Jul 07, 2025
On June 12, The Capitol Forum held a conference call with Jeremy Furchtgott and Riley Kruse of Baron Public Affairs to discuss their recent article analyzing the information environment around Secretary of Health and Human Services Robert F. Kennedy, Jr., and the key influencers in the Make America Healthy Again (MAHA) movement. The full transcript, which has been modified slightly for accuracy, can be found below.
TEDDY DOWNEY: Good morning, everyone. Welcome to our Conference Call, “Analyzing MAHA: Influencers Shaping RFK Jr.’s Health and Human Services Agenda.” I’m Teddy Downey, Executive Editor here at The Capitol Forum. And today’s guests are Jeremy Furchtgott and Riley Kruse of Baron Public Affairs. We’re talking about MAHA today. And thank you so much for being here, guys.
JEREMY FURCHTGOTT: Thanks for having us.
TEDDY DOWNEY: So, maybe you could start out by telling us, just giving us a little background on the two things that you have out recently, the Influencer Analytics, the methodology. I think it’s just so compelling and so rigorous the way that you do that. Maybe you can explain for our audience, not all of them may be familiar with what you do, but with the methodology, and then we can get into the conclusions. And then I also want to rope in the latest report that you guys did as well.
JEREMY FURCHTGOTT: Terrific. Thanks, Teddy. I’ll dive in with just a brief explanation of Influencer Analytics. The basic concept behind Influencer Analytics is that policymakers do not operate in a vacuum. They operate in an information environment. People write things. People post things on social media. And we developed Influencer Analytics to provide customers with a rigorous and a quantifiable way of identifying who actually verifiably is important in this information environment.
There’s a lot of speculation in D.C. There are a lot of people who like to talk about just the latest chit-chat – who spoke to so-and-so, and who said such-and-such. There’s a lot of that in D.C. In many ways, that kind of qualitative anecdotal is the main currency of D.C.
And this is designed to be very different. It’s all quantifiable. It’s robust. It’s rigorous. And the goal is to provide a metric of who matters in the public policy debate.
TEDDY DOWNEY: And you’re going through insane amounts of references, social media, papers, you name it, just an incredible amount of documents and material to parse that, right? To get to the bottom of that.
JEREMY FURCHTGOTT: Yes, that’s exactly right. So, to figure out who really matters, we look at any public material coming out of government agencies or key officials. They could be reports, speeches, op-eds, a lot of social media content. In this administration, it’s, of course, X, but also Truth Social. And we look at any instance of an organization being mentioned by a government official or agency.
That outside person could be a journalist. They could be a social media influencer. They could be an academic. They could be someone from industry. There are all kinds of possibilities. And we collect thousands and thousands of these instances of people being mentioned. And we start to see patterns in who is being mentioned most often.
And we have an algorithm that looks at different forms of distribution across different government officials, across time, smooth it out, and we look at who is getting mentioned the most. And for us, that is a rigorous way of determining who is affecting the public policy debate.
TEDDY DOWNEY: And maybe the best way to talk about this is what did you find and how was that different in terms of who the Influencers are? And how is that different from the Biden administration and the last Trump administration? Or maybe even just the last Trump administration?
JEREMY FURCHTGOTT: That’s a great question, Teddy. We’ve done similar types of healthcare Influencer Analytics studies, actually several times over the past roughly five or six years now. And previously, what we tended to find was the following. We tended to find that the people who had the greatest measurable influence were people who were either academics or who had some kind of formal healthcare training. They were an MD. In certain cases, they were a nurse.
And so, pretty much everybody came out of the academy or really had some kind of academic training. And this time it is completely different. And I’ll turn it over to my colleague, Riley Kruse, to explain the contrast.
RILEY KRUSE: Yeah. So, in this last, I think it was 2022, healthcare Influencer Analytics – which is a little different, it was, of course, the Biden administration – seventeen of these twenty Influencers were academics. And of those 17, seven were just academics at Harvard University.
And so, the contrast could not be stronger to these RFK Jr. Influencers who are either social media influencers. You have Tucker Carlson. You have Russell Brand, people from all over the place, from Hollywood, from social media. And another thing to point out is that none of these people have any government, previous government, experience, which is also a sharp contrast to our past Influencer Analytics work, where you’ll see a lot of academics who had previously served in government.
JEREMY FURCHTGOTT: And Teddy, the archetype that I like to point to is Scott Gottlieb, who for many years was really the leading Republican Super Influencer on healthcare policy. He was writing op-eds in the Wall Street Journal, had really stellar credentials in terms of government experience, as well as academic and medical training. And the information environment has shifted just dramatically from circa 2019, 2020, when really the archetype of a Super Influencer on healthcare was someone like Scott Gottlieb.
