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Category: Kim Bellard

Stuck in the Middle

By KIM BELLARD

Even before the war – oops: special operation, excursion, or whatever your preferred term is – with Iran started, people were complaining about how expensive things are. Home ownership for first time buyers seems out of reach. Sure, egg prices may be down from the late stages of the Biden Administration (thank you so much, bird flu!), but most of us are still dismayed by our grocery bills. Health insurance costs what a house might have cost fifty years ago and what a new car might have cost twenty years ago.

The latest findings from the West Health-Gallup Center on Healthcare in America show that a third of Americans have cut back on expenses in order to pay health care expenses. We’re stringing out their prescriptions, borrowing money, even skipping meals to pay our health care bills. Even among those with health insurance 29% are cutting back; 62% of those without health insurance are making trade-offs, and I’m surprised the latter isn’t much higher.

Similarly, Kaiser Family Foundation found that 4 in 10 Americans have not taken their prescription medications due to costs, and 6 in 10 worry about being able to afford prescription drugs for themselves or their families. Even among those with insurance, a majority worry.  

Gallop also found that Americans are delaying major life events due to their health care costs, including taking vacations (29%), surgical or medical treatments (26%), or changing jobs (18%). Even a quarter of those with family incomes over $240,000 report such delays.

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Trust No One

By KIM BELLARD

You know, it’s gotten to the point when I just try to tune out the things Robert F. Kennedy Jr. says. “Schizophrenia can be cured with a keto diet”? Sure, whatever. “The war on protein is over”?  Who even knew there was such a war? The carnivore diet is a great way to lose weight and gain “mental clarity”? It sure doesn’t show.

His most dangerous statements, though, are probably those related to vaccines. He was known as a vaccine skeptic – no, make that critic – long before he was named as HHS Secretary, but being Secretary put him in position to put his anti-vaccine views into action. He has revamped the committee that make vaccine recommendations, putting people on them that share his skepticism.

The committee has already made significant changes to childhood immunization schedules, and they’re not done yet. The head of the vaccine advisory committee isn’t just skeptical of measles vaccines, he’s not keen on mandating the polio vaccine either. His committee is expected to go after COVID vaccines next.

One particularly outspoken committee member, Dr. Robert Malone said: “I’m not deaf to the calls that we need to get the Covid vaccine mRNA products off the market. All I can say is, stay tuned and wait for the upcoming A.C.I.P. meeting. If the F.D.A. won’t act, there are other entities that will.” He told The New York Times that scientists or regulators who claimed COVID vaccines were safe are “either being disingenuous, or they are not considering the context or are ignorant.”

Meanwhile, RFK Jr.’s nominee for Surgeon General is, shall we say, big in the MAHA movement but not so much in medical professional circles, having placed her medical license in “inactive” status. Her own website brags that she “is considered controversial because her work challenges the economic and cultural foundations of U.S. healthcare, agriculture, and food systems.”

The impacts of these attitudes are neither academic nor far in the future: we’re already in the midst of an unprecedented measles outbreak that many attribute to the vaccine skepticism that RFK Jr. and his ilk have spawned and encouraged.

What caused me to write about this is a new poll out from KFF: Trust in the CDC and Views of Federal Childhood Vaccine Schedule Changes. Top-line finding: “the public’s trust in the CDC remains at its lowest point since the COVID-19 pandemic.”  Well, you can’t be surprised by that.

“Six years ago, 85% of Americans, and 90% of Republicans, trusted the CDC. Now less than half trust the CDC on vaccines,” KFF President and CEO Drew Altman said. “The wars over COVID, science, and vaccines have left the country without a trusted national voice on vaccines, and that trust will take time to restore.”

What I found particularly interesting is that, as Dr. Altman said, pre-COVID trust in the CDC was both high and across party lines. Republicans, though, lost trust during the pandemic and basically have never recovered. It took the Trump Administration to get Democrats to lose their trust – but, in fact, their trust still remains higher (55% versus 43%). Independents hover slightly above Republicans, but well below Democrats.

