Better Health Care Newsletter - April 2025

Plutocrats reigned. The gulf between rich and poor was huge. Nativist extremists, populist politicians, and major elements of the media clamored about the waves of immigrants flooding into America. And health challenges abounded for the country.

Sound familiar? It actually happened in the first decade of the 20th century. That was when a new type of journalism — “muckraking” — rose up and shocked the nation’s consciousness. Author Upton Sinclair became famous for exposing corruption, injustice, and social inequity. His best-known work, The Jungle, tore into the back-breaking, filthy, pittance-paying food factories that exploited poor, uneducated newcomers to this country and endangered the health of everyone with tainted food products.

Here’s the historic twist to his dramatic writing: In describing the squalor and disgusting practices at meat-packing plants of his day, Sinclair helped launch the sweeping reforms that made U.S. food cleaner, safer, and less likely to sicken the public.

But after a century of major advances, health advocates have begun to worry whether federal efforts to protect people from bad food are buckling and even collapsing.

Recent high-profile recalls have fueled the concern. Consumers have confronted lethal, bacteria-tainted Boar’s Head deli meats, problematic onions on McDonald’s Quarter Pounders, and contaminated frozen waffles and pancake products sold at big-name groceries from coast to coast. The Food and Drug Administration reported that by last September, almost 2,000 food and cosmetic products (the two of which are reported together) had been recalled — the highest number in five years.

With the current administration sowing fear and confusion about the federal commitment to public health, firing thousands of expert government workers and disrupting multiple U.S. health agencies, what do regular folks need to know about the safety and quality of their foods? What steps can we all take to protect ourselves from debilitating and even deadly food-borne illness?

Recalls provide a stark warning

Are the foods we eat riskier or safer these days?

Experts are divided. Benjamin Chapman, a food safety extension specialist at North Carolina State University, takes an upbeat view, telling the Washington Post:

“I have a lot of confidence that the world of food safety is doing a better job than it was 30 years ago. The science is better. The approach is better. It’s much more collaborative than it was, and people are employing better technology.”

Others are less sanguine, including respondents to a recent Gallup Poll, in which public confidence in U.S. food safety efforts sank to a new low, according to National Public Radio.

The Public Interest Research Group’s education fund, in its “Food for Thought 2025” report, offered this pointed information about U.S. food safety, reporting:

“More people in the United States got sick from contaminated food outbreaks in 2024 than the year before, and the number of people who were hospitalized or died doubled … Nearly 1,400 people became ill from food they ate in 2024 that was later recalled – 98% of them from just 13 outbreaks, a stunning fact that shows the consequences of companies producing or selling contaminated food. All but one of the 13 outbreaks involved Listeria, Salmonella, or E. Coli.”

The group further advised:

“Overall, contaminated food sickened more people in 2024 than in 2023: total illnesses increased to 1,392, up from 1,118 in 2023. An important point: This only includes foods that were recalled during the year. Tens of millions of people get some level of food poisoning every year. They either don’t require medical care, or the exact source of the illness isn’t determined, or both.

“Worse than the overall illnesses, instances of severe illness increased dramatically last year, as hospitalizations more than doubled from 230 in 2023 to 487 in 2024. This increase is worrisome, as severe illness can have long-lasting consequences: lifetime health conditions, distressed loved ones and families burdened by medical expenses.

“Sadly, deaths also more than doubled, from eight in 2023 to 19 in 2024, further raising the alarm for us about the food we buy. Deaths in 2024 were associated with deli meat, cucumbers, onions, carrots, soft cheese, chocolate snacks with mushrooms and ready-to-eat meat and poultry.”

Federal food oversight is complex

Policing and protecting the nation’s food is a complicated job.

Just consider the complex federal government machinery with food safety responsibilities, as reported in a 1998 study by the National Academy of Sciences:

“At least a dozen federal agencies implementing more than 35 statutes make up the federal part of the food safety system … Four agencies play major roles in carrying out food safety regulatory activities: the Food and Drug Administration (FDA), which is part of the Department of Health and Human Services (DHHS); the Food Safety and Inspection Service (FSIS) of the U.S. Department of Agriculture (USDA); the Environmental Protection Agency (EPA); and the National Marine Fisheries Service (NMFS) of the Department of Commerce. More than 50 interagency agreements have been developed to tie the activities of the various agencies together.”

