January 2025
Donald Trump took office on January 20, 2025, and has already announced measures that will affect the world, such as the withdrawal of the United States from the World Health Organization (WHO) and the Paris Climate Agreement. In addition, his return to power also brought up discussions about American politics itself. In this brief interview with our blog, Ted Brown, Professor Emeritus of History and Public Health Sciences at the University of Rochester, delves into the profound implications of the 2024 US Presidential election.
Brown provides an incisive analysis of Kamala Harris’s defeat and the evolving challenges within the Democratic Party. The professor also examines the controversial appointment of Robert F. Kennedy Jr. as Secretary of the Department of Health and Human Services, highlighting the potential risks posed to vaccine confidence, US public health, and scientific integrity.
Why do you think Kamala Harris did not have enough support in the recent election and was defeated by Donald Trump?
Kamala Harris’ campaign was hampered from the start by several factors. First, it got off to a late start because President Joseph Biden insisted on remaining an active candidate until very late in the American Presidential election season and only withdrew after a disastrous and alarming televised debate against Donald Trump.
Second, although President Biden threw his support to Harris, he also unintentionally burdened her with having to remain committed to most of his policies because, undeniably, she had served loyally as Vice President in his administration until that point. Many of Biden’s policies had become quite unpopular with the American voting public, as he was widely blamed for high inflation rates which were actually closely connected with Covid-19 and its economic aftermath and despite the fact that those rates had come down after a high of 9.0 percent inflation in 2022. Yet polls in 2024 revealed that more than two-thirds of American voters thought the economy was not good or poor because annual inflation was still at 2.7 percent, and 70% of the voters preferred Trump to Biden on economic grounds, an association Harris could not overcome. In addition, immigration policy (including sometimes genuinely loose border security and a broken asylum system) had become deeply problematic under Biden and Harris was closely associated with those policies and could not abandon them for radically new ones without being seen as disloyal to the man she had served as Vice President.
A third factor was that, although Harris distanced herself to some extent from a few of Biden’s other policies, notably his staunch backing of Israel, she did not distance herself sufficiently to convince large numbers of especially disaffected younger voters who chose to vote for neither Harris nor Trump or for no candidate at all. On top of these problems, Harris proved to be a poor political performer, as she had in national election campaigns before. Except for her stance on abortion and women’s health rights, Harris sometimes seemed to shift positions without clear or convincing reasons, generally avoided interviews and frequently performed poorly when she granted them, and in general quickly lost momentum after an early burst of enthusiasm in the first weeks of her campaign. As the election approached, Harris’ campaign seemed increasingly flat and sputtering, and many voters failed to believe or take seriously her stern reminders of Trump’s adjudicated criminal behaviors and dire warnings about what she identified as his authoritarian tendencies. A majority of American voters, although a slim one, discounted or forgave Trump’s legal transgressions and dismissed or, in some cases, condoned the telltale racist and proto-fascistic things he said as campaign talk rather than as foreshadowings of a frighteningly undemocratic and vindictive political future.
With the defeat of the Democratic Party in this recent election, how do you see the future of this party? Do you think that the bipartisan system will persist in the U.S.?
The Democratic Party made several serious miscalculations in the 2024 election. It assumed the support of its traditional White working class base and thought it could add working class Blacks and Hispanics to that base as well. But many of its traditional supporters were dissatisfied because of a downplaying of substantial consumer price inflation in the 2020s, which dramatically affected the daily cost of living and created a sense of abandonment by 2024 while the Democratic Presidential candidate seemed to focus on women’s issues like the right to abortion, transgender rights, and “identity politics” in general. Not only many working class Whites but also working class Blacks and Hispanics, especially Black and Hispanic men, were unenthusiastic about this political focus, as socialist-sympathetic Senator Bernie Sanders pointed out. Socialist-inclined progressive Democrat Alexandria Ocasio-Cortez, an ally of Sanders, won handily in her New York City Congressional district, but pointed out after the election that many of her supporters voted not only for her but also for Donald Trump because they sensed a populist working class appeal in both candidates but not in the Democratic Presidential candidate Kamala Harris. Some analysts also point to a surge of a “prosperity gospel” among working class Black and Hispanic men and an apparent identification of the promises of that belief system with the deliberately macho and wealthy Donald Trump.
According to several analysts, these issues reflect a deeper alienation among the traditional Democratic electoral base because that base sensed an abandonment of its values and aspirations by a party leadership which had bought into “neoliberal” values during the Clinton years and remained faithful to those values during the presidency of Barack Obama. Those values favored the deregulation of industry, global “free trade” agreements, the international relocation of many American manufacturing industries with the consequent loss of American jobs, and the toughening of requirements for domestic social assistance programs. In other words, the Democratic Party had over time abandoned the New Deal policies of President Franklin Roosevelt and the Great Society policies of President Lyndon Johnson and left many in the American working class feeling forgotten, aggrieved, and susceptible to the blandishments of a new pseudo-populist figure, Donald Trump. Joseph Biden made efforts to refocus the Democratic Party on working class values and issues and strongly supported organized labor, but his efforts were overwhelmed by fears of his declining cognitive abilities, identity politics, inflation, feelings of White grievance, and changes in the occupational orientation and demography of American workers. There are new, post-election efforts underway within the Democratic Party to move it back to its traditional left of center position, and those efforts will likely strengthen over the next several years, while the party struggles internally with its identity but probably holds intact.
