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Misaligned incentives plague our health-care system. Here’s how to make America healthy again

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The Trump administration has a laudable goal: to make America healthy again. This would entail improving nutrition and care to address chronic diseases so Americans can live longer and healthier lives.  

Unfortunately, despite spending more than other nations, having more advanced technologies, and having some of the world’s best caregivers, we are not able to take full advantage of these benefits because of the misaligned incentives that pervade our health-care ecosystem. In our system, providers and insurers often profit when patients require more treatment, not when they are and remain healthy.  

Misalignment leads to several negative results. One example is the disparity in life expectancy that can be as high as 20 years between counties in the U.S. In California, wealthy counties like Marin have a life expectancy of 85 while a host of poorer rural counties generate far worse outcomes. Another effect of misalignment is inefficiency, leading to hundreds of billions in wasteful government spending and $150 billion in health-care administrative costs alone. Lack of alignment also precludes the technological integration that AI and massive amounts of data have brought to other industries.  Finally, we saw the tragic effects of misalignment during the COVID-19 crisis, which exposed how unprepared our system was for a large-scale health emergency. 

To fix these problems, we need health care that gives providers incentives to improve access and outcomes, making care more preventative and proactive. Getting this alignment will require improvements in both the public and private sectors. On the regulatory front, the General Catalyst Institute has just issued a white paper with specific policy recommendations that the Department of Health and Human Services can start implementing in the next nine months to get the government moving towards health-care transformation.

The recommendations call for more innovation that would lead to faster learning, which speeds up transformation. To do that, the government could develop regional health-care innovation “sandboxes” that will allow health-care experimentation at the local level. These sandboxes can be advanced through existing waiver authorities and help generate what is known as the flywheel effect: insights from system-wide efforts can help players evolve faster, while new applications drive additional system improvements. This continuous exchange builds momentum, making change easier and more sustainable. 

Regulations also have to be changed so that patients can own their health data and share it across providers, rather than dealing with multiple medical portals that don’t communicate. Doctors and insurers need incentives to focus on prevention and proactive health management. The government needs to lower regulatory barriers that make it unreasonably hard for innovative companies to disrupt incumbent players that have zero incentive to cooperate with new entrants, and as a result, are not working in the best interests of the patient and consumer. 

With such regulatory changes in place, the private sector could do even more to promote and accelerate change. No one company can bring about true transformation. Instead, we need an ecosystem of companies that can work together to help keep people healthy in an affordable way that is accessible to all. An innovative regional health ecosystem could incorporate new technologies like AI and use it to make the system more efficient, affordable, and effective. 

Such an ecosystem could replicate and scale best practices, while reducing the burden on individual health systems to develop their own bespoke transformation assets. Different companies engaging in radical collaboration across an ecosystem can tackle different parts of the health-care challenge. For instance, if thousands of hospital systems used AI sepsis detection tools, they could identify warning signs hours earlier than usual, saving tens of thousands of lives and reducing costs by keeping patients out of intensive care. 

One promising technology is an operating system designed specifically for health care. Just like DOS revolutionized personal computing by creating an accessible platform for users, a health-care operating system could break down data silos, allow for faster insights to identify more effective and efficient practices, and promote the adoption of those improved practices quickly and seamlessly.  

Another promising application is a new health insurance interface to make health care benefit management simpler. This interface could make it easier for people to take their insurance with them when they change jobs so they feel less trapped in unsatisfying situations just for health care. Portability also means people could see the same doctors for years, rather than finding that their new insurance doesn’t cover their regular providers. Creating an ongoing relationship between patients and providers gives providers an incentive to care about long-term patient health.  

When the new technologies prove their value, they can be adopted across the system. In this way, by 2030, we could have a blueprint for what works and then spend the next decade scaling the proven technologies across our entire health system.

The goal is a collaboration between the most advanced and promising technologies with caregivers who are directly treating patients. Each iteration can bring about better results, reducing unnecessary costs and improving access to all. Replicating this model across 10 to 15 regional platforms can allow the flywheel of intentionality and exploration to take our health system to the next level, to make health care accessible, proactive, and affordable, and truly fulfill the promise of making America healthy again.

The opinions expressed in Fortune.com commentary pieces are solely the views of their authors and do not necessarily reflect the opinions and beliefs of Fortune.