In addition, numerous industry and consumer groups play key roles. So do the Centers for Disease Control and Prevention and an array of agencies and organizations at the state and local levels.

A lot to oversee

The thicket of overseers — including research scientists, inspectors, and those involved in educating and informing the public — has grown in response to factors including globalization and other shifts in the food supply chains. The volume, diversity, and voraciousness of the U.S. market means that food products more than ever are sourced to farms, factories, and shippers around the world.

Further, as consumers, our food demands add major challenges to quality and safety oversight of supplies: We increasingly want fast, convenient meals, meaning we eat more highly processed products — which are handled more, thus increasing their risk of contamination and other issues. Many of us heed the call by doctors and nutritionists to add more plant-based materials to our diets to improve our health — though this means we devour more items, like fruits and vegetables, that are vulnerable to compromises from pesticides, pollutants, poor hygiene, foreign objects, unwanted allergens, and other causes. Many of our “fresh” foods, due to year-round demand in this country, come from across our borders and from growers and manufacturers whose safety and quality standards our federal regulators are supposed to ensure are maintained.

The public interest group found this:

“The FDA and USDA regulate all food sold in the United States – not just products made in this country, with 60% of FDA-registered facilities abroad. Indeed, a significant amount of certain foods is imported: 61% of fresh fruit, 35% of vegetables, and 91% of seafood. Overall, when you look at dairy; processed foods; packaged snacks, breads and cereals; and other food in cans and boxes, the United States imports about 15% of our food supply.”

The FDA recently wrote to Congress that it “employs 443 food inspectors but needs 1,500 more to inspect 36,000 food facilities, foreign and domestic, once every five years or once every three years for high-risk producers,” the New York Times reported.

In this country, Big Food has pushed relentlessly for lower costs, higher profits, and less regulation. The industry, spending big on lobbying, has found friends in the nation’s capital. In this administration’s previous stint in office, consumers — especially during the coronavirus pandemic times — were stunned to find shortages in supplies and soaring costs (which have stayed high) for foods like pork, chicken, and beef. Critics say this occurred, in big part, because federal officials allowed industry consolidations, more self-policing, and faster handling of products.

The pandemic provided a few nanoseconds of attention to the low pay, long hours, and health-damaging conditions that an immigrant labor force endures in the nation’s heartland while processing chickens, pigs, and cattle. Contemporary journalists have dug into and written about the dangerous and unappetizing labor, notably when illness felled and even killed so many workers. The muckraking apparently hasn’t swayed public opinion or changed conditions as occurred in Upton Sinclair’s era.

Alarms sound over chaos and cuts

Ready, fire, aim.

Critics have feared that the new administration, which has not finished its first 100 days, would — as Silicon Valley likes to describe it — move fast and not worry about breaking stuff.

That might work with tech startups. It has sent chills through the folks who have spent years laboring to safeguard the nation’s food. They have reason to panic, news reports say.

The head of the mammoth federal operation that covers food, medicine, health, and many other concerns is a novice in food safety. Robert Kennedy Jr. is an environmental lawyer, scion of a legendary Democratic political family, and as idiosyncratic an individual as can be found now in the top echelons of the federal government. He is not a doctor. He is not a scientist. His own family has denounced his personal behavior and his advocacy for conspiracy theories, especially those involving vaccines. He has talked about his drug abuse, weird physical maladies, and bizarre experiences with wild animals, including a road-kill bear cub and a beached, then beheaded whale.

Adding to the fear and furor is Elon Musk — the world’s richest man and the self-described chain-saw change agent empowered solely by the president to attack the federal government in the name of greater efficiencies and saving.

In response to Musk’s sweeping edicts, HHS in February gave pink slips to hundreds, many of them “probationary” employees. That status affected not only those relatively new to their jobs but also senior leaders recently promoted into new roles, which makes them technically also “probationary” employees. After an outcry erupted, however — including protests by Big Pharma, which pays special fees to support the nation’s review system for prescription medicines — HHS, and specifically the FDA, rehired many of those it dismissed, notably those who review drugs, medical devices, and are involved in food safety.

