Medical Fascism: How Truth Is Losing to Power in American Health Policy

HHS or Ministry of Truth? This Week in American Medical Dystopia

Samuel Corum / Stringer/Getty Images

It’s been an amazing, and not in a good way, past week in the world of governmental pronouncements on health care “policy”, such as it is. Rather than ramble on with a long introduction, let’s get right at it and discuss what is going on with new governmental attacks on three extremely well documented evidence-based medical practices: (1) fluoride pills to reduce dental caries for children who don’t get fluoride in drinking water; (2) the safety and efficacy of oral mifepristone for medical abortion; and (3) the safety and efficacy of COVID-19 vaccination during pregnancy.

Let’s start with the facts.

Fluoride Supplements

Adding fluoride to water reduces dental caries in children. According to the American Dental Association (ADA):

Topical fluorides strengthen teeth already present in the mouth, making them more decay resistant, while systemic fluorides are those that are ingested and become incorporated into forming tooth structures. Systemic fluorides also provide topical protection because fluoride is present in saliva, which continually bathes the teeth.

When drinking water does not have fluoride, the ADA, the American Academy of Pediatrics, the American Academy of Family Physicians, and the U.S. Preventive Services Task Force (USPSTF, which is notoriously strict with the evidence it accepts) recommend that children receive fluoride oral supplements (drops or tablets). These supplements are prescription, but in Utah where it is now illegal to add fluoride to drinking water, these fluoride products will apparently be available over-the-counter to improve access. (No word on Florida, which also just banned fluoride in drinking water). The amount of fluoride associated with water fluoridation and supplements (when used as directed) is safe. If it were unsafe, it would not be recommended by all of these medical professional organizations.

Mifepristone

Mifepristone, one of the drugs for medication abortion, is one of the safest drugs that we have. It is even safer than phosphodiesterase inhibitors (drugs, like Viagra, for erectile dysfunction). It is endorsed by the American College of OB/GYNs (ACOG). and multiple other medical professional organizations here in the United States and around the world. The risk of death with mifepristone is 5 per 1 million prescriptions. Let’s put this into perspective. The risk of death from phosphodiesterase inhibitors is 49 per million prescriptions and the risk of death from pregnancy in the United States is 223 per 1 million live births (2022 data). The risk of severe adverse events from mifepristone in the first trimester is often reported as 0.3%. In a fairly recent study from Canada, severe adverse events for first-trimester medical abortions with mifepristone were “<6 events per 25,744 abortions [too infrequent to report exact incidence]), the incidence of abortion complications was 0.76%, and the incidence of subsequent uterine evacuation was 4.5%.” The risk of blindness from phosphodiesterase inhibitors is 15.5 cases per 10,000 or 39.9 per 25,744.

COVID-19 Vaccination During Pregnancy

Many viral infections, including COVID-19, are more serious during pregnancy. Data from 2020 showed that 25% of women of reproductive age who were admitted to the hospital with complications from COVID-19 were pregnant (about 4% of women of reproductive age are pregnant at any given time, emphasizing the increased risk in pregnancy). In addition, pregnant women were more likely to be in the intensive care unit and to need a ventilator than women who were not pregnant. Fortunately, vaccination against COVID-19 reduces the risk of death and serious complications for pregnant women from COVID-19 and also reduces neonatal mortality. ACOG and numerous other medical professional societies recommend COVID-19 vaccine during pregnancy as the safety and effectiveness has been shown in multiple studies. For example, back in 2023, a meta analysis looked at 30 studies, where a total of 308,428 pregnant individuals were vaccinated and 553,844 who were not. Vaccination during pregnancy reduced the risk of COVID-19 infection by 60%, reduced the risk of being hospitalized for COVID-19 during pregnancy by 53%, and reduced the risk of being admitted to the ICU with COVID-19 by 82%. Regarding pregnancy complications, vaccination against COVID-19 during pregnancy was associated with a 45% reduced risk of stillbirth, a reduced risk of preterm birth, and the risk of needing neonatal intensive care was 20% lower for the babies whose mothers were vaccinated. In addition, the V-safe registry collected data on approximately 23,000 women who were vaccinated against COVID-19 during pregnancy or within 30 days before their last menstrual period and there were no safety concerns.

Let’s Contrast This Reality with This Past Week

Really, it’s just been a week. Or five days to be precise.

