The obscure example of the grifter Surgeon General
Trump recently nominated Casey Means as surgeon general, America’s top public‑health messenger. She is grossly unqualified for the job, but Trump likes her style. Means is a physician who left surgical training to become a wellness influencer and entrepreneur, building a brand on warning people not to trust mainstream doctors and promoting “root‑cause” health products and protocols with scant evidence. Reporting notes that she has sold supplements and other wellness products, aligned with anti‑vaccine figures like Robert F. Kennedy Jr. She allowed her medical license to lapse, even as she positions herself as a visionary who sees through “corrupt” conventional medicine. This obscure personnel move captures the larger catastrophic transition. The United States is drifting from flawed but mostly rule‑bound democracy toward a more openly corrupt, propaganda‑driven, authoritarian politics. That accelerating trend tracks closely with Trump’s rise since 2016. (link 1, link 2, link 3, link 4)
Trump’s nomination of Means reflects the broader MAGA demagoguery pattern. Sophisticated grifters and cranks who thrive on misinformation, crackpottery and conspiratorial rhetoric are elevated because they weaponize distrust of institutions and expertise. Her message that doctors and public‑health institutions are fundamentally untrustworthy fits with a media ecosystem where “disinformation doctors” exploit professional credentials to spread vaccine and other falsehoods, often for fame, power or profit. Public‑health experts now warn that coordinated health misinformation erodes trust, worsens outcomes, and makes it far easier for political demagogues to present themselves as lone truth‑tellers against a system that demagogues falsely claim is rigged and malevolent. (link 2, link 5, link 6)
The problem for democracy from too much distrust
American democracy depends on a critical mass of people believing that facts exist, that expertise is real, and that institutions, though imperfect, are at least somewhat accountable. Today that belief is being steadily hollowed out by a tidal wave of propaganda that intentionally blurs the line between truth and grift. Research on recent U.S. elections shows that systematic disinformation—amplified by social media and foreign and domestic actors—has fueled false beliefs about fraud, depressed confidence in vote counting, and deepened polarization. At the same time, broad public trust in the federal government has been stuck below 30 percent for nearly two decades, with recent readings in the teens and single digits for many groups. (link 7, link 8, link 9)
This trust collapse creates an opening for three interlocking flavors of kleptocratic authoritarianism. First, a personalized Trumpist dictatorship uses executive power for self‑protection and revenge, following the global pattern of “executive aggrandizement” that weakens oversight, attacks independent institutions, and normalizes election denialism. Second, a billionaire‑corporate oligarchy leverages deregulation, dark money, and captured media to tilt policy toward a tiny donor class, a trend supercharged by the Citizens United decision and subsequent campaign‑finance rulings. Third, a Christian nationalist project seeks to entrench minority rule under the banner of “taking back” a Christian nation, using structural biases like the Senate and Electoral College to impose the values of a shrinking faction on a diverse public. (link 10, link 11, link 12, link 13, link 14)
Conclusion
All three major strands of American authoritarianism now vying for long-term power, dictatorship, oligarchy and fundamentalist Christian theocracy, depend on the same dishonest information strategy. All three knowingly train people to distrust accountable expertise and democratic institutions while embracing charismatic figures who weaponize grievance and identity to deceive the public. Years of radical‑right demagoguery and organized disinformation have changed the mental environment that Americans live in. That has made sophisticated propaganda and organized grift feel normal and even virtuous to far too many Americans. They are deceived and betrayed. The Means nomination is just one corrupt, authoritarian cut among thousands. It exemplifies how far we’ve fallen when Trump’s morally depraved authoritarian government, awash in public‑health and democratic crises, selects as the nation’s doctor, a dishonest crackpot grifter whose career was built on persuading the public that its doctors cannot be trusted. (link 15, link 2)
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