Mass firings

Kennedy — a longtime critic of evidence- and science-based medicine and of the giant department he now heads — has followed up swiftly on the Musk-led slashing of HHS. Only months after he even had an inkling he would head the department, he announced he had plans for it — slashing a total of 20,000 staff and a top-to-bottom reorganization. He is moving to consolidate functions like human resources, IT, procurement, communications, and putting them more directly under his centralized control.

He has started in on 10,000 new firings, combined with 10,000 employees who already had agreed to quit — with many of these highly credentialed, highly trained, and experienced folks going to higher-paying jobs in the private sector.

The fury has only begun over these changes, which Kennedy says will save $2 billion annually in a department with a $2.4 trillion budget and prospectively now 62,000 staffers.

He says the department will be more efficient and will focus on different priorities (like chronic illness). He insists that key areas, like the safety of drugs, medical devices, and food, will be unaffected. Critics disagree, with employees (who want to stay anonymous in talking to reporters because they hope to stay in their roles) saying that the 3,500 staff eliminated in the FDA alone might not be involved directly in food, medical devices, or drug oversight. But how are remaining staff to go on with their expert work, they ask, if they lack assistance from thousands of soon-to-be-gone researchers, scientists, and analysts while also competing within the agency for aid from IT, HR, procurement, communications, and other support staff?

Even before the latest word of mass layoffs came down, the New York Times reported these aspects of the administration’s chaotic cuts that harm efforts to safeguard the nation’s food:

“At the [FDA], freezes on government credit card spending ordered by the Trump administration have impeded staff members from buying food to perform routine tests for deadly bacteria. In states, a $34 million cut by the FDA could reduce the number of employees who ensure that tainted products — like tin pouches of lead-laden applesauce sold in 2023 — are tested in labs and taken off store shelves …

“And at the Agriculture Department, a committee studying deadly bacteria was recently disbanded, even as it was developing advice on how to better target pathogens that can shut down the kidneys. Committee members were also devising an education plan for new parents on bacteria that can live in powdered infant formula. ‘Further work on your report and recommendations will be prohibited,’ read a Trump administration email to the committee members.

“Taken together, there is concern in the food safety field that the number of outbreaks could grow or evade detection. By limiting resources, the cutbacks pare back work meant to prevent problems and to focus efforts on cases in which someone was already hurt or killed, Darin Detwiler, a food safety consultant and associate professor at Northeastern University, said. His toddler son died in an E. coli outbreak in 1993. ‘It’s as if someone, without enough information, has said, What’s a good way to save money on our automobiles?’ he asked. ‘Let’s just take out the seatbelts and airbags, because do we really need them?’”

Kennedy and others in the administration have said they are only getting started. Scrutiny will be a must for us all … Stay tuned …

Self-protection for consumers

As the uncertainty about the nation’s food supplies grows even more, consumers can “C” ways to safeguard themselves, their loved ones, and their food, experts say.

Caution — If in doubt, toss that food out. Sure, this stuff isn’t cheap in these inflationary times. But food-borne illness, even when not severe, can keep folks out of work and kids out of school. Worse cases can end up with costly medical bills. It isn’t a matter of waste (states are clarifying “past due” dates) but common sense. If an item has an unpleasant odor, feel, or texture to it — out it goes. It is also helpful to be certain about safe vendors: Yes, recalls and bad incidents have affected many big-name grocers, retailers, and restaurants. Remember, though, reputable sellers often undergo more frequent inspections, and goods they are passing along to the public are more likely flowing through supply chains that also get more extensive oversight.

Cleanliness — It should go without saying: Hygiene matters a lot in food safety, experts say, noting that the battle against germs should be relentless. Clean kitchen tools and food prep areas vigorously, looking out for spots where gunk gathers and allows bacteria to build up. When handling food, be sure to wash your hands and consider if extra steps — with gloves, masks, or hair nets — are needed. Rinse fresh foods like vegetables and fruits under running water while rubbing vigorously. Don’t soak produce in a bowl to clean it, as this can spread pathogens from item to item. Avoid cross-contamination: Clean surfaces and utensils (like cutting boards) robustly each time after use. Consider having different utensils (again, cutting boards) for bread and produce vs. raw meat, poultry, and seafood. Pork and poultry products, especially, either should not be rinsed or handlers should rigorously clean areas before other foodstuffs make contact with affected vessels or sinks.

