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An El Niño–fueled ocean wave could raise California flood risks as Florida’s vaccine debate sparks outbreak concerns
An El Niño–driven ocean surge threatens coastal flooding, researchers warn that a plan to loosen vaccine requirements will increase measles risks in Florida, and experts debunk a viral TikTok cold remedy
Alex Scott Injury Raises Fresh Bournemouth Fears After England Break
Alex Scott's dream England breakthrough has been overshadowed by injury, with the Bournemouth midfielder potentially facing two months out. After a brilliant start to the season, his absence comes at the worst possible time, while his injury raises familiar frustrations around AFCB's rising stars.
How will Florida's minimum wage increase to $15 affect workers and businesses?
A University of South Florida economics professor shares insight on concerns over the recently raised minimum wage in Florida on "The Florida Roundup."
Ed Sheeran's newest opening act praises Macklemore amid tour drama
After other musical acts quit his tour following Macklemore's removal for pro-Palestinian messaging during a performance, Ed Sheeran found a replacement opening act for a night.
Basalt Health Raises $20 Million Series A Led By NEA
Basalt Health has raised $20 million in Series A funding led by returning investor NEA to expand its AI platform for post-acute care admissions. Existing investors Frist Cressey Ventures and 25m Health also participated. The round brings Basalt's total funding to approximately $24.5 million.
Magic's Jevon Carter Praises Team Chemistry, Work Ethic
Orlando Magic guard Jevon Carter had a lot of good things to say about the team following the fifth day of training camp.
How To Catch Up On The Hellraiser Movies Before 'Revival'
The first survival horror video game in the Hellraiser series is quickly approaching, which means it's a great time to catch up on the films.
How Americans’ Financial Health Is Faring In The “K-Shaped” Economy
Hey all, Jason here. Money20/20 is still two weeks away, but I’ve already started packing (not procrastinating for once!). My calendar is already filling up with various sessions I want to catch, meetings, and of course happy hours, dinners, and other side events. If you’ll be in Vegas and want to catch up, let me know by replying to this email, and we can try to find a time amidst the chaos of the Venetian. A big if not totally unexpected piece of news dropped on Friday: the Independent Community Bankers of America, a trade group that represents smaller U.S. banks, filed a lawsuit against the OCC and Comptroller Jonathan Gould, arguing that the regulator’s move to grant trust bank charters to firms seeking to use them to conduct substantial non-fiduciary activities exceeds the authorities granted to the OCC by Congress. I haven’t had time to fully digest the legal filing or speak to folks in my network about it, but you can expect to see coverage and analysis on it in next week’s newsletter. Subscribe or Support by Upgrading The NerdCon agenda just dropped. It’s stacked. Partner content: Nubank built an AI-first bank. Chime built its own banking core. Figure and Valon are rebuilding the mortgage stack. At NerdCon, you’ll hear from the people behind those bets: what they chose, what they learned, and what they’re still figuring out. The agenda is live, with leaders from Nubank, Chime, OpenAI, Remitly, Mercury, Figure, Valon and more. Follow the mainstage conversations, bring the problem your team is wrestling with to a hands-on workshop, or pull up a chair at a roundtable. Pick your quests. Meet us in San Diego, November 18–20. Fintech Business Weekly readers save 20% with code FBW20. Explore the Agenda Things To Know & Other Good Reads Federal Reserve Board finalizes changes to enhance the transparency and public accountability of its stress test and reduce volatility in its stress test-related capital requirements (Federal Reserve Board of Governors) FDIC Announces Conclusion of Independent Monitorship (FDIC) Modernizing Financial Regulation: Initial Observations from eSLR (Fed Vice Chair for Supervision Michelle Bowman) The Data Version of Godzilla versus Kong: FRED Takes on AI (Fed Governor Christopher Waller) Financing the AI buildout (Brookings) Q3’26: Rules for Banks but Not for Crypto (Fintech Takes Banking) The Inevitability of Local Stablecoins (Lombard Notes) Delusions of AI Governance: The Human-in-the-Loop Comfort Blanket (Fintech Snark Tank) Stripe agrees to acquire Parafin to expand revenue opportunities for platforms and help small businesses grow (Stripe) Listen: Fighting Fraud in the Age of AI, with SEON’s Tamas Kadar (Fintech Business Weekly) How Americans’ Financial Health Is Faring In The “K-Shaped” Economy If there is one overarching theme across the economy and politics in the U.S. at the moment, it’s “affordability.” The term is vague enough to encompass a panoply of factors shaping Americans’ day-to-day lives: rising costs for the hallmarks of being “middle class,” including healthcare, housing, childcare, and education, inflation and rising interest rates, and a job market with the specter of AI hovering over it. At the same time, policy shifts under the Trump administration have resulted in reduced subsidies to those who get health insurance under the Affordable Care Act and new restrictions on qualifying for Medicaid and SNAP, the impacts of which have yet to be fully felt. These factors are contributing to declining consumer confidence and general dissatisfaction with the economy, despite continuing GDP growth and stock market records. This divergence is encapsulated in the idea of the “K-shaped” economy, in which a small proportion of Americans have seen their wealth balloon, while the majority of American households struggle to preserve the lifestyle they have. Perhaps the greatest determinant of which branch of the “K” a household is on is whether their wealth and income are primarily derived from employment vs. from assets. Nearly two decades of low interest rates and, more recently, elevated rates of inflation have benefited asset owners, while those whose income is primarily or solely derived from labor have largely seen real purchasing power stagnate or decline. This is reflected in recent Bureau of Labor Statistics data showing that labor share of U.S. GDP — the fraction of economic output that accrues to workers as compensation in exchange for their labor — dropped to just 52.8% in Q2 2026, the lowest since the BLS began keeping records. In 1947, approximately 2/3rds of economic output accrued to workers; even as recently as 2001, labor’s share of GDP was 64.1%. Against this backdrop, we’ve seen the rise of more credit and credit-like products: cash advance apps, “no-fee” overdraft, earned wage access, and buy now pay later, which are often used as small-dollar short-term borrowing mechanisms to meet immediate consumption needs or pay other bills (eg utilities, cell phone, other debt payments). With the markers of a middle class existence and, increasingly, basic financial stability seemingly out of reach for many, it should be no surprise there’s been an increase in “financial nihilism,” something industry peers like Alex Johnson and Frank Rotman have discussed and analyzed the roots of. The explosion of gambling and gambling-adjacent products and services — often marketed under the guise of being an “investment” — is inextricably intertwined with the rise of financial nihilism. Crypto, sports betting, and, more recently, prediction markets offer an escape or even hope of sorts, like a contemporary, digital version of a scratch-off lottery ticket, while leaving the overwhelming number of people who use such products worse off. Share of Households That Are Financially “Vulnerable” Ticks Up The Financial Health Network’s 2026 Financial Health Pulse® report adds context on how American households are faring. (I linked to this report in last week’s newsletter, but wanted to take time to further unpack the data in the report this week.) The Financial Health Network publishes the report annually, providing insight into how Americans’ financial circumstances are changing over time. The 2026 report is derived from a survey fielded in April and May 2026. The report leverages survey responses to assess indicators of financial health across spending, saving, borrowing, and planning/protecting and to determine a zero to 100 “FinHealth” score. Those with scores between 0 and 39 are considered “Financially Vulnerable,” consumers with scores ranging between 40 and 79 are defined as “Financially Coping,” and those with scores of 80 to 100 are “Financially Healthy.” The report found that moderate improvements in 2025 were reversed, with the share of respondents considered financially “vulnerable” rebounding to 17%. The longitudinal data reflect the impact of pandemic-era programs, like expanded unemployment, cash