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How to choose the right health insurance plan for 2027
'Your premiums will change. Your out-of-pocket costs can change. Drug coverage can change.'
Health Brief: Election Watch | Rising health costs become a key issue in governors’ races
Plus: Medicare drug plan costs rising by 50 percent
FDA scientists opposed the Trump administration\'s move to ease peptides access
Food and Drug Administration scientists didn't support a new policy by President Donald Trump's administration to loosen rules on unproven peptide drugs. That's according to people familiar with the policy’s
Sanford Health, Lewis Drug start construction of southeast-side location
Sanford Health has started construction on a combined clinic and Lewis Drug location in southeast Sioux Falls.
Rob Riggle revels in Drunk Santa role in ‘Christmas at the Kringles’
“You have a horror film. You have a holiday film. You have a comedy — and you have a little action mixed in.” — Rob Riggle
How to choose the right health insurance plan for 2027
'Your premiums will change. Your out-of-pocket costs can change. Drug coverage can change.'
AFGHS co-signatory countries ask health care users to help fill the financing gap
Hundreds of thousands of Ugandans living with HIV on antiretrovirals could be targeted for user fees or community health insurance schemes requiring modest premium payments, according to the April 2026 version of the country’s America First Global Health Strategy implementation narrative.1 As part of the “sustainable financing for the private not for profit sector” strategy, 491 facilities will be targeted for a phased introduction of user fees and scale up of community health insurance programs.2 In the Ugandan context, PNFP facilities include faith-based hospitals and other health facilities, US missionary organizations and centers of excellence—services that are often co-located at government facilities but run with additional financial and technical resources. 402,000 people—or about 28 percent of the total Ugandan adult PLHIV population on treatment—get ART from the private not for profit sector. The selected facilities provide the majority of ART and prevention of mother to child transmission (PMTCT) services. The plan doesn’t give the total number of clients served by the 491 facilities, so it is not possible to give a precise number. But the majority of 402,000 is a figure in the hundreds of thousands—hence the estimate I’m using.3 The April draft of the Ugandan implementation plan narrative is the only one I’ve been able to review. But the government of Uganda is not alone in turning to health care users to help fill the financing gaps caused by the abrupt withdrawal of US funds. In July 2025, the Government of Liberia introduced user fees for previously free services including “registration, accommodation, patient feeding, hospitalization, and a wide range of surgical and diagnostic procedures.”4 Earlier that year, Liberia rolled out a revolving drug fund designed to stabilize drug supplies by “allowing patients to pay a small fee for standardized, quality medications,” according to a Ministry of Health press release.5 (Both of these approaches had been proposed in the National Health Policy 2022-2031; media coverage explicitly connects the launch with the US foreign aid cuts.) The health financing strategies proposed by Uganda and established in Liberia are qualitatively different from user fees officially adopted by specific health facilities to cover funding shortfalls caused by the new US approach.6 The latter is a stopgap, adhoc change. The former is a national governmental adoption of policies that pass costs on to health care users, despite evidence that such approaches can exacerbate inequities and leave deficits unfilled. Two countries does not make a pattern, but they do point to urgent questions: Have other countries, including Liberia, included user fees or community health insurance schemes in their implementation plans? If so, do any of these narratives have what Uganda’s lacks: a fall-back plan in place in case these strategies for sustainable health systems fail to deliver—as they have before? I wonder if you think about it Subscribe Predictable pitfalls Both community-based health insurance and user fees are as old as the hills. And after decades of people climbing up these hills, duking it out, climbing back down—neither strategy has shown the results the Ugandan implementation plan is counting on. This is, in fact, a hill some folks are willing to die on. (You knew I’d get there, right?) In November 2025, an African-led team of health system experts published a paper directed at low- and middle income country governments trying to figure out how to create self-sustaining health systems. The money wasn’t coming back. It had been more than nine months since the season of freezing, waivering and wood-chippering; two months since AFGHS tumbled into the world touting co-financing requirements and reductions in future US government health aid. Governments were looking for strategies for sustainable, self-financed health systems, the authors wrote. For countries considering user fees and community health insurance to fill the financing gaps, they had a simple message: Don’t. On user fees, the paper states: “Reliance on user fees is ultimately a regressive and inequitable approach. It places a disproportionate burden on the poor and undermines health system goals of equity and financial protection. […] There is overwhelming evidence that user fees mobilise very limited resources for the public health sector, making it an inefficient mechanism for revenue mobilisation.” On community health insurance: “Attempting to shift the burden of funding previously donor-funded services, such as HIV care and management, and TB treatment, onto contributory schemes would exacerbate their fragility and fail to protect the population.”7 The WHO says that community-based health insurance “cannot be expected to provide a major source of funding or coverage,” and noted that most schemes offer only moderate benefit to individuals paying into them, and exclude the poorest segment of the population.8 And yet, the US-Ugandan implementation plan says that community health insurance is “the central pillar of this [PNFP] sustainability strategy” and that this approach that will generate “pre-paid pooled funding at facility and community level [that] improves financial risk protection for households, reduces catastrophic out-of-pocket expenditure, and generates structured, transparent revenue streams that can progressively absorb recurrent costs including health worker salaries.” Unfortunately, Uganda’s own history suggests the pillar might not be able to bear this weight. Ugandans Have Been to this Rodeo Before—and Some Want Their Money Back Uganda introduced its first community health insurance scheme in 1996 with support from international donors.9 Thirty years later, somewhere between 0.2 and 0.3 percent of the population is covered by CHI; just over 1 percent has any kind of health insurance.10 User fees were universally introduced in 1993 as a condition of a World Bank loan.11 They were abandoned in 2001, and in 2004—the year I moved to Uganda to watch the free HIV program get underway—a definitive study found that the fees did not improve health systems and outcomes.12 In 2004, most clinics and hospitals had ‘free’ and ‘fee for service’ options for getting care.13 The fee for service, or “cash and carry” programs had often been established in the years prior to PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria. People who could afford to paid for the drugs, often at facilities in the private-not-for-profit (PNFP) sector. When free drugs arrived, some people who’d been paying kept on doing so, perhaps because of shorter wait times, greater confidentiality, convenience or other factors. But in the year that I spent visiting the same clinics around the country week after week—including a “center of excellence” that maintained separate days for cash and carry clients and those accessing free ARVs—lots of people who had been paying tried to switch to the free option. They’d paid because they had no other choice. They’d sold pieces of family land, begged family members for loans, bought pills by the week, and sometimes by the day. Or they were just cash-strapped, like most of us, and wanted the funds for other things. 14 Twenty-two years later, this hasn’t changed. Ugandans pay out of pocket for 30-40 percent of their health care costs, leading one paper to declare that “falling ill is more than a health crisis. It is a financial emergency.”15 One recent study found that up to 48.5 percent of households dealing with tuberculosis sold something, took out a loan or dug into savings to defray the costs of TB care—which is supposed to be universally free.16 The Ugandan implementation plan does anticipate challenges. It proposes a phased approach, with 187 facilities introducing user contribution systems in Year 1, 152 in Year 2, and 153 in Year 3. Willingness to pay and feasibility studies will precede roll out; fees will be tiered by region, and a waiver system is proposed to ensure that no one has to pay who is unable to. Moreover, the plan provides for quarterly reviews of epidemiological data to “ensure that user contributions do not compromise epidemic control gains, ART continuity for the client cohort, TB case management, or PMTCT services.” Alt text: A screenshot of a table included in the implementation plan narrative that is the subject of this stack. It’s got a fetching pink bar at the top. It uses the abbreviation “CHI” which is Community Health Insurance, and FBO which is Faith Based Organizations, and it details the number of facilities that will implement user fees with waivers and community health insurance schemes over the five years of the agreement. As I said in the footnote, this is a super interesting document with a lot of other rich material. Tell me what you see—and what you would have focused on. And if you’ve seen something like this, or