Health Train Express
HEALTH TRAIN EXPRESS Mission: To promulgate health education across the internet: Follow or subscribe to Health Train Express as well as Digital Health Space for all the updates for health policy, reform, public health issues. Health Train Express is published several times a week.Subscribe and receive an email alert each time it is published. Health Train Express has been published since 2006.
Monday, October 26, 2026
Where Was My Generic Prescription Drug Made? - Rx Inspector - ProPublica
Watch this robot cut a cucumber.
Watch this robot cut a cucumber. Look closely at its hands. They’re shaking. The knife wobbles. Every slice looks like a struggle. And this is a cucumber, sitting still on a cutting board. Now picture that same tremor inside someone’s knee. Elon Musk recently said robots will be better than the best human surgeons within a few years. I have a lot of respect for what he’s built. He’s been right about plenty of things people laughed at. But I see this one differently, from where I stand every week in the OR. There are robots far more advanced than this one. I use robotic tools myself, and they make me more precise. But each one works with a surgeon standing right there, ready to take over the moment something looks wrong. Fully autonomous means nobody is standing there. So what happens when the robot starts doing this halfway through a case? Next to a major artery. Near a nerve. While cutting bone a few millimeters from where it should stop. There are no low-stakes moments in surgery. Every procedure is sensitive, because every patient is someone’s mom, dad, husband or kid. A shaky hand at a trade show booth is a funny clip. In an operating room, it’s a disaster. Could fully autonomous surgery happen someday? Maybe. I’d never say never about technology. But not anytime soon. Until a machine can sense trouble, stop, and fix it as fast as a trained human hand, there has to be a surgeon in the room. Would you let a robot operate on you with no surgeon watching? Also... I wrote a publication about disrupting the status quo in our broken healthcare system. Join me here: 👉 https://lnkd.in/gjhatcTH
Wednesday, October 21, 2026
Your DNA Kit Feeds a Surveillance Database, and the Law Does Not Protect Your Data Privacy
Before that cheek swab hits the mailbox, I need you to stop and hear this. The moment the envelope leaves your hand, a private company owns a copy of the one piece of personal data you will never change, never replace, and never get back, and no federal privacy law stands guard over it from that second forward. Read that twice.
What Rides Along in That Envelope
Think of your DNA as the instruction manual for building you. Any mail-in test sends roughly three billion base pairs of that manual to a lab you have never seen. Most labs read between 600,000 and 700,000 markers, and then computer models use a process called imputation to fill in millions of extra data points, the same way autocomplete finishes your sentences on your phone, until the company holds a detailed picture of your biology that no single test ever measured directly. Scientists have shown as few as 30 markers single out one person from the entire human population. That person is you.
Your Family Got Signed Up Too
Your DNA works like a group photo, so when you share it, everyone standing next to you shows up in the picture. Researchers found in 2018 that a genetic database covering only 2 percent of a population finds a third cousin match for almost anyone in it. The day you mail your kit, you enroll your grandmother and your nephew, your second cousins and your kids, in a database none of them ever agreed to join, and not one of them will see a consent form carrying their own name.
15 Million People Learned This the Hard Way
In 2023, hackers accessed about 14,000 23andMe accounts using passwords stolen from other websites. Using the company’s relative matching feature, they scraped data on roughly 6.9 million people, nearly half of its customers.
A hacker calling himself Golem posted one million profiles of people with Ashkenazi Jewish ancestry on a dark web forum. The price, per person, was one dollar. The company took five months to detect the intrusion and then blamed its own customers for reusing passwords.
On March 23, 2025, 23andMe filed for bankruptcy. Twenty-eight attorneys general and the Federal Trade Commission stood up to block the sale of genetic data belonging to 15 million customers who never agreed to any of it, and the bankruptcy court approved the sale anyway, turning those customers’ DNA into an item on an auction block. That is the law today.
Delete Means Something Different Here
Close a 23andMe account, and the company still keeps your genetic information and your date of birth for what it calls regulatory compliance. Data already shared with research partners stays out of your reach for good. Gone is gone. Direct-to-consumer tests sit completely outside HIPAA, the federal health privacy law covering your doctor, and GINA, the closest thing this country has to a genetic privacy law, leaves your life insurance and your long-term care insurance wide open.
Your Move Before the Mailbox
Treat the research consent form like a lease you will live under for the rest of your life, and read it line by line, because 80 percent of 23andMe customers opted into research, many of them without grasping how much they handed over to strangers.
Check your state. California, Montana, Indiana, Texas, Illinois, and Maryland have dedicated genetic privacy laws, and Illinois lets you sue for up to $15,000 per violation. If your state has none, call your legislators and ask for one by name. If you already tested, download a copy of your data, delete your account, destroy your stored sample, and revoke your research consent today in writing. A company’s promise to protect your DNA lasts exactly as long as the company does.
Your ancestry report fits on one page, and the surveillance risk you hand a stranger inside that envelope follows your family for generations, so share this with the people who share your DNA and make the call together before anyone licks the seal.