stimulus payments, and pauses of federal student loan payments. The positive impacts of those programs, as reflected in the Financial Health Pulse reports, had largely disappeared by 2023. While pandemic-era inflation — to be fair, in part caused by the various support and stimulus measures — had come down from as high as 9% in 2022, it has rebounded since the start of Trump’s second term, with tariffs and energy market disruptions owing to the war in Iran pushing prices back up. Specific indicators in the survey that deteriorated from 2025 to 2026 include the share of respondents spending less than their income over the past 12 months, the share paying all bills on time over the past 12 months, the share that have a manageable amount or no debt, the share that are “moderately” or “very” confident their insurance is adequate to cover them in an emergency, and the share that “somewhat” or “strongly” agree that their household plans ahead financially. Unsurprisingly, lower- and moderate-income households are more likely to struggle to pay their bills on time and have any funds leftover to save. The share of low-income households whose income exceeded their spending dropped from 35% in 2025 to 31% in 2026, while the share of upper-income households whose income exceeded expenses remained unchanged at 63%. Households with student loans or revolving credit card debt reported having “a bit more” or “far more” debt than was manageable at rates far higher than those not carrying these types of debts. The share of those with student loan debt indicating their debt load was too high to manage increased from 50% in 2025 to 55% in 2026, while the share of those with revolving credit card debt saying the same ticked up from 51% in 2025 to 54% in 2026. Households that had student loans were markedly more likely to be financially “coping” or “vulnerable” vs. those without student loans. In 2026, 27% of households with student loans were considered financially vulnerable, a jump of 6% points vs. 2025. Households without student loans saw just a 1% point increase (not statistically significant) in those considered financially vulnerable. Households’ perception of the affordability of categories of goods and services paints a stark picture, with less than one-fourth considering higher education affordable, about a third deeming childcare affordable, and less than half viewing healthcare as affordable. Fintech Business Weekly is made possible by the generous support of paying subscribers — bringing you independent analysis of banking, fintech, and crypto without fear or favor. You can support my work by becoming a paying subscriber if you aren’t already. Paying subscribers enjoy: access to the entire archive of nearly six years of newsletters extended versions of the weekly newsletter, with additional content and analysis and (for founding member tier) quarterly personal 1:1 fintech Q&A / strategy calls with me, tapping into my unparalleled knowledge of the intersection of banking and fintech and experience working in the sector, including helping to launch Goldman Sachs’ retail bank Marcus Support Fintech Business Weekly You can also support Fintech Business Weekly by sponsoring a newsletter or podcast, putting you in front of 93,000+ of the most influential decision makers in banking, fintech, and crypto. Learn more about sponsor opportunities or request a media kit by dropping me an email. Democratic Senate Report Highlights How Iran Uses Tether to Evade U.S. Sanctions Iran uses stablecoins, specifically Tether, to evade sanctions, fund regional proxies, and to purchase military drones, a report released last week by the Senate Permanent Subcommittee on Investigations says. The report was authored by committee ranking member Senator Richard Blumenthal (D-CT) and the minority staff. Crypto and stablecoin proponents will often push back on criticism that criminals make use of these assets by arguing that, on an absolute dollar basis, far more illicit funds flow through traditional banking systems and payment rails than via crypto and stablecoins. And while that is likely true, it elides the reality presented in news story after news story: whether state actors — Russia, Iran, North Korea — or criminal groups, those looking to engage in illicit transactions increasingly favor stablecoins and, specifically, Tether (USDT). The report from the Senate Permanent Subcommittee on Investigations released last week adds context to how Iran uses Tether has a lynchpin in its shadow banking system. The report analyzed 846 wallets that have been sanctioned or targeted for seizure, finding that 84% of them transacted exclusively or primarily in Tether. The ability to create near limitless, anonymous wallets and to move funds effectively instantaneously and irreversibly have made crypto a favored financial mechanism for bad actors. Stablecoins solved key drawbacks of bitcoin, namely, the original cryptocurrency’s highly volatile value in dollars. And while Tether (the company) has the technical ability to “freeze” or destroy funds, the company is often limited and reactive in its approach to doing so, the Senate report argues. Tether, which is nominally based in crypto-friendly El Salvador, “has stated that its compliance with OFAC sanctions is ‘voluntary’ and that it follows ‘OFAC guidelines,’” the Senate report says. Owing to these favorable attributes, Tether “became a primary cryptocurrency for Iran, Hamas, Hizballah, and the Houthis beginning in 2023 and has expanded in scale since,” according to the report. Tether’s role in Iran’s shadow banking system, the report says, is enhanced by crypto exchanges like Bybit, Kyrrex, OKX, Gate, and Binance, and through “over the counter” exchanges and hawala networks. The consequences of these financial flows aren’t hypothetical. The Senate report links Tether as a funds transfer mechanism to Iranian proxies in the region, including Hizballah, the Houthis, and Hamas. Tether has also been used to make payments to secure components necessary to manufacture drones, the report says. The report concludes by arguing that “[s]tablecoin issuers with a significant nexus to the United States, particularly those that offer dollar-denominated stablecoins, should be subject to American sanctions law rather than being allowed to hide behind foreign jurisdictions.” Stablecoin issuers like Tether must be held accountable for repeated failures to prevent illicit finance and sanctions violations by law enforcement, the Department of Justice, the Securities and Exchange Commission, and OFAC, the report argues. [Paying Subscriber Exclusive] OUSD Goes Live, Make Your Own Neobank, U.S. Sanctions Russia’s A7 Network As “Transnational Criminal Organization” OpenUSD, the stablecoin issued by the Open Standard consortium that includes Stripe, Visa, Mastercard, core providers, crypto firms, and numerous banks, went live last week. Social commerce platform Whop raised eyebrows in fintech by offering creators on its platform the ability to launch their own neobanks, which the company describes as “great businesses that are easy to run,” in just 15 minutes. And OFAC and FinCEN target Russia’s “shadow banking” A7 Network — more on these stories after the paywall.
Can One Drink a Day Raise Your Cancer Risk? | Hartford HealthCare
Learn more about News Detail at hartfordhealthcare.org
New Research Just Linked a Popular Supplement to Faster Progression of Dementia
New research raises some questions.
What Amendment 3 reveals about housing and politics
As we approach the Nov. 3 midterm elections, when seemingly everything is politically filtered or turned into a line of attack, it raises the question: is housing political?
Beshear teases 2028 run, shares message of healing at Nashville stop
Democratic Kentucky Gov. Andy Beshear fueled speculation of a 2028 presidential bid while visiting Nashville for a fundraiser and book event.
Mum fundraises to install mental health bench in Wellingborough
The bench includes phone numbers and a QR link that offer support to people in need of help.
Luka Doncic praises Adou Thiero's 'insane' improvement
Lakers second-year forward Adou Thiero could be poised to make a sizable jump this season.
Montreal-raised Juno-award-winning singer Sass Jordan dies at 63
Sass Jordan, the Montreal-raised rock singer whose career spanned nearly four decades, has died at 63.
Hundreds gather in Duxbury to raise awareness for perinatal mental health support
Hundreds of people came together in Duxbury Saturday to make sure parents struggling with their mental health know they don’t have to face it alone.
Eating More Protein Might Not Be as Healthy as You Think
A comprehensive look at scientific research to date points to unexpected benefits from consuming less protein, challenging the surging popularity of protein-packed meals and snacks. The research also raises a bigger question: How much protein do we really need?
