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Commentary: MAHA report's misrepresentations will harm public health and hit consumers' pocketbooks

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Commentary: MAHA report's misrepresentations will harm public health and hit consumers' pocketbooks

Serious followers of healthcare policy in the U.S. didn’t expect much good to emerge from its takeover by Donald Trump and his secretary of Health and Human Services, the anti-vaccine activist Robert F. Kennedy Jr.

But the agency and its leadership managed to live down to the worst expectations May 27, when HHS released a 73-page “assessment” of the health of America’s children titled “The MAHA Report” (for “Make America Healthy Again”).

A sloppier, more disingenuous government report would be hard to imagine. Whatever credibility the report might have had as a product of a federal agency was shattered by its obvious errors, misrepresentations and outright fabrications of source materials, some of it plainly the product of the authors’ reliance on AI bots.

I, and my co-authors, did not write that paper.

— Epidemiologist Katherine Keyes says a citation to her work by the MAHA report was fabricated

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At least seven sources cited in the report do not exist, as Emily Kennard and Margaret Manto of the journalism organization NOTUS uncovered. HHS hastily reissued the report with some of those citations removed, but without disclosing the changes — an extremely unkosher action in the research community.

“I, and my co-authors, did not write that paper,” epidemiologist Katherine M. Keyes of Columbia told me by email, referring to a citation to a purported paper about anxiety among American adolescents resulting from the COVID pandemic. “It does make me concerned given that citation practices are an important part of conducting and reporting rigorous science.”

Keyes said she has done research on the topic at hand: “I would be happy to send this information to the MAHA committee to correct the report, although I have not yet received information on where to reach them,” she said.

We’ll go deeper into the fabrication fiasco in a moment. What’s important is its context: concerted attacks by Kennedy and his associates on the fundamentals of public health in America.

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Those attacks have profound implications not only for Americans’ health, but on pocketbook issues and the U.S. economy generally. HHS bowed toward the latter issue by asserting in the report that the health profile of American children poses “a threat to our nation’s health, economy, and military readiness.”

As it happens, the recent actions at HHS and its subagencies, the Food and Drug Administration and the Centers for Disease Control and Prevention, increase those threats.

Take the agencies’ May 20 decision to remove COVID boosters from the CDC’s list of recommended vaccinations for healthy children and pregnant women. The decision opens the door for insurance companies to start charging full price for the shots, rather than covering them without copays as the law requires for preventive services.

That could mean out-of-pocket charges of $100 or more each booster, which could itself discourage families from getting vaccinated. This is a reminder of how family economics affect health.

The original version of RFK Jr.’s MAHA report cited this paper by Katherine Keyes and associates about adolescents’ pandemic-era mental health. The paper doesn’t exist; the citation to the Journal of the American Medical Assn. goes to a page saying it can’t be found. However …

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(HHS)

The MAHA report attributes the rise in childhood obesity and diabetes in part to ultraprocessed foods, or UPFs. But it’s silent on what experts call the “social determinants of disease,” which are heavily related to economics. The report doesn’t mention “food deserts,” mostly low-income neighborhoods in which “children do not have access to anything other than UPFs, … or the cost of fresh food vs. the hyperpalatable and cheap UPFs,” observed the Delaware Academy of Medicine in its gloss on the report.

keyes gone

… after the fabrication was exposed, Heath and Human Services reissued the report, removing the citation without explanation.

(HHS)

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And although the report mentions that safety net programs such as the Supplemental Nutrition Assistance Program — SNAP, or food stamps, school lunch and breakfast programs, and the Special Supplemental Nutrition Program for Women, Infants, and Children, or WIC, could play a role in promoting healthy eating, it doesn’t mention that those programs face severe budget cuts from the Trump White House.

Last month, HHS canceled nearly $800 million in grants to the pharmaceutical company Moderna for the development of a human vaccine against bird flu, part of a Biden administration effort to prepare for possible future pandemics, the potential social and economic impact of which should be self-evident, given our experience with COVID. Bird flu already has devastated the dairy and poultry industries in many regions and sickened dozens of farmworkers.

There was some hope in the research community that sound science might still live at HHS because some HHS appointees had scientific or medical credentials that Kennedy lacked. Those hopes get dashed on a regular basis.

