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Sensible PCP's avatar

I remember when Michelle Obama launched “Let’s move!” in 2010. I also remember all the uproar about government overreach into what people should eat. I can provide quotes if needed.

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Julia's avatar

Thank you very much, Dr Marine. I remember sitting in a Bible study with a bunch of very red leaning Catholics and the teacher put up a picture of Michelle Obama with children digging in a garden, which was part of her “let’s move” initiative, and all the future Trumper’s laughed. I pledge to be more open minded.

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ADWH's avatar

Dr. Marine- curious about your thoughts on the data they cited that does not actually exist.

https://www.nytimes.com/2025/05/29/well/maha-report-citations.html

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Sensible PCP's avatar

Well you see a study that doesn’t exist technically has zero flaws.

When it’s COVID or DEI, much of SM readership rips into it. Often with straw man and false equivalence, but that’s another story.

But when it’s MAHA, they put on the kid gloves. Never mind the extrapolations or poor studies, it’s the effort and vibes that we should focus on.

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ADWH's avatar

It’s wild. Truly.

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Sheila Crook-Lockwood's avatar

Thank you for the summary

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Larry J Miller MD's avatar

This is the best news we have had in 50 years. We are on the verge of a great revolution in healthcare. The major problem in the program is that it has neglected (or been blinded to) the most important element in our overall health decline and how to fix it. The hidden enemy. Medicine is controlled by big pharma in the USA, pumping $Billions into controlling congress, the FDA, advertisements and the practicing physicians. This has got to stop if we are ever to make any meaningful changes. Follow the money $1.5 Trillion per year for Big Pharma. Let's stop being puppets controlled by administration, government, industry, legal and specialty agencies. Let's start treating our patients like human beings and address the root causes of most chronic illness.

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Gorf's avatar

Joseph, this is fantastic article. There's a *lot* to be encouraged about.

Your suggested courses of action for the sensible are obvious and well advised.

I'm trying to be optimistic.

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Joseph Marine, MD's avatar

Thank you - we should always look on the bright side of life!

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GBM's avatar
3dEdited

I fear the lack of intellectual curiosity and engagement on the part of the medical profession. I see most physicians as over-extended and all to contented in their silos. They do not read widely and they are reluctant to engage in many of these topics. As retired physician in my 70s, I have a great array of personal physicians but I do not sense these essential qualities in these well-above average physicians. I would think that medical school curricula need a critical review and reform.

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Robert M.'s avatar

Most doctors follow the consensus algorithm. That's how they got good grades, and through medical school. The system doesn't select for radicals, but when you need radical change, you need R*******.

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GBM's avatar

I would argue that modern citizens must involve themselves in the issues of the day. Physicians must go beyond consensus to make the daring, correct diagnosis and to participate in quality improvement to enhance their fields. Status quo is NOT acceptable and we were not taught in medical school that it was.

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Steve Cheung's avatar

The guiding principles/ areas of focus do not seem all that controversial. But where the rubber meets the road will be in how the government dispenses its guidance and recommendations. Hopefully the foundational through-line will be “rigorous scientific evidence”.

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Don Gaede's avatar

Thanks for that great summary. I hope that MAHA achieves its goals for a healthier society, particularly for children.

But at the same time, this administration has been slashing all efforts to fight climate change, while encouraging the development of fossil fuels. The Baldwin coal-fired power plant in southern Illinois was just exempted from complying with federal limits on soot, mercury, and other pollutants. Pollutants from fossil fuels injure thousands of children each year. (The EPA estimated last year that coal regulations will provide up to $3 billion in health benefits by 2037, while costing industry up to $330 million.)

Let's hope the people that wrote this MAHA report can dampen the current administration's love affair with fossil fuels.

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Ernest N. Curtis's avatar

The greatest benefit for children and everyone else could be achieved by getting the government out of the medical care field. This is the same government that has caused immense harm to children through their policies that have weakened the family structure and virtually ruined the educational system.

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Larry J Miller MD's avatar

Absolutely correct.

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Doug Graham's avatar

Sensible Medicine is a very important service. I only am nitpicking because I like it so much. There are multiple typos in this post and while it doesn't change anything factual, it is not a good look. Thanks for all you do.

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Robert M.'s avatar

The typos show ChatGPT didn't write it.

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Joseph Marine, MD's avatar

Fact check - true!

