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When President Donald Trump delivered his second inaugural address on Monday, January 20, he preserved a tradition of national mythmaking that has only served Americans poorly. Beyond the expected theatrics, Trump declared the U.S. to be “history’s greatest civilization,” despite its fixture as the most unequal nation with the lowest life expectancy, even just among Western democracies of today. And, despite his record-thin margin of victory in November’s election, the President claimed that “the entire nation is rapidly unifying behind our agenda.”
What’s actually noteworthy about this moment, however, is that there is a rare current of agreement among Americans today. The consensus comes in the form of a deep pessimism about our most cherished national story. One recent poll of American voters conducted by WSJ/ NORC found that only 36% still believe in an American Dream broadly defined by the idea that hard work begets success and upward mobility. This finding represents a big tumble downward from 2012 when, even in the shadow of the Great Recession that cleaned millions of families out, 52% of Americans still held fast to the story of the dream.
The far-reaching senses of despair and disenchantment in the U.S. aren’t solely the results of bad trade deals or corporate concentration or the American retreat from social and civic engagement. They can’t be described strictly through the failure of the government to protect citizens and consumers from the exploding cost of necessities like housing, healthcare, education, and childcare. The national gloom stems from something deeper, specifically the torment of a supposedly cohering national story about opportunity that is encoded in culture, policy, and civic life.
Read More: Why a ‘Third Life’ Is the Answer to America’s Loneliness Epidemic
Historically, to be American (for some at least) meant the chance to live free of the titles, class static, and feudal baggage of the Old World. Even before the term was coined, an American Dream of being socially mobile by means of hard work dusted industriousness with a special merit-driven magic that has seduced and frustrated millions. From the Pilgrims and founding fathers through the frontier and all the way to today’s hustle culture, gig economy, and ragged-by-design safety net, the essential American folk tale has plaited hard work with destiny, self-reliance with self-actualization, and success with moral worth.
The trouble with that story is that it makes struggle feel shameful. Take the nation’s kludgy public assistance programs, which are purposefully gummed up with red tape. A 2020 audit by the Government Accountability Office, for example, found that roughly 8,000 Americans file for bankruptcy and another ten thousand people die every year while waiting for a disability benefit decision (or an appeal) to be decided by the Social Security Administration. “The administrative burdens themselves are, in some sense, a deliberate test of deservingness,” Dr. Heather Hahn, an associate vice president at the nonpartisan think tank Urban Institute, explained of America’s social insurance programs. “It’s this assumption that only someone truly, desperately needy, who really has no other options, is going to put up with all that is required. That adds to this deservingness.”
Meanwhile, in public retellings, the Americans who don’t make ends meet while providing care work for loved ones or battling at terrible jobs are just people without sufficient ambition. “I don’t think hard-working Americans should be paying for all the social services for people who could make a broader contribution and instead are couch potatoes,” former Florida representative Matt Gaetz once argued in 2023 while lobbying against anti-poverty programs.
Similarly, an individual drowning in student debt is never someone who took out loans to go to nursing school or dropped out of an engineering program to care for a sick parent. It’s always some loafer or wastrel who, in the words of Senator Ted Cruz, “studied queer pet literature” or a “slacker barista who wasted seven years in college” and can’t “get off the bong for a minute.” On the other hand, those who make it are upheld as virtuous and enlightened. Calling up the 2016 electoral map, former Secretary of State Hillary Clinton argued that, “All that red in the middle, where Trump won, what the map doesn’t show you is that I won the places that represent two-thirds of America’s gross domestic product. So I won the places that are optimistic, diverse, dynamic, moving forward.”
While the narrative around opportunity has largely remained fixed, the American experience has degraded from one of bootstrapping to one of white-knuckling. Over the past 45 years, the U.S. economy has doubled in size and American workers have grown 81% more productive while their wages have only grown 29%, according to the Economic Policy Institute . (Workers of color and workers without college degrees have seen their real wages decline.) Today, medical debt is the biggest cause of bankruptcy in America and baby formula is one of the most shoplifted items. According to a Brookings Institution study, 44 % of Americans work jobs that qualify as low-wage.
“I did everything I was supposed to do,” Nakitta Long, a single mother of two with a Master’s degree in North Carolina, told me about the impossibility of finding a job that might sustain her family. “Why is this not simple?”