Cooking — Be sure items are cooked to the correct temperature to kill harmful bugs. Use a meat thermometer. A thermometer can also prevent overcooking, like turning a pork chop into an unappetizing brick. Keep cooked foods hot until served, remembering how residual heat can affect items’ doneness and taste. Use care with microwave heating and cooking, which can affect different foods unevenly. While “raw” foods are rising in popularity, think twice about the risks with items like unpasteurized milk and cheeses. Don’t play sushi chef at home. Remember that the Japanese experts train for years and are scrupulous about the sourcing and hygienic preparation of their raw fish.

Chill — Perishable foods must get into refrigeration pronto, within two hours, experts say. It’s just wise not to let food sit, uncovered, for long periods after preparation. Proper food storage and refrigeration become even more important as the weather warms and folks want to enjoy outdoor dining more. When food goes into the fridge, is it properly cool? The rule is 40 degrees F for the refrigerator and 0 degrees F for the freezer. Take a look to ensure that the fridge is also clean and that, in storage, cross-contamination is not occurring with cooked and uncooked foods.

What to do if sickened

By the way, food-borne illnesses are so common that most patients know the symptom, described by the CDC as including: diarrhea, stomach pain or cramps, nausea, vomiting, and fever.

The experts at the agency advise that patients should seek medical help if they experience: bloody diarrhea or diarrhea lasting more than three days, fever (especially exceeding 102F, frequent vomiting that prevents keeping down even liquids, and signs of dehydration like dry mouth and throat, dizziness, and a halt to urination. Pregnant women should see doctors if they develop a fever or other flu-like symptoms.

More resources

Want more info on food safety? The federal government and its web pages can be helpful and informative (no matter some of the extreme attacks on them and weird takedowns of online material). An overview of food safety steps is available by clicking here, while the FDA offers more info available by clicking here. Get started with the USDA’s food safety info by clicking here.

The FDA offers detailed information about its recalls, available by clicking here. Consumers can get emails about safety alerts and recalls by clicking here.

Consumer Reports has long been committed to watchdogging food safety with its starter page on this issue, available by clicking here. NPR has posted a good, timely look at food safety, available by clicking here, and the New York Times has devoted extensive coverage to this crucial issue, available by clicking here.

A focus on the fringes raises bigger worries

MAHA — Make America Healthy Again — has become the slogan for the new administration’s health and medical policies, especially under the leadership of HHS Secretary Robert Kennedy Jr.

Critics agree with some key aspects of this viewpoint. One of its chief targets — chronic illness — is an inarguable nightmare for Americans’ health and has been a frequent topic of this newsletter.

Here is where MAHA both alarms its detractors and worries even some of its supporters, as the Kennedy-led efforts on food safety and quality, for example, get misdirected.

These advocates are going in sound directions, questioning the sway that Big Food has over Americans’ eats. They’re onto something when they ask about duplicative or bureaucratic bogs in the federal government’s health, medical, and scientific efforts.

The early indicators, however, aren’t promising for MAHA improving our lives, as promised.

The movement has, for example, lit out after the water additive fluoride. Utah became the first state to ban the use of this substance that protects teeth from decay, which once was a much more significant problem for kids in this country. A recent study has shown that issues can arise with fluoride dosage in ultra-high levels — far beyond what anyone would experience in U.S. water systems. Rearguing the wisdom of fluoride — a controversy that tracks back to the times after World War II —appeals to conspiracists, but what does it do for the public’s health?

In tackling food, Kennedy and his MAHA advocates have spoken with zeal about additives, including dyes with which even progressive states like California have found health concerns.

Alas, in tackling this issue, MAHA hasn’t looked at Big Food’s stranglehold on supplies, vendors, and advertising and marketing. The movement has not yet called for rigorous research. Kennedy, instead, has leaped ahead without careful evidence and linked “toxins” added to food to illness spikes.

