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Five midterm winners and losers: MAHA mowed down, Dem docs scrub in, Medicare for All returns
Democratic doctors were among the winners in the midterm elections, while the MAHA movement and President Trump's health agenda were losers.
CVS to break up $117B business, separating pharmacies from insurance
The split comes amid growing scrutiny from lawmakers and regulators of vertically integrated health care companies such as CVS.
Health insurers, hospitals rally after sweeping midterm win for Democrats
Nov 4 (Reuters) - Shares of Medicaid-focused US health insurers and hospital operators rose in early trading on Wednesday as Democrats' sweep of the Senate and House of Representatives in the midterm
UWM profitability rebounds in Q3 amid elevated interest rates
The news comes three months after a massive loss that led to an expensive deal to obtain cash.
Health survey of local students shows encouraging trend
Hopkinton’s middle and high school students are feeling less anxious and depressed, but there still are areas of concern, particularly for students with
Melco Resorts & Entertainment: Disciplined spending and lower CapEx anchor plans amid softer Macau demand
Q3 adjusted property EBITDA was $288 million, while Macau demand softened in October amid broader China economic weakness and intense competition. Deleveraging and disciplined reinvestment remain priorities; FY2027 CapEx guidance fell to ~$275 million.Based on Melco Resorts & Entertainment Q3 2026…
Fox News host reacts after he’s caught on hot mic asking if network can ‘do a spin on the races’ amid election results
“I guess we’re on TV now,” Bret Baier said live on the air.
The Donald Trump Era in American Politics Is Ending
The takeaways from the midterms are clear: no amount of billionaire spending could overcome the fact that Donald Trump’s dominance is coming to a close, the Left has much more room to grow, and we have entered a period of new possibility in US politics.
This Week In Politics: G20 Foreign Ministers’ Meeting
Amid national divides over the upcoming midterm elections, international friction also surfaced at the Group of Twenty’s (G20) foreign ministers’ meeting in Atlanta, Georgia, on Friday, Oct. 30, and Saturday, Oct. 31. Top diplomats from the G20, an international forum comprising the world’s largest economies that convene to address global economic policy and development, gathered...
Israel politicians accuse Netanyahu of being 'danger to Israel,' harming ties with US Democrats
Yair Lapid, who leads the Yesh Atid party, added that the midterm results have ruined any chance of forming a unity government with Netanyahu.
Voya Financial Expands its Multiple Employer Solutions as Business Nearly Doubles
WINDSOR, Conn., November 04, 2026--Voya Financial, Inc. (NYSE: VOYA) today announced new capabilities that will expand its Multiple Employer Solutions (MES) business, giving employers, workers and advisors more choice and a simpler experience. Voya’s MES business serves a wide range of organizations, including industry associations, faith-based groups, public sector entities, professional employer organizations and small-to-middle market businesses.
INTERVIEW: WEAU Political Analyst John Frank discusses results of midterm election
Hello Wisconsin’s Bob Gallaher sat down with WEAU Political Analyst John Frank.
Midterm Voters Give Democrats a Big Advantage to Handle Health Care
KFF's analysis of the 2026 Voter Poll by SSRS shows midterm voters gave Democrats a 19-percentage-point advantage on which party is better able to handle health care.
Video: McKennie joins Juventus group training before AZ Alkmaar clash
Juventus midfielder Weston McKennie trained with his teammates at Continassa this morning, on the eve of a Europa League game against AZ Alkmaar.Juventus are preparing for Thursday’s away Europa Lea...
NBA sits out Election Day yet again while other sports leagues go about business as usual
The NBA's "Get In The Game. VOTE." campaign saw all 30 teams sit out Tuesday's midterm election as players wore vote shirts at Monday's games.
CVS Health beats estimates, raises guidance amid split plans
Investing.com -- CVS Health Corporation (NYSE: CVS) reported third-quarter adjusted EPS of $2.09, beating analyst estimates of $1.65, as the healthcare giant announced plans to separate into two independent companies.
CVS Health's (NYSE:CVS) Q3 2026: strong sales
Diversified healthcare company CVS Health (NYSE:CVS) reported revenue ahead of Wall Street's expectations in Q3 2026, with revenue up 5.4% year on year to $108.4 billion. The company's full-year revenue guidance of $420 billion at the midpoint came in 0.5% above analysts' consensus estimates. Its non-GAAP profit of $2.09 per share was 26.6% above analysts' consensus estimates.
Data center memes flood X after Democrats' 2026 midterm wins
Democratic wins sparked data center memes on X, including a post from Elon Musk, as voters push for more limits on the AI infrastructure boom.
Top health takeaways from the midterm elections
Democrats gained control of both chambers of Congress, and doctors and scientists won key seats. Here are the top health takeaways from the midterms.
Manchester City Faces 114 Charges Amid Champions League Speculation
A shocking twist: Manchester City's massive financial cheating scandal might actually increase their chances of winning the Champions League. Here is why.