Specifically, about trust in childhood vaccine recommendations only about 44% have some or a lot of faith in federal agencies such as the CDC and FDA, and that doesn’t vary much by either party ID or support for MAHA.  E.g., 47% for MAHA supporters versus 43% for Not MAHA Supporters. What does it say about MAHA that believers don’t have faith what the creator of MAHA is doing? 

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It’s Only a Subsidy If You’re Poor

By KIM BELLARD

Even though most ACA enrollees/would-be enrollees have made their 2026 enrollment decisions assuming the expanded premium subsidies are not going to be renewed, the renewal of those subsidies is not entirely dead. Last week the House narrowly passed an extension, relying on a discharge petition and 17 Republican Congressmen willing to go against their leadership. Meanwhile, in the Senate, Senator Bernie Moreno (R-OH), of all people, is leading an effort to come up with a bill to expand them as well.

Whether it will eventually get passed is uncertain, as is how/when it might be reconciled with the House bill, and the President might just veto whatever extension might manage to emerge. The expanded subsidies aren’t dead yet, they’re just “mostly dead,” as Miracle Max would say.

The seeming indifference to the concerns of over twenty million ACA enrollees is appalling, but in character. This is an Administration and a Republican Congress that doesn’t like SNAP, Medicaid, school lunches, or aid to starving people in Third World countries, among other things. If you’re poor, they think, too bad; get a job, or a better job, and pull yourself up yourself. No handouts.

If they were against federal subsidies generally, out of fiscal prudence or other guiding principles, I could respect it. I wouldn’t agree with it, but it’d at least be intellectually honest. The trouble is, they’re not against subsidies per se; they just don’t like them going to poor people. I.e., the ones who need them most.

What set me off on this was a ProPublica/High Country News investigation into grazing on public lands. If you live in the East you probably don’t think much about either grazing or public lands, but if you live in the West you are probably very familiar with both. Almost 50% of land in Western states is federally owned. It ranges from 85% in Nevada to 4% in North Dakota. Almost half of California is federal land. You might be forgiven if you assume federal lands must be national parks, but they are small relative to land managed by the Bureau of Land Management (BLM), the U.S. Fish & Wildlife Service (FWS), and the U.S. Forest Service (USFS).

According to ProPublica: “The federal government allows livestock grazing across an area of publicly owned land more than twice the size of California, making ranching the largest land use in the West.” Well, you might think, that’s not inherently bad; we might as well use the land for something, maybe even make a little money from it. That’s the problem; the federal government is practically giving it away. Its analysis found that the grazing fees charged amount to a 93% discount relative to the market rate. You read that right: ninety three percent. That’s not a discount, that’s a giveaway.

OK, that’s eye-opening, but if it helps a bunch of ranchers who are struggling to survive, maybe that’s not so bad; ranching goes back to frontier days and has a certain cowboy appeal. Unfortunately, that stereotype isn’t quite true.

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Brick by Brick by (Smart) Brick

By KIM BELLARD

I’m an innovation junkie, the further out there the better, but every so often it’s good to be reminded that just because a company has been around for a while, innovation is still possible.

Two examples: LEGO® and Kodak.

Let’s start with LEGO. If you are around any small children – and perhaps not even all that small – you probably have seen them playing with Legos. Legos have been around, in various incarnations, for longer than I’ve been alive, and that’s saying something. Most adults watching kids assemble their Legos probably have two reactions: “gosh, I wish they’d make them even more complicated” (note to the oblivious reader – that was sarcastic), and “well, at least they’re not on their screens.”

So I bet a lot of us have a slightly surprised reaction to Lego’s announcement Monday Jan 6th to CES 2026: LEGO SMART Play™.

The key innovation is the SMART Brick, which “is packed with technologies that bring play to life including sensors, accelerometers, light sensing and a sound sensor as well as a miniature speaker driven by an onboard synthesiser, and much more, in addition to easy wireless charging.” All that is powered by a custom chip, which is smaller than one of the studs on a LEGO brick.