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John Mandrola's avatar

I was so excited to get it posted that I skipped the Claude step. As my daughter said often: “my bad”

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Elise Morse-Gagne's avatar

Interesting. I have long had concerns about all these elements of children's health and its overall decline. Maybe I skimmed too fast, but I didn't spot anything in the summary about living in poverty in America, which -- with its increases in exposure to most or all of these stressors, and its concomitant failure to provide access to most of the "benefits" of living in an advanced society -- is an important aspect of this issue. I teach juvenile delinquents and youthful offenders, so I have some insight into the ways we fail to care for the health of children in poverty. Living in the juvenile justice system, most of them are getting basic health care for the first time, including the glasses without which they were doing poorly in school and the dental care that will help them keep their teeth into adulthood (if gunfire doesn't end their lives early). A further note: I'd say that with health as with education, Covid didn't so much knock the edifice down as deliver the final blow to an edifice already riddled with gaps and structural defects. It exposed existing problems as well as worsening them, rather as catching a communicable illness can expose vulnerability in the immune system.

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Joseph Marine, MD's avatar

I agree that MAHA is going to have to address other social determinants of health to have a major impact on the problems they outline.

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ADWH's avatar

77% of kids unfit for military service… that is the barometer of good health? That seems like a very odd barometer. My husband recently retired from the military after 22 years, and I hope my children choose otherwise, but that just seems a very strange line in the sand.

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ADWH's avatar
1dEdited

Many other metrics could be used to make the point better. This point stank as if the only reason for health is to pass a PT test. “77% of youth are unfit to serve in the military.” Who cares? My husband, the actual veteran, thought it was absurd as well and likely written by someone who probably is clueless about military life beyond the entrance PT test and definitely has never served their country in that way. My point is there are many other, arguably better, ways to speak to the lack of health.

There absolutely is a health crisis in the country, and I don’t see solutions like cutting SNAP, Medicaid, deregulating industry, etc as solving it. But there is a HUGE mental and physical health crisis in the military, so making it a bastion of comparison is silky but also ignorant. And you know what is terrible for children’s mental health? Watching their dad go off to war over and over again.

But, beyond all that, this report cites studies that don’t exist. So, there’s that.

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JHM's avatar

77 % of US children are to unhealthy to participate in the military. That means 77% of US children are going to be more prone to chronic illness, morbidity, a drain on the US healthcare system and will overall contribute less to society. This is an excellent way to measure the health of our nation.

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ADWH's avatar
3dEdited

Having lived the military life, by my husband’s side, the military is no pillar of health. Perhaps they mean the day they enlist? They could pass a PT test? They met taping standards? But the military is rife with substance abuse, mental health issues, toxic behavior… Not to mention what serving actually does to the body. And plenty of service members get waivers.

For those of us who saw the military up close and personal, it simply isn’t a good barometer. At all. And the whole you need to be healthy so you can serve your country implication is kind of gross. Especially coming on the tails of Memorial Day weekend, when many of us are remembering those killed by IEDs, electrical accidents, during routine training, and by suicide because the carnage of war was too great. And talk about chronic health issues…you GET them while serving.

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JHM's avatar

This really isn't about the military... . It's just a way of saying that a large portion of US youth are chronically ill mentally and physically. HHS are using the tools and metrics that they currently have. Yes, maybe we should make a new metric. But, while we are creating this new metric, use what we have. OR see below some good metric's on US health. Is your counter argument that there isn't a health crisis in the US? I'm really not sure of the point your are trying to make.

"U.S. has the highest rate of people with multiple chronic conditions and an obesity rate nearly twice the OECD average" https://www.ncesc.com/geographic-faq/how-unhealthy-is-america-compared-to-other-countries/

2015 https://www.healthsystemtracker.org/brief/the-u-s-has-highest-rate-of-disease-burden-among-comparable-countries-and-the-gap-is-growing/

"The United States spends more on health care than any similarly large and wealthy country. However, in 2023, Americans had a life expectancy of 78.4 years, compared to an average of 82.5 among peer countries. https://www.healthsystemtracker.org/chart-collection/what-drives-differences-in-life-expectancy-between-the-u-s-and-comparable-countries/

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HardeeHo's avatar

Perhaps a point. Healthy young people start with a chance to grow within the military. Indeed over time service may take its toll but healthy recruits have a better chance.

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Seneca Plutarchus's avatar

Yes, they mean they don’t have the fitness to pass a military physical fitness entrance exam.

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ADWH's avatar

And what does that matter? I probably don’t either. But, I am in excellent health. Very fit and active. Zero chronic conditions. Healthy weight. Again, a terrible barometer.

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Seneca Plutarchus's avatar

I imagine a military physical fitness exam as a young person is highly correlated with good physical health.

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Tina C's avatar

Thank you for your synopsis of the MAHa report. Based on your reporting it sounds logical and transparent. Attributes that have been missing from the discussion for some time.

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