Boston Celtics Draw High Praise in Poll of Executives
Besides the Knicks, are the Celtics the team that's most likely to come out of the Eastern Conference?
Hundreds gather to support Mental Health Awareness
MADISON, (WKOW) — More than 700 people gathered for a NAMIWalks event in Dane County, coming together to raise awareness about mental illness and support mental health resources in the
NAMIWalks at Asbury Methodist Church raises over $116,000 for mental health awareness
The National Alliance on Mental Illness (NAMI) held its annual walk fundraiser on Saturday at the Asbury Methodist Church on East Avenue.
The Climb raises awareness about maternal mental health in Nebraska
The Climb raises awareness about maternal mental health in Nebraska
JJ Redick Defends Dalton Knecht Amid Rumored Lakers’ Roster Cu
JJ Redick praises Dalton Knecht.
David Jolly clears $1M raised in a week with help of matching funds, but can't keep pace with Byron Donalds
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FAU graduate student uses Miss Fort Lauderdale crown to turn science into action
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Live Nation Entertainment (LYV) Stock Stays Hard To Read After Its 93% Run
Live Nation Entertainment has seen its share price advance strongly over the past few years, which naturally puts the focus on whether the current US$168.77 level is supported by what the business can generate in cash. With the stock giving back some ground in recent weeks, the question now is how that recent share move lines up against the value implied by its cash flows. Over the past 3 years the stock has returned 92.9%, which raises the issue of whether the market is now asking investors...
Bucks Owner Gives High Praise to New Coach Taylor Jenkins
Going into the first year of a monumental rebuild, new Bucks head coach Taylor Jenkins has total backing from the franchise's leadership.
Weather extremes could raise costs and reshape decisions for Indiana businesses
By Sam Stall | Indianapolis Business Journal
NVIDIA Raises Shield TV Pro Price to $299, Discontinues Standard Shield TV
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Your gut may be making a molecule that raises Alzheimer’s risk
Scientists have linked a gut bacterial compound called ImP to greater Alzheimer’s risk, harmful brain protein buildup, and faster cognitive decline. The finding raises the possibility that reducing ImP in the blood could one day help slow or prevent dementia.
U.S.-Russia Talks on Ukraine Now Involve an Oil Deal Tied to Trump Allies
President Vladimir V. Putin brought up a sale of Russian energy assets with President Trump’s envoys, Jared Kushner and Steve Witkoff, pushing a deal that raises new questions about conflicts of interest.
Madison Square Garden Entertainment (NYSE:MSGE) Upgraded at Wall Street Zen
Wall Street Zen raised Madison Square Garden Entertainment from a "hold" rating to a "buy" rating in a research note on Saturday.
Sunland Park residents raise health concerns over proposed concrete plant near homes
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This week on Power & Politics: Cornell latest, Tax Hike proposals, RAISE Act breakdown
J.J. McCarthy feels 'blessed' after Giants trade, loves the Harbaughs
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Raise the Stakes | RennerVation Foundation Poker Night Supports Nevada Foster Youth
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Milwaukee brothers use youth sports to support local church
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A system under strain: Deadly attack raises questions about mental health beds
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Pacers Coach Rick Carlisle Strongly Praises Newcomer Kelly Oubre Jr.
Indiana Pacers head coach Rick Carlisle praised new small forward Kelly Oubre Jr.
October 1 ushered in a new era in U.S. foreign aid. What's the plan? Will it work?
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Bishop’s computer science chair says AI is eliminating ‘grunt work’ and reshaping digital jobs
Dr. Russell Butler, chair of Bishop’s University’s Department of Computer Science, says artificial intelligence is increasingly taking over routine digital “grunt work,” changing the skills students and workers may need in the years ahead. Photo courtesy of Bishop’s University. Click here to read our platform! Get local news like this every morning. Subscribe free below. Subscribe Pulse Newsroom Artificial intelligence is already taking over some of the routine digital work once performed by entry-level employees, according to Bishop’s University Computer Science chair Dr. Russell Butler — a shift he believes will make expertise, judgement and the ability to evaluate AI-generated work increasingly important. Butler described the change as automation reaching what he calls the “bottom of the cognitive pyramid” during an interview with The Pulse about AI, university education and the future of digital work. His argument is not that humans are disappearing from the workplace. Instead, he sees their role changing as AI becomes capable of handling more of the repetitive tasks involved in computer-based work. “Everything’s converging on just AI basically doing all the grunt work,” Butler said. The bottom of the cognitive pyramid Butler is from Lennoxville, completed his undergraduate studies at Bishop’s and later earned his PhD at the Université de Sherbrooke. He joined Bishop’s in 2019 and now chairs its Department of Computer Science. He uses AI in research, teaching and other creative work, and said the technology is increasingly capable of handling routine digital tasks that once required substantial human time. “You’ve got the grunt work, like moving things around in Excel, doing basic programming tasks,” Butler said. “That’s like the bottom grunt work that the entry-level worker would have done two or three years ago.” Butler went further, saying in his view that much of this type of work has already been absorbed by AI tools. He connected that change to a shift he sees taking place in computer science, where entry-level roles have declined while experienced workers can use AI to increase what they can produce. “A senior developer now has access to essentially an unlimited amount of junior developers on demand,” Butler said. He was describing AI systems metaphorically, not literal employees. His point was that one experienced developer can now ask AI tools to produce code or other technical work that might previously have been assigned to more junior workers. That raises a broader question for universities and employers. If some of the simpler work traditionally given to newcomers can now be done by machines, how do people gain the experience needed to become senior workers themselves? Students doing work that once required years of programming Butler said he is already seeing the change inside his classroom. He created a Bishop’s course called CS208, Coding in Plain English, to show students — including those without traditional programming backgrounds — what they can accomplish using AI. Some come from disciplines such as psychology or neuroscience with no previous programming experience. “What I’m finding is that students who have zero programming experience, they come in from another discipline like psychology or neuroscience or something, they are now able to get up and running with real data sets,” Butler said. Butler’s own doctoral work involved neuroimaging, and he said he has assigned students work he considers comparable to the kinds of analysis he performed during his PhD. He described giving students a real dataset, an expected result and instructions to use AI to complete the analysis. Butler said those students have been able to carry out work at a level he associates with tasks he once performed after years of programming experience. That does not mean a student using AI instantly acquires the same knowledge as an experienced computer scientist. But Butler sees it as evidence that AI can dramatically lower the technical barrier between having a problem to solve and producing a working result. The role of the person using the system then changes. They need to know what to ask for, understand enough about the subject to judge the answer and take responsibility for what is ultimately produced. What about AI hallucinations? One persistent concern surrounding generative AI is hallucination — when a system produces information that sounds convincing but is false or unsupported. Butler said that problem has improved substantially in newer systems and is not as severe as it was with earlier models. He pointed in particular to newer AI systems’ ability to search the web, consult scientific databases and return source links rather than simply generating a citation from their internal model. Butler nevertheless said users should verify what AI produces. “You should verify,” he said while discussing citations generated with AI. His position is that hallucinations have become less common in the systems he uses, not that incorrect AI output is impossible. Human checking remains part of the process. Hours of work compressed Butler offered another example from his administrative work at Bishop’s. The university has been comparing CEGEP courses with first-year Bishop’s courses to determine where students may qualify for advanced standing. Traditionally, Butler said, that means reviewing two sets of course descriptions and manually matching one institution’s courses with another’s. As department chair, that could require hours of reading and comparison. He said AI can now be given both sets of material and asked to generate an initial mapping automatically. “It saves me hours and hours of work,” Butler said. Butler said the AI-generated mapping can also produce a better result than he would produce himself. He sees similar opportunities in businesses. A company may receive specifications, drawings, emails or other digital material from customers and then have employees convert that information into an internal format before anything can be manufactured or delivered. AI can increasingly perform parts of that intermediate processing. In Butler’s view, the employee does not necessarily disappear. Instead, the job becomes more about checking the result. “The human is still there,” he said. Judgement could become more valuable That change is central to Butler’s view of where digital work may be headed. If AI can produce a first draft, write basic code, compare documents or process large amounts of information, he argues that knowledge and judgement become increasingly important. “The real scarce resource going forward is going to be domain knowledge, expertise, and… credentials, authority, the ability to work with other people,” Butler said. He is therefore encouraging students not only to learn AI tools but also to broaden their education. He mentioned acting, fine art and photography as examples of courses that can help develop what he described as taste and intuition — the ability to recognize what is good, what is not and what should be changed. “And that’s the skill that they need now because the grunt work has been automated and now it’s about evaluating what the AI produces and telling it how to improve or expand the