On May 13, the U.S. Food and Drug Administration (FDA) announced it will remove fluoride supplements from the market effective October 2025, after a safety review is completed. Why do the safety review if you already know you are going to remove it? It’s a bit like a dictator staging an election and declaring victory before the election. The answer: the theater lends a false appearance of weighing the data (it’s already been weighed, but it’s not about facts) and increases media coverage for the propaganda. (And oh the irony of removing one of the few supplements with actual scientific backing!) As fluoride tablets and drops are prescription, the FDA has authority here. If individual States allow these supplements to be sold without a prescription, like in Utah, that may be a work around. However, there has been an increase in fluoride related lawsuits and legal threats, so might the companies that make these products just throw in the towel? If the FDA declares them unsafe, that will probably make litigation a lot easier.

Why remove fluoride supplements? It’s about power and control, but the basis is an unproven claim about a negative impact on the microbiome, and false claims about fluoride being associated with “weight gain and possibly decreased IQ.” Marty Makary, the FDA commissioner, claims to be worried about “the risks of systemic fluoride exposure from FDA-regulated pediatric ingestible fluoride prescription drug products” and we should “err on the side of safety.” According to actual experts, there is no credible safety concern with the tablets or drops when used as directed. In addition, many people live in communities with water that has naturally high levels of fluoride, higher than achieved by fluoride supplements, and no one at Health and Human Services seems to give a shit about that. But fluoridation is one of RFK Jr’s fake enemies of the state. (A personal “Emmanuel Goldstein” if you will, for those familiar with the novel 1984.). But in the hypocrisy of all hypocrisies, Kennedy actually sold bottled water in 1999, called Keeper Spring, which had 1.3 mg of fluoride/liter. The recommended amount in tap water is 0.7 mg/liter so Kennedy’s product managed to exceed the recommended amount by 85%, so it’s safe when it’s personally profitable.

On May 14, Kennedy announced the FDA will review the regulations concerning mifepristone. There is no new science here, but conveniently there is a new junk “paper” that claims 11% of women who take mifepristone have a “serious” complication. It was put out by the Ethics and Public Policy Center (EPPC), one of the right-wing groups involved with Project 2025, and is not peer-reviewed. It uses an unidentified insurance claims database to look at mifepristone-related adverse events and apparently the authors have refused requests to reveal the database. The paper has multiple serious methodological flaws, and really, to call this a paper is insulting. For example, the authors considered treatment to complete the abortion as a serious adverse event when it is a known side effect. They considered someone just going to the emergency room as a serious adverse event, but didn’t separate out visits that may not even have been related to the medication (they cut themselves slicing bread) or may have just been someone who was unsure if their bleeding was typical or not and there was no medical concern. You can read a detailed review of why this paper is a piece of shit here,

This is what Kennedy, the man whose brain worm died from lack of nutrition, said about the “paper:” “It’s alarming, and it indicates that at the very least, the label should be changed,” and, “I’ve asked Marty Makary at the FDA to do a complete review and report back.” Oh good, two of the four Horsemen of the Medical Apocalypse are on the job! (If you are wondering, Dr. Bhattacharya from the NIH and Dr. Belly-Blasting Oz from the Centers for Medicare & Medicaid Services are the other two).

There are over 100 quality publications showing the high level of safety of mifepristone and recent data from Canada published in the New England Journal of Medicine (not written in crayon and held in place with a magnet in the shape of a fetus on someone’s mother’s fridge) that show it can be and is safely prescribed like any other medication without Risk Evaluation and Mitigation Strategy (REMS) type restrictions. How long has this been the practice in Canada? About eight years.

And on May 15, the Wall Street Journal reported that Health and Human Services will likely no longer recommend COVID-19 vaccines for pregnant women. No one knows what the scope will be here, but if the vaccine falls off the schedule that opens the door for insurance companies to no longer cover the cost, which effectively ends vaccination for pregnant women. There is also a concern that new COVID-19 and flu vaccines in the fall may not even be available altogether, but that’s a whole separate issue.

Again, the hypocrisy here is stunning. if someone actually cared about the future life of a fetus, they would want all pregnant women to be vaccinated. The keywords in the previous sentence are “if” and “actually cared” for those keeping score.

It’s Medical Fascism

Here we have three solid, evidence-based recommendations, (oral fluoride, mifepristone, and COVID-19 vaccination in pregnancy). These aren’t situations where experts are in disagreement, but this doesn’t matter, because in this week, in quick succession, we had three “We don’t give a shit about your science,” proclamations from Trump’s toadies.

Isn’t medical fascism being a bit…alarmist?

No. The enemy of fascism is the truth, because truth is required for people to have informed consent and act with free will. The goal of fascism is control and subjugation, so the truth is inconvenient. This is why science is so threatening to people like RFK Jr and his apocalyptic horsemen. Because science teaches people to think. To have a hypothesis, design interventions and then find answers. People invested in the scientific method are going to question the policies and the legitimacy of a fascist state.

