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🗞️ Jesús de Miguel remembered, Champions League Wednesday's front pages

Football is in shock. The death of Jesús de Miguel has stunned the entire sporting world on a Tuesday to forget.On days like this, there is little point in talking about the Champions League or the s...

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Nov 4 • 2:34 AM EST • Sports • sports.yahoo.com
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Dolphins announce passing of perfect 1972 team member Bob Heinz

The Miami Dolphins are mourning the loss of former defensive lineman Bob Heinz, who helped the franchise win consecutive Super Bowls and complete the NFL’s only undefeated campaign in 1972-73. He passed away in California on Oct. 31 at 79 years of age. This news comes shortly after the Detroit Lions handed the Minnesota Vikings their first loss of […] The post Dolphins announce passing of perfect 1972 team member Bob Heinz appeared first on ClutchPoints.

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Nov 4 • 2:22 AM EST • Sports • sports.yahoo.com
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Girls' flag football: Tuesday's City Section playoffs scores

Check out Tuesday's girls' flag football scores.

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Nov 4 • 2:19 AM EST • Sports • sports.yahoo.com
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Gardner-Johnson released by Bills after spitting ban

The Buffalo Bills release safety CJ Gardner-Johnson after he serves a one-game suspension for spitting in the direction of an opponent.

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Nov 4 • 2:17 AM EST • Sports • sports.yahoo.com
“Sad To Hear What Jorge Posada Had To Say” – Alexandria Ocasio-Cortez Takes Shots at Aaron Boone and Yankees Management

U. S. Representative Alexandria Ocasio-Cortez has questioned the New York Yankees’ decision to retain manager Aaron Boone, calling for changes within the organization after another disappointing season.

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Nov 4 • 2:14 AM EST • Sports • sports.yahoo.com
Hinge Health (HNGE) Stock Looks Stretched On Its 156% YTD Run

Hinge Health has been one of the stronger movers in digital health this year, and the stock’s sharp climb now puts a spotlight on a simple question for investors: Is the current share price adequately supported by the company’s earnings power? The stock is up 156.5% year to date, which puts a lot of pressure on its earnings profile to justify the enthusiasm baked into today’s valuation. Recent earnings news highlighted stronger profitability and an expanded client base, which can support...

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Nov 4 • 2:11 AM EST • Health • finance.yahoo.com
Death is big business in I.Coast, where funerals cost fortunes

Valerie Bli Lou is a shopkeeper from a modest family, but she is determined to give her late father the sumptuous funeral that Ivorian tradition demands -- whether she can afford it or not.- Tears and...

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Nov 4 • 2:02 AM EST • Business • yahoo.com
Sabres Get Major Zach Benson Update After Missed Practice

The Buffalo Sabres got some worrisome news on Monday. In addition to Konsta Helenius being ruled out as week-to-week, Zach Benson missed practice. It wasn’t necessarily an expected absence, and so it raised worries about a potential injury absence for the dynamic winger. Buffalo was returning home from a West Coast trip, and the Sabres […] The post Sabres Get Major Zach Benson Update After Missed Practice appeared first on HEAVY.

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Nov 4 • 1:46 AM EST • Sports • sports.yahoo.com
Nebraska voters appear to say 'no' to legalizing online sports betting

Though margins were still slim late Tuesday night, Nebraska voters were on track to reject a pair of ballot measures looking to legalize and regulate online sports betting, according to unofficial results. Initiative Measures 440 and 441 would together amend the Nebraska Constitution and state law, respectively, to legalize and regulate online sports wagers. Initiative […]

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Nov 4 • 1:42 AM EST • Sports • nebraskaexaminer.com
“I Don’t Know If I’m Willing to Do It Just to Fight” – UFC Fans May Have Seen the Last of Beneil Dariush Inside the Octagon

Fans may have already seen the last of Beneil Dariush inside the Octagon. The veteran lightweight has endured a difficult stretch lately, losing four of his last five UFC fights, with all four defeats coming by knockout. Most recently, Dariush was stopped by Quillan Salkilld at UFC Perth in May 2026. Before that, he suffered …

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Nov 4 • 1:42 AM EST • Sports • sports.yahoo.com
WATCH: Sen. Chuck Schumer speaks after Democrats win control of Senate

The longtime Democratic leader told reporters in Washington that “Americans voted for change” and that there had been a “generational remake of the Senate map.”

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Nov 4 • 1:42 AM EST • Politics • pbs.org
Texas just went blue, and the tech bros are sad

Texas, with its limited red tape and vast resources, drew in the tech crowds. Now, it's politics turned bluer, and the execs are a little upset.

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Nov 4 • 1:39 AM EST • Business • businessinsider.com
Lewiston’s mayor faces runoff after a tumultuous year in city politics

Challenger Rick LaChapelle had 45.7% of votes to 35.3% for Mayor Carl Sheline, according to unofficial results.

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Nov 4 • 1:35 AM EST • Politics • bangordailynews.com
Drake women's basketball wins season opener

Drake women's basketball wins season opener at Knapp Center on Tuesday.

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Nov 4 • 1:31 AM EST • Sports • sports.yahoo.com
Democrat J.D. Ford wins election to U.S. House in Indiana's 5th Congressional District

In an upset that many analysts did not see coming, Democratic nominee J.D. Ford defeated three-term Rep. Victoria Spartz in Indiana’s 5th Congressional District in Tuesday's election.

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Nov 4 • 1:29 AM EST • Politics • pbs.org
Trump reacts to Republican losses and declines to take blame

By the time the House and Senate had been called for Democrats on Tuesday, a consensus among members of both parties was forming: voters had rejected President Donald Trump’s record in office, and he would face a starkly different political reality for the remainder of his term.

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Nov 4 • 1:21 AM EST • Politics • cnn.com
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NBA Fans Outraged Over Adam Silver’s Latest Idea

The NBA fans are pushing back against Adam Silver’s interest in shorter games, and their objections go beyond simply resisting change. A post from NBACentral, citing Sports Illustrated’s Chris Mannix, revived discussion of the commissioner’s preference for 40-minute contests. Several responses challenged whether cutting basketball is the right solution to the league’s problems.The replies showed […] The post NBA Fans Outraged Over Adam Silver’s Latest Idea appeared first on HEAVY.