anything else that strikes you, in another implementation plan, tell me that too. You can use the Substack message platform or try me on Signal at @endaplague_again.25 (because @mercoonfan was, weirdly, taken). But the plan doesn’t fully explain what will happen if this approach doesn’t work out. Yes, progress will be monitored, and corrective action triggered. However, there is no specified funding replacement if premium and fee revenue prove inadequate. Instead, the authors write, “Currently, COEs serve a total client cohort of over 180,000 across 28 facilities. In the initial years, the U.S. Government (USG) will provide financial support for clients; over time, user fees generated by COEs will become the primary source of funding for sustaining their services.” Failure does not really seem to be an option. Health insurance schemes are more acceptable to the Ugandan population than user fees. Members of Parliament and civil society traveled to Ethiopia to see how that country’s scheme worked. In a follow up report, a veteran civil society group recommended allowing the “health insurance ecosystem to grow organically and [to] keep reviewing the law and regulations as this growth takes root.”17 One study found that more than three-quarters of Ugandans were willing to join a health insurance program.18 However, coverage of community-based health insurance is minimal, as is coverage of any kind of insurance—including private plans.19 A national health insurance scheme bill has been stalled for several years and presently sits with President Yoweri Museveni.20 Community-based health insurance scheme that do exist are expanding in number, but losing enrollees. Between 2022 and 2026, the number of community-based health financing schemes across the country increased by 42 percent, while the number of people enrolled decreased by nearly 11 percent.21 None of this means that community-based health insurance should not happen in Uganda—or that people do not want insurance. It doesn’t even mean that user fees and waivers won’t ever work. But there is highly relevant evidence from Uganda and the surrounding region that it is quite optimistic to describe community health insurance and user fees as central supports for sustainable financing in any sector of the health system. And now for the best-case scenario In the best-case scenario22, the Ugandan approach does exactly what it sets out to do, and so does the Liberian fee structure and revolving pharmacy fund—though I’ve not confirmed that these are in the MoU. In one best-case scenario, Uganda is an outlier, and user fees and community health insurance are not recurrent pillars of self-sustaining financing in other countries’ implementation plans. In another best-case scenario, all countries that include these strategies enjoy success beyond anyone’s evidence-informed wildest dreams: reliable funding generated by health care users fees, great health care outcomes for everyone, no exacerbation of inequities, no crippling household debt. No sold land, repurposed school tuition or high-interest loans. In the best-case scenario, not one of the hundreds of thousands of Ugandans living with HIV receiving antiretrovirals from 491 PNFP facilities misses a refill or leaves care because of user fees or community health insurance premiums. This is the best-case scenario for these people for their own health, and for their families. It is also the best-case scenario if Uganda wants to stay on the path to eliminating HIV as a public health threat. According to the country’s most recent data, 96.5 percent of people living with HIV on antiretrovirals are virologically suppressed. Epidemic control depends ensuring that 95% of people living with HIV know their status, 95 percent of those individuals are on ART, and 95% of those individuals are virologically suppressed. Uganda is still struggling with the first “95"—a frankly abysmal 85.3 percent. If HIV epidemic control and the attendant prevention of new infections, avoidable suffering and premature death matter, the country cannot afford to lose any clients who are currently in care.23 As I write this a couple hours before the polls close for the US elections in the city I live in, I say with soul-deep sincerity: I am rooting for the best-case scenario. I think it’s safe to say that we all are.24 I think it’s also safe to say that if the US and co-signatory governments have inked plans that lead to successful expansion of community health insurance and strategic use of user fees, we all would like to know, now, so that we don’t miss the opportunity to celebrate when success happens. The implementation plan narratives have to enter the public domain. They are the fullest expression of a strategy co-created by two governments. There are assumptions and details that people living in the US and co-signatory countries need to understand that are not available in the MoUs or, to date, in the Congressional Notifications. Some of these details can help other countries that are, as I write this, still working on implementation plans. Others, like a solid count of how many other countries have plans for expanding user fees or health insurance, are important for regional and global health architecture reform initiatives. No matter how this election night turns out, there will be a slew of new Congressional member orientations, briefings and talking points papers in the next few months. Release of implementation narratives should be a bullet point in every context that AFGHS is discussed. These documents can be redacted so that procurement sensitive information isn’t disclosed. There is much more historical precedent for sharing such documents than there is for relying on user fees to fill health financing gaps. Let’s look at the information together so we can hope for the best and prepare for, you know, the other thing. Alt text: A substack first: a bicep selfie! It’s my arm - peachy-white skin, black shirt (flannel, notch neck, too hot for this appallingly balmy November weather, if you’re wondering) and a sticker that says I VOTED 2026. Beige letters on red for I voted. Beige on blue for 2026. You bet I did.25 In your wildest dreams. Subscribe 1 This is a really, really rich 95 page document. There are fascinating ideas and detailed plans in it. It is all worth reading AND I have, in this post, highlighted an instance of content that could pose challenges and certainly posits success of strategies that haven’t worked before. I would love to hear what readers’ see that’s interesting and should be lifted up as something to check for in other implementation plans. I will also shortly be adding a static page to the substack site where implementation plan documents will live. I will put the url into this footnote and it will also be there on emilybass.substack.com by the end of the week. Uganda Implementation Narrative Section 4 April 22 2026 Draft 1.51MB ∙ PDF file Download Download 2 User fees are costs charged for visits, labs, medicines or other health services, usually at the time they are provided. Community health insurance, or community-based health insurance, is what the World Health Organization calls “micro insurance,” which is health insurance targeted at low-income people. 3 As usual (by which I mean always), please prove me wrong. 4 https://smartnewsliberia.com/liberias-ministry-of-health-announces-2025-hospital-service-fees-for-public-facilities/?utm 5 https://moh.gov.lr/news/2025/grand-cape-mount-leaders-residents-embrace-new-community-pharmacy-program/?utm 6 https://www.christianitytoday.com/2026/09/hiv-usaid-pepfar-africa-foreign-aid-cuts-mission-hospitals/?utm 7 https://gh.bmj.com/content/10/11/e021270 8 https://www.who.int/news-room/fact-sheets/detail/community-based-health-insurance-CBHI 9 https://pmc.ncbi.nlm.nih.gov/articles/PMC2827475/ 10 https://pmc.ncbi.nlm.nih.gov/articles/PMC10861328/#b3-jpmph-23-110 11 https://pmc.ncbi.nlm.nih.gov/articles/PMC527704/ 12 Same citation as the footnote 2 - the article is called “Learning from failed health care reform in Uganda.” To which I say: If only. If. Only. 13 There is a whole taxonomy of user fees to be aware of, if not commit to memory. Out of pocket costs are everything that someone pays for themselves. In this Stack, user fees are planned and policy-supported out of pocket costs. There are also out of pocket costs that people pay to buy drugs or receive tests or health care assessments that would be free if the drugs were on the shelves, or the machines or kits were available, or the staff were on site. A user fee is usually designed to be modest, pegged to willingness to pay, and may be waiveable at the point of care for anyone who is unable to do so. The costs for things that would otherwise be free are whatever the market will bear and people either have to pay them or go without. Out of pocket costs for services and stuff that aren’t available in public facilities are different again from bribes or unofficial fees that some health workers may impose, even though most are indefatigable, tireless and tired, and devoted to their clients. 14 For the record—which really is these footnotes—I would give a whole stack of fridge magnets for a systematic analysis of the economic and social impact of the Mass Unemployment Event in AFGHS countries among the very people who used to be able to afford and cover user fees, both for themselves and vast family networks. Locally employed USAID technical staff, house cleaners, caregivers, drivers and technicians were financial anchors for cousins, friends, friends’ children, friends’ childrens’ cousins, teachers, pastors, neighbors and so many other kinds of kin. Aid recipients lost direct funding; many other people who had not been aid recipients, but parts of the elaborate care webs that function as safety nets for so many people, lost crucial support too. And that’s even before we get to the people who worked at the hotels and restaurants and bars where people employed by the US and its implementing partners used to spend disposable income. Those businesses have lost revenue; those folks have lost jobs. It will be some time coming—and someone will have to fund this work—but I do hope it happens. And I hope, as usual, to be proven wrong. 