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Tesla’s CEO Elon Musk returns to rally his troops in company all hands: ‘The future of Tesla is incredibly bright’

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  • Criticized for spending too much time with President Trump and not enough running Tesla, Musk hosts an emergency all-hands meeting where he unveils his dream of building legions of Optimus robots that usher in a utopian age of ‘sustainable abundance’ in which mankind will want for nothing.

The image Elon Musk posted to X in the early hours of Thursday explained a lot of the criticism he’d been receiving. As Tesla faced its biggest crisis since the 2017 launch of the Model 3 nearly bankrupted the company, the serial entrepreneur decided to show off his new office as head of President Trump’s DOGE initiative. 

The posting of the DOGE photo came at a time when Tesla customers were afraid to leave their car unattended because of increasing vandalism against them, and his personal baby, the Cybertruck, had just suffered its eighth formal recall in 15 months. Company analysts and investors had also begun to worry that he wasn’t paying attention to his EV company, with several telling him the ‘clock struck midnight‘ and it was time to find a ‘suitable CEO’ to replace him at Tesla.

Musk appears to have gotten the message, because he returned to the company’s Austin headquarters in Texas to host an emergency all-hands meeting on Thursday, which he uploaded live to his social media platform.

Thanking his staff, Musk told everyone gathered and across Tesla the world over they are part of an elite club of handpicked people destined to make history: they will be the ones to forge a new utopian age in which humans will want for nothing.

Meeting served as important hand-holding for Tesla investors

“What I’m here to tell you is that the future is incredibly bright and exciting,” he said, “and we’re going to do things that no one I think has even dreamed of.” 

Tesla superbull Dan Ives of Wedbush Securities breathed a sigh of relief that Musk had recognized the severity of the “dark brand crisis tornado” and engaged in what he called some “important hand holding” of investors to soothe their frayed nerves. 

“Elon Musk took a major and much needed step forward by hosting a rare all-hands meeting for employees, which was quickly put together and broadcast live on X,” Ives wrote afterwards.

Ives had hiked his price target to $550 immediately after the Trump inauguration, just as the stock began its unprecedented descent to its current $230 price.

Ten ‘legions’ of Optimus robots scheduled for production

Musk touched on Tesla’s production milestone of over 7 million cars to date with another three million to come before the next year is out. He also promised the Model Y would once more be the best-selling car of any kind in 2025 for the third year running. 

In addition, he said Tesla’s unique competitive edge stems from its ability to be the only company able to manufacture the world’s most sophisticated humanoid robot at scale. Tesla’s Optimus, he promised, would one day be the biggest product ever by far and launch mankind into a new era where our every heart’s desire would be fulfilled by millions of Musk’s automatons at our beck and call.

Musk said Tesla would usher in this utopian age—no one else—because only his company could manufacture humanoid robots by the “legion”, choosing the Roman empire’s term for an army for 5,000 soldiers.

“It’s kind of a cool unit,” he said, saying he hoped to already expand production of Optimus robots next year to 10 full legions.

Musk’s vision: ‘You can literally just have anything you want’

For the first time Musk publicly wove a narrative thread spanning the company’s stated mission of accelerating the transition to sustainable energy through its EVs and storage batteries to his new vision he described as “sustainable abundance”.

There will be no more scarcity of resources, Musk said. Mankind across the world will live as kings and serving them will be a Tesla Optimus in every household.

Powered by a Tesla battery and fed renewable energy from a Tesla solar roof, Optimus would autonomously produce goods and services “basically with no limit” while being butler to its owner’s every whim, educating his child and serving as a part-time buddy on the side. 

“It sounds impossible, it sounds like surely such a thing cannot be the case. What I’m here to tell you is that will indeed be the case,” Musk explained. “The future we’re headed for is one where you can literally just have anything you want.”

This story was originally featured on Fortune.com



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Delta plane that flipped on Toronto runway and burst into flames was descending at high speed, initial report says

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The alert system on a Delta Air Lines jet that flipped upside down and burst into flames as it tried to land in Toronto last month indicated a high rate of descent less than three seconds before touchdown, a preliminary report said Thursday.

The Transportation Safety Board of Canada, which issued the report, continues to investigate the Feb. 17 crash-landing in which 21 people were hospitalized.

All 76 passengers and four crew members survived when the Delta plane arriving from Minneapolis burst into flames after flipping over and skidding on the tarmac.