These are some of the mad-making, faith-shredding headwinds that made arguments about preserving democracy fall flat for people already failed by a democracy where hard work doesn’t pay off.
They are the same winds that have rustled President-elect Donald Trump back into power. And we’re learning again, from Capitol rotunda to the displaced communities of Southern California, winds can very easily carry fires.
Adapted excerpt from 99% PERSPIRATION by Adam Chandler. Reprinted by permission of Pantheon Books, an imprint of the Knopf Doubleday Publishing Group, a division of Penguin Random House LLC. Copyright (c) 2025 by Adam Chandler.
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The family of Nnamdi Kanu, the detained leader of the Indigenous People of Biafra (IPOB), has criticized President Bola Tinubu for allegedly failing to honor an agreement reportedly made between his son, Seyi Tinubu, and the Kanu family regarding Nnamdi Kanu’s release.
According to reports, Kanu’s younger brother, Prince Emmanuel Kanu, issued a statement on Thursday alleging that he and Seyi Tinubu reached an agreement shortly before the 2023 general election.
He claimed that during a meeting in Abuja, approved by President Tinubu, it was agreed that IPOB would not boycott the election in exchange for a promise that Nnamdi Kanu would be released after Tinubu assumed office.
Prince Emmanuel expressed disappointment that nearly two years into Tinubu’s presidency, his brother remains in detention despite Justice Binta Nyako, the presiding judge, recusing herself from the case.
He described the situation as disgraceful, stating, “It is shameful that those who claim to be honorable have failed to uphold their word.”
The statement read: “Before the last election, I received a message from an ex-governor that Seyi the son of President Tinubu wanted to see me. I agreed to meet with him on the condition that the overriding priority and hence the fulcrum of our discussion will be the release of my brother. The meeting was held in Abuja in the presence of another individual whom I asked along to witness the deliberations and if need be provide independent verification should the need arise.
“Seyi confirmed to me that his father sanctioned the meeting and that I should consider any agreement we reach as binding on the then candidate Senator Bola Ahmed Tinubu.
“In good faith we agreed that I shall relay the outcome to my brother to reinforce the long held tradition of IPOB not interfering with the conduct of elections, either through boycott or any other form of civil disobedience. This understanding was duly communicated to my brother and he reaffirmed his commitment not to stop the elections or order any boycott.
“When President Tinubu as a candidate visited Owerri during his campaign, he too reiterated his commitment to facilitate the release of my brother if elected. We took his public statement as a tacit reaffirmation of the understanding I reached with his son Seyi.
At the end, IPOB did not call for election boycott despite having the capacity to do so. IPOB also made sure that discordant voices urging election boycott were overcome because election boycotts would not reflect well on the reputation of a global movement that prides itself on adherence to democratic tenets.
“It therefore, defies logic that nearly two years after President Tinubu assumed the mantle of leadership in Nigeria, my brother is still in detention despite not having any charge against him. It’s been over three months now that Justice Binta Nyako recused herself from the case yet no new judge has been assigned the case.
“This is on top of the fact that Appeal Court had earlier discharged him of the sham charges and ordered his release which the previous regime of Buhari declined to obey.
“Supreme Court determination that his bail ought not to have been revoked has been ignored by the courts and the government. The latest insult is that Abuja courts of all persuasion are no longer willing to determine the case of Mazi Nnamdi Kanu on merit but are rather relying on ludicrous and inapplicable technicalities to stall the timely determination of his cases.
“The truth is that Nigerian courts cannot, will not and do not have both the substantive and procedural jurisdiction to try him. His detention is without the backing of any known law in Nigeria or elsewhere in the world.
“It’s a shame that those who claim to be men of honour cannot honour their word.”
It shouldn’t have taken a tragedy to launch a national conversation about our broken healthcare system and the pain it causes. But the question now is how can we use this moment of collective focus to fully acknowledge how poorly the American public is served by our healthcare system? And what can be done to fix it? Technology has the potential to be part of the solution—or to exacerbate existing issues.