Mitch Jackson, Esq. [recommendations]
Free subscribers get my new five-page special report, Take Back Your Data Privacy in 30 Minutes. Upgrade to a paid subscription and not only are you helping support this Substack, you also get full access to the PDF version of my 21-chapter, 251-page book, Privacy in America: What Every American Needs to Know.
Monday, October 19, 2026
Epic plans to launch medication price transparency tool
There is now a major effort to lower the cost of prescription drugs. Will it work?
Epic is partnering with Amazon Pharmacy, Mark Cuban Cost Plus Drugs, Costco, and Eli Lilly’s LillyDirect to develop a tool that lets clinicians and patients compare prescription drug prices.
Through the prescription marketplace, slated to launch next summer, clinicians and patients at health systems using Epic will compare medication costs at different pharmacies—patients’ insurance prices and pharmacies’ cash prices—before the prescription is sent. Depending on the medication, the patient’s insurance plan, and the pharmacy, paying cash can sometimes cost less, Epic executives said in a press release.
Any pharmacy can share its cash prices with health systems using Epic, the company said.
Epic is bringing pharmacy price shopping directly into the doctor's office and the prescribing workflow, potentially eliminating the need for patients to discover after leaving the doctor’s office that their prescription is cheaper elsewhere or without insurance.
More than 40% of American adults report not taking their medications as prescribed because of cost, a KFF survey found. Epic currently offers a real-time prescription benefit feature in its electronic health record (EHR) platform that shows physicians what the patient will pay under their insurance, alongside generic alternatives. Epic claims that feature helped patients save more than $250 million in 2025.
Amazon Pharmacy has worked with Epic since early 2025 to help shape development of the prescription marketplace. "Getting medications should be simple, transparent, and convenient," said Tanvi Patel, vice president and general manager of Amazon Pharmacy. "Customers deserve to know what their medications will cost, choose whether to use insurance or pay cash, and get their prescriptions in a way that works for them—whether delivered to their doorstep or picked up at an Amazon Pharmacy kiosk where available."
Mark Cuban, co-founder of Mark Cuban Cost Plus Drugs, said the prescription marketplace will give patients transparency. "If someone’s insurance says a prescription costs $500 but they can buy the exact same drug for $100 at CostPlusDrugs.com, they should know that before they leave the doctor’s office," Cuban said in a statement.
"Having integrated access to clear and transparent pricing enables patients and prescribers to make better decisions, reduce abandonment at the pharmacy counter, and close care gaps," said Ricky Li, assistant vice president at Costco, in a statement.
“Patients shouldn’t have to navigate a complicated healthcare system on their own to understand their options for filling a prescription,” said Jen Mazur, general manager of U.S. LillyDirect at Eli Lilly and Company. “Through LillyDirect, we’re focused on making access to prescribed medicines simpler, more transparent and more convenient. Giving patients and their healthcare providers greater visibility into pharmacy options and costs at the point of care is another important step toward reducing friction in the healthcare experience.”
Drugmakers, retailers and pharmacies are shifting toward greater price transparency and more direct-to-consumer models. Mark Cuban Cost Plus Drugs officially launched in January 2022 as an online pharmacy providing affordable prescription medications through transparent pricing.
Amazon has leveraged its reach with U.S. consumers to expand its online pharmacy business, layering on multiple savings programs such as RxPass and Prime Rx.
Eli Lilly and Company rolled out LillyDirect in early 2024 as an end-to-end portal for patients to access telehealth consultations and order therapies directly from the manufacturer.
Trump Rx launched in February as a direct-to-consumer portal that offers pharmacy coupons and directs patients to drugmakers’ websites, where they can buy certain brand-name drugs at government-negotiated discounts.
Sunday, October 18, 2026
- Sleep
- Exercise
- Stress Control
- Nutrition
- Light
- Focus, Motivation, and Learning
- Personal Growth
Each of these protocols is based on scientific evidence.
Sleep. Sleep helps the brain by actively clearing metabolic waste, consolidating memories, and repairing neurons.
Waste Clearance (The Glymphatic System)
• Clears toxic proteins: During deep sleep, the brain's Glymphatic system expands the spaces between brain cells by 60%.
• Flushes out debris: Cerebrospinal fluid washes through the tissue to remove harmful metabolic waste, including beta-amyloid and tau proteins linked to Alzheimer's disease.
Memory and Learning (Memory Consolidation)
• Transfers memories: The brain replays neural patterns from the day, turning fragile short-term experiences into stable long-term memories.
• Prunes connections: Sleep supports neuroplasticity by strengthening essential neural pathways while pruning away weak or unnecessary information.
• Boosts performance: Adequate rest restores focus, problem-solving skills, creativity, and decision-making abilities.
Reality check. Have you ever worked on a problem and not been able to solve it? You go to sleep and wake up, and the answer presents itself. The common phrase to sleep on it illustrates memory consolidation.