The LEGO Group states: “Without any setup, SMART Bricks are magically ‘aware’ of each other’s positions and orientations in 3D space, thanks to a novel, high-accuracy, magnetic positioning system. They can also communicate via a self-organizing network that adapts to play. Advanced onboard systems let SMART Bricks comprehend and interact with each other, as well as the fans building with them.” “Magic” in this context meaning Bluetooth.

Nerdist calls it “the most exciting innovation in screenless play ever,”  

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Let’s Check the Math on Health Subsidies

By KIM BELLARD

It’s December 3, and, to no one’s surprise, Congress still has not acted on extending the expanded health care premium tax credits for ACA. To Congress, the subsidies don’t expire until the end of the year, so they figure they have until at least then to act, or maybe sometime after that, given the way they handled the recent government shutdown.

On the other hand, consumers who are renewing or shopping for ACA plans face a more immediate deadline; they have until December 15 to enroll for January 1st. They’re already seeing huge increases that result from a normal renewal increase plus the loss of the generous subsidies; Kaiser Family Foundation estimates that their premiums will more than double without them. They can’t wait while Congress plays politics.

There seems to be agreement that something will be done about the subsidies, but less clarity about what that something is. Some centrists argue to extend the enhanced subsidies but with some tweaks, such as lowering the upper income levels and/or requiring everyone to pay at least some minimum premium. To me, that’d be a reasonable compromise. But some Republicans, including President Trump, are calling for a more radical change: instead of giving the expanded premium tax subsidies to those “fat cat” insurers, give them directly to consumers through health savings accounts (HSAs). Put individuals over insurers, they argue. 

I’m here to tell you: the math does not work.

I am not an actuary, but long ago I was a group underwriter, setting rates for employer groups’ health insurance, and, also long ago, I was involved in the early days of so-called consumer directed health plans (CDHPs), including HSAs and high-deductible health plans. I don’t disagree that HSAs and high-deductible plans can play a role, but one has to understand the math that drives health care spending.

The central fact of health care spending is that it isn’t evenly distributed. It is a perfect example of the Pareto principle: 80% of spending comes from 20% of people. The flip of that is that about 15% of people have no healthcare spending in any given year. What insurance does is take money from everyone and use it to fund the spending of the high cost people. That’s what all insurance does.

OK, I’ve avoided doing the math as long as I could, but here goes. One proposal has called for $2,000 to be deposited in each enrollee’s new HSA. Let’s keep it simple and say there are 1,000 such people, and that their average annual health care spending is $2,000 (which, of course, is way low). So we have 1,000 x $2,000 = $2 million in both subsidies and spending. It works out perfectly, right?

Not so fast.

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If You Could read My Mind – Wait, You Can?

By KIM BELLARD

Over the years, one area of tech/health tech I have avoided writing about are brain-computer interfaces (B.C.I.). In part, it was because I thought they were kind of creepy, and, in larger part, because I was increasing finding Elon Musk, whose Neuralink is one of the leaders in the field, even more creepy. But an article in The New York Times Magazine by Linda Kinstler rang alarm bells in my head – and I sure hope no one is listening to them.

Her article, Big Tech Wants Direct Access to Our Brains, doesn’t just discuss some of the technological advances in the field, which are, admittedly, quite impressive. No, what caught my attention was her larger point that it’s time – it’s past time – that we started taking the issue of the privacy of what goes on inside our heads very seriously.

Because we are at the point, or fast approaching it, when those private thoughts of ours are no longer private.

The ostensible purpose of B.C.I.s has usually been as for assistance to people with disabilities, such as people who are paralyzed. Being able to move a cursor or even a limb could change their lives. It might even allow some to speak or even see. All are great use cases, with some track record of successes.

B.C.I.s have tended to go down one of two paths. One uses external signals, such as through electroencephalography (EEG) and electrooculography (EOG), to try to decipher what your brain is doing. The other, as Neuralink uses, is an implant directly in your brain to sense and interrupt activity. The latter approach has the advantage of more specific readings, but has the obvious drawback of requiring surgery and wires in your brain.

