{"id":1978,"date":"2026-06-03T17:00:05","date_gmt":"2026-06-04T00:00:05","guid":{"rendered":"https:\/\/aculpableinnocence.com\/home5\/aculpabl\/anthony_blog\/?p=1978"},"modified":"2026-06-03T19:37:59","modified_gmt":"2026-06-04T02:37:59","slug":"1978-2","status":"publish","type":"post","link":"https:\/\/aculpableinnocence.com\/home5\/aculpabl\/anthony_blog\/1978-2\/","title":{"rendered":"Assuring the Health of Americans"},"content":{"rendered":"<p>&nbsp;<\/p>\n<p>In our Democracy, every candidate for the Presidency must be of and for the people, meaning he\/she must care for all citizens and serve their interest and well-being. Otherwise, \u201cdemocracy\u201d\u2014that is, \u201cpeople rule\u201d\u2014has no meaning. If so, then how is President Trump living up to that dictum? For example, does he support the health and well-being of all Americans? Well, let&#8217;s review his interest in their healthcare:<\/p>\n<ul>\n<li>He has cut the annual budget of the National Institutes of Health (NIH) by $18-19 billion per year (which includes $1billion from institutions he eliminated).<\/li>\n<li>He has cut $4-5 billion per year from Centers for Disease Control and Prevention (CDC), including $3.8 billion internal transfers. Before these cuts and transfers, the CDC budget was 9.2B.<\/li>\n<\/ul>\n<p>But he has done much more than defund portions of Americans&#8217; healthcare, he has reorganized it and created a new agency to centralize much of our healthcare infrastructure. The rest of this blog will summarize the changes and their impact.<\/p>\n<p>On March 27, 2025, the Department of Health and Human Services (HHS) announced the creation of the Administration for Healthy America (AHA), a sweeping executive reorganization initiated by HHS Secretary Robert F. Kennedy Jr. The AHA consolidates five existing federal agencies \u2014 the Office of the Assistant Secretary for Health (OASH), the Health Resources and Services Administration (HRSA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Agency for Toxic Substances and Disease Registry (ATSDR), and the National Institute for Occupational Safety and Health (NIOSH) \u2014 into a single new entity operating under the HHS umbrella. This consolidation represents one of the most significant reorganizations of the federal public health infrastructure in decades and affects programs that collectively serve tens of millions of Americans.<\/p>\n<p>In May of this year, this blogger submitted \u201cA Consolidated Policy Analysis\u201d to Congress in which key questions were raised concerning the creation of the Administration for a Healthy America (AHA). Herein is a shortened version of my most salient concerns regarding AHA\u2019s impact on Americans\u2019 health and treasure.<\/p>\n<p>The stated rationale for AHA centers on administrative efficiency. HHS has indicated that the reorganization will reduce the department&#8217;s total workforce from 82,000 to 62,000 full-time equivalent positions \u2014 a reduction of approximately 24%, representing roughly 20,000 eliminated jobs \u2014 and will produce estimated annual savings of $1.8 billion. The reorganization also consolidates 28 HHS divisions into 15 and reduces the department&#8217;s regional office network from 10 offices to 5. HHS has characterized this restructuring as a means of eliminating redundancy, streamlining interagency coordination, and refocusing resources on front-line health service delivery. These workforce reductions began taking effect as early as April 1, 2025 \u2014 within days of the initial announcement. But will these reductions be offset by degraded service quality, reduced crisis-response capacity, and the irreversible loss of specialized institutional expertise across the five merged agencies? Each of the consolidating agencies carries distinct statutory mandates, highly specialized workforces, and established relationships with state governments, grantees, tribal health programs, and community providers. The rapid pace of reorganization, the absence of a publicly released implementation or transition plan, and the scale of workforce reduction raise serious questions that are not answered by the gross savings figure alone. Could programs like SAMHSA crisis-response delays, NIOSH workplace safety gaps, or HARSA grant backlogs be negatively affected, or even be at risk?<\/p>\n<p>Any efficiency claims must be validated against measurable service quality outcomes. And Congress clearly has both the authority and the obligation to demand that validation before further implementation proceeds. The analysis submitted to Congress questions whether sufficient transition time was allocated and what medical services were put at risk.\u00b9 Further, there was never sufficient time to produce a for a full cost\/benefit analysis.\u00b2 The more far- reaching concern is whether \u201ccore functions\u201d will or can be preserved and at what costs.