Trump’s FDA Pick: A Superficial Swipe at Governance

6 min readNov 23, 2024

You know, Donald Trump picking Dr. Marty Makary to lead the FDA is like putting a vegan in charge of a barbecue joint — sounds intriguing at first, but then you realize nobody’s getting what they came for. It’s just another episode of “What’s the Deal with This Guy?” where we’re all left wondering if Trump actually understands the FDA or if he just thought Makary looked good in a lab coat. Let’s break it down.

The FDA: Where Bureaucracy Meets Big Pharma — and Nobody’s Happy

The FDA’s job is to make sure we don’t all drop dead from a tainted hotdog or a miracle cure that turns out to be cyanide in a pill. It’s a balancing act between “Let’s innovate!” and “Maybe we shouldn’t poison people.” But Trump? He’s not into nuance. He sees the FDA like he sees every other government agency: a giant pain in his very stable genius ass.

So here comes Dr. Marty Makary. He’s a surgeon, a Johns Hopkins guy, the type of dude who probably reads medical journals for fun. On paper, he’s got the chops. But in Trump World, paper doesn’t matter unless it’s a headline that makes him look good. “Trump Taps Makary for FDA Chief: Big Pharma’s Worst Nightmare!” That’s what this is about. Optics. Surface-level crap that looks good on cable news but doesn’t actually mean a damn thing.

Trump and Makary: A Match Made in… Contradiction?

Now, Makary’s not a bad pick — if you want someone who actually cares about things like transparency and public health. He’s all about calling out overpriced drugs and unnecessary treatments. Sounds good, right? Except Trump’s FDA playbook is all about speed and deregulation. “Get that drug approved faster than a toddler downs a candy bar.” Who cares if it works? We’ll figure that out after the lawsuits.

And here’s the kicker: Makary’s a guy who’ll say, “Hey, let’s pump the brakes and make sure this stuff is safe.” Meanwhile, Trump’s standing behind him, yelling, “Faster, Marty, faster!” It’s like putting a lifeguard in charge of a waterpark where the motto is “Cannonballs Only.”

The Big Pharma Shuffle

Trump’s been waving his “I’m tough on Big Pharma” flag for years. Lower drug prices! Beat the greedy bastards! But here’s the dirty little secret: his policies often help the same pharmaceutical giants he’s railing against. It’s like yelling at the bank for high fees while you’re cashing their checks. Makary, on the other hand, actually wants to hold these companies accountable. But can he do that under an administration that treats oversight like it’s a four-letter word?

COVID-19 and the Fine Art of Missing the Point

Both Trump and Makary have beef with pandemic policies, but for entirely different reasons. Trump’s all about whatever makes his base cheer: “No masks! No mandates! Freedom!” Makary’s over here going, “Hey, let’s look at the data.” They’re like two guys arguing at a diner: Trump’s yelling about the coffee being cold, and Makary’s trying to explain how the coffee pot works. Guess who gets the crowd’s attention?

The FDA’s Balancing Act

The FDA is supposed to be the adult in the room, saying, “No, you can’t sell that miracle weight-loss drug that’s just crack in a capsule.” But Trump doesn’t want an adult. He wants a cheerleader. Somebody to slap an approval stamp on whatever shiny new thing Big Pharma rolls out. Makary’s too smart for that. He’s a guy who’d read the fine print before signing a contract. And that’s exactly why this marriage is doomed.

The Real Problem: Trump’s Surface-Level Understanding

Here’s the thing about Trump: he doesn’t do depth. Everything’s about how it looks, not how it works. FDA? It’s just three letters to him. He doesn’t care about balancing innovation with safety or the nitty-gritty of clinical trials. He cares about the headline. “Trump Picks Tough Doc for FDA!” Boom. That’s the win.

But governance isn’t a reality show. You can’t just hire people for the optics and hope it all works out. The FDA is one of the most complex agencies in the country. It needs leadership that understands its intricacies, not someone picked because they said something cool on Fox News.

A Missed Opportunity

Dr. Makary could actually bring meaningful reform to the FDA. The guy knows his stuff. But under Trump? He’s just a prop in the larger show. And that’s the tragedy here. Instead of using Makary’s expertise to fix real problems, Trump’s using him as another shiny object to distract the crowd.

So where does that leave us? Probably the same place we always end up with Trump: a lot of noise, a flashy headline, and a system that’s still as broken as ever. And in the end, the only thing getting fast-tracked is our collective sense of disappointment.

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