There’s a competition held every four years called Cybathlon, sponsored by ETH Zurich, that “acts as a platform that challenges teams from all over the world to develop assistive technologies suitable for everyday use with and for people with disabilities.” A profile of it in NYT quoted the second place finisher, who uses the external signals approach but lost to a team using implants: “We weren’t in the same league as the Pittsburgh people. They’re playing chess and we’re playing checkers.”  He’s now considering implants.  

Fine, you say. I can protect my mental privacy simply by not getting implants, right?  Not so fast.

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Support your neighborhood scientist

By KIM BELLARD

These are, it must be said, grim times for American science. Between the Trump budget cuts, the Trump attacks on leading research universities, and the normalization of misinformation/ disinformation, scientists are losing their jobs, fleeing to other countries, or just trying to keep their heads down in hopes of being able to just, you know, keep doing science.

But some scientists are fighting back, and more power to them. Literally.

Lest you think I’m being Chicken Little, warning prematurely that the sky is falling, there continue to be warning signs. Virginia Gewin, writing in Nature, reports Insiders warn how dismantling federal agencies could put science at risk. A former EPA official told her: “It’s not just EPA. Science is being destroyed across many agencies.” Even worse, one former official warned: “Now they are starting to proffer misinformation and putting a government seal on it.”  

A third researcher added: “The damage to the next generation of scientists is what I worry the most about. I’ve been advising students to look for other jobs.”

It’s not just that students are looking for jobs outside of the government. Katrina Northrop and Rudy Lu write in The Washington Post about the brain drain going to China. “Over the past decade,” they say, “there has been a rush of scholars — many with some family connection to China — moving across the Pacific, drawn by Beijing’s full-throttle drive to become a scientific superpower.” They cite 50 tenure track scholars of Chinese descent who have left U.S. universities for China. Most are in STEM fields.

“The U.S. is increasingly skeptical of science — whether it’s climate, health or other areas,” Jimmy Goodrich, an expert on Chinese science and technology at theUniversity of California Institute on Global Conflict and Cooperation, told them. “While in China, science is being embraced as a key solution to move the country forward into the future.”

They note how four years ago the U.S. spent four times as much in R&D than China, whereas now the spending is basically even, at best.

I keep in mind the warning of Dan Wang, a research fellow at Stanford’s Hoover Institution:

Think about it this way: China is an engineering state, which treats construction projects and technological primacy as the solution to all of its problems, whereas the United States is a lawyerly society, obsessed with protecting wealth by making rules rather than producing material goods.

We’ve seen what a government of lawyers does, creating laws and regulations that protect big corporations and the ultra-rich, while making everything so complex that, voila, more lawyers are needed. Maybe it’s time to see what a government of scientists could do.

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Life Is Geometry

By KIM BELLARD

In 2025, we’ve got DNA all figured out, right?  It’s been over fifty years since Crick and Watson (and Franklin) discovered the double helix structure. We know that permutations of just four chemical bases (A, C, T, and G) allow the vast genetic complexity and diversity in the world. We’ve done the Humam Genome Project. We can edit DNA using CRISPR. Heck, we’re even working on synthetic DNA. We’re busy finding other uses for DNA, like computing, storage, or robots. Yep, we’re on top of DNA.

Not so fast. Researchers at Northwestern University say we’ve been missing something: a geometric code embedded in genomes that helps cells store and process information. It’s not just combinations of chemical bases that make DNA work; there is also a “geometric language” going on, one that we weren’t hearing.

Wait, what?

The research – Geometrically Encoded Positioning of Introns, Intergenic Segments, and Exons in the Human Genome – was led by Professor Vadim Backman, Sachs Family Professor of Biomedical Engineering and Medicine at Northwestern’s McCormick School of Engineering, and director of its Center for Physical Genomics and Engineering. The new research indicates, he says, that: “Rather than a predetermined script based on fixed genetic instruction sets, we humans are living, breathing computational systems that have been evolving in complexity and power for millions of years.”