15 https://eprcug.org/blog/how-out-of-pocket-healthcare-costs-keep-driving-ugandans-into-poverty/ 16 Another straight-to-the-point journal article title. Households experiencing catastrophic costs due to tuberculosis in Uganda: magnitude and cost drivers. https://pubmed.ncbi.nlm.nih.gov/32938411 17 https://www.cehurd.org/download/technical-policy-brief-on-community-health-insurance-scheme/?wpdmdl=13661&refresh=6ae9122f5d4ed1793659439 18 https://pmc.ncbi.nlm.nih.gov/articles/PMC10125197/ 19 https://pmc.ncbi.nlm.nih.gov/articles/PMC10861328/#b3-jpmph-23-110 20 https://ugandapost.news/uganda-to-make-health-insurance-mandatory-by-2026/ 21 https://shu.org.ug/download/235 22 With a nod, tip of the stack hat, and wag of the Mercoon tail to a deeply valued reader who told me that I have a tendency to speculate about the worst-case scenarios a little too much of the time. 23 https://news.mak.ac.ug/2026/10/uphia-2025-shows-ugandas-hiv-status-awareness-gap-despite-strong-treatment-outcomes/ As you’ll see in the next footnote, I’ve already written a subSubstack on another topic, so I will be brief with regard to the study referenced in this article. The Uganda Population-Based HIV Impact Assessment, or UPHIA, will never happen in this way again. For more than a decade, PHIAs have been supported by the US government as a way to generate accurate estimates of country progress on key HIV indicators. They are a holdover from the PEPFAR program that was laser focused on ensuring US taxpayer dollars subsidized progress in pandemic control. There may be other population-level surveys and the data may even be publicly released, as the entire set of FY2026 MER data have not. But PHIAs will never happen again. If you’re wondering whether the estimates of HIV progress at country level might get less reliable….you’re not alone. 24 Ooh baby, I hate “we” in almost all forms. But sometimes I go there, when I am looking for company, which I am. Because this Stack moves into the somewhat-uncharted territory of assessing what the implementation plan narratives may suggest about co-signatory countries’ roles and responsibilities to the people living within their borders. The MoUs, specimen and data sharing agreements were templates. Countries’ answers fit into pre-specified questions that did not include, “how are you going to fill financing gaps and stabilize your health system as this plan unfolds?” In contrast, the implementation narratives are open form—the product of co-creation between the two governments. Co-creation can mean lots of things, but nothing leads me to believe that implementation plans are ghost-written by the US government, or that contents were imposed by the US counterparts. Instead, I think the parts of the plans that read like country government initiatives are endorsed, if not initiated by, those governments. For instance, the Ugandan implementation plan narrative describes plans for revenue-generation through fees charged for equipment calibration, repair and maintenance provided through Uganda’s National Equipment Calibration Laboratory, and laboratory accreditation through the Uganda National Accreditation Service (UGANAS), targeting private sector, PNFP, research and academic clients. That’s super specific and also quite ambitious. It doesn’t read like an American idea. There’s also a provision for solar panels, and other stuff that feels country owned and driven. This is where it gets interesting. If co-creation is the case, then both the US and co-signatory governments are accountable for the contents and the outcomes. Most discourse about AFGHS to date has focused on the decisions that America has made, or demanded that other countries make. The AFGHS architects have monopolized the hot seat. As they should, in so many ways. America absolutely created the conditions under which countries needed to come up with health financing strategies to fill unanticipated, catastrophic funding gaps. And with not-too-long a lens, we can look back and see that America is also on the hook for its role in the Bretton Woods institutions that made user fees and health system fiscal austerity conditions of loans during the era of structural adjustment. But in the here and now, it is not at all clear to me that the US is requiring Uganda or any other country to implement specific approaches to sustainable financing. Instead, it is as the authors of that paper up in footnote 6 suggest: African governments have agency. As implementation plans roll out—whether or not the narratives are shared—it will be important to understand what this agency looks like and what it means for people, including the poorest of the poor. And it will be important to figure out how to talk about it safely, respectfully and critically in places other than the literal and metaphorical footnotes. 25 This week’s song is “Once upon a time” by the Moody Blues. (I know, this is gonna be a weird, largely banger-free end of 2026 playlist. HMU with requests.) AND please do watch the video and appreciate the truly amazing opening sequence—a drum kit wasteland, a coupla plastic bags, a bit of sand. Sort of like the hill where fiscal austerity policies that put costs on health care users might go to perish. But then there’s a lady with amazing hair. It’s worth it.
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CVS Health to split in two, separating pharmacy business from insurance
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World Conference on Traditional Medicine 2026 delivers landmark outcomes for global health
Expert Committee Meeting members at the World Conference on Traditional Medicine 2026© WHOThe World Conference on Traditional Medicine 2026 concluded in Beijing on 18 October with several key outcomes aimed at strengthening global cooperation for health and well-being. These included the adoption of the Beijing Initiative on the Conservation and Sustainable Use of Traditional Medicinal Plant Resources, the promotion of the New-Era Shennong Herbal Project, and the publication of the Report on artificial intelligence empowering global traditional medicine development (2026). The conference also marked the establishment of the Global Alliance for Traditional and Integrative Medicine (GATIM) to foster international scientific collaboration.The biennial conference, held on 17–18 October at the China National Convention Center in Beijing, was co-hosted by the People's Government of Beijing Municipality, the National Health Commission, the National Administration of Traditional Chinese Medicine, and the National Medical Products Administration. WHO joined the Conference as co-sponsor, aligning with the country’s Healthy China initiative, which is overseen by President Xi Jinping. The initiative seeks to expand inclusive, high-quality health services, drive innovation in traditional medicine, and reinforce the principle that a healthy population is fundamental to national prosperity and strength. H.E. Li Qiang, Premier of the State Council of the People’s Republic of China, addressed the opening ceremony, emphasizing the critical role of traditional medicine as a unique force in safeguarding human health and advancing civilization. "Traditional medicine has followed a distinctive path of development through long-term practice," Li stated. He called on the international community to strengthen cooperation, make better use of global traditional medicine resources, and jointly address challenges to human health. Premier Li also highlighted the necessity of harnessing science and technology to accelerate the innovative development of traditional medicine. He announced that China would promote the digital and intelligent transformation of Traditional Chinese Medicine (TCM) and encourage active participation from both Chinese and foreign research institutions and enterprises. Furthermore, he expressed China's willingness to expand pilot programs to open up the medical service sector and work with all parties to advance the development of Belt and Road medicinal resources conservation centre.Addressing the Conference participants via a video message, Dr Tedros Adhanom Ghebreyesus, WHO Director-General, said, "This is not a choice between tradition and science. It is about bringing knowledge systems together through research, innovation, regulation and quality assurance. We need stronger evidence on what works, for whom, and under what conditions."Dr Saia Ma'u Piukala, WHO Regional Director for the Western Pacific, addressed the opening session, underscoring the importance of integrating traditional medicine into mainstream health systems in line with the call of the WHO Global Strategy on Traditional Medicine 2025–2034. In the closing session, Dr Shyama Kuruvilla, Director of the WHO Global Traditional Medicine Centre, expressed appreciation for the achievements of the conference, where different world views and scientific and programmatic advances were exchanged with a clear focus on practical action to advance traditional medicine for the health and well-being of people and the planet.The conference, held under the theme Technology Empowerment and Integrated Development: Advancing Traditional Medicine for All, featured a government forum, ministerial round table and eight parallel forums to advance all four objectives of the WHO Global Traditional Medicine Strategy 2025–2034: strengthening evidence, ensuring safety through regulation, integrating traditional, complementary and integrative medicine into health systems, and realizing its value through action across sectors.Over the two-day event, nearly 2000 participants, experts and scholars from 103 countries and areas, including 16 ministerial-level health officials, delivered over 150 high-level speeches and reports. Discussions covered key areas such as the integration of traditional medicine into international health systems, evidence-based development, drug regulation and the application of artificial intelligence in traditional medicine.
