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Opini | Bagaimana menghancurkan kesehatan bangsa, dengan angka

Opini | Bagaimana menghancurkan kesehatan bangsa, dengan angka

Sources: HHS TAGGS; Grant Watch

Note: Data as of June 23.

The administration has upended the operation of almost every agency that deals with our health and medical care, leaving behind fewer staff members and programs to address critical needs, and changing policies in ways that could endanger us all. Regulations to protect health and safety are being lifted. Experts who monitor health threats have been fired. Medical schools are threatened. Congress is poised to make huge cuts to Medicaid, which would leave millions of Americans without health care coverage and force closures of health clinics, many in rural areas.

Don’t get me wrong, I am not defending the status quo. There is plenty of waste and inefficiency to fix in health care and research, and fresh approaches can help. But dismembering health agencies won’t improve efficiency. Real change comes from streamlining programs to better serve the public, not from closing programs and walking away.

The ripple effects of the havoc at health agencies will eventually reach you. The air you breathe could become more polluted because the administration is permitting factories to resume emitting toxins. Your drinking water could contain lead because the administration is closing lead abatement programs. Bacterial contamination of your food may increase since food safety workers have been fired. There may be fewer primary care doctors in your community because the administration is cutting funding for training programs. Cutting-edge treatments may be unavailable because the N.I.H. has terminated clinical trials.

Source: Cleary et al., JAMA (2023)

The logic is baffling. Even though the United States faces a mental health crisis, especially among youth, the Trump administration is slashing funding for programs on mental illness, addiction, domestic violence and suicide prevention. It’s no longer offering specialized support to L.G.B.T.Q. callers to the national suicide prevention hotline, and it’s cutting nearly 600 contracts for the Department of Veterans Affairs. It canceled funding for a desperately needed program that expanded the number of mental health professionals in our children’s schools, which had won bipartisan support in Congress after the mass shooting in Uvalde, Texas. Unintentional injuries are the leading cause of death in children, but the administration has all but eliminated the injury prevention center working on efforts to prevent deaths from poisoning, car accidents and drownings.

Diseases that are preventable and rare in modern countries may now pose a threat in the United States. The measles outbreak is our first warning. Other vaccine-preventable diseases will increase if politicians like Mr. Kennedy continue to cast experts aside, roll back immunization guidelines and sow doubt about their safety.

All this under the banner of “Make America Healthy Again.” In a dangerous sleight of hand, Mr. Kennedy goes before cameras to make a big deal about food dyes and bizarre claims about autism while his department erases programs to address the nation’s leading chronic diseases. For example, smoking is the leading cause of preventable deaths in the United States. If this administration’s goal is truly to make America healthier, why has it effectively shuttered the nation’s top office on smoking? Mr. Kennedy rightly promotes the importance of healthy eating, but the administration is cutting funding for food assistance. He warns about the dangers of pesticides, but the administration is reportedly reconsidering a ban on asbestos and is moving quickly to relax other regulations meant to protect Americans from toxins.

Planned cuts by the Trump administration would defund research on the leading causes of death

Heart disease 681,000 National Institute on Body Systems* -39%
Chronic lower respiratory diseases 145,000
Diabetes 95,000
Cancer 613,000 National Cancer Institute -37%
Stroke 163,000 National Institute on Neuroscience and Brain Research* -40%
Alzheimer’s 114,000 National Institute on Aging -40%
Drug overdoses 97,000 National Institute of Behavioral Health* -38%
Suicide 49,000
Covid, flu and pneumonia 95,000 National Institute of Allergy and Infectious Diseases -36%

Sources: HHS.gov; CDC WONDER

Note: Annual deaths as of 2023. Proposed funding cut figures are based on the difference between 2025 and 2026 budget proposals. Institutes with asterisks are proposed consolidations of existing N.I.H. institutes.

Organizations like the American Medical Association are beginning to speak out, but their comments are largely restricted to specific issues such as Medicaid or immunization guidelines. The threat to the health of Americans is larger than one issue. It’s about more than Medicaid. It’s about more than vaccines. It’s about the totality of the administration’s agenda. It’s the cumulative effects of the entire basket of policies that put Americans at greatest risk.

Physicians like me know from the data that lives will be lost as a consequence. More than 6,000 health professionals (myself included) have warned the public about their concerns in an open letter. Yet institutions of all kinds seem to be cowering to Mr. Trump, afraid of being punished or prosecuted for questioning his wishes. The administration has defied the courts and gone after law firms and universities, and is unlikely to spare medicine. Just as it has pressured the media to alter the news, the government is now challenging medical journals to alter what they publish.

Times like these call on us to speak the truth. On matters of life and death, physicians like me have an added duty to warn patients and the public. People may feel that a shakeup in Washington is long overdue. But too many Americans, including our leaders, take their health for granted, assuming that the infrastructure to prevent disease and save their lives will always be there, that America will always lead the world in science and that systems to keep their children safe will always exist. None of this can be counted on, especially now.

About this data

For this analysis, The New York Times used data from the lists of terminated grants provided by the Department of Health and Human Services, as well as a crowdsourced list of grant terminations by Grant Watch. In cases where grants could be included under several categories, grants are listed under the category corresponding to the central focus of the research.

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