The ripple effects of the killing of UnitedHealthcare CEO Brian Thompson have been significant. Shares of UnitedHealth Group dropped by nearly 15% in the days following the shooting. And shares of other insurers, like Cigna and Humana, also dipped. The day after the shooting, Anthem Blue Cross Blue Shield announced it would halt its controversial plan to limit reimbursement for anesthesia for surgeries that went over certain time limits.
The attack also sparked renewed anger at our broken healthcare system. It’s not hard to see why people are furious. A 2023 American Medical Association (AMA) survey found that 94% of doctors said prior authorization requirements delayed care, and 78% said this sometimes caused patients to give up seeking treatment altogether. Nearly one in four said prior authorization requirements had led to serious adverse outcomes for patients. According to an Experian survey, denials of health claims increased 31% between 2022 and 2024. And appealing such a denial is seldom successful. The Patient Advocate Foundation estimates that in 2018, case managers would have to initiate an average of 16 phone calls or emails to resolve a claim. That number is now up to 27.
So it is no surprise that the number of Americans who positively rate their quality of healthcare is at its lowest point since Gallup began tracking such sentiments in 2001. And those in poorer health—presumably those interacting more with the healthcare system—tend to give their health insurance lower ratings.
The symptoms of our sick healthcare system
The healthcare industry needs not just incremental fixes, but transformative change. For instance, soaring costs demonstrate plainly how our current system is unsustainable. Healthcare costs have risen from $353 per capita in 1970 ($2,400 in today’s dollars) to $14,423 in 2023. Spending on healthcare reached $4.9 trillion in 2023, a 7.5% increase from 2022, with projections nearing $6 trillion by 2027. The average annual premium for family coverage reached $23,968 in 2023 and this number is expected to increase by roughly 8% over next year. According to Willis Towers Watson, employees spend as much as 25% of their take home pay on healthcare premiums. And a 2022 study found that 1 in 3 adult Americans has medical debt—$220 billion in total—and medical debt is the leading cause of bankruptcy in the U.S.
Much of this is due to administrative bloat. Athenahealth’s research suggests that since 1970, the administrative headcount at insurance companies has increased by 3,200% but productivity has declined. And the administrative demands on doctors have a huge impact on how much time they can spend caring for patients. On average, doctors spend only one-third of their time on clinical care. The rest is spent on administrative tasks. This is yet another form of denial of care. And it’s not just terrible for patients. According to the AMA, nearly half (48.2%) of physicians report experiencing at least one symptom of burnout.
Can AI help heal our health care system?
These high costs and significant administrative bloat make the healthcare sector prime for disruption and transformation. AI is already transforming nearly every business sector. What this will mean for healthcare is the subject of an upcoming paper, “The GenAI Juggernaut: US Healthcare Is Not Prepared,” by Eric Larsen, a healthcare veteran and member of Thrive’s board.
“The promise of AI in healthcare is immense,” writes Larsen, who suggests that healthcare “has the greatest surface area exposure to GenAI disruption.”
Many experts agree that AI has the potential to vastly reduce administrative costs, including burdens on doctors. “Initially, we’ll see Generative AI as a boon and a deliverance for physicians—streamlining administrative tasks and reducing bureaucratic burdens, providing something of a ‘restoration of joy’ to the practice of medicine,” writes Larsen.
But equally important is what AI can mean for patients. The goal should be not just more care, by increasing the amount of time doctors can spend with patients, but better care, through personalization. As Larsen writes, the true AI “killer app” will be one that can use personal data, behavioral health data, biometric data, pharmacology data and social determinants of health to “distill guidance to a hyper-personalized level of specificity.”
Right now, our Balkanized system of downstream “sick care” treats all aspects of our health—our physical health, our mental health, the medications we take, our daily lifestyle choices—in isolation. But, of course, all of these aspects of our health are deeply interconnected. I believe AI holds the promise of integrating and unifying them and so improving holistic health.
People aren’t just angry at health insurers and pharmacy benefit managers. They also want to take more control of their own health. An increasing number of Americans (65%) are turning to Google for health advice. That’s 70,000 searches per minute and more than 1 billion per day. And more and more Americans are now using AI chatbots like ChatGPT, Gemini, and Claude to answer their health questions. The problem is that only 40% find online health content reliable, and when people do find credible information, they’re unable to make practical use of it and incorporate it into their lives. Hyper-personalized AI can bridge this gap.
