With the November 5 election upon us, health policy is once again at the forefront of political discourse. Recently, Robert F. Kennedy Jr. has been making headlines after presidential candidate Donald Trump indicated that if he were elected, Kennedy could "go wild on health" with a health policy role in the White House. Kennedy made alarming comments about overhauling critical health agencies, and over the weekend he said that fluoride is an "industrial waste" and should be removed from public drinking water. All of this has sparked renewed discussion about the future of our healthcare system.

As an emergency department physician, I have witnessed firsthand the profound impact that health policies can have on patient care. The question of who has a hand in health policy in the White House is deeply personal to me and crucial for every voter to consider.

In my daily practice, I encounter patients whose lives are affected by decisions made far beyond the walls of the emergency department. For instance, I recently treated a young mother who arrived in crisis, her child suffering from an asthma attack exacerbated by a lack of access to preventive medications due to insurance issues. Her story is not unique; it reflects a systemic failure traced back to the policies that govern healthcare access and affordability. According to the Kaiser Family Foundation, one in four Americans report skipping necessary medical care due to costs. This number jumps to six in 10 among the uninsured. The current landscape is fraught with challenges, and the ramifications of misguided health policy can be catastrophic.

While the Trump campaign walked back the initial report that Kennedy would control agencies such as HHS, CDC, FDA, and NIH, he would reportedly be given a role in women's health and nutrition, and would go after federal data on vaccines, reportedly to prove they are "not safe." This introduces a major risk: granting Kennedy, who has a long history as an anti-vaccine activist, access to information with a stated goal of disproving vaccine safety. For public health, which relies on the transparency and integrity of data, this could be disastrous, further eroding the public's fragile trust in vaccines and threatening the progress we've made in infectious disease control.

Vaccination rates are already declining, with CDC reporting significant drops in adult and childhood coverage during the pandemic. Vaccines are one of the greatest public health successes in history, and further undermining their importance would put countless lives at risk. With Kennedy given a platform to spew more anti-vaccine rhetoric, the implications could be disastrous.

But vaccines aren't the only health intervention that would hang in the balance if he were put in a position of power. Kennedy's statements against antidepressants -- claiming they are linked to the increase in school shootings -- would have profound consequences. A National Health and Nutrition Examination Survey found that about 13% of Americans ages 18 and older used antidepressants, indicating a widespread reliance on these medications for mental health treatment.

Moreover, Kennedy's unfounded claims that Wi-Fi exposure can lead to cancer demonstrate a troubling disregard for evidence-based medicine, as multiple studies and federal guidance on the matter suggest no causal link between Wi-Fi exposure and cancer. Such rhetoric on Wi-Fi and antidepressants not only spreads misinformation, but also deters individuals from seeking appropriate care.

At a time when confidence in our healthcare system is already low -- largely due to misinformation amplified during the pandemic -- having Kennedy in a position of power would further erode public trust. According to a 2022 Gallup poll, only 38% of Americans expressed confidence in the healthcare system, the lowest level recorded since the survey began in 2001. The consequences of Kennedy's leadership could extend far beyond policy changes; they could influence the very fabric of our healthcare system.

We are already witnessing a troubling rise in healthcare violence against providers. The American College of Emergency Physicians found that 91% of emergency physicians said that they, or a colleague, were a victim of violence in the past year. This trend correlates with the spread of misinformation. When patients distrust the healthcare system, they may lash out against those who are trying to help. At a time when assaults against physicians are on the rise and trust is already low, do we need to fan the flames?

As voters and healthcare professionals, we must critically assess health policy discussions rather than passively accept rhetoric. The stakes are high, and our choices at the ballot will directly influence the future of U.S. healthcare. It is imperative that we engage in conversations grounded in evidence, focusing on improving patient outcomes and ensuring equitable access to care. We need to challenge leaders who promote policies that threaten our collective health and safety.

Let us prioritize healthcare as a key issue as we head to the polls. We must advocate for leaders who value science and evidence-based practices over fear-mongering and misinformation. We have the power to shape a system that prioritizes patient care over political agendas. It's time for us to demand informed choices and hold our leaders accountable for the policies they propose. The health of our nation hangs in the balance. Together, we can create a future where health policy is rooted in truth, understanding, and respect for the science that guides our profession.