output,” Butler said. That does not remove the need for technical knowledge. Butler’s argument is that the emphasis may shift away from manually completing every step of a task and toward directing, checking and improving work produced with AI assistance. He also stressed that humans remain responsible for final decisions. “At the end of the day, the human has to make the final call,” Butler said, pointing to the question of accountability. Physical work may be different Butler draws a distinction between digital work and jobs requiring people to manipulate the physical world. He expects AI to continue advancing quickly in tasks performed almost entirely on computers. He is more cautious about claims that humanoid robots will soon be able to replace workers such as plumbers or electricians. Butler said those trades would not be replaced “anytime soon” in his view and described some current robotics demonstrations as overhyped. He described the situation as counterintuitive. “It’s almost like we solved the highest level first,” he said, contrasting advances in digital AI with the harder problem of building robots capable of operating reliably in the physical world. Butler’s argument is that some digital occupations could face automation sooner than trades requiring complex physical work. The wider AI shift in the Townships Butler’s comments come as local institutions are increasingly grappling with how AI should be used. The federal government recently announced up to $162 million over five years for 10,000 AI-related placements through Mitacs. The Université de Sherbrooke told The Pulse that the number of its collaborative research and innovation projects supported through Mitacs has approximately doubled since 2018-19, while the number of placements has approximately tripled. UdeS also said it already has projects involving both AI adoption and the application of AI to other fields. At Bishop’s, Butler said part of his role involves building the Computer Science department’s local presence, connecting students with regional partners and strengthening relationships with the Sherbrooke technology ecosystem. Those developments put universities in a difficult position. They have to prepare students to use the tools employers increasingly have available while also making sure graduates understand enough to recognize when those tools are wrong, incomplete or being applied to the wrong problem. The risk of losing human skills Butler does not see AI as risk-free. Later in the interview, he raised a separate concern: as AI becomes better at reading, writing, programming and other cognitive tasks, people could lose some of the underlying skills that historically helped produce new ideas. “The other danger is that we’re going to lose the human skills,” Butler said. He specifically mentioned reading and writing and argued that people could lose some of the lower-level understanding that contributes to breakthroughs. Butler said AI systems are based on existing human knowledge and argued that they become much more powerful when paired with a capable person. That tension runs through his view of the technology. AI can remove hours of routine work. It can allow beginners to perform tasks that once required substantial technical training. It can give experienced workers significant leverage. But the more capable the technology becomes, the more important it may be for people to develop the judgement needed to decide what should be done in the first place. For Butler, that is where education may have to change. Students still need to understand their field. They still need to know when something is wrong. And they still need to be able to make the final decision. But if AI increasingly handles the bottom of the cognitive pyramid, the value of a worker may depend less on how quickly they can perform the grunt work and more on whether they understand what the work is supposed to accomplish. Don’t miss the next story that affects your community. Join thousands of readers getting The Pulse every morning—plus breaking news alerts when it matters most. If you value this kind of local journalism, consider supporting it. Subscribe, share and like! Subscribe Share
Sean McVay’s Comments About Call Raise Questions About NFL Policy
Discussions between teams and the NFL are not always treated as confidential.
Junior Achievement honors Eastern Iowa business leaders, raises more than $167,000
Junior Achievement of Eastern Iowa raised more than $167,500 during its 27th annual Corridor Business Hall of Fame event last month.The event, presented by U.S.
Analysis-Vance's fraud crackdown may raise costs for US health insurers, enrollees
NEW YORK, Oct 2 (Reuters) - A crackdown on Obamacare health insurance could raise prices for US consumers and insurers by removing healthy, low-cost enrollees, adding pressure to a shrinking marketplace.
Vance's fraud crackdown may raise costs for US health insurers, enrollees
A crackdown on Obamacare health insurance could raise prices for US consumers and insurers by removing healthy, low-cost enrollees, adding pressure to a shrinking marketplace.
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Strong start
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Science Central brings science and spirits together for Mixology 2026
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'Mini-Woodstock' Music Series Raises Money for Mental Health
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How are higher interest rates and rising prices affecting you?
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Time lost to political haggling means lost momentum for research
While it’s not up to universities to set deadlines for EU institutions, “lost time” in the run-up to the launch of the next Horizon Europe would translate into “lost momentum” for universities, according to Dag Rune Olsen, president of the Young European Research Universities Network.“I think it's important to have [the EU budget] in place in order to be able to work on the research funding mechanisms, because we cannot afford to lose more momentum than we already have,” Olsen told Science|Business in an interview in September, just after EU research lobbies gathered in Brussels to push for a €200 billion budget for the next Horizon Europe programme.A funding gap would mean ramping down research activities, said Olsen. “You can do that quite swiftly, that’s not a problem, but ramping up again is much more difficult.”The last-minute push for an ambitious budget, and for a timely adoption of the research programme, comes at a time when the richest EU states have teamed up to call for significant cuts to European Commission’s proposal for the next multiannual budget, which allocates €175 billion for Horizon Europe. At the same gathering of research associations in September, the European Parliament’s budget rapporteur warned that the EU will need to raise its own taxes, otherwise political pressure and tighter national budgets will translate into a limited EU budget with a less ambitious envelope for research. The research sector hopes EU institutions will reach timely agreement on the budget and on Horizon Europe, but progress has been slow. Legislative progress has been delayed, partly because the European Parliament’s budget committee is still haggling over how to apply new EU-wide spending rules, known as the Performance Framework Regulation, and partly because EU governments have yet to agree on the size of the next EU budget. EU research Commissioner Ekaterina Zaharieva told Science|Business in July that she was hoping for an agreement on Horizon Europe by the end of 2026, but the timelines have been pushed back significantly, with the Parliament now aiming to announce its official position on Horizon Europe only in November. Avoid the funding gapAccording to Olsen, delayed EU funds could prompt universities and researchers to move on and do something else, potentially jeopardising years of work building consortia and collaborations. “If funding is interrupted, the networks fall apart in just a few months,” he said. Olsen also noted that an interruption would affect junior researchers first. PhD students and postdocs are on shorter term contracts and universities risk losing them if funding for EU projects is interrupted. Related articlesEU own resources ‘essential’ for future research budget, says leading MEPParliament haggle over EU-wide spending rules delays vote on Horizon EuropeZaharieva hopes for a Horizon Europe deal in 2026Universities usually have more employees, permanent and short-term staff, than they can cover with national funding, and external funding is essential to keep them all on the payroll. In case of an EU funding gap, “there will be a huge number of people that might end up without any contracts,” he said. Apart from the money issue, Olsen said EU projects forces universities to collaborate more which, in turn, increases the quality of teaching and research. In case of a funding dip, people will look around for opportunities elsewhere, in the private sector or abroad. “And then then you have to recruit again, and it's a tedious business,” said Olsen. “A gap is not a good idea, it's actually a waste of money.”According to Olsen, the difficult political context should encourage universities to make a stronger case for the EU increasing research funding, as universities can deliver on competitiveness, technological sovereignty, security and defence. “The reason why we ask for substantial investments in research is exactly what the Commission, what Europe, the Parliament have been discussing,” he said. “You really need to invest in order to thrive in the longer run.”Focus on the member statesBut EU and national R&D expenditure hasn't kept up with the times. EU governments have failed to reach a spending target set almost 25 years ago. Only six EU countries spend 3% or more of their GDP on R&D. Asked whether universities should put more effort into convincing the governments to ramp up their own spending, but also to support a strong budget for Horizon Europe in the ongoing budget negotiations, Olsen said “the answer is yes.”“We are very actively encouraging our members to talk to their ministries in order to enlighten them about the joint effort,” he said. The network is made up of 25 universities from across Europe, all established in the past 60 years or so.Who will call the shots?Budget and timing issues aside, the Parliament’s research committee has been locked in behind-the-scenes negotiations over the future structure of Horizon Europe, with MEPs disagreeing on the degree to which its collaborative research should be governed by councils of experts.The European Parliament’s lead rapporteur on Horizon Europe wants councils of independent experts to decide on the funding agenda, but the Commission, the Council, and parts of the Parliament disagree. For Olsen, it is normal for politicians to point at the big challenges, but when they start detailing how those challenges should be solved, the endeavour “fails utterly.” He does not necessarily think that “bureaucrats who don’t know the field” would be “much better at it” either. “There has to be a combination” of broad political directions and bottom-up implementation, Olsen said.
