RFK Jr: You Do Not See What You Are Seeing
Trumpian gaslighting is more akin to 1984-style re-education ("How many fingers?")
Note: Today is the 8th anniversary of Single Payer Links (now a podcast called “Do Not Resuscitate”). It started out in 2017 as a group education exercise for our committee to learn the nuances of why we need a single-payer health financing system to cut out the parasitical insurance industry and to assist us in engaging people in discussions.
I believe there is a larger audience for this weekly digest given the urgency of a building a mass movement to preserve Medicare/Medicaid and to demand a sane alternative to the increasingly dysfunctional current system that Trump is making a complete disaster. To that end, I have migrated here to Substack.
I go through several hundred pages of reporting on relevant topics each week, boil them down to key items to illuminate trends, and annotate the articles to give readers the salient points. I would like to ask everyone who finds the digest useful to help me circulate it to people who need this kind of information for their advocacy efforts. Please share with individuals and groups and encourage them to subscribe here.
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SINGLE PAYER LINKS #389
11 APR 2025
I believe one important aspect of the Trumpian assault is psychological, specifically the habit they have of looking us straight in the eye and saying they are not doing what they are doing. The standard term for this pattern is “gaslighting,” but this is more akin to the even cruder, Orwellian variety: we beat you senseless until you see how many fingers we say we are holding up versus what your eyes tell you. This week’s Do Not Resuscitate has multiple examples.
The on/off tariff whiplash is so fluid that I’ll save any attempt to review their impact to next week or beyond.
Listen here: https://www.podbean.com/eas/pb-8dv2s-18788b8
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Rebecca Pifer, “Trump’s CMS dramatically raises payments to Medicare Advantage plans,” Healthcare Dive, Apr 8, 2025 https://bit.ly/3XS8iOp
Medicare Advantage—the most glaring example of waste, fraud, and abuse in the federal health budget—is getting a “massive gift” in the form of a higher reimbursement rate—5.1%—plus a more generous calculation of their risk scores. Insurance stocks took off while the rest of Wall Street was plummeting. “Humana, which is particularly exposed to MA, quickly climbed 16% after the rates were announced.” It will provide plenty of extra cash for the next round of campaign contributions while the giveaway will be funded with even deeper cuts everywhere else.
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Arielle Zionts, “Rural hospitals questions whether they can afford Medicare Advantage contracts,” KFF Health News/States Newsroom, Apr 8, 2025 https://bit.ly/4jqVeI1
While the financiers get a huge payoff, rural hospitals are ending their MA contracts because insurers aren’t passing along the bounty. Even traditional Medicare, notoriously stingy, pays better than the MA grifters. Complaints also include payment delays and obstructionist prior authorization practices. As hospitals bail, local patients with MA plans have to seek care farther and farther away. A hospital CEO in rural Georgia said he “had to set up a team to deal solely with coverage denials, mostly from Medicare Advantage companies,” including refusals to pay for services they already had approved. These are mostly bright red GOP zones—is anyone noticing yet?
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Nathaniel Weixel, “How Kennedy’s cuts to HHS could curb ‘MAHA’ agenda,” The Hill, Apr 7, 2025 https://bit.ly/3G1Q8nf
RFK Jr argues that federal workers weren’t “doing their jobs” resulting in poorer health for Americans, so he has to “streamline” the agencies. How is that working out? We now have no scientists to test for food and drugs contaminants and no staff to respond to disease outbreaks. We also no longer have a Division of Environmental Health Science and Practice to address all those nasty additives that Kennedy pretends to care about, like lead in applesauce. And that concern about children with asthma? He abolished the entire CDC National Asthma Control Program.