More Segunda matches postponed: Andorra-Mallorca also called off ❌
This weekend’s match between FC Andorra and RCD Mallorca has been officially postponed. The sporting authorities and both clubs have agreed to call off the fixture amid the shock gripping Spanish fo...
Geron Corporation Reports Third Quarter 2026 Financial Results and Recent Business Highlights
Achieved $60.1 million in RYTELO® (imetelstat) net product revenue in Q3 2026, an increase of 5% compared to Q2 2026 Reiterated 2026 RYTELO net product revenue at the mid-to-high end of the $220 million to $240 million range; lowered 2026 total operating expenses range to $220 million to $230 million Initiated gated commercial launch to expand RYTELO access to eligible LR-MDS patients in targeted European markets, with availability expected in Germany by end of year Ended Q3 2026 with cash, cash
How space weather shapes young planets
Scientists suspect powerful solar flares helped strip away the atmospheres of planets like Mars. A Michigan State University researcher is now searching for evidence of how those same forces shape planets beyond our solar system. Adina Feinstein, assistant professor of physics and astronomy, believes exoplanets are the key to understanding the early days of our solar system. This week, she received a Schmidt Sciences FirstLight grant to investigate how space weather influences young planets.
Sydney's new $641m Powerhouse arts and science museum to open amid crisis
Due to open on 7 November, the space is mired in controversy as senior executives stand aside during an ongoing misconduct and procurement investigation
The political map is anyone's guess after a Democratic wave in the midterm elections
Voters have dramatically shifted the political landscape by electing Democrats in traditionally Republican states.
The political map is anyone's guess after a Democratic wave in the midterm elections
Voters have dramatically shifted the political landscape by electing Democrats in traditionally Republican states.
The political map is anyone's guess after a Democratic wave in the midterm elections
Voters have dramatically shifted the political landscape by electing Democrats in traditionally Republican states.
Democrats seize Congress in sweeping midterm repudiation of Trump
Democrats seized control of both the Senate and House of Representatives on Tuesday, scoring sweeping victories in Republican strongholds for the first time in generations.
CVS Raises Guidance After Announcing Plan to Split in Two
CVS Health raised its full-year guidance on gains in its health-care benefits and pharmacy segments, but said it remains cautious amid high costs and potential macroeconomic headwinds.
Breaking down the midterm results with Radford University political science professor Dr. Chapman Rackaway
A blue tsunami wipes out Republicans
Jonathan Freedland and Shrai Popat run through the results of the US midterms, on a historic night for Democrats and a night to forget for Republicans
Xeris adds longtime biotech exec to its board
The move to bring Menassie Taddese on comes amid reports that the Chicago-based rare disease and endocrinology drug company is being considered for acquisition.
Trump has defied political consequences for years. The midterms changed that
The elections were a categorical repudiation of a Republican president who has spent the first half of his second term governing without regard to consequences.
Title-chasing McIlroy says there's no risk playing in Abu Dhabi amid tensions in Middle East
Rory McIlroy has played down safety concerns about competing at the Abu Dhabi Championship this week amid tensions in the Middle East that have impacted the sports calendar in the region.
Winners and losers from the 2026 midterm elections
Millions of Americans voted in a midterm election with incredible consequences on billionaires, taxes, AI regulation, and data centers.
FBI arrests Oklahoma man for mailing hundreds of threats to political officials ahead of midterms
FBI agents have arrested an Oklahoma man in connection to hundreds of threatening messages to political and public officials sent in the mail.
International Politicians React to Democrats Winning US Midterms
Nov 4 (Reuters) - Governments and politicians around the world reacted to the Democrats winning the US midterm elections, a result that could have major implications for global trade, security and energy prices. Here is a selection of the reaction: SPAIN PRIME MINISTER PEDRO SANCHEZ ON X
El-Sayed Celebrates ‘an America Big Enough for All of Us’
In Michigan, Adbul El-Sayed outlasted former Representative Mike Rogers in a Senate campaign marred by ugly attacks.
West Ham confirm Parker as boss
West Ham confirm the appointment of former midfielder Scott Parker as their head coach on a two-and-a-half-year deal.
Watch CNN’s coverage of Election Night in 5 minutes
The 2026 midterms results have revealed a blue tsunami as Democrats take back control of Congress. CNN’s coverage over the night highlights the stunning turn of the tides for Donald Trump’s Republican Party.
Sporting News' NFL midseason All-Pro team: 26 best players by position (so far) in 2026
Here's our All-Midseason team for the 2026 NFL season.
DAZN Pulse: Miami wins college football's bizarre Midterm Elections
Miami Hurricanes take center stage in college football’s bizarre midterm elections, with the latest headlines, analysis and reaction. Read more at DAZN News.
Silicon Valley‘s political spending spree meets a blue wave — and a data center revolt
Tech billionaires poured hundreds of millions into the midterms, but it didn’t buy them much.
What’s next after Trump’s massive miscalculation triggers historic defeat
There’s only way to view the Democrats’ staggering midterm election triumph: It is one of the most colossal repudiations of a sitting president in modern history.