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Inside Business 2026 Top Forty Under 40: Charles Bruce Jr., Drucker + Falk
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Over 400 people detained in drug raid on Jalan Sultan Ismail entertainment centre
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Hackensack Meridian Health Becomes First Hospital Network in the Northeast to Administer Pixclara®, the Only FDA-Approved PET Imaging Drug for Brain Cancer
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A drug-free diabetes treatment? An implant lowers blood sugar in mice
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Dassault Systèmes Completes ArisGlobal Acquisition to Expand Life Sciences AI Platform
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A golden age of science is coming
It’s almost hard to remember, but just a few years ago, a lot of very smart people thought that science was in terminal decline. Respected researchers were writing papers with titles like “Are Ideas Getting Harder to Find?”, “Papers and patents are becoming less disruptive over time”, and “Slowed canonical progress in large fields of science”. In 1996, science writer John Horgan even published a book called The End Of Science: Facing The Limits Of Knowledge In The Twilight Of The Scientific Age. The fundamental idea was that the Universe only has so many insights to discover, and that we’ve picked the low-hanging fruit. It was the idea that Joseph-Louis Lagrange expressed when he said that “we cannot find more than once a system of the world to establish.” As the big ideas and the simple ideas get mined out, we’re forced to throw ever more brains at the mysteries of nature just to keep scientific progress going at a fraction of its old pace: It looked like science was hitting a wall. Then along came AI. It’s far too early to tell how much AI will eventually speed up the growth of total factor productivity. But already we can see signs of a speedup in science. Anthropic Founder Jack Clark assembled some of the hopeful data points in a recent lecture: [ Dror Poleg@drorpoleg "If you pick different parts of science, you see the same pattern show up: Progress is accelerating, and it has started to accelerate in the last two years." Jack Clark @jackclarkSF I’m speaking at the IMF in an hour about the singularity and why I believe it has begun and the choices we'll need to make. Watch live here: https://t.co/Hj9HzcXx5h 6:08 PM · Oct 18, 2026 · 21.2K Views 2 Replies · 10 Reposts · 123 Likes ](https://x.com/drorpoleg/status/2111882070376980529) Anthropic is accelerating its investment into drug discovery, and is already announcing some impressive preliminary results: [ BioTender@Junioryu136689 BREAKING: Anthropic unveils early results from six Claude-powered drug development collaborations. • 70% shorter CAR-T signaling domain • ~35,000 antibody designs • >10× tighter antibody binding • 89% less batch-record review time Still largely preclinical. Anthropic @AnthropicAI Over the past few months, Anthropic scientists have engaged in deep research partnerships with six organizations developing new medicines. We've also begun drug discovery efforts of our own. In doing so, we’ve learned much more about how Claude can support the many stages of 9:43 PM · Oct 27, 2026 · 11.2K Views 3 Replies · 24 Reposts · 205 Likes ](https://x.com/Junioryu136689/status/2115197821150495150) Claude also appears to be enabling rapid progress toward a treatment for food allergies. OpenAI, meanwhile, announced a possible breakthrough treatment for neurodegenerative disease. Meanwhile, Google Cloud Chief Scientist Pushmeet Kohli has a list of recent scientific advances that have been enabled by its new Gemini model, including breakthroughs in nuclear fusion reactor design, rare disease research, and quantum computing: [ Pushmeet Kohli@pushmeet Gemini 4 Argon is a step change in model performance. In recent weeks, it has had a transformative impact on the Science projects in our team at @GoogleDeepMind and our external collaborators, and helped make a number of remarkable advances across scientific disciplines. 🧵👇 4:47 PM · Oct 13, 2026 · 36.5K Views 8 Replies · 41 Reposts · 497 Likes ](https://x.com/pushmeet/status/2110049807385702623) But as cool as these stories sound, they’re just very minor, preliminary efforts. There are a number of reasons to think that AI is going to propel us into a golden age of scientific discovery. That age might not last forever — AI might still run into diminishing returns eventually. But the next few decades are probably going to be an absolutely amazing time for human science. The number of “effective researchers” is no longer limited The most important input into science is scientists themselves. Until this year, that meant human brains — talented, highly trained human brains. The number of trained human brains could be increased by sending more people to grad school, but only to a point — the smartest people tend to be sent into the hardest research fields first, and if you 10x the number of researchers, the average quality will go down. This constraint was already starting to bite, as Ekerdt and Wu argued in 2024: We argue that a substantial portion of the downward historical trend in U.S. research productivity is a composition effect resulting from self-selection in researcher ability and the dramatic expansion of the research sector…[W]e find that this composition effect has lowered average researcher ability by between 37% and 53%[.] And of course, low fertility was making the problem worse, because fewer children meant fewer people who were able to become future scientists. AI just blows up this constraint completely. If an AI agent can function as an autonomous researcher, there’s no constraint on the number of researchers in the world — you can just build more of them, by building more computer chips and data centers that enable the running of more AI agents. Whether or not massive hordes of agents can collaborate to solve individual problems much faster, increasing the number of agents allows them to tackle many different research questions in parallel. What’s more, these AI “researchers” can be trained incredibly quickly compared to human beings. A human scientist takes decades to train, and more years to reach the frontier of their research field by diligent reading and conversation. This is the “burden of knowledge”, and it’s commonly believed to be one reason ideas have been getting harder to find — by the time human scientists can get up to speed, they’re often so old that their ideas are no longer novel. AI just annihilates this constraint — it can assimilate the entire literature and reach the frontier of research extremely quickly, and it can also tell human scientists where the frontier lies without forcing them to discover that for themselves. It can also pivot to new research directions more easily than humans can. And there’s also a self-reinforcing economic cycle here. Because scientific advances enable higher GDP, they enable more resources to be invested into the creation of yet more electronic “scientists”. Now that doesn’t mean the amount of scientific research goes to infinity — there may still be some essential bottleneck task that human researchers are still needed to perform. There are some indications that AI’s progress on open-ended conceptual research tasks is slower than in other dimensions, and it may be that humans are still needed to provide some of this long-term conceptual thinking. I’d bet against this being true for much longer, but it might be true for a long time. Even in this most “pessimistic” case, though, the amount of effective capital that scientists can use to leverage their work just went up by a lot. AI eliminates the theory bottleneck Science proceeds by an iterative process of theory and experiment. The theory part of that cycle is typically short, but non-trivial — it took a couple of years after the blackbody radiation spectrum was observed for Max Planck to come up with the quantum hypothesis to explain it, and decades longer before quantum theory as we now know it was created. It took about a year for Watson and Crick to figure out the shape of DNA after the requisite data was gathered. AI will basically eliminate the theory bottleneck entirely — or at least shorten the turnaround time between experiment and theory by an order of magnitude. AI is an absolute beast at math. Recently, an OpenAI model solved some of the most important open problems in computer science, math, and theoretical physics, and no one even batted an eyebrow because that sort of triumph is becoming increasingly commonplace. One of those solutions was a proof that the Standard Model of Particle Physics could be mathematically well-defined — a problem that human theorists had so far been unable to tackle. Not all research relies equally on theory, but understanding novel experimental results almost always involves some important component of either mathematical or spatial reasoning. That part of the task has now been made much, much faster. And on top of that, science is now open to a greater number of humans who