April 24, 2026
Dear Interested Readers,
MAHA and Other Healthcare Concerns
One underdeveloped component of my personal version of “Trump Derangement Syndrome” has been my failure to provide an in-depth discussion of the MAHA (Make America Healthy Again) movement initiated by Robert F. Kennedy, Jr. In case you aren’t sure about the meaning of Trump Derangement Syndrome, which I will abbreviate as “TDS,” Google’s Gemini (AI) defines it as:
Trump Derangement Syndrome (TDS) is a colloquial, pejorative term describing irrational, extreme negative reactions to Donald Trump’s presidency and policies, often disregarding his actual actions. Coined by Charles Krauthammer, it characterizes intense hostility or “general hysteria”. While often used by supporters to dismiss criticism, it is not a recognized medical condition.
The first link in the top line of this letter provides a Wikipedia overview of Trump Derangement Syndrome and links it to 2003, when physician-turned-conservative Pulitzer Prize-winning journalist Charles Krauthammer (HMS Class of 1975) coined the term “Bush Derangement Syndrome.” I also suffered from that Bush Derangement Syndrome, which now seems to have mutated or evolved to the even more crippling Trump Derangement Syndrome (TDS) condition. Each week, I have an internal battle. My first inclination each week is to write only about my fears and concerns as they have been exacerbated during the past week by our president, whose pathologies defy adequate description in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), published by the American Psychiatric Association in 2022.
I can usually calm myself enough to at least find some way to connect my Trump-generated psychopathology to some legitimate healthcare issue that will likely still include my concerns about the president, but at least touch tangentially on healthcare. In retrospect, perhaps since late 2024, I should have retitled the Friday letter as “Musings on Trump’s Current and Future Destructive Impact on Healthcare.” I apologize, before you read further, that my derangement seems to be getting worse since our “Dear Leader” has cast himself not as an “antichrist” but as some embodiment of Jesus himself. In his new fantasy, he has attacked the Pope, and his wannabe successor, VP Vance, has taken the cue and is trying to upstage his mentor with his own rude, ill-informed comments about what the Pope can and can’t say as he provides spiritual guidance for a billion-plus Catholic faithful. It seems to me like we are entering new territory in terms of mental and moral decline regarding the president, and derangement regarding the president for me. I have questioned whether I have some new form of PTSD.
I usually find it difficult to read the offerings of Thomas Edsall, who is a frequent contributor to the opinion pages of the New York Times. His posts, like my letters, are usually long. Mr. Edsall is 84. He has an interesting family history. He is the grandson of a former dean of Harvard Medical School. After a long career in journalism, he was named the Joseph Pulitzer II and Edith Pulitzer Moore Professor of Public Affairs Journalism at the Columbia University Graduate School of Journalism, where he also served as chair from 2006 to 2014.
Mr. Edsall has an interesting writing style that is not much different from the way I have written lately. He poses a question by email to experts and academics he knows, and then he constructs his piece by sharing the answers he receives and adding his comments to the received wisdom. I do something similar to construct my letters. I gather articles that interest me and then construct my letter by sharing and annotating what I have read. Mr. Edsal’s column this week was entitled “Easily the Worst President in U.S. History.” The first two paragraphs of the piece resonate with me. I think Mr. Edsall also has “Trump Derangement Syndrome.”
The damage President Trump has inflicted on the United States and the world is so enormous and wide-ranging that it is hard to grasp.
It runs the gamut from public and private institutions to core democratic customs and traditions, from the legal system to universities, from innocent targets of fraud to those duped into believing vaccines do more harm than good.
He continues with a description of all the deaths caused worldwide by Trump’s attacks on our healthcare, his withdrawals of foreign aid, and the abandonment of commitments to public health around the world. The numbers are staggering. Pardon the length of the quotation:
I have described in earlier columns bits and pieces of Trump’s destructiveness, but the list grows daily.
Projections suggest there will be millions of dead men, women and children as a result of his budget cuts, which were made without direct congressional approval. A study published in The Lancet, the London-based medical journal, found that Trump administration cuts in U.S.A.I.D. funding “would result in approximately 1,776,539 all-age deaths and 689,900 deaths in children younger than 5 years” in 2025 alone.
