This post began as a litany of the devastating cuts the Trump administration already has made to public health and the even more extreme ones it will have to make now that Congress has passed the very big, very ugly bill. I gathered statistics from multiple reports, kept them in a pile on my desk, and then found I couldn’t bear to read them. So I decided instead to explore how members of the Trump administration justify dismantling a system that advances the wellbeing of us all. In his recent Substack entry, Robert Reich, the former Secretary of Labor, referred to the “magnet of malevolence” surrounding Trump, noting how the people closest to him are “amplifying his cruelty.” How do people tarred with those words live with themselves? Below are four of the major arguments they use to justify their actions.
The first is that essential services are simply “waste, fraud, and abuse.” Trump campaigned on that slogan, and Elon Musk used it to justify DOGE’s brutality. Just before Congress voted on the budget bill slashing Medicaid to give tax breaks to the wealthy, Trump tried to ensure its passage by issuing an executive order titled “Eliminating Waste, Fraud, and Abuse in Medicaid.” How then should we view the waste of 500 tons of emergency food that was allowed to expire and had to be incinerated rather than distributed to poor children around the world? And the Trump administration is about to destroy a $9.7 million stockpile of contraceptive devices intended for use by women in Sub-Saharan Africa because Trump shut down the agency scheduled to distribute the contraceptives—the U.S. Agency for International Development (USAID). In a New York Times column titled “The Waste Musk Created,” Nicholas Kristof gives another example of Trump’s squandering of taxpayer dollars: a West African warehouse filled with medicines donated by US pharmaceutical companies for another USAID program. “Yet the medications are gathering dust,” Kristof writes, “and some are approaching their expiration and may have to be destroyed, at immense expense.” Traveling through Sierra Leone and Liberia, Kristof found children “dying because medicines have been abruptly cut off, and risks of Ebola, tuberculosis and other diseases reaching America are increasing.”
The second argument used by Trump and his supporters is that empathy is not a virtue and in fact can be even more harmful than cruelty. According to the head of the Baptist Theological Seminary, empathy is “used politically in ways that are very destructive and manipulative.” Elon Musk made a similar claim on Joe Rogan’s podcast in February, declaring that “the fundamental weakness of Western civilization is empathy.” He told Rogan that Democrats “are exploiting a bug in Western civilization, which is the empathy response.” Two recent books help to spread that message: the New York Times bestseller, Toxic Empathy: How Progressives Exploit Christian Compassion, by Christian podcaster Ellie Beth Stuckey, and The Sin of Empathy: Compassion and Its Counterfeits, by Joe Rigney, a pastor. “By the end of their books,” David French observed in a New York Times book review, “both authors suggest that empathy as it exists is the work of the Devil and his minions.”
In a Fox News interview in January, JD Vance defined the Catholic doctrine ordo amoris (order of love) this way: “You love your family, and then you love your neighbor, and then you love your community, and then you love your fellow citizens in your own country. And then after, you can focus and prioritize the rest of the world.” Pope Francis was among the many people who responded to Vance’s claim with outrage. “Christian love is not a concentric expansion of interests that little by little extend to other persons and groups,” he wrote. “The true ordo amoris that must be promoted” is “love that builds on fraternity open to all, without exception.”
The third argument is that wellness products and services are all we need to serve our health needs. Of course, the wellness world was around long before Trump returned to the White House. According to the Global Wellness Institute, the global wellness market is valued at $6.3 trillion. Americans are some of the biggest consumers of wellness products and services; the US market is worth $1.8 trillion.
What has changed since January 2025 is that Robert F. Kennedy, Jr., long an enthusiastic advocate for the wellness industry and a recipient of its largesse, is now the U.S. Secretary of Health and Human Services. Since his confirmation, he has opened the floodgates for entrepreneurs with dubious medical credentials.
The wellness industry and longtime public health officials do agree on one point—illness prevention must receive far more attention. Casey Means, nominated to be U.S. surgeon general, claims that she left her medical residency because she wanted to focus on the causes of disease rather than on “sick care.” The American Public Health Association (APHA) frequently points out that although 75 percent of the causes of premature death are preventable, the health care system spends a mere three percent of its resources on illness prevention.
In every other way, the wellness industry and the public health system are diametrically opposed. Like many of the administration’s policies, the embrace of wellness shifts responsibilities from the government to individuals. In contrast, public health relies on government programs and laws to safeguard the health of the entire nation. The wellness industry pushes products and services that have not been proven to help and may in fact harm. Public health relies exclusively on evidence-based medicine. Hawking expensive products and services, the wellness industry serves those who need it least.
A recent CNN article by Kati Chitrakorn suggests that the wellness industry has transformed health into a commodity. “For many people,” she writes, “good health is a precious asset—one that has arguably become more valuable than material possessions.” The bulk of the article focuses on the spa that Dior will soon open in its refurbished flagship store in New York. Chitrakorn quotes Thomas Serdari, Luxury and Retail MBA director at the NYU Stern School of Business, who observes that unlike the many spas that cater to the “bottom of the pyramid,” Dior’s spa “targets the top: It’s as luxurious as it gets.” In contrast, the APHA, defines public health as an endeavor that “promotes the health of all people and their communities.”