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Nov 4 • 1:21 AM EST • Sports • sports.yahoo.com
Letters: Credit card change could hurt small businesses

I recently read an op-ed in this newspaper arguing that the Durbin-Marshall credit card mandates would ease pressure on Louisiana businesses and keep our economy growing. As an entrepreneur, I

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Nov 4 • 1:15 AM EST • Business • nola.com
😐 Neutral (0%)
Flats plan for aparthotel in Reading after business changes

City Wall House's apartments are used less following the pandemic, the building's owner says.

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Nov 4 • 1:10 AM EST • Business • bbc.com
😐 Neutral (9%)
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Tight race between LA Mayor Karen Bass and democratic socialist Nithya Raman

The first returns were a tally of mail ballots received before Election Day. Others, including results from in-person voting, were to follow.

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Nov 4 • 1:10 AM EST • Politics • spectrumlocalnews.com
Tight race between LA Mayor Karen Bass and democratic socialist Nithya Raman

The first returns were a tally of mail ballots received before Election Day. Others, including results from in-person voting, were to follow.

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Nov 4 • 1:10 AM EST • Politics • spectrumnews1.com
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Business-friendly Texas flips: Democrats end nearly 40-year drought, winning Senate seat and governor’s mansion

James Talarico and Gina Hinojosa turned Elon Musk’s $190 million campaign blitz into their closing arguments.

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Nov 4 • 1:07 AM EST • Business • yahoo.com
Problems at health trust buildings could cost additional £20m

The maternity building on the Royal Victoria Hospital site is already tens of millions of pounds over budget.

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Nov 4 • 1:00 AM EST • Health • yahoo.com
Nebraska men’s golf fall season recap

Sports writer Connor Krumme describes the many highs and lows that have occurred throughout the Huskers’ latest golf season.

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Nov 4 • 1:00 AM EST • Sports • dailynebraskan.com
Schumer praises ‘great candidates’ as he celebrates Democrats’ big night
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Nov 4 • 12:53 AM EST • Politics • cnn.com
Shapiro becomes first Democrat to win Lancaster County vote since 1990

Gov. Josh Shapiro not only won reelection Tuesday, he became the first Democratic gubernatorial candidate to win Lancaster County since Robert P. Casey won here in 1990.

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Nov 4 • 12:42 AM EST • Politics • lancasteronline.com
The historic firsts of the 2026 election

Winners up and down the 2026 ballot will make history this year, CNN’s Decision Desk projects, including the first Black woman governor and the first out gay male US senator.

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Nov 4 • 12:41 AM EST • Politics • cnn.com
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Nebraska on track to add gender-based school sports requirements to state Constitution

Voters appeared to agree to cement sex-separate school sports requirements into the Nebraska Constitution with the approval of the Fairness for Girls ballot measure.

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Nov 4 • 12:40 AM EST • Sports • nebraskaexaminer.com
Lightning’s Nikita Kucherov has been on fire since trade request

Nikita Kucherov wants out of the Tampa Bay Lightning , but he still can’t stop going all out for his team. Reports surfaced last Friday that the 33-year-old Kucherov had already asked the Lightning to move him. In the two games since, the two-time Hart Memorial Trophy winner has done nothing on the ice but rack up points. Against the Nashville […] The post Lightning’s Nikita Kucherov has been on fire since trade request appeared first on ClutchPoints.

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Nov 4 • 12:39 AM EST • Sports • sports.yahoo.com
Democrat Xavier Becerra wins California governor’s race

Becerra will be California’s first Latino governor since the late 19th century

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Nov 4 • 12:34 AM EST • Politics • spectrumnews1.com
Michele Tafoya Loses Senate Race Amid Nationwide Democratic Rout

Tafoya came up short against Democratic Lt. Gov Peggy Flanagan.

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Nov 4 • 12:33 AM EST • Sports • sports.yahoo.com
Here are the results from the sports wagering ballot measures

Two ballot measures are seeking a constitutional amendment to legalize online sports betting in the state and to create the regulatory framework to tax the wagers.

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Nov 4 • 12:26 AM EST • Sports • nebraskapublicmedia.org
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😐 Neutral (5%)
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Amy Acton reflects on her childhood in acceptance speech

Democrat Amy Acton reflected on her journey from childhood homelessness to becoming a doctor and now projected as Ohio’s next governor as she celebrated her win over Republican Vivek Ramaswamy. The former state health director will become the first woman elected governor of Ohio and the first Democrat to win the office since 2006.

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Nov 4 • 12:25 AM EST • Politics • cnn.com
John King analysis of Michigan vote tabulation
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Nov 4 • 12:24 AM EST • Politics • cnn.com
😐 Neutral (0%)
Issue 3 trails; voters approve other constitutional amendments

A proposed constitutional amendment that would allow cities and counties to form economic development districts to attract retail businesses and other operations was at slightly below 50% as of 11...

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Nov 4 • 12:21 AM EST • Business • talkbusiness.net
Issue 3 trails; voters approve other constitutional amendments

A proposed constitutional amendment that would allow cities and counties to form economic development districts to attract retail businesses and other operations was at slightly below 50% as of 11...

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Nov 4 • 12:21 AM EST • Politics • talkbusiness.net
Jake Ferguson gets good prognosis on ankle injury

Dallas Cowboys tight end Jake Ferguson suffered an ankle injury in Week 8, but head coach Brian Schottenheimer said the initial feedback was good.

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Nov 4 • 12:15 AM EST • Sports • sports.yahoo.com
El Camino Healthcare District’s Measure S gets the greenlight

A ballot measure to establish term limits for El Camino Healthcare District’s board members appears headed for victory.

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Nov 4 • 12:14 AM EST • Health • mv-voice.com
‘Became a RINO’: President Donald Trump blames Abbott’s lost in Texas governor race on political life

Republican President Donald Trump released a public statement after incumbent Republican Greg Abbott conceded the Texas governor’s race to Democrat Gina Hinojosa.

