Don’t Waste Time Arguing Over the Surgeon General Nominee. Abolish the Office.

President Donald Trump’s most recent pick for the office of U.S. Surgeon General, Nicole Saphier, is a source of tension between the MAGA and MAHA factions of his supporters. Given that she’s the president’s third pick for the slot, the administration would undoubtedly just like to put disputes over this one office behind them. But there’s an easy path to a conflict-free resolution: The Trump administration could leave the Office of the Surgeon General unfilled and push for its abolition.

Saphier, a radiologist, comes from a rather conventional medical background and has been critical of Health and Human Services Secretary Robert F. Kennedy Jr., who set the initial lifestyle-conscious but conspiratorial MAHA tone for the administration’s health policies. She’s also the president’s third choice for the post, after the nominations of Janette Neshiewat and Casey Means faltered over questions about their credentials. Saphier is more likely than the first two nominees to win Senate approval, but that comes at the risk of alienating some of the president’s fragmenting base. There’s no reason for an avoidable battle over a completely unnecessary office.

“The Office of the Surgeon General and the Public Health Service Commissioned Corps, which the office oversees, are unnecessary relics,” writes Jeffrey A. Singer, an Arizona surgeon and senior fellow at the Cato Institute. “The surgeon general has drifted from an apolitical public health role into a politicized platform, weighing in on issues far beyond its proper scope—from gun control to social policy—thereby undermining trust in legitimate health functions.”

The Office of the Surgeon General was originally established to oversee the Marine Health Service “to provide health care to sick and injured merchant seamen,” as the office’s official history puts it. This later expanded into a national hospital system with a Commissioned Corps organized along military lines. Mission creep set in, and the medical bureaucracy was eventually renamed the Public Health Service and tasked with “preventing the spread of contagious diseases throughout the United States.”

The Surgeon General lost responsibility for the Public Health Service in 1968. The office was briefly abolished and then recreated as an advisory position with authority over the uniformed Public Health Service Commissioned Corps. Well, over some of members of the Corps. Many officers in the Corps “are assigned to all HHS Agencies and to a number of agencies outside of HHS, including the District of Columbia Commission on Mental Health Services, Environmental Protection Agency, Federal Bureau of Prisons, National Oceanic and Atmospheric Administration, National Park Service, U.S. Department of Agriculture, U.S. Department of Defense, U.S. Department of Homeland Security, and the U.S. Marshals Service,” and work within the chains of command in those agencies, according to the Office of the Surgeon General.

In other words, the Surgeon General doesn’t really have a clearly defined role or a good reason to parade around in a quasi-naval uniform. That is, unless you like the office’s transformation into a national nag that lectures Americans on whatever alleged lifestyle sins most annoy the current Surgeon General. Cigarettes and firearms have been favorite choices over the years.

“Successive administrations have turned the Office of the Surgeon General into a highly political platform that opines on divisive non–public health issues ranging from gun control and social media to labor and housing policy. Such mission creep undermines the effectiveness of legitimate government public health activities,” Singer noted last year along with Akiva Malamet, Bautista Vivanco, and Michael F. Cannon in Unnecessary Relics, a Cato Institute report on the Surgeon General and the Public Health Service Commissioned Corps.

Basically, the Surgeon General and the Public Health Service Commissioned Corps now exist to frame the policy preferences of whoever occupies the White House as public health necessities. Anybody who doesn’t favor those policies is clearly against The Science™ and wants people to die.

That’s a pretty apt description of the entire field of public health, which seems to exist entirely to frame political choices—especially authoritarian ones—in medical terms.

But there is also a dollars-and-cents reason to object to sticking medical personnel in uniforms and then sending them around to various government agencies for random staffing assignments: It’s expensive.

A “complicated funding structure, as well as various other special benefits and privileges, contributes to making Corps officers more expensive than other federal employees,” the Cato authors wrote in the 2025 report. “In 2010, the average Corps officer cost was $169,000, which at the time was $22,000 or 15 percent higher than the cost of employing a civilian equivalent.”

Part of the cost comes from the fact that “in accordance with their military pay scale, Corps officers have the privilege of receiving a portion of their salary in the form of housing and subsistence allowances wholly exempt from federal income taxes.”

In other words, we’re paying an awful lot for the privilege of being nagged by a government medical bureaucrat who oversees an archaic uniformed corps that mostly exists to provide overly expensive staffing services for government agencies.

With all of that to consider, Saphier’s nomination is getting a lot of pushback from MAHA.

“Dr. Saphier would be a catastrophic mistake on messaging and communicating with MAHA at a time where the coalition is very fragile,” prominent MAHA influencer Alex Clark posted May 1. “It will be perceived as the admin breaking another promise to them and embracing the status quo in health care that ended us smack dab in the middle of the chronic disease epidemic we now find ourselves in.”

But Clark offered a viable alternative. She added, “My position isn’t to replace Dr. Saphier. It’s to completely DOGE the Surgeon General role.”

Clark wants to ditch the Office of the Surgeon General to smooth over political rifts. But that move would also rid us of a national annoyance, ditch a vestigial bureaucratic position, and potentially save money.

There’s no reason to waste time arguing over which nominee would be the best fit for an office that, if it ever served a legitimate purpose, has long since become an anachronism. We should just get rid of the Office of the Surgeon General.