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Envy takes over German politics
Germany’s political decline is rooted not only in economic weakness, but in a broader shift from responsibility toward redistribution and resentment.
Editor’s Note: Must Even the Biggest Booms Go Bust?
The Twin Cities theater scene was once the envy of the nation. Now, like our once-flourishing craft beer movement, it's facing seriously tough times.
What’s Nashville have that we ain’t got in Seattle?
Amid the bitterness in Seattle over Starbucks' big Nashville office was more than a little envy. How did a town with a fraction of Seattle’s population win Starbucks?
Why K-Pop Took Off When C-Pop Didn’t
“For more than a decade, China has looked on with undisguised envy as its Korean neighbor has accumulated soft power through cultural exports,” writes Bobby Ghosh.
Maggie Gyllenhaal admits to feeling 'envy' toward brother Jake Gyllenhaal early in their careers
Maggie Gyllenhaal admits to feeling a latent jealousy toward her brother Jake Gyllenhaal early in their acting careers: 'I don't think I was in touch with the envy, but it was there.'
Why doesn’t high speed rail work in America?
American railroads were once the envy of the world and the engine of its industrial age. But that hasn’t been the case for more than half a century.
They're Building Half A Bridge to Save Science...
Today’s post is about science: what you can do now to protect it from unprecedented threats, and how your action is the first half of a long-term program that Congress must take up next. Let me start with describing the embryonic state of science advocacy. There are many well-meaning organizations: the American Association for the Advancement of Science, Research!America, and subject-specific organizations such as the Society for Neuroscience and the American Physical Society. Their general approach is to emphasize the common good: the remarkable value that science and innovation have provided to all Americans. However, these organizations are offering an incomplete solution. Before I start, a preliminary: If you already know about the threat, go ahead and weigh in with OMB at this link. Ideas about what to say come from Research!America and the American Physical Society. You have until Monday, July 13 at 11:59pm Eastern. Then come back here and read the rest of this post. Finally, get in touch with whoever is likely to be your next member of Congress in 2027. The threat: An end to merit-based science… The onslaught of attacks on science is accelerating. It’s not just cuts to grants, which was the last battle. That battle is not done yet, but there is a new and worse threat. Now comes a proposed public rule from the Office of Management and Budget. The rule would take decision-making power over grants away from experts and put it into the hands of political appointees. Former NIH official Elizabeth Ginexi wrote an excellent summary of what OMB is trying to do, which is codify the executive branch’s ability to award or terminate grants, for arbitrary cause or no stated cause. Since World War II, a necessary step in scientific grant-making has been consideration of scientific merit. This approach has made America into a dominant scientific superpower, the envy of the world. Of course, political considerations do come into the mix. The proposed rule tilts the balance dramatically away from merit. …but why? Many people have difficulty comprehending why Russell Vought and OMB would want to damage science in this way. If you’re a working scientist, you are likely to be particularly uncomprehending. Who would hurt an activity so self-evidently good? The answer is: this is part of the program to replace the rule of law with a personalist regime. OMB Director Russell Vought, a Christian nationalist, would like to implement what legal scholars call a “unitary executive,” and what I would call a dictatorship. Or if you like, a personalist authoritarian regime. I am a working scientist. This rule will debilitate my research. It may chill the speech of scientists for speaking freely in the public sphere. It is a form of personalizing power and decision-making within the executive branch. In short, it sacrifices science in the service of tyranny. To Russell Vought, a decrease in the quality of science might be an acceptable cost. He might even consider it an added benefit to weaken a pillar of soft U.S. power based on knowledge and skepticism. The professional societies are building half a bridge The nonprofits are asking you to make public comment. Public comment is like building the first half of a bridge. Before implementation, OMB is compelled by law to have a period of public comment. Rules have to be consistent with the law and the Constitution. They express the federal government’s stance toward how those laws will be implemented. When a presidential administration works in good faith, these public comments are used to inform their eventual action, and sometimes mitigate it. The comment period reflects our First Amendment right to petition our government. The executive branch is then supposed to take those comments into account - completing the bridge between us, the people, and our government. Project 2025 seeks to take away the second half of the bridge. We have to replace it. The first half of the bridge Organizations like AAAS, Research!America, and SfN are partly right. You should certainly comment. Their core model is earnest: if enough of us make noise, then we will achieve change. This idealistic point of view is offered in good faith. That point of view is also currently bullshit. The fundamental reason is that the federal rulemaking process has two parts: There has to be a period of public comment. OMB makes the final rule…but is free to disregard public comment. Oops. That’s a loophole. However, not all is lost. Congress can complete the bridge Congress has enormous power. That