As critics already have noted, the movement’s “ingredient-focused approach” to food and nutrition “is a distraction from policy changes that could actually improve public health, like expanding nutrition assistance programs, regulating corporate food marketing, and increasing access to health care. Rather than advocating for systemic solutions, MAHA’s rhetoric plays into wellness industry narratives that ultimately benefit those who profit from selling expensive ‘clean’ alternatives, not the communities struggling most with chronic disease.”

The Los Angeles Times took seriously the suggestion that the nation needs a tough, careful look at food additives. But the newspaper noted, for example, that a current federal acceptability standard, “GRAS” or generally recognized as safe, alone applies to more than 1,000 compounds. Tackling just these — and more — would be a pricey proposition. And who would pay? Consumers, already struggling in inflationary times? Big Food? As the newspaper reported:

“Analyzing additives — either before or after they are on the market — takes manpower, and more work will require more money. Yet the $1.2-billion budget for the FDA’s food program in fiscal year 2024 was dwarfed by the $3.7 billion devoted to drugs, biologics and medical devices for people.”

Kennedy’s launch into U.S. health care policy and practice, as noted above, has been to slash his department, shedding tens of thousands of staff and promising more budget cuts. As Stat, the health, medical, and science site, reported:

“The cascade of budget cuts from Washington has hundreds of state and local health officials around the country struggling to assess the impact on their communities and departments. ‘I have food programs in some of the poorest ZIP codes that I can’t give food to children today. I have rec centers that are not going to be able to do certain community outreach,’ said Matifadza Hlatshwayo Davis, who leads the City of St. Louis Department of Public Health.”

Recent Health Care Developments of Interest

Here are some recent health, science, and news articles that might interest you

§ The 2025 measles outbreak has spread from Texas to multiple states and hundreds of people have contracted the highly contagious, preventable, and potentially devastating disease. It once was considered all but eradicated in this country due to widespread adoption of safe, effective vaccination. Experts believe the current,major outbreak may take up to a year to quell, though worries persist that it may grow further (the number of cases already is believed to be an undercount). U.S. health officials normally intervene aggressively during infectious disease outbreaks like this. Robert Kennedy Jr., the head of the sprawling, federal Health and Human Services department, has been dismissive about the measles’ spread and has not been an advocate for vaccination. Instead, he has offered suggestions for dietary changes and taking of nostrums like cod liver oil and high-dose vitamins — approaches that doctors and medical experts have warned are ineffective and potentially harmful.

In the meantime, vaccinations against infectious diseases can have unexpected, significant benefits, the New York Times has reported, citing a growing body of research that shows that the shingles shot can significantly reduce patients’ chances of suffering dementia. The vaccine lowered by 20% the chance that individuals in a large study developed dementia within seven years after getting vaccinated. With treatment and preventive steps spare or less for the fearsome possibility of cognitive decline, experts have found guarded optimism in preventing later-life viral infections like shingles. They theorize that vaccines may prevent severe inflammation that can affect the brain and neurological systems from viral illnesses like shingles. It is an uncomfortable ill tied to chicken pox and caused by the varicella-zoster virus.

§ Despite the efforts of lawmakers, regulators, and others at the state and federal levels, big problems persist with insurers’ practices requiring patients to seek prior authorization for an array of tests and procedures. The nonpartisan, independent KFF Health News has reported that the sickest patients needing the most care face the most daunting problems in getting insurers to cover their costly medical care. Insurers defend their practices, which they say help to hold down costs and to avert needless, expensive medical treatment. That assertion has been assailed by doctors, patients, regulators, and lawmakers. But their reform efforts haven’t dealt with a big group of patients in most dire need, KFF Health News has found.

§ Medical care in this country remains “stubbornly” unaffordable and out of reach for too many Americans, the New York Times has reported. The newspaper cited a new survey showing a spiking percentage of respondents — 11% — said they could not afford medications or care in the last three months. A third of respondents said they could not afford medical care if they were to need it. These are among the highest such responses in recent times to these survey questions. Experts warn of a worsening in the affordability and accessibility of medical care and drugs for millions as the current administration keeps chopping off federal support for Obamacare and a range of health programs.

HERE’S TO A HEALTHY 2025 AND BEYOND!

Sincerely,

Patrick Malone
Patrick Malone & Associates