The Northwestern press release elaborates:

The geometric code is the blueprint for how DNA forms nanoscale packing domains that create physical “memory nodes” — functional units that store and stabilize transcriptional states. In essence, it allows the genome to operate as a living computational system, adapting gene usage based on cellular history. These memory nodes are not random; geometry appears to have been selected over millions of years to optimize enzyme access, embedding biological computation directly into physical structure.

Somehow I don’t think Crick and Watson saw that coming, much less either Euclid or John von Neumann.

Coauthor Igal Szleifer, Christina Enroth-Cugell Professor of Biomedical Engineering at the McCormick School of Engineering, adds: “We are learning to read and write the language of cellular memories. These ‘memory nodes’ are living physical objects resembling microprocessors. They have precise rules based on their physical, chemical, and biological properties that encode cell behavior.”

“Living, breathing computational systems”? “Microprocessors”? This is DNA computing at a new level.

The study suggests that evolution came about not just by finding new combinations of DNA but also from new ways to fold it, using those physical structures to store genetic information. Indeed, one of the researchers’ hypothesis is that development of the geometric code helped lead to the explosion of body types witnessed in the Cambrian Explosion, when life went from simple single and multicellular organisms to a vast array of life forms.

Coauthor Kyle MacQuarrie, assistant professor of pediatrics at the Feinberg School of Medicine, points out that we shouldn’t be surprised it took this long to realize the geometric code: “We’ve spent 70 years learning to read the genetic code. Understanding this new geometric code became possible only through recent advances in globally-unique imaging, modeling, and computational science—developed right here at Northwestern.” (Nice extra plug there for Northwestern, Dr. MacQuarrie.)

Coauthor Luay Almassalha, also from the Feinberg School of Medicine, notes: “While the genetic code is much like the words in a dictionary, the newly discovered ‘geometric code’ turns words into a living language that all our cells speak. Pairing the words (genetic code) and the language (geometric code) may enable the ability to finally read and write cellular memory.”

I love the distinction between the words and the actual language. We’ve been using a dictionary and not realizing we need a phrase book.   

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Halo, Heresy, and Health Care

By KIM BELLARD

If you are of a certain age – say, mine, that is to say, a Baby Boomer – last week’s announcement that Microsoft was going to release a new version of Halo on Sony’s PlayStation console may have passed you by. So what, you might have said? If, on the other hand, you are one of the three-fourths of Americans who play video games, you might have more immediately grasped the significance.

The gaming industry is like porn industry in that it tends to be early on the technology front. Since I don’t follow the porn industry, I try to watch the gaming industry to see what trends in it may suggest for the future of other industries, especially healthcare.

In case you weren’t aware, Halo is a Microsoft game, and has historically been played on Microsoft’s Xbox console. Sony’s PlayStation is Microsoft biggest competitor, and has been winning the war handily. So making Halo available on PlayStation is a somewhat surprising move. As Zachary Small wrote in The New York Times: “It is the equivalent of Disney letting Mickey Mouse roam Universal Studios.”

Or, as Grant St. Clair marveled in Boing Boing:

I cannot possibly emphasize how big a deal this is, but odds are you already know yourself. Halo is bar none the biggest IP Xbox has, and historically one of the biggest draws to the console. It’d be like Nintendo suddenly putting Super Mario Galaxy on Steam. This is a tacit admission that Xbox has lost the hardware war — the writing was on the wall already, granted, but this italicizes and underlines it.

A gamer told BBC Newsbeat that the announcement was “massive” and “broke the internet a little bit.” She’s happy about the news, adding: “I know there’s a bit of controversy about it coming to PlayStation, but I don’t see any reason why it should be like that at all. I just think it’s a win for all gamers.”

So, whether you realize it or not, this is kind of a big deal.