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Drew Altman, “Decoding the HHS reorganization,” KFF Health News, Apr 01, 2025 https://bit.ly/4joJZj8
RFK Jr and Musk claim they are bringing “efficiency” to HHS, but the real impact is not “moving boxes around on the organizational chart” but the tens of thousands of staff reductions. The new Administration for a Healthy America will now include an alphabet soup of former HHS subunits, but “it isn’t at all clear how their restructuring with a name change will reduce chronic diseases and their causes.” Some branches disappeared completely such as the Office of Infectious Diseases and HIV/AIDS Policy (too gay), the Office of Minority Health (too black), and the Administration for Community Living (too woke). Instead, we get new outfits like the Office of Vaccine Injury and the Assistant Secretary for Strategy to be run by Kennedy’s toadies.
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Suzanne Gordon, “How vets will fare in Missouri in DOGE’s VA,” VA Champion/St Louis Post Dispatch, Mar 28, 2025 https://bit.ly/42EBQl2
Our troops are great! Thank you for your service! We will never abandon you! (How many fingers am I holding up??) As Trump fires 80,000 employees of the Veterans Administration, we’re supposed to believe that everything will be even better than before. That’s because vets will now be referred to a network of “equally qualified private sector providers” who receive $30 billion a year in government cash to provide substitute services.
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Wendell Potter, “Report shows how UnitedHealth Group is enriching itself at the expense of our nation’s veterans,” Health Care Un-covered, Mar 18, 2025
The “Veterans’ Community Care Program” is privatization with a fancy name. Federal money previously funneled through the VA now goes to big health insurance companies like UnitedHealth who then overbill the government just like they do with MA plans, as documented by the VA’s own inspector general. The IG showed how UH’s Optum subsidiary vacuumed up millions in overpayments by charging the government more than it paid to subcontracted providers. Due to a loophole in the contracts, it was all legal.
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Brenda Goodman, “A city responding to a lead crisis in schools reached out to the CDC for help. The agency’s lead experts were just fired,” CNN, Apr 3, 2025 https://bit.ly/4lqid7U
RFK Jr promised to end “America’s epidemic of chronic illness by focusing on safe, wholesome food, clean water, and the elimination of environmental toxins.” Sounds great, let’s proceed! When Milwaukee public schools, full of dangerous lead dust from pre-1970s constructions, asked the CDC to help, it did—but then its lead experts all disappeared. As CDC staff working on toxic substances are “absorbed” into the MAHA-laden Administration for a Healthy America, an HHS flak assured reporters that the office “did not have any cuts.” (I am holding up how many fingers??) If the employees working on lead paint are out there somewhere, Milwaukee can’t find them. Maybe they’re headed to prisons in El Salvador?
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Alexander Tin, “RFK Jr. cuts CDC labs investigating outbreaks of STDs and hepatitis,” CBS News, Apr 3, 2025 https://bit.ly/42Dm1ey
All the CDC’s labs handling sexually transmitted diseases and hepatitis are closed. “There was not enough time for scientists to properly shut down the laboratories before they were locked out from their email systems and the building with equipment still running and hazardous materials left unattended. Specimens [from state labs] have continued to arrive with no one from the agency’s now-gutted lab staff left on the job to handle them.” We care about your health!
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Brett Kelman, “Trump says he’ll stop health care fraudsters. Last time, he let them walk,” KFF Health News/CBS News, Apr 1, 2025 https://bit.ly/4icBSFj
Trump and his minions can’t stop talking about fraud. But major fraudsters—if they’re connected—can count on Trump for get-out-of-jail-free cards. The CEO of a pain clinic got prison time for a $4 million kickback scheme. Four months later, Trump pardoned him, saying that “no one suffered financially” from his crime. What about the federal money that he scammed? Waste, fraud & abuse! Waste, fraud & abuse! The article details a string of similar cases: “Trump has granted pardons or commutations to at least 68 people convicted of fraud crimes or of interfering with fraud investigations,” including 13 fraudsters who scammed a billion and a half from Medicare and Medicaid. He also fired all 17 independent inspectors general who used to perform audits.