AI Teammates Launches Ongoing AI Implementation Program for Mid-Market Business Owners
Program builds a working AI system in the first 6 weeks, then continues as an ongoing operating partnership for owners of $1M to $20M businessesSilicon Valley, California--(Newsfile Corp. - November 4, 2026) - AI Teammates, founded by Alice Y. Chen, has launched the AI Architecture Method, a structured implementation program that builds and operates AI systems on behalf of business owners rather than training them to build their own.Image Credit: AI TeammatesTo view an enhanced version of this..
A Political Reckoning Shatters Trump’s Grip on Washington
Republican midterm losses leave the president weakened during his final two years in the White House.
Democrats secure historic majorities in the midterms — and are poised to win even more seats
The party is poised to have strong majorities in Congress for the final two years of President Trump’s term. Follow for live updates.
Elon Musk's Texas-sized midterms failure
Elon Musk was the biggest funder of the effort to keep Texas red. It failed.
How the Stock Market Is Reacting to the Midterm Elections
U.S. stock futures fell as the first results came in, but later traded higher as investors assessed the outlook for artificial intelligence and other key sectors as the balance of power shifts in Washington.
Democrats flip four governorships, extending the party’s inroads into red states
Republicans entered Tuesday’s midterms with a 26-24 advantage in governor’s offices across the country.
Trump says Democrats 'did a good job,' blames Republican candidates for midterm losses
Voters delivered a significant rebuke to President Donald Trump on Tuesday by handing Democrats control of the Senate, rejecting his handpicked candidates while airing widespread concerns about high costs in the wake of his war against Iran and his punishing tariff policy.
Michele Tafoya Loses Senate Race Amid Nationwide Democratic Rout
Tafoya came up short against Democratic Lt. Gov Peggy Flanagan.
The Midterm Election Was About Health Care
In the face of Trump’s destruction of public health and modern science, voters are putting candidates who support Medicare for All, doctors, and nurses into positions of power.
Before the Dawn in America’s Heartland
With hardly a cloud in sight, astronauts had a sweeping view of nighttime lights in the U.S. Midwest.
US stock futures mixed as Democrats score key midterm election wins
Wall Street faces fresh uncertainty over what Democratic control of Congress could mean for taxes, government spending and regulation.
US stock futures tumble as Democrats score key midterm election wins
Wall Street faces fresh uncertainty over what Democratic control of Congress could mean for taxes, government spending and regulation.
AFGHS co-signatory countries ask health care users to help fill the financing gap
Hundreds of thousands of Ugandans living with HIV on antiretrovirals could be targeted for user fees or community health insurance schemes requiring modest premium payments, according to the April 2026 version of the country’s America First Global Health Strategy implementation narrative.1 As part of the “sustainable financing for the private not for profit sector” strategy, 491 facilities will be targeted for a phased introduction of user fees and scale up of community health insurance programs.2 In the Ugandan context, PNFP facilities include faith-based hospitals and other health facilities, US missionary organizations and centers of excellence—services that are often co-located at government facilities but run with additional financial and technical resources. 402,000 people—or about 28 percent of the total Ugandan adult PLHIV population on treatment—get ART from the private not for profit sector. The selected facilities provide the majority of ART and prevention of mother to child transmission (PMTCT) services. The plan doesn’t give the total number of clients served by the 491 facilities, so it is not possible to give a precise number. But the majority of 402,000 is a figure in the hundreds of thousands—hence the estimate I’m using.3 The April draft of the Ugandan implementation plan narrative is the only one I’ve been able to review. But the government of Uganda is not alone in turning to health care users to help fill the financing gaps caused by the abrupt withdrawal of US funds. In July 2025, the Government of Liberia introduced user fees for previously free services including “registration, accommodation, patient feeding, hospitalization, and a wide range of surgical and diagnostic procedures.”4 Earlier that year, Liberia rolled out a revolving drug fund designed to stabilize drug supplies by “allowing patients to pay a small fee for standardized, quality medications,” according to a Ministry of Health press release.5 (Both of these approaches had been proposed in the National Health Policy 2022-2031; media coverage explicitly connects the launch with the US foreign aid cuts.) The health financing strategies proposed by Uganda and established in Liberia are qualitatively different from user fees officially adopted by specific health facilities to cover funding shortfalls caused by the new US approach.6 The latter is a stopgap, adhoc change. The former is a national governmental adoption of policies that pass costs on to health care users, despite evidence that such approaches can exacerbate inequities and leave deficits unfilled. Two countries does not make a pattern, but they do point to urgent questions: Have other countries, including Liberia, included user fees or community health insurance schemes in their implementation plans? If so, do any of these narratives have what Uganda’s lacks: a fall-back plan in place in case these strategies for sustainable health systems fail to deliver—as they have before? I wonder if you think about it Subscribe Predictable pitfalls Both community-based health insurance and user fees are as old as the hills. And after decades of people climbing up these hills, duking it out, climbing back down—neither strategy has shown the results the Ugandan