“Over the remainder of the period,” the study continues, “the complete defunding of U.S.A.I.D. would cause an estimated 2,450,000 all-age deaths annually, leading to a total of 14,051,750 excess all-age deaths and 4,537,157 excess under-5 deaths by 2030.”
There are the fraud victims who will never get court-ordered restitution because Trump pardoned the guilty. In a June 2025 report, Democrats on the House Judiciary Committee found that “Trump’s pardons cheat victims out of an astounding $1.3 billion in restitution and fines, allowing fraudsters, tax evaders, drug traffickers to keep ill-gotten gains.”
It doesn’t stop there. America can thank the president for environmental deregulation that could sicken and kill people by the tens or even hundreds of thousands.
I am sure that the president or his latest mouthpiece, Karoline Leavitt, would call this “fake news,” but even if only a fraction of these numbers is accurate, we would still be contending with an abomination of policy that doesn’t “Make America Great or Healthy Again,” but rather precipitates internal fear and international disgust. I won’t reproduce all the grim news, but you might be interested to know that it appears we have been glossing over the damage when we don’t try to get specific about the impact of MAGA policies. Below is a little more of the data Edsall presents:
Everything happens in such a rapid and scattershot way with Trump that it is easy to forget what happened as recently as last year.
An Associated Press investigation published in 2025 found that Trump’s Environmental Protection Agency was seeking to eliminate or weaken “at least 30 major rules that seek to protect air and water and reduce emissions that cause climate change.”
If successful, the E.P.A. would gut pollution rules that were estimated, according to The Associated Press, to save “more than 30,000 lives annually.”
At the same time, the administration has been canceling funding for lifesaving scientific and medical research. In November, JAMA Internal Medicine published “Clinical Trials Affected by Research Grant Terminations at the National Institutes of Health.”
It said that “in the first half of 2025, the N.I.H. terminated grants supporting 383 unique clinical trials, affecting 74,311 individuals.”
I have been interested in knowing what we could do to improve the lives and health of the American public if we spent the money we are squandering while undermining the world’s economies and killing thousands with Trump’s unlawful war in Iran. The government is not providing accurate cost estimates, but I read that experts suggest the tab is about $1 billion a day, if not more. That means we are approaching $60 billion, which would probably be enough to fund a year of universal pre-K for children ages 3 and 4, plus leave enough over to reinstate the ACA marketplace subsidies. What have we gotten for our $60 Billion? Not much but grief so far, and most analysts agree, not as much as Obama’s 2015 agreement negotiated without bombs, which Trump trashed in 2017.
Mr. Edsall goes on to catalog many of Trump’s other policy disasters we have suffered, such as tariff fiascos and our abuse of our NATO allies. The end result is that the world has changed. America is on the road to being an international problem, and any greatness we had before Trump turned our back on our leadership of the free world for the last 80 years has become a matter of past history. In my estimation, in his misguided attempts to bully the world in an effort to Make America Great Again, he has succeeded in making America loathed and distrusted by many nations that once were willing to see us as “better” and more trustworthy than China and Russia, if not the greatest nation in history. Trump has elevated the status and fortunes of China and Russia. Our status as the most respected and dominant nation of the world has been severely damaged since Trump took his hatchet to our tree of international life. The Chinese must be loving it.
At one point in his piece, Edsall confused me for a moment until I read the entire comment from one of his responders, who startled me by saying that Trump was one of the five most consequential presidents in American history. Before reading the whole statement, my 80-year-old brain was confused by the expert’s lumping of Trump together with Washington, Lincoln, FDR, and Lyndon Johnson, all of whom are easily defended as positively consequential.
Trump makes the list not for being positively consequential, but for being so destructively consequential that it will take us generations, if ever, to recover from the traumas of his presidency. I ask you, how long has it taken Germany to recover from following Hitler? Perhaps comparing what lies ahead for us to post-war Germany is inappropriate, but there is no doubt it will be decades before we recover the goodwill and trust of other nations that Trump has squandered with his schemes. Here is Edsall’s pen pal’s comment on Trump’s consequential presidency:
I asked Donald Kettl, a professor emeritus and former dean of the School of Public Policy at the University of Maryland and the author of “The Right-Wing Idea Factory: From Traditionalism to Trumpism,” which will be published in May, to assess — without regard to merit — how consequential the Trump presidency will be.
