Who Pays?

In today's issue:

• Who pays when AI gets our health wrong?
• How did the rich man’s disease become everyone’s problem?

I keep hearing the same promise from Big Tech: AI will make health care safer, cheaper, and smarter.

Then the researchers quietly admit something else: AI errors may never be eliminated. Not at Google, not at OpenAI, and not at the FDA.

Ever.

But hospitals are rushing in, health systems want speed, startups want scale, investors want returns, and the FDA clears tools based on limited trials.

AI points out possible cancer on scans, predicts sepsis, and suggests treatments. That can save lives, but it can also miss the one patient who doesn't look like the training data.

So how do we protect ourselves right now?

The answer? We ask who trained the system, on what data, and who is liable when it fails. We demand a human in the loop who can say no, and we treat AI like a second opinion, not a verdict.

Between you and me, should AI companies be forced to publish error rates like drug side effects? Should hospitals disclose when AI is involved in our care? And more importantly, should regulators slow down?

Who Franchised the Rich Man’s Disease?

I used to hear type 2 diabetes called the rich man’s disease. So why is it now crushing families who aren't rich, who work two jobs, and buy the cheapest food they can find?

Did millions of people across the world suddenly lose discipline at the same time, or did something else change?

History gives us a clue: Sugar used to be a flex, white bread used to signal status, and constant sweetness and refined flour were limited by price and access.

Then industry stepped in, scaled production, cut costs, and pushed these foods everywhere. The luxury diet didn't disappear; it got mass-produced.

The International Diabetes Federation estimates about 589 million adults live with diabetes today, and four out of five are in low and middle-income countries.

Does that sound like a self-control problem or a global food environment problem?

We know food companies follow incentives: cheap inputs, high-reward taste, endless marketing, and repeat purchases. Just like social media keeps us scrolling, ultra-processed food keeps us eating.

Now let's look at accountability: governments approve the food, companies market it, health systems treat the damage, our families carry the cost, and when it breaks our bodies, we're told to eat better, have more willpower, show more discipline, make better choices, and take personal responsibility, even when we live in a food environment designed to make these choices harder.

So, the question isn't whether personal responsibility matters; it does. The real question is, why do we act like the world around us has no influence on our choices and our health, when the evidence shows it clearly does?

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