Why most AI healthcare applications are misconceived

From the text:

Yet decades of transactional, episodic, payment-driven infrastructure undermined the patient–physician relationship at the center of health.

Financing models have stripped Primary Care form its primary role.

That said, Healthcare AI will not be won on automation. Winners will likely optimize for three things simultaneously:

• Outcomes
• Experience — patient and physician
• Economic impact on total cost of care long term

But most healthcare AI investments are mispriced because they target short term transactional efficiency, not long term strategic value creation.

I'm thinking that Ribitzky's need to interpreted in terms of idolatry. Why? Because they reduce humans to mechanisms to be optimized rather than being cared-for.

Adam Neely points out the folly of misusing AI to create music

Neeley (16:33): “I hate small-minded people with money who use technology as a cudgel to enforce their terrible taste on the rest of us.”

Neely's page:

Berklee College of Music now teaches classes in AI songwriting, and that's a really dumb idea.

0:00 Intro
0:43 Student Backlash
2:53 Berklee President’s ties to Suno
4:01 “book burning”
5:42 Problem 1 - Branding
8:17 Problem 2 - Berklee is out of touch
11:03 Problem 3 - “AI Music” and Suno
14:11 Problem 4 - People really don’t like AI music

CEO of Suno, Michael Shulman (c. 5:35):

MIKEY: It’s not really enjoyable to make music now. It takes a lot of time. It takes a lot of practice. You need to get really good at an instrument or really good at a piece of production software. I think the majority of people don't enjoy the majority of the time they spend making music.

ADAM: Berklee had better hope that that's not true because its business model - as well as any music school’s - is based on the idea that people like to make music.

In fact, they like it so much that they're willing to spend a lot of money to learn how to do it better.

Suno was created so that people could make music without having to learn to play instruments, to sing, or how to arrange and compose. It was created to circumvent the human process of music-making. This makes use of Suno idolatrous in the technical sense of that word.

On Problem 2, Berklee being out of touch, Neeley points out that Berklee has courses offering to teach students how to use the Metaverse, which Zuckerberg killed in March, 2026.

Friday Fotos: Popeye's at Newport Mall

Idolatry and A.I. [Magnifica humanitas]

Yuval Levin,  Idols of the Valley, The New Atlantis, May 27, 2026.

Levin is commenting on Pope Leo  XIV's recent encyclical, Magnifica humanitas. The following paragraphs are from the last two sections (of five) in Levin's article.

* * * * * 

Our new technologies are neither demons nor idols, and we must make sure to keep them that way. But it is the challenge of idolatry that will be greatest. It increasingly seems to me that the essential text of the era we are entering will be this opening portion of Psalm 115:

Not to us, LORD, not to us
but to your name be the glory,
because of your love and faithfulness.

Why do the nations say,
“Where is their God?”

Our God is in heaven;
and does what he wills.

But their idols are silver and gold,
made by human hands.

They have mouths, but cannot speak,
eyes, but cannot see.

They have ears, but cannot hear,
noses, but cannot smell.

They have hands, but cannot feel,
feet, but cannot walk,
nor can they utter a sound with their throats.

Those who make them will be like them,
and so will all who trust in them.

Ever since I encountered this mysterious poem as a teenager, I have wondered at the image it paints of idolatry, especially in its stunning two final lines. The idols are made to seem human but do not partake of genuine embodied human experience. And both their makers and those who trust in them are destined to become like them — and so less than human — because they elevate them.

These lines have come to seem less mysterious to me in the last few years. They describe precisely the danger to which Pope Leo is pointing. It is the danger of turning our tools into idols, and thereby of becoming little more than tools ourselves. It is a danger that afflicts those who make these idols, and also threatens those who put their trust in them.

The appeal of idols has always been that they offer shortcuts. The God of the Bible demands that you live in a way that forms your mind and heart and soul toward your fullest human potential. This requires hard work but it yields a kind of person both capable and worthy of a flourishing life. The idol offers the material benefits of such a life without that formative work. And if all you care about are the benefits, not the form of your mind, heart, and soul, then the offer is awfully hard to resist. [...]

