Robert F. Kennedy Jr. is wrong about a lot of things in public health. Vaccines don’t cause autism. Raw milk is more dangerous than pasteurized milk. And cellphones haven’t been shown to cause brain cancer. But the basic idea behind his effort to “Make America Healthy Again” is correct: America is not healthy, and our current system has not fixed the problem.

Joe Biden entered office promising to “beat” the coronavirus pandemic, cure cancer, and get more people health care. Arguably no one on Earth can talk more passionately about funding cancer research than Biden, whose son Beau died of brain cancer in 2015 and who, in 2022, announced an initiative to halve U.S. cancer deaths in the next 25 years. Robert Califf, Biden’s FDA commissioner, has been particularly stalwart in arguing that the agency must play a role in reversing a “catastrophic decline” in Americans’ life expectancy, and has repeatedly warned of “an ever-growing epidemic of diet-related chronic diseases,” such as cardiovascular disease and type 2 diabetes. A 2019 study found that just 12 percent of Americans are considered metabolically healthy, based on their waist circumference, blood sugar, blood pressure, and cholesterol.

Of course Biden’s White House was never going to end cancer or obesity in four years. But many of its policies barely scratched the surface of America’s wide-ranging health problems. Despite Califf’s dramatic language about the country’s diet problems, for example, the FDA’s efforts to improve the situation have mostly revolved around giving Americans more information about healthy foods.

The public-health bureaucracy that the Trump administration will inherit is more focused on and skilled at treating America’s health problems than preventing them. That shortcoming—despite the billions of dollars spent every year at these agencies—has damaged the credibility of the public-health establishment enough that Kennedy is now Donald Trump’s nominee for secretary of Health and Human Services. Marty Makary, Trump’s pick to lead the FDA, has similarly risen in prominence by second-guessing "medical dogma" in the U.S. and beyond. And Trump’s pick to lead the CDC, former Representative Dave Weldon, has criticized the agency’s vaccine policies and once attempted to block its vaccine-safety research because of what he claimed were conflicts of interest. A set of men who have made careers of distrusting our existing health-care agencies may soon be empowered to try to blow them up.

The Biden administration, to be fair, had less time to deal with America’s deeper health issues, because it was forced to deal with at least a few calamities. Much of Biden’s term was spent navigating the country out of the pandemic. On the whole, his administration achieved most of its COVID goals. The Biden White House provided Americans with free COVID tests and mounted a vaccination campaign that resulted in more than three-quarters of the country getting a shot. Still, the pandemic left the CDC beleaguered by claims that it was simultaneously too slow and too aggressive in its efforts to fight the virus. During Biden’s presidency, the agency promised to “share science and data faster” and “translate science into practical policy,” but it has struggled to respond to the continued spread of bird flu. Public-health experts have slammed the CDC for not sharing enough information about the virus’s spread, including a human case in Missouri earlier this year, and farmers have been reluctant to implement the agency’s recommendations for preventing transmission of the virus from sick cattle to humans.

Some of those calamities were self-inflicted. The FDA is entrusted with ensuring that our food and medicines are safe, and it generally does spot issues quickly after they occur. But for months, the FDA failed to act on a whistleblower complaint alerting regulators to deplorable conditions at an infant-formula factory that eventually caused nationwide formula shortages and two infant deaths. The FDA is also supposed to decide what tobacco products can be sold, but it has failed to police the illegal market for vapes and nicotine pouches, such as Zyn. And for all the administration’s talk of being guided by “science and truth,” the White House seemingly bowed to political pressure and abandoned a plan to ban menthol cigarettes at the very end of a long rule-making process. The past four years have revealed that crucial parts of the agency’s remit—most notably its oversight of tobacco and the food system—have been neglected by agency leadership; in 2022, independent reviews of the FDA’s food and tobacco centers found that both lacked clarity on mission and goals.

At the same time, the administration has failed to deliver on its loftier ambitions. Biden quietly dropped some of his bolder ideas, such as his campaign promise to create a public-option insurance plan. The Advanced Research Projects Agency for Health, a new government agency that funds high-risk, high-reward research and is essential to Biden’s cancer goals, is in its infancy, and Republicans in Congress are already eager to cut its budget. And some promises, such as Biden’s grand goal to help change America’s diet, have been approached more like trivial pursuits.