aren’t naturally good at theorizing. AI can read the whole literature Much of the work of human scientists involves reading and understanding endless amounts of papers and going to endless conferences and seminars. The purpose of that work is to understand the existing scientific literature. Understanding the literature allows scientists to do the following things: Come up with new ideas for hypotheses to test Avoid doing research that someone else has already done Synthesize approaches from different areas or fields AI can reduce this effort to almost zero. Consider this excerpt from OpenAI’s blog post about their new research into neurodegenerative disease: The team divided the analysis among thousands of AI agents powered by GPT‑Rosalind, an approach we call distributed biological reasoning. The agents examined a whole-brain CRISPR atlas…a dataset showing how gene disruptions affect different types of cells across the mouse brain. Each agent investigated a gene disruption, analyzed cellular responses, searched scientific literature, and proposed explanations for the results. Their reports were combined into a reasoning atlas linking genes, cellular effects, relevant publications, and possible biological mechanisms. The research team estimated that comparable human analysis and literature review, conducted one perturbation at a time, would take months to a year. The agents reproduced findings from human analyses while uncovering additional leads. Their assessments of novelty and scientific value also aligned with judgments from blinded human experts. These findings help prioritize further experiments needed to test the proposed biological mechanisms. Some of these insights point to new leads for understanding brain disease. [emphasis mine] This is one case in which parallel work by a large number of agents really does make a huge difference: [ Haider.@haider1 this is actually insane openai deployed thousands of GPT-Rosalind agents to analyze millions of mouse brain cells in 32 minutes, work that could take human researchers months to a year also the agents uncovered new leads for brain diseases like Alzheimer's and Parkinson's OpenAI @OpenAI GPT-Rosalind surfaced a new lead for drug discovery: could restoring cholesterol transport protect neurons from degeneration? DCTN1 is a gene linked to Perry syndrome, a rare neurodegenerative disorder. In mouse-brain data, disrupting it increased expression of genes involved in 2:41 PM · Oct 21, 2026 · 51.5K Views 26 Replies · 95 Reposts · 1.26K Likes ](https://x.com/haider1/status/2112917197903540516) Not only does instantaneous literature review vastly speed up the research process, but it allows AI to make novel conceptual leaps from combining approaches from wildly different fields of research. AI regularly does this in math research, combining results, approaches, and theorems from far-flung places that no human mathematician would have thought to combine. It can do it in science, too. Much of scientific innovation, historically, has been “recombinant” innovation — scientists applying insights from one field to another. With AI, essentially all research is now cross-disciplinary — AI can read not just the literature on a particular subject, but the literature on a million other subjects that might have produced useful techniques or insights for the problem at hand. Superscience So far, all of the factors I’ve listed are ways that AI can speed up science as it’s already done. I’ve basically described how AI can send gigantic hordes of superhumanly fast, superhumanly well-read, superhumanly mathematically gifted researchers to re-accelerate scientific discovery. But it’s also possible that AI will enable types of discovery — and ways of understanding the natural world — that no network of humans, no matter how large or how brilliant it was or how long it had to work, would ever be able to discover. In a post back in July, I wrote about how that might work: What if there are lots of…aspects of the Universe that [are] too complex to understand in terms of simple laws, but not so complex that they just dissolve into unknowable chaos? It’s possible that we can reliably control these complex phenomena with AI, even if we never reduce them to the kind of principles that we can teach a grad student in a textbook… Another way of saying this is that there may be laws of the universe that humans can’t understand but AI can. I call these “cloud laws” — causal regularities that can be exploited by technology, but which are too diffuse and complex for an individual human being to either intuit or communicate… Perhaps social sciences like economics, sociology, and political science obey similarly complex regularities, and AI can help us find them. Perhaps there are physical processes — plasma, or topological materials, or aerial turbulence, etc. — that obey cloud laws instead of chaos?… [H]uman collaboration is bottlenecked — it’s limited by our ability to intuit patterns at an individual level, and to communicate these patterns from one individual to another. AI, being a computer, just doesn’t have this sort of limitation; it can work with vast, diffuse patterns without having to break them into pieces or simplify them in order to compress them into the tiny pipelines of person-to-person explanation… If much of the Universe turns out to be ruled by cloud laws, we could be on the precipice of a scientific renaissance. In order to discover cloud laws, AI will need huge amounts of data about the natural world. AI figured out human speech by assimilating essentially all of the text humans have ever written. If it’s going to figure out hidden patterns in biology, neuroscience, materials science, etc., it’s going to need similarly massive amounts of data from physical instruments. That data will be far, far more than humans — individually or collectively — would be able to parse, label, characterize, or model. But AI was built to do this. If scientists simply build huge arrays of sensors to measure complex phenomena like the brain, the cell, the economy, etc., they may be able to feed this flood of data to AI directly and bypass human cognitive intermediation entirely. AI would then learn about the world directly, and it might learn things that humans never could. This “superscience”, if you want to call it that, would actually go beyond the kind of science humans have done heretofore. Many of the technologies it yielded would be beyond human comprehension — indistinguishable from magic. But to the AIs, they would make perfect scientific sense. In any case, it seems clear that the scientific slowdown that threatened human progress will now be delayed — at least for a while. Unless humans have somehow found most of the actual exploitable regularities in our Universe, we’re about to enter a new golden age of science. Subscribe Share
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2026-2027 Audree V. Fowler Fellows in Protein Science
Graduate students Lenka Milojević (Zhou group), Akshaya Narayanasamy (Lindert group), Sarah Singleton (Conway group), and Janet Zhong (Feigon group) have been selected as 2026–27 Fowler Fellows and shared their research at a special event on Oct. 13, 2026. 2026-27 Fowler Fellows – Sarah Singleton, Lenka Milojević, Janet Zhong, and Akshaya Narayanasamy. Akshaya Narayanasamy and Prof. Steffen Lindert. Sarah Singleton and Prof. Stuart Conway. Janet Zhong and Prof. Juli Feigon. About the 2026-27 Audree Fowler Fellows in Protein Science Lenka Milojević is a fifth-year Biophysics Ph.D. candidate in the lab of Professor Z. Hong Zhou at UCLA. As an undergraduate at Maastricht University, she studied the structural basis of Mycobacterium tuberculosis virulence and amyloid-β fibril nucleation in the lab of Professor Peter Peters. She completed her bachelor’s thesis research at UCLA in the lab of Professor David Eisenberg, focusing on amyloid disaggregation, before beginning her doctoral studies. In the Zhou lab, Lenka uses cryo-electron tomography to visualize and characterize membrane-associated protein assemblies across a range of viral and cellular systems. Akshaya Narayanasamy is a fifth-year Ph.D. student in the Department of Chemistry and Biochemistry at UCLA, mentored by Professor Steffen Lindert. She earned her B.S.