Kennedy, may be a third-world witch doctor, but she’s a first-world scientific bureaucrat.
Or was. On Wednesday night, 28 days into her tenure, she was fired. (Sort of.)
According to sources who spoke to the Washington Post, Monarez “was pressed for days by Kennedy, administration lawyers and other officials over whether she would support rescinding certain approvals for coronavirus vaccines.” I won’t do it without consulting my advisers, she told him. He replied by questioning her loyalty to the Trump agenda and demanding her resignation, prompting her to pick up the phone and call … Bill Cassidy.
Cassidy, the great restrainer, then called the secretary to complain. Not only did Kennedy not back off, he allegedly grew angrier at Monarez for involving the senator in their dispute. By nightfall she was gone—as were four other department chiefs at the agency, all of whom resigned in protest. One cited the “intentional eroding of trust in low-risk vaccines,” adding of Kennedy’s anti-vax efforts that he had “never experienced such radical non-transparency, nor have I seen such unskilled manipulation of data to achieve a political end rather than the good of the American people.”
Like the imbecile swing voters of America, Bill Cassidy gambled that a second Trump administration would be a lot of sound and fury that ultimately signified nothing, or at least not much. Kennedy would be a figurehead prone to babbling irresponsibly yet ineffectively in interviews about vaccination, the senator likely imagined, with hard-nosed policy decisions about vaccines left to the Serious People at the CDC.
He placed his bet and lost, realizing too late that being a Serious Person is disqualifying in this administration.
And so a first-world public health agency, the most well-known of its kind on Earth, is about to become a third-world soapbox for voodoo and superstition. The day before Monarez was fired, Kennedy said at a Cabinet meeting that his department would soon have an announcement about unnamed “interventions” that are “clearly almost certainly causing autism,” which sounds suspenseful but is exactly the opposite. He arrived at the conclusion he wanted to reach on that subject long ago and is working backward to support it, enlisting “researchers” who he knows will tell him what he wants to hear.
As for the Serious People who would supposedly guarantee our access to vaccines, a few hours before Monarez was canned, RFK’s FDA released its recommendations for COVID-19 immunizations this fall. The shot should no longer be authorized for adults under 65 unless they suffer from some underlying health condition, it said, which would mean those in that group who want to protect themselves will need to find a doctor willing to prescribe it off-label and perhaps have to pay full freight for the privilege. As a result, “access will be greatly reduced, thus so will demand,” virologist Angela Rasmussen explained. “In the years to come, vaccine manufacturers may withdraw from the U.S. market altogether.”
Which has been the plan from the start, of course.
America at last has its own Trofim Lysenko, a crank whose screwy ideas about science gained influence over policy not because of their methodological rigor but because their contrarianism reflected the prejudices of a feral populist revolutionary movement. (Socialism without socialism!) You tell me: Is a country that’s transitioning from relying on vaccines to prevent disease—including brain cancer, perhaps—to relying on Ivermectin and beef tallow more or less of a sh-thole than it used to be?
The only good news is that Robert F. Kennedy Jr. is unlikely to rack up a body count as large as his Soviet predecessor. But he’s sure gonna try.
The resignation dilemma.
And so we return to an old and recurring moral dilemma: Did Monarez’s deputies do the right thing by resigning?
I think they did. Although, for reasons I’ve explained before, that would have been a harder question during the president’s first administration.
The excuse for Trump voters the first time around was that they didn’t know what they were getting into. They didn’t want to be governed by Hillary Clinton, so they rolled the dice on the new guy, not knowing what he was capable of. We all make mistakes, and it’s cruel to let someone suffer terribly for a mistake when you might be able to prevent it.
So the Serious People stuck around in his first term, doing their noble best to contain the damage he caused and accidentally convincing voters in the process that reelecting him wouldn’t be risky. Health bureaucrats in particular might have felt obliged at the time to grit their teeth and endure whatever chaos and indignity he visited upon them, particularly during a pandemic: To a great extent, the point of medicine is to rescue human beings from their own poor decisions.