On Sunday, for instance, FDA Commissioner Marty Makary — a former professor of medicine at Johns Hopkins — was reduced to incoherence when CBS’ “Face the Nation” moderator Margaret Brennan reminded him that on May 20 he co-authored a report in the New England Journal of Medicine that identified pregnancy as factor increasing the risk of “severe COVID-19” — warranting that pregnant women get the vaccine.

“Yet seven days later,” Brennan said, Makary joined with Kennedy in a video announcement recommending against giving pregnant women the booster. “So what changed in the seven days?” Makary argued that only 12% of pregnant women got the shot last year, “so people have serious concerns.”

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What he didn’t say was that those concerns have been ginned up by FDA critics — including Makary — and vaccine opponents, even though clinical trials involving tens of thousands of subjects have validated the recommendation that pregnant women get the vaccine.

That brings us back to the MAHA report.

Let’s start with its core assertion — that “today’s children are the sickest generation in American history.” As soon as the report was issued, this trope was picked up uncritically by the news media, before the report’s citation errors were discovered. But it’s undoubtedly wrong, the product of cherry-picking official statistics and ignoring what they really say.

An attack on childhood vaccination gets a subject heading all its own in this report, which asserts that the number of recommended vaccines for children by 1 year of age has increased from three in 1986 to 29 now, including vaccines for pregnant mothers.

Pediatrician Vincent Iannelli has ably punctured this claim, which he identifies as anti-vax “propaganda.”

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The report reaches its count of 29 by including some vaccines given to children older than 1 year and double-counting shots such as the RSV vaccine, given to either the mother or the infant, not both. An honest count would be as few as 17, not all of which are injections. The report also counts combination vaccines such as MMR and TDaP as three shots rather than one.

In pushing the “sickest generation” trope, the report glides over the heath threats faced by children — and adults — before vaccines were available for specific diseases. In the U.S., measles cases averaged more than 530,000 per year throughout the 20th century; as of 2023, the average was 47, according to the CDC.

Mumps fell from more than 162,000 cases annually to 429 and rubella from nearly 48,000 to three. Whooping cough, or pertussis, fell from nearly 201,000 cases to 5,611. And polio, the fearsome nemesis of American families in the 1950s, from 16,300 to zero.

One can trace the “sickness” of children in bygone generations through child mortality statistics. In 1900, the average life expectancy of a 1-year-old in the U.S. was about 56 years; that bespeaks a morbid population of infants. In 1950 it was still only about 70. Now it’s 79.

For all that the MAHA report purports to identify the leading health threats to America’s kids — processed foods, environmental chemicals, vaccines — it totally ignores what we know to be the single biggest cause of childhood mortality in the U.S.: firearms.

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The CDC has reported that in 2021, firearm injuries killed 2,571 children. That rate of 3.7 deaths per 100,000 children aged 17 and younger was an increase of 68% since 2000. The firearm death rate of 6.01 per 100,000 children aged 1-19 was 10 times the rate in Canada and 20 times the rates in France and Switzerland. Why the silence in the MAHA report? What does that say about how far you should trust the MAHA team at HHS?

As for the multiple false citations in the report, they point to the sheer irresponsibility of a federal agency’s outsourcing of research to AI.

I asked HHS for an explanation of how these errors got into the MAHA report, but I received no reply. White House spokeswoman Karoline Leavitt, however, responded to a reporter’s question about the fiasco by claiming there were “formatting issues” with the report.

Her excuse made me laugh, because it was the same excuse offered by the big law firm Latham and Watkins when it was caught submitting AI fabrications to a judge as part of a legal filing, as I reported recently. In neither case did the excuses explain how “formatting issues,” whatever that means, resulted in the fabrication of source citations.

HHS attributes the report to a 14-member “Make America Healthy Again” commission, composed mostly of cabinet members and other officials with no responsibility for or expertise in public health, such as the secretaries of Housing and Urban Development, Education, Agriculture and Veterans Affairs and directors of White House budget and economic offices. Makary and Bhattacharya are on the panel. They lent their names and reputations to this product, much to their discredit.

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But it’s unclear about who actually put pen to paper. Some of its language can be traced back to Kennedy’s own words. The report’s assertion that “today’s children are the sickest generation in American history” was picked up and amplified by media coverage of the report’s release, even though it’s not supported by the facts. It is a verbatim echo of a claim Kennedy has made repeatedly, however, mostly as a plank in his anti-vaccination platform. It was part of the title of a book his anti-vaccine organization, Children’s Health Defense, issued in 2018 (“The Sickest Generation”).

