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Cancer, healthcare and support with a woman holding hands with her man in the hospital. Medicine, insurance and trust with a couple in a clinic for treatment or help before death, mourning and loss
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What a health insurance CEO's murder reveals about America's pain
Jan 10, 2025
The murder of UnitedHealthcare CEO Brian Thompson represented a horrific and indefensible act of violence. His family deserves our deepest sympathy.
As a physician and healthcare leader, I initially declined to comment on the killing. I felt that speculating about the shooter’s intent would only sensationalize a terrible act.
Regardless of the circumstances, vigilante violence has no place in a free and just society.
But now, more than a month later, I feel compelled to address one aspect of the story that has been widely misunderstood: the public’s reaction to the news of Thompson’s murder. Specifically, why tens of thousands of individuals “liked” and “laughed” at a post on Facebook announcing the CEO’s death.
What causes someone to ‘like’ murder?
News analysts have attributed the social media response to America’s “simmering anger” and “frustration” with abroken healthcare system, pointing to rising medical costs, insurance red tape, and time-consuming prior authorization requirements as justifications.
These are all, indeed, problems and may explain some of the public's reactions. Yet these descriptions grossly understate the lived reality for most of those affected. When I speak with individuals who have lost a child, parent, or spouse because of what they perceive as an unresponsive and uncaring system, their pain is raw and intense. What they feel isn’t frustration—it’s agony.
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By framing healthcare’s failures in terms of statistical measures and policy snafus, we reduce a deeply personal crisis to an intellectual exercise. And it’s this very detached, cognitive approach that has allowed our nation to disregard the emotional devastation endured by millions of patients and their families.
When journalists, healthcare leaders, and policymakers cite eye-popping statistics on healthcare expenditures, highlight exorbitant insurer profits, or deride the bloated salaries of executives, they leave out a vital part of the story. They omit the unbearable human suffering behind the numbers. And I fear that until we approach healthcare as a moral crisis—not merely an economic or political puzzle to solve—our nation will never act with the urgency required to relieve people’s profound pain.
A pain beyond reason
In Dante’s Inferno, hell is a place where suffering is eternal and the cries of the damned go unheard. For countless Americans who feel trapped in our healthcare system, that metaphor rings true. Their anguish and pleas for mercy are met with silence.
It is this sense of abandonment and powerlessness, not mere frustration, that fuels both a desperate rage and anger at a system and its leaders who appear not to care. The response isn’t one of glee—it’s a visceral reaction born of pain and unrelenting remorse.
As a clinician, I’ve seen life-destroying pain in my patients—and even within my own family. When my cousin Alan died in his twenties from a then-incuurable cancer, my aunt and uncle were powerless to save him. Their grief was profound, unrelenting, and eternal.They never recovered from the loss. But Alan’s death, heartbreaking as it was, stemmed from the limits of science at the time.
What millions of Americans endure today is different. Their loved ones die not because cures don’t exist but because the healthcare system treats them like a number. Bureaucratic inefficiencies, profit-driven delays, and systemic indifference produce avoidable tragedies.
To appreciate this depth of pain, imagine standing behind a chain-link fence, watching someone you love being tortured. You scream and plead for help, but no one listens. That is what healthcare feels like for too many Americans. And until all of us acknowledge and feel their pain, little will improve.
Curing America’s indifference
When we focus solely on cold numbers—the millions who’ve lost Medicaid coverage, the hundreds of thousands of avoidable deaths each year, or the life-expectancy gap between the U.S. and other nations—we strip healthcare of its humanity.
But once we stop framing these failures as bureaucratic inefficiencies or frustrations and, instead, focus on the devastation of having to watch a loved one suffer and die needlessly, we are forced to confront a moral imperative. Either we must act with urgency and resolve the problem or admit we simply don’t care.
In the halls of Congress, lawmakers continue to weigh modest reforms to prior authorization requirements and Medicaid spending—baby steps that won’t fix a system in crisis. The truth is that without bold, transformative action, healthcare will remain unaffordable and inaccessible for millions of families whose anguish will grow. Here are three examples of the scale of transformation required:
- Reverse the obesity epidemic with a two-part strategy. Congress must tax ultra-processed, sugary foods that drive hundreds of billions of dollars in healthcare costs yearly. In parallel, lawmakers should cap the manufacturer-set price of weight-loss medications like Ozempic and Wegovy to be no higher than in peer nations.