On this measure he placed Trump in the Top 5 of American presidents, alongside George Washington, Abraham Lincoln, Franklin Roosevelt and Lyndon Johnson, noting, however, that “Trump’s consequences have been aggressive efforts to unravel the ideas of the other four presidents.”
Being consequential is too diminutive for Trump’s ego. It is hard to imagine what is going on in his mind. Every time he calls Biden our worst president, I imagine he thinks he is the GOAT of presidents. I say to myself, as a manifestation of my TDS:
“You are no GOAT of presidents, but the title of ‘worst president of all time’ is yours without a doubt. Your conduct in office easily smells worse than Warren Harding’s or Andrew Johnson’s. Herbert Hoover was misguided and not capable of leading the country out of the Great Depression, but he had a little integrity and respected established norms. You fail greatness on all positive accounts. Your trademark scowl says it all.”
Edsall quotes an authority with more expertise than I have, as he justifies the title of the article, “Easily the Worst President in U.S. History.” He writes:
Michael Bailey, a political scientist at Georgetown, prefaced his assessment of Trump’s consequentiality by pointedly noting that he would rank Trump “as easily the worst president in U.S. history. The corruption and damage to long-term U.S. institutions and reputation are far beyond anything we’ve seen before,” including Andrew Johnson, James Buchanan and Rutherford Hayes.
As for being consequential, Bailey continued, Trump has been “highly consequential in an overwhelmingly negative way. He will leave a lasting negative legacy.”
Edsall doesn’t quit here. The article continues for another 926 words, extensively quoting correspondence from additional academic authorities. I will leave the remainder of the article for your perusal and move on to a few more comments about RFK, Jr. and MAHA confusion, since I believe that Trump’s appointment of him as Secretary of Health and Human Services was intended to efficiently undermine American healthcare as proposed in Project 2025. Mr. Kennedy has drawn negative attention to himself once again this week, with about 20 hours of bombastic, misleading, and frequently just false testimony before some angry members of Congress. If you want to read more about Mr. Kennedy’s adventures on Capitol Hill this week, click here.
Many of the initiatives on the Project 2025 agenda and other Trump administration policies have components that seem positive, which can be confusing as you try to imagine the impact if the ideas were fully implemented by humane, positive, and effective policies approved by bipartisan action in Congress. Who doesn’t want secure borders? Who doesn’t want to be healthier? Who isn’t afraid of being a victim of crime in our cities? Who wouldn’t like to make America secure from the threat of nuclear weapons from hostile nations like Iran? Who wouldn’t like to pay a smaller tax bill on April 15?
The bait and switch with MAHA is the idea that RFK, Jr. is trying to improve your health against resistance from a bloated medical research community, profit-oriented drug companies, the developers of potentially toxic vaccines, and the manufacturers of polluting and poisoning products that include everything from fast foods and cosmetics to industrial products you don’t even know exist. In his statement to Congress this week, he twisted reality when he shouted that there were no cuts to Medicaid and that chronic diseases kill two million Americans every year, while measles killed only three last year. The truth is that there will be no cuts to basic Medicaid until after the midterm elections, but there have already been significant changes to eligibility requirements, more frequent reviews of eligibility status, and substantial cuts to ACA marketplace subsidies. Millions have already lost coverage, millions have dropped their coverage because it has become too expensive, and millions more have had substantial increases in out-of-pocket expenses for their care. If Mr. Kennedy were really concerned about Americans dying of the chronic diseases they already have, he would be expanding the effort to give more Americans access to care, even as he launches his efforts against polluters and the producers of toxic products from food to insecticides, which contribute to the chronic diseases we currently have.