As we’re seeing with the AI coach that Thrive AI Health is building, the hyper-personalization of AI makes it possible to lower friction and help people adopt healthier behaviors that can lead to dramatically better health outcomes. As Daisy Wolf and Vijay Pande from Andreessen Horowitz wrote, “The biggest step changes in human health lie not just in curing every disease, but in revolutionizing the consumer experience. We can markedly improve our health by simplifying health monitoring, ensuring medication adherence, and promoting healthier lifestyles — all areas where traditional healthcare companies have struggled.” This is why companies like Microsoft are building teams to focus specifically on consumer health.
Will AI be used to help, or hurt, patients?
Patients are eager to use tools that will empower them to have more control over their health. Whether the healthcare industry is ready to use AI for the benefit of patients is another matter. After the shooting, reports came out detailing lawsuits both UnitedHealthcare and Humana are facing over their use of algorithms to systematically deny patients’ claims. The lawsuit against UnitedHealth claims that 90% of the algorithms’ decisions were reversed on appeal.
This is an important reminder that AI is just a tool. It can be used to deepen the flaws in the system that’s fueling so much outrage, or it can be used to create more time for doctors to treat patients and more support for patients to improve their health between doctor visits through personalized behavior change.
As Michele Gershberg and Michael Erman report for Reuters, in the wake of Thompson’s shooting, “healthcare companies are taking a step back to better understand patients’ experiences.”
I would argue that they also need to take a step forward, and use AI not to maximize profit by more efficiently denying care, but to maximize health outcomes by enabling better health care and better health habits.
“We know the health system does not work as well as it should, and we understand people’s frustrations with it,” wrote Andrew Witty, the CEO of UnitedHealth Group in the New York Times. “Our mission is to help make it work better.”
The time to act on that mission is now. The U.S. healthcare system is currently an oligopoly, concentrated in the hands of a few CEOs who exert tremendous power on the lives of millions. With great power comes great responsibility. The healthcare system is front and center in both our national and personal conversations. Healthcare leaders need to use this opportunity not just to talk about the need for big changes—but to make big changes happen.
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As Dave told Today, “I couldn’t even see his face. He downplays it all, but I’m telling you, he was really engulfed. I couldn’t see his face. It was a wall of fire.”
Jay suffered yet another accident in January 2023 when he broke his collarbone, ribs and cracked his kneecaps after getting knocked off his motorcycle.
“I turned down a side street and cut through a parking lot,” he told the Las Vegas Review-Journalafter the incident, “and unbeknownst to me, some guy had a wire strung across the parking lot but with no flag hanging from it.”
He continued, “So, you know, I didn’t see it until it was too late. It just clothesline me and, boom, knocked me off the bike. The bike kept going, and you know how that works out.”
But Jay isn’t the only person in Hollywood to be the victim of a freak accident. For more, keep reading.
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Bitcoin ETF holders are taking profits as a six-day winning streak comes to an end, with most ETFs experiencing outflows on Nov. 14.
BlackRock’s ETF stood out by attracting an inflow of $126.5 million, while other major funds like Fidelity’s FBTC and Bitwise’s BITB saw outflows of $179.2 million and $113.9 million, respectively.
Farside data indicates that ETFs from Ark, Invesco, Franklin, Valkyrie, and VanEck also faced withdrawals, with Grayscale’s BTC product losing $69.6 million and GBTC dropping by $5.3 million. The total outflow across all tracked ETFs amounted to $400.7 million for the day.
According to CryptoSlate data, Bitcoin’s price reflected this shift, decreasing by 3.12% to $88,091.43. Despite the decline, it remains up 16.07% over the past week and 30.51% over the past month. Its market capitalization stands at $1.74 trillion, with a 24-hour trading volume of $84.9 billion.
The recent outflows suggest that investors are locking in gains after a significant rally, though BlackRock’s continued inflow indicates sustained interest from some institutional players. The divergence in ETF flows highlights varying strategies among investors in response to market movements.
While Bitcoin is currently 6% below its recent all-time high of $93,311.31, the overall market sentiment remains cautiously optimistic. The mix of profit-taking and selective investment points to a dynamic market adapting to rapid changes.