The most frightening aspect of the MAHA report is that it’s likely to be the blueprint for a comprehensive attack on public health; scarier in that news media and political leaders are citing it as though it has scientific value. It’s so infected with falsehoods, misrepresentations and ideological blinkers that it will only subject the health of American children to the greatest risk they’ve faced in, yes, American history.

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Waymo reports teen riders for bad behavior and delivers them to the police

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Waymo reports teen riders for bad behavior and delivers them to the police

Robotaxis could be turning into robocops.

A self-driving Waymo reported two teens to San Mateo, Calif., police on Monday after they were found drinking alcohol and shooting toy guns in the back of the vehicle.

According to a social media post from the San Mateo Police Department, officers detained two 15-year-olds after the Waymo they were riding in contacted the department and stopped in a parking lot until law enforcement arrived.

“Parents do you know where your teens are?” the San Mateo Police Department wrote on Facebook following the incident. “Waymo does!”

Officers removed both teens from the vehicle and determined they were using toy guns to shoot Orbeez out the windows. Orbeez are small, water-absorbing beads sold at toy stores.

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“Toy guns, water guns, and BB guns all pose real dangers, especially to an untrained eye,” the Police Department said. “The simple handling of them can cause fear in [passersby].” “

A video posted on Facebook shows at least five officers and a police dog responding to the scene and approaching the Waymo with their weapons raised.

Waymo did not immediately respond to a request for comment.

Waymo vehicles have internal cameras and microphones that may be used in an emergency or to “promote safety and security,” according to Waymo’s online support page.

The cameras are also used to ensure the vehicles are clean and to help find lost items, according to the support page.

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The company said it does not use facial recognition or other biometric identification technologies to identify individuals.

“In more urgent circumstances, support may access live video during a trip,” the Waymo page said.

The San Mateo Police Department’s Facebook post has garnered nearly 60 comments, with one user accusing Waymo of “snitching.”

“At least they got a designated driver?!” one user commented.

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Commentary: How right-wing anti-transgender attacks led to a Supreme Court ruling upholding sex discrimination

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Commentary: How right-wing anti-transgender attacks led to a Supreme Court ruling upholding sex discrimination

At the Supreme Court, the unfounded fear of boys masquerading as girls in youth sports rolled the clock back on gender equality.

On the surface, the Supreme Court’s June 30 opinion upholding state laws barring transgender girls from women’s and girl’s sports teams looks like a victory for women’s rights.

The 6-3 opinion by Justice Brett M. Kavanaugh certainly presents itself that way. “Females and males have inherent physical differences relevant to athletic performance,” Kavanaugh wrote. “Therefore, in contact sports, forcing female athletes to compete against males can create significant safety risks.” He also asserted that “forcing female athletes to compete against males can undermine competitive fairness.”

The ruling applied to prohibitions enacted in Idaho and West Virginia against “biological” males’ participation on women’s teams in public schools. Federal judges in both states overturned the bans. The Supreme Court majority restored them. The ruling essentially upholds similar bans enacted in 25 other states.

There was no record of any transgender person participating in school sports in the State, let alone any ‘problem’ with transgender students … creating unfair competition or unsafe conditions.

— Justice Sonia Sotomayor, demolishing the Supreme Court’s argument in favor of banning transgender girls from girl’s sports

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Kavanaugh, like Donald Trump and others in the anti-transgender camp, maintained that one’s gender is an immutable fact of life, established even before birth.

Anything else, Trump stated in an executive order he issued on inauguration day 2025, could only be the product of “gender ideology extremism.” The U.S., his order stated, recognizes “two sexes, male and female. These sexes are not changeable and are grounded in fundamental and incontrovertible reality.” That’s a “biological truth,” he declared.

In his own version of this overconfident and factually insupportable conclusion, Kavanaugh wrote: “As all agree, females and males have inherent physical differences relevant to athletic performance.”

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Science recognizes that some people are “born with sex traits that don’t fit into typical male or female patterns,” to cite a discussion on the Cleveland Clinic web page on the topic “intersex.” The condition “may involve chromosomes, hormones, reproductive organs or genitals.”

