What I Would Tell RFK Jr. If I Ever Get to Meet with Him RICHARD HOROWITZ MAR 19 (Edited)

Where it went right. Where it went wrong. Where we can make it better, and how we can cut costs and improve outcomes.

Get to the basics of why we are now all living through a chronic disease epidemic, where roughly one in two Americans now suffers with a chronic illness. I know RFK Jr. has said that he wants to reform the healthcare system to make it better. I have some ideas on that one.

Having been in healthcare for 41 years, I have a pretty good perspective on what is working and what isn’t, because over 13,000 chronically ill people have to come to see me from all of the world during the last 4 decades. They often came in with the same story. They had seen dozens of doctors (the winner of all time was a patient who saw 100 doctors before seeing me!), complaining about their chronic fatiguing, musculoskeletal, cardiopulmonary, neuropsychiatric illness.

They were frequently dismissed and gaslit by physicians they saw and told that it was all in their head (because the doctors had the gall to believe that if they couldn’t find an answer, there was none) or sent to a subspecialist who supposedly knew more than they did. I listened to their frustration and healthcare failures, having to go from one doctor to the next, and still not get answers. Or at least any that benefited them. They just walked away with more medication to treat their symptoms, because no one got to the root cause(s) of why they were sick. Many were disabled and unable to work, having to live on disability payments from their state.

Which brings us to first reason that the healthcare system is broken--apart from burnout among physicians who hate the administrative burden of their jobs--which is the “I will name your disease and then throw drugs at it hoping you get better” system of medicine. That approach is doomed to fail. You will never have a healthy society and keep costs down if the primary way you approach a disease is to attempt to fix it once it and you are already broken. That is backwards. You need to invest a good part of your healthcare system funds in prevention. Give people back money on their taxes to stay healthy if they go to Prevention Centers of Excellence.

If approximately 18% of the national GDP is spent on healthcare, and 85% of the costs of that healthcare come from the treatment of chronic disease, then the obvious answer is to properly address the root causes of chronic illness before it happens. Then you save a boatload of money and improve people’s lives. You must address why so many people are getting sick with cardiovascular disease and strokes, autoimmune illnesses like MS and rheumatoid arthritis, Alzheimer’s dementia, autism spectrum disorder, ADHD, chronic fatigue syndrome (CFS/ME, fibromyalgia), or Long Covid. Why more and more young people are now being diagnosed with cancer. You have to ask the big, essential questions. What has happened to our bodies in the past 50-75 years that has made them more susceptible to chronic disease? Did something change? What has led to the common occurrence of all of these chronic illnesses that are breaking the healthcare bank and the back of Americans? Thinking about cutting Medicaid to people in need is not the answer to our healthcare crisis or our budgetary problem. Medicine needs to be done with compassion and common sense.

Two factors are foremost responsible IMO for the chronic disease epidemic raising our healthcare costs and affecting our quality of our lives, apart from inadequate prevention. Which are: infectious diseases spreading in epidemic proportions, and massive amounts of environmental toxins we’re ingesting on a daily basis. Both of these factors drive inflammation, and inflammation is the number one underlying factor in all chronic disease. How bad are the infections?

The CDC stated a few years back that 476,000 Americans were getting Lyme disease every year. That was a big jump from the 30,000/year being touted a decade before. But hold on. Then the CDC said that they looked at Medicare rates and found Lyme disease rates were 7x higher in that population. So we are now closer to 2-3 million cases of Lyme disease every year. And this epidemic has been going on for decades under everyone’s nose, meaning A LOT of people have likely been affected. BMJ Global Health said that 14.5% of the global population has been exposed to Lyme.

A colossal failure of our healthcare system was to ignore an epidemic under our noses because it was not medically, financially, or politically expedient to do so. While attacking doctors on the front lines trying to find answers. Not to mention that almost everyone I see with Lyme also has Babesia and Bartonella infections. The 3 B’s are the rule, not the exception. Many of those chronically ill individuals also have Long Covid and reactivated viral infections. Plus quite a few have a Candida overgrowth in the gut, because they took antibiotics throughout their life without properly avoiding simple carbohydrates and taking high doses of the right probiotics (or they just ate meat laden with antibiotics).

So, if we are to fix the broken healthcare system, whose funds primarily go to treating chronic disease, one of the first truths that must be addressed in every doctor’s office is that many of these chronically ill individuals don’t just have one infection. They have many different infections. They have a broad range of bacteria, parasites, viruses and fungi. And what do all these infections do? They increase inflammation--the underlying factor in most chronic disease. Which is causing rising healthcare costs and suffering.

