Sobering Stories (and more bullshit) - October 25, 2025

Welcome back to another edition of The Public’s Health. Much of the media has focused squarely on the sudden demolition of the East Wing of the White House. The world of public health is still turning, even if Trump has destroyed the girl-zone of the White House, so here I am with some news for you!

Dr. Oz has told NBC News that “there is all kinds of ideas” for a plan that would replace the Affordable Care Act. I can’t say I’m the least bit excited for what that could possibly entail, especially as Oz went on to say that the changes to Medicare earlier this year are a part of this so-called “plan.” Despite being a part of the One Big Beautiful Bill Act, the changes coming to Medicare will be ugly. If you want to read about the coming effects of those changes, this interview from Johns Hopkins Bloomberg School is great.

Kristen Welker, the journalist interviewing Oz, asked what on it would mean to lower drug prices 1000%, something Trump has repeatedly ranted about doing at some unspecified point in 2026. Wouldn’t you know it, Oz just says some bullshit about how a 50% price cut is really a 100% price cut. Wow, dude, I’ve never really thought about it like that. For, um, a good reason, I think.

Hats off to Welker for keeping a straight face during this segment. Here’s the clip, if you want to cringe at a terribly incorrect math explanation from a heart surgeon:

He goes on to mention the “signed contracts” with big phrama companies that promise to lower drug prices. These contracts apparently exempt the pharma company from tariffs for the next three years (at least, that’s what’s happened with the Pfizer and AstraZeneca deals). So… Trump levees tariffs, gives tariff exemptions as a “deal” in exchange for lower drug prices, and none of the lower prices will even be seen by Americans at the pharmacy. What a win.

…That supplements are not regulated, and can in fact harm you. If you take a supplements, I’d recommend reading that article from The Guardian. You should also double check that your supplements are safe for you to take. If you have a primary care provider, I’d start by asking them what they think of your supplements and medications, in case you are accidentally taking a dangerous combination. If you don’t have a primary care provider (or a regular medical provider to consult), I’d suggest you look up the name of your supplement(s) with words like “side effects” or “injury” and see what comes up.

Western Alaska weathered the end of typhoon Halong earlier this month, which devastated several communities. The Trump administration has finally promised $25 million to help the recovery efforts (but preliminary damage estimates have reached over $28 million). Alaska Public Media has published a thorough story of the storm and aftermath, so far.

I came across this piece in The BMJ and was glad to see it, despite the subject matter. I’ve seen too many stories about violent attacks on healthcare institutions and workers around the world, and these authors pulled the data together and analyzed this for what it is: a deadly and depraved pattern emerging in global conflict. It is of utmost importance that we refuse to look away from uncomfortable truths like those presented in this piece. A global blurring of civilians and combatants spells disaster for us all, should we not act now. You can act by reading this, reviewing the suggestions to put a stop to this at the end, and contacting your representatives to tell them to take action that protects us all.

Many public health professionals took to social media this week to discuss a new report from the AP that identified over 420 anti-science bills across 43 states. The bills tend to focus on the MAGA classics: raw milk, fluoride, and vaccines. To clarify, they want access to raw milk and the “freedom” to not have vaccination mandates or fluoridation of municipal water.

MAGA-type want to argue that this is all about autonomy by claiming the government has no right to prevent the sale of dangerous raw milk or mandate vaccine requirements in schools. Public health is no stranger to ethics or philosophy when it comes to autonomy, and it’s tempting to dive right into this in good faith. But I think anyone that approaches this as a discussion about autonomy is missing the actual driving force behind the attitudes that underlie these bills. This is just a bog standard appeal to nature combined with the conservative contrarianism. It’s less about autonomy and more like this: raw milk must be better because heating it up is “unnatural” (plus I hate that you said I can’t have it because it will make me sick or whatever).

The successes of public health over the 20th century shifted many parts of the world out of a health landscape where infectious disease dominated to a landscape where chronic disease dominates. This is called the epidemiological transition, for anyone that wants to read more about it. What isn’t really discussed in the epidemiological transition is the way that culture is changed by what diseases are present in that culture. Living in a culture where diabetes and cancer are at the top of mind for most people is very different from the era of consumption, in which deadly tuberculosis raged while the culture of the time heavily romanticized this infection.

Currently, American life is not shaped by infectious disease, rather, many Americans are romanticizing alternatives to public health and science as some “natural” way to deal with diabetes and cancer and obesity and so on. They do not fear the infectious disease that awaits those that drink raw milk. Even as terrible news breaks this month related to raw milk, it’s not enough to shift American culture into caution regarding infectious disease. As Dorit Reiss told the AP “misinformation is infectious.” We need to treat the growing anti-science culture as the threat infectious disease once was, and we need to start working on cultural strategies to inoculate against misinformation. Just look at this news out of Idaho, again masquerading as some quest of autonomy:

I think you should read the AP report in full (and the ProPublica one on Idaho, too, if you have the time). I also think you should call your representatives about it and tell them to refuse to pass any of these bills in your state!

I’ll see y’all in the next one. In the meantime, catch me playing some BALL x PIT.

Professor Batty