TEDDY DOWNEY: And what else can you tell us about these people? From what you gather, how do they engage in the information ecosystem? What is the approach to — if you’re a lobbyist or you’re a public interest advocate, if you’re someone who wants to either just figure out how they’re going to make their decisions or influence their decisions, can you tell us more a little bit about that information ecosystem that they’re involved in? I think you point out the difference between new media, mainstream media, in your reports. Maybe get a little bit into that as well. That’d be great.
JEREMY FURCHTGOTT: So, the key thing here is to understand that MAHA is not a monolith. There are different schools of thought within MAHA. And our data shows this. And I think it’s worth taking a few minutes to explain what are the different major factions within MAHA? Because if we understand some of these different schools of thought within MAHA, we understand the interaction between them, then what’s happening, I think, makes a lot more sense.
And I want to use a term here that, Teddy, I think you think about a lot, which is competition. There’s competition within MAHA. And there are two main schools of thought and various sub‑schools of thought and adjacent ones as well. But the two main schools of thought are as follows.
So, one is that the biggest challenge that America faces from a health point of view is processed food. That’s one school of thought. The other school of thought is that the biggest challenge is some version of Big Pharma or vaccines, that intersection of pharma and vaccines and the medical establishment.
Now, many people will say, well, they’re both a problem. We need to reform the food industry and we need to reform the pharmaceutical industry. But when we really take a close look at the viewpoints of the top RFK Jr. Influencers, we see that most of them actually are focused on either food or pharma.
And it’s pretty close to a 50-50 split in the top Influencers that we found. Slightly more are focused on pharma than on food, but it’s pretty close. And that tug of war between a focus on Big Food and a focus on Big Pharma we think is really the most important thing about MAHA to understand right now.
Now, it’s possible that the administration will just — they’ll do everything. They’ll go after the vaccine manufacturers the way some people are calling for and they will go after processed food manufacturers as well as upstream agriculture as well. And it’s possible that it’ll be a kind of 10 out of 10 attack on everybody.
But usually, the way things work is that certain things get prioritized over others. And as a result, from our vantage point, a really important policy question with just dramatic consequences for the private sector is which of these potential targets is actually going to get prioritized over the others? Is it really going to be a big attack on Big Pharma? Is it really going to be a focus on food and ag? And we can walk through some examples of certain Influencers who are very clearly focused on one or not the other.
TEDDY DOWNEY: Yeah, that would be great. Obviously, you have this other report, “MAHA at a Crossroads”, which I found super fascinating as well. Before we get into that, if you have questions, you can put them in the control panel questions pane. Or you can email us at editorial@thecapitolforum.com. We’ll get to them in a bit.
You’ve got this “MAHA at a Crossroads” report. You link up specific people and how their views align with some of the initiatives and some of the broad policy goals that we’ve seen so far coming out of the administration.
If you wouldn’t mind doing that for our readers — and I think there are even more of these tensions — it’s not even just tensions within MAHA that you get into. You get tensions within the Republican Party overall. Which creates an even more complex picture of how things can play out. To me, the most interesting being the difference — you’ve already touched on this — the difference between the people who are really super focused on MAHA and either food or pharma.
But then you’ve got these sort of New Right JD Vance types who want to do something a little bit more holistic. They sort of view the problem as, sort of a community crisis or a connections crisis or a loneliness epidemic of sorts. And they want a broader approach where you’re relying less on medicine, you’re sort of allowing people to be more spiritual, tapped into community.
Anyway, fascinating stuff. Obviously, encourage everyone to read “MAHA at a Crossroads”. But maybe that’s a good transition to get into not just the MAHA internal fight, but this broader fight and then how these MAHA principles are lining up.
JEREMY FURCHTGOTT: The broader fight can be encapsulated in just the following split. Within MAHA, there’s actually continuity between those who are focused on pharma and those who are focused on food. The continuity is they both focus on what people are ingesting.
There’s a very tangible or physical aspect to how they think about problems with health. Some of them say, well, people are eating unhealthy food. Other people say, well, people are basically consuming unhealthy or unnecessary medications. But the common thread is that it’s about the physical world. It’s about consumption. And if you abstract it out a little bit’s really about the environment around us, the physical things around us.
And that contrasts with a view that was more prominent in the conservative movement towards the end of the first Trump term. And you saw this in J.D. Vance’s book, “Hillbilly Elegy”. You also saw this in some of the things that Tucker Carlson was talking about around four or five years ago or so, which was an emphasis on the relationship between family structure, community, employment, especially manufacturing jobs, and then health. And the connection point between family, community, jobs, and health is loneliness and mental health and addiction.
And so, you had people like Tucker Carlson talking about the lack of manufacturing jobs leading to problems in family structure. Men not having the types of meaningful employment that, in his view, men need, and as a result, kind of collapse both at the family and community level, but also at the individual level, and the opioid crisis.