The administration branded its 2022 hunger and nutrition conference, for instance, as the largest and most important gathering on nutrition policy since the Nixon administration. That 1960s conference led to millions of children gaining access to school lunch and to the creation of the Special Supplemental Nutrition Program for Women, Infants, and Children (or WIC), which provides food to about 6 million Americans each month. The Biden administration’s summit ended with a pledge to end hunger and improve America’s diet by 2030, but the steps taken toward tackling those goals—such as developing a plan to add warning labels to unhealthy foods—have been modest. And all the agency has done so far on that project is conduct research on the labels’ potential design. The FDA has also pledged to lower the sodium in foods, but the targets it’s set for the food industry are entirely voluntary.

These efforts are understandably careful and bureaucratic. The agency’s caution over warning-label design comes amid threats from the food industry to sue over any label deemed unjustified. Indeed, in the U.S. legal system, regulators have trouble mandating that companies do much of anything without it being branded as unconstitutional. But the Biden administration’s efforts look comically inadequate given the scope of America’s health problems.

RFK Jr. is promising a break from the status quo. This is not to say that he, should he be confirmed as health secretary, has a better plan. Most of his ideas amount to little more than pronouncements that he will take sweeping actions immediately once Trump is sworn in as president. The reality is that many of those efforts would take months, if not years, to implement—and some might not be feasible at all. He has signaled, for example, that he will clear house at the FDA’s food center, despite rules that prevent government bureaucrats from being fired willy-nilly. He also has pledged to ban certain chemicals from food, which he’s argued are contributing to American’s lower life expectancy. But for every chemical the FDA bans, it will have to go through a lengthy regulatory process, which would likely be challenged by food companies in court. Kennedy’s notion of significantly altering the system of fees that drug makers pay the FDA to review their products would likely send the agency into a budgetary crisis.

If Kennedy gets confirmed to lead HHS, he will quickly be confronted with the reality that governing is a slow and tedious process that doesn’t take kindly to big, bold ideas, even with an impatient leader like Trump calling the shots. At the outset of his first term, Trump declared war on drug companies, which he claimed were “getting away with murder” due to their high prices. Trump’s then–health secretary, Alex Azar, in turn spent the next four years trying radical fixes that included requiring drug makers to post their prices in TV ads, importing drugs from Canada, tying American drug prices to other countries’, and eliminating the rebates that middlemen negotiate for insurance companies. But each idea got bogged down in bureaucracy and lawsuits. Trump’s early attempts to contain COVID by blocking international air travel similarly did little to keep the virus out of America, despite his claims at the time that the policy “saved us” from widespread outbreaks.

Biden benefited from Operation Warp Speed's rapid push to create vaccines, but it was his team of technocrats that finally got them distributed. And they eventually lowered drug prices too, in a much simpler way than Trump was proposing. But technocracy has also failed to address our most pressing—and most visible—health problems. Trump’s picks have little experience navigating the Rube Goldberg puzzle that is American bureaucracy. They certainly aren’t afraid of trying something new, but we’re about to find out how far that will get them.

Robert F. Kennedy Jr.’s movement has repeatedly been written off as a farce, a stunt, a distraction. Now Donald Trump has nominated him to lead the Department of Health and Human Services, where, if confirmed, he’ll oversee a life-and-death corner of the federal government.

RFK Jr.’s operation had been building toward this moment for months. On August 23, Kennedy suspended his independent presidential bid and endorsed Trump after what he described as “a series of long, intense discussions” that proved the two were ideologically aligned. Almost immediately, the “Make America Healthy Again” (MAHA) movement was born, as was a super PAC of the same name.

The group’s near-term goal was simple: persuade Kennedy’s coalition to vote for Trump. His former national field director, Jeff Hutt, became one of the MAHA PAC’s leaders, and throughout the fall, in his phone calls and meetings with Kennedy supporters, he kept hearing the same message: If RFK Jr. couldn’t become president, he should zero in on health reforms.

