Science
Why picking RFK Jr. to lead HHS is raising alarms among many public health specialists
With President-elect Donald Trump’s selection of Robert F. Kennedy Jr. as his nominee to lead the Department of Health and Human Services, numerous public health leaders are voicing fears that the nation’s premier health agencies will be weakened at a time when the country faces rising threats from infectious diseases, emboldened industry lobbyists and the dangerous consequences of medical misinformation.
If confirmed as secretary of HHS, Kennedy — a proponent of fringe medical conspiracies and a self-described “poster child for the anti-vax movement” — would have oversight of institutions including the Centers for Disease Control and Prevention, the Food and Drug Administration, the Centers for Medicare & Medicaid Services and the National Institutes of Health.
Like the two most recently confirmed HHS secretaries, Xavier Becerra and Alex Azar, Kennedy is an attorney with no formal scientific or medical credentials. His purview would include programs and departments he has fiercely criticized in the past, often in ways that opponents say distort or ignore facts and misinterpret science.
Many of the problems Kennedy has publicly said he wants to tackle are concerns shared broadly by healthcare providers, public health officials and members of the public. They include pervasive chronic disease, poor nutrition and the ubiquity of processed foods containing artificial chemicals.
But his nomination has alarmed many public health and medical officials who say they are worried that the solutions Kennedy might deem appropriate could undermine Americans’ health in the long run.
“Putting somebody in charge who is unable to discern the difference between good and bad science is really dangerous for the American people,” said Dr. Peter Lurie, president and executive director of the Center for Science in the Public Interest.
“Yes, there are some things that he supports that we would agree with, but they feel more like the stopped clock that’s right twice a day,” Lurie said, citing food additives as one example. “There are opportunities for small victories. … But overall, it’s dissolved in so many bad ideas that it’s absolutely not worth it.”
Kennedy declined to discuss his plans for HHS with The Times, but he has indicated some priorities for the agency in previous public statements.
For instance, he said Trump would advise against water fluoridation on his first day in office. He told NBC News he wouldn’t “take away” vaccines, but he would “make sure scientific safety studies and efficacy are out there, and people can make individual assessments about whether that product is going to be good for them.”
More than half a dozen experts who spoke with The Times said Kennedy’s suggestions that the science around vaccines is unsound would undercut public health.
The United States has “the best vaccine safety system in the world,” said said Dr. Richard Besser, a former acting CDC director who now leads the Robert Wood Johnson Foundation. “RFK Jr. has done a lot to undermine confidence in that.”
Indeed, cases of measles have been rising in the U.S. as childhood vaccinations lag, especially since the COVID-19 pandemic. The CDC has identified 277 measles cases this year, up from 59 in 2023.
“I don’t want to have to see us go backwards in order to remind ourselves that vaccines work,” Dr. Mandy Cohen, the CDC’s director, said this week at the Milken Institute Future of Health Summit in Washington, D.C.
Kennedy’s zeal to remove fluoride from drinking water on the claim that the mineral causes neurodevelopmental disorders and other health conditions is another example of shirking the best science, said Dr. Walter Willett, a professor of epidemiology and nutrition at the Harvard T.H. Chan School of Public Health.
“That has been looked at carefully and there has not been evidence of a link,” Willett said. “On the other hand, there are serious problems with lead in water systems.”
Vaccines and fluoride are just two areas where Kennedy will have an opportunity to implement ideas that lack strong scientific support.
Last month, he decried the FDA’s “aggressive suppression” of unproven health remedies like dietary supplements and ivermectin and warned: “If you work for the FDA and are part of this corrupt system, I have two messages for you: 1. Preserve your records, and 2. Pack your bags.”
But food safety advocates who have shared many of Kennedy’s criticisms about lax regulation said gutting the agency is not the answer. Any effort to reduce or eliminate chemical additives in foods would require experienced staffers to draft new rules and shepherd them through the required regulatory process, said Ken Cook, president of the Environmental Working Group.