From a psychological standpoint, medical science recognizes “gender dysphoria” as a real condition often requiring counseling and medical intervention such as the use of puberty blockers and hormones to stave off the development of secondary sex characteristics until the condition can be resolved.

No one disputes that there are physical differences between the sexes. Few would dispute that on average or even at the median, males may be bigger and more powerful than females, or that in certain contact sports the difference may be telling and on occasion dangerous.

But that’s not the same as asserting that the physical differences between males and females invariably mean that men will invariably prevail over women in all competitions or that their participation will endanger women.

The International Olympic Committee — in a policy statement Kavanaugh cited incompletely — says that in “most running and swimming events,” males have a 10% to 12% advantage over women. That’s a range that would accommodate the full spectrum of outcomes — transgender females win, cisfemales win, they tie. (The “cis” prefix denotes those living consistent with their birth gender.)

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West Virginia and Idaho addressed this ambiguity by banning transgender women from all girls’ teams. So under their rules transgender girls can’t play football or soccer with cisgirls. But what’s the argument in favor of banning them from the 100-yard dash, or cross-country track, or diving, or archery?

But something else is going on here. The Supreme Court’s ruling was almost preordained, given the years-long campaign by conservatives to demonize transgender individuals as if they’re members of an alien species.

It will be recalled that during his presidential campaign, Trump spun a despicable fantasy in which children were kidnapped in school and secretly subjected to sex-change operations.

Trump’s executive order wiped out policies aimed at protecting transgender adults from discrimination. He moved to outlaw gender-affirming medical therapies for anyone under 19 by cutting off federal funding for healthcare institutions that provide such care.

He banned transgender individuals from serving in the military and ordered federal prison officials to move transgender inmates into the general populations consistent with their birth genders, which exposes them to physical assault. (Federal Judge Royce Lamberth of Washington, D.C., has blocked the government from transferring three transgender women into the male prison population or terminating their hormone treatments.)

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I wrote during Trump’s first term, when his anti-transgender policies were still gestating, that the goal was to show that “one can target any community, as long as it doesn’t have a strong political voice or political power. These are the actions of bullies and cowards, pretending to be strong.”

Last year, the Supreme Court struck its first blow against transgender rights by upholding a Tennessee law banning transgender care, including puberty blockers and hormone therapy, for minors. Similar laws have been enacted in 25 other states. The majority in that ruling by Chief Justice John G. Roberts Jr. was identical to the one in the June 30 ruling — Roberts, Kavanaugh, and Justices Clarence Thomas, Samuel A. Alito Jr., Neil M. Gorsuch and Amy Coney Barrett.

Who are the targets of this ideological campaign? They number only about 1.6 million U.S. adults, or one-half of 1% of the U.S. population. About 300,000 adolescents ages 13 to 17, or 1.4%, identify as transgender, according to a study by UCLA School of Law.

In West Virginia, as Justice Sonia Sotomayor observed in her dissenting opinion, “there was no record of any transgender person participating in school sports in the State, let along any ‘problem’ with transgender students … creating unfair competition or unsafe conditions.”

In endorsing the flat bans directed at transgender women in Idaho and West Virginia, Kavanaugh argued that any attempt to implement case-by-case judgments of students’ requests to join sports teams inconsistent with their biological gender would create “an enormous practical and administrability problem.”

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Is that so? That wasn’t the case in Maine, where the annual K-12 population is more than 170,000. There, a committee was charged with determining whether a student’s participation in a sport consistent with their gender identity but inconsistent with their biological sex would “result in an unfair athletic advantage” or present a risk of injury to others. The committee held 56 hearings from 2013 through 2021, or an average of seven per year. During the entire time span, only four involved transgender girls. (The outcome of those hearings couldn’t be learned.)

It was Maine’s policy, one might recall, that provoked a confrontation between Trump and Maine Gov. Janet Mills at the White House last year, when Trump threatened to withhold federal funding from the state unless it barred transgender students from competing on women’s sports teams. “We’ll see you in court,” Mills snapped.

Whether the Idaho and West Virginia laws genuinely protect girls from unfair competition is questionable. (The Idaho law is styled the “Fairness in Women’s Sports Act.”) In practice, the laws may subject women in public schools to “invasive sex verification procedures,” as educational expert George Theoharis of Syracuse University wrote after the court ruling.