[John Hendrickson: The first MAGA Democrat]

“HHS is the place where they wanted Mr. Kennedy to be,” Hutt told me last night. He fully expects Kennedy to be confirmed. Hutt and his team have set up a “war room” and are identifying which senators will support the HHS nomination, and which will need coaxing. Either through standard procedure or via a recess appointment (an idea Trump has teased), Hutt said he was confident that Kennedy will land the job.

Kennedy was offered such a significant position—and will have such a “big rein,” as Hutt put it—because Trump returns favors. In 2016, Trump courted Christian voters by dangling the prospect of appointing conservative judges who would overturn Roe v. Wade. This year, Trump spent the final months of the election wooing the MAHA bros. How many Kennedy supporters actually voted for Trump is unclear, but Hutt and others I spoke with believe that Trump’s victory is partially on account of the RFK Jr. brigade showing up. “He got behind them, and he got elected,” Hutt said of Trump.

Kennedy’s acolytes are elated that he will have such a prominent position in the administration. In my conversations with former Kennedy volunteers and others in his orbit this week, I heard some skepticism as to whether he’ll actually be able to accomplish a revolution inside a sprawling government bureaucracy. But for now, Kennedy’s champions are hopeful that he’ll catalyze policy changes that would lead to a “healthier” society—even if they don’t all agree on what that means.

In late September, at a festival of “free thinkers” in Washington, D.C., where RFK Jr. was the star attraction, Mike Patton, a former campaign volunteer who lives in Florida, told me he was unsure about whether he could bring himself to vote for Trump after all the work he’d done for Kennedy.

This week, Patton told me that, in the end, he and his wife each wrote in Kennedy’s name on their ballot. He is happy that Kennedy is ascending to a place of power, and excited that Trump has promised to give Kennedy authority over health matters, but he’s dismayed that Trump apparently wants to keep him away from areas involving fossil fuels and renewable energy. Patton isn’t sure what Kennedy might be able to accomplish within Trump’s administration. The idea of fighting all manner of chronic diseases with cleaner food and water is a pillar of the MAHA movement. But this will be an uphill battle. “Even when he was campaigning, he was saying he was going to make a drastic reduction in chronic disease in his four years, and I can’t wrap my head around how you can make a measurable difference [that quickly],” Patton told me. “But he seems confident, and Bobby seemed confident before. So, pop some popcorn.”

Another Kennedy supporter, Jennifer Swayne, who served as his campaign’s Florida volunteer coordinator, told me she somewhat reluctantly voted for Trump. Swayne is the mother of a child with autism, and she believes that mothers like herself are searching for answers—that’s partly what drew her to Kennedy. “We want to know what's causing this,” she said of autism. “We want to prevent other moms from having to go through this.” She said she would define success for Kennedy’s HHS tenure as removing “dangerous products off the market” and holding drug manufacturers accountable for adverse effects and chemical dependency.

[Yasmin Tayag: ‘Make America healthy again’ sounds good until you start asking questions]

When I asked Hutt how he’d gauge Kennedy’s success, he had a range of ideas. “The amount of money flowing through government into corporations would be dramatically reduced. Government would be out of a lot of things, like health care. We would take the middleman out of a lot of things. We would have government agencies whose sole purpose is to publish and report facts and numbers in ways that educate the American people, not to convince them one way or the other of something,” he said. He envisioned Kennedy ushering in an era of more family farms, of citizens gardening and growing their own food. “I guess that's really what it looks like: sort of a health revolution, in a sense,” he said. “Nobody’s ever asked me that question before.”

In announcing the nomination, Trump echoed Kennedy’s core campaign messaging: “Americans have been crushed by the industrial food complex and drug companies who have engaged in deception, misinformation, and disinformation when it comes to Public Health.” Kevin Roberts, the president of the Heritage Foundation and one of the key people behind Project 2025, said in a statement that Kennedy’s nomination “sends a clear message to our failed public health establishment,” and that under Trump and Kennedy, “Americans will be in control of their health, not the commissars of three-letter health agencies.”

Many questions surround the HHS nomination, none more significant than whether Kennedy would use his authority to block or recall certain vaccines. Kennedy has spent years sowing doubt about their safety. In the early 2000s, he helped popularize the unproven theory of a link between vaccines and autism. More recently, he was an influential opponent of the COVID vaccines and accompanying mandates. Now he’s poised to inform drug policy at the highest level.