Such temptations of idolatry are ever-present. We resist them, now as always, by allegiance to a higher truth about ourselves that is as demanding as it is liberating. And we resist more actively and assertively, too — with the help of rules of conduct that constrain our appetites, of days of rest that offer us relief from the demands that expose us to temptation, and of formative disciplines of the soul embodied in family, faith, community, learning, work, and leisure toward which we are drawn by well-ordered loves.

All of these require us to choose the long, demanding, formative way through life. But various idolatries offer us shortcuts that promise the benefit without the work: Just turn yourself into a tool and you will be more productive without more effort. This is of course just what Magnifica Humanitas warns of. It is what AI at its most idolatrous and dangerous can offer. That doesn’t have to be what AI is in our experience — not at all. But it can be if we aren’t careful.

Negative ROI on AI

The AI numbers are starting to look very ugly.

Even under "best case" assumptions, FT's own data shows Microsoft AI ROI at -9%, Google at -15%, Meta at -28%, Oracle at -35%. Only Amazon barely comes out positive.

This is exactly why I keep comparing this to the dot-com era.… pic.twitter.com/O9Sfaya5Oa

— Yoshik (@AskYoshik) May 28, 2026

The fountain in Shipyard Park, plus geese

Alexandria as the Manhattan of the ancient world, Rome, writing (Rank 2 culture)

Tyler Cowen, Toby Wilkinson on Ptolemaic Egypt and the First Great Commercial Civilization (Ep. 278), May 27, 2026.

Toby Wilkinson is one of the world’s leading Egyptologists, whose books have ranged across the full sweep of pharaonic history. His latest, The Last Dynasty: Ancient Egypt from Alexander the Great to Cleopatra, covers the 300-year Ptolemaic period — stranger and more modern-feeling than the Egypt of the pyramids, built around commerce and cosmopolitanism rather than divine kingship, and home to the greatest concentration of scientific talent the ancient world ever saw.

Tyler and Toby cover how Alexander took over the empire almost without a fight, why Alexandria became the Manhattan of the ancient world, whether the era was as philosophically fertile as it was scientifically, whether your ancient doctor’s visit had positive expected value, what Egypt was actually exporting and selling, whether living standards rose above subsistence or stayed Malthusian, how the ethnic divide between Greek rulers and Egyptian subjects shaped society, what constrained the Ptolemaic Empire from becoming the next Rome, whether Cleopatra has been overhyped, what Julius Caesar was really thinking when he sided with her over her brother, the new frontiers in archeology, whether Herodotus can be trusted, what ancient Egypt knew about Israel and India, when Egyptian jewelry peaked and why, what triggered the sudden emergence of civilization across the ancient world, why a six-year-old Tyler knew King Tut better than Napoleon, and much more.

After the preliminaries, the first of three segments from the whole conversation:

I. On intellectual activity of Alexandria

COWEN: How large was the library in Alexandria and how did they build that out?

WILKINSON: This is interesting because the Ptolemaic kings not only wanted to be wealthy economically, but they wanted to be renowned throughout the ancient world as great scholar leaders. They thought it was important that a new dynasty establish its credentials as a patron of the arts and of learning, not just as the head of a great commercial enterprise.

They invited all the leading scholars from the Greek-speaking world, from right across the Mediterranean to Alexandria, where they provided them with a library, with what was called a museum or a temple of the muses, a place where scholars could think great thoughts and be well looked after. The library was developed over centuries, really, as the greatest repository of learning that the world had ever seen up to this point. It is thought that maybe at its height, it contained half a million volumes, half a million manuscripts, mostly written on papyrus, but representing really the sum total of human knowledge at that time.

COWEN: Euclid and Eratosthenes are connected to this era?

WILKINSON: Almost any big name from ancient science has some connection