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Nov 4 • 12:06 AM EST • Politics • click2houston.com
The Midterm Election Was About Health Care

In the face of Trump’s destruction of public health and modern science, voters are putting candidates who support Medicare for All, doctors, and nurses into positions of power.

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Nov 4 • 12:05 AM EST • Health • prospect.org
Circadian depression: Body clock disruptions take mental health toll

About one in four depression cases follow disruptions to the sleep-wake cycle in what scientists say is a circadian subtype of the condition. After assessing data for more than 10,000 patients, resear...

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Nov 4 • 12:03 AM EST • Health • yahoo.com
Yankees news: Skubal linked to Yanks

Yankees among several teams in on top FA; Murphy walks back taunt; Chisholm likely to walk

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Nov 4 • 12:00 AM EST • Sports • sports.yahoo.com
Nature comes to life in ‘MOMIX: Botanica’ at the Schaefer Center on Nov. 12

MOMIX presents Botanica, a visually stunning dance and illusion show exploring nature’s rhythms, at Appalachian State University’s Schaefer Center on November 12. This multisensory performance combines athleticism, inventive props, and atmospheric music to transform dancers into flowers, insects, and fantastical creatures.

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Nov 4 • 12:00 AM EST • Entertainment • wataugademocrat.com
A jack of all tales: Orville Hicks delights museum annual meeting with stories of Appalachia

JEFFERSON — The Orion Schoolhouse became storyteller Orville Hicks’ front porch on Oct. 20 as he regaled the Museum of Ashe County History’s board members with old mountain tales and

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Nov 4 • 12:00 AM EST • Entertainment • wataugademocrat.com
Region semifinal pairings finalized for Watertown, Aberdeen area teams

Semifinal pairings have been finalized in area Class A and B region volleyball tournaments.

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Nov 3 • 11:58 PM EST • Sports • sports.yahoo.com
AFGHS co-signatory countries ask health care users to help fill the financing gap

