By Irwin Redlener
Former President Barack Obama once said, “elections have consequences.”1 But historically, the consequences tend to be less dramatic than supporters of the winning candidate hoped for—and less than opponents feared. That’s because the American system of government, driven by the principles laid out in the US Constitution, explicitly establishes checks and balances designed to shield us from the domination of extremists of any political stripe.
For well over 200 years, those principles have held. But since the second inauguration of President Donald Trump, our country is facing an existential crisis of constitutional fragility2 across every aspect of government and governing in the United States.
For doctors and for public and global health, the Trump administration’s executive orders and plans are beyond worrisome, as is the confirmation of Robert F. Kennedy Jr.3 as Health and Human Services (HHS) secretary. Proposed disruptions or elimination of vital healthcare access for vulnerable populations,4 massive cuts in critical medical research,5 and withdrawal from long-standing commitments to global health6 will affect all of us.
But with major medical organizations standing by rather than leveraging their influence to intervene, many physicians and other healthcare professionals are left wondering, “What can I do?”
An Attack on Public and Global Health
The impacts of these new policies regarding patient care and public health are neither accidental nor shambolic. The plans are organized and intentional, just as spelled out in Project 2025,7 the radical roadmap designed to upend the way the federal government prioritizes and functions (despite Trump’s claims that he had “nothing to do with”8 it).
Some of you may be thinking, “Well, good! The health ‘system’ is broken; it needs a wholesale shake-up.” Maybe you’re focused on the negative impact of bureaucrats on your practice, or the influence of health insurers on clinical decision-making, or how pharmaceutical companies may be exploiting you and the public. Maybe you think we’re spending too much money on the health and well-being of people outside the United States or on programs that appear wasteful.
There is some legitimacy to many of these concerns. We absolutely need positive reforms, more accountability for health-related expenditures, and the return of more control over medical practice to doctors. But that’s a far cry from what the new administration has in mind.
As seen in AFT:
