Two weekend ‘must reads’: the New Yorker’s Sam Altman/OpenAI exposé–and comments; a further deep dive into Carbon Health’s implosion

Too long to summarize or opine on this week–but a must for your weekend reading. Grab the cuppa for the talk of AI World–a New Yorker dissection of Sam Altman, the CEO of OpenAI (link below). To say it is an exposé worthy, at first glance, of the Old School (ain’t no school like the Old School–Ed.) on probably the most important company of AD 2026 is to undersell it. It’s a long article and you’ll need at least one break.

OpenAI, founded as a non-profit with integrity at its core to “prioritize the safety of humanity over the company’s success, or even its survival”, recapitalized last year as a for-profit corporation with 26% of the shares owned by the OpenAI Foundation. It is now a trillion-dollar company that had no trouble raising a paltry $122 billion last week [TTA 2 April] though arguments are made that at least some of that money are IOUs or contingent. ChatGPT has become almost generic for AI, like Kleenex has become for tissues. The battles over control and direction of the company are now totally controlled by Sam Altman, whom former colleagues are not shy about pointing out his difficulty with the truth and a pattern of deceit, for instance to his board, to employees, and Microsoft. Yet everyone continues to do business with him. The FOMO Factor is very strong.

Mr. Altman makes extremely broad statements on the future of work (most traditional managerial, healthcare, and IT jobs will be taken over by AI, thus most of us will be unemployed), has easy access to President Donald Trump, as well as other world executives, and may, as the headline barks, control our future. Thus, he is a person of consequence.

My read so far of this is that within OpenAI, there is no one to counterbalance Mr. Altman’s immense ambition, his desire to dominate and win, not only with AI but also over all business and everyday life. These are character issues that also show up in aspects of his personal life, detailed in the article. If past results are predictive of the future, this flaw usually curdles into the desire to control countries and a complete disrespect for the rest of us leading our lives. 

Sam Altman May Control Our Future–Can He Be Trusted?

I will offer two LinkedIn comment posts on this article from an AI person I respect, the head of Curiouser.ai, Stephen Klein. Many of his posts on LinkedIn deal with what AI can and cannot do in business. He writes that he is “committed to designing technology that augments people, creates jobs, and elevates humanity. It’s time we all got back to thinking for ourselves.” 7 April, 8 April 

Our second Must Read is from Sergei Polevikov’s AI Health Uncut, a long analysis on the failure of Carbon Health and what it tells us in “this business we have chosen”. “What The Hell Went Wrong?” and its implications need answers–because it’s being repeated again and again. Today’s article (9 April) is Part 1 of 2, sets the stage about the mistakes made (insiders talk) and, with full credit, springboards off Stuart Miller’s (Haverin Consulting) original analysis made at the time of the Chapter 11 reorg. What we called the ‘Ominous Parallels’ was a Must Read here on 12 February.  TTA (as Telecare Aware, our original name) and this article are also mentioned twice (thanks!).

Those who have yet to subscribe for Mr. Polevikov’s analytic, erudite, and revealing (Emperor’s New Clothes!) POVs can read part of this article for free–but seriously, if you’re in this business, the subscription is worth your money. He also podcasts (links are on his Substack, link at lower right sidebar).

An early and scandalous publisher (before he utterly lost it), Matt Drudge, used to say that he ‘went where the stink is’. Mr. Polevikov does the same. The stink is of our broken primary care reimbursement system, the Covid steroids that pumped up the company, flailing management running through money like drugs, and good ideas for patient care buried under incompetence. 

This week’s Must Read: a deep dive on football’s Tom Brady’s involvement with GLP-1 e-Rx eMed

For your reading before the NFL Conference championships on Sunday–when celebrity and phenomenal ability don’t necessarily translate to sound judgment. Sergei Polevikov’s latest dissection of Shady Digital Health Doings in AI Health Uncut focuses on Patriots’ quarterback great Tom Brady’s splashy deal with GLP-1 telehealth prescriber/reseller eMed.–then segues to eMed’s story. Brady was named chief wellness officer of the company last Monday. His job with them? “To raise awareness of a more accountable approach for employers to offer medically supervised population health benefits, including GLP-1 therapies, emphasizing the importance of eMed’s medical oversight and its ability to drive long-term health outcomes.” Qualifications? Brady was famous for his TB12 rigorous training and diet regimen, which extended his career to age 45, about 10-15 years longer than most players. He has zero medical background. 