- Change clinician payments from volume to value. Current fee-for-service payment systems incentivize unnecessary tests, treatments, and procedures rather than better health outcomes. Transitioning to pay-for-value would reward healthcare providers, specifically primary care physicians, who successfully prevent chronic diseases, better manage existing conditions, and reduce complications such as heart attacks, strokes, and kidney failure.
- Empower patients and save lives with generative AI. Tools like ChatGPT can help reduce the staggering 400,000 annual deaths from misdiagnoses and 250,000 more from preventable medical errors. Integrating AI into healthcare enables at-home care, continuous disease monitoring, and personalized treatment, making medical care safer, more accessible, and more efficient.
If elected officials, payers, and regulators fail to act, they will have chosen to perpetuate the unbearable pain and suffering patients and families endure daily. They need to hear people's cries. The time for transformative action is now.
Robert Pearl, the author of “ChatGPT, MD,” teaches at both the Stanford University School of Medicine and the Stanford Graduate School of Business. He is a former CEO of The Permanente Medical Group.
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A Look Ahead at AI, privacy and Social Media Regulation under the New Trump Administration
Jan 10, 2025
Artificial intelligence harms, problematic social media content, data privacy violations – the issues are the same, but the policymakers and regulators who deal with them are about to change.
As the federal government transitions to a new term under the renewed leadership of Donald Trump, the regulatory landscape for technology in the United States faces a significant shift.
The Trump administration’s stated approach to these issues signals changes. It is likely to move away from the civil rights aspect of Biden administration policy toward an emphasis on innovation and economic competitiveness. While some potential policies would pull back on stringent federal regulations, others suggest new approaches to content moderation and ways of supporting AI-related business practices. They also suggest avenues for state legislation.
I study the intersection of law and technology. Here are the key tech law issues likely to shape the incoming administration’s agenda in 2025.
AI regulation: innovation vs. civil rights
The rapid evolution of AI technologies has led to an expansion of AI policies and regulatory activities, presenting both opportunities and challenges. The federal government’s approach to AI regulation is likely to undergo notable changes under the incoming Trump administration.
The Biden administration’s AI Bill of Rights and executive order on AI established basic principles and guardrails to protect safety, privacy and civil rights. These included requirements for developers of powerful AI systems to report safety test results, and a mandate for the National Institute of Standards and Technology to create rigorous safety standards. They also required government agencies to use AI in responsible ways.
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Unlike the Biden era, the Trump administration’s deregulatory approach suggests a different direction. The president-elect has signaled his intention to repeal Biden’s executive order on AI, citing the need to foster free speech. Trump’s nominee to head the Federal Trade Commission, Andrew Ferguson, has echoed this sentiment. He has stated his opposition to restrictive AI regulations and the adoption of a comprehensive federal AI law. With limited prospects for federal AI legislation under the Trump administration, states are likely to lead the charge in addressing emerging AI harms. In 2024, at least 45 states introduced AI-related bills. For example, Colorado passed comprehensive legislation to address algorithmic discrimination. In 2025, state lawmakers may either follow Colorado’s example by enacting broad AI regulations or focus on targeted laws for specific applications, such as automated decision-making, deepfakes, facial recognition and AI chatbots.
Data privacy: federal or state leadership?
Data privacy remains a key area of focus for policymakers, and 2025 is a critical year to see whether Congress will enact a federal privacy law. The proposed American Privacy Rights Act, introduced in 2024, represents a bipartisan effort to create a comprehensive federal privacy framework. The bill includes provisions for preempting state laws and allowing private rights of action, meaning allowing individuals to sue over alleged violations. The bill aims to simplify compliance and reduce the patchwork of state regulations.
These issues are likely to spark key debates in the year ahead. Lawmakers are also likely to wrestle with balancing regulatory burdens on smaller businesses with the need for comprehensive privacy protections.