They’re also based on a retrograde view of women as fragile creatures needing men’s protection, Theoharis wrote — “the same logic that has historically been used to justify excluding women from making their own healthcare decisions and girls from rigorous math and science; that physically demanding work is simply beyond them.” (There don’t appear to be any state laws barring transgender women from competing in men’s sports.)

Becky Pepper-Jackson, the plaintiff in the West Virginia case, in which she is identified only as B.P.J., is the only transgender girl who sought to join girl’s teams — track and cross-country — in the state. That was in 2021, just after West Virginia passed its law and she was about to enter sixth grade. She didn’t appear to pose any competitive risk to others on the track and cross-country teams she applied to join — her lawyers told the Supreme Court that on those no-cut teams, she “came in near the back.”

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Anyway, she had not gone through male puberty, which theoretically might have endowed her with a competitive advantage, because she had been taking puberty blockers and female hormones.

Thanks to the court’s ruling, Sotomayor observed in a dissent joined by Justices Elena Kagan and Ketanji Brown Jackson, West Virginia can deny Becky access to school sports “because it thinks they have an inherent athletic advantage, even if the facts show that they do not.”

B.P.J., Sotomayor wrote, “cannot practice on girls’ teams, even if she would not take anyone’s spot in an eventual competition, even if everyone who tries out for the team makes it, and even if having the chance to participate could aid immensely in treating B. P. J.’s gender dysphoria.”

So whose interest was really protected by the Supreme Court?

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Orange County real estate investor pleads not guilty in $100 million bank fraud case

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Orange County real estate investor pleads not guilty in 0 million bank fraud case

An Orange County real estate investor accused of criminally defrauding an Arizona bank of nearly $100 million pleaded not guilty Monday and remains in custody.

Mahender Makhijani, 44, of Corona del Mar — who also was ordered by an arbitrator to pay $1.34 billion in a separate civil fraud case — was arraigned in Santa Ana federal court on two charges.

He is accused of bank fraud and making a false statement to a bank in a June 8 case involving a $100 million real estate loan made by Phoenix-based Western Alliance Bank. He was taken into custody on June 10.

Makhijani is accused of providing bogus collateral for the October 2024 loan now in default. In a civil lawsuit, Western Alliance said the outstanding balance as nearly $99 million.

Prosecutors say he falsified title insurance policies that showed the bank would have a first lien on the underlying collateral if the loan went bad, when in fact it did not.

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A trial was set for August 11 before U.S. District Judge David O. Carter in Santa Ana.

Michael Schachter, his criminal defense attorney, did not respond to messages seeking comment.

In the civil case, an arbitrator in May ordered Makhijani to pay Laguna Beach real estate mogul Mohammad Honarkar $1.34 billion after ruling he had fraudulently induced him into a 2021 joint venture — and then wrested control and lost to creditors more than two dozen properties Honarkar had owned.

Makhijani has not been criminally charged in that case, but prosecutors alleged in an affidavit in support of the bank fraud charges that he used “force and threats” in his dealings with Honarkar and others — including taking over the landmark Hotel Laguna in 2023 that Honarkar was renovating.

Prosecutors sought to hold Makhijani without bail after his arrest.

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The affidavit noted he is a legal Indian immigrant with a home and bank accounts in that country, has access to private jets and threatened to “run away” if caught in a difficult situation.

The request was denied and he was granted $500,000 bail.

However, Makhijani remains in custody after a hearing sought by prosecutors last month before Magistrate Judge Autumn Spaeth.

The judge declined to accept a $450,000 cashier’s check submitted by a Makhijani associate for the bail, finding insufficient proof the source of the funds was legitimate, according to court records.

Makhijani is not prominent outside Orange County real estate circles, but he established a thriving distressed-assets business over the last decade that attracted prominent Southern California real estate investors.

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Prosecutors said it paid for a lifestyle that included two multimillion-dollar homes in Corona del Mar, a luxury apartment in Newport Beach and various luxury vehicles.

As of last month, prosecutors had not fully traced his assets, which they believe are not held in his name and some of which may be in India.

The businessman employed an array of shell companies and strawmen to sign documents on his behalf, and to stand in for him as operators of his companies, according to the affidavit.

Makhijani told an associate he took extra precautions because wanted to insulate himself from litigation and that “they were sharks in the distressed world who took advantage of people,” the affidavit stated.

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