“If you’ve gotten rid of all the bureaucrats, who’s going to write the regulation?” Cook said.
Or consider FDA’s reliance on user fees from companies that want the agency to approve its medical products. Such fees make up nearly half of the agency’s operating budget. Kennedy and others have criticized such fees, but if those dollars went away, Congress would be unlikely to backfill them, Lurie said.
“Ending user fees is tantamount to starving the agency,” he said. “That would mean a food program that’s limited in what it can do, drugs coming to market more slowly, and vaccines that are even less well-monitored for safety.”
Lurie said he wouldn’t be surprised to see Kennedy task researchers at the National Institutes of Health with looking for damaging side effects of vaccines and elusive benefits of potential therapies that have already been shown to be ineffective, such as chelation as a treatment for autism and ivermectin and hydroxychloroquine for COVID-19.
“He seems to think these hold great promise,” Lurie said. “Most of those ideas are sinkholes for government spending, which is ironic given the Trump administration’s purported devotion to efficiency.”
Significant as the HHS role is, Kennedy would still find his powers curtailed by the limits of the agency’s reach — and potentially by the whims of his boss.
Willett said he agrees with Kennedy that the nation’s health is in decline, and that our food and healthcare systems are “in many ways dysfunctional.” He would welcome efforts to crack down on the amount of salt allowed in foods and to curtail consumption of added sugars, refined grains and sugar-sweetened beverages.
But if Kennedy takes steps like these, “we know for sure he will run into resistance from industry,” Willett said. “It would be interesting to see if he’s prepared to take on Coca-Cola.”
Although Kennedy is passionate about reducing pesticides and other chemicals in foods, it’s up to the Department of Agriculture to regulate pesticide use on crops, and it’s the job of the Environmental Protection Agency to determine what exposure levels are considered safe for people, Cook said. Nor would Kennedy have the power to reform farm subsidies to encourage organic and regenerative agriculture.
“He doesn’t have much purchase on pesticides from his perch,” Cook said. “That’s not really an HHS thing or an FDA thing.”
The FDA does have the authority to regulate the chemicals that come off of food packaging and can find their way into food, and Kennedy could prioritize that, Cook said.
It’s also possible that Kennedy could protect the budgets of the National Institute of Environmental Health Sciences and the Agency for Toxic Substances and Disease Registry, Cook said.
To help him achieve his goals, Kennedy has invited the public to weigh in on people who could fill important roles within the federal government’s health agencies.
Names that have garnered thousands of votes in the “America’s Health” category of his “Nominees for the People” website include Dr. Sherri Tenpenny, who claimed COVID-19 vaccines made people magnetic, and Dr. Simone Gold, the anti-vaccine Beverly Hills physician whose medical license was suspended after she pleaded guilty to unlawfully entering the U.S. Capitol on Jan. 6, 2021. (Her license has since been restored.)
Kennedy’s own accession to the HHS secretary post is not yet certain. Cabinet positions are supposed to be confirmed by the Senate, though Trump has suggested that he may use recess appointments to bypass the need for lawmakers’ approval.
Dr. Georges Benjamin, executive director of the American Public Health Assn., said that even if Kennedy wins confirmation, it’s uncertain how long he would remain in Trump’s good graces.
“I remind folks that his first health secretary didn’t last a year,” Benjamin said. “We’ll see what happens here.”
Science
Can fire-resistant homes be sexy? ‘You be the judge,’ says this Palisades architect
At first glance, it looks like nothing more than a charming Spanish-revival, quintessentially Californian home — but this Pacific Palisades rebuild is constructed like a tank.
Every exterior wall of the steel-framed home is a foot-thick, fire-resistant barricade. The home is connected to a satellite fire monitoring service. Should a fire start in town, sturdy metal shutters descend to cover every window. An exterior sprinkler system can pump 40,000 gallons of water from giant tanks hidden behind the shrubs in the property’s yard. If the cameras and heat sensors around the house detect danger, the system can envelop the home in over 1,000 gallons of fire retardant and hundreds of gallons of fire-suppressing foam.