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Megan Molteni & Ed Silverman, “Federal advisory panel on ethical, legal issues in human health research disbanded,” STAT, Apr 3, 2025 https://bit.ly/3G1Abxk
Institutional review boards (IRBs) monitor research to make sure human subjects are not abused Tuskegee-style. But if there’s no research, who needs research reviews? As a matter of fact, why do we need to think about ethics and legality? It’s so last year. “Members were informed over email that their service was complete.”
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Jeremy Faust, “Patient safety network abruptly cut by Trump Administration,” MedPage Today, Apr 1, 2025 https://bit.ly/3EhoL87
Three decades of work up in smoke as Trump “suddenly” cut all funding for the Patient Safety Network and stopped its work on decreasing medical errors. “The funding has ended. We sincerely thank our 41,000 subscribers and millions of readers across the country.”
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Carla K. Johnson, “Trump administration cancels at least 68 grants focused on LGBTQ health questions,” Associated Press, Mar 24, 2025 https://bit.ly/4i5Zv2p
Dozens of institutions lost their funding for the now verboten LGBTQ world. One at Vanderbilt had been following the health of hundreds of LGBTQ seniors; the data will be lost as no one will follow up. “We now have no one anywhere studying LGBT cancer in the United States.” The termination letters said the research did “nothing to enhance the health of many Americans.” All you oddballs don’t need your health enhanced given that you are not “many Americans.”
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Hayley Smith, “‘Inbox from hell’: Environmental groups outraged after EPA says polluters can email for exemptions,” Los Angeles Times, Mar 29, 2025 https://bit.ly/3EhFmZt
RFK Jr: We must address the causes of chronic disease and remove dangerous substances from our environment! Reality: “The EPA has set up an electronic mailbox to take companies’ requests for presidential exemptions from provisions of the Clean Air Act,” exemptions like permission to dump coal plant waste or copper smelter emissions. “The announcement also contained a template for applicants to use in their requests.”
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Tara Bannow, “Largest U.S. pension fund claims UnitedHealth cheated investors by concealing Medicare Advantage scheme,” STAT, Mar 26, 2025 https://bit.ly/4cn4Hh6
California’s giant public pension fund, CalPERS, sued UnitedHealth for hiding the company’s illegal MA upcoding behavior for years and harming the fund’s investment. Named defendants (including one Brian Thompson) are accused of knowing of UH’s legal troubles and selling off their own stock profitably before the news emerged. But what if Trump lets UH and other MA insurers off the hook, and the company’s profits are safe?
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Wendell Potter, “Not just Democrats anymore. Republicans mounting a crackdown on big health insurers,” Health Care Un-covered, Apr 3, 2025 https://bit.ly/42xq7Uu
A bright spot: bipartisan worry over MA abuses and costs. Both Rs and Ds, says Potter, are “focused on concrete policy solutions to stop insurers from gaming regulations, overcharging taxpayers, and undermining free-market competition through monopolistic behavior.” He points to some of MA’s original boosters, like Iowa senator Chuck Grassley, who are having second thoughts.
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Lao-Tzu Allan-Blitz & Jeffrey D. Klausner, “Why hasn’t RFK Jr paused drug ads?” MedPage Today, Apr 3, 2025 https://bit.ly/4lw1ZKz
The average American watches nine drug advertisements a day. RFK Jr could take action; the authors never say why he hasn’t.
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Alexander Tin, “RFK Jr.'s layoffs expected to gut worker safety agency NIOSH, officials say,” CBS News, Mar 31, 2025 https://bit.ly/3YqyKyC
At least two-thirds of the staff at the 75-year-old National Institute of Occupational Safety and Health (NIOSH) are expected to be laid off. No “health hazard evaluations” will take place for weeks, and a national registry of cancer in firefighters is suspended. Everything will be moved over to the reorganized MAHA super-agency where they can study autism and vaccines.