-M.S. in Chemistry from the Indian Institute of Science Education and Research, Thiruvananthapuram, where she worked in Professor Mahesh Hariharan’s lab investigating how single-atom substitutions influence crystal packing and charge transport behavior. She received her M.S. in Physical Chemistry from The Ohio State University before moving with the Lindert lab to UCLA. At UCLA, Akshaya develops integrative modeling methods that combine deep learning and Rosetta with experimental data, such as ion mobility mass spectrometry and cryo-EM, to improve protein structure prediction. Her current work focuses on developing an experimentally guided diffusion model and designing de novo protein binders with potential antibacterial activity. Ultimately, she aims to bridge AI-based structure prediction and experimental data to make computational protein models more reliable for drug discovery and therapeutic design. Sarah Singleton is a 4th year BMSB student, working in Professor Stuart Conway’s lab. She earned her B.S. in Biochemistry at Simmon University (Fenway, MA). Her research is centered on drugging the previously undruggable class of proteins—transcription factors. Zinc finger (ZF)-containing transcription factor proteins typically contain multiple ZF motifs, but little is known about the principles that govern the recognition of multi-ZF arrays by immunomodulatory imide drugs (IMiDs). In a multi-ZF array that contains several potentially targetable ZFs, which will be accessible and why? How does the surrounding protein architecture inform IMiD recognition? Sarah’s research aims to utilize her findings on the fundamental principles of ZF recognition to design IMiD therapeutics for transcription factors involved in health and disease. Janet Zhong is a fourth-year BMSB student, working in Professor Juli Feigon’s laboratory. She received her BSc and MRes from Imperial College London. At UCLA, Janet combines cryo-electron microscopy (cryo-EM) and biochemical approaches to investigate how proteins and RNAs assemble into ribonucleoprotein structures. Her research focuses on telomerase, the enzyme that maintains chromosome ends, with interests in its structure, assembly, and mechanisms. She has also worked on capturing the cryo-EM structure of a small bacterial non-coding RNA called raiA motif RNA. About Dr. Audree Fowler A strong supporter of the basic sciences and medicine at UCLA, alumna Dr. Audree Fowler (B.S. ’56 chemistry, Ph.D. ’63 biochemistry) established the Audree V. Fowler Fellows in Protein Science in 2008. Fowler was Director UCLA Protein Microsequencing Facility from 1984-1999 and is a Researcher Emeritus of the UCLA Department of Biological Chemistry. She is one of the first four women to receive a Ph.D. from the UCLA Department of Chemistry & Biochemistry. In 2018, the women were awarded the department’s 2018 Alumni Legacy Awards in recognition of their achievements in life, and generous support and service to UCLA. “The sciences gave me a great life. Now I want to help others have access to the same opportunities I enjoyed,” Fowler explained when she established the Fowler Fellowships endowment. Applications for the fellowships are solicited from graduate students in the Molecular Biology Interdepartmental (MBI) Ph.D. Program, Biological Chemistry, and Chemistry & Biochemistry Departments. In addition to presenting their research at a special seminar, the recipients each receive a $5,000 award. Previous Fowler Fellows from the UCLA Department of Chemistry & Biochemistry 2025-26 – Nikki Cheung (Clubb Group), Jonathan Jih (Zhou Group), Eileen Olivares (Loo Group), and Lily Taylor (Rodriguez Group) 2024-25 – Andrew Goring (Clubb lab), Eric Pang (S. Clarke and Rodriguez labs), and Miranda Villanueva (Backus lab) 2023-24 – Alexandra Turmon (Backus lab), Cindy Wang (S. Clarke and C. Clarke labs) 2022-23 – Cody Gillman (Gonen lab), Declan Evans (Houk lab), Troy Lowe (S. Clarke lab), Ashley Julio (Backus lab), and Alex Stevens (Hong Zhou lab) 2021-22 – Weixian Deng (Wohlschlegel/Plath labs), Yi Xiao “Sean” Jiang (Eisenberg lab), Maria Flores (Rodriguez lab), Carter Lantz (Loo lab), and Logan Richards (Rodriguez lab). 2020-21 – Janine Fu (Loo lab), Calina Glynn (Rodriguez lab), and Jiahui Lu (Eisenberg lab) 2019-20 – David Boyer (Eisenberg lab), Orlando Martinez (Clubb lab) and John Muroski (Loo lab) 2018-19 – Scott McConnell (Clubb lab), Kevin Murray (Eisenberg lab), Rebeccah Warmack (S. Clarke lab) 2017-18 – Michael Hughes (Eisenberg lab), Yuxi Liu (Yeates lab), Kanishk Jain (S. Clarke lab) 2016-17 – Brendan Amer (Clubb Lab) and Jeff Vinokur (Bowie Lab) 2015-16 – Henry Chan (Feigon lab), Smriti Sangwan (Eisenberg lab), Nicholas Woodall (Bowie lab) 2014-15 – Dan McNamara (Yeates lab) 2013-14 – Alex Jacobitz (Clubb lab), Alexander Patananan (S. Clarke lab), Carly Ferguson (Loo lab) 2012-13 – Letian Xie (C. Clarke lab), Anni Zhao (Eisenberg lab) 2011-12 – Timothy Anderson (Clubb lab), Soohong Kim (Weiss lab) 2010-11 – Zeynep Durer (Reiser lab), Cecilia Zurita-Lopez (S. Clarke lab) 2009-10 – Luki Goldschmidt (Eisenberg lab), Kristofer Webb (S. Clarke lab), Sheng Yin (Loo lab) 2008-09 – Nathan Joh (Bowie lab), Neil King (Yeates lab) Photos courtesy of Helen Houldsworth, the Molecular Biology Institute.
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Science Begins With Wonder and Sometimes With a Salamander.
The Bar Harbor Story is generously sponsored by the Don & Beth Straus Center at Birch Bay Village. BAR HARBOR—The children had come to see the axolotls, those odd little salamanders with pink frills around their heads and the remarkable ability to grow back what they lose. But also there were stickers. There were crafts. There was the kind of excitement that makes a roomful of kindergarteners forget, for a little while, that sitting still is ever a requirement. And then there were the animals themselves, alive in their clear cases at the MDI Biological Laboratory, where 12 children from Pemetic Elementary School got to meet the creatures they had been learning about in class. “Do you love them?” their teacher, Carol Null, asked. The answer came back in a chorus. “I do!” “I do!” “I do too,” Null said, smiling. “I love them even more now.” That was the thing about a day at the lab. Science was no longer a picture in a book, or a word on a classroom wall. It had a face, a tail, and a set of extraordinary powers. And for a child, sometimes that is where wonder begins. Sometimes learning about science is about stickers. Sometimes it’s about bright pink feathers and getting super excited about that glow in the dark. Sometimes learning about science is joy—pure and simple joy. That’s how it was October 28 at the MDI Bio Lab as Miss Hannah (known in the lab as Dr. Hannah Lust, director of STEM, undergraduate and graduate Training), other scientists, graduate students, and MDI Bio Lab staff, hosted 12 students from Carol Null’s Pemetic Elementary School’s kindergarten class. The 2.5-hour program created by Dr. Lust focused on axolotls, a species of mole salamanders, a superhero in the animal world: a superhero with some scientific-study worthy superpowers. One of those superpowers come from the axolotls’ ability to regenerate body parts, including entire limbs. But also, they’re cute. This fall, before coming to the internationally renowned lab nestled in Salsbury Cove, Null has been integrating axolotls into her class. They’ve been part of the kids’ vocabulary and their storytelling. They’ve been part of science. They’ve been part of the children’s learning about facts vs opinions. The Pemetic Elementary kindergarten students learn about invasive species and the impact on the ecology and one student related it to their dad, who lobsters, and his worries about green craps, an invasive species in Maine. “Are they bigger or smaller than you thought they’d be?” the children are asked after the scientists show them multiple see-through cases of axolotls, lined up on a table that they’re told not to jiggle. “Bigger!” “I think they’re bigger.” “Smaller!” The bio lab opening its doors to the collaborations and to students and families is a norm, but this is the first program of this kind. It’s meant to encourage kindergarten students about axolotls. But when the students come to the bio lab something else happens too—something beyond Null’s child-focused teaching—the students see science—and the regenerating creatures in real life. They do crafts. They speak with them. They meet people who know all about them: scientists and educators who talk to the kids like they’re equals. That’s a superhero power, too. Null speaks about meeting the kids where they’re at in her classroom, letting their interest and hearts lead her in their learning. That requires recognition of interests, of individuality, of empathy. Some would argue that’s a super power, too, but it’s also in those 12 students as they listen to the storybook, encounter those live axolotls, and hear about how axolotls might help advance society’s understanding of human health. As Eddie Seckeler (comparative animal models, CORE facility manager), carefully puts the axolotls on a cart and rolls them away, some of the children stop what they’re doing to watch. “Bye axolotls.” “Bye!” “Bye!” The axolotls are not just images in a book, Hello, I’m an axolotl by Hayley and John Rocco; they are real and cool. MDI Biological Laboratory scientists Dr. Prayag Murawala and Dr. James Godwin who both feature in the Roccos’ book. The kindergarteners get to meet them in real life, off the page, in the world, doing science. They learn from them, laugh with them. “The visit is about more than meeting an unusual animal. By introducing children to scientists working in their own community, the experience helps make science tangible and accessible. Students can see that science is not just something they read about in books or learn about at school. It is something real people do every day by asking questions, making observations and working to understand how the world works,” explains MDI Biological