Mr. Polevikov’s narrative documents Brady’s hands-on (so to speak) involvement with a 2014 football championship scandal (“Deflategate”), then his $30 million spokesman engagement with FTX, Sam Bankman-Fried’s crypto-currency exchange that spectacularly imploded in 2022. For a quarterback whose fame hinged on excellent judgment, except in returning to football after his first retirement, he (and other celebrities) didn’t do the due diligence. But eMed is a step further for Brady. He is more than an eMed endorser–he has an actual company title and an attributed function. Certainly, Brady did not come inexpensively for this relatively young company, funded most recently by Aon Investment for an undisclosed amount.

Background–and interesting intersections. eMed was founded in 2020 by investor Michael Ferro. It started with 2020’s hot product–pandemic Covid-19 tests with online reporting at $35. In 2023, they pivoted into GLP-1 e-prescribing and blood testing. Ferro also founded in-store health kiosk Higi in 2012, though departing management by 2016. Higi was sold to Ali Parsa’s Babylon Health after their spectacular SPAC in late 2021. This would not be the last time Ferro’s and Parsa’s paths would cross, as after Babylon’s Chapter 7 (US) and administration (UK), eMed bought the remains of Babylon Health UK while GP at hand stayed with a group of central London GPs and the NHS. Like the US, the UK operation markets GLP-1 meds to men and women on separate websites (HeMed and SheMed). The US sells both injectable GLP-1s and the new Wegovy oral semaglutide pill.

The rest of the article opens up eMed’s hood, looking at Michael Ferro’s background, some of his hires including Linda Yaccarino (ex-X), Dr. Patrice A. Harris (founder), and (under the chassis) Charlie Javice (a de facto CEO now facing seven years in Club Fed for defrauding JP Morgan with the sale of her company, Frank), and the parts that don’t quite work, such as its financials (allegedly burning through cash) and lack of patient outcomes on GLP-1 meds.

Part of the article is posted on LinkedIn. The article is also on AI Health Uncut on Substack, but a full read requires a modest subscription. It is definitely worth it. Sergei Polevikov is also the host of a podcast, Digital Health Inside Out (free on YouTube), recently interviewing Halle Tecco on what is really broken in healthcare, with a preview of her book ‘Massively Better Healthcare’ (out in February).

Weekend reading/viewing (for me too): Rural telehealth blackouts and value-based care’s ‘utopia’

Your Editor recommends grabbing lunch or a cuppa for these lengthy reads/views:

Flawed Federal Programs Maroon Rural Americans in Telehealth Blackouts. This is mostly about the billions spent in ‘last mile’ programs since the Clinton Administration (!) through the first Trump Administration that were supposed to subsidize better internet connectivity to the un- and poorly connected in US rural areas. This Editor has written about both the FCC Rural Health Program, state programs funded by Covid money, and more pilots going back a decade that never seemed to culminate in success. The programs were makeshift and while some have worked, have left nearly 3 million other rural Americans, young and old, in “dead zones” where even where there is connectivity, there’s not enough bandwidth for telehealth. It focuses on about one-third of West Virginia: 14 counties where high-speed internet deserts overlap with health care provider shortages. Warning, mildly ax-grinding political. Published in the Daily Yonder from KFF Health News.

Value-Based Care: Sluggish Adoption or an Unrealistic Utopia? This panel discussion up on YouTube hosted by Alex Koshykov brings together Sergei Polevikov (AI Health Uncut, see sidebar), Arvind R. Cavale (Clinical Endocrinologist, Diabetes & Endocrinology Consultants of Pennsylvania, LLC), Sally Lewis (Swansea University Professor Value in Health Management), and Mendel Erlenwein (Founder and CEO of CareCo) to discuss what the infamous VBC is really (again) all it’s cracked up to be. It’s supposed to be all about the outcomes, but when was the last time a patient walked in and asked for ‘value’? Having played in the ACO world where the mantra was VBC all the time, like ACOs what it meant went from three supports to four and in the view of whomever you were speaking with. 1 hour 20 minutes.

Weekend reading: 23andMe updates, a view at variance from the former co-founder, and a deeper historical analysis

23andMe passes the ‘First Day Motions’ test in Federal bankruptcy court. On Wednesday, 23andMe received permission from the court to, during their Chapter 11:

  • Pay employee wages and benefits
  • Compensate certain vendors and suppliers in the ordinary course of business for goods and services
  • Enter into the term sheet of the $35 million debtor-in-possession financing agreement (DIP Facility) with JMB Capital Partners
  • Begin the process of selling substantially all of its assets* through a Chapter 11 plan or pursuant to Section 363 of the US Bankruptcy Code.

The court also approved the bidding procedures that take place over the 45-day clock that started with the bankruptcy petition on 23 March. Bidding is conducted by the company and Moelis, their independent investment banker.