So, it seems like beneath the surface in the conservative movement, there is an implicit debate over what really causes, what really is the nation’s greatest public health challenge? Is it loneliness, family breakdown, and addiction? Or is it this more tangible, physical, environmentally connected question of the foods that we consume and the medications that we take?
And, of course, many people will say, well, it’s all of the above. Why does it have to be one or the other? And it could be all of the above, but these are very different viewpoints whose logical conclusions are very different. If you think that the problem is what people consume, then your solution is going to be, well, people need to consume healthier food and different types of medications.
Healthier food in terms of organics. For example, there’s a very strong pro-organic movement within MAHA. And then on the medication side, different forms of medication. If you abstract out a little bit, there’s a lot of people in conservative movement who are very interested in supplements, who take supplements.
That wasn’t the case 10 or 15 years ago in the Republican Party. I mean, there’s even interest in psychedelics and the medicinal values of psychedelics, which you didn’t really have not that long ago in the Republican Party. And that’s connected to this theory that if what’s wrong with America is what people consume, then the solution is that we need people to consume things that are better and different.
Whereas, if you take what we call the “Hillbilly Elegy” view, then the solution is going to have to do with employment, manufacturing jobs, family formation, and community.
TEDDY DOWNEY: And the MAHA report, just to be clear, is different from Influencer Analytics in that you went out and talked to a lot of leaders in Republican policy circles to better understand all of this tension. And so, I can’t stress enough, these two are very close to The Capitol Forum’s view of what a rigorous review of policy would look like. You really closely understand the people, and then you go to those people and you talk to them about the key policy concerns and how the things that motivate them are potentially at odds.
You break up this tension in the Republican Party into a bunch of different factions. You’ve got America First, the Bro Right, Disaffected Progressives and Independents, Free Market Conservatives and Libertarians, Homesteaders and Crunchy Cons, I love that. In the report, you get into how there are these hippie conservatives who care about organic foods or getting into nature and things like that.
You’ve got MAGA, MAHA Moms, New Right, Techno Optimists and Siliconservatives, like you were just talking about the people that might want to try new drug treatments to fix problems, and then Vaccine Warriors. What I would love to do is, at least for some of the leaders within MAHA or within the Trump administration who are in charge, you mentioned pharma and Big Food. Maybe we can start with those. What are some of the policies or the goals that you’ve seen thrown out by these — not thrown out — presented, put out there, by these leaders that come from their beliefs and that affect competition in markets and whether it’s cracking down on Big Pharma or Big Food, and then we can go from there. It would be great.
RILEY KRUSE: Well, Teddy, I think there’s another big tension within these tribes of MAHA, and maybe within the Right more broadly as well right now, and that is between less regulation and more regulation. Where you have the White House often talking about cutting regulations, laying off a lot of federal workers, and then RFK Jr.’s MAHA agenda, which is going to require a lot more regulation.
And so, when you have these policy proposals like regulating food dyes, labeling on food packaging, that’s going to require a lot more regulation, probably a lot more staff at FDA and USDA and other agencies. And so, I think that seems to be a big kind of tension within the Trump administration right now and probably within the different agencies, USDA, EPA, and HHS. And I think that probably applies to pharma as well where you have some people, especially Silicon Valley world people, wanting to cut a lot of staff at FDA and make the drug approval process easier versus a lot of the people probably closer to RFK Jr. who would actually like to see the drug approval process be harder and more challenging and more rigorous.
TEDDY DOWNEY: And we’ve got some questions from the audience. Maybe I’ll start with some of these to kind of get into some of these specific policy proposals. We’ve got one question here.
Who is leading the new NIH-FDA Joint Research Initiative, the Nutrition Regulatory Science Program? And what is on their agenda? I don’t know if you’ve looked at that specifically, but that’s our first question. If you haven’t, we can just quickly move on.
JEREMY FURCHTGOTT: I do not know off the top of my head.
TEDDY DOWNEY: Okay, let’s go seed oils. That is something they hear a lot from MAHA. Have there been proposals that come up, seed oils come up, in your conversations interviewing these folks when it comes to the MAHA priorities?
RILEY KRUSE: So, we actually did a precursor study to this report in 2023 looking at specifically New Right and populist conservative views on healthcare. And this was July 2023. And even then, we were really starting to hear people talk about seed oils and some of the other ingredients and food products.
And so, I would say, yes, seed oils definitely came up in a lot of the conversations. I haven’t seen any tangible policy proposals introduced from HHS or USDA right now, but I do think it’s definitely on the radar. And it’s been in the conversation on the Right now for two or three years.
