Only a few months ago, Science — America’s leading scientific journal — published an op-ed saying that scientists and scientific institutions need to be even more political than they already are. Now, Nature — Britain’s leading scientific journal — has published a very similar one. (To my knowledge, neither journal has published any article recently making the opposite case — though I’m happy to be corrected if wrong.)
Anyway, the Nature op-ed gets off to a bad start. The author, Eric Reinhart, trots out the well-worn claim that the US spends more on healthcare than other rich countries but has higher mortality. He attributes this to “market-based ideologies” and “system-wide failure”.
What he doesn’t mention is that most of the mortality gap between the US and other countries is due to factors unrelated to the healthcare system. Americans are fatter, they get into more traffic accidents, and they have a habit of shooting one another. Once you adjust for these factors, Americans live about as long as expected. Plus, the main reason they spend so much on healthcare is that they have more money to spend.
Incidentally, I’m not saying there’s nothing to criticise in the US healthcare system — just that Reinhart’s framing is tendentious.
And what of his main argument? “The real crisis,” he notes, is not that public health has been politicised. “It is that it has not been politicised nearly enough.” You read that right — “not nearly enough”. Later on, he declares that we must “aggressively” politicise public health.
Remember when 1,000 ‘experts’ signed an open letter supporting BLM protests in the middle of a pandemic — on the grounds that “white supremacy is a lethal public health issue”? Or when a group of virologists dismissed the possibility of a lab leak despite one of them writing in private that it was “so friggin’ likely”? Reinhart apparently doesn’t consider this level of politicisation sufficient.
He says “there can never be an apolitical approach to public health”. But this is hardly a deep insight. There can never be an “apolitical” approach to any field that relates to politics, but that doesn’t mean such fields should be politicised — a different concept. While public health scientists are perfectly entitled to their political views, they ought to keep them separate from the science itself. In the two examples above, they didn’t do this.
The fact is that public health, along with other areas of science and medicine, became highly politicised during the pandemic and the Great Awokening — which has led to a dramatic loss of trust among political conservatives.
The charts above show the percentage of Americans who have “a great deal” of confidence in the scientific community (left) and the medical community (right), broken down by party. Since 2018, Republicans have become far less confident in the scientific community and somewhat less confident in the medical community. Meanwhile, Democrats have become more confident in both groups.
Such polarisation can’t be a good thing for America. And Reinhart’s solution is: double down. He complains about the Trump administration’s “dismantling of public-health systems” without asking why so many Americans might support such a policy in the first place. Could it be that they see public-health systems as… politicised?
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