In the absence of federal action, states may continue to dominate privacy regulation. Since California passed the Consumer Privacy Rights Act in 2019, 19 states have passed comprehensive privacy laws. Recent state privacy laws have differing scopes, rights and obligations, which creates a fragmented regulatory environment. In 2024, key issues included defining sensitive data, protecting minors’ privacy, incorporating data minimization principles, and addressing compliance challenges for medium or small businesses.
At the federal level in 2024, the Biden administration issued an executive order authorizing the U.S. attorney general to restrict cross-border data transfers to protect national security. These efforts may continue in the new administration.
Cybersecurity, health privacy and online safety
States have become key players in strengthening cybersecurity protections, with roughly 30 states requiring businesses to adhere to cybersecurity standards. The California Privacy Protection Agency Board, for example, has proposed rulemaking on cybersecurity audits, data protection risk assessments and automated decision-making.
Meanwhile, there is a growing trend toward strengthening health data privacy and protecting children online. Washington state and Nevada, for example, have adopted laws that expand the protection of health data beyond the scope of the federal Health Insurance Portability and Accountability Act.
Numerous states, such as California, Colorado, Utah and Virginia, have recently expanded protections for young users’ data. In the absence of federal regulation, state governments are likely to continue leading efforts to address pressing privacy and cybersecurity concerns in 2025.
Social media and Section 230
Online platform regulation has been a contentious issue under both the Biden and Trump administrations. There are federal efforts to reform Section 230, which shields online platforms from liability for user-generated content, and federal- and state-level efforts to address misinformation and hate speech.
While Trump’s previous administration criticized Section 230 for allegedly enabling censorship of conservative voices, the Biden administration focused on increasing transparency and accountability for companies that fail to remove concerning content.
With Trump coming back to office, Congress is likely to consider proposals to prohibit certain forms of content moderation in the name of free speech protections.
On the other hand, states like California and Connecticut have recently passed legislation requiring platforms to disclose information about hate speech and misinformation. Some existing state laws regulating online platforms are facing U.S. Supreme Court challenges on First Amendment grounds.
In 2025, debates are likely to continue on how to balance platform neutrality with accountability at both federal and state levels.
Changes in the wind
Overall, while federal efforts on issues like Section 230 reform and children’s online protection may advance, federal-level AI regulation and data privacy laws could potentially slow down due to the administration’s deregulatory stance. Whether long-standing legislative efforts like federal data privacy protection materialize will depend on the balance of power between Congress, the courts and the incoming administration.
Tech law in 2025: a look ahead at AI, privacy and social media regulation under the new Trump administrationwas first published on The Conversation, and was republished with permission.
Sylvia Lu is a Faculty Fellow and Visiting Assistant Professor of Law, University of Michigan
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Former President Donald J. Trump answers question from Pastor Paula White-Cain at the National Faith Advisory Board summit in Powder Springs, Georgia, United States on October 28, 2024.
(Photo by Nathan Posner/Anadolu via Getty Images)
Presidential promises, promises, promises....
Jan 09, 2025
When Donald Trump made his first successful run for president in 2016, he made 663 promises to American voters. By the end of his 2021 term of office, he could only fulfill approximately 23 percent of his vows. Before we get too excited as to what will happen when Trump 2.0 takes effect on Jan. 20, let’s take a moment to reflect on covenants made by a couple of other presidents.
PolitiFact tracks the promises our presidents have made. PolitiFact is a non-partisan fact-checking website created in 2007 by the Florida-based Tampa Bay Times and acquired in 2018 by the Poynter Institute, a non-profit school for journalists. Here’s a report card on three presidents:
· Barack Obama kept 47 percent of his campaign assurances, 23 percent were broken, and 27 percent ended up as a compromise.
· During 2017-2021, Donald Trump kept 23 percent of his pre-election pledges, 55 percent were broken, and compromise occurred on 22 percent of his promises.
· Joe Biden has been able to keep 33 percent of his commitments, 35 percent were broken, 28 percent ended up in a compromise, and 3 percent of his promises are in the works.
Regardless of our past presidents’ political affiliation, evidence abounds that voters are gullible, easily persuaded, and shouldn’t pay too much attention to a candidate's campaign rhetoric. Unfortunately, candidate platitudes are often made to disinform, misinform, and hoodwink the voter.
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Back to our 45th and soon-to-be 47th president, Mr. Trump.