The TSB of Canada report says that when the plane’s ground proximity warning system sounded 2.6 seconds before touchdown, the airspeed was 136 knots, or approximately 250 kph (155 mph). It says the plane’s landing gear folded into the retracted position at touchdown and the wing detached from the fuselage, releasing a cloud of jet fuel, which caught fire as the plane slid along the runway.

The fuselage rolled upside down and a large portion of the tail came off in the process, the report says.

“Accidents and incidents rarely stem from a single cause,” TSB chair Yoan Marier said in a video statement Thursday. “They’re often the result of multiple complex, interconnected factors, many extending beyond the aircraft and its operation to wider systemic issues.”

The crew and passengers started evacuating once the plane came to a stop, the report says, adding that some of the passengers were injured when they unbuckled their seatbelts and fell to the ceiling.

The TSB says it’s not aware of any issues with the seatbelts or seats during the incident.

The cockpit door was jammed shut, forcing pilots to escape through the emergency hatch on the ceiling of the cockpit after everyone else was out, the report says.

Emergency response personnel then went into the fuselage, and there was an explosion outside the plane near the left wing root shortly afterward, the TSB says. The cause of the explosion has not yet been determined.

So far, the investigation has found no pre-existing problems with the flight controls, though some components were damaged in the crash, the board said.

The safety board says its ongoing investigation is focusing on several key areas, including metallurgical examination of the wing structure, landing techniques, pilot training and the passenger evacuation process.

All of those who were hospitalized were released within days of the crash.

At least two lawsuits have been filed in the United States, and a law firm in Canada has said that it’s been retained by several passengers.

Delta declined to comment on the preliminary report.

“We remain fully engaged as participants in the investigation led by the Transportation Safety Board of Canada. Out of respect for the integrity of this work that will continue through their final report, Endeavor Air and Delta will refrain from comment,” the airline said.

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New Trump administration guidelines create new ways for employees to report corporate DEI programs

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Good morning!

Companies are already facing major pressure to scrap or change their DEI programs. Now further guidance from the Equal Employment Opportunity Commission (EEOC) and the Department of Justice (DOJ) is encouraging employees to join in on the fight by investigating DEI policies at their own companies. 

On Wednesday, the agencies released two documents entitled “What You Should Know About DEI-Related Discrimination at Work” and “What To Do If You Experience Discrimination Related to DEI at Work.” These new resources describe what counts as “DEI-related discrimination,” and how to report it to the EEOC. Perhaps most important though, they encourage the public to speak up if they can provide “a fact-specific basis” around why they believe certain policies or practices related to DEI violate Title VII of the Civil Rights Act. 

“These technical assistance documents will help employees know their rights and help employers take action to avoid unlawful DEI-related discrimination,” EEOC Acting Chair Andrea Lucas wrote in a statement about the new guidance. The move follows similar recent anti-DEI efforts from Lucas. On Monday, she sent letters to 20 law firms requesting information about their diversity, equity, and inclusion-related employment practices. 

What do the new DOJ and EEOC employee guidelines mean for workplaces around the U.S.? They add to the heightened culture of fear for employers who are already nervous about trying to preserve their DEI policies in a tough political climate, says David Glasgow, executive director of the Meltzer Center for Diversity, Inclusion, and Belonging at New York University

“Employers are already very nervous, and feeling threatened with civil compliance investigations,” he says. “This latest guidance is pouring fuel on an already raging anti-DEI fire.”

But while these documents seem daunting at first glance, he notes that they don’t change any current laws. And he says that the bar for claiming DEI-related discrimination is very high. 

“I think guidance like this could make people unnecessarily worried about, ‘Oh no, what if our DEI trainings are creating a hostile work environment?’ When 99.9% of trainings don’t actually do that,” he says. 

In short, companies should make sure that their programs are bulletproof, but avoid scrapping them altogether, says Nonnie L. Shivers, attorney and office managing shareholder at legal firm Ogletree Deakins. She says many court cases have supported an employer’s right to train their employees, and create an equal opportunity workplace. 

“Employers should continue to conduct privileged assessments of their DEI programs and evaluate risk, leaning into existing civil rights law for what is legal as the law has not changed,” she says.

Brit Morse
brit.morse@fortune.com

This story was originally featured on Fortune.com



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