implementation plan is counting on. This is, in fact, a hill some folks are willing to die on. (You knew I’d get there, right?) In November 2025, an African-led team of health system experts published a paper directed at low- and middle income country governments trying to figure out how to create self-sustaining health systems. The money wasn’t coming back. It had been more than nine months since the season of freezing, waivering and wood-chippering; two months since AFGHS tumbled into the world touting co-financing requirements and reductions in future US government health aid. Governments were looking for strategies for sustainable, self-financed health systems, the authors wrote. For countries considering user fees and community health insurance to fill the financing gaps, they had a simple message: Don’t. On user fees, the paper states: “Reliance on user fees is ultimately a regressive and inequitable approach. It places a disproportionate burden on the poor and undermines health system goals of equity and financial protection. […] There is overwhelming evidence that user fees mobilise very limited resources for the public health sector, making it an inefficient mechanism for revenue mobilisation.” On community health insurance: “Attempting to shift the burden of funding previously donor-funded services, such as HIV care and management, and TB treatment, onto contributory schemes would exacerbate their fragility and fail to protect the population.”7 The WHO says that community-based health insurance “cannot be expected to provide a major source of funding or coverage,” and noted that most schemes offer only moderate benefit to individuals paying into them, and exclude the poorest segment of the population.8 And yet, the US-Ugandan implementation plan says that community health insurance is “the central pillar of this [PNFP] sustainability strategy” and that this approach that will generate “pre-paid pooled funding at facility and community level [that] improves financial risk protection for households, reduces catastrophic out-of-pocket expenditure, and generates structured, transparent revenue streams that can progressively absorb recurrent costs including health worker salaries.” Unfortunately, Uganda’s own history suggests the pillar might not be able to bear this weight. Ugandans Have Been to this Rodeo Before—and Some Want Their Money Back Uganda introduced its first community health insurance scheme in 1996 with support from international donors.9 Thirty years later, somewhere between 0.2 and 0.3 percent of the population is covered by CHI; just over 1 percent has any kind of health insurance.10 User fees were universally introduced in 1993 as a condition of a World Bank loan.11 They were abandoned in 2001, and in 2004—the year I moved to Uganda to watch the free HIV program get underway—a definitive study found that the fees did not improve health systems and outcomes.12 In 2004, most clinics and hospitals had ‘free’ and ‘fee for service’ options for getting care.13 The fee for service, or “cash and carry” programs had often been established in the years prior to PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria. People who could afford to paid for the drugs, often at facilities in the private-not-for-profit (PNFP) sector. When free drugs arrived, some people who’d been paying kept on doing so, perhaps because of shorter wait times, greater confidentiality, convenience or other factors. But in the year that I spent visiting the same clinics around the country week after week—including a “center of excellence” that maintained separate days for cash and carry clients and those accessing free ARVs—lots of people who had been paying tried to switch to the free option. They’d paid because they had no other choice. They’d sold pieces of family land, begged family members for loans, bought pills by the week, and sometimes by the day. Or they were just cash-strapped, like most of us, and wanted the funds for other things. 14 Twenty-two years later, this hasn’t changed. Ugandans pay out of pocket for 30-40 percent of their health care costs, leading one paper to declare that “falling ill is more than a health crisis. It is a financial emergency.”15 One recent study found that up to 48.5 percent of households dealing with tuberculosis sold something, took out a loan or dug into savings to defray the costs of TB care—which is supposed to be universally free.16 The Ugandan implementation plan does anticipate challenges. It proposes a phased approach, with 187 facilities introducing user contribution systems in Year 1, 152 in Year 2, and 153 in Year 3. Willingness to pay and feasibility studies will precede roll out; fees will be tiered by region, and a waiver system is proposed to ensure that no one has to pay who is unable to. Moreover, the plan provides for quarterly reviews of epidemiological data to “ensure that user contributions do not compromise epidemic control gains, ART continuity for the client cohort, TB case management, or PMTCT services.” Alt text: A screenshot of a table included in the implementation plan narrative that is the subject of this stack. It’s got a fetching pink bar at the top. It uses the abbreviation “CHI” which is Community Health Insurance, and FBO which is Faith Based Organizations, and it details the number of facilities that will implement user fees with waivers and community health insurance schemes over the five years of the agreement. As I said in the footnote, this is a super interesting document with a lot of other rich material. Tell me what you see—and what you would have focused on. And if you’ve seen something like this, or anything else that strikes you, in another implementation plan, tell me that too. You can use the Substack message platform or try me on Signal at @endaplague_again.25 (because @mercoonfan was, weirdly, taken). But the plan doesn’t fully explain what will happen if this approach doesn’t work out. Yes, progress will be monitored, and corrective action triggered. However, there is no specified funding replacement if premium and fee revenue prove