When it comes to public health, the first year of the second Trump administration has been an unusually busy one and unusually controversial.

Most of this has run through Robert F. Kennedy, Jr., the Secretary of Health and Human Services.

In just the past few weeks, Kennedy overhauled the government's recommendations

for childhood vaccines and revised the so-called food pyramid, promoting animal proteins, especially,

while downgrading ultra-processed foods, refined carbohydrates, and added sugars. Kennedy's policies

affect several agencies under his purview, including the Food and Drug

Administration. The FDA has had a busy year of its own, approving new treatments for several

rare diseases, including cancers, as well as for rheumatoid arthritis and HIV. The agency also

approved a non-opioid pain medicine, the first of its kind in many years.

The next few years may be even busier. The FDA today is not going to be an FDA in a receive-only

mode. We're not going to be stingy librarians. We're going to go into the pipeline, find out what sounds promising, and bring that to the

forefront. That is Marty McCarrie, Commissioner of the FDA. He has been on Freakonomics Radio a few

times in the past, and he made a brief appearance in last week's episode about brain supplements.

McCarrie was a longtime surgical oncologist and professor of surgery at

Johns Hopkins University. He's also done a lot of health policy research. He's published hundreds

of papers and three books that critiqued the American health care system. Running the FDA is

McCarrie's first job in government, and he knows it's a big one.

The FDA regulates 20% of the U.S. economy, and there are so many aspects to the FDA,

and there are so many things broken at the FDA.

I spoke with McCarrie in October, but our release of this episode was delayed by the government shutdown.

What's interesting is just how timely the conversation feels right now.

It's always good to get an insider's view from an institution like the FDA.

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