Collaboration
Come on, doesn’t this seem sort of symbolic?
HOBOKEN, MARCH 14, 2025. “Zeke,” a healthcare journalist I admire, is facing an ethical dilemma. He specializes in showing that common medical interventions are ineffective and even harmful. Folks working for Secretary of Health Robert Kennedy (how strange it still feels to say that!) asked Zeke if they could tap his expertise.
The prospect of influencing federal healthcare policies tempts Zeke. But he does not want to “collaborate”—his word--with an administration that traffics in “conspiracy theories and lies” and is “corrupt in its use of power.”
In a recent column, “Resistance,” I mull over options for those of us horrified by what’s happening in the U.S.: resist, run or “hunker down and pretend everything’s gonna be okay.” There’s another option: collaboration.
Zeke’s use of the term collaborate, which recalls enablers of Nazi occupation, implies that the Trump regime is irredeemably bad, incapable of producing anything good. Is it? Is the Trump regime that bad? People I’ve polled are divided.
Yes, it’s that bad, say some, the term collaborate is appropriate, it’s immoral to work with this sexist, racist, fascist government, it must be resisted.
No, others say, Trump’s America, as bad as it is, isn’t comparable to Hitler’s Germany. If you think you can accomplish some good by working with this administration, it’s wrong not to.
I’m writing this column to sort out how I feel about this conundrum.
Like Zeke, I’ve criticized U.S. healthcare, especially involving cancer and mental illness. The per-capita costs of U.S. healthcare are much higher than those of any other country. And yet countries spending a fraction of what Americans pay have longer life spans.
The U.S. demonstrates, to my mind, that healthcare and capitalism don’t mix; providers prioritize profits over patients. Things could get worse under the hyper-capitalist Trump, especially since his Health Secretary is a vaccine skeptic.
But some contributors to Sensible Medicine think the Trump/Kennedy shakeup of the biomedical establishment might have positive outcomes. I’m a fan of Sensible Medicine, an online forum where physicians and other experts debate medical issues.
These experts agree that the medical industrial complex needs reforming, but they disagree on how and by whom. They have debated for months whether Robert Kennedy will on balance be good or bad for American healthcare.
Vinay Prasad, a founder of Sensible Medicine, thinks Kennedy might do some good. Prasad, an oncologist whose critiques of cancer tests and treatments I’ve cited, is a controversial figure. He accuses Anthony Fauci and other federal health officials of promoting Covid-19 policies—whether involving school shutdowns, masks or vaccines--based on insufficient evidence.
Prasad applauds Trump’s appointments of Marty Makary (who posted on Sensible Medicine last fall) and Jay Bhattacharya as heads of the FDA and NIH (National Institutes of Health), respectively. Each has challenged the medical establishment in ways that Prasad admires.
Prasad approves of Trump’s proposed cuts of NIH funding, because “there is colossal waste in the system.” Another Sensible Medicine contributor, Leslie Bienen, disagrees, arguing that the NIH “is being slashed and burned, not reformed.”
My point is that Sensible Medicine contributors weigh the pros and cons of Trump initiatives rather than unequivocally condemning them. They’re guided by science rather than politics. That approach strikes me as, well, sensible.
Let me be clear: Trump appalls me. I fear he might be dragging this country, and the world, into a new dark age, an abyss of predatory capitalism, Dickensian inequality, tech-enabled tyranny. Noam Chomsky once told me that Trump and other Republicans who refuse to acknowledge the threat of climate change are “criminally insane.” Hard to argue with that. When I tell my friend Vicki that Trump isn’t imprisoning or killing his critics, she replies, Give him time! He’s been in office less than two months! Years from now, our descendants may indeed look back at those who worked with this administration, or even said anything positive about it, as cowards, fools, collaborators.
But perhaps because I’m compulsively optimistic, I cling to the hope that the U.S. will survive this test of its democratic principles. I can even imagine Trump appointees doing some good, whether reducing prescriptions of medications with dubious benefits or slashing the nuclear arsenal.
A final note, or confession: I’ve worked for a regime I loathed. Twenty years ago Centra Technology, a defense firm, sent me an email asking for “novel ideas that will advance the analysis of counterterrorism.” Centra was a contractor for the National Counterterrorism Center, which is overseen by the CIA. I assumed the email was a joke, but it wasn’t.
I hated the Bush/Cheney “war on terror,” but I took the gig, because I needed the $3,000 Centra offered me (Stevens Institute hadn’t hired me yet). I was also flattered that someone working for the CIA wanted my ideas, and I kidded myself that I might do some good. The main idea I pitched to Centra was getting the writings of Gene Sharp, an advocate of nonviolent resistance, into the hands of potential terrorists. I’m pretty sure the CIA didn’t take my advice.
After his election last November Trump promised, “I’m going to stop wars.” I can’t help it, that line made my old hippy heart twitch. If Trump’s people asked me for ideas on reducing the threat of war, I’d hesitate. I don’t need the money anymore, Stevens pays me well, and I’m getting Social Security (at least for now). I’d worry about the reaction of my Trump-hating friends.
But how could I pass up the chance to pitch my ideas for ending war to people in power? I’d probably collaborate. If nothing else, maybe I’d get a story out of it.
Further Reading:
I Am One of Those Evil Woke Professors
Why Chomsky Called Trump and Republicans “Criminally Insane”