Then add to the infectious burden the daily exposure to hundreds and thousands of environmental toxins. Most of my patients have some levels of heavy metals in their blood when I test serum levels, like mercury, lead, cadmium, aluminum, and arsenic. Those toxins increase inflammation and can cause fatigue, pain, memory loss, and psychiatric symptoms. They can cause a loss of IQ points among children who are being dumbed down by all these toxins. Thousands of chemicals (endocrine disruptors) are also now being found in our bodies just from food packaging materials. Then at least 80-90% of my chronically ill patients are testing positive for mold toxins, which suppress the immune system and increase inflammation and mitochondrial dysfunction while leading to a worsening of their chronic fatiguing, musculoskeletal, cardiopulmonary, neuropsychiatric illness.

On top of that, getting a credit card of plastic in your body every week doesn’t help matters. You can’t go shopping with it and buy cool stuff. Nano and microplastics are being found in arteries, like the carotid, leading to strokes; they are infiltrating coronary arteries, contributing to heart attacks. They are getting into our brains, acting as a shuttle for more environmental toxins, which then act like hormone disruptors, increasing insulin resistance—yet another underlying cause of heart attacks, strokes, cancer, and Alzheimer’s disease. And if you are eating a Standard American Diet full of processed food and chemicals, which lacks adequate vitamins and minerals (because the food you are eating is coming from depleted soil that has not been farmed properly), while trying to fight these infections and detox these chemicals, your poor diet affects the microbiome of your gut. The result is dysbiosis, impairing your detoxification pathways and adversely affecting your immunity.

Too many bad bacteria, and not enough healthy bacteria in your GI tract, along with the wrong viruses and fungi, further increases inflammation. Dysbiosis and leaky gut has now been linked to everything from cancer to cardiovascular disease to Alzheimer’s, Parkinson’s, and autoimmunity.

These infections and toxins also affect mood, and many can result in and increase anxiety and depression, while also causing OCD, bipolar disorder, and schizophrenia. Microbes do cause mental illness. So do environmental toxins. Are we treating these psychiatric manifestations with medication like benzo’s, selective serotonin uptake inhibitors (SSRIs), and anti-psychotics because it is easy to do so, while ignoring the role of infections and toxins on our mental health? Yes, in some cases we are. It’s not to say there aren’t genetic predispositions for mental health disorders, or traumatic factors worsening them. But when you mix infections and toxins with modern day stressors…like living through a pandemic where many people you know may have died, including close relatives and friends, and you are still grieving their loss…or if you mix those infections and toxins in a young person already grieving climate change on our planet, losing hope that the “grownups” will someday put their well-being and the well-being of future generations above financial concerns…that is a lot to handle when you are a feeling, caring person.

Many of my current patients have also been traumatized by their dysfunctional families. Traumatized by society and their judgments. By those who lack discriminating wisdom who have hurt them, physically, mentally, emotionally or had them suffer sexual abuse. Trauma in the central nervous system causes more inflammation and prevents healing. You can’t heal when you don’t feel safe. And if you can’t feel safe because hurricanes or wildfires keep breaking out in your area, or because the changes at the federal level have affected you personally…all of this affects acute and chronic health.

If we don’t get to the root causes of chronic illness, which is responsible for 85% of our healthcare costs, we will eventually break the healthcare bank. Our health will eventually fail under the stress and strain of these untreated infections, toxins, and microbiome issues, with vitamin and mineral deficiencies leading to insomnia…further increasing your inflammation and causing to chronic disease epidemics.

When we stop supporting science it will eventually backfire. You need strong science to find solutions to healthcare problems, which are driving up your budget, AND disabling people, stopping them from living the American dream. Science and university-based research, funded by the NIH, allowed me to find a solution for chronic Lyme disease. (I submitted an R34 NIH planning grant to prove it to the world…hoping the federal freeze doesn’t affect my application).

We can and should question things in our lives to know what is true and what is not. Where we are being manipulated by social media, and when we are hearing the truth. Science, in its purist form, is truth. It depends on scientific method. The scientific method is a systematic, problem-solving approach to understanding the world, involving making observations, formulating hypotheses, conducting experiments, analyzing data, and drawing conclusions, often iteratively refining the process with new insights. It is based on facts. Facts. Something we all should cherish these days. Something we can believe in.

Science has improved our lives. Most of us wouldn’t be alive reading this Substack if it weren’t for the scientific advances that happened in part by NIH researchers, who are some of the best in the entire world. I have pride over America’s accomplishments in the scientific arena that have improved our lives and lives of people all over the world.

So if I were to meet with RFK Jr. and have an honest conversation on how he can improve the healthcare system, saving lives and money at the same time, it would be to focus on the root causes of chronic illness. 

I am qualified to have this conversation on how to fix the healthcare system because I have been on the inside for over 4 decades, and I know firsthand what works and what doesn’t. Support science. Support prevention. Get to the root causes of chronic disease and don’t just treat symptoms. Integrate compassion and caring into the healthcare system and open up Prevention Centers of Excellence as well as Chronic Disease Centers of Excellence to help all those who cannot get help anywhere else. That will require a radical shift in how healthcare has been practiced in the United States. I hope RFK Jr. is up to the task. I see us talking in my meditations. My phone line is open and waiting.