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Jie Jenny Zou, “Trump’s federal cuts push New York mental health programs to brink of collapse,” New York Focus, Mar 31, 2025 https://bit.ly/3G3ktBT
Trump: Fentanyl is a big threat to America. Solution: slash “tens of millions in grants for addiction and mental health services.” The logical result is mass layoffs, program reductions, and closures of things like 24/7 stabilization centers for the mentally ill, 988 hotlines, and other programs. New York State upped its spending on mental health, but those funds were to be used in conjunction with federal dollars. (NYC just lost $100 million.) Look for more mentally ill homeless people to roam our subways.
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David Moore, “Joe Manchin heads to K Street,” Sludge, Feb 17, 2025 https://readsludge.com/2025/02/17/joe-manchin-heads-to-k-street/
No more revolving door, right? Drain the Swamp, etc. Outgoing senator Manchin (D-WV) zipped across town to a lucrative post with investment giant Apollo’s insurance arm, Athene. Apollo is the biggest PE owner of U.S. hospitals. Surprised he wasn’t hired by Dr Oz.
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Lizzy Lawrence, “Makary’s first speech to FDA staff focuses on challenging norms, fighting chronic disease, STAT, Apr 2, 2025 https://bit.ly/3RLMvUM
FDA chief Makary was more popular at his hearings than the obvious crackpots, but his first appearance to his devastated workforce was a tone-deaf pep rally. He made sweeping declarations about the need to “identify the root causes of chronic disease” but made no references to the mass firings, making him look like RFK’s, let’s say, prison servant. RKF fired top regulatory staff at the agency’s centers for new drugs, biologics, tobacco control, and veterinary medicine as well as library, policy, management, and communications staff. But remaining FDA employees got “an emotional anecdote about how Makary’s father once gave a cancer patient a hug at the grocery store.”
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Kelly Hooper, “Means defends HHS cuts, calls bureaucracy an ‘utter failure,’” Politico, Apr 2, 2025 https://bit.ly/3FWG5zB
Kennedy BFF Calley Means tells us that “not $1 of services has been cut.” (I still see four fingers, Mr O’Brien!) Means also said HHS has been controlled by industry lobbyists and the “medical establishment,” which they’ll replace with supplement hawkers and different industry lobbyists.
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Anil Oza & Sharon Begley, “Why a small journal’s ‘blueprint for NIH’ may offer clues to the agency’s future,” STAT, April 3, 2025 https://bit.ly/3Eeqb3b
Martin Kulldorff, a co-signer (with NIH chief Bhattacharya) of the infamous Great Barrington Declaration, has now authored a blueprint on how the NIH should be “reformed.” One key element in the change is to “be more open and transparent and have open scientific discourse.” You achieve this by firing all your public information officers.
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David Lim, “The health industry is starting to express alarm about RFK Jr.,” Politico, Apr 1, 2025 https://bit.ly/4ln3dri
Drug and medical device makers thought Trump’s assault on the regulatory apparatus would suit them fine and so kept quiet. But now they’re a tad worried that dismantling the entire government might be bad for their businesses. The main Pharma lobby cautioned that the FDA “has the expertise and capacity it needs to maintain its gold standard regulatory review.” And here I thought NO regulatory review was the ideal.
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Sarah Todd & Isabella Cueto, “Make America Healthy Again is ringing through statehouses across the U.S.,” STAT, Mar 26, 2025 https://bit.ly/4ispgdH
Some states are following the lead of California and New York in getting ahead of the feds on dyes, preservatives, and other regulatory matters. West Virginia banned most artificial coloring; Oklahoma is going after artificial sweeteners; and Texas wants warning labels on additives that are banned in other countries. OTOH, states are starting to prohibit fluoridation of drinking water and restricting mRNA technologies. Industry is “expressing concern” about having to deal with a patchwork of state-by-state regs after they successfully wrecked federal regulation. BOO HOO.
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Tim Henderson, “Some measles response plans crash to a halt after Trump cuts,” Stateline, Apr 8, 2025 https://bit.ly/4j4oWTp
While federal grants to deal with measles were abruptly cut off, states are warning about “‘measles parties’ where people try to expose themselves and their children to the disease hoping to gain immunity.” Maybe autism comes from having parents like those.
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