Fascism is also about power, and bending people to your will. To achieve these goals, fascism needs propaganda and rhetoric. The lies need to be repeated over and over again to be accepted and the goal is for all of us to accept Kennedy’s pseudoscience as science. It doesn’t matter what studies say about fluoride, or mifepristone, or how many pregnant women (or their babies for that matter) die from COVID-19. It’s not about health and it’s not about facts–there could be 1,000 randomized placebo controlled trials for the COVID-19 vaccine and it wouldn’t matter, because the point isn’t the truth. There can never be enough studies, because knowledge is the enemy. It’s about control and forcing the population to accept pseudoscience as the new truth.

Kennedy and Makary’s actions make me think of Joseph Goebbels, the chief propagandist for the Nazi party. This is what Goebbels wrote in his diary:

“The essence of propaganda consists in winning people over to an idea so sincerely, so vitally, that in the end they succumb to it utterly and can never again escape from it.”

Science is ill equipped to deal with these fascist ways, because science assumes everyone involved wants the truth, is being honest, and is invested in the process not the outcome. Science is also often be messy and filled with nuance and we can only be as certain as the data allows, while pseudoscience is bold, facts be damned.

Being honest and explaining risks vs benefits also doesn’t go viral, so science is infinitely less “click-baity” than medical fascist propaganda which gives RFK Jr and his horsemen an added advantage. For example, false claims about that new paper claiming mifepristone harms 11% of women are more likely to go viral than the letter detailing why that study is garbage.

When presented with the carnage that he is creating, Kennedy will simply stonewall with an answer that can be summed up as, “I know you are, but what am I.” He simply won’t respond to the few politicians trying to hold him accountable or to press inquiries. Take a look at this interaction this week when Rep. Bonnie Watson Coleman was trying to hold him accountable for gutting LIHEAP, the Low Income Home Energy Assistance Program.

Kennedy will just keep repeating his pseudoscience-of-the-day bullshit or not even answer at all, because he knows he can stall and there will be no accountability. The press will repeat his words with a disclaimer at the very end that his claims are unproven, but the impact is the same: the repetition is easily mistaken for accuracy. And the theater is sadly entertaining.

There is an even more harm beyond the complete dismissal of medical and dental literature as if it doesn’t exist and how that will negatively affect, and even kill, people. The websites at the FDA and the CDC will undoubtedly be updated to reveal these new lies masquerading as “truths.” The division of Oral Health at the CDC is gone (as of April 1, 2025). Who is left with the knowledge to speak up? “Fluoride supplements has always been harmful,” will be the new “We have always been at war with Eastasia.” And who will track the consequences? No one.

Dr. Peter Marks, the top vaccine official from the FDA, resigned, and per the New York Times, he said, “It has become clear that truth and transparency are not desired by the secretary, but rather he wishes subservient confirmation of his misinformation and lies,” and about Kennedy, “This man doesn’t care about the truth. He cares about what is making him followers.” The NIH has cut funding for research that attempts to understand and design ways to address vaccine hesitancy and they have dropped their scientific integrity policy. And so, the value of COVID-19 vaccination during pregnancy will fade. It’s already hovering at 14%, so it’s not going to take much to completely decimate.

Thousands of people who study the science, administer programs, and write guidelines for our various health agencies have been fired. Programs that help people live better lives are gone and the ability to track many of the negative consequences is questionable. The whole infrastructure and the guardrails that control how we study medicine and ensure we are serving those who need it has been gutted.

While we didn’t really need it, this week is further proof that as far as health and Human Services is now concerned, facts are malleable and science is not a guide for the truth.

Here’s another quote from the master of propaganda, Goebbels, which is frighteningly spot-on:

“If you tell a lie big enough and keep repeating it, people will eventually come to believe it. The lie can be maintained only for such time as the State can shield the people from the political, economic and/or military consequences of the lie. It thus becomes vitally important for the State to use all of its powers to repress dissent, for the truth is the mortal enemy of the lie, and thus by extension, the truth is the greatest enemy of the State.”

So what can you do?

You will have to be like me, and look towards other countries as quality sources of information, because I’m fairly sure we won’ be able to count on the CDC, FDA, and NIH for at least the next 4 years because Kennedy is in charge of all of it and he is replacing science with pseudoscience like a perverted alchemist. You can count on me to continue to be here working my way through the literature and trying to provide critical reviews of medical information and misinformation.