Trying to push back against the half-truths and the veiled consequences of the policies that the Trump administration is systematically implementing is difficult because of the huge number of programs at risk and the rapid barrage of attacks Trump and his cronies are making on the infrastructure of public services, education, and healthcare. In many ways, the seemingly positive components of RFK, Jr.’s MAHA movement complicate the resistance to Trump’s healthcare agenda as described in Project 2025. To help articulate the intertwined strategies, I turned to AI and asked, “How is RFK, Jr implemeting the healthcare ideas in Project 2025?” I don’t really expect most people to carefully read it all, but I hope that you will quickly scan the answer I got, including sources, which was:
As Secretary of Health and Human Services (HHS) in 2025, Robert F. Kennedy Jr. has implemented several healthcare initiatives that align with the goals of Project 2025, particularly through his “Make America Healthy Again” (MAHA) agenda, which focuses on restructuring public health agencies, challenging vaccine policies, and altering food safety regulations. PBS
While some observers initially saw his appointment as a departure from the traditional conservative framework of Project 2025, Kennedy’s actions in 2025 have mirrored many of its key proposals, including dismantling existing public health infrastructure and re-examining drug approvals. Guttmacher Institute
Here is how RFK Jr. has implemented key Project 2025-aligned ideas:
- Restructuring and “Dismantling” Public Health Agencies
Project 2025 advocated for splitting the CDC into separate agencies, removing its power to make policy recommendations, and introducing “strong political leadership” to federal health agencies. American Public Health Association
- Agency Overhaul: Kennedy has actively restructured the CDC and FDA, pushing out senior leadership, including CDC director Susan Monarez, and replacing them with officials aligned with his MAHA agenda.
- Cutting Scientific Staff: Reports indicate that under Kennedy’s leadership, the NIH and HHS have slashed funding for research on vaccines, HIV, and other areas, in line with Project 2025’s push to reduce the power of federal scientists.
- “Snake Pit” Rhetoric: Kennedy has publicly referred to the CDC as a “snake pit” and criticized its employees, aiming to change the culture of these agencies from within. NPR
2. Vaccine Policy and “Medical Freedom”
Project 2025 calls for stopping the CDC from issuing guidance on vaccines, limiting vaccine mandates, and removing the “double standard” in vaccine safety evaluations. American Public Health Association
- Vaccine Advisory Board Changes: Kennedy dismissed all members of the CDC’s independent vaccine advisory board (ACIP) and replaced them with known vaccine critics.
- Reassessing Childhood Vaccine Schedule: The MAHA Commission, under Kennedy’s direction, has pressured for a reassessment of the childhood vaccine schedule and is investigating the “combined impact” of vaccinations, questioning the established evidence-backed infrastructure.
- Ending COVID Vaccine Recommendations: In May 2025, Kennedy announced that COVID-19 vaccines would no longer be recommended for healthy children and pregnant women. NPR
- Reproductive Health and Medication Abortion
Project 2025 urges the HHS to restrict access to abortion medication, specifically mifepristone, and to use the Comstock Act to stop its distribution by mail. Guttmacher Institute
- Mifepristone Review: In 2025, Kennedy and the FDA Commissioner initiated a review of the safety of mifepristone, with the explicit goal of strengthening Risk Evaluation and Mitigation Strategy (REMS) restrictions to limit access. Guttmacher Institute
- Food Safety and Dietary Guidelines
- MAHA Agenda Implementation: Kennedy has used the HHS to target “ultra-processed” foods, pushing for bans on certain artificial dyes and working to restrict the purchase of sugary foods/drinks by SNAP recipients.
- Transparency Tool: His office launched a Chemical Contaminants Transparency Tool, aligned with the broader goal of questioning current food production methods. HHS.gov
- Shifting Funding and “Transparency”
- Cancellations of Research Grants: The Trump administration, with Kennedy leading HHS, has canceled hundreds of grants related to mRNA technology, DEI (Diversity, Equity, and Inclusion), and LGBTQ+ health, fulfilling Project 2025 goals of reducing “unscientific” or socially focused research.