inadequate. Instead, the authors write, “Currently, COEs serve a total client cohort of over 180,000 across 28 facilities. In the initial years, the U.S. Government (USG) will provide financial support for clients; over time, user fees generated by COEs will become the primary source of funding for sustaining their services.” Failure does not really seem to be an option. Health insurance schemes are more acceptable to the Ugandan population than user fees. Members of Parliament and civil society traveled to Ethiopia to see how that country’s scheme worked. In a follow up report, a veteran civil society group recommended allowing the “health insurance ecosystem to grow organically and [to] keep reviewing the law and regulations as this growth takes root.”17 One study found that more than three-quarters of Ugandans were willing to join a health insurance program.18 However, coverage of community-based health insurance is minimal, as is coverage of any kind of insurance—including private plans.19 A national health insurance scheme bill has been stalled for several years and presently sits with President Yoweri Museveni.20 Community-based health insurance scheme that do exist are expanding in number, but losing enrollees. Between 2022 and 2026, the number of community-based health financing schemes across the country increased by 42 percent, while the number of people enrolled decreased by nearly 11 percent.21 None of this means that community-based health insurance should not happen in Uganda—or that people do not want insurance. It doesn’t even mean that user fees and waivers won’t ever work. But there is highly relevant evidence from Uganda and the surrounding region that it is quite optimistic to describe community health insurance and user fees as central supports for sustainable financing in any sector of the health system. And now for the best-case scenario In the best-case scenario22, the Ugandan approach does exactly what it sets out to do, and so does the Liberian fee structure and revolving pharmacy fund—though I’ve not confirmed that these are in the MoU. In one best-case scenario, Uganda is an outlier, and user fees and community health insurance are not recurrent pillars of self-sustaining financing in other countries’ implementation plans. In another best-case scenario, all countries that include these strategies enjoy success beyond anyone’s evidence-informed wildest dreams: reliable funding generated by health care users fees, great health care outcomes for everyone, no exacerbation of inequities, no crippling household debt. No sold land, repurposed school tuition or high-interest loans. In the best-case scenario, not one of the hundreds of thousands of Ugandans living with HIV receiving antiretrovirals from 491 PNFP facilities misses a refill or leaves care because of user fees or community health insurance premiums. This is the best-case scenario for these people for their own health, and for their families. It is also the best-case scenario if Uganda wants to stay on the path to eliminating HIV as a public health threat. According to the country’s most recent data, 96.5 percent of people living with HIV on antiretrovirals are virologically suppressed. Epidemic control depends ensuring that 95% of people living with HIV know their status, 95 percent of those individuals are on ART, and 95% of those individuals are virologically suppressed. Uganda is still struggling with the first “95"—a frankly abysmal 85.3 percent. If HIV epidemic control and the attendant prevention of new infections, avoidable suffering and premature death matter, the country cannot afford to lose any clients who are currently in care.23 As I write this a couple hours before the polls close for the US elections in the city I live in, I say with soul-deep sincerity: I am rooting for the best-case scenario. I think it’s safe to say that we all are.24 I think it’s also safe to say that if the US and co-signatory governments have inked plans that lead to successful expansion of community health insurance and strategic use of user fees, we all would like to know, now, so that we don’t miss the opportunity to celebrate when success happens. The implementation plan narratives have to enter the public domain. They are the fullest expression of a strategy co-created by two governments. There are assumptions and details that people living in the US and co-signatory countries need to understand that are not available in the MoUs or, to date, in the Congressional Notifications. Some of these details can help other countries that are, as I write this, still working on implementation plans. Others, like a solid count of how many other countries have plans for expanding user fees or health insurance, are important for regional and global health architecture reform initiatives. No matter how this election night turns out, there will be a slew of new Congressional member orientations, briefings and talking points papers in the next few months. Release of implementation narratives should be a bullet point in every context that AFGHS is discussed. These documents can be redacted so that procurement sensitive information isn’t disclosed. There is much more historical precedent for sharing such documents than there is for relying on user fees to fill health financing gaps. Let’s look at the information together so we can hope for the best and prepare for, you know, the other thing. Alt text: A substack first: a bicep selfie! It’s my arm - peachy-white skin, black shirt (flannel, notch neck, too hot for this appallingly balmy November weather, if you’re wondering) and a sticker that says I VOTED 2026. Beige letters on red for I voted. Beige on blue for 2026. You bet I did.25 In your wildest dreams. Subscribe 1 This is a really, really rich 95 page document. There are fascinating ideas and detailed plans in it. It is all worth reading AND I have, in this post, highlighted an instance of content that could pose challenges and certainly posits success of strategies that haven’t worked before. I would love to hear what readers’ see that’s interesting and should be lifted up as something to check for in other implementation plans. I will also shortly be adding a static page to the substack site where implementation plan documents will live. I will put the url into this footnote and it will also be there on emilybass.substack.com by the end of the week. Uganda Implementation Narrative Section 4 April 22 2026 Draft 1.51MB ∙ PDF file Download Download 2 User fees are costs charged for visits, labs, medicines or other health services, usually at the time they are provided. Community health insurance, or community-based health insurance, is what the World Health Organization calls “micro insurance,” which is health insurance targeted at low-income people. 