Hundreds of thousands of Ugandans living with HIV on antiretrovirals could be targeted for user fees or community health insurance schemes requiring modest premium payments, according to the April 2026 version of the country’s America First Global Health Strategy implementation narrative.1 As part of the “sustainable financing for the private not for profit sector” strategy, 491 facilities will be targeted for a phased introduction of user fees and scale up of community health insurance programs.2 In the Ugandan context, PNFP facilities include faith-based hospitals and other health facilities, US missionary organizations and centers of excellence—services that are often co-located at government facilities but run with additional financial and technical resources. 402,000 people—or about 28 percent of the total Ugandan adult PLHIV population on treatment—get ART from the private not for profit sector. The selected facilities provide the majority of ART and prevention of mother to child transmission (PMTCT) services. The plan doesn’t give the total number of clients served by the 491 facilities, so it is not possible to give a precise number. But the majority of 402,000 is a figure in the hundreds of thousands—hence the estimate I’m using.3 The April draft of the Ugandan implementation plan narrative is the only one I’ve been able to review. But the government of Uganda is not alone in turning to health care users to help fill the financing gaps caused by the abrupt withdrawal of US funds. In July 2025, the Government of Liberia introduced user fees for previously free services including “registration, accommodation, patient feeding, hospitalization, and a wide range of surgical and diagnostic procedures.”4 Earlier that year, Liberia rolled out a revolving drug fund designed to stabilize drug supplies by “allowing patients to pay a small fee for standardized, quality medications,” according to a Ministry of Health press release.5 (Both of these approaches had been proposed in the National Health Policy 2022-2031; media coverage explicitly connects the launch with the US foreign aid cuts.) The health financing strategies proposed by Uganda and established in Liberia are qualitatively different from user fees officially adopted by specific health facilities to cover funding shortfalls caused by the new US approach.6 The latter is a stopgap, adhoc change. The former is a national governmental adoption of policies that pass costs on to health care users, despite evidence that such approaches can exacerbate inequities and leave deficits unfilled. Two countries does not make a pattern, but they do point to urgent questions: Have other countries, including Liberia, included user fees or community health insurance schemes in their implementation plans? If so, do any of these narratives have what Uganda’s lacks: a fall-back plan in place in case these strategies for sustainable health systems fail to deliver—as they have before? I wonder if you think about it Subscribe Predictable pitfalls Both community-based health insurance and user fees are as old as the hills. And after decades of people climbing up these hills, duking it out, climbing back down—neither strategy has shown the results the Ugandan implementation plan is counting on. This is, in fact, a hill some folks are willing to die on. (You knew I’d get there, right?) In November 2025, an African-led team of health system experts published a paper directed at low- and middle income country governments trying to figure out how to create self-sustaining health systems. The money wasn’t coming back. It had been more than nine months since the season of freezing, waivering and wood-chippering; two months since AFGHS tumbled into the world touting co-financing requirements and reductions in future US government health aid. Governments were looking for strategies for sustainable, self-financed health systems, the authors wrote. For countries considering user fees and community health insurance to fill the financing gaps, they had a simple message: Don’t. On user fees, the paper states: “Reliance on user fees is ultimately a regressive and inequitable approach. It places a disproportionate burden on the poor and undermines health system goals of equity and financial protection. […] There is overwhelming evidence that user fees mobilise very limited resources for the public health sector, making it an inefficient mechanism for revenue mobilisation.” On community health insurance: “Attempting to shift the burden of funding previously donor-funded services, such as HIV care and management, and TB treatment, onto contributory schemes would exacerbate their fragility and fail to protect the population.”7 The WHO says that community-based health insurance “cannot be expected to provide a major source of funding or coverage,” and noted that most schemes offer only moderate benefit to individuals paying into them, and exclude the poorest segment of the population.8 And yet, the US-Ugandan implementation plan says that community health insurance is “the central pillar of this [PNFP] sustainability strategy” and that this approach that will generate “pre-paid pooled funding at facility and community level [that] improves financial risk protection for households, reduces catastrophic out-of-pocket expenditure, and generates structured, transparent revenue streams that can progressively absorb recurrent costs including health worker salaries.” Unfortunately, Uganda’s own history suggests the pillar might not be able to bear this weight. Ugandans Have Been to this Rodeo Before—and Some Want Their Money Back Uganda introduced its first community health insurance scheme in 1996 with support from international donors.9 Thirty years later, somewhere between 0.2 and 0.3 percent of the population is covered by CHI; just over 1 percent has any kind of health insurance.10 User fees were universally introduced in 1993 as a condition of a World Bank loan.11 They were abandoned in 2001, and in 2004—the year I moved to Uganda to watch the free HIV program get underway—a definitive study found that the fees did not improve health systems and outcomes.12 In 2004, most clinics and hospitals had ‘free’ and ‘fee for service’ options for getting care.13 The fee for service, or “cash and carry” programs had often been established in the years prior to PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria. People who could afford to paid for the drugs, often at facilities in the private-not-for-profit (PNFP) sector. When free drugs arrived, some people who’d been paying kept on doing so, perhaps because of shorter wait times, greater confidentiality, convenience or other factors. But in the year that I spent visiting the same clinics around the country week after week—including a “center of excellence” that maintained separate days for cash and carry clients and those accessing free ARVs—lots of people who had been paying tried to switch to the free option. They’d paid because they had no other choice. They’d sold pieces of family land, begged family members for loans, bought pills by the week, and sometimes by the day. Or they were just cash-strapped, like most of us, and wanted the funds for other things. 14 Twenty-two years later, this hasn’t changed. Ugandans pay out of pocket for 30-40 percent of their health care costs, leading one paper to declare that “falling ill is more than a health crisis. It is a financial emergency.”15 One recent study found that up to 48.5 percent of households dealing with tuberculosis sold something, took out a loan or dug into savings to defray the costs of TB care—which is supposed to be universally free.16 The Ugandan implementation plan does anticipate challenges. It proposes a phased approach, with 187 facilities introducing user contribution systems in Year 1, 152 in Year 2, and 153 in Year 3. Willingness to pay and feasibility studies will precede roll out; fees will be tiered by region, and a waiver system is proposed to ensure that no one has to pay who is unable to. Moreover, the plan provides for quarterly reviews of epidemiological data to “ensure that user contributions do not compromise epidemic control gains, ART continuity for the client cohort, TB case management, or PMTCT services.” Alt text: A screenshot of a table included in the implementation plan narrative that is the subject of this stack. It’s got a fetching pink bar at the top. It uses the abbreviation “CHI” which is Community Health Insurance, and FBO which is Faith Based Organizations, and it details the number of facilities that will implement user fees with waivers and community health insurance schemes over the five years of the agreement. As I said in the footnote, this is a super interesting document with a lot of other rich material. Tell me what you see—and what you would have focused on. And if you’ve seen something like this, or anything else that strikes you, in another implementation plan, tell me that too. You can use the Substack message platform or try me on Signal at @endaplague_again.25 (because @mercoonfan was, weirdly, taken). But the plan doesn’t fully explain what will happen if this approach doesn’t work out. Yes, progress will be monitored, and corrective action triggered. However, there is no specified funding replacement if premium and fee revenue prove inadequate. Instead, the authors write, “Currently, COEs serve a total client cohort of over 180,000 across 28 facilities. In the initial years, the U.S. Government (USG) will provide financial support for clients; over time, user fees generated by COEs will become the primary source of funding for sustaining their services.” Failure does not really seem to be an option. Health insurance schemes are more acceptable to the Ugandan population than user fees. Members of Parliament and civil society traveled to Ethiopia to see how that country’s scheme worked. In a follow up report, a veteran civil society group recommended allowing the “health insurance ecosystem to grow organically and [to] keep reviewing the law and regulations as this growth takes root.”17 One study found that more than three-quarters of Ugandans were willing to join a health insurance program.18 However, coverage of community-based health insurance is minimal, as is coverage of any kind of insurance—including private plans.19 A national health insurance scheme bill has been stalled for several years and presently sits with President Yoweri Museveni.20 Community-based health insurance scheme that do exist are expanding in number, but losing enrollees. Between 2022 and 2026, the number of community-based health financing schemes across the country increased by 42 percent, while the number of people enrolled decreased by nearly 11 percent.21 None of this means that community-based health insurance should not happen in Uganda—or that people do not want insurance. It doesn’t even mean that user fees and waivers won’t ever work. But there is highly relevant evidence from Uganda and the surrounding region that it is quite optimistic to describe community health insurance and user fees as central supports for sustainable financing in any sector of the health system. And now for the best-case scenario In the best-case scenario22, the Ugandan approach does exactly what it sets out to do, and so does the Liberian fee structure and revolving pharmacy fund—though I’ve not confirmed that these are in the MoU. In one best-case scenario, Uganda is an outlier, and user fees and community health insurance are not recurrent pillars of self-sustaining financing in other countries’ implementation plans. In another best-case scenario, all countries that include these strategies enjoy success beyond anyone’s evidence-informed wildest dreams: reliable funding generated by health care users fees, great health care outcomes for everyone, no exacerbation of inequities, no crippling household debt. No sold land, repurposed school tuition or high-interest loans. In the best-case scenario, not one of the hundreds of thousands of Ugandans living with HIV receiving antiretrovirals from 491 PNFP facilities misses a refill or leaves care because of user fees or community health insurance premiums. This is