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The high stakes U.S. election this week is on track to match the record 66% turnout set four years ago, and surpass the routinely lower midterm election turnout that peaked at 49% in 2018. But as records go, these look sad when you consider that many democracies get closer to 80% of their voters to head to the polls.
With between a third or half of all voters deciding to stay home, and most voters expressing dissatisfaction with the options they are being offered at the ballot box, it is worth taking a step back to understand how America elects its leaders. These choices are not just leaving people disillusioned with politics, they are turning people away from our democracy itself and opening a door to ever-more extreme candidates.
The U.S. electoral system remains an outlier among democracies. Instead of electing a single representative from a district, most democracies elect multiple ones from each district in proportion to the share of votes each party receives. So, for example, in a district with five members, if a party gets 40% of the votes, it gets two of the five seats. This kind of system is called proportional representation. Most democracies embraced proportionality decades ago—and for good reason.
That’s because when elections are more competitive, more voters turn out because they think their voice actually matters. So it’s no surprise that U.S. turnout is so abysmal. Every cycle, at least four-out-of-five congressional districts are safe for their incumbents. Nationwide, seven out of 10 races in the general election were uncontested, including almost half of state legislative races and five percent of congressional ones where only one candidate was on the ballot. This lack of competition is one consequence of our choice to elect representatives from single-member districts.
And the culprit for this is not gerrymandering. Even states that have created independent redistricting commissions to avoid partisan gerrymandering are still mostly uncompetitive. As Americans continue to sort themselves geographically in Red or Blue areas, natural clusters dominated by one party are increasingly emerging. In some cases, the geography of where and how people live makes it impossible to draw single member districts that give partisan or racial minorities a fair shot at representation.
Look at Massachusetts and Oklahoma. A third of voters in Oklahoma are Democratic, but all five of its congressional seats went to Republicans. And a third of voters in Massachusetts are Republicans, but all nine of that state’s congressional seats went to Democrats. And it’s not because Massachusetts drew districts that disadvantaged Republicans—it’s because you cannot draw a single member district in the state that would elect a Republican. In fact, researchers found that “[t]hough there are more ways of building a valid districting plan than there are particles in the galaxy, every single one of them would produce a 9–0 Democratic delegation.” In order words, drawing single member districts differently isn’t enough—we need to rethink the map entirely.
There are sensible reforms that can help fix things. Moving away from single-member districts and toward proportional representation would force Democrats and Republicans to compete in more districts, encourage other candidates to run, and increase turnout because voters have actual choices. It is also functionally impossible to gerrymander districts under proportional representation.
The good news is that federally and across many states, these reforms can be adopted by simple statutory changes. And at the state level, the ballot initiative process allows voters to change the constitution at the ballot box.
Proportional representation has been tried before. Illinois used a partially proportional system for over a century after the Civil War. Representatives for the state House were elected from three member districts, roughly in proportion to the votes cast. If a candidate could get over a quarter of the vote, they could generally win one of the seats in a district. The results in Illinois reflected the experience of other democracies with proportional systems—elections are generally more competitive, and minorities are able to secure representation that better reflects their numbers. Unfortunately, Illinois repealed its proportional voting system in 1980, and the share of state House races that went uncontested rose from 4% then to 44% this year.
Many Americans are angry at the electoral system. They don’t trust our democratic institutions. They are tired of the choices or lack of choices that it is offering. But it doesn’t have to be this way. The question is: Are people angry enough to pass reforms—like proportional representation—that can make some big changes to finally fix it?
Our democracy may come to depend on the answer.
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In a dramatic twist to the 2024 summer transfer saga, Victor Osimhen’s highly anticipated move to Chelsea has collapsed. The deal fell through with just two hours left before the transfer window closed, as the Nigerian forward and the Premier League side failed to reach an agreement.
Osimhen’s prospects of moving to Saudi Arabia have also evaporated. Al Ahli, a potential suitor for the Nigerian striker, chose to sign Brentford’s Ivan Toney on deadline day instead.
The collapse of the Chelsea deal is compounded by a significant breakdown in Osimhen’s relationship with Napoli. Romano reported that if no new bid arrives before the Saudi League transfer window closes—Osimhen risks being frozen out of Napoli’s first-team squad. READ MORE
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