3 As usual (by which I mean always), please prove me wrong. 4 https://smartnewsliberia.com/liberias-ministry-of-health-announces-2025-hospital-service-fees-for-public-facilities/?utm 5 https://moh.gov.lr/news/2025/grand-cape-mount-leaders-residents-embrace-new-community-pharmacy-program/?utm 6 https://www.christianitytoday.com/2026/09/hiv-usaid-pepfar-africa-foreign-aid-cuts-mission-hospitals/?utm 7 https://gh.bmj.com/content/10/11/e021270 8 https://www.who.int/news-room/fact-sheets/detail/community-based-health-insurance-CBHI 9 https://pmc.ncbi.nlm.nih.gov/articles/PMC2827475/ 10 https://pmc.ncbi.nlm.nih.gov/articles/PMC10861328/#b3-jpmph-23-110 11 https://pmc.ncbi.nlm.nih.gov/articles/PMC527704/ 12 Same citation as the footnote 2 - the article is called “Learning from failed health care reform in Uganda.” To which I say: If only. If. Only. 13 There is a whole taxonomy of user fees to be aware of, if not commit to memory. Out of pocket costs are everything that someone pays for themselves. In this Stack, user fees are planned and policy-supported out of pocket costs. There are also out of pocket costs that people pay to buy drugs or receive tests or health care assessments that would be free if the drugs were on the shelves, or the machines or kits were available, or the staff were on site. A user fee is usually designed to be modest, pegged to willingness to pay, and may be waiveable at the point of care for anyone who is unable to do so. The costs for things that would otherwise be free are whatever the market will bear and people either have to pay them or go without. Out of pocket costs for services and stuff that aren’t available in public facilities are different again from bribes or unofficial fees that some health workers may impose, even though most are indefatigable, tireless and tired, and devoted to their clients. 14 For the record—which really is these footnotes—I would give a whole stack of fridge magnets for a systematic analysis of the economic and social impact of the Mass Unemployment Event in AFGHS countries among the very people who used to be able to afford and cover user fees, both for themselves and vast family networks. Locally employed USAID technical staff, house cleaners, caregivers, drivers and technicians were financial anchors for cousins, friends, friends’ children, friends’ childrens’ cousins, teachers, pastors, neighbors and so many other kinds of kin. Aid recipients lost direct funding; many other people who had not been aid recipients, but parts of the elaborate care webs that function as safety nets for so many people, lost crucial support too. And that’s even before we get to the people who worked at the hotels and restaurants and bars where people employed by the US and its implementing partners used to spend disposable income. Those businesses have lost revenue; those folks have lost jobs. It will be some time coming—and someone will have to fund this work—but I do hope it happens. And I hope, as usual, to be proven wrong. 15 https://eprcug.org/blog/how-out-of-pocket-healthcare-costs-keep-driving-ugandans-into-poverty/ 16 Another straight-to-the-point journal article title. Households experiencing catastrophic costs due to tuberculosis in Uganda: magnitude and cost drivers. https://pubmed.ncbi.nlm.nih.gov/32938411 17 https://www.cehurd.org/download/technical-policy-brief-on-community-health-insurance-scheme/?wpdmdl=13661&refresh=6ae9122f5d4ed1793659439 18 https://pmc.ncbi.nlm.nih.gov/articles/PMC10125197/ 19 https://pmc.ncbi.nlm.nih.gov/articles/PMC10861328/#b3-jpmph-23-110 20 https://ugandapost.news/uganda-to-make-health-insurance-mandatory-by-2026/ 21 https://shu.org.ug/download/235 22 With a nod, tip of the stack hat, and wag of the Mercoon tail to a deeply valued reader who told me that I have a tendency to speculate about the worst-case scenarios a little too much of the time. 23 https://news.mak.ac.ug/2026/10/uphia-2025-shows-ugandas-hiv-status-awareness-gap-despite-strong-treatment-outcomes/ As you’ll see in the next footnote, I’ve already written a subSubstack on another topic, so I will be brief with regard to the study referenced in this article. The Uganda Population-Based HIV Impact Assessment, or UPHIA, will never happen in this way again. For more than a decade, PHIAs have been supported by the US government as a way to generate accurate estimates of country progress on key HIV indicators. They are a holdover from the PEPFAR program that was laser focused on ensuring US taxpayer dollars subsidized progress in pandemic control. There may be other population-level surveys and the data may even be publicly released, as the entire set of FY2026 MER data have not. But PHIAs will never happen again. If you’re wondering whether the estimates of HIV progress at country level might get less reliable….you’re not alone. 