the best-case scenario for these people for their own health, and for their families. It is also the best-case scenario if Uganda wants to stay on the path to eliminating HIV as a public health threat. According to the country’s most recent data, 96.5 percent of people living with HIV on antiretrovirals are virologically suppressed. Epidemic control depends ensuring that 95% of people living with HIV know their status, 95 percent of those individuals are on ART, and 95% of those individuals are virologically suppressed. Uganda is still struggling with the first “95"—a frankly abysmal 85.3 percent. If HIV epidemic control and the attendant prevention of new infections, avoidable suffering and premature death matter, the country cannot afford to lose any clients who are currently in care.23 As I write this a couple hours before the polls close for the US elections in the city I live in, I say with soul-deep sincerity: I am rooting for the best-case scenario. I think it’s safe to say that we all are.24 I think it’s also safe to say that if the US and co-signatory governments have inked plans that lead to successful expansion of community health insurance and strategic use of user fees, we all would like to know, now, so that we don’t miss the opportunity to celebrate when success happens. The implementation plan narratives have to enter the public domain. They are the fullest expression of a strategy co-created by two governments. There are assumptions and details that people living in the US and co-signatory countries need to understand that are not available in the MoUs or, to date, in the Congressional Notifications. Some of these details can help other countries that are, as I write this, still working on implementation plans. Others, like a solid count of how many other countries have plans for expanding user fees or health insurance, are important for regional and global health architecture reform initiatives. No matter how this election night turns out, there will be a slew of new Congressional member orientations, briefings and talking points papers in the next few months. Release of implementation narratives should be a bullet point in every context that AFGHS is discussed. These documents can be redacted so that procurement sensitive information isn’t disclosed. There is much more historical precedent for sharing such documents than there is for relying on user fees to fill health financing gaps. Let’s look at the information together so we can hope for the best and prepare for, you know, the other thing. Alt text: A substack first: a bicep selfie! It’s my arm - peachy-white skin, black shirt (flannel, notch neck, too hot for this appallingly balmy November weather, if you’re wondering) and a sticker that says I VOTED 2026. Beige letters on red for I voted. Beige on blue for 2026. You bet I did.25 In your wildest dreams. Subscribe 1 This is a really, really rich 95 page document. There are fascinating ideas and detailed plans in it. It is all worth reading AND I have, in this post, highlighted an instance of content that could pose challenges and certainly posits success of strategies that haven’t worked before. I would love to hear what readers’ see that’s interesting and should be lifted up as something to check for in other implementation plans. I will also shortly be adding a static page to the substack site where implementation plan documents will live. I will put the url into this footnote and it will also be there on emilybass.substack.com by the end of the week. Uganda Implementation Narrative Section 4 April 22 2026 Draft 1.51MB ∙ PDF file Download Download 2 User fees are costs charged for visits, labs, medicines or other health services, usually at the time they are provided. Community health insurance, or community-based health insurance, is what the World Health Organization calls “micro insurance,” which is health insurance targeted at low-income people. 3 As usual (by which I mean always), please prove me wrong. 4 https://smartnewsliberia.com/liberias-ministry-of-health-announces-2025-hospital-service-fees-for-public-facilities/?utm 5 https://moh.gov.lr/news/2025/grand-cape-mount-leaders-residents-embrace-new-community-pharmacy-program/?utm 6 https://www.christianitytoday.com/2026/09/hiv-usaid-pepfar-africa-foreign-aid-cuts-mission-hospitals/?utm 7 https://gh.bmj.com/content/10/11/e021270 8 https://www.who.int/news-room/fact-sheets/detail/community-based-health-insurance-CBHI 9 https://pmc.ncbi.nlm.nih.gov/articles/PMC2827475/ 10 https://pmc.ncbi.nlm.nih.gov/articles/PMC10861328/#b3-jpmph-23-110 11 https://pmc.ncbi.nlm.nih.gov/articles/PMC527704/ 12 Same citation as the footnote 2 - the article is called “Learning from failed health care reform in Uganda.” To which I say: If only. If. Only. 13 There is a whole taxonomy of user fees to be aware of, if not commit to memory. Out of pocket costs are everything that someone pays for themselves. In this Stack, user fees are planned and policy-supported out of pocket costs. There are also out of pocket costs that people pay to buy drugs or receive tests or health care assessments that would be free if the drugs were on the shelves, or the machines or kits were available, or the staff were on site. A user fee is usually designed to be modest, pegged to willingness to pay, and may be waiveable at the point of care for anyone who is unable to do so. The costs for things that would otherwise be free are whatever the market will bear and people either have to pay them or go without. Out of pocket costs for services and stuff that aren’t available in public facilities are different again from bribes or unofficial fees that some health workers may impose, even though most are indefatigable, tireless and tired, and devoted to their clients. 14 For the record—which really is these footnotes—I would give a whole stack of fridge magnets for a systematic analysis of the economic and social impact of the Mass Unemployment Event in AFGHS countries among the very people who used to be able to afford and cover user fees, both for themselves and vast family networks. Locally employed USAID technical staff, house cleaners, caregivers, drivers and technicians were financial anchors for cousins, friends, friends’ children, friends’ childrens’ cousins, teachers, pastors, neighbors and so many other kinds of kin. Aid recipients lost direct funding; many other people who had not been aid recipients, but parts of the elaborate care webs that function as safety nets for so many people, lost crucial support too. And that’s even before we get to the people who worked at the hotels and restaurants and bars where people employed by the US and its implementing partners used to spend disposable income. Those businesses have lost revenue; those folks have lost jobs. It will be some time coming—and someone will have to fund this work—but I do hope it happens. And I hope, as usual, to be proven wrong. 15 https://eprcug.org/blog/how-out-of-pocket-healthcare-costs-keep-driving-ugandans-into-poverty/ 16 Another straight-to-the-point journal article title. Households experiencing catastrophic costs due to tuberculosis in Uganda: magnitude and cost drivers. https://pubmed.ncbi.nlm.nih.gov/32938411 17 https://www.cehurd.org/download/technical-policy-brief-on-community-health-insurance-scheme/?wpdmdl=13661&refresh=6ae9122f5d4ed1793659439 18 https://pmc.ncbi.nlm.nih.gov/articles/PMC10125197/ 19 https://pmc.ncbi.nlm.nih.gov/articles/PMC10861328/#b3-jpmph-23-110 20 https://ugandapost.news/uganda-to-make-health-insurance-mandatory-by-2026/ 21 https://shu.org.ug/download/235 22 With a nod, tip of the stack hat, and wag of the Mercoon tail to a deeply valued reader who told me that I have a tendency to speculate about the worst-case scenarios a little too much of the time. 23 https://news.mak.ac.ug/2026/10/uphia-2025-shows-ugandas-hiv-status-awareness-gap-despite-strong-treatment-outcomes/ As you’ll see in the next footnote, I’ve already written a subSubstack on another topic, so I will be brief with regard to the study referenced in this article. The Uganda Population-Based HIV Impact Assessment, or UPHIA, will never happen in this way again. For more than a decade, PHIAs have been supported by the US government as a way to generate accurate estimates of country progress on key HIV indicators. They are a holdover from the PEPFAR program that was laser focused on ensuring US taxpayer dollars subsidized progress in pandemic control. There may be other population-level surveys and the data may even be publicly released, as the entire set of FY2026 MER data have not. But PHIAs will never happen again. If you’re wondering whether the estimates of HIV progress at country level might get less reliable….you’re not alone. 24 Ooh baby, I hate “we” in almost all forms. But sometimes I go there, when I am looking for company, which I am. Because this Stack moves into the somewhat-uncharted territory of assessing what the implementation plan narratives may suggest about co-signatory countries’ roles and responsibilities to the people living within their borders. The MoUs, specimen and data sharing agreements were templates. Countries’ answers fit into pre-specified questions that did not include, “how are you going to fill financing gaps and stabilize your health system as this plan unfolds?” In contrast, the implementation narratives are open form—the product of co-creation between the two governments. Co-creation can mean lots of things, but nothing leads me to believe that implementation plans are ghost-written by the US government, or that contents were imposed by the US counterparts. Instead, I think the parts of the plans that read like country government initiatives are endorsed, if not initiated by, those governments. For instance, the Ugandan implementation plan narrative describes plans for revenue-generation through fees charged for equipment calibration, repair and maintenance provided through Uganda’s National Equipment Calibration Laboratory, and laboratory accreditation through the Uganda National Accreditation Service (UGANAS), targeting private sector, PNFP, research and academic clients. That’s super specific and also quite ambitious. It doesn’t read like an American idea. There’s also a provision for solar panels, and other stuff that feels country owned and driven. This is where it gets interesting. If co-creation is the case, then both the US and co-signatory governments are accountable for the contents and the outcomes. Most discourse about AFGHS to date has focused on the decisions that America has made, or demanded that other countries make. The AFGHS architects have monopolized the hot seat. As they should, in so many ways. America absolutely created the conditions under which countries needed to come up with health financing strategies to fill unanticipated, catastrophic funding gaps. And with not-too-long a lens, we can look back and see that America is also on the hook for its role in the Bretton Woods institutions that made user fees and health system fiscal austerity conditions of loans during the era of structural adjustment. But in the here and now, it is not at all clear to me that the US is requiring Uganda or any other country to implement specific approaches to sustainable financing. Instead, it is as the authors of that paper up in footnote 6 suggest: African governments have agency. As implementation plans roll out—whether or not the narratives are shared—it will be important to understand what this agency looks like and what it means for people, including the poorest of the poor. And it will be important to figure out how to talk about it safely, respectfully and critically in places other than the literal and metaphorical footnotes. 25 This week’s song is “Once upon a time” by the Moody Blues. (I know, this is gonna be a weird, largely banger-free end of 2026 playlist. HMU with requests.) AND please do watch the video and appreciate the truly amazing opening sequence—a drum kit wasteland, a coupla plastic bags, a bit of sand. Sort of like the hill where fiscal austerity policies that put costs on health care users might go to perish. But then there’s a lady with amazing hair. It’s worth it.