Kennedy’s spokesperson did not respond to my request for comment last night as to whether, as HHS secretary, RFK Jr. would move to outlaw any existing vaccines, and referred me to his victory-lap post on X, which did not mention the topic. Tony Lyons, who founded a different Kennedy super PAC, American Values 2024, said in a text message: “Bobby has said very clearly that he’s not going to take away anyone’s vaccines.” If, hypothetically, we faced another pandemic during Trump’s second term, I asked Lyons, would Kennedy stand in the way of a vaccine-development project such as Operation Warp Speed? Lyons didn’t offer a clear answer. “[Kennedy] believes in robust, transparent and independent science, rather than corporate science propped up by censorship and propaganda,” he wrote.

In my conversations with Kennedy’s supporters, I heard a lot about “medical freedom” and “personal choice,” but no one mentioned the word ban. Kennedy stiff-arms the “anti-vax” label, and his allies steadfastly maintain that he’ll use his position to scrutinize vaccine science—but not to institute a vaccine moratorium for the greater population.

[Benjamin Mazer: The sanewashing of RFK Jr.]

Perhaps the clearest way to understand Kennedy’s HHS aim is to listen to his musings on “corporate capture”: the idea that government agencies are overly influenced by the companies within the industries they’re supposed to be regulating. This is a long-standing liberal complaint, which Kennedy has built up to the status of a conspiracy theory. (Anthony Fauci, for instance, has not personally profited off of vaccines, as Kennedy has claimed.) His top-line goal is to sever the relationships between corporations and the federal government, but he has yet to explicitly state how he’ll do that. Reforming fast food may be his biggest source of tension with Trump. The future 47th president didn’t just serve fries at a (closed) McDonald’s as a campaign stunt; he seems to genuinely love Mickey D’s, while Kennedy sees it as a scourge—the antithesis of MAHA. But that’s just one company. Hutt conceded that his team faces a challenge in persuading senators from agricultural-heavy states to support the sort of reforms Kennedy is promising: fewer food chemicals, an emphasis on regenerative soil.

And some of what Kennedy speaks of accomplishing is well beyond his reach. For instance, he has called for removing fluoride from our drinking water—something even Republican dentists oppose. But such a change could occur only at the local level, not the federal level. In New York City, for example, Mayor Eric Adams has said he will follow the fluoridation recommendations of city and state health departments.

As Trump prepares to take office again, Kennedy remains a confounding presence: He’s a dreamer, but he’s destructive. Kennedy was never going to win the White House, but he’s now, at last, on his way to Washington. And we all have to live with it.

In June, Ivan Raiklin, a retired Green Beret and pro–Donald Trump activist, sat down for a chat with Cliven Bundy, a Nevada cattle rancher who instigated an armed standoff with federal authorities in 2014 over his refusal to pay grazing fees.

In the video—posted on the America Happens Network, which has aired documentaries such as Bundy vs. Deep State and the series Conspiracy Truths—Raiklin explained that tens of thousands of service members had refused to comply with a Defense Department mandate that all personnel receive a vaccine for COVID-19, because they did not want to be “experimented on with an unsafe and ineffective, what I call ‘DNA-mutilation injection.’” He told Bundy that the “illegal” mandate, since rescinded, was to blame for the “total destruction of our constitutional order.”

“There must be consequences,” Raiklin said, for the “unlawful, immoral, unethical, illegal” vaccination program, which he also asserted, with no evidence, “ended up killing lots of people.” In fact, tens of thousands of service members did refuse the vaccine, and about 8,000 were discharged for failing to comply with the policy. But Raiklin speculated that as many as 1 million more still in uniform might “want to participate in retribution” against Pentagon leadership. (Depending on where in the world they serve, military personnel are required to receive about a dozen other vaccinations, including for polio, influenza, and typhoid.)

Retribution is Raiklin’s watchword these days. He calls himself Trump’s “secretary of retribution,” settling scores from the first term and ready to do the same in a potential second. His battles aren’t only with military leaders. After Trump lost the presidency in 2020, Raiklin suggested that Vice President Mike Pence could reject electors from the states that Joe Biden had won, on the grounds that they might be fraudulent. Those ideas were later taken up by John Eastman, a lawyer who has been indicted in Arizona for his alleged efforts to overturn the 2020 election results there. (He has pleaded not guilty.) Raiklin may be one of the intellectual founders of Trump’s election denialism.