In a 2023 interview, Naomi Klein, the well-known Canadian author and social activist, pointed to the “explicitly supremacist views” of the wellness world, citing statements such as, “Well, maybe they should die. If they don’t take care of their bodies, that’s not my problem.” Klein would not have had to look hard for a wellness champion expressing that view. Three years earlier, at the height of the Covid-19 pandemic, Casey Means and her father wrote, “It is, without exaggeration, a Darwinian moment for America. Americans must build personal immunity defenses through radical changes in diet and exercise, or risk getting sick and dying.” More recently, a May 2025 article in the Guardian noted that RFK Jr. is “at best indifferent, and at worst welcoming, of the idea that those who don’t heed his counsel might die.” As Klein concluded, “Once you start ranking human life and deciding that certain people have more of a right to live than others, you’re going down a pretty ominous path.” Violently arresting and deporting immigrants and slashing the safety net for vulnerable populations, the Trump administration and its supporters make it clear that only some lives are worth saving.
The fourth argument is that public health has lost its way. In a recent article in The Atlantic, John Tierney, a former professor at Boston College, contends that at the turn of the 20th century, public health was primarily concerned with epidemics. Now it seeks to promote social justice, a goal Tierney condemns as “ideological.”
It hardly needs to be said that a vital reason public health officials today focus less on epidemics than before is that, until the measles epidemic erupted under Kennedy’s watch, we could count on vaccines to stave off the worst health threats. And Tierney is simply wrong when he argues that public health in the late 19th- and early 20th-centuries was not concerned with social justice. Allying themselves with housing and labor reformers, public health officials viewed their mission as ameliorating the environmental and working conditions that helped to spread disease. They campaigned for laws requiring indoor plumbing in new houses, restricting housing density, ensuring the quality of food and water, regulating slaughter-houses and tanneries, improving working conditions, and abolishing child labor.
To be sure, the turn of the twentieth century was hardly the golden age of public health. Throughout the United States, public health officials helped to inflame prejudice against immigrants by associating them with epidemics. Although John L. Pomeroy, the chief health officer of Los Angeles County from 1915 to 1940, had the overwhelming task of building public health infrastructure for a rapidly expanding population, he focused on the need to protect whites from Mexican immigrants, whom he considered unusually susceptible to, and carriers of, dread disease. When the great flu epidemic of 1918-19 struck Los Angeles, Pomeroy explained why he had sent guards to one neighborhood: “conditions among the Mexicans made it necessary to safeguard the rest of the population.” We hear similar comments today from many governmental officials about immigrants and infectious disease.
So here we are now—a country that recycles old myths about the relationship between immigrants and disease, views empathy as destructive, derides medical expertise, and condemns social justice. We can do better.
Emily K. Abel is professor emeritus at the UCLA-Fielding School of Public Health. Her most recent book is Gluten Free for Life: Celiac Disease, Medical Recognition, and the Food Industry (NYU Press, 2025).
Sources
Derek Beres, “Maga’s Era of ‘Soft Eugenics’: Let the Weak Get Sick, Help the Clever Breed,” Guardian, May 5, 2025.
Casey Means and Grady Means, “Healthy Food: The Unexpected Medicine for COVID-19 and National Security,” The Hill, April 21, 2020.
Mira Miller, “Naomi Klein on the Link between Wellness Influencers and Far-Right Propagandists,” Globe and Mail, October 5, 2023.
Robert Reich, “Trump’s Magnet of Malevolence: Why Miller, Voight, Bondi, Patel, Noem, Vance, Kennedy Jr., Rubio, and Hesgeth Are Amplifying His Cruelty,” July 11, 2025, available here.
“Eliminating Waste, Fraud, and Abuse in Medicaid,” Presidential Memoranda, June 6, 2025, www.whitehouse.gov.
David French, “Behold the Strange Spectacle of Christians against Empathy,” New York Times, February 14, 2025.
Kati Chitrakorn, “’Hauture Couture” Facials and Re-Engergizing Mattresses: Inside Dior’s First Permanent Spa in the US,” CNN, August 5, 2025.
Colleen Derkatch, Why Wellness Sells: Natural Health in a Pharmaceutical Culture (Baltimore: Johns Hopkins University, 2022).
Amy L. Fairchild, et al., “The EXODUS of Public Health: What History Can Tell Us about the Future,” American Journal of Public Health, 100, no. 1 (January 2010).
Emily K. Abel, Tuberculosis and the Politics of Exclusion: A History of Public Health and Migration to Los Angeles (Rutgers University Press, 2007).
Nicholas Kristof, “The Waste Musk Created,” New York Times June 21, 2025.