Emotional Regulation and Restoration
• Balances mood: Sufficient sleep stabilizes emotional circuits, reducing irritability, anxiety, and high stress responses.
• Repairs cells: Neurons rest, repair, and replenish vital energy stores and neurotransmitters during active sleep cycles.
Nutrition: The central nervous system receives 35% of blood flow. The brain is highly metabolic, requiring calories and glucose to function.
• Glucose: The obligatory main fuel for the normal adult brain, supplying energy for cellular integrity, ion gradients, and neurotransmission.
• Lactate: Produced and shuttled by astrocytes to neurons via the astrocyte-neuron lactate shuttle (ANLS), or delivered by oligodendrocytes to sustain axons, serving as an active fuel during high neural activity.
• Ketone bodies: D-β-hydroxybutyrate and acetoacetate become major alternative fuels during prolonged fasting, starvation, a ketogenic diet, or the neonatal period.
• Lipids and fatty acids: Recent research demonstrates that synaptic activity can trigger the local oxidation of lipid droplets and consumption of triacylglycerols as an energy source.
• Mannose: Can substitute for glucose by directly entering glycolysis during brief episodes of hypoglycemia.
Saturday, October 17, 2026
Google is Not Your Doctor.
No, Google is not your doctor. Google and Gemini are actually violating your privacy. Hidden within your Gmail, Google is reading it all. It operates all the time, unknown to almost all Gmail users. You can turn it off with little effort.
Contrary to popular opinion, Gmail is not free. Users pay a high price: loss of confidentiality, spam, phishing, and risks of malware.
Thank you to Mitch Jackson, Esq. of Jackson and Wilson Attorneys
If you have used the Gemini app, go to myactivity.google.com/product/gemini, turn off Keep Activity, and delete your history for all time. Know the limit. Google holds every chat for 72 hours even with that setting off, and any chat a human reviewer already pulled stays on Google’s servers, cut loose from your account, for up to three full years after you hit delete.
If you live in the United States and use Gmail, Google’s AI smart features are on unless you turned them off. Google keeps those features off by default in Europe, the United Kingdom, Japan, and Switzerland, places where data privacy law pushes companies to ask first, and here at home the job of finding the off switch lands squarely on you. That is a choice.
Ten Minutes in Settings
On your computer, open Gmail, click the gear, choose See all settings and uncheck Smart features. Stay on the General tab, click Manage Workspace smart feature settings and switch off both toggles inside. Save.
Now pick up your phone, because Google’s own help page admits some changes made on a computer never reach the mobile app, so open the Gmail app, go to Settings, tap your account, and clear the smart features box there as well. You lose Smart Compose. Your privacy is worth more. Check back every few months, since some users have watched these features turn themselves back on after an update.
Every email you send lands in a second inbox you do not control, and the moment it arrives, the recipient’s settings decide what happens to your words and attachments. If your accountant, your doctor, your best friend, or the stranger who answered your email uses Gmail with smart features left on, Google’s AI processes your message inside their account to summarize it and draft their reply, and Google keeps that copy on its servers for as long as they keep it.
Most of the people you write to never touched theirs, which leaves your medical questions and your settlement numbers sitting inside a data surveillance machine you never agreed to, and no court has ruled that anyone owed you a warning. Treat email like a postcard. Before you hit send, picture your words stored on Google’s servers under someone else’s name, because that is exactly where they go when the recipient uses Gmail.
One Big Problem: Your Privacy Ends in Someone Else’s Inbox
Every email you send lands in a second inbox you do not control, and the moment it arrives, the recipient’s settings decide what happens to your words and attachments. If your accountant, your doctor, your best friend or the stranger who answered your email uses Gmail with smart features left on, Google’s AI processes your message inside their account to summarize it and draft their reply, and Google keeps that copy on its servers for as long as they keep it.
Most of the people you write to never touched theirs, which leaves your medical questions and your settlement numbers sitting inside a data surveillance machine you never agreed to, and no court has ruled that anyone owed you a warning. Treat email like a postcard. Before you hit send, picture your words stored on Google’s servers under someone else’s name, because that is exactly where they go when the recipient uses Gmail.
For anything you would not want a machine reading, move the conversation to Signal or to Proton Mail, where messages between two users stay encrypted from your device to theirs, and no company in the middle reads them. That is why I use Signal with every one of my clients, and it is why you should ask the people you trust most to meet you there and send them this post so they understand what the law has left in their hands. Guy Kawasaki co-wrote an excellent book on how to use the Signal app titled, “Everybody Has Something To Hide.” You can download a free PDF of the book here.
For anything you would not want a machine reading, move the conversation to Signal or to Proton Mail, where messages between two users stay encrypted from your device to theirs, and no company in the middle reads them. That is why I use Signal with every one of my clients, and it is why you should ask the people you trust most to meet you there and send them this post so they understand what the law has left in their hands. Guy Kawasaki co-wrote an excellent book on how to use the Signal app titled “Everybody Has Something To Hide.” You can download a free PDF of the book here.