[From the January/February 2024 issue: If Trump wins]

More recently, Raiklin, who left the Army Reserve in 2022 at the rank of lieutenant colonel, according to an Army spokesperson, has promoted the potentially illegal idea that state legislatures could withhold their electors in the event that Trump loses. He has shown up in swing states, including North Carolina, where he pushed for lawmakers to award the electors to Trump ahead of time, on the theory that Hurricane Helene had disrupted the casting of ballots in the state.

Raiklin’s ideas for ensuring a Trump victory dovetail with the plans he has hinted at for exacting retributive justice on government officials. In his conversation with Bundy, Raiklin said that he would like to “coordinate” with those members of the armed forces supposedly still aggrieved over mandatory vaccinations, “to channel those skills, training, passion, in a positive way, to kind of autocorrect the lawlessness and to create consequences for those who created that lawlessness.”

Raiklin did not explicitly call for violence, even though he praised Bundy as “quite the legend” for his aggressive opposition to federal authority. Rather, he said he wanted “appropriate lawful justice”—but archly suggested that this should come from outside the court system. Raiklin chooses his words carefully, even when they are freighted with menace. Bundy asked how the ex-soldier would treat the federal prosecutors in his own case, and Raiklin replied calmly, “I would conduct the most peaceful and patriotic legal and moral and ethical actions that they’ve ever experienced in their life.”

A New York native with a degree from the Touro Law Center, in Central Islip, Raiklin describes himself as a constitutional lawyer. He served as an intelligence officer in the National Guard in several states as well as in the regular Army, deploying to Jordan and Afghanistan. Among his numerous commendations and awards is the Bronze Star Medal, given for meritorious service or acts of valor in a combat zone.  

He has suggested that military personnel could be “deputized by sheriffs,” as he told Bundy in their conversation. This idea is rooted in the fringe theory that local sheriffs possess law-enforcement authority superseding that of any elected official or officer, at any level of government. Proponents of the so-called constitutional sheriffs’ movement urged sheriffs to investigate disproven claims of election fraud in 2020 and to get involved this year in election administration.

Bundy seemed a bit daunted by the scale of resistance that Raiklin described to him. The federal bureaucracy is “so broad,” he said, that it’s practically immovable. Raiklin reassured him: “That’s where people like me come into play, that know the system very well and in detail, to create priorities. You start with the top, and you work your way through the system.”   

To guide that work, Raiklin has created a “deep-state target list,” with the names of more than 300 current and former government officials, members of Congress, journalists, and others who he thinks deserve some of that “lawful justice.” The names of some of their family members are also included.

The list, which is helpfully color-coded, reads like a greatest hits of all the supposedly corrupt plotters who Trump and his supporters allege have targeted them. Among others, it includes FBI officials who worked on the investigation into potential links between Trump’s 2016 presidential campaign and Russia; lawmakers and congressional staff who managed both Trump impeachments; members of the Capitol Police who defended Congress from pro-Trump rioters on January 6, 2021; witnesses who later testified to Congress about the attack; and the senior public-health officials who led the federal government’s response to the coronavirus pandemic. As if to demonstrate that even the closest of Trump’s allies can still be in league with the forces of government treachery, the former president’s son-in-law, Jared Kushner, who helped speed development of the COVID vaccine as a member of Operation Warp Speed, also made Raiklin’s list.

Several former intelligence officials Raiklin has singled out told me they are well acquainted with his threats. They presume that if Trump is reelected, the Justice Department, the IRS, and other federal agencies will conduct capricious audits and frivolous investigations, all designed, if not to put them in prison, then to spend large sums of money on legal fees. A few told me they worried that Raiklin would publish their addresses or details about their families. They were less concerned about him showing up at their home than about some unhinged deep-state hunter he might inspire. In interviews with right-wing podcasters, Raiklin has said he would conduct “livestreamed swatting raids” against his targets. Swatting is the illegal practice of falsely reporting an emergency in order to summon armed law enforcement to someone’s home.