  • Qualified bids must agree to comply with 23andMe’s consumer privacy policy and laws regarding treatment of customer data.
  • Any sale transaction involving the transfer of customer data requires court oversight and regulatory approvals.

Additional first day orders on the Kroll (claims agent) website are the retention of two law firms, Goodwin Procter LLP and Lewis Rice LLP by the Special Committee of the board of directors, and the continued use of cash management systems, intercompany transactions, honoring certain prepetition obligations, and priority on administrative expense to postpetition intercompany claims against debtors.

The next step is the ‘Second Day’ hearing that follows up on financing, with the entry of an order approving the DIP Facility and ‘additional requested relief’ that isn’t specified in the 23andMe release

*Given that thousands, perhaps tens or hundreds of thousands of a reported 14 million users, are deleting as much data as they can from the 23andMe database, what will the value of that genetic database be? Regarding that database, will there be a third-party ‘guard’ on that database appointed by the Court?

The TTA summary of the bankruptcy 24-26 March  This Editor likened the 23andMe implosion to that of Theranos–a watershed event that forces a rethinking of how we treat the privacy of customer medical data not covered by HIPAA, such as genetic data, as we approach (or try to approach) the mountain called ‘personalized medicine’.

23andMe’s co-founder, Linda Avey, essayed in LinkedIn yesterday that 23andMe was a missed opportunity to create a grand genomic dataset that would combine blood work, deeper gene sequencing, and wearable date culminating into actionable insights. The data is now fragmented among many holders.  In her conclusion, she was polite but unsparing: “Without continued consumer-focused product development, and without proper governance, 23andMe lost its way, and society missed a key opportunity in furthering the idea of personalized health. The 14+ million people who bought into the concept deserve to see their data moved to a secure platform with new leadership and vision. Consumers, however, should be careful sharing their data if they don’t trust its secure and ethical use”.Ms. Avey, a scientist and venture investor, was forced out of the company in 2009.

23andMe’s failure is more significant than Theranos as an example of reality versus the hype. Theranos was a near-straight up fraud with blood labs that didn’t work. 23andMe had a technology that worked and could with accuracy your ancestry and genetic risk factors, though the latter got them into trouble with the FDA with a cease-and-desist in 2013 [TTA 2 April 2014] that they didn’t emerge from till late 2015. But ancestry and genetic risk are ‘one and done’ readings. It’s not an ongoing business model. How do you get members to return and pay for more tests, even if they lose money? How do you get investors? Pivot to research and ‘therapeutic development’. The reality, as Anne Wojcicki herself admitted, is that there’s no money in diagnosis and prevention. “No one makes money in healthcare by keeping you healthy” and  “There’s no profit motive for people to get this information. A doctor does not make money if they give a diagnostic”–and this was said by her in 2019.

So how did the company become valued at $6 billion by 2021? Work the story, work the hype around preventative healthcare to get more venture rounds and then a SPAC facilitated IPO. “Personalized healthcare”.  A “research platform powered by engaged customers”.  While the real money was in selling the data to Pfizer, Genentech, and GSK–and that started back in 2015. All couched in ‘personalized healthcare’ and research.

Far, far more on this is over at AI Health Uncut, Sergei Polevikov’s Substack site. Grab your cuppa and/or lunch. It has more financial facts, particularly around 23andMe’s early years, and the botched opportunity of the Lemonaid acquisition. Everyone is a loser when it comes to 23andMe, except the Lemonaid founders who walked away with $100 million in cash (but lost $300 million in stock). It comes to the sad and numerically relentless conclusion that 23andMe was actually bankrupt since 2018. It was chasing ‘an impossible dream’ and was dishonest about its business model. The end result was that public trust in health tech erodes again–and that investors and founders trust each other a lot less. (And Mr. Polevikov also dubbed 23andMe another Theranos.)

Editor’s note: AI Health Uncut may be paywalled. I encourage our Readers to support Sergei’s work on Substack–for a modest annual subscription amount, you gain full access to his work, past and present, charts, videos, and articles.

Two Must Reads: What’s Glen Tullman’s real game with Transcarent and the Accolade buy? (updated) Plus an extra helping on the VC ‘mafia’ and Hippocratic AI.

Make some time over the morning cuppa or lunch for a brilliant investigative report on Transcarent and Glen Tullman. Arundhati Parmar over at MedCity News pulls aside some of those Great Oz curtains, surveys the scene, then asks the questions that few have dared to. Such as:

  • Is Transcarent’s model not working? Are they successful or not?
  • Or are those corporations and benefits consultants so hidebound, so powerful, so exclusive, that they forced Glen Tullman to buy into the traditional care navigation model–and he is a Victim of the System?

