Bask in the Glory of These Doctors Ripping Trump Apart

Let's face it, we knew our healthcare was going to change under a Donald Trump administration, but perhaps we didn't realize how much. (Tonic has you covered with a list of all the moves that could affect your health under this new leadership.) Doctors and healthcare experts have been paying close attention and some have taken to leading medical journals to denounce some of Trump's most divisive policies.

Here are the strongest criticisms from the health and science community so far:

The backstory: Trump made it a part of his platform to repeal and replace the ACA. Hours after his inauguration, he signed an executive order to begin unravelling the program. But the realization that people might lose their healthcare has slowly dawned on both Trump voters and Republican lawmakers.

The case against it: As lawyers Timothy Stoltzfus Jost and Simon Lazarus point out in the New England Journal of Medicine, Trump's executive order can't repeal the ACA but as various federal agencies take steps to undo its components—like halting enforcement of tax penalties for not complying with the individual mandate to have health insurance, which is already happening—the market will come crashing down. The journal burn: "Precipitous changes in the enforcement of the law would severely disrupt insurance markets, with political, no less than policy or humanitarian, consequences. The Congressional Budget Office projects that gutting the law would lead to comparatively healthy people to drop coverage, forcing insurers to raise premiums or withdraw from markets altogether. Such actions would, in turn, further shrink the insurance pool, raise premiums, and reduce insurance availability—resulting in an increase of 18 million in the number of uninsured Americans by 2018. Mulling such prospects, Republican strategists, both in and outside the administration, are reportedly already having second thoughts about precipitously sabotaging the ACA."

The backstory: Trump reinstated the so-called "Mexico City Policy," which restricts international NGOs from receiving US funding if they counsel patients about abortion or refer them to a place where they can get an abortion. Not only will women's reproductive rights be affected around the world as a result, but overall well-being will take a hit because Trump expanded the gag rule to include global health organizations that offer treatment for malaria, tuberculosis, and HIV.

The case against it: Michele Barry, the senior associate dean for global health at Stanford University, and Nathan Lo, an MD candidate in epidemiology at Stanford, argue in the New England Journal of Medicine that the Mexico City Policy actually increases abortion rates. Defunding family planning and general health providers over abortion counseling will restrict access to contraception and lead to more deaths from pregnancy complications and unsafe abortions, higher rates of unsafe sex. The move will also weaken healthcare systems that can protect against the global spread of diseases like Ebola, Zika, and the pandemic flu. Health crises can also lead to civil conflict.

The journal burn: "The decision to ignore data when crafting foreign-aid strategies can jeopardize the mission of US foreign policy to help ensure economic and geopolitical security. The Mexico City Policy is but one of many foreign-aid decisions that the Trump administration will have to make to guide our country and the world. Ineffective foreign-aid policies that ignore basic scientific analysis will undermine our ability to support global development, waste valuable resources, and ultimately hurt the American people."

The backstory: In late January, Trump signed an executive order than banned immigrants and refugees from seven Muslim-majority nations from entering the US for 90 and 120 days, respectively. Among the people affected were doctors, researchers, and medical students as well as people seeking life-saving treatment in the United States. The order was blocked by the 9th Circuit Court of Appeals on February 9, but Trump is expected to sign a new immigration order on Wednesday. The case against it: Katherine Peeler, a pediatrics professor at Harvard Medical School, wrote in the New England Journal of Medicine that the travel ban has only heightened fear for people seeking asylum in the US from abuse, torture, and persecution. Some people already in the country are not seeking medical care because they're scared of being arrested and deported. The journal burn: "Refugees and immigrants have helped to make this country what it is. But for thousands of people…around the world, that door has been slammed shut. President Trump took office only weeks ago, but the values our country stands for are fading fast. In addition to continuing the protests and fortifying our towns' resolve to stand their ground as sanctuary cities, physicians can continue to welcome all patients into our clinics and hospitals and defend the right of our undocumented medical students to study and learn. That is what will make America great again."

The backstory: If there was one buzzword in the past few weeks that made us cringe it was "alternative facts"—an incredibly cynical response to reality from Trump counselor Kellyanne Conway. And she was just bickering about his inauguration crowd sizes. As absurd as the kerfuffle was, it certainly isn't funny when the administration applies the same kind of indignation to concerns about health and science. The stifling of communication from several federal organizations including the Environmental Protection Agency and National Park Service has been distressing, as have implications that Trump is forming a vaccine safety commission, and those involved certainly aren't taking to the situation lightly.

The case against it: Three editors of the BMJ and a professor at the Harvard T.H. Chan School of Public Health declared in an editorial that the science and healthcare communities have to commit to providing high-quality, independent evidence and open debate that will inform policy and practice.

The journal burn: "Many of the new administration's pronouncements seem to place little value on facts or analysis. They also seem lacking in careful consideration of the consequences for biomedical research, healthcare, and ultimately the health of people in the US and the rest of the world. We are particularly concerned that Trump's administration is acting in ways that will suppress research and limit communication on scientific topics it it deems politically inconvenient. "

"Whenever someone of prominence snubs or distorts science, it is up to the scientific community to hold them to account. But this situation seems different and more worrisome. The United States is a powerful nation with a profound influence on the health of the world's population. It is one of the largest funders of global health, and offers unparallelled research capacity, innovative technology and products, and a skilled healthcare workforce. That power and influence, if misdirected, will damage efforts to create a healthier, stronger world, one that supports women's health, condemns torture and other human rights abuses, treats refugees and migrants with dignity and hospitality, and ensures that all people, especially the most vulnerable, have access to high quality healthcare."