Ryan Koronowski, director at the Center for American Progress Action Fund, reflected on Trump’s 2016 guarantees and felt “... many of the promises that he broke, he was insincere about them or didn’t care enough about them. They were political and meant to earn votes. They weren’t actual policy goals, or corporate backers and power brokers actually moved to shut them down …” (MTN, Nov. 7).
Ron Filipkowski of the pro-democracy MTN (MeidasTouch Network) documented Trump making 93 campaign promises while vying to be America’s 47th president. Filipkowski summarized, “After failing to deliver on his major pledges during the first administration, president-elect Trump resurrected many of the same promises in his 2024 campaign.”
Trump made a multitude of promises during the Sept. 5 economic policy debate and the Sept. 10 presidential debate. On July 8, the Republican National Committee published its 2024 party platform, which included 63 additional promises should Trump get elected (RNC platform.donaldtrump.com).
Mr. Trump repeatedly disavowed Project 2025 – created by the far-right extremist Heritage Foundation -- to be implemented in the first 180 days of his second presidency. However, CBS News identified at least 270 of the 700 policy proposals from Project 2025’s 922-page guide that matched Trump’s past policies and current campaign promises.
And, since the Nov. 5 election, where Trump received less than 50 percent of the votes – not a “mandate” as he claims – he has backed off his promise to bring down grocery costs, end the Ukraine-Russia war before he takes office, and use tariffs to bolster the US economy. Trump’s transition team admits Trump has shifted “from sweeping campaign rhetoric to the nuances and realities of governing” (The Hill, Dec. 29).
Trump made eight promises that would occur on Jan. 20, the day of his inauguration. On Jan. 21, note a `yes’ or `no’ next to each of these promises as to whether they occurred or not. The result may be a bellwether sign of what is yet to come during his 1,461 days as our 47th president:
_____ 1) close the US-Mexico border,
_____ 2) begin “the largest deportation program in American history,”
_____ 3) expedite permits for drilling and fracking,
_____ 4) roll back environmental regulations,
_____ 5) pardon 1,561people convicted of crimes related to the Jan. 6, 2021, US Capitol insurrection (contradiction to supporting law and order),
_____ 6) cut federal funding for any school “pushing critical race theory, transgender insanity and other inappropriate racial, sexual or political content on the lives of our children,”
_____ 7) roll back President Biden’s electric vehicle policies and
_____ 8) enact tariffs on goods coming in from Mexico, Canada, and China.
Should Mr. Trump’s daily rhetoric, actions, and flip-flopping on promises get under your skin, three coping methods are offered. First, say to yourself, “I can’t help the way I feel right now, but I can help the way I think and act.” Secondly, recall what King Solomon, William Shakespeare, and Abraham Lincoln have said: “This too shall pass.” Third, promise – and fulfill the promise -- to do a better job of vetting future presidential candidates (regardless of their and your political party of preference) and heavily discount their promises.
And perhaps most importantly understand that not fulfilling promises is common amongst not only past Presidents but members of Congress as well, regardless of their political affiliation.
With a little research, you can determine if a member of Congress has fulfilled their promises:
- Track Their Voting Record: Websites like GovTrack.us and Congress.gov allow you to see how your representative or senator has voted on various bills and issues. This can give you insight into whether they are supporting the policies they promised to back.
- Use Fact-Checking Websites: Organizations like PolitiFact and FactCheck.org track politicians' promises and rate their progress. They provide detailed reports on whether promises have been kept, broken, or are still in progress.
- Review Legislation They Sponsored: Check if they have introduced or co-sponsored any bills related to their campaign promises. This can be a good indicator of their commitment to their pledges.
- Follow News and Reports: Stay informed through reputable news sources and watchdog organizations that cover congressional activities and hold politicians accountable.
- Engage with Constituents: Attend town hall meetings, read newsletters, and participate in community forums where you can hear directly from the member of Congress and ask questions about their promises.
- Look at Endorsements and Ratings: Organizations like the League of Conservation Voters, the American Civil Liberties Union, and others often rate politicians based on their performance and alignment with specific issues.
Perhaps if more citizens take the time to become involved, our elected representatives will not just throw out promises to garner votes and instead focus on solving the serious problems facing our nation.