Those of us in the healthtech/digital health industry have looked with amazement, mixed with dismay, at Mr. Tullman. The amazement is the powerful voice he has among us, reinforced by his investment funds. The dismay comes from the $18 billion sale of Livongo to Teladoc in the palmy days of 2020. As we reported, even then it was regarded as a dubious move. It then became a case study in What Not To Buy–Or Do. From Mr. Tullman’s and his management’s perspective, Teladoc’s offer proved to be Grand Theft Auto. In other words, a heist to end all heists. For Teladoc, it was a disaster. Mr. Gorevic, as we know, is gone and Teladoc is rebuilding. In many ways, Teladoc has never recovered and may never. 

Mr. Tullman, who founded two VCs, 7wireVentures and most recently 62 Ventures, after selling Livongo almost at once founded Transcarent with a vision that it would do the job through software that human corporate care navigators and benefits consultants couldn’t do–take out all these middlemen and deliver to both companies and their employees better quality healthcare at a much lower cost. It would also turn the PMPM (per member per month) pricing scheme into a risk-sharing model based on use. He made the rounds at every conference pitching against traditional care navigators, including the most prominent, Accolade.

Last month, he and Transcarent made a substantial offer to buy, yes, Accolade, for $621 million [TTA 8 Jan]. Publicly traded and struggling for years, recently losing major accounts, Accolade was on the block–yet its model is so different than Transcarent’s that it feels like double vision. In fact, this deal had been in the works since last July–initiated by Glen Tullman. Why?

A clue from one of Ms. Parmar’s sources, most of whom have had to be anonymous for obvious reasons:

“He is an amazing storyteller and amateur magician. But like any story and magic trick, sometimes it’s hard to tell what is real and the trick doesn’t work. ”

Ms. Parmar’s path to answering these questions is top notch, and this Editor invites you to read it, start to finish–and return to it again. When you finish it, you’ll not only know about Transcarent’s current business realities, but also learn a great deal about how companies regard care navigation plus the economics. The discrepancy, as always, is between the ‘vision’ and reality. Is he in it for the mission, or has reality bitten? Is Glen Tullman a Hypocrite or a Victim of the System He Aimed to Disrupt? (I also want to commend MedCity News for publishing this)

Update: See Ms. Parmar’s video on LinkedIn regarding the response to her article. Of note: 1) the complete lack of response from Transcarent’s corporate communications team*. 2) If you want investigative journalism, you have to be willing to be a source, so when you see something wrong, you have to reach out. That means risk. (*No surprise to this Editor, who directly contacted Transcarent’s corporate comms team to clarify whether 98point6’s telehealth service, purchased for $100 million, still was operating–no reply to this simple ‘layup’. TTA 5 Feb)

Our ‘extra of the day’ is from AI Health Uncut. Sergei Polevikov, publishing on Substack, puts on the scuba gear and dives deep not only into Hippocratic AI, which promotes AI agents for various types of healthcare contact requirements, but also its key funder, General Catalyst and its head, Hemant Taneja. For starters: Hippocratic AI is the most expensive AI company on Planet Earth if viewed as valuation x revenue multiple. Mr. P brings the numbers and the heat.

If you’ve looked at fundings in the past two years, versus the ‘olden days’, and wonder why the same names always seem to pop up, it is because VC fundings have become concentrated among very few companies. As this Editor noted in the Rock Health 2024 results, of 391 VC funds, 30 raised 75% of all US committed capital. Nine of those funds accounted for 50% (Pitchbook). Sitting at or near the top is General Catalyst, which has moved into wealth management and through HATco, owning hospitals such as Summa Health. But there are other reasons as well, and Mr. Polevikov gets into the murk.  It’s another one for a long cuppa or lunch. And it is part one of two, upcoming!

I encourage our Readers to support Sergei’s work on Substack–for a modest annual subscription amount, you gain full access to his work, past and present, charts, videos, and articles. (I did, and have noted his site among Websites We Like.) The link above may be paywalled as a result for non-subscribers. [Disclaimer: through commenting in this article, I pointed out GC’s move into GC Wealth, and my short news item is linked.] He also recently posted a lively panel discussion video with Alex Koshykov, Matthew Holt, and James Wang.  

2025 is proving to be a year of massive change in healthcare. It may be a year of comeuppance for those we’ve regarded as all powerful and fearsome. Yes, the cliché ‘sunshine is the best disinfectant’ is true, but a good dose of hydrogen peroxide, boric acid, or Lysol helps.