Fascists want science and pseudoscience to be indistinguishable. They want chaos, which helps support conspiracy theories that they can use to stay in power. That is why I have long maintained that the most dangerous medical influencers are those who mix facts with fiction, because how can someone who isn’t an expert know the difference?

And so the one very important thing we can all do right now is to continue to speak and share the truth.

References

US Preventive Services Task Force. Screening and interventions to prevent dental caries in children younger than 5 years: US Preventive Services Task Force recommendation statement.  JAMA. 2021;326(21):2172-2178. doi:10.1001/jama.2021.20007

Clark MB, Keels MA, Slayton RL; Section on Oral Health. Fluoride use in caries prevention in the primary care setting.  Pediatrics. 2020;146(6):e2020034637. doi:10.1542/peds.2020-034637

Maguire A. ADA clinical recommendations on topical fluoride for caries prevention.  Evid Based Dent. 2014;15(2):38-39. doi:10.1038/sj.ebd.6401019PubMedGoogle ScholarCrossref

American Academy of Pediatric Dentistry. Fluoride therapy. In: The Reference Manual of Pediatric Dentistry. American Academy of Pediatric Dentistry; 2022.

American Academy of Family Physicians. Oral health. Accessed September 20, 2023. https://www.aafp.org/about/policies/all/oral-health.html

Do LG, Sawyer A, John Spencer A, et al. Early Childhood Exposures to Fluorides and Cognitive Neurodevelopment: A Population-Based Longitudinal Study. Journal of Dental Research. 2024;104(3):243-250. doi:10.1177/00220345241299352

Maternal Mortality Rates in the United States 2022, CDC https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2022/maternal-mortality-rates-2022.htm#figures

Schummers L, Darling EK, Dunn S, et al. Abortion Safety and Use with Normally Prescribed Mifepristone in Canada N Eng J Med 2022; 386: 57-67 doi:10.1056/NEJMsa2109779

Etminan M, Sodhi M, Mikelberg FS, Maberley D. Risk of Ocular Adverse Events Associated With Use of Phosphodiesterase 5 Inhibitors in Men in the US. JAMA Ophthalmol. 2022;140(5):480–484. doi:10.1001/jamaophthalmol.2022.0663

Mitka M. Some Men Who Take Viagra Die—Why? JAMA. 2000;283(5):590–593. doi:10.1001/jama.283.5.590-JMN0202-2-1

Rahmati M, Yon DK, Lee SW, et al. Effects of COVID-19 vaccination during pregnancy on SARS-CoV-2 infection and maternal and neonatal outcomes: a systematic review and meta-analysis.  Rev Med Virol. 2023;33(3):e2434. doi:10.1002/rmv.2434

Carlsen EO, Magnus MC, Oakley L, et al. Association of COVID-19 vaccination during pregnancy with incidence of SARS-CoV-2 infection in infants.  JAMA Intern Med. 2022;182(8):825-831. doi:10.1001/jamainternmed.2022.2442

Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons. (2021). The New England journal of medicine, 385(16), 1536. https://doi.org/10.1056/NEJMx210016

Zauche, L. H., Wallace, B., Smoots, A. N., Olson, C. K., Oduyebo, T., Kim, S. Y., Petersen, E. E., Ju, J., Beauregard, J., Wilcox, A. J., Rose, C. E., Meaney-Delman, D. M., Ellington, S. R., & CDC v-safe Covid-19 Pregnancy Registry Team (2021). Receipt of mRNA Covid-19 Vaccines and Risk of Spontaneous Abortion. The New England journal of medicine, 385(16), 1533–1535. https://doi.org/10.1056/NEJMc2113891

Moro, P. L., Panagiotakopoulos, L., Oduyebo, T., Olson, C. K., & Myers, T. (2021). Monitoring the safety of COVID-19 vaccines in pregnancy in the US. Human vaccines & immunotherapeutics, 17(12), 4705–4713. https://doi.org/10.1080/21645515.2021.1984132

Madni, S. A., Sharma, A. J., Zauche, L. H., Waters, A. V., Nahabedian, J. F., 3rd, Johnson, T., Olson, C. K., & CDC COVID-19 Vaccine Pregnancy Registry Work Group (2024). CDC COVID-19 Vaccine Pregnancy Registry: Design, data collection, response rates, and cohort description. Vaccine, 42(7), 1469–1477. https://doi.org/10.1016/j.vaccine.2023.11.061

Abortion Safety and Use with Normally Prescribed Mifepristone in Canada. Laura Schummers, Sc.D. Elizabeth K. Darling, Ph.D., Sheila Dunn, M.D. et al. N Engl J Med 2022;386:57-67 DOI: 10.1056/NEJMsa2109779