Republicans will also have considerable reckoning and reorientation to do, especially when Trump’s promises to his working class supporters fall short of their expectations as is likely given the extremely wealthy and privileged (“oligarchic”) people he has surrounded himself with and nominated for major positions in his Administration (Elon Musk most notably) and the loyalty of key advisors to right-wing policies such as those advocated by the Heritage Foundation that would result not only in widespread government cutback and deregulation but in much lower corporate taxes and taxes on the wealthy. These tax policies would lead in turn to major cuts in programs that are of concern to the working class like Social Security and Medicare, along with assaults on the social safety nets for the poor of Welfare, Food Stamps, and Medicaid. If Trump implements his proposed tariffs and mass deportation, these policies will increase rather than diminish inflation at the very time when entitlement programs and social supports are being cut. If this scenario plays out, the Republicans could well lose many of their 2024 working class supporters – White, Black, and Hispanic – and may be again more clearly seen as the party of privileged and significantly White, suburban, and upper-class voters. It is unlikely, however, that the two-party system will change dramatically, but both parties are likely to reposition themselves from their stances in the 2024 election and return to positions that were more common earlier in their political histories.
The United States does not have a public health system on the same model as Brazil, for example, and is known for its unequal access and costly private health care. In this context, what is the role of the Department of Health and Human Services, and what is the significance of the appointment of Robert F. Kennedy Jr., known for his negationist views on health, as Secretary of the Department?
Although it is true that the U.S, health system is already fragmented and very costly and inequitable, the appointment of Robert F. Kennedy Jr. could cause considerable further harm. He would be very unlikely to improve and could well further damage the already dysfunctional, largely private and for-profit, employment-based system through which 54.5% of Americans currently receive their medical coverage. Moreover, as DHHS Secretary he would oversee several Federal agencies and public programs which are supposed to provide coverage for elderly men and women, poor children and adults, military personnel, veterans, Native Americans, and workers who are forced by their employers to purchase individual private insurance through the “Marketplace” mechanism of the Affordable Care Act (“Obama Care”) if they are to get health insurance at all. In addition, branches of DHHS exercise some oversight over pricing policies and reimbursement mechanisms for pharmaceutical products and preventive and clinical services, and these can all be skewed in negative ways under Kennedy. Although state governments and the U.S. Congress through its various oversight and policy-making committees and the Executive Branch of the Federal government through its Office of Budget and Management also play roles in attempting to monitor and regulate the U.S. health system, the DHHS and its Secretary could exercise the largest sway over the extent, quality, and cost of the health services received by the American public. There is little in Mr. Kennedy’s history or experience that suggests he would perform these functions competently, judiciously, and in the interest of equity.
In addition to his potentially negative influence over American medical care, as DHHS Secretary Robert F. Kennedy Jr. could put the health of the American public in jeopardy in several other direct and frightening ways. He would be responsible for several key agencies: the Administration for Strategic Preparedness and Response (ASPR); the Agency for Healthcare Research and Quality (AHRQ); the Centers for Disease Control and Prevention (CDC); the National Institutes of Health (NIH); and the Food and Drug Administration (FDA). Mr. Kennedy has already indicated his skepticism about much of the scientific research produced and funded by the NIH, has questioned the preparedness and public health measures researched and implemented by CDC, and, most worrisomely, has expressed doubts about the efficacy and safety of vaccines approved by FDA, an agency he has already attacked through an anti-vaccine advocacy group he has founded and challenged legally through a lawsuit. As Secretary of HHS with authority over these agencies, Mr. Kennedy, both by himself and with the support of the Trump administration, could literally wreak havoc and directly threaten the health of Americans and, beyond U.S. borders, the health of all of the Americas and the larger world. It is already clear that his appointment as DHHS Secretary would be very controversial and divisive and may not succeed in getting the Senate confirmation it requires. As the Washington Post reported on January 18, 2025, “Bipartisan critics of Robert Kennedy Jr. are sharpening their arguments that he is unfit to serve as the nation’s top health official.” It also reported that Scott Gottlieb, who led the FDA during President Trump’s first administration, said that Kennedy “could undermine America’s vaccine confidence and help foster a resurgence in vaccine-preventable disease.” These critics could well succeed in narrowing Kennedy’s path to confirmation or in scuttling his appointment altogether, an outcome many American health professionals are hoping for.
Related articles:
La pandemia: ¿El acto final de Donald Trump? “De nuevo, se nota el genio político de Trump – o de sus asesores. El sentimiento anti-Trump en este país es tan fuerte que anula todo razonamiento frío de la situación actual.” Eric Carter, Profesor en el Macalester College hace una reflexión sobre la actuación del presidente de Estados Unidos en la pandemia.
A referendum on Trump’s policies and leadership Eric D. Carter, Edens Associate Professor of Geography and Global Health at Macalester College examines the midterm election results and the prominence of themes such as healthcare and immigration.
A divided US: The unexpected electoral victory of Trump Theodore Brown, professor of history at the University of Rochester analyses the victory of Donald Trump and the reactions of the progressive political forces in the US.