\u00b3 Further, and more concerning, previous Federal mergers have shown us what is at risk in terms of institutional expertise, mission dilution, Grant backlogs, reduced regional presence, transition disruption window, and accountability and oversight gaps.4<\/p>\n<p>In conclusion, HHS should publish a full implementation and transition plan\u2014including detailed cost estimates, staffing continuity schedules, program-by-program continuity schedules, and measurable performance benchmarks&#8212;<em>before<\/em> further reorganization implementation proceeds. Also, to preserve Constitutional accountability, there should be independent assessments by the Government Accountability Office and the HHS Office of Inspector General. These measures are not punitive but are standard operating procedures of the American government. Do they not oblige us \u201cto promote the general welfare,\u201d as premised and thereby promised by our Constitution? And that obligation is a key element to every American\u2019s pledge \u201cto form a more perfect union.\u201d<\/p>\n<p>__________________________________________________________________________________________________<\/p>\n<p>Footnotes for \u201cHow to Assure Healthy Americans:<\/p>\n<ol>\n<li>\u201cCan $1.8 billion in projected annual administrative savings justify the very high risk of weakening the federal public health infrastructure \u2013 across prevention, primary care access, behavioral health, environmental monitoring, and occupational safety \u2013 at precisely the moment when the United States faces a growing chronic disease burden, a protracted behavioral health crisis, and escalating environmental health threats?\u201d Ref. \u201cAHA, A Consolidated Policy Analysis,\u201d Section 3, Page 4.<\/li>\n<li>\u201cThe core accountability gap: HHS has publicized the gross savings figure without releasing a full cost-benefit analysis. Until transition costs, service-quality impacts, and downstream public health costs are modeled and disclosed, the net savings figure for AHA cannot be independently validated,\u201d <em>Ibid<\/em>. Section 4, Pages 7-8.<\/li>\n<li>\u201cIn sum, the cost-effectiveness argument for AHA rests entirely on a single, unverified assumption that \u201ccore functions\u201d will be preserved at current effectiveness levels . . . but (AHA) has not published the implementation plan, staffing model, program continuity schedule, or performance benchmarks that would allow independent verification,\u201d <em>Ibid<\/em>. Section 5, Page 9. (And no federal reorganization of this scale has preserved full program effectiveness without a detailed transition plan).<\/li>\n<li>A reorganization that cuts 14% of the workforce while simultaneously expanding the organizational mandate creates structural conditions for oversight failures that could, over time, produce financial and programmatic losses that dwarf the administrative savings claimed at the outset., <em>Ibid<\/em>. Section 6, Pages 10-12.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; In our Democracy, every candidate for the Presidency must be of and for the people, meaning he\/she must care for all citizens and serve their interest and well-being. Otherwise, \u201cdemocracy\u201d\u2014that is, \u201cpeople rule\u201d\u2014has no meaning. If so, then how is President Trump living up to that dictum? For example, does he support the health [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[2,1],"tags":[],"class_list":["post-1978","post","type-post","status-publish","format-standard","hentry","category-domesticissues","category-uncategorized"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_shortlink":"https:\/\/wp.me\/p3UqUK-vU","jetpack_likes_enabled":true,"jetpack-related-posts":[],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/aculpableinnocence.com\/home5\/aculpabl\/anthony_blog\/wp-json\/wp\/v2\/posts\/1978","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/aculpableinnocence.com\/home5\/aculpabl\/anthony_blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/aculpableinnocence.com\/home5\/aculpabl\/anthony_blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/aculpableinnocence.com\/home5\/aculpabl\/anthony_blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/aculpableinnocence.com\/home5\/aculpabl\/anthony_blog\/wp-json\/wp\/v2\/comments?post=1978"}],"version-history":[{"count":7,"href":"https:\/\/aculpableinnocence.com\/home5\/aculpabl\/anthony_blog\/wp-json\/wp\/v2\/posts\/1978\/revisions"}],"predecessor-version":[{"id":1991,"href":"https:\/\/aculpableinnocence.com\/home5\/aculpabl\/anthony_blog\/wp-json\/wp\/v2\/posts\/1978\/revisions\/1991"}],"wp:attachment":[{"href":"https:\/\/aculpableinnocence.com\/home5\/aculpabl\/anthony_blog\/wp-json\/wp\/v2\/media?parent=1978"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/aculpableinnocence.com\/home5\/aculpabl\/anthony_blog\/wp-json\/wp\/v2\/categories?post=1978"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/aculpableinnocence.com\/home5\/aculpabl\/anthony_blog\/wp-json\/wp\/v2\/tags?post=1978"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}