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Today's word count is 1,114, or a 4-minute read.

HHS Secretary Robert F. Kennedy Jr.'s vaccine skepticism may be the hallmark of his public persona, but his and his followers' questioning of the medical and pharmaceutical establishment goes much deeper.

Why it matters: In recent weeks, it's become pretty clear that Kennedy's views haven't changed all that much from his pre-HHS days. That could have implications that go far beyond vaccines and put him at even greater odds with the industries he's charged with regulating, let alone mainstream science.

• If his past views hold up, antidepressants, ADHD medication and drugs that use mRNA technology — both those on the market and those under development — could end up as his next targets.
• In fact, some of his words and actions since being nominated and confirmed as the nation's top health official suggest they're already on his list.

Driving the news: Kennedy may not have mentioned vaccines at Wednesday's press conference on autism, but that's where many people's minds went because of the way he's consistently linked the two.

• He notably contradicted CDC researchers about why autism diagnoses are rising, pointing to what he called toxins in the environment, not better diagnostics (another familiar talking point).
• He's also pledged to have results of a government-led effort to identify the cause of autism by September, a timeline that's stoked deep suspicion in the public health community about his commitment to scientific rigor or accurate conclusions.
• And his recent remarks to FDA staff reinforcing his belief in the "deep state" caused enough alarm that Leerink Partners warned clients in an investor note that his agenda "is likely to negatively impact FDA's commitment to proven science and its retention of talent."

What they're saying: "He's still pressing his pseudoscience agenda, he still shows no interest in understanding the complexity of autism and how it operates through autism genes with environmental factors, he still talks in childlike terms about how to deal with autism," said professor and vaccine scientist Peter Hotez.

• "Everything I've seen him say in public is as unhinged as it's ever been."

In light of Kennedy's recent comments, I spent part of the week reading a book recently published by the Children's Health Defense, the anti-vaccine group Kennedy founded, titled "The Medical-Pharmaceutical Killing Machine."

• The book was published after Kennedy took leave from the organization, but the group remains aligned with his agenda and is a useful proxy when attempting to understand Kennedy's worldview.
• "He's the same Bobby Kennedy, 100%," Mary Holland, CEO of Children's Health Defense, recently told Stat News.
• An HHS spokesperson did not respond to a question about how closely the book does or doesn't reflect Kennedy's current views.

Reality check: For any of the book's major assertions to be true, there would have to be a massive coverup occurring at the highest levels of science, medicine and government (which is pretty much what the book says is happening).

• Many of them are directly contradicted by established scientific evidence, and others defy logic.
• I'm writing about them not to lend them credence, but because I think they offer insight into what we could see coming from Kennedy and thus the federal government in the future.

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Some of the most notable big-picture assertions from the book:

• There's a name for what's going on. "Iatrogenocide — 'the mass killing of a population by scientific and medical professionals,'" as the book asserts in its opening pages. The book's goal is to help people understand "medical weapons of mass destruction."
• Everyone's in on it. The players involved in "the medical-pharmaceutical killing machine" range from "individual clinicians to corporations, governments, and the military."
• It's not all about the money, but profit is a big driver. Part of the goal is to create "customers for life," which implicates pediatricians in particular. For example, vaccines may not be a huge source of revenue, but "the ill health that so often follows the barrage of early vaccinations results in the very conditions that are conventional pediatricians' bread-and-butter."
• The opioids storyline is more of a rule than an exception. The marketing of OxyContin to doctors, part of the process that led to the opioid epidemic, utilized "tactics that remain in use to the present day."
• Some diseases aren't even real. The book devotes space to what it calls the "'One Disease with One Cause' Narrative," which basically argues that some diseases are invented to deflect attention away from man-made causes of symptoms and/or to sell drugs. Some of the conditions that fit in this category: AIDS, Parkinson's disease, polio and COVID-19.

It also hinted at what other classes of drugs — beyond vaccines — could end up in Kennedy's crosshairs:

• Psychiatric drugs. The book devotes a significant amount of real estate to the thoughts of psychiatrist Peter Breggin, a major critic of such drugs. One book Breggin wrote "makes a strong case that psych drugs are both dangerous and useless, and highlights the risk of iatrogenic (medically induced) addiction."
• Psychiatric drugs include antidepressants, antipsychotics used to treat "conjured up diagnoses" like schizophrenia or bipolar disorder, mood stabilizers, stimulants and tranquilizers.
• ADHD drugs, particularly for children. The book writes that "the drugs remain a source of widespread harm."
• New mRNA treatments: It's no secret that the anti-vaccine movement was deeply skeptical of COVID vaccines, but that skepticism extends to all the new ways scientists and drug developers are hoping to deploy new mRNA technology. That includes making new vaccines against other infectious diseases, but also to treat conditions like cancer or cardiovascular disease.
• "The formal inauguration of mRNA technology may be a major feather in the cap of the military-medical-biopharmaceutical cartel, but for the world's citizens, it has represented a horrific and unsubtle ramping up of iatrogenesis," the book writes.

Between the lines: I didn't need to read the book to know that Kennedy has harbored some of these views.

• His comments about SSRIs — a type of antidepressant — have drawn rebukes from mental health advocates and Democrats, and his past comments about AIDS have also been heavily criticized.
• President Trump's Make America Healthy Again Commission, announced in February, has been tasked with assessing "the prevalence of and threat posed by the prescription of selective serotonin reuptake inhibitors, antipsychotics, mood stabilizers, stimulants, and weight-loss drugs."
• And Kennedy's never been shy about his view that sick kids are profitable for the health care industry, creating a perverse incentive.

What we're watching: Even if Kennedy does use the platform of the federal government to cast suspicion on various drug classes, impacting access to them is a different story.

• He ultimately still answers to the White House, and it's unclear exactly how wild he would be allowed to go.

Medicines that come in pill or tablet form are some of the most convenient and effective treatment options for patients.

The pill penalty must be fixed to protect access to these vital medicines.

Learn more about the impact of the pill penalty.

Thanks to Adriel Bettelheim for editing and Matt Piper for copy editing.