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Nov 3 • 11:57 PM EST • Health • emilysbass.substack.com
U.S. Congressman Tim Moore, a longtime fixture of NC politics, defeated in reelection bid

Before moving to Congress, Moore was the longest-sitting Speaker of the N.C. House of Representatives.

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Nov 3 • 11:53 PM EST • Politics • wunc.org
The Midterm Election Was About Health Care

In the face of Trump’s destruction of public health and modern science, voters are putting candidates who support Medicare for All, doctors and nurses into positions of power.

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Nov 3 • 11:50 PM EST • Health • prospect.org
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Alabama’s CFP ranking gets mocked on social media: ‘Legit insane’

Social media wasn't kind to the Crimson Tide on Tuesday.

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Nov 3 • 11:50 PM EST • Sports • sports.yahoo.com
Biz leaders react as a 'blunami' sweeps America on Election Night

Business leaders and tech executives are now weighing in on what the new political landscape could mean for their industries.

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Nov 3 • 11:49 PM EST • Business • businessinsider.com
Tulsans approve hotel tax hike backed by business groups

Tulsa voters approved a measure to raise the city’s lodging tax from 5% to 9.9%. The new revenue will pay for upgrades at BOK Center and Arvest Convention Center.

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Nov 3 • 11:49 PM EST • Business • tulsaflyer.org
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Vikings mentioned among 'dream trades' for new DL

The Vikings have been linked to an Eagles DL ahead of next week's trade deadline.

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Nov 3 • 11:40 PM EST • Sports • sports.yahoo.com
CNN projects Democrat Gina Hinojosa will win Texas governor’s race
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Nov 3 • 11:39 PM EST • Politics • cnn.com
😐 Neutral (0%)
Democrat Jon Rosenthal appears on track to win Texas Railroad Commissioner race

The three-member Railroad Commission of Texas regulates the state’s massive oil and gas industry, overseeing everything from pipeline safety to natural gas rates.

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Nov 3 • 11:38 PM EST • Politics • houstonpublicmedia.org
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How Texas Turned Blue

An impossible Democratic dream has finally come true.

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Nov 3 • 11:38 PM EST • Politics • theatlantic.com
Speaker Johnson reacts as CNN projects Democrats will flip House
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Nov 3 • 11:36 PM EST • Politics • cnn.com
Republicans win contested legislative races in the Fort Smith metro

Republicans prevailed in all contested legislative races in the Fort Smith metro, with Sen. Justin Boyd, R-Fort Smith, returning to the Arkansas Senate for a second term, and Charlene Fite...

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Nov 3 • 11:34 PM EST • Business • talkbusiness.net
Constitutional convention fails, Money Out of Politics approved

LANSING, MI (WKZO AM/FM) - Michigan voters have said a loud "no" to Proposal 1 to hold a constitutional conven...