power suggests a roadmap for how to proceed. This lawless administration is still going to issue that rule. Nonetheless, your comments still play an essential role. Here are two steps you can take. Step 1: Send your comment to your Representative and Senator. Whether they are Democrats or Republicans, many of them support science. Whatever you wrote as public comment in the Federal Register, also send it to your member of Congress. You can include information about jobs in your district or state by looking at Joshua Weitz’s ScienceMatters interactive map. Call the U.S. Capitol switchboard at (202) 224-3121 and give your town, zip code, or state, then deliver your message. Step 2: Politicize the hell out of science. You heard me, politicize it as an issue. We hear a lot from the old scientific establishment about science being nonpartisan. This is obsolete, sentimental thinking. Under normal conditions, it was true. But we can no longer make that assumption. We can keep on pretending, but we’re putting science at risk. There is a way forward. Rules are subordinate to the law…and Congress makes laws. Therefore Congress can step in. In this fall’s election, it is likely that Democrats will retake the House of Representatives. That puts at least one chamber of Congress in the hands of Democrats. They are far more inclined than the current Congress to investigate and legislate. This opens a path to undoing the damage. It also creates a permission structure for pro-science Republicans to find a way back from the brink. We have to encourage them. In the House, every district is up every two years. In your district, contact both of the major party candidates. If your state has a Senate race, contact those candidates too. Specifically mention the proposed OMB rule. Ask for two things: For this year’s appropriations process in August and September, ask that amendments be added to stop the implementation of the new rule. Those amendments should support peer-reviewed science and stop political interference. Looking ahead to next year, ask the Congressman/Congresswoman/Senator to work to hold hearings in 2027 on the importance and benefits of peer-reviewed science for health and prosperity. What hearings and amendments will accomplish Congress can use its investigatory power to summon heads of agencies and the director of the OMB. That will allow fact-finding regarding the consequences of this rule. Congress can override the rule through the appropriations process. They can write into statute a requirement to follow peer review and best scientific practices. In this way, Congress can stop the attacks on science. Postscript: Moving forward Now I have a request for you, to help me. As many of you know, I ran for Congress in order to save democracy and science. Although I did not win, that battle continues by other means. I met and heard from thousands of supporters both here in New Jersey and nationally. I learned that pro-science, pro-democracy activists have the potential to become a much greater force. In the weeks and months ahead, I will be building ways to harness that energy. I will be announcing those plans soon. In the meantime, an important step is to wind down the Congressional campaign, which has a few remaining bills to pay. Please help me retire that last debt.
The science behind greener, healthier lawns
A healthy, green lawn can be the envy of any neighborhood, but how does someone cultivate a yard like that? Assistant Professor of Ecosystem Science Amber Churchill has been getting her hands dirty and ...
Marc Theissen warns Democrats embracing ‘politics of envy’ amid AOC’s criticism of billionaires
The ‘Fox News Sunday’ panel debates Democratic messaging on billionaires and the party’s shift toward socialism.
We asked US researchers how the Trump administration's science policies have affected them
The American academic research engine has long been the envy of the world. Generally well-funded, labs in the United States have been able to attract the best minds who generate breakthroughs and train ...
Man City scandal risks damage to Premier League's booming brand
The Premier League has won a lengthy legal battle with Manchester City over financial impropriety, but the consequences could leave lasting damage for a league that has long since become the envy of world football.But the damage may not be limited to City alone with an entire era of the Premier League now under a cloud.
GLP-1 Envy Was Just the Beginning
A Super Bowl ad by Hims & Hers sells the idea that everyone should want to be billionaire-healthy.
Envy on the ballot
GAWD, I hate the rich. The top hats. The monocles. The dinner jackets. The way they twirl their mustaches while evicting orphans. Before we drag them into the public square, though, we should probably define “rich.” Amendment 87, the temporary “graduated” income tax, defines rich as earning $500,000 a year. And yes, it is temporary. […]
Trump admin’s policies negatively impacting U.S. science research
OPINION — The American academic research engine has long been the envy of the world. Generally well-funded, labs in the United States have been able to attract the best minds who generate breakthroughs and train the next generation workforce that powers the U.S. economy. But since the start of the second Trump administration in January 2025, new federal policies have destabilized the American scientific enterprise.
The Science Behind Greener, Healthier Lawns
A healthy, green lawn can be the envy of any neighborhood, but how does someone cultivate a yard like that? Assistant Professor of Ecosystem Science Amber Churchill has been getting her hands dirty and digging into the science behind it.
Man clears driveway with autonomous snow blower during storm
Forget robotaxis — a man and his robo-snow blower were the envy of X during the weekend's winter storm.
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