Good science requires much more than evidence
Empiricists believe that scientific theories are true only if they make correct empirical predictions: if we can't verify these predictions, then there is no reason to expect that they tell us anything about reality. However, Professor of Philosophy at King's College David Kyle Johnson argues that this is mistaken. In response to Bas van Fraassen, who has written on this subject for the IAI, he argues that we have many reasons for believing a theory to be true, such as it being parsimonious and having large scope — qualities which have been used throughout the history of science as criteria for judging theories. In 2024, Princeton philosopher Bas van Fraassen wrote a short article for IAI News entitled “Science Does not Describe Reality: The Limits and Benefits of Explanation.” At the time, I was working on two projects (a science book and a Great Course) that, when completed, would (among other things) defend science’s ability to describe reality. I wanted to write a response to van Fraassen, but the projects demanded too much of my attention. But now that those projects are complete, I am in a position to explain the objections to van Fraassen’s thesis. Summarizing van Fraassen’s argumentIn a nutshell, his argument is this: What scientists do is make predictions based on theories and then invite others to test to see whether those predictions are borne out. “If theory T is right, result R should happen in experimental condition C.” Many think that running an experiment that shows that R happens in condition C is proof that theory T is true (and should be believed). But, van Fraassen argues, that R happened in condition C is only a reason to think that R happens in condition C. That’s the only observable, or empirical, result we can actually see, so that is all that we are really justified in believing. (The underlying theory that made that prediction still may or may not be true.) That is why he calls those who accept his position “empiricists.”Before I explain what is wrong with this position, let me explain what it gets right. What van Fraassen Gets RightFirst, a theory correctly predicting the results of an experiment is not, strictly speaking, “proof” that the theory is correct. The basic line of reasoning is this:If the theory T is true, result R should happen. Result R did happen. Thus, theory T is true.In other words:“If T then R. R. Thus, T.”This is a deductively invalid, fallacious mode of reasoning, called “affirming the consequent.” Those premises do not guarantee that the conclusion follows. “If I am in Pennsylvania, then I am in the USA. I am in the USA. Thus, I am in Pennsylvania.” Clearly that argument doesn’t guarantee its conclusion; neither does the above argument.However, science is not a deductive method of reasoning; it is an inductive one. And inductive arguments merely try to raise the probability of their conclusion, not “prove” them for certain. Thus, the fact that an experimental result doesn’t prove a theory is true is irrelevant; it’s not supposed to. That is not what scientific reasoning is about.___If the hypothesis that something exists clearly provides the best explanation for what we can observe, then the belief that it exists is what is rational.___Second, it’s also true that a single experimental result doesn’t provide enough justification to believe that a theory is true. Scientists do not come to a consensus about whether a theory is true by looking at a single experiment; they look at all the evidence to determine where the preponderance of evidence points. The mere fact that I am in the USA raises the probability that I am in Pennsylvania, but not nearly enough to conclude that I am in Pennsylvania. However, if I am also regularly encountering people wearing Eagles and Phillies hats and seeing advertisements for Founding Father tours, I probably am. In the same way, a theory successfully predicting the outcome of one experiment is not enough to conclude that it is true; but if a theory makes a wide variety of predictions that are all vindicated by multiple experiments, performed by many different groups and people, all actively trying to prove the theory false (which is what good scientific experiments are designed to do)—that is a good reason to conclude that the theory is true. In other words, if you repeatedly try to prove something false but can’t, that is a very good indication that it isn’t. The problem of underdeterminationIn reply, those whom van Fraassen calls “empiricists” often point to the “problem of underdetermination.” For any given theory that makes successful predictions about what happens in experimental conditions, there are countless other possible theories that make exactly the same predictions—and since they do, the experimental evidence in question is just as much reason to accept any of those theories as it is to accept our original one. Thus, the argument goes, we have no way of knowing whether our original theory is true, or one of the other “predictively equivalent” theories is true. SUGGESTED VIEWING How Occam's Razor changed the world With Johnjoe McFadden As an example of underdetermination, philosophers often offer this example. The evidence of fossils seems to provide reason to conclude that the universe is quite old; ancient fossils are what the “ancient universe” hypothesis predicts. But it’s also possible that God created an ancient-looking universe 200 years ago, complete with a “fake” fossil record for us to find, to make it look old. The existence of fossils is what that theory predicts too. So, the argument goes, the fossil record can’t be used as evidence that the universe is ancient; the fossil record supports the “200-year-old ancient-looking universe” theory just as much. The problem of underdetermination points out that, for any theory with supporting evidence, we could invent another completely different theory that predicts exactly the same evidence, and thus undermine that evidence’s ability to support the original theory.But this “argument from underdetermination” betrays a fundamental misunderstanding of what scientific reasoning is and how it works. To explain, let me use another rather strange (but very real and commonly discussed) philosophical thought experiment called “The Grue Problem.” The “Grue” ProblemSuppose I want to know what color emeralds are, so I observe a few, see that they all appear green, and form the theory that “all emeralds are green.” I thus predict that the next 100 emeralds I find will also appear to be green. And let’s say that happens, and so I thus conclude that my theory that all emeralds are green is true. Now, one might rightly point out that I don’t know for sure that all emeralds are green—I have not seen them all. Maybe some I haven’t found yet are blue. Fair enough. After all, we used to think that all swans were white, until we found some black ones. But let’s say that I go on a quest and collect every emerald in the universe—and, for the sake of the argument, let’s say I can do this, and can even know that I have every one of them. So, I collect them all, look at them all, and verify that they all appear green. Can’t I now rightly conclude that all emeralds are green?Inspired by the problem of underdetermination, a friend might argue that I cannot.Sure, they all appear green now—but there could be another kind of color called “grue.” Something is grue if it is green up to a certain point in time, but then spontaneously turns blue. And there could be an infinite number of “shades” of grue. Something that is one shade of grue will turn blue at noon today, but something that is another shade of grue will turn blue at noon tomorrow, etc. So yes, the emeralds appear green now; and since they haven’t turned blue yet, they are not some “past” shade of grue. But they might be some “future” shade of grue (e.g., they may turn blue at noon tomorrow). And since all future shades of grue are consistent with “being green up to this point in time,” the evidence you have is completely consistent with the notion that all emeralds are some future shade of grue, rather than green. Indeed, that they would appear green until now is what the “some future shade of grue” hypothesis predicts. So, we have just as much reason to conclude that all emeralds are some shade of grue as we do to conclude that they are green.You’re probably thinking “It’s not equally possible that the emeralds are grue; they are obviously green.” You are right! But explaining why your instinctive reaction to my friend’s argument is correct will help inform why van Fraassen’s “empiricist” is wrong and science actually does describe reality.The main mistake my