JEREMY FURCHTGOTT: Teddy, the seed oils example is a great one. As Riley mentioned, it’s been around for a few years now. And if you take a closer look at how MAHA has gotten to where it is right now, seed oils play a very important role. Because going back a few years, you had, especially on social media, you had various new theories of nutrition or non-mainstream theories of nutrition getting a lot of prominence.
So, seed oils was one of them. And you have all these people now posting about how they’re cooking. They’re using beef tallow instead of seed oils. And it’s a big thing. But in a way, my sense qualitatively, this is not based on the data, but this time it’s just qualitative. I think that wave has peaked and that there was a lot of novelty around the seed oils issue. I think a lot of people, the people who have started using beef tallow instead of seed oils, they’re doing it. People just aren’t talking about it as much anymore just because it’s lost its novelty a little bit. So, I think if we were talking, say, a year ago or two years ago, that would have been one of the main things.
There was, of course, a little bit of controversy a few months ago when one of the key lobbyists for the seed oils industry was appointed to an important position at USDA. So, people are aware of it, but I think it’s no longer the battle cry in a way that it was perhaps a year ago or so.
TEDDY DOWNEY: We’ve got a couple other questions here, specific markets, I guess. Vaccines, that’s big. Been in the news lately. What’s the tension there, getting rid of all of them, just the COVID stuff. Your report gets into this. Would love to hear your thoughts on vaccines.
JEREMY FURCHTGOTT: So, there’s so much to say about vaccines. I’d like to highlight two things that happened on June 10th – so, just a couple of days ago — which highlight this tug of war. Dr. Mary Talley Bowden appeared on the Joe Rogan podcast. And the podcast was something like two and a half hours. And a huge chunk of it was about vaccines. Maybe most of it was actually about vaccines. There were only a couple of mentions of food. That same day, over on X, Alex Clark from Turning Point USA, which is one of the main MAGA organizations these days, is very active tweeting about glyphosate and infant formula.
So, on literally the same day, you’ve got two people in different parts of the MAHA MAGA world talking about completely different things. Glyphosate and infant formula on one side, and vaccines on the other side.
Everything is kind of in the balance right now. It’s not clear what the administration is actually going to do. On June 2nd, or something like June 2nd, when, I guess, shortly after the MAHA Commission report, which was released by the White House, the same person who was on the Joe Rogan podcast a couple days ago, Dr. Mary Talley Bowden, one of the main MAHA influencers, posted on X. She wrote, “MAHA report didn’t utter a peep about mRNA. Why is that?”
So, there are these increasingly vocal calls from part of the MAHA world. People are concerned that the administration is just not living up to their promises to go after vaccine manufacturers. Riley, I’ll turn it over to you to add to this.
RILEY KRUSE: Yeah, we also, in the RFK Jr. analysis, we explored the range of views on vaccines. There’s definitely not – not all the Influencers have the same view. And I think across MAHA, there’s really a spectrum from COVID vaccines, maybe we don’t want mandates, or we didn’t want mandates during the pandemic, and now maybe we don’t want mandates on kids and pregnant women, to all vaccines, investigating all mRNA technology. And so, I think there’s a wide range. I think in the MAGA world, and for a lot of conservatives, not necessarily tried and true MAHA people, I think the focus is more on just the COVID vaccines.
But I do think a lot of these people in MAHA, a lot of the Influencers, certainly some people still around RFK Jr., are taking a much wider approach to vaccines. And you can see it in the people that he just named to the immunization committee yesterday, I think, for the CDC.
TEDDY DOWNEY: You know, I think one thing to sort of drill down on here when it comes to vaccines or any of these other sort of, I would say, not necessarily radical, but sort of significant policy proposals, it takes some kind of, historically, if you want to actually get change in Washington, you sort of have to have some expertise, some policy expertise, some strategic ability, to get your goal policy across the goal line.
Something that jumps out to me in your report is that none of these people has any real experience in the government. They’re sort of very good at social media, perhaps. But I think it’s an open question of whether or not they can achieve their goals. What do you say to that lack of expertise, lack of government experience?
You know, obviously, you could say, hey, this is a great thing that there’s no revolving door here. But there’s also no experience at all in some respects. So, if you’re a company, can you just wait them out? You know, you hope they go away in two or four years? What gives you some confidence that they can actually sort of push ahead with some of these more aggressive ideas?
JEREMY FURCHTGOTT: First of all, Teddy, I want to say that although the external Influencers, those outside of government, do not have the academic or healthcare practitioner or government experiences that we would expect. Many of the people actually staffing HHS at a senior level, the political appointees, have very impressive experience just based on people who I know and I’ve met. I mean, these are people who have impeccable expertise. I think that the complicated dynamic is that you have people in the agencies, in many cases with a lot of expertise, but they need to be aware of and responsive to surrounding political information environment that is not driven by expertise.