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Nov 3 • 11:34 PM EST • Politics • wtvbam.com
Why Everyone Is Watching Hinge Health (HNGE) Now

Hinge Health (HNGE) just posted third quarter 2026 results that flipped the business from loss to profit, with sales of US$234.97 million and net income of US$57.4 million catching investor attention. That earnings surprise has landed on a strong run in the Hinge Health share price, with a 30 day share price return of 19.63% and a 90 day gain of 44.62%, building on a year to date share price return of 156.45% and a 1 year total shareholder return of 118.64% at a latest share price of...

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Nov 3 • 11:32 PM EST • Health • finance.yahoo.com
Caddo Parish voters reject $60 million bond for proposed sports complex

Approved: Caddo Parish voters have approved a $60M bond measure to help fund a proposed $70M sports complex in Shreveport. Full election results here. Rejected: Caddo Parish voters have rejected a $60M bond measure proposed to fund a $70M regional sports complex in Shreveport. Full election results here.

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Nov 3 • 11:32 PM EST • Sports • ksla.com
Democrats capture full control of Congress, NBC News projects, fueled by victories in deeply Republican states

Democrats capitalized on voter anger over Trump and affordability, flipping seats in deep-red and major battleground states alike.

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Nov 3 • 11:24 PM EST • Politics • nbcnews.com
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Talarico flips Texas Senate seat, in historic win for Democrats

Democrat James Talarico, a former schoolteacher and Presbyterian seminarian who campaigned on a "politics of love," on Tuesday won the US Senate race in Texas, flipping yet another seat for his party ...

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Nov 3 • 11:24 PM EST • Politics • yahoo.com
Marni von Wilpert flips California House seat, bringing a personal health care fight to Congress

The bisexual lawmaker from California flipped a Republican-held seat amid an overwhelming blue wave.

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Nov 3 • 11:20 PM EST • Health • yahoo.com
Zach Dembo will win Kentucky’s 6th Congressional District race
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Nov 3 • 11:19 PM EST • Politics • cnn.com
Michigan approves Proposal 2, citizen-lead effort to limit corporate influence in politics

Michigan voters passed Proposal 2 during the Nov. 3 midterm election. The Associated Press called the race at 9.38 p.m on Nov.3, 80.9 % of voters cast their ballot in favor of the proposal, 19.1% with more than 24% of the vote in.

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Nov 3 • 11:14 PM EST • Politics • michigandaily.com
WATCH: Pennsylvania Gov. Josh Shapiro speaks after winning reelection

Shapiro was seeking a second term. He previously served two terms as state attorney general, and he's considered a potential contender for the White House in 2028.

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Nov 3 • 11:13 PM EST • Politics • pbs.org
Takeaways from election night: Young voters, Hispanics shift away from the GOP as voters show unhappiness with Trump

President Donald Trump repeatedly encouraged voters to pretend he's on the ballot this Election Day. They appear to be taking his advice — and that's not a good thing for the Republican president or his party.

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Nov 3 • 11:12 PM EST • Politics • pbs.org
Erin Andrews Reacts to NFL Legend Tom Brady's Foxborough Return
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Nov 3 • 11:10 PM EST • Sports • sports.yahoo.com
Vote-scanning machine malfunction expected to delay counting in New York's Westchester County

A judge has granted permission for elections officials in a major New York county to move thousands of paper ballots to a secure warehouse after a technical problem caused vote-scanning machines to malfunction.

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Nov 3 • 11:03 PM EST • Politics • pbs.org
Schmaltz scores game-winner in Mammoth 3-2 win

TORONTO (ABC4 Sports) – Nick Schmaltz scored the winner on a power play with 6:48 left in regulation and the Utah Mammoth beat the Toronto Maple Leafs 3-2 on Tuesday night. Dylan Guenther and Andrew Peeke also scored for Utah. Sebastian Cossa made 27 saves. Clayton Keller added three assists and Mikail Sergachev had a […]

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Nov 3 • 11:01 PM EST • Sports • sports.yahoo.com
Former Health and Human Services Secretary Xavier Becerra wins California governor’s race

Becerra, a longtime fixture in Democratic politics in the state, beat Republican Steve Hilton, NBC News projects.

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Nov 3 • 11:00 PM EST • Health • yahoo.com
Lakers star Luka Dončić has second technical foul rescinded
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Nov 3 • 10:57 PM EST • Sports • sports.yahoo.com
Alabama Dealt Surprising News Days Before SEC Showdown vs. LSU

Alabama was just dealt some major news days before the team's showdown against LSU. The post Alabama Dealt Surprising News Days Before SEC Showdown vs. LSU appeared first on HEAVY.

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Nov 3 • 10:56 PM EST • Sports • sports.yahoo.com
Van Jones: ‘Can I be happy right now?’
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Nov 3 • 10:55 PM EST • Politics • cnn.com
Takeaways from the midterms: Americans broadly rejected Trump — and Democrats stand to make huge gains because of it

The Democratic wave is here — and now, as votes are counted in key states, the question is how many Republicans it will wipe out.

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Nov 3 • 10:50 PM EST • Politics • cnn.com
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Democrat Paige Cognetti wins election to U.S. House in Pennsylvania's 8th Congressional District

She campaigned as an independent-minded Democrat and corruption-fighting city leader.

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Nov 3 • 10:49 PM EST • Politics • pbs.org
🙂 Positive (35%)
Which sports figures won or lost in the midterm elections? Tracking 7 big names

Ex-NFL player Colin Allred returned to the U.S. House, while ex-coach Tommy Tuberville and broadcaster Michele Tafoya were also in races.

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Nov 3 • 10:48 PM EST • Sports • nytimes.com
15 players to watch amid NFL trade deadline buzz
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Nov 3 • 10:32 PM EST • Sports • sports.yahoo.com
😐 Neutral (0%)
Postgame Reaction: There’s No Excusing These Avalanche Performances

This is bad. The Colorado Avalanche’s 9-6-1 record isn’t the issue. It’s a fine place to be after 16 games […]

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Nov 3 • 10:24 PM EST • Sports • sports.yahoo.com
😐 Neutral (0%)
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Byron Donalds will be Florida’s next governor
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Nov 3 • 10:23 PM EST • Politics • cnn.com
Massachusetts Gov. Maura Healey wins reelection after strengthening protections for trans health care

The Democrat defeated Republican Mike Minogue after a first term that included stronger safeguards for abortion and gender-affirming care.