friend makes is in thinking that the “empirical evidence” (of all the emeralds appearing green) is (or even should be) all I am using to draw the conclusion that all emeralds are green. It is not. I am also considering known facts about how colors typically work; things don’t usually change color, and when they do, they don’t do so suddenly, without cause, and all at once. So, even though the simple evidence of the emeralds all appearing green up to this point is consistent with them being some future shade of grue—that is even what the grue hypothesis “predicts”—it is still exceedingly unlikely that they are. The hypothesis that they are green is much more likely. Understanding science refutes the problem of underdetermination The misunderstanding about science that the “empiricist” pointing to “the problem of underdetermination” makes is similar to the one that my friend made. Science is not just about considering experimental evidence; in fact, it’s not even just about considering empirical evidence. As Ernan McMullin and many other philosophers of science have pointed out, the inference that makes science is “inference to the best explanation” (sometimes called “abduction” or “retroduction” by McMullin). While, depending on the circumstances, scientists use many different kinds of reasoning, science as a whole is, simply put, the process of considering multiple competing explanations and comparing them to certain criteria—explanatory criteria (the kinds of things explanations must be and do, by definition, to be a good explanation)—to see which explanation is the best.And these criteria do not deal only with empirical results. Yes, successful predictions raise the probability of a hypothesis, but it’s also the case that the more new assumptions a theory makes, the less likely it is to be true; every new assumption presents an opportunity for the theory to be false. (The fewer assumptions a theory makes, the simpler or “more parsimonious” it is said to be.) Likewise, the more existing evidence a theory contradicts, the less likely it is, because in order for a theory to be true, every piece of evidence it contradicts has to be somehow faulty. (The fewer established theories a new theory contradicts, the more “conservative” it is said to be.) And, obviously, the more something explains, the better explanation it is. (This is called having “scope.”) If a theory raises unanswerable questions, it’s not expanding our understanding, and thus is not wide-scoping. Scientists consider all these things when deciding which theory to accept, because the theory that adheres best to these explanatory criteria is most likely to be true.___the mere fact that a theory’s predictive success is why it “sticks around” or “becomes accepted” in the scientific community is not a reason to be skeptical about its truth.___The reason the grue hypothesis is no good is because it invents an entirely new kind of color—not just a new shade, but an entirely different category of color (a different way colors work)—and thus is not parsimonious. It raises unanswerable questions about how and why emeralds would just spontaneously change from green to blue (and thus does not have wide scope). And it contradicts what is already well established about how color works (and thus is unconservative).The theories that the problem of underdetermination points to do the same thing. Yes, the theory that God created an “ancient-looking universe” (complete with an ancient-looking fossil record) two hundred years ago is also consistent with the empirical evidence (of a fossil record) that presently exists; but that theory is monumentally unparsimonious (it requires many extra assumptions about infinite entities) and not wide-scoping (it raises unanswerable questions about why God would do such a thing). So, I can rationally conclude that it is false.Indeed, the history of science includes many examples of theories that were rejected because they lacked parsimony and/or scope, even before their falsity (and the truth of their competing theory) was confirmed by observation. As I point out in my book, geocentrism was rejected by the scientific community because it lacked parsimony, almost 200 years before the observation of parallax confirmed that the Earth moves around the sun. And the continuum theory of matter was completely rejected by 1860, because it couldn’t explain chemical reactions or organize matter into a periodic table, even though the experiments that eventually confirmed atomic theory weren’t even proposed until the 1870s. Solving the best of a bad lot problemIn response, the “empiricists” are likely to object, this time pointing to the “best of a bad lot” problem. “We have no reason to conclude that an explanation that has been shown to be better than others is true because we have no guarantee that the true theory was among those that we were considering.” If you have a “lot” (a collection) of poor explanations, even the best one is not true.The responses to this problem, however, are numerous. Peter Lipton argues that the set of hypotheses that scientists consider are not just randomly selected and thus unlikely to contain a theory that is true; they use existing knowledge to home in on what is most likely to be true. A doctor trying to explain abdominal pain is not going to bother wondering whether demons are causing it; they are going to stick with things like appendicitis and kidney stones, because they are most likely. Further, despite its name, inference to the best explanation is not just the process of comparing hypotheses and accepting the best one; we also want one that is a good explanation in its own right. If it’s not, we are going to keep looking until we find an explanation that is. And while that process does not guarantee that we will come across the exact truth, it’s very likely that the theory that emerges as the best will be at least approximately true, and thus we will be justified in believing it. And lastly, as I point out in my book, although many theories not based in scientific evidence (like geocentrism and continuum theory) have been completely overturned, science almost always progresses by the refinement of scientifically established theories—not their replacement. (Although our sun is not the center of the universe, heliocentrism was our first step in understanding the Earth’s true place in the universe.) So even if a theory we accept today may not be completely right, accepting it is a step on the journey toward the complete truth. The example of atomic theoryNow, it’s worth pointing out that most empiricists are not skeptical of all scientific theories; they are only skeptical of the ones that hypothesize the existence of “unobservables.” It’s not like they think that round Earth, heliocentrism, and germ theory are just useful (but untrue) “instruments” for making predictions about how to most efficiently navigate the seas, predict planetary motion, and treat diseases. They admit that the Earth actually is round, that the planets revolve around the sun, and that germs exist and cause disease. These facts and entities can be observed; the theories that suggest they exist are true. It’s only when theories start hypothesizing the existence of unobservables—like electrons, or quantum fields—that can’t be observed directly, that we should start doubting the theories’ truth. And to be fair to van Fraassen, in this published work, he doesn’t really say that we should doubt the truth of such theories. Only that scientific reasoning does not rationally force us to accept them as true. Skepticism, or agnosticism, he argues, is warranted. SUGGESTED READING Science is based in metaphor By Andrew Reynolds But the history of atomic theory throws a monkey wrench into that argument. Atoms used to be unobservable; again, scientists first accepted the theory that they exist because it had such grandiose explanatory power. But then atoms were seen with electron microscopes. They thus moved into the category of the observable. But this didn’t substantially change anything about what scientists were justified in believing; it certainly didn’t change any “atomic skeptics’” minds. It just confirmed what everyone already knew! If the hypothesis that something exists clearly provides the best explanation for what we can observe, then the belief that it exists is what is rational. The fact that the thing itself is not technically observable does not make doubting its existence rational.What’s more, the atoms were seen with an electron microscope. But electrons are themselves unobservable. How can an electron microscope reveal an atom if electrons are not real? This leads us to what is famously known as Hilary