And this is really one of the most important shifts. Where it used to be the case that opinions were set based — or the consensus was set based — on expertise in some way. For example, if you look at the tobacco wars, if you go back to the 1990s and the Master Settlement Agreement, that was driven — yes, maybe there was a cultural aspect of it, but it was just driven by a lot of research showing the effects of smoking. And so, there was an expertise driven change.
And here the main lever of change, from a political point of view, is not expertise. It’s cultural tribal affiliation. And this is, I think, a great challenge for companies because companies have expertise. Companies can legitimately, and in a very important way, participate in the public policy debate by offering their expertise. Companies have experience. They’ve got data. They’ve got experts. They can participate in a public policy discussion where expertise is valued.
But when what’s really valued is questions of cultural affiliation — and I use the word tribes deliberately, where there is an aspect of loyalty and kind of mutual affiliation and mutual, frankly, protection — it’s really hard for companies to engage because they’re not part of these tribes generally. By design, they’re not involved in the culture wars. And so, at best, they can be a neutral party, but it’s become much more difficult for companies to engage.
And what we have seen to be most effective is companies that are able to somehow show that their products or their business model or their sector, somehow linking it to the major cultural issues, which is uncomfortable for many companies. It’s just a completely different approach to interacting with Washington.
TEDDY DOWNEY: And you actually have an example in the report of a company or a PR firm trying to buy off influencers. Can you tell that quickly, just as a crash and burn story? That was pretty good.
RILEY KRUSE: This was a controversy, I think a couple months ago now, and especially in the MAGA world, where you have a couple top MAGA influencers who essentially exposed a handful of other MAGA influencers who were posting tweets that eventually people found out were paid for by some part of the beverage soda industry through a PR firm. And so, I think it shows also the risks of what Jeremy is saying of engaging in MAHA and MAGA in certain ways.
JEREMY FURCHTGOTT: And Teddy, for the record, we always recommend that our clients not do exactly what Riley just said. We do not recommend buying off social media influencers. Because our view is that, first of all, it doesn’t work. It’s very superficial. And second, it’s just going to blow up at some point.
TEDDY DOWNEY: It’s also illegal, isn’t it? I mean, isn’t that an FTC — don’t they have rules on that? I don’t know. If you don’t disclose it, I don’t know. Maybe not. Maybe we’ll see. You’ve got some FTC listeners on here probably. They probably know. Maybe they’ll ask.
JEREMY FURCHTGOTT: The disclosure standards, just in practice, are incredibly low. But also, I think it’s usually not effective. Because if it’s artificial, then it’s going to smell artificial, and we always discourage our clients from doing it. But some companies are doing it.
TEDDY DOWNEY: It’s either illegal or it doesn’t work. Those are good reasons not to do it. I’ve got some other questions here. I want to make sure we get to them. MAHA. We’ve got, I think, some illicit sort of sin industry stuff, alcohol, marijuana, hemp, THC. You mentioned psychedelics. What’s the MAHA view on all this stuff? I imagine there’s a lot of tension across the board on all these. We can go one at a time. You can do it all together. However you guys want to tackle that.
JEREMY FURCHTGOTT: I would love to, at some point, actually quantitatively measure views on all the different frowned upon or illicit substances. We’ve not done that. But I can give you just a qualitative impression, which I think is reasonably accurate.
One is that tobacco has made a comeback. This administration is very pro-tobacco. And Teddy, in all the different things that you listed there, you did not actually list tobacco.
TEDDY DOWNEY: I didn’t. It wasn’t on the question list. Yeah, there you go.
JEREMY FURCHTGOTT: So, I think tobacco is a very interesting one to talk about. The second is I think that the pro-marijuana constituency in the Republican Party is not particularly influential at this point. I think that the pro-psychedelic constituency, it may be very small, but I think it’s highly influential.
When we look at the different constituents of the conservative movement, we break it out into nine major — we call them tribes. And one of the tribes that we point to is Silicon Valley conservatives. We call them Siliconservatives, Silicon Valley. And in that tribe, there’s a lot of openness to psychedelics, I think more than marijuana. And I think, on the Right, marijuana may have had its peak, I don’t know, maybe sometime early in the first Trump term or late Obama years. And I think politically where we are right now with psychedelics is similar to where we were with marijuana roughly 10 to 15 years ago, which is a lot of interest in therapeutic benefits and kind of elite-driven — some elite-driven acceptance.
Alcohol is an interesting one. Yeah, alcohol is a very interesting one. I haven’t really seen a lot of people making strong pro‑alcohol arguments out there. Riley, I don’t know if you’ve seen much.
