Twenty-plus years ago, Thomas Frank wrote a book called What’s the Matter With Kansas? in hopes of shedding some light on the new-ish at the time phenomenon of people actively and consistently voting against their own best interests.

Obviously that wasn’t brand new — the Reagan era ushered in a whole generation of voters deeply affected by the exact political machinations that Frank describes in his book that turned former working-class populist types into fervent Republicans.

But what Thomas Frank outlined in the book about using social issues to make people forget about economic ones is now even more apparent. And ironically, it’s thanks to Kansas. Republicans there, possibly setting the tone for the GOP across the country, have begun making everything into a social issue, even health.

There was a time not so long ago when, apart from moms who were convinced by convicted fraudster Andrew Wakefield’s bogus 1998 study linking vaccines to autism, everyone agreed that not only were vaccines universally good, but that they were perhaps the greatest medical advancement in human history.

Vaccines have been mandated for soldiers, health care workers, schoolchildren, and any number of other people for generations now. But when COVID-19 broke out, enterprising Republicans, trading on the fact that their voters will believe anything they tell them, decided to turn the vaccine mandates intended to stem the pandemic into a political issue.

Kansas took it a step further. The Republican legislature there passed, and the governor signed, a law that restricted federal vaccine mandates to the point that literally anyone could refuse to be vaccinated and all it would take to be “in compliance” with the provided exemptions is a written note from the objector that it violates their sincerely-held beliefs to be vaccinated. That note, said the November 2021 law, could not be questioned by workplaces or schools.

The new law made it so that not only could literally anyone claim an exemption, but they could sue and almost be guaranteed a win. It even provided unemployment insurance in the interim for people who were fired for not complying with the mandate.

The result is that not only did legions of people refuse the COVID vaccine, thereby prolonging the pandemic, but they began to refuse any vaccines at all.

Fast-forward to 2025, and this is the headline:

That’s right, tuberculosis, the lung infection that killed the author of 1984 in 1950. You know, that thing that we so effectively eradicated with vaccines that routine childhood vaccination for it hasn’t been required for 20 years. Most people still do get the vaccine, right along with their MMR, tetanus, and polio shots, an account of not wanting to drown in their own lungs from a preventable infection.

Not Kansas, though. With 70 cases recently reported (as in, read the date on that headline I screencapped), you can’t even tell a joke about tuberculosis in Kansas anymore. You know, since it spreads when you laugh. Coughing, sneezing, even singing or laughing are all vehicles for the spread of this resurgent infection. The last time people died en masse from TB, the famous people whose names you’d recognize were poets.

In case you’re one of the smart folks that knows that correlation does not imply causation, I’ll draw a straight line for you. From the Independent article I snagged that headline from:

In September 2023, a CDC report revealed that an outbreak of multidrug-resistant (MDR) TB had driven up cases from 2019–2021 when recorded cases were between 37– 43 – a number that increased to 52 in 2022.

Well, that’s weird. What happened in late 2021 that could have caused such a huge uptick in preventable TB infections? Oh, that’s right, Republicans cynically and dangerously used people’s political leanings to turn them against basic preventative healthcare.

So what are the symptoms of TB? According to the CDC, an active TB case can present in the lungs through symptoms such as:

• A bad cough that persists for 3 weeks or longer • Chest pain • Coughing up blood or sputum (phlegm) from deep inside the lungs • Weakness or fatigue • Weight loss • No appetite • Chills • Fever • Sweating at night

So, wonderful! It presents exactly the same as COVID. That means even if people did get the COVID vaccine, the appearance of TB in others belies the efficiency by making it look like the vaccine didn’t work to stop the spread.

It’s self-perpetuating mythology at this point.

Unfortunately, this phenomenon is nowhere near limited to Kansas. It’s only a matter of time until larger, more “purple” states begin to see the same problems just due to there being enough people who are politically anti-vax to affect the more sensible folks who try to stay healthy.

What’s the matter with Kansas? Currently it’s tuberculosis. In the long run, it’s Republicans and Donald Trump.