Putnam’s “miracle argument.” It’s (not) a miraclePhilosopher Hilary Putnam’s miracle argument is somewhat famous. Basically, he argued that a scientific theory being able to repeatedly make successful predictions—even about unobservables—without being at least approximately true would require a “miracle.” In other words, it would be such an improbable occurrence that it could not rationally be believed—the better explanation for why scientific theories about unobservables make the right predictions is because the unobservable entities and structures they hypothesize exist.Van Fraassen has addressed this argument. Indeed, in his original article, where he references Alison Gopnik’s point about orgasms not being “necessary for procreation” even though the desire for orgasm “drives the creation of progeny,” he is pointing to his own argument about how organisms are not naturally selected by evolution to get true beliefs; to the extent that belief-forming processes are selected for, the ones that are selected are the ones that are useful for survival—not the ones that produce true beliefs. In the same way, van Fraassen argues, scientific theories are accepted, not because they are true, but because they aren’t falsified; they make successful predictions; that’s what makes them “stick around.” So, the fact that they make successful predictions (and thus became accepted) is not a reason to think they are true.This argument is similar to C. S. Lewis’s “argument from reason,” which he used to argue against evolution: “The truth of evolution undercuts our ability to know that it is true.” Lewis’ argument famously failed; Elizabeth Anscombe, by Lewis’s own admission, demolished Lewis in a debate on the topic, and I have explained elsewhere why modified versions of the argument fail as well. In short, it’s because it fails to recognize that a belief-forming process can make an organism more likely to survive because it reliably produces true beliefs. It is therefore not the case that beliefs generated by naturally selected belief-forming processes are automatically false or unjustified.In the same way, the reason a theory “sticks around” could be because it’s not falsified, because it “makes correct predictions.” But the reason it makes correct predictions is most likely because it is true. (In pointing this out, I am echoing the arguments of Musgrave, Lipton, Psillos, and Kitcher, who refuted van Fraassen’s argument and analogy long before his 2024 article.) It would be a huge coincidence that it could do so without being true. And that is the point of Putnam’s miracle argument. Thus, contrary to van Fraassen’s suggestion, the mere fact that a theory’s predictive success is why it “sticks around” or “becomes accepted” in the scientific community is not a reason to be skeptical about its truth. ConclusionLet me close by saying something about the fact that empiricists don’t doubt the truth of all scientific theories, just the ones that hypothesize unobservables. In today’s society, this theory is dangerous to espouse publicly. The nuance between being skeptical about all of science, and just the highly technical theories about unobservables, is guaranteed to be lost to the average reader. And there is so much unjustified skepticism and doubt about the findings of science and experts that a headline like “Science Does Not Describe Reality” could easily fuel the anti-science movement, worsen climate change denial and cause the next pandemic.This is why I believe it was important to still respond to van Fraassen’s article, a full two years after he wrote it. Not only, as I have argued, does it represent a philosophically inaccurate view of how scientific reasoning works and what scientific reasoning can do, but it is a dangerous view to boot. It should thus be rejected.
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September Monthly Review: Health MCP Guy?
For all the time I spend talking about APIs and data exchange, this newsletter has had embarrassingly little interoperability of its own. It’s old-school SaaS, baby - UI or bust. Not all of that is my fault! Substack, for all its popularity, is (as mentioned before) really frustrating as my system of record. The primary user it optimizes towards is the reader, whose attention feeds the app, the Notes feed, and the recommendation network that Substack is actually selling. Health API Guy is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe They’re falling into the same trap that Medium once sprinted into, albeit at a much more glacial speed. Younger generations may not remember (or never knew) it, but Medium once lured publications like The Ringer and Signal v. Noise onto its platform, only to lose them as it rebuilt itself around a paywall and an algorithmic feed. Substack’s original pitch circa 2020 was the antidote (you own your list), but every new feed feature chips away at it. I get it: writers are generic supply in the eyes of the Substack product team. Generic supply follows demand, so the consistent pressure on the PMs is to generate demand, which leads to every product cycle going toward discovery (Notes, recommendations, the app, live video). The end result lackluster author tools (laggy and broken analytics are truly crippling) all despite the premium price point. The archive is where it crosses from authorial gripes to actual reader impact, though. Across Substack and LinkedIn, I’ve published 1,218 posts and nearly 900,000 words since 2018. Substack’s native search can see only the 464 posts that live on Substack, and even there it’s woefully inadequate at surfacing relevant content (even for the guy who wrote it)! Readers have the same problem, writ large. Ask the Archive Fixing search (for both my readers and my own use) turned out to be extremely non-trivial, unfortunately: There’s no public API for readers to access content RSS exists for new content notification, but it only carries the 20 most recent posts and cuts paid ones off at the preview The only Substack MCP is an admin tool for analytics The export exists for authors, but it’s painfully awkward and slow. So I built something to work around that: the Health API Guy MCP. It’s a private MCP server holding the full text of everything I’ve written across Substack and LinkedIn. Add it to Claude or ChatGPT as a connector and you can ask things like: It pairs keyword search (for acronyms and case names, of which we have many) with semantic search. Every post is also labeled by topic, form, and court case, so you can pull a lawsuit’s (or multiple cases’) entire docket across Substack and LinkedIn in one query: Hail, Healthapiguyhydra This is also a bit of me eating my own cooking. I’ve spent the year arguing that headless healthcare is arriving and that developers want primitives over abstractions. Last week in Hail, Benihydra, I watched Salesforce plug its platform into Claude and bet that the records underneath outlive whatever interface sits on top: Salesforce must believe that the Hydra’s immortal head is the records, permissions, and business logic (in that they will survive whatever happens to the interface). It felt a bit hypocritical to keep my own archive behind a Substack search bar. The archive is the body. Substack is one head, and now whatever tool you might use is another. Will the EHRs follow my lead? Probably not imminently, but one can hope! Why Founding Members Only The MCP is available to Founding Member subscribers. A few reasons: It costs money and time to run. Hosting, the database, Clerk usage and AI compute for search and labeling are significant operational costs (that increase with usage). Substack gives me no way to automate access. There’s no API to check whether someone is a paid subscriber, so every user is manual operations for now. It’s a beta. We’ll need to improve things and parts will break. I’d rather they break for a small group of dedicated readers who will tell me about it. The Founding tier deserved a real benefit. Until now it was mostly a generous tip. Now it comes with something. If you’re already a Founding Member, reply to this email with the address you’d like provisioned. If you’re not and want in, upgrade here. Larger teams (such as companies) can get access too: group subscriptions at the Founding tier come with the group discount. The admin for the subscription can reply with the list of addresses to provision. Get 20% off a group subscription Pricing Founding membership is now a flat $200 a year, replacing the old suggested $150 that readers could adjust. Existing Founding Members will have access grandfathered in at their previous rate. Month in Review Articles Published Make Networks Dumb Again (Sep 11): AI is making