As the November election to decide who will be the American president in the next four years heats up, the stakes seem to also be increasing.
A former Trump administration official has suggested that a complete restructuring of the CDC could be in order if Trump gets into office. In his view, the CDC as an organization has lost the trust of the American people and needs to be heavily changed.
Former Agency Director’s Comments
Roger Severino is a former director of the Health and Human Service’s (HHS) Office for Civil Rights under former President Donald Trump. In comments to Politico, he talked about how the CDC has lost its way as a public health organization and needs to change.
“We have to move away from social engineering and more towards good outcomes,” Severino said.
Criticism of the CDC
Republicans and other critics point to the fact that the CDC at times has made contradictory health recommendations to the public and that it seems they are changing these recommendations with a political agenda.
For example, the CDC has updated its health recommendations for masks several times. At some times they recommended universal masking while at other times top health officials have urged the public to stop buying masks altogether.
Stop Buying Masks
In February 2020 the US Surgeon General Dr. Jerome Adams, the nation’s top health official, sent out a warning to stop buying masks in a now-deleted tweet.
“Seriously people — STOP BUYING MASKS!” They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!”
The Guidelines Update As Information Becomes Available
Supporters of the CDC as an institution will point out that the CDC’s guidelines do have a valid reason for changing, and that it is because new information becomes available that makes new recommendations necessary.
However, detractors point to reviews of the data that suggest the CDC may have exaggerated the evidence of mask effectiveness in the service of promoting the policy.
Losing Trust in Institutions
Wherever the truth of the matter lies, what is clear is that the CDC has lost the trust of some Republicans and members of the general public. A 2023 study published in the journal Health Affairs found that nearly 1 in 4 Americans now actively distrust CDC recommendations.
The study was not all bad news however, as a higher 42% of Americans trust the CDC “a great deal” to provide accurate COVID-19 information.
Breaking the Agency Apart
One suggestion that Republicans and conservatives have looked to to fix this public perception issue is in a proposal called the 2025 Presidential Transition Project. This project from the conservative think tank The Heritage Foundation asserts that the CDC should be reduced in size and split into two different agencies.
One agency would be responsible for collecting data about outbreaks and pandemics while the other one would provide health recommendations for agencies and Americans. This separation would theoretically make it harder for recommendations and data to get mixed up.
Problems with the Plan
Critics of this proposal point out that shrinking the CDC like this would limit its effectiveness. It would also make it slower to react to a quick outbreak of disease.
Dr. Tom Frieden, former leader of the CDC under the Obama Administration said “If you have different agencies, you’re not going to make it easier to deal with an outbreak. You’re going to make it harder to deal with an outbreak and you’re going to reduce the likelihood that Americans will be resilient and healthy enough to withstand it.”
Organization Flexibility
Frieden illustrated his point by comparing the CDC to other government organizations, suggesting the solution to the CDC’s public perception problem is more government oversight.
“We don’t split up the military because it’s too big. We don’t split up corporations because they’re too big,” Frieden said. “Big organization needs a big management structure and also flexibility.”
Prescriptive Changes
Severino is a critic of CDC regulations that make prescriptive guidelines that people fundamentally disagree with. He prefers that parents or medical professionals make those calls.
“By statute or regulation, CDC guidance must be prohibited from taking on a prescriptive character. For example, never again should CDC officials be allowed to say in an official capacity that school children ‘should be’ masked or vaccinated … Such decisions should be left to parents and medical providers,” Severino wrote.
Religious Conscience Rules
Another way the HHS could change under Trump is the restoration of religious conscience rules.
These rules would limit the previous expansions of civil rights protections under the Biden administration and allow health providers a greater ability to refuse abortions, limit birth control, and other actions that affect the provider’s religious conscience.
It May Take Time
If the Trump presidency in 2024 does come to pass, this radical change in the CDC would likely take time to implement. Bill Hoagland, the senior vice president at the Bipartisan Policy Center told Politco that the change would likely need legislation, though other options were possible.
Any legislation effort would take time to pass, leaving a moment for other government institutions and the general public to weigh in on the process.