24 Ooh baby, I hate “we” in almost all forms. But sometimes I go there, when I am looking for company, which I am. Because this Stack moves into the somewhat-uncharted territory of assessing what the implementation plan narratives may suggest about co-signatory countries’ roles and responsibilities to the people living within their borders. The MoUs, specimen and data sharing agreements were templates. Countries’ answers fit into pre-specified questions that did not include, “how are you going to fill financing gaps and stabilize your health system as this plan unfolds?” In contrast, the implementation narratives are open form—the product of co-creation between the two governments. Co-creation can mean lots of things, but nothing leads me to believe that implementation plans are ghost-written by the US government, or that contents were imposed by the US counterparts. Instead, I think the parts of the plans that read like country government initiatives are endorsed, if not initiated by, those governments. For instance, the Ugandan implementation plan narrative describes plans for revenue-generation through fees charged for equipment calibration, repair and maintenance provided through Uganda’s National Equipment Calibration Laboratory, and laboratory accreditation through the Uganda National Accreditation Service (UGANAS), targeting private sector, PNFP, research and academic clients. That’s super specific and also quite ambitious. It doesn’t read like an American idea. There’s also a provision for solar panels, and other stuff that feels country owned and driven. This is where it gets interesting. If co-creation is the case, then both the US and co-signatory governments are accountable for the contents and the outcomes. Most discourse about AFGHS to date has focused on the decisions that America has made, or demanded that other countries make. The AFGHS architects have monopolized the hot seat. As they should, in so many ways. America absolutely created the conditions under which countries needed to come up with health financing strategies to fill unanticipated, catastrophic funding gaps. And with not-too-long a lens, we can look back and see that America is also on the hook for its role in the Bretton Woods institutions that made user fees and health system fiscal austerity conditions of loans during the era of structural adjustment. But in the here and now, it is not at all clear to me that the US is requiring Uganda or any other country to implement specific approaches to sustainable financing. Instead, it is as the authors of that paper up in footnote 6 suggest: African governments have agency. As implementation plans roll out—whether or not the narratives are shared—it will be important to understand what this agency looks like and what it means for people, including the poorest of the poor. And it will be important to figure out how to talk about it safely, respectfully and critically in places other than the literal and metaphorical footnotes. 25 This week’s song is “Once upon a time” by the Moody Blues. (I know, this is gonna be a weird, largely banger-free end of 2026 playlist. HMU with requests.) AND please do watch the video and appreciate the truly amazing opening sequence—a drum kit wasteland, a coupla plastic bags, a bit of sand. Sort of like the hill where fiscal austerity policies that put costs on health care users might go to perish. But then there’s a lady with amazing hair. It’s worth it.
The Midterm Election Was About Health Care
In the face of Trump’s destruction of public health and modern science, voters are putting candidates who support Medicare for All, doctors and nurses into positions of power.
Democrats take control of the Senate after winning key midterm races
Democrats have won the U.S. Senate, ending Republican dominance in Washington by harnessing voters' frustration with President Donald Trump.
Democrats capture full control of Congress, NBC News projects, fueled by victories in deeply Republican states
Democrats capitalized on voter anger over Trump and affordability, flipping seats in deep-red and major battleground states alike.
Marni von Wilpert flips California House seat, bringing a personal health care fight to Congress
The bisexual lawmaker from California flipped a Republican-held seat amid an overwhelming blue wave.
Michigan approves Proposal 2, citizen-lead effort to limit corporate influence in politics
Michigan voters passed Proposal 2 during the Nov. 3 midterm election. The Associated Press called the race at 9.38 p.m on Nov.3, 80.9 % of voters cast their ballot in favor of the proposal, 19.1% with more than 24% of the vote in.
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Former Health and Human Services Secretary Xavier Becerra wins California governor’s race
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The president told voters to act like his name was on the ballot—and they did.
AP Voter Poll: How key demographic groups voted in the 2026 midterms
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Proposal 2 for 'money out of politics' passes in Michigan
Voters approved Proposal 2 in Michigan in the 2026 midterm election. Proposal 2 would regulate political spending by utilities and large government contractors.
Michigan voters pass 'Money out of Politics' proposal, reports say
Michigan voters approved a ballot initiative banning utility companies and other state contractors from making political donations.
US stock futures dip as midterm election results loom
Early results showed Democrats making gains in the Senate, although control of both chambers of Congress remained uncertain.
Keisha Lance Bottoms wins the Georgia governor’s race, flipping the office for Democrats
NBC News projects that Bottoms, the former mayor of Atlanta, defeated billionaire Republican Rick Jackson in the contest to succeed Gov. Brian Kemp.
2026 Minnesota Election Results
Minnesota Election results for the November 3, 2026, midterm elections.
Kyler Murray Gets Concerning Take Amid Vikings’ Offensive Woes
Whether the Minnesota Vikings have to make a change at QB due to Kyler Murray’s hamstring soreness that he suffered during the Week 8 loss to the Detroit Lions or due to his play, one former player believes that it could be time to make a switch at center. Murray finished 17-of-29 on his pass […] The post Kyler Murray Gets Concerning Take Amid Vikings’ Offensive Woes appeared first on HEAVY.
DHS secretary plans post-election investigation
Homeland Security Secretary Markwayne Mullin raised the prospect of a post-election investigation into the midterm results, saying his department would examine whether any noncitizens voted. CNN’s Gabe Cohen reports.