old analog networks cheaper to use and flooding them with machine traffic in the process. A plea for agent-native rails with the intelligence at the endpoints, and for Washington to drag them to ubiquity. Interoperability, Unbuttoned (Sep 29): Interoperability is a series of workflows in a trenchcoat, and this post finally takes the trenchcoat off. A color-coded map shows which provider workflows went digital, which are fragmented, and which still run on fax. Video Content Antitrust’s System of Record Problem (Sep 3): The FTC’s investigation into Epic prompted a ninety-minute webinar, now posted with chapters and a smoothed transcript. We get into why market definition, missing B2B share data, and the SSNIP test leave antitrust poorly suited to systems of record, plus why information blocking may be doing more than any pending lawsuit. The Information Exchange: Cerner Milking Edition (Sep 18): This was so fucking fun. Ryan Tucker, Ryan Brickner, Brad Thorson, and I try an Around the Horn format, complete with points, penalties, and a mute button. We debate whether Oracle Health is dead, who would actually buy Cerner (IBM enters the chat), p(Doom), and why the front desk still hands you a clipboard. Regulatory Ask Not What Your Network Can Do (Sep 23): CDC’s RFI on public health data intermediaries lists use cases already served, unevenly, by eCR, lab reporting, IZ Gateway, and syndromic surveillance. The real opportunity sits in one question about AI: a network that can handle the next emergency without another interface project. Court cases Particle v. Epic: The Naughty Schoolteacher (Sep 4): After a summer-long vigil, the answer on Epic’s early summary judgment bid is two paragraphs and a remedial assignment. Particle advances to the next grade, and market definition gets another year of discovery. The Epic Discovery Files (Sep 8): Texas’s motions to compel arrive with a 251-page appendix of requests, objections, and meet-and-confer letters with Cravath. Inside: Epic using generative AI for document review, denied interoperability requests in scope, and Noerr-Pennington raised against lobbying discovery. Epic v. Health Gorilla: “Working as Designed” (Sep 9): Epic wants nothing to do with the data breach MDL, and explaining why puts fresh discovery on the public docket. The spiciest allegation: Health Gorilla told GuardDog to scrub its law firm business from its website instead of cutting off access. Veeva v. Epic: Legal Bypass Surgery (Sep 15): Veeva asks the Wisconsin Supreme Court to skip the Court of Appeals, while law professors and three policy groups line up as amici. Meanwhile, Epic’s lawyers apologize for another round of citation errors, including a quote that never existed. Texas v. Epic: Behind the Black Bars (Sep 17): The court portal served up Epic’s unredacted filings, revealing a $5 million document review budget and the AI workflow behind it. Also inside: the 200-plus company names Texas wants searched, and one very expensive Zoom invitation. OpenEvidence v. Doximity: Consequences Will Follow (Sep 25): OpenEvidence tells the court it will not comply with a discovery order, and its own lawyers at Quinn Emanuel say they won’t defend the choice. Add years of Slack reported unrecoverable, and Rule 37 sanctions come into view. Health Tech Keeps Choosing Violence (Sep 28): Doximity moves to end OpenEvidence’s case, Epic asks Texas to show its work, and a sleepy Audacious Inquiry patent fight sprouts antitrust and information blocking counterclaims. The main event is a long-sealed Cognizant v. Infosys ruling that hints where system of record antitrust claims can survive. EHRs One Verb for Oracle Health (Sep 14): Oracle’s earnings call quantifies every data center to the decimal point, while Oracle Health gets a single verb: “accelerate.” Panning the few healthcare mentions turns up an agentic care management system, a research-to-care ledger play, and the question of whether healthcare gets Larry’s patience. Epic’s Forretress Under Siege (Sep 30): Judy Faulkner tells a panel Epic paused hundreds of projects to harden its software and calls it a “shame,” while a spokesperson insists the roadmap hasn’t changed. Project Glasswing, a Pokémon-branded QAN sprint, and a trove of Jodel grievances reconcile the two Epics and preview the Jevons paradox coming for all software. Industry Analysis Scanning for a Network (Sep 1): Scan.com raises $220M to build the imaging network labs never got, speedrunning Zocdoc’s consumer-to-B2B pivot. Its wedge to network density may be the most American one available: personal injury litigation. The Front Desk Wants the Damn Whole Building (Sep 16): Hello Patient buys Converse Health, pushing its AI front desk into referrals, chart work, and prior auth. The copilot categories keep blurring, and your distribution partner is still your final boss. Cross-industry Comparisons A Different Patchwork Quilt (Sep 10): Healthcare loves to envy open banking, but the US version has no mandate, a toll booth at Chase, and data quality problems of its own. The grass isn’t greener; it’s another American patchwork quilt, and perhaps a worse one. Hail, Benihydra (Sep 21): Salesforce brings its platform into Claude, Slack, and its own agent, inviting the interfaces that might replace it. Cut off one head and more grow back, so long as the records underneath stay put. Living on A Trade Secret Prayer (Sep 22): Six credit unions are suing Fiserv, the Epic of core banking, by claiming their own member records as trade secrets. Banking has no Cures Act, so its lawyers reach for legal alchemy that healthcare has already tried. Other News None this month External Media Nabla Accelerate NYC: I kicked off fall conference season at Nabla’s Accelerate event in New York, where Delphine Groll opened by asking the room to picture the company it wants to become and the one it doesn’t. I liked her framework of bureaucracy, fear, and ego as the blockers. I also love vendor conferences/events in general - different vibe than industry biggies. Healthcare 101 with Nikhil Krishnan: I briefly guest lectured Out-Of-Pocket’s Healthcare 101 class. Appreciated Nikhil’s takeaways cover whether AI doctors can query HIEs, why healthcare’s data-liberation rules beat most industries’, and the hi-res graphic is in the comments. HCN: Epic Probed by the FTC: I joined the HCN guys to talk through the FTC’s investigation into Epic. Cedric’s new hairdo was an unexpected plot twist. The episode also covers MFN drug pricing, healthcare M&A and Eli Lilly’s acquisition streak. Fall Conferences: At eHealth Exchange’s Annual Meeting in Austin on Oct 27, I’ll moderate a panel on the tensions between AI, HIEs, and timely patient access with Jean Ross (Primary Record), Therasa Bell (Kno2), Byron Crowe (Doctronic), and Michael Marchant (Freenome). Here’s the rest of my schedule if you want to meet up: CommonWell (Redwood Shores, CA): Oct 13-14 Will be participating in a fun Jeopardy event Open@Epic (Madison, WI): Oct 20-23 Will be enjoying Verona, Willy Street, and other local adventures eHealth Exchange and Sequoia Project (Austin, TX): Oct 27-29 Yeehaw HLTH (Vegas): Nov 15-18 Groundhog Day, Venetian Edition RSNA (Chicago): Nov 30-Dec 2 See me at “Governing AI in Breast Imaging: What Health Systems Are Actually Doing” Digital Health Counsel 2026 AI Summit (Seattle): December 2-3 Will likely be speaking to a bunch of lawyers about information blocking Posts I Liked ChatGPT’s Epic integration: game changer or nothing burger?: Joshua Liu, MD offers five thoughts on OpenAI’s Epic launch, starting from the point that it rides the same open APIs available to anyone. He argues read-only access leaves ordering to Art and the ambient startups, and asks why HCA is piloting it alongside Commure. He’s sorta a must-follow at this point - consistently excellent, thought-provoking takes. Epic, Lilly, and the Discovery pass: Seth Chaney reads Epic’s first major Discovery deal (with Eli Lilly), as well as its revised developer terms on commercial displays, as the pipe finally opening between EHRs and pharma. Life sciences and health continue to collide. Scott Rossignol on EHR payer platforms and ePA fees: Scott argues the top ambulatory EHR vendors are turning the prior auth mandate into a per-member-per-year toll on payers, for an API whose operating cost has nothing to do with covered lives. His fix is two lines of regulatory text: put the CRD/DTR/PAS certification criteria in the Base EHR definition, and bring payer-facing ePA connectivity under § 170.404’s cost-based fee rules. It’s a good solution. Health API Guy is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe
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