Raiklin’s future in a Trump administration is uncertain. But he is close to major figures in Trump’s orbit, particularly Michael Flynn, the former national security adviser who was indicted for lying to the FBI. Trump pardoned him in November 2020.

Raikiln is also a board member of America’s Future, a nonprofit organization that has pursued conservative causes for decades, of which Flynn is the chair. Other board members have amplified the “Pizzagate” conspiracy theory—promoted by the QAnon movement, of which Flynn is an ally—that some Democratic politicians kidnap, torture, and eat children.

Like Raiklin, Flynn has long railed against suspected deep-state actors, whom he has accused of torpedoing his career in intelligence. Flynn was regarded as a brilliant tactical intelligence officer when he served in Afghanistan and Iraq. But after he became the director of the Defense Intelligence Agency, senior intelligence officials worried that his erratic management style and conspiratorial attitudes made him unfit for the job. Top intelligence officials pushed Flynn out in 2014, after an unhappy and sometimes-tumultuous two-year tenure. James Clapper, who was the director of national intelligence at the time, is on Raiklin’s list.

A few years later, Trump named Flynn to be his national security adviser, a position he held for just 24 days. Flynn resigned in February 2017, following revelations that he’d had contact with Russia’s ambassador to the United States and given misleading statements to senior administration officials.

A Trump-campaign official told me that Raiklin has “no role or affiliation with the campaign.” Raiklin seems to like to suggest a relationship by promoting his physical proximity to Trump. In a post on X, he shared a photo of himself standing feet from Trump while he spoke from the lectern at an unidentified rally. Also standing nearby was Kash Patel, a fierce Trump loyalist said to be on a shortlist for a senior national-security position in a second Trump administration, possibly director of the CIA.

[From the October 2024 issue: The man who will do anything for Trump]

Raiklin is not shy about his aspirations. I sent him an email, requesting an interview about his deep-state list. Rather than reply, he posted a screenshot of my message on X and said he would “much rather discuss” the subject, as well as the direct appointment of electors through state legislatures, “with Americans operating in good faith.” He suggested a number of conservative podcasters he thought fit the bill.

Raiklin invited me to post my questions on X, “in the interest of public transparency and exposure and [to] show the world you are operating in good faith.” So I did.  

“What is the purpose of this list?” I asked. “Why did you select these people? Do you intend to do anything to the people on this list?”

Raiklin replied with links to videos of interviews he had already done with conservative media figures, including the former television star Roseanne Barr. On her show, Raiklin explained that although the deep state went by many other names—“permanent Washington,” “the Uniparty,” “the duopoly”—“I just simply call them war-criminal scum.”

“I happen to be the guy that said, You know what? I’ve had enough,” he said. “Let me expose them by name, date, place, transgression, category. And let’s start educating the country on who they are, so that they’re not able to walk anywhere, whether it’s in the digital space or physical space, without them feeling the, let’s just say, wrath of their neighbors, friends, relatives, family.”

Barr then sang to Raiklin lyrics from “The Ballad of the Green Berets,” to his obvious delight.

It’s hard to know whether Raiklin is a true believer—and potentially dangerous—or just a profiteering troll. His unwillingness to respond to direct questions from a journalist suggests the latter.

After I pressed Raiklin to answer me, rather than post interviews he’d done with friendly hosts inclined to agree with him, he invited me to direct further questions through Minnect, an app that lets you solicit advice from self-professed experts. According to his Minnect profile, Raiklin’s current rate for answering a question via text is $50. For $100, he’ll provide a recorded video response. A video call, “for the most personalized advice,” will run you $20 a minute, with a 15-minute minimum.

“Are you asking me to book you for a fee?” I wrote in his X thread. I wanted to be sure I correctly understood Raiklin’s proposal. He replied, “And 50% of the revenue created from the article you write. Send the contract to [his email] for my team to review.”

I declined.

A few days later, he was back to campaign work, exhorting state officials to intervene in the presidential election.

“Republican State Legislatures just need to hand their States’ electors to Trump, just like the Democrat elites handed the primary ‘win’ to Kamala Harris,” he wrote Wednesday on X, adding, “276 electors on Nov 5 ... CheckMate! Then we can Castrate the Deep State and Crush the Commies immediately on January 20, 2025.”