RILEY KRUSE: I was just going to go back to these two schools of thought between the kind of New Right, Hillbilly Elegy worldview and the more MAHA consumption-oriented worldview. And looking at our report on the New Right healthcare views a couple years ago, you would have thought that conversations around the opioid epidemic, fentanyl coming from Mexico or China, would have been a bigger part of the MAHA agenda and a second Trump administration’s HHS agenda.
But it’s also been surprising to me that there’s been a lot less focus on the opioid epidemic and opioids in general, prescription or illicit, from RFK Jr. and from HHS currently. And I think that’s probably a tension as well between these two camps, between the kind of pro-industrialism, pro‑work, pro-labor parts of the Republican Party and the MAHA around RFK Jr.
TEDDY DOWNEY: Yeah, alcohol is pretty surprising. I wonder if it — just because you would think the New Right would have a similar issue with that if they’re worried about loneliness. I guess going to a bar is kind of, I don’t know. It’s hard to see how it fits as a good thing, I would imagine.
JEREMY FURCHTGOTT: Well, Teddy, one way to make sense of what’s going on is you have to keep in mind that you can organize both the conservative movement as well as MAHA on an elite to populist spectrum. And the different types of health care challenges that people are focused on reflect where they are on this elite to populist spectrum.
One of the reasons why, I think, the first Trump term was much more focused on opioids and just addiction in general was that those are issues that affect the voting base and really a large swath of the non-elite parts of the country. And the administration was very focused on that audience.
Whereas, MAHA is a much more elite driven movement. And so, I think that’s why MAHA will speak about issues like the nutritional value of breakfast cereals, for example, or vaccine requirements at schools. These are issues that, frankly, upper middle class or wealthier parents care about and they’re very attuned to. Whereas, these parents might not have someone in their family who’s suffering from addiction. So, an addiction, whether that’s opioids or alcohol or gambling perhaps or anything else. So, I think the shifts from an addiction framework to this nutritional health framework, I think it maps onto a populist elite split within the movement.
TEDDY DOWNEY: Well, maybe we could focus on some of this elite policy ideas. One that you bring up is SNAP spending on junk food. You know, on the one hand, that seems like — I mean, it’s kind of hard to imagine how it got in there in the first place, to be honest, but it’s in there. But it also kind of — I’ve seen tons of Republican focused ads over the years that are like, this is nanny state liberalism type stuff, sugar tax, telling people what they can eat. So, where do you see that? Is there a lot of tension there? Or is there more like, you know what? They’re just going to get rid of that? And then like, how do you even define junk food?
And you also mentioned in the report letting people spend their health care money on like healthy foods or maybe gym memberships or something like that. You know, I see all this kind of tied together. Where it’s like kind of behavioral kind of taking the money that’s out there and using it for my hot goals. Are those possible non-starters? How do you think of that in terms of the support and the tension within the Republican Party?
JEREMY FURCHTGOTT: I think there’s a big elite populist split here. Because the more elite parts of the movement are going to be happy to see the SNAP cut. And they will very rightly point to just the nutritional value of different types of foods. And they’ll say, well, really, SNAP is supposed to be about supplemental nutrition. It’s supposed to be nutrition.
But other parts of the Republican Party who are maybe more focused on the average voter, they’re going to look at, well, what are the kinds of foods that the average voter likes to consume? And they’re going to look at who is the typical Trump rally attendee, for example? And they might even look at the personal food preferences of President Trump, who I think is known to appreciate fast food, for example. And they’ll look at that part of the conservative movement and say, look, our voters like these foods. Politically, do we really want to be the ones to restrict access to these kinds of foods?
So, it’s a very real tug of war. I think right now if you look at the SNAP battles at the state level, it definitely seems like the restrictions on SNAP usage have the upper hand. Seems like the momentum is going in that direction. But I think that the challenge that part of MAHA is going to face is, at the end of the day, are they really aligned with the GOP voter?
And I think that’s it’s unclear. I think one can make a strong argument that the GOP voter, who, frankly, frequently might be using SNAP, wants to be able to go to the grocery store and spend SNAP on whatever they want.
TEDDY DOWNEY: Yeah, and also gets into a little bit of like how do you think about fixing this problem? Because ostensibly you could go and you could take out subsidies for corn syrup or you could do a more sophisticated play with through the food system, food subsidies. But that then gets you further afield.
I mean, even SNAP is kind of not within MAHA’s jurisdiction, right? Like that’s like a congressional play. And there’s not a lot of MAHA Senators running around, I don’t think. Unless you guys tell me that’s wrong, which you’re welcome to do.
Well, we could stay on that for a long time, but we’ve got a couple of other questions here that I’d love to get to. Pharma and pharma ad spending or any other pharma policies. I know you two think a lot about PBMs. We’ve sort of covered the antitrust side of the PBM fight, which is a lot of litigation against PBMs for their role in market power.