Pacers News: Indiana Finds Bright Spot Amidst Injury Woes
The Indiana Pacers' news cycle lately has consisted of injuries; however, following the contest against the Hawks, Indiana may have found a diamond in the rough. The Pacers' main story for the start of the season has been their injury-plagued roster, including Tyrese Haliburton, missing at least two weeks due to a hamstring strain. In …
I look up as I walk, my healthcare costs look down
An Osaka Metropolitan University researcher analyzed 338,706 person-months of data linking objective smartphone step counts from Osaka Prefecture’s official health app with health-insurance claims for 20,950 adults aged 40 and over. Generalized additive models revealed that the non-linear association between daily steps and subsequent 6-month healthcare expenditures transforms with age. Predicted costs were largely insensitive to steps among middle-aged adults but fell steeply with increasing steps among older adults.
Missouri live election results: Amendment 3, St. Louis, St. Charles and Jefferson counties
In the Nov. 3 midterm election, Missourians voted on an abortion ban and a measure that would make it harder for lawmakers to override voter-approved statutes and constitutional amendments. U.S. Rep. Ann Wagner faced Democrat Fred Wellman to represent Missouri’s 2nd Congressional District.
Wake Forest political science professor John Dinan stops by WXII to analyze midterm election success means for Democrats and Republicans
US midterm elections 2026 live updates: key House and Senate races to determine control of Congress for remainder of Trump’s term
Key states like Florida, Georgia, Michigan and North Carolina see record turnout as Americans decide the direction of Congress for remainder of Trump’s term
In the Heart of National Politics, GU Students Face Barriers to Mail-In Voting
As polling for the tightly contested 2026 midterm election closes Nov. 3, Georgetown University students remain motivated to vote amid federal attacks on mail-in voting across the country. Tuesday’s elections will determine control of both the U.S. House of Representatives and the U.S. Senate as Democrats fight to break a Republican trifecta in the federal...
Many voters see midterm election as a rebuke of Trump, NBC News Exit Poll shows
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How Will the Midterms Play Out? These Races May Provide Early Clues.
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Overwatch’s Midseason Patch Adds Teaser For Its Sexy New Omnic Detective Hero
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New Mexico midterm election turnout continues to surge
By Kevin Hendricks, Jesse Jones, Rodd Cayton and Pat Davis, The Paper & The New Mexico News — 2026’s midterm elections may be among the biggest in recent memory, both nationally and here in New Mexico, if early voting and midday Election Day turnout trends continue until polls close at 7 p.m. tonight. Election Day […]
PAMT sees Q3 loss of $8 million, revenue up 8%
Tontitown-based carrier PAMT Corp. posted its eighth straight quarterly loss as revenue rose for the second consecutive quarter amid rising rates and costs. After markets closed Monday (Nov. 2), PAMT...
Live 2026 midterm election coverage in Washington
Election Day is here in Washington and the nation. Numerous pivotal races will be decided. There are three conservative-backed initiatives, on the state’s new income tax for high earners, the participation of transgender girls in girls’ school sports and parental rights of public school students. There’s a momentous election for the state Supreme Court, with […]
The Waiting Begins
Millions of Americans headed to the polls Tuesday for a midterm election that could shape the future of health care and artificial intelligence in the U.S. and will determine how much Democrats can try to constrain President Donald Trump during his last two years in office. The political contest has ...
Seattle sandwich chain to close 2 stores, end operations
The Seattle-based sandwich chain Homegrown will close its remaining two stores and catering business amid rising labor costs and food prices.
40+ and Not Feeling Like Yourself? 7 New Rules for Women's Health
Dr. Kanchi Chadha, MD, FACOG, Director of the Midlife Women's Health and Longevity Center at Hackensack Meridian Health, explains how hormone changes in midlife affect your muscle, bones, sleep, and heart.
Area voters flock to polls, make voices heard for midterm elections
Matthew Hantz of Latrobe said he feels so strongly about the gubernatorial race that he voted in a midterm election for the first time on Tuesday.
M&F Bank holders vote Wednesday amid criticism over deal
Durham-based M&F Bancorp officials say they expect to win approval for the proposed merger of Mechanics & Farmers Bank into South Carolina’s Optus Financial in a shareholder vote Wednesday morning, despite efforts to derail the plan.
‘Challenger Center’ planned for Waterloo to boost space science education
Hawkeye Community College in Waterloo plans to build a space education center for Iowa middle-schoolers. Bids are being taken on a project that will bring Iowa’s only Challenger Center to ca…
First ‘Challenger Center’ planned for Iowa to boost space science education
Hawkeye Community College in Waterloo plans to build a space education center for Iowa middle-schoolers. Bids are being taken on a project that will bring Iowa’s first Challenger Center to c…
First 'Challenger Center' planned for Iowa to boost space science education
Hawkeye Community College in Waterloo plans to build a space education center for Iowa middle-schoolers. Bids are being taken on a project that will bring Iowa’s first Challenger Center to campus, honoring the seven astronauts killed in the 1986 Space Shuttle Challenger disaster. The 32 other centers nationwide are run by a Washington D.C.-based nonprofit […]