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Nov 3 • 10:21 PM EST • Health • yahoo.com
Michigan votes in favor of Proposal 2 to get ‘Money Out of Politics,’ AP projects

Watch News 10+ for continuing election coverage

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Nov 3 • 10:12 PM EST • Politics • wilx.com
Bruins Among Teams Talking To Red Wings About Blockbuster Trade

Reports say the Boston Bruins aren’t among the six to eight teams on Dylan Larkin’s list. That said, they want to be, and general manager Don Sweeney is kicking tires.Pierre LeBrun of TSN reports that the Bruins have called the Detroit Red Wings about a Larkin trade. Unfortunately, of the ten teams Larkin’s camp has […] The post Bruins Among Teams Talking To Red Wings About Blockbuster Trade appeared first on HEAVY.

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Nov 3 • 10:12 PM EST • Sports • sports.yahoo.com
Montgomery leaders approve resolution to form new health care authority

The Montgomery City Council announced Tuesday night that it voted 6-3 to approve a resolution authorizing the establishment of the Health Care Authority of Montgomery.

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Nov 3 • 10:08 PM EST • Health • wsfa.com
Democrats win control of the House of Representatives, with a vow to combat Trump

NBC News projects that Democrats will take control of the House next year, giving them the power to investigate Trump and advance legislation to check his policies.

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Nov 3 • 10:08 PM EST • Politics • nbcnews.com
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Political newcomer tapped by voters to lead Oklahoma Insurance Department

In a race that saw both candidates vowing to tackle the state’s soaring insurance rates, voters selected a Republican to lead the state’s Insurance Department.

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Nov 3 • 10:07 PM EST • Politics • oklahomavoice.com
Hakeem Jeffries is on track to make House speaker history. But major challenges lay ahead

Hakeem Jeffries is now on a clear path to be elected House speaker in January, a position that effectively hands him control of a newly resurgent Democratic party in President Donald Trump’s final two years in power.

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Nov 3 • 10:05 PM EST • Politics • cnn.com
AP Voter Poll: How key demographic groups voted in the 2026 midterms

The poll, an expansive survey of about 80,000 voters in all 50 states, suggests young voters were less likely to back House Republicans this year than they were to support Trump in 2024.

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Nov 3 • 10:04 PM EST • Politics • pbs.org
Proposal 2 for 'money out of politics' passes in Michigan

Voters approved Proposal 2 in Michigan in the 2026 midterm election. Proposal 2 would regulate political spending by utilities and large government contractors.

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Nov 3 • 10:00 PM EST • Politics • michiganpublic.org
Democrats eye sweeping gains and reshaping of political map

Two Senate races that a year ago were thought to be battlegrounds turned out to be slam-dunks for the Democrats.

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Nov 3 • 9:57 PM EST • Politics • bbc.com
Abortion rights amendment passes in Virginia

2026 ELECTION COVERAGE: Watch Live | Poll Closing Times | All Live Results | Live Updates | Live Fact Check Voters have approved a ballot measure that creates a “fundamental right to reproductive freedom” in the Virginia Constitution. The amendment passed Tuesday ensures abortions can occur during the first two trimesters of pregnancy. It allows government regulations during the third trimester while still ensuring that abortions can be carried out to protect the life and

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Nov 3 • 9:56 PM EST • Politics • pbs.org
Vic Fangio: J.J. McCarthy was a "steal" for the Giants
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Nov 3 • 9:52 PM EST • Sports • sports.yahoo.com
WATCH: Democrat Chris Pappas speaks after winning New Hampshire Senate seat

Pappas, a four-term House member, said his U.S. Senate victory is proof that Washington needs a "new generation at the table to fix things."

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Nov 3 • 9:52 PM EST • Politics • pbs.org
Michigan passes limits on utility money in politics, setting up likely court fight

LANSING, Mich. (WLNS) — Michigan voters approved Proposal 2 Tuesday, a citizen-led measure its backers say will get “money out of politics,” setting up a likely court fight in the coming months. Th…

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Nov 3 • 9:50 PM EST • Politics • wlns.com
Yankees’ perfect trade offer for Brewers’ Trevor Megill

The New York Yankees should pursue Trevor Megill with an offer that supports the Milwaukee Brewers’ championship defense. New York needs late-inning pitching , but Milwaukee needs a reason to surrender its proven closer. ESPN’s Jeff Passan reported Monday that the Brewers would at least listen to offers for Megill. This package is a proposal, with […] The post Yankees’ perfect trade offer for Brewers’ Trevor Megill appeared first on ClutchPoints.

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Nov 3 • 9:49 PM EST • Sports • sports.yahoo.com
Dark Chocolate, The Celebrity Treat With Surprising Health Benefits
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Nov 3 • 9:46 PM EST • Health • yahoo.com
Michigan voters pass 'Money out of Politics' proposal, reports say

Michigan voters approved a ballot initiative banning utility companies and other state contractors from making political donations.

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Nov 3 • 9:45 PM EST • Politics • freep.com
Penguins Waste Late Chances, Lose Third in Row

Goals weren’t coming in bunches — or even in trickles — by either team for most of the game Thursday […]

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Nov 3 • 9:45 PM EST • Sports • sports.yahoo.com
Robertson's natural hat trick has Capitals seeing Stars

While Washington did their best to rally after a Jason Robertson natural hat trick in the second period, the Capitals' comeback attempt fell short in a 6-4 loss to Dallas.

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Nov 3 • 9:40 PM EST • Sports • sports.yahoo.com
Former Steelers QB Russell Wilson interviews for head coach job

Former Steelers QB Russell Wilson interviews for college head coach job.

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Nov 3 • 9:39 PM EST • Sports • sports.yahoo.com