Laboratory Director of Communications Rebecca Woods. While the students make axolotl-related crafts around tables, graduate students and staff help out. Ryan holds up his construction paper setting and axolotl to show Omar Maged, a graduate student. “Do you like it?” Ryan asks, eyes wide, turning from his axolotl to look up at Omar. Omar studies the construction paper for a moment, smiles and says definitively, each word important. “It is beautiful.” Null says that she’s so thankful for all the “amazing” community partners that her school and her students get to interact with as they learn and grow and live, but emphasized how the MDI Bio Lab goes out of its way to create something meaningful, something that allows her young students to build their own agency, to know that they can be impactful in their community, to show them how how things they learn about in text is connected to themselves and their community. Woods explains, “Axolotls have an extraordinary ability to regenerate, or regrow, certain body parts, including limbs. Scientists study these animals to understand how regeneration works and what their biology might teach us about tissue repair and healing in humans.” The children enter the space for “a memorable introduction to a big scientific question,” Woods said. “How can some animals regrow body parts? The encounter encourages children to look closely, wonder about what they see and begin to understand how scientists use observations and experiments to investigate questions.” “For the students, the visit is an opportunity to explore a fascinating animal and meet scientists in their own community,” Woods explains. “For MDI Biological Laboratory, it is a chance to share the excitement of research, nurture curiosity, and help young learners discover that science begins with asking questions.“ At the beginning of the school year, Pemetic kindergarteners didn’t know what the axolotl was—at least not exactly—now they know all about the axolotl’s life cycle. “It’s different than a butterfly,” one student told Mrs. Null. It is. The change and knowledge might seem small**,** but it offers a glimpse of what happens when a subject moves beyond the pages of a book and into a child’s world. The children have been learning about butterflies at the Charlotte Rhoades Park and Butterfly Garden. At both the garden and the MDI Bio Lab, the children see the animals, meet the scientists who study them and at the lab encounter a question that researchers are still working to answer: how can some creatures regenerate body parts, and what might that teach us about healing in humans? They leave with gift bags, paper-plate salamanders, new things to wonder about and a connection between the science they learn in school and the work happening in their own community. The axolotls may be remarkable for their ability to grow back what they have lost. For these young students, the day offers something different: a chance to discover how much there is to ask, observe, and imagine. When Null’s students had time to use chalk and draw whatever they want, in the beginning of the year, they drew rainbows. Now? They’re using that chalk and choosing to draw axolotls instead. About MDI Bio Laboratory For more than 125 years, MDI Bio Lab has been a center for training and research in comparative biology. In the last two decades its biomedical research has focused on aging, regeneration, and environmental toxins. The Laboratory houses 11 research groups staffed by an international team of world-class scientists and graduate students. It also leads a statewide network of colleges, universities and research institutions that collaborate to provide training, research experiences and financial support to help young Mainers play a bigger role in today’s biomedical revolution. Located on Maine’s rugged coast, the Laboratory’s 100+ acre campus houses research facilities, cottages and dorms that house visiting scientists and students. It is also home to MDI Bioscience, a subsidiary working to design innovative techniques to speed the drug discovery process. The Bar Harbor Story is generously sponsored by Rick Osann Art. LINKS TO LEARN MORE NIH INBRE MDI BIOLOGICAL LABORATORY Pemetic Elementary School Hello, I’m an Axolotl Photos: Carrie Jones/Bar Harbor Story HELP SUPPORT THE BAR HARBOR STORY When we started The Bar Harbor Story, we didn’t know if anyone would read it. But you showed up. You shared. You sent tips. Now—over 400,000 views every month later—it’s clear: people here care about their community and each other. We’ve kept everything free because news should never be out of reach, but every one of our stories takes time to write, and your support keeps The Bar Harbor Story going. If you value our work, please consider a paid subscription, a founding membership, or a sponsorship. It truly helps us cover one more meeting, tell one more story, shine one more light. Even $5 a month makes a difference. Click here to become a one-time supporter now. Thank you so much for being here. Founding member information can be found here. Have questions about sponsorships? 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What has actually caused the decline in drug overdose deaths?
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Why 2026 Is a Health Care Election
_Ypsilanti, Michigan_THE MIDTERM ELECTION IS ABOUT a lot of things: gas prices and groceries, the spread of corruption, and the future of democracy. And yet, as much as any single issue, it’s about health care. You can tell by listening to all the Democrats talking about high deductibles, drug costs, and insurance companies as they campaign around the country. Or you can tell by reading all the public-opinion surveys in which voters consistently rank health care as one of their top concerns. But if you really want to know why this is a health care election, your best source isn’t the politicians or the pollsters. It’s the people on the front lines. One of them is Raymond Rion, a family medicine physician and executive director of Packard Health, a small network of clinics spanning Ann Arbor and Ypsilanti on the western outskirts of the Detroit metro area. Packard is what’s known as a Federally Qualified Health Center, where anybody can get care regardless of income or insurance status. And like similar safety-net providers all over America, for the past decade it has benefited directly from the Affordable Care Act. “We almost went bankrupt in 2011,” Rion told me in a conversation last week, recalling how in the old days staff at Packard would work the phones furiously to get supplies and find specialists who would take referrals. Now many more patients have either Medicaid or private coverage they’ve purchased through HealthCare.gov, the online marketplace that the law created, so that the proportion of uninsured patients has fallen from around one in three to one in ten. It’s a lot easier to find referrals for these insured patients, though thanks to the infusion of paying customers Packard can do much more on its own. In particular, Rion said, the organization has opened two new branches, started a pharmacy, begun offering prenatal services, and vastly expanded behavioral health care by bringing on a half-dozen new doctors, nurses, and case workers. Now a retrenchment is underway. Coverage options on the HealthCare.gov marketplace got more expensive because Donald Trump and the Republicans refused to renew temporary subsidies that had been reducing the price of insurance. On top of that, the first cuts to Medicaid as part of last year’s “One Big Beautiful Bill” are starting to take effect. Rion told me Packard has already laid off a provider in anticipation of less revenue next year.1 Patient volume is down, he went on to explain, in part because uninsured patients sometimes avoid care altogether out of fear a single visit will lead to more treatments with more bills. And postponing care in that way can have serious medical consequences, as his colleague Ron Romero told me. “So you have somebody with diabetes, their chronic condition isn’t getting cared for,” said Romero, who like Rion is a family physician. “Their sugars rise, and they end up having other medical problems. Their kidneys start to get damaged. They start to have eye damage. They increase risk for heart attacks and strokes. . . . They end up in the emergency room.” And things are likely to get worse. Partly that’s because next year most of the remaining Medicaid cuts will take full effect, throwing more people off coverage. And partly it’s because forces that have nothing to do with Trump or Republican actions are making medical care more expensive for everyone, including those with employer insurance and Medicare. That will lead to still more people delaying or skipping care, ending up in the emergency rooms, and putting yet more cost pressure on providers. Rion wasn’t taking a position on the election or political parties, he made clear. He was just describing the reality he sees around him: “The whole system is being pressured. Nobody is immune to this stuff.” He’s right. And here’s the thing: This has all happened before. We know happens next.