But it’s harder to make that argument in Trump’s second term.
You can still make it. Today at The Bulwark, Jonathan Last foresaw the terrible consequences to public health from the U.S. transitioning fully to a third-world model. “The U.S. government will no longer be a reliable vector for information about medical science,” he wrote. “Real scientists will leave the country. Research will move to Europe and China. Innovation will happen elsewhere as one more American industry succumbs to the poisonous effects of corruption. Oh, and Americans will get sick.” A conscientious CDC deputy might consider all of that and resolve to stay on and fight Lysenkoism for the sake of the public good.
But saving Americans from their own terrible choices again, after they doubled down on the president last year, feels a bit like restarting a dying patient’s heart only to have him immediately light up a cigarette. At some point, you’re under no further obligation to restrain someone who’s bent on destroying himself from doing so.
Voters didn’t make a “mistake” this time by electing Trump. They watched him mismanage the pandemic and plot a coup in broad daylight, and they chose to bring him back. Nor were they blindsided when Kennedy, one of his most prominent surrogates on the trail, landed in the administration. The president’s campaign was quite enthusiastic about RFK’s program and how it might be implemented.
Populists wanted Lysenkoism, and imbeciles were willing to tolerate it as a trade-off for cheaper groceries. So what’s left to talk about? The Serious People should resign and give Americans what they voted for. Let them learn their lesson the hard way.
“But children will be harmed,” you might say. Yes, and that’s a strong argument against bureaucrats resigning. Kids are in the line of fire here. Just explain to me how a well-meaning health official who resolves to stay on the job to protect children from Lysenkoism is supposed to succeed.
In Trump’s first term, a deputy stood a fair chance of changing the president’s mind about a horrible decision he was planning. He had enough Serious People around him that a consensus in favor of reversal might plausibly form among advisers, pressuring him to relent. In his second term, nearly all of the Serious People have been excluded to facilitate zealotry in policymaking. If Kennedy is willing to have Trump fire the new CDC chief after 28 days for refusing to launder his anti-vax propaganda, why would anyone else at the agency think they’ll get through to him?
Kennedy has been at this for decades. Just yesterday he stood at a microphone and babbled about his supposed ability to diagnose “mitochondrial challenges” in the faces of children when he passes them in the airport. He’s a bona fide nut. Neither he nor the president is going to listen to reason. The political project they’re part of has been designed to make listening to reason as difficult as possible.
Despite their best efforts, the Serious People will not protect kids from this insanity. They’ll be fired in due course if they try, as Monarez was. The most productive thing they can do if they’re employed by this administration is resign noisily rather than lend the credence of their profession to witch-doctoring that will eventually lead thousands of parents to let their children die of preventable diseases. If every credible scientist in Trump’s government bailed out, the spectacle of their departure might help discredit the forthcoming voodoo about vaccines supposedly causing autism.
The best-case scenario for public health until 2029 is that no one except the populists pays the slightest bit of attention to the federal government’s medical recommendations. Mass resignations would encourage that.
But if that’s not enough, I think resigning is also compelled by basic dignity. Refusing to participate in a corrupt enterprise is a mark of good character and an act of moral hygiene. What Trump and Kennedy are doing is indecent, and decent people being involved in it both obscures that fact and subjects those people to temptations to behave indecently themselves. Ask Marco Rubio or Mike Lee.
If Bill Cassidy had any dignity left, he would resign from the Senate, admit that the president and RFK had made a schmuck out of him, and devote himself to rebutting the administration’s vaccine disinformation over the next several years. Yes, the person who replaces him in the Senate would be a MAGA zombie, but so what? Cassidy voted like a MAGA zombie when he confirmed Kennedy. A senator who bows to the president reluctantly rather than enthusiastically is still bowing.
Instead, I assume he’ll slog on to his Senate race next fall and vote to confirm whichever Weldon-ish kook Trump nominates to replace Monarez at the CDC. Having already done his part to accelerate America’s transition into a third-world country, there’s really no point in him holding things up any further.