- Targeting Health Workers: Kennedy has overseen the termination of thousands of federal health workers and senior leaders to remove those he claims have conflicts of interest with the pharmaceutical industry. American Public Health Association
While Kennedy’s focus is on his “MAHA” agenda—which also includes efforts to reduce chronic disease and lower healthcare costs—his methods for achieving these goals, such as undermining the established scientific consensus on vaccines and restructuring agencies, have heavily aligned with the strategies laid out in Project 2025. NPR
Before you turn away in hopeless dismay, let me remind you that this could all be brought to a screeching halt or at least significantly resisted by the power of investigation that belongs to the majority in the House. The majority can hold hearings, it can draw up a bill of impeachment. Better yet, if Democrats held both the House and the Senate, the change in climate could work wonders in the efforts to halt the damage occurring to our healthcare at the hands of MAGA and MAHA ideologues.
This week, the New York Times published an article entitled “The Doctor Will Seek Your Vote Now: Dozens of Democratic doctors are running for office in the midterms, including some spurred by opposition to Robert F. Kennedy Jr. and his anti-vaccine stance.” It was written by healthcare writer Nina Agrawal. The principal focus was on Dr. Annie Andrews, a pediatrician in South Carolina who is running for the Senate against Lindsey Graham, but it also mentions a host of doctors and nurses across the land who are running for public office.
Most of the healthcare professionals running in the Democratic primaries are in primary care specialties, and many, like Dr. Andrews, are women. Ms. Agrawal notes that historically, doctors in Congress have been male, often specialists, and Republican. Senator Cassidy, a gastroenterologist elected from Louisiana who is chair of the committee that enabled the confirmation of RFK, Jr., is a good example. Senator Barrasso of Wyoming, an orthopod, and Senator Paul of Kentucky, an ophthalmologist, are other examples of Republican physician legislators who have enabled resistance to policies that would promote the ideals of the Triple Aim or improve the Social Determinants of Health. I welcome and find hope in the concept of electing physicians to Congress who are running to prioritize the nation’s health over the profitability of medical practice. We will see if voters will improve their own health with their ballots in November. I can hope the midterms bring some relief, and you can be assured I will keep reminding you of our need to work together to elect a Congress that will cut our healthcare losses, defang RFK, Jr., and begin the repair of the damage to our nation wrought by the worst president in our history.
Despite My TDS, I Have Much To Celebrate!
My wife and I had planned to go to Maine last weekend to visit our 2-year-old grandson, his parents, and my wife’s nursing school friend and her husband, who live near our son’s family. We knew it would probably be our last visit before the birth of the grandson we were expecting on May 11.
Early Saturday, before leaving for Maine, we got a text from our son saying they were at Maine Medical Center and that the new grandson was on the way, a little ahead of schedule. The little fellow took his time, but he finally arrived in good shape at 6:53 AM on Sunday, April 20. Everybody was so exhausted that we just had a pleasant visit with my wife’s nursing school buddy, who is a great cook, and satisfied ourselves with dozens of pictures and texts while we let the mom, pop, and the new arrival recover.
I was very worried for over 24 hours, but now all is well. Simon Mitchell Horton-Lindsey came in at 6 pounds and 11 ounces and 18.5 inches despite being 3 weeks early. He has a lot of hair, big hands and feet, and in my opinion, is a good-looking young fellow. One worry had been how well received he would be by his older brother. It turns out that with a lot of prep and good friends to help him have a good time while his little brother made his entrance, the older grandson is as delighted as I am with his status as big brother.
It has been a chilly week here. We actually had a nice covering of snow late Sunday that quickly cleared on Monday, but our nighttime temps remain mostly below freezing. Last week, we had enjoyed an early preview of summer, but this week, we have had a chilly reminder that winter lasts as long as it wants to, and spring is a fleeting and unreliable concept.
Despite the chillier weather, the loons are back. Just as I never tire of looking at pictures of my grandchildren, I never tire of pictures of our loons. My neighbor, Peter Bloch, published a loon video this week, and I have lifted today’s header from the 3-minute gift. Click here to see the whole presentation.
We have a few daffodils, and I can see magnolia and forsythia buds getting ready to burst out soon. Let me suggest that you combat any TDS you might have by being out and about in some pleasant early-spring weather this weekend.
Be well,
Gene