Steve Corbin is a professor emeritus of marketing at the University of Northern Iowa.
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A bold next step for the Democratic Party
Jan 09, 2025
In order to think about the next steps for the Democratic Party and the February 1, 2025, vote for a new Democratic National Committee Chair, it is useful to remember the context of three pairs of Democratic Presidents since the 1960s.
JFK and LBJ led the way for major progressive changes, ranging from the Civil Rights Act of 1964 to the Voting Rights Act of 1965 to Affirmative Action and the War on Poverty. Johnson's Great Society was the most progressive agenda ever promoted by an American president.
President Jimmy Carter and President Bill Clinton especially represented the centrist turn in the Democratic Party. Two Southern Democrats openly recognized the limits of the federal government even as they advanced a range of progressive policies, including Carter's renewable energy agenda and Clinton's signature on the Family and Medical Leave Act Bill. Carter encouraged self-sacrifice, and Clinton chanted, "The era of big government is over," and supported initiatives like welfare reform. Carter's centrism was complicated and particularly visible in his efforts to build up the military. Some recent commentators argue that with his human rights crusade, he, more than President Ronald Reagan, set things in motion to defeat the Soviet Union in the Cold War.
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President Barack Obama and President Joe Biden returned to a more progressive orientation in domestic affairs. Obama countered Reagan and President George W. Bush's trickle-down economic agenda with some old-fashioned Keynesian deficit spending during the 2009-10 financial crisis. Obamacare was his historic achievement. Biden followed suit by supporting investments in the child tax credit, green energy, semiconductor chips, and infrastructure. In foreign affairs, Biden asked Congress for substantial financial support for Ukraine against Russia and, to a lesser extent, for Israel against Hamas.
Democrats are trying to figure out the next steps after Vice President Harris's loss to President-elect Trump. Rather than move left, right, or center, a more fruitful but admittedly risky approach for the Democratic Party would be to break out of this pendulum cycle and take the very bold step of reinventing the Democratic Party in such a way that it is able to work effectively with the rising group of independents in the United States.
Ironically, Democrats could advance their cause if they recognized the importance of the over 40% of Americans, according to Gallup, who identify as independents, not in the sense of getting independents to vote for Democrats but getting independents in some select races to vote for independent politicians.
To many, this will sound counterintuitive if not self-destructive. But pursuing this path can help Democrats in the years ahead get 60 votes in the Senate regarding policy bills and 50 votes regarding budget bills and the reconciliation process.
How might this work? I have argued in the last year and a half in the "Fulcrum" and in over 50 US newspapers that our politics should gradually replace the value of bipartisanship with the value of tripartisanship. Independents need representation on Capitol Hill, especially in the Senate, where five to six members, either elected or senators who switched to Independent, could have substantial leverage. Dartmouth economics professor Charles Wheelan illustrated how this "fulcrum strategy" for centrists might work in "The Centrist Manifesto." It would also work for independents.
Democrats in the years ahead might incentivize some Republicans to leave the Republican party and become Independents who would either caucus with them or establish their own Independent Caucus. For example, they might incentivize Sen. Lisa Murkowski (R-Ak) away from the Republican Party by offering her a Chairmanship or Ranking Member position on an important Senate Committee. Likewise, in Senate races where chances of electing a Democrat seem slim, Democrats might support a candidate running as an Independent.
In fact, in the case of one of the two races for the U.S. Senate in Nebraska, the Nebraska Democratic Party offered its endorsement to an independent, Dan Osborn. But he turned it down because he was not accepting party endorsements. Still, many Democratic PACS supported Osborn, as did many Democratic voters, and it was a surprisingly close race even though incumbent Senator Deb Fischer ultimately won.
Republicans could use the same strategy, but they are currently feeling confident about their power in the Senate, the House, and the White House and are less likely to reinvent themselves. Getting a new DNC Chair to start a war with the Republicans is a 20th-century strategy. Being bold involves doing something new, not just picking up missiles and bombs that have not been used for a while and using them again.
Anderson edited "Leveraging: A Political, Economic and Societal Framework," has taught at five universities and ran for the Democratic nomination for a Maryland congressional seat in 2016.
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