Much of the recent news concerning the intersection of politics and health care has been about the restriction of care: dismantling reproductive rights, eliminating gender affirming care for transgender youths and rolling back Covid-19 related vaccine and mask requirements. While not obvious on the surface, all these issues are related and united by common themes: They promote disinformation, often by employing fringe leaders with science degrees to give the patina of credibility, and they encourage the misinformed to abuse the legal system in the hopes of altering beneficial public health laws at the local, state and federal levels.
Much of the recent news concerning the intersection of politics and health care has been about the restriction of care.
The attack on the Centers for Disease Control and Prevention’s transit mask requirement is a perfect illustration of such abuse. The legal conversation has focused on the defendant, that is, whether the CDC exceeded its authority in recommending masks on planes, trains and buses; but more attention should be paid to the lead plaintiff in the lawsuit. That plaintiff is not an aggrieved patient, a front-line essential worker or an employee of a commercial airline, but a Wyoming nonprofit called the Health Freedom Defense Fund founded by an anti-vaccine crusader.
The bigger story behind the dismantling of the mask mandate is the power of organizations to weigh in on matters of great importance, such as public health and access to care, without any inclusion of scientific evidence, consensus studies, medical associations, public health organizations or even direct voices of patients and families, and for conservative judges to give weight to what those organizations argue.
Leslie Manookian, a former Wall Street executive who is founder and president of the Health Freedom Defense Fund, has long been on a campaign to turn the public against vaccines. She founded the fund in 2020 and has not had any filings with the IRS yet, but she claims to have thousands of small private donors that fund the organization’s work.
An unfortunate series of events, including symptoms associated with prior vaccinations, propelled Manookian to direct a 2011 documentary called “The Greater Good,” which stealthily disseminates anti-vaccine sentiment through a series of incredibly compelling emotional stories. The film features a cheerleader who suffered disabling strokes and the parents of a baby whose tragic death was associated with routine immunizations, although it provides little to no data to support broad claims against vaccines and the federal government.
At the beginning of the pandemic Manookian founded the Health Freedom Defense Fund to fight the “erosion of the rights of Americans.” The organization began to legally challenge state mandates related to the coronavirus, including mask and vaccine requirements. In some instances, the organization won. For example, its lawsuit in Arizona resulted in a ban on vaccine mandates by Republican Gov. Doug Ducey at a time when Arizona had the third-highest death rate for Covid-19 in the nation. It lost some, too. In a suit against the city of Hailey, Idaho, and its Mayor Martha Burke, the fund was defeated in a lawsuit that claimed that mask mandates were “akin to forced human experimentation” in violation of the public’s civil rights.
The fund’s website features a section for member education resources that provides a template for an open letter to any school that hosts a vaccine clinic on campus. It contains paragraph after paragraph of misinformation and fearmongering: “How is the school going to feel, having promoted these shots and facilitated on campus administration of an experimental medical product which could render students infertile, mentally impaired, or dead?” The letter’s resources are unreliable to say the least; One claim that the mRNA vaccine results in cognitive impairment comes not from a scientific study or expert consensus but from a blog post on Medium.
Part of what makes Manookian’s campaign distinct is her incredibly sympathetic story. She reportedly suffered for years and was shuffled between specialists for symptoms that never quite fit into a neat diagnosis. After countless dollars wasted on repeat tests and treatments, she ultimately found relief with a homeopathic practitioner.
The gaslighting of women who present with pain and other symptoms and are repeatedly dismissed by medical professionals is all too common. But instead of using her story to dismantle gender bias in medicine, Manookian’s nonprofit has amplified fear and mistrust with a powerful anti-vaccination mission. A recent Kaiser Family Foundation analysis estimates that since June 2021, approximately 234,000 Covid-19 deaths could have been prevented with free and easily accessible vaccines. Experts have estimated that in 2020 alone, up to 58,000 lives could have been saved if all states had mandated masks mandates. The question now is what happens if Manookian’s organization follows the trend set by other groups opposed to masks and vaccines and begins campaigning against reproductive rights? The Health Freedom Defense Fund has not filed any lawsuits targeting reproductive freedoms, but Manookian has said, “When government gets into the business of mandating what people can and can’t do with their bodies, I think that we have a problem. … Can government mandate that you get an abortion?” What happens if Manookian’s organization follows the trend set by other groups opposed to masks and vaccines and begins campaigning against reproductive rights? The ability of so many conservative groups to disguise disinformation as advocacy for freedom and autonomy is frightening. They wield freedom as a cudgel when it serves a particular political interest. But those same principles do not apply to a woman’s reproductive rights or to the medical needs of a transgender or gay youth. This movement also exploits the public’s frustrations with a broken health system. More and more people feel lost and betrayed by a medical establishment and are seeking health advice from unreliable sources, including a nonprofit run by a former finance executive. My ability to protect my body is weakened when the mask I wear to protect myself and my immunocompromised family members is perceived to cause more destruction than the virus that has killed millions around the world. The Biden administration is appealing a court’s finding that the CDC lacked the authority to impose a mask mandate, and as tragic as it is that a court found that the agency does not have that authority, the bigger story is the ability of bad actors to mount a campaign against health itself. History will not look kindly upon this time in American history when science and medicine were forced to retreat by bullies telling lies.
Dr. Kavita Patel
Dr. Kavita Patel is a teaching professor of medicine, Division of Hospital Medicine, at Stanford University and a board-certified internal medicine physician. She served in the Obama administration as director of policy for the Office of Intergovernmental Affairs and Public Engagement in the White House. Her area of expertise is around the intersection of health policy, clinical medicine and innovation. She also spends time advising venture capital and is a medical contributor for NBC News. 