You mentioned pharma ad spending, which I thought was really interesting, all the different views on pharma ad spending, and how that became an issue. Maybe you could talk a little bit about that and then maybe broader pharma policy, where that sits in this relationship ecosystem.
RILEY KRUSE: Well, I would say, like we mentioned in the RFK Jr. Influencers brief, is the Influencers tend to be a leading indicator of where policy making is going to go. And for every single one of these Influencers, the pharma advertising and some sort of restrictions, and RFK Jr. himself, have been talked about for years. And so, I think if you’re trying to forecast those policy proposals, looking at these Influencers and seeing the fierce criticism of the direct-to-consumer ads, I think it’s likely that there’s going to be some sort of regulation of these ads in the near future.
JEREMY FURCHTGOTT: Teddy, I think it’s also important to keep in mind that the administration is also eager to go after the media industry. So, going after DTC pharma ad spending not only can be an anti-pharma move, but it’s also an anti-Big Media play. So, I think that the politics kind of align there in the direction of a higher likelihood of some kind of restriction on DTC. I think the PBM issue —
TEDDY DOWNEY: Actually, can I stay on that for a second? I thought it was really fascinating how you mentioned that the Influencers, the thing that activates the Right, it actually is even more sophisticated than just not liking the media. It’s actually believing — and as someone who runs a media company, I think there are conflicts of interest issues if you’re taking a ton of money from one specific advertiser. They are concerned at a profound level with how much money pharma ads makeup for media companies, and they think it affects their content. They think it affects their editorial decisions, which I think is a fair criticism. I’m in a very limited minority thinking that media companies are not above conflict of interest concerns. But talk a little bit about that. I thought that was a fascinating part of the report.
JEREMY FURCHTGOTT: This is absolutely a mainstream view in these circles, which is that pharmaceutical manufacturers spend so much money on advertising, they utterly dominate ad spending relative to other healthcare companies. And as a result, they distort editorial decisions. We’ve heard anecdotally many people who are very concerned about this and have stories that they point to.
I think one of the deeper reasons for this is that if you look at the healthcare industry, relatively few types of healthcare companies are really selling a product to a consumer. PBMs, for example, are not. They’re a B2B company.
Insurers usually are not. Because usually what they’re doing is they’re chasing either a Medicaid contract or an employer-sponsored insurance contract with a major employer. Or in certain cases, yes, they’re on the individual market. But for the most part, the insurance industry is not really a B2C. They’re not doing B2C advertising that much. And then hospital industry similarly, with the exception of maybe maternity a little bit.
So, as a result, in the healthcare industry, the only companies who are really behaving in this way where they think of the average American as, they would say, a patient, really a consumer, it’s really pharma.
I mean, wholesalers aren’t operating that way, of course. It’s B2B. And so, not only is pharma spending a lot more in advertising than anyone else, but our view is actually pharma companies have developed deeply ingrained strategies and behaviors that are different from other healthcare companies. If you look at our government affairs strategies, pharma companies are used to thinking about the kind of average voter. Because there is this consumer-facing aspect to pharmaceutical manufacturers that you don’t see in other parts of the healthcare industry.
I think that is really the biggest tailwind that pharma manufacturers have, aside from their heft. It’s their orientation towards the average voter, which other healthcare companies really struggle with.
RILEY KRUSE: I also don’t think it’s a coincidence that Tucker Carlson is the top RFK Jr. Influencer, as being the only one who has this kind of media experience and has been a very outspoken critic of pharma ads, and has talked about his time at Fox News, and how he felt it influenced the news reporting.
TEDDY DOWNEY: I’ve got one last question here. I think it’s an interesting question here. RFK Jr., former heroin addict. I’m not a huge expert, but I think I’ve seen him talk about mental health. What do you think about his views and MAHA’s views on behavioral health organizations, or mental health therapy, that type of stuff? You could see a world where you can squint and maybe see some alignment with the populist New Right. If they think you’ve got a lot of mental health problems, maybe you should get some mental health help.
Obviously, it’s not like just — probably they wouldn’t want it to be just limited to paying some psychiatrists or anything like that. But you could see a world where there’s kind of some broad interest in taking mental health seriously from a therapy standpoint. I don’t know. That’s an interesting question. I wanted to bring it to you guys to see if that came up at all when you were doing your analysis.
JEREMY FURCHTGOTT: We really don’t see that much of it in the information environment around Secretary Kennedy. If you look even more closely, you’ll actually see a certain knee-jerk negative reaction to anything that uses the term mental health. Because in certain parts of the MAGA world, it’s become associated with the Left.
Where I do think you would find greater connectivity in the administration on this perhaps with the Vice President, and this is the Hillbilly Elegy worldview, where you have broken families, broken communities, lack of employment opportunities leading to addiction, depression and addiction.