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In brief: Orlando Bloom, Elijah Wood joining 'The Gentlemen'
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Young students give new teachers infections; the daylight saving time debate; circadian depression; plus other stories with Vanderbilt Health sources
William Schaffner, MD, Professor of Preventive Medicine, was quoted by several news outlets about public health issues, including: Axios Nashville (flu season beginning early); Prevention (how long does norovirus last?); Education Week (how young students make new teachers sick). AAMC News posted a story about the debate about whether to eliminate the twice-yearly time change, and, if so, whether to permanently stay on standard or daylight time. Beth Malow, MD, director of the Vanderbilt Sleep Center, is quoted in the piece. A Men’s Health story on circadian depression, a type of depression caused by an out-of-synch internal clock in the brain, quotes Aaron Brinen, PsyD, Assistant Professor of Psychiatry and Behavioral Sciences. Michael Lester, MD, Assistant Professor of Medicine, was quoted in a Medscape story about treating chronic bronchitis with bronchial rheoplasty. Shravani Durbhakula, MD, Associate Professor of Anesthesiology, was quoted in a CNN piece about the drug cychlorphine. Art Dalley, PhD, Professor of Cell and Developmental Biology, emeritus, was quoted in a story in The Guardian about anatomical donation. The National Multiple Sclerosis Society quoted Subramaniam Sriram, MBBS, Professor of Neurology and Director of the Vanderbilt Multiple Sclerosis Center, in a story on its website about the differences in brain and spinal cord lesions in MS. (Note: some links may require registration or subscription)
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Phantom Blade Zero made $223M on Steam and PS5 in five days
Phantom Blade Zero was always going to be a hit. We’ve been banging on about it for months now. Well, the results are in, and Phantom Blade Zero has indeed been a hit. Yesterday, S-Game reported that Phantom Blade Zero has sold 4M copies. As of this morning, our estimates show that Phantom Blade Zero has generated $223M via 4.3M copies sold across Steam (3.1M) and PlayStation (1.2M). This instantly makes Phantom Blade Zero this year’s #10 new 2026 game by premium revenue across Steam, Xbox, and PlayStation – and without an Xbox release to boot. Want more free estimates and insights in your inbox twice a week? Subscribe below! Subscribe Combined, China, Taiwan, and Hong Kong account for 55% of Phantom Blade Zero’s copies sold – 56% of copies on Steam and 50% on PlayStation. But revenue is slightly different. Phantom Blade Zero actually made more revenue outside of China However, due to regional pricing, China, Taiwan, and Hong Kong account for a lower share of revenue, 45%. The three countries account for 40% of Phantom Blade Zero’s revenue on PlayStation, and 47% on Steam. This is due to regional pricing, which you can easily check in our platform: Using the $59.99 USD base price as a starting point, we can see that Phantom Blade Zero costs the equivalent of $40.31 in China (-32.8% of the US price) and $41.80 in Hong Kong (-30.3%). So while Chinese culture is at the heart of Phantom Blade Zero (in terms of theme and player base), it’s actually making more money in non-China markets. In fact, markets outside of China, Hong Kong, and Taiwan account for $123M in Phantom Blade Zero revenues via 2M copies. Even when we remove revenues from these markets from the analysis, Phantom Blade Zero remains a top 20 new 2026 title by revenue across Steam, Xbox, and PlayStation. Want more free estimates and insights in your inbox twice a week? Subscribe below! Subscribe In other words, Phantom Blade Zero is a global hit. It’s not all China – or even majority China, when it comes to revenues. The China spring board helped, but a successful State of Play and – more importantly – positive reviews helped this one land in other markets. Quality sells. China was hyped from the start, but Western players needed more convincing As we wrote back in August, China was always going to show up early for Phantom Blade Zero. Our daily Steam revenue data shows just that, and we can see when S-Game’s banging RPG won over players outside of China: On the day Phantom Blade Zero’s Steam pre-order button went live in mid-August, China accounted for nearly 70% of Phantom Blade Zero’s Steam revenue. The shares hovered around 68% throughout August. This is the hometown-hero effect we’ve covered in the past, with the home market committing first – almost sight unseen – on national pride and a lush-looking trailer alone. Then things get even more interesting. Following the State of Play on August 18, US daily revenue more than doubled (from $72K to $146K), China’s daily take nearly quadrupled ($237K to $892K), and the rest of the world’s revenues also more than doubled. As China spiked so much harder than the others, its share of revenue hardly moved, holding at around 68%. So the by-all-counts-awesome State of Play got non-China markets and the West interested (you can see daily spend jump), but it didn’t move the needle for overall revenue shares. Positive reviews were the Western tipping point. US daily revenue went from $106K on October 25 to $230K when the embargo lifted on the 26th, to $463K on the 27th, to $899K on the 28th. So nearly 8.5x more revenue in four days, boosted by the positive reviews and subsequent word of mouth. When Phantom Blade Zero launched on the 29th, things hit critical mass. On launch day, the US and the rest of the world combined out-earned China for the first time in Phantom Blade Zero’s whole pre-order history. You can see this unfolding pretty nicely in the revenue shifting shares, too. China’s lifetime revenue share sat at 68% in August and was still 65% as late as October 25th, but it dropped to 45% by November 2. Over that same period, the US nearly doubled its share from 10% to 18%, and the rest of the world climbed from 25% to 38%. Want more free estimates and insights in your inbox twice a week? Subscribe below! Subscribe That’s not to say that China sold less – far from it. The West and non-China markets just showed up later, won over by the reviews and word of mouth. However you look at it, Phantom Blade Zero has become one of this year’s highest-grossing premium games. Daily volume seems to be decelerating a bit (which is natural), so subscribe below for more updates on performance. Speaking of performance and deceleration… Gran Turismo 7 is one of PlayStation’s biggest earners While games like Ghost of Yotei, Helldivers 2, Astro Bot, Wolverine (2.7M now, by the way), and even Marathon and Saros tend to get all the headlines (we hold our hand up there, too!), there’s one PlayStation game from the past five years that’s earned more than all of these games: and it’s one that’s rarely talked about in enthusiast circles. Gran Turismo 7, which launched in March 2022, has sold 12.7M copies. This amounts to $840M in revenue, second only to Spider-Man 2’s $1.3B – if we’re talking PlayStation first-party for this generation. Gran Turismo 7 still brings in around 3M players every month (and between 400K and 700K active players per day). It’s also an evergreen seller every year. For example, Gran Turismo 7 generated: $189.7M in 2023 via 2.9M copies $161.3M in 2024 via 2.7M copies $119.1M in 2025 via 1.7M copies This year, Gran Turismo 7 has already sold 1.3M copies, generating $74.7M And there’s more laps to come Every December is comfortably GT7’s biggest month of the year (except launch), and the gap is widening there. December generated 2.1x a normal month in 2023, and by 2025 that had grown to 2.8x. Want more free estimates and insights in your inbox twice a week? Subscribe below! Subscribe As the typical months cool off with age, Christmas always holds strong, so the holiday period is becoming a bigger slice of Gran Turismo 7 yearly revenue. For Gran Turismo 7, the week around Christmas does 3x to 5x a typical week – three years running: Christmas week 2023: $14.7M (4.6x the year’s median week) Christmas week 2024: $9.3M (3.3x) Christmas week 2025: $8.5M (4.6x) These Christmas peaks happened at the full $59.99 (Gran Turismo 7 wasn’t discounted at all in December 2023 or December 2025). And although there was a discount late in December 2024, GT7’s peak week that year still happened at full price. You can really see why PlayStation hasn’t added this one to PlayStation Plus, eh? Say it after me: Subscriptions cannibalise premium revenue! On that note… Let’s take a quick look at how Gran Turismo 7 is doing versus its nearest competitor, Xbox console exclusive and long-running sim racer Forza Motorsport (released in 2023 as a reboot for the franchise, about 19 months after GT7). Forza Motorsport has sold around 1.3M copies across Xbox (75.4% for Xbox console and PC) and Steam (24.6%), grossing $89.9M across those platforms. Launch aligned, and on just PlayStation, Gran Turismo 7 had sold 10.2M copies, generating $676.1M, by that point. In other words, Gran Turismo 7 has sold the same number of copies this year as Forza Motorsport has sold since launch. When all is said and done, Gran Turismo 7’s 2026 revenues will have lapped Motorsport’s lifetime, too. It’s worth noting that Forza Motorsport was not released on last-gen consoles, and under a quarter of Gran Turismo 7’s revenue has come from PS4 consoles. Critically, Forza Motorsport is also on Game Pass, where nearly 7M players have accessed it. Meanwhile, the Forza Horizon series has been performing incredibly in terms of revenue. This year’s Forza Horizon 6 has generated $583.7M across Xbox and Steam despite Game Pass cannibalisation, and last year’s Forza Horizon 5 PlayStation port has generated $383.5M on PS5 alone. So two questions, then: How well is Forza Horizon 6 going to do when it launches on PS5 in January? Hit subscribe to get that in your inbox in January (which is in two months somehow!?) Subscribe 2. Open-world arcade Gran Turismo when? Also, if you like arcade racers, go and play Star Wars Galactic Racer. It rules. Like GOTY material, seriously. The last word Reply to this email – or reach out here – if you have any feedback for the newsletter – or want to request a game for us to cover. [Alinea Analytics boasts the most accurate PC and console estimates in the business. Game makers use our platform to understand their audience, keep an eye on the competition, monitor sales trends, and spot new opportunities. We equip game studios and financial institutions with accurate data and the confidence to make smarter, data-driven decisions. Want to talk about all things games market data? We’d love to chat!]
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