History has a habit of repeating itself.

Just prior to the 1929 crash, ads supporting the presidential candidacy of Herbert Hoover promoted a tag line promoting prosperity that has lived in infamy: “A chicken for every pot and a car in every garage.”

Now we have Robert Kennedy—our Secretary of Health and Human Services, the cheerleader for the “Make America Healthy Again” movement—promoting another grand idea to solve our nation’s problems: “A smartwatch on every wrist and a glucose monitor on every arm!”

As history reminds us, we didn’t get a chicken in every pot or a car in every garage. Heck, within a short time folks were hoping they could even afford a chicken, let alone a car.

And in 2025 smartwatches are not going to solve the huge problems we have with improving our nation’s health. Hopefully, our health care won’t tank in 2025 the way the economy tanked in 1929—but right now it certainly seems to be on a similar path.

Does this guy have a clue what he is talking about?

I don’t think so.

In contrast to making our nation healthier, Kennedy is in the process of tearing down a lot of the support structure that—if properly funded and deployed—could do much more to make us healthier. But no matter: food dyes out of our Froot Loops and petting cows to determine if they are free of disease are not going to lead us to the promised land of a healthy nation.

Mr. Kennedy’s next great idea is completely unsupported by reality and resources.

Sorry, old chap: It ain’t gonna happen—and you have no evidence to support it on a population-wide basis.

There is an important disclaimer to mention here: I am a huge fan of my Apple Watch and other trackers/apps that inform me about my health.

If you follow this blog, you already know I rely on my watch and other apps to give me actionable information about lots of things related to my health, especially my diet. They have made a difference in my health.

For several months I used a glucose monitor (at a cost of $89 per month). That monitor provided me important health-related information: my weight loss was successful, and my blood sugar was under good control. I stopped wearing the glucose monitors after a couple of months.

Eighty-nine dollars a month is not a huge burden for me. That is not the case for many other folks.

Learning how to use the monitor, interpret the data, and implement lifestyle change is in real life beyond the capacity of many people: they want to do better, but they don’t have the time to focus on doing better. They have too many other things to do that are part of their everyday lives. They simply can’t cram in one more thing they want to do, let alone what someone like Mr. Kennedy (or their clinician) says they want them to do.

Which brings me to a larger point:

I may be a physician, but I am also what I call an “activated patient.” I suspect Mr. Kennedy and his friends who find their monitors so helpful improving their health are similar type A folks. There are lots of “activated” people out there, people who embrace technology, use it, interpret it, and appreciate it. Kudos to them.

But one of the vexing parts of population health is that many people are NOT activated. They rely on “the system” to help them get through the details of what they should do for their health. Doctors, advanced practice nurses, coaches, whatever: people need help putting all this together into actionable bits and pieces of healthy living.

Then there is the problem of people taking the advice and using it. Just because it works for me doesn’t mean it works for thee.

News flash: people may listen and say they will do something, but sadly they lose interest quickly. Case examples: New Year’s resolutions to improve diet, exercise, lose weight, decrease alcohol, etc.

Ever heard that story? Two, three weeks then poof!!

Key message #1 (and will always be key message #1) when it comes to patient care and healthy behaviors: Just because someone says they will do it doesn’t mean they will do it.

• How many people take their antibiotics as instructed? Not many.
• How many people take their blood pressure medicines as instructed? Not many.
• How many people take their cholesterol medicine every day for years on end? Not many.
• How many people succeed in losing weight and sustaining the loss, even with the best of intentions? Not many.

So, while Mr. Kennedy hails the value of smartwatches and demeans the cost of the GLP-1 medicines, those medications work. People who use them consistently and properly along with lifestyle modifications do lose weight. Not everyone, but many.

Even for the GLP-1 drugs, the evidence is mounting that people don’t continue them long term, with dramatic fall-off in adherence at one year and subsequent intervals. It may be the cost, it may be the increasing barriers put into place to prevent access, it may be side effects, it may be “medication fatigue.”

It doesn’t matter: people don’t continue their chronic medications.

As clinicians taking care of real people, we face that reality every day in daily practice. It has been part of our professional lives and our patients’ lives for decades.

As clinicians, we have been telling folks what they need to do to live healthier lives. And for decades, our patients—who are wonderful, well-meaning, hardworking, honest folks—look us in the eye and say “I understand. I will do it!!!!” only to return for the next visit, not doing it.

Then there is the larger issue of remote patient monitoring (RPM): the scales, the blood pressure monitors, whatever.

I believe in RPM. I have advocated for RPM. I agree we need to invest resources to figure out the best way to use RPM. As of today, we are failing with RPM.

RPM is not a new concept, and there are proven values to its use such as remote monitoring to help manage congestive heart failure. But folks have difficulty using RPM, especially among the older crowd who have difficulties using and understanding the technology.

We know that with well-designed interactive systems where there is someone (or some AI device) on the other end who can interpret the data, contact the patient, and cajole them to improve their behavior or take certain actions that RPM can make a difference, especially if you can get paid for doing all of this (How’s the payment thing working for you?).

We all want to believe RPM can make a difference. Belief is grand, but evidence is better. Unfortunately, the evidence isn’t always as convincing as our belief.

Mr. Kennedy—a man who admittedly pays detailed attention to his health—says the entire nation should do what he and his friends do: we should all have smartwatches and other devices and monitor away. That, he says, is the key to making America healthy.

Another news flash: what a waste of time, effort, and most importantly money.

Folks who want to use monitors and interpret the data from the monitors should use monitors. They should collect the data, look at the data, and act on data. I do believe under the right circumstances that data can improve health. Unfortunately, many people can’t do that.

When most folks are eating junk food regularly, then slapping a watch on their wrists, a glucose monitor on their arms, giving them scales and blood pressure devices that upload data may help some but won’t help many.

The world is full of great ideas that will make everything better. Sometimes they work, too often they don’t. The fads of today will be on the trash heaps of tomorrow.

Mr. Kennedy, please get off your horse and work on real-world problems, like creating livable, safe spaces so people can walk in their neighborhoods, helping folks afford access to fresh foods, get medical care instead of putting more barriers in place, figuring out how to improve the primary care workforce and care delivery. Help people who live in rural areas get access to quality medical care, instead of passing big, beautiful bills that threaten to take away from real people even the limited resources they rely on for medical help when they need it.

Those are the realities of making America healthy. They are inconvenient truths. They are tough problems—maybe intractable problems—without obvious solutions.

Fixing those problems is a lot less glamorous and a lot more difficult than revving up a major advertising campaign to boost sales of smartwatches and other monitoring devices that people can’t afford, let alone use effectively.

Folks, we are in very serious trouble when it comes to our nation’s health. We need solutions, not unproven pontifications offered by Mr. Kennedy.

Mr. Kennedy represents as large a danger to the public’s health as anyone I have ever known—and he is now our fearless leader. He has no relevant experience, except in his personal experiences, the courtroom, and the world of public opinion. He has never sat across that desk or in a chair next to a patient and begged them to change their health-related behaviors. Now he proclaims broad-scale solutions that have no basis they will actually advance the health of America.

Could it be any worse?

Our health care—especially primary care—is deep in the ocean without a life jacket, having difficulty staying afloat and sinking fast.

We need a lifeboat, not a smartwatch.

J. Leonard Lichtenfeld is an oncologist.