Microsoft has desperately been trying to stay relevant in gaming. A couple years ago Microsoft shelled out $70 billion to acquire Activision Blizzard, and a couple years prior to that paid $7.5b for ZeniMax Media. Still, though, as Joost van Dreunen, a market analyst and professor at New York University, told Mr. Small: “When it comes to consoles, Xbox has always been the bridesmaid and never the bride. They just haven’t been able to outmaneuver PlayStation and Nintendo.”

It may have found a way. Earlier this year Microsoft made Gears of War and Forza Horizon 5  available on PlayStation, and Microsoft Flight Simulator will join them later this year. Indeed, Mr. Small points out: “Between April and July, six of the top 10 best-selling games on Sony’s consoles were Microsoft properties.”

I.e., if you can’t beat them, join them.

“We are all seeking to meet people where they are,” Matt Booty, the president of Xbox game content and studios, told Mr. Small. Even more interesting, he further explained: “Our biggest competition isn’t another console. We are competing more and more with everything from TikTok to movies.”

Lesson #1: your competitors are not necessarily the ones you think they are.

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Let a Thousand DNA Flowers Bloom

By KIM BELLARD

When I saw a headline about “DNA flowers,” I was nonplused. I mean: aren’t all flowers made out of DNA, like every living thing on our planet? Well, it turns out that the DNA flowers are actually soft robots – make that nanobots – so my interest was definitely piqued.

The DNA flowers are out of the Freeman Lab at the University of North Carolina, led by Dr. Ronit Freeman, and the research about them was just published in Nature Nanotechnology with the less sexy title “Reversible metamorphosis of hierarchical DNA-organic crystal.”  Had I seen that before “DNA flowers” I probably would have passed it over, so I’m glad someone has an eye towards marketing.

Designer Daniel Burham famously said: “Make no little plans,” and I kind of think he’d like Dr. Freeman. Her bio says she has formal training in computer science, chemistry, nanotechnology, and regenerative medicine (plus even ballroom dancing, if you’re counting), and she probably needs all that training, because her primary interest is “in supramolecular self-assembly, a field where common biological materials like DNA and proteins are seen not simply as information carriers, but also as tunable structural materials for next-generation sensors, nano robots, drug breakthroughs, and clinical tools.”

Accordingly, what the Lab has done now is to combine DNA with inorganic materials to allow them to respond to their environment. Professor Freeman says: “We take inspiration from nature’s designs, like blooming flowers or growing tissue, and translate them into technology that could one day think, move, and adapt on its own,”

Indeed, the Freman Lab prides itself on “bioinspired technologies,” the purpose of which is: “We engineer living and synthetic materials to accelerate healthier outcomes for global communities.” The website talks about “building block designs.” featuring hierarchical self-assembly, temporal structural reconfiguration, and adaptive behavior.

Hence, DNA flowers. 

The flowers are actually shaped like flowers, although they are microscopic, and what makes them both interesting and potentially useful is that the various strands of DNA allow them to move, open or close, or trigger chemical reactions, based on environmental cues like temperature, acidity, or chemical signals. The DNA sequences guide nanoparticles to organize into complex structures, which can reverse shape as desired.  

“People would love to have smart capsules that would automatically activate medication when it detects disease and stops when it is healed. In principle, this could be possible with our shapeshifting materials,” said Professor Freeman. “In the future, swallowable or implantable shape-changing flowers could be designed to deliver a targeted dose of drugs, perform a biopsy, or clear a blood clot.”

Yeah, I’d love that, and I bet you would too.

The team acknowledges that the technology is in the early stages, but see a future where, say, a DNA flower is injected into a cancer patient, in whom it travels to a tumor, whose acidity causes the petals to release a medication or even take a tiny tissue sample. When the tumor is gone the DNA flower would deactivate until/unless new environmental triggers reactivate it.  

Thinking beyond healthcare, the team sees their creations helping to clean up environmental contamination, or as a great digital storage device — up to two trillion gigabytes in just a teaspoon. 

The fact that the DNA flowers can sense and respond to their environment makes the team believe these are a major step forward in bridging the gap between living systems and machines. We’re going to see more of that in the rest of the 21st century.

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