So, if someone were really trying to identify opportunities, trying to figure out where in the administration is the most likely home, I don’t think it would be the MAHA core, which is much more focused on food or vaccines. I think it would be the Hillbilly Elegy-oriented parts of the administration. And so, off the top of my head, it’s, of course, the Vice President. But then you’ve got some key people in the White House who come out of similar New Right offices, national conservative offices, on the Hill, former Rubio staffers, for example, might have a similar orientation to the Vice President on that.
TEDDY DOWNEY: And I have a last question. I know you guys have got to go, but last question here. This is me. Something that came up in my reading your report, which was you mentioned hippie conservatives or granola conservatives or crunchy conservatives. I’m reading this report and some of the stuff about the New Right’s concerns about loneliness. That is a very frequent topic of conversation.
Not that I’m an expert on hippies. But on a podcast, I heard about a book called “The Connection Cure”. It’s about social prescriptions where — and it seems like a hippie concept, but again, I don’t know the full extent of hippie medicine historically. But where a doctor would basically say, hey, oh, you’ve got stress. You’ve got depression. Instead of just giving you a pill — they might give you a pill, but they would also give you a prescription to go join — they find out you like cycling, go join the local cycling group, right? That’s your prescription. Like you’ve got to go do that, sign up and go do that.
It’s kind of out of left field, but are there any — I could see that alignment too, where you’re like, okay, you’ve got this aversion to pharma. You’ve got this interest in other solutions. Is there anything like that kind of rethinking, re-imagining, your relationship with your doctor or the types of solutions to your loneliness as tapping back into community or stuff like that? And we obviously cover technology a lot, banning cell phones in schools, that type of thing, banning whatever, being more aggressive about social media enforcement and regulation. Obviously, famously Zuckerberg said that people only have three friends and they should rely on AI bots. That doesn’t seem like something that would resonate with the MAHA or the New Right. What’s your kind of take on these sort of like outside the pharma solution to loneliness or whatever? And how does that come up? How does that come up in this ecosystem?
JEREMY FURCHTGOTT: That definitely is huge. And just on the point about tech and screen addiction and loneliness, there’s a reason why one of the major sections of the MAHA Commission report the White House released a couple of weeks ago was a section on tech. So, absolutely, the tech health nexus is huge. A lot of concern about negative health consequences of tech.
In terms of loneliness and the role of doctors, it’s a very big topic, especially on questions of what type of spending should be eligible for HSAs? And there’s a lot of interest in expanding the parameters of HSAs to include things like what you described, things like a gym membership, and having doctors have to provide some kind of — you use the word prescription, but it wouldn’t have to be literally a prescription. It’s some kind of letter of medical necessity. And it’s about having policymaking reflect a broader concept of what health is.
So, that health is not just what conservatives conventionally used to say, which is, conservatives used to say the doctor-patient relationship. You go to the doctor. Doctor prescribes a medication. You take the medication. That is health. And that previously was the view. And now the view is much more expansive.
And the ideal, nowadays, I think, in the MAHA worldview is not that there’s a “doctor-patient relationship”. Because that assumes that everybody’s a “patient,” assumes everybody’s sick. The ideal is that you’re healthy. You’re engaging in activities.
Teddy, as a cyclist myself, I love your example. You’re engaging in activities like your local cycling club. And federal policy recognizes that and supports that as something that is basically health care spending. So, there’s a lot of interest, I think they’re working at the mechanics, whether it’s going to just be through HSAs or through other mechanisms. So, there’s a lot of interest in that.
And this reopening of the concept of what is health, it’s much deeper than just a technical question of what should be allowable for HSA spending? It really goes back, I would argue, hundreds or possibly even thousands of years. If you go back to biblical concepts of health and different concepts of health in ancient societies, you have a similar debate occurring. Is health really about behaviors? Or is health about a magic potion?
And so, we’re reopening these very ancient debates about what makes us healthy. And the view that our behavior makes us healthy is gaining ascendancy and is going to have massive consequences for industry.
TEDDY DOWNEY: Well, I think it’s super interesting. The idea that you just take a pill for loneliness never really strikes me as getting to the core of the problem. You two and Baron just do incredibly rigorous work. I think we saw that from these papers, from this conversation today.
I can’t recommend Baron Public Affairs enough for that rigor, for strategically, you know, I’ve gone to a lot of your conferences. I think your clients are the most sophisticated, the most savvy, when it comes to strategically thinking about Washington. And so-so impressed by the work that you do. And thank you so much for doing this. This was a real pleasure.
JEREMY FURCHTGOTT: Well, thank you so much, Teddy. We are big fans, and we really appreciate you having us on.
TEDDY DOWNEY: All right. Well, thanks again. And thanks to everyone for joining the call. This concludes the call.
