The meeting place between making America healthy and efficient

If Robert F. Kennedy Jr. is confirmed as health secretary, can his "Make America Healthy Again" movement work together with Elon Musk's Department of Government Efficiency without massive cuts to health care spending taking place right away?

The answer is that it definitely can.

At first glance, it would seem the DOGE’s goal of cutting hundreds of billions of dollars from the federal budget would automatically put it in direct opposition with an extremely expensive and wasteful health care system. Health and Human Services alone has a massive budget of nearly $1.8 trillion, and Medicare combined with Medicaid spends close to $1.5 trillion. But consider that much of this money is spent on preventable illnesses, including heart disease, type 2 diabetes and many cancers.

RFK Jr. is declaring war on chronic illness. If he succeeds in this, he will not only make us healthier but also cut down dramatically on sick-care costs, bringing him in line with DOGE's goals.

The place to start with this war is a war on obesity.

Consider that this “sick-care system” is, by definition, far more expensive than a true health care system would be. Obesity is a large part of the reason why. RFK Jr. comes from a family of famous ferocious reformers, from his two uncles to his father. While some of his major targets (including vaccines) have been the subject of serious criticism when it comes to the food we eat and the fact that most of us live an unhealthy lifestyle he has hit a bullseye.

The ultra-processed foods we eat lead to obesity which leads to heart attacks, strokes, diabetes, dementia, high blood pressure and many cancers, all of which are extremely expensive to treat, all of which cripple our workforce. Eating more organic food, exercising regularly, sleeping better and cutting down on alcohol would be a big win for societal health.

Other RFK Jr. targets, such as artificial food coloring, have been linked not only to cancer risk but also to Attention Deficit and Hyperactivity Disorder, which has just been shown in a large British study to be associated with a shorter lifespan.

Imagine if more federal dollars were spent on subsidizing organic farming, healthy options including fresh produce at school, and tax incentives for gym memberships. Imagine if we could eat pasta occasionally again, the way they can in Europe, without gaining weight.

At the same time, I am not against people using the GLP-1 agonists Wegovy and Ozempic or the GLP-1 plus GIP drugs Mounjaro or Zepbound. I agree with Elon Musk on this. They are short-term tools I can use to combat obesity, and they should be covered by insurance, even if the longer-term solution to our obesity and chronic illness epidemic will usually involve a change in lifestyle. At the same time, however, we must protect those whose illness is genetic or environmentally linked. We must continue to care for our chronically ill.

Meanwhile, biotechnology and artificial intelligence have advanced to the point where they can help us prevent diseases before they ever happen. The Stargate program described by President Trump during a press conference with OpenAI CEO Sam Altman, Oracle chairman Larry Ellison and Softbank CEO Masayoshi Son last week spoke to the future of personalized medicine.

An initial expenditure of $100 billion by the companies to build a huge AI databank infrastructure would appear to contradict DOGE’s stated purpose to cut federal spending. But first, the money is coming from the private sector, and second, the personalized solutions envisioned (such as combining blood screening for cancer markers with cancer vaccines) will actually save money. No matter how expensive it is to prevent cancer, it will never be more expensive than cancer itself.

We are entering a brave new world of preventive health which occurs outside the doctor’s office and outside the hospital.

I am not for big slashes to Medicare or Medicaid. I believe in sustaining these programs but making them more efficient while focusing on developing a slimmer healthier population, which is cheaper to care for.

Federal funding must still be targeted to those who need it the most. We must take care of our sick, even as we work to prevent illness where we can. Heart attacks can often be prevented, whereas congenital heart disease cannot. Type-one diabetes is frequently not preventable, whereas Type-two diabetes often is.

Decreasing the amount of inflammation in the body (COVID-19 is clearly linked to increasing it) by any means decreases chronic illness. Eating and sleeping better and exercising more while losing excess weight decreases inflammation.

Learning how to stay healthy longer while developing advanced biotechnology to help us will save large amounts of money as well as lives.

Marc Siegel MD is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent and author of “COVID; The Politics of Fear and the Power of Science.”

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