Palisades resident and architect Ardie Tavangarian is so confident in his design that he even asked the fire department if they could start a controlled fire on the property to test it all out. (They said no.)
Tavangarian built a career designing multimillion-dollar luxury homes in Los Angeles, but after the Palisades fire destroyed 13 of his works — including his family’s home — he found another calling: how to design a house that can handle what the Santa Monica Mountains throw at it. And how to do it quickly and affordably.
Water tanks form part of a backup water supply in a newly built fire-resistant home in Pacific Palisades.
“Nature is so powerful,” he said, sitting on a couch in the new house, which he built for his adult twin daughters. “We are guests living in that environment and expecting, ‘Oh, nature is going to be really kind to me.’ No, it’s not. It does what it’s supposed to do.”
Tavangarian watched the Jan. 1 Lachman fire from his property not far from here; a week later that fire rekindled, grew into the Palisades fire, and burned through his house. But the painful details of the fire — the missteps of the fire department, the empty reservoir — didn’t matter when it came to deciding how to rebuild, he said. The reality is, many fires have burned in these mountains. Many more will.
A sprinkler on the roof is part of a house-wide sprinkler system.
For the architect, who has spent much of his 45-year career designing for luxury, hardening a home against wildfire has brought a new kind of luxury to his homes: peace of mind.
It’s a sentiment that resonates with fire survivors: Tavangarian says he’s received considerable interest from other property owners in the Palisades looking to rebuild their houses.
The metal shutters and advanced outdoor sprinkler system are the flashiest parts of Tavangarian’s home hardening project, and the efficacy of these adaptations is still up for debate. Because the measures have not yet been widely adopted, there are few studies exploring how much or little they protect homes in real-world fires.
Architect Ardie Tavangarian inside the house he designed.
Anecdotal evidence has indicated the effectiveness of sprinklers can vary significantly based on the setup and the conditions during the fire. Extreme wind, for example, can make them less effective. Lab studies have generally found shutters can reduce the risk of windows shattering.
These measures aren’t cheap, either. Sprinkler systems can cost north of $100,000, for example. However, Tavangarian said when all was said and done, the home he built for his daughters cost around $700 per square foot — less than what Palisades residents said they expected to pay, but more than what Altadena residents expected for their rebuilds.
Tavangarian also hopes to see insurers increasingly consider the home-hardening measures property owners take when writing policies, which he said could potentially offset the extra cost in a decade or less. As he explored getting insurance for the new home, one insurer quoted him $80,000 a year. After he convinced the company to visit the property, it lowered the quote to just $13,000, he said.
The house includes metal heat shields that can drop down if a fire approaches.
The home also has essentially all of the other less flashy — but much cheaper and well-proven — home hardening measures recommended by fire professionals: The underside of the roof’s overhang is closed off — a common place embers enter a home. The roof, where burning embers can accumulate, is made of fire-resistant material. The windows, vulnerable to shattering in extreme heat, are made of a toughened glass. There is virtually no vegetation within the first five feet of the home.
When asked if he felt he had compromised on design, comfort or aesthetics for the extra protection — one of the many concerns Californians have with the state’s draft “Zone Zero” requirements that may significantly limit vegetation within five feet of a home — Tavangarian simply said, “You be the judge.”
Science
Commentary: My toothache led to a painful discovery: The dental care system is full of cavities as you age
I had a nagging toothache recently, and it led to an even more painful revelation.
If you X-rayed the state of oral health care in the United States, particularly for people 65 and older, the picture would be full of cavities.
“It’s probably worse than you can even imagine,” said Elizabeth Mertz, a UC San Francisco professor and Healthforce Center researcher who studies barriers to dental care for seniors.
Mertz once referred to the snaggletoothed, gap-filled oral health care system — which isn’t really a system at all — as “a mess.”
But let me get back to my toothache, while I reach for some painkiller. It had been bothering me for a couple of weeks, so I went to see my dentist, hoping for the best and preparing for the worst, having had two extractions in less than two years.
Let’s make it a trifecta.
My dentist said a molar needed to be yanked because of a cellular breakdown called resorption, and a periodontist in his office recommended a bone graft and probably an implant. The whole process would take several months and cost roughly the price of a swell vacation.
I’m lucky to have a great dentist and dental coverage through my employer, but as anyone with a private plan knows, dental insurance can barely be called insurance. It’s fine for cleanings and basic preventive routines. But for more complicated and expensive procedures — which multiply as you age — you can be on the hook for half the cost, if you’re covered at all, with annual payout caps in the $1,500 range.
“The No. 1 reason for delayed dental care,” said Mertz, “is out-of-pocket costs.”
So I wondered if cost-wise, it would be better to dump my medical and dental coverage and switch to a Medicare plan that costs extra — Medicare Advantage — but includes dental care options. Almost in unison, my two dentists advised against that because Medicare supplemental plans can be so limited.
Sorting it all out can be confusing and time-consuming, and nobody warns you in advance that aging itself is a job, the benefits are lousy, and the specialty care you’ll need most — dental, vision, hearing and long-term care — are not covered in the basic package. It’s as if Medicare was designed by pranksters, and we’re paying the price now as the percentage of the 65-and-up population explodes.
So what are people supposed to do as they get older and their teeth get looser?
A retired friend told me that she and her husband don’t have dental insurance because it costs too much and covers too little, and it turns out they’re not alone. By some estimates, half of U.S. residents 65 and older have no dental insurance.
That’s actually not a bad option, said Mertz, given the cost of insurance premiums and co-pays, along with the caps. And even if you’ve got insurance, a lot of dentists don’t accept it because the reimbursements have stagnated as their costs have spiked.
But without insurance, a lot of people simply don’t go to the dentist until they have to, and that can be dangerous.
“Dental problems are very clearly associated with diabetes,” as well as heart problems and other health issues, said Paul Glassman, associate dean of the California Northstate University dentistry school.
There is one other option, and Mertz referred to it as dental tourism, saying that Mexico and Costa Rica are popular destinations for U.S. residents.
“You can get a week’s vacation and dental work and still come out ahead of what you’d be paying in the U.S.,” she said.
Tijuana dentist Dr. Oscar Ceballos told me that roughly 80% of his patients are from north of the border, and come from as far away as Florida, Wisconsin and Alaska. He has patients in their 80s and 90s who have been returning for years because in the U.S. their insurance was expensive, the coverage was limited and out-of-pocket expenses were unaffordable.
“For example, a dental implant in California is around $3,000-$5,000,” Ceballos said. At his office, depending on the specifics, the same service “is like $1,500 to $2,500.” The cost is lower because personnel, office rent and other overhead costs are cheaper than in the U.S., Ceballos said.
As we spoke by phone, Ceballos peeked into his waiting room and said three patients were from the U.S. He handed his cellphone to one of them, San Diegan John Lane, who said he’s been going south of the border for nine years.
“The primary reason is the quality of the care,” said Lane, who told me he refers to himself as 39, “with almost 40 years of additional” time on the clock.
Ceballos is “conscientious and he has facilities that are as clean and sterile and as medically up to date as anything you’d find in the U.S.,” said Lane, who had driven his wife down from San Diego for a new crown.
“The cost is 50% less than what it would be in the U.S.,” said Lane, and sometimes the savings is even greater than that.
Come this summer, Lane may be seeing even more Californians in Ceballos’ waiting room.
“Proposed funding cuts to the Medi-Cal Dental program would have devastating impacts on our state’s most vulnerable residents,” said dentist Robert Hanlon, president of the California Dental Assn.
Dental student Somkene Okwuego smiles after completing her work on patient Jimmy Stewart, 83, who receives affordable dental work at the Ostrow School of Dentistry of USC on the USC campus in Los Angeles on February 26, 2026.
(Genaro Molina / Los Angeles Times)
Under Proposition 56’s tobacco tax in 2016, supplemental reimbursements to dentists have been in place, but those increases could be wiped out under a budget-cutting proposal. Only about 40% of the state’s dentists accept Medi-Cal payments as it is, and Hanlon told me a CDA survey indicates that half would stop accepting Medi-Cal patients and many others will accept fewer patients.
“It’s appalling that when the cost of providing healthcare is at an all-time high, the state is considering cutting program funding back to 1990s levels,” Hanlon said. “These cuts … will force patients to forgo or delay basic dental care, driving completely preventable emergencies into already overcrowded emergency departments.”
Somkene Okwuego, who as a child in South L.A. was occasionally a patient at USC’s Herman Ostrow School of Dentistry clinic, will graduate from the school in just a few months.
I first wrote about Okwuego three years ago, after she got an undergrad degree in gerontology, and she told me a few days ago that many of her dental patients are elderly and have Medi-Cal or no insurance at all. She has also worked at a Skid Row dental clinic, and plans after graduation to work at a clinic where dental care is free or discounted.
Okwuego said “fixing the smiles” of her patients is a privilege and boosts their self-image, which can help “when they’re trying to get jobs.” When I dropped by to see her Thursday, she was with 83-year-old patient Jimmy Stewart.
Stewart, an Army veteran, told me he had trouble getting dental care at the VA and had gone years without seeing a dentist before a friend recommended the Ostrow clinic. He said he’s had extractions and top-quality restorative care at USC, with the work covered by his Medi-Cal insurance.
I told Stewart there could be some Medi-Cal cuts in the works this summer.
“I’d be screwed,” he said.
Him and a lot of other people.
steve.lopez@latimes.com
Science
Diablo Canyon clears last California permit hurdle to keep running
Central Coast Water authorities approved waste discharge permits for Diablo Canyon nuclear plant Thursday, making it nearly certain it will remain running through 2030, and potentially through 2045.
The Pacific Gas & Electric-owned plant was originally supposed to shut down in 2025, but lawmakers extended that deadline by five years in 2022, fearing power shortages if a plant that provides about 9 percent the state’s electricity were to shut off.
In December, Diablo Canyon received a key permit from the California Coastal Commission through an agreement that involved PG&E giving up about 12,000 acres of nearby land for conservation in exchange for the loss of marine life caused by the plant’s operations.
Today’s 6-0 vote by the Central Coast Regional Water Board approved PG&E’s plans to limit discharges of pollutants into the water and continue to run its “once-through cooling system.” The cooling technology flushes ocean water through the plant to absorb heat and discharges it, killing what the Coastal Commission estimated to be two billion fish each year.
The board also granted the plant a certification under the Clean Water Act, the last state regulatory hurdle the facility needed to clear before the federal Nuclear Regulatory Commission (NRC) is allowed to renew its permit through 2045.
The new regional water board permit made several changes since the last one was issued in 1990. One was a first-time limit on the chemical tributyltin-10, a toxic, internationally-banned compound added to paint to prevent organisms from growing on ship hulls.
Additional changes stemmed from a 2025 Supreme Court ruling that said if pollutant permits like this one impose specific water quality requirements, they must also specify how to meet them.
The plant’s biggest water quality impact is the heated water it discharges into the ocean, and that part of the permit remains unchanged. Radioactive waste from the plant is regulated not by the state but by the NRC.
California state law only allows the plant to remain open to 2030, but some lawmakers and regulators have already expressed interest in another extension given growing electricity demand and the plant’s role in providing carbon-free power to the grid.
Some board members raised concerns about granting a certification that would allow the NRC to reauthorize the plant’s permits through 2045.
“There’s every reason to think the California entities responsible for making the decision about continuing operation, namely the California [Independent System Operator] and the Energy Commission, all of them are sort of leaning toward continuing to operate this facility,” said boardmember Dominic Roques. “I’d like us to be consistent with state law at least, and imply that we are consistent with ending operation at five years.”
Other board members noted that regulators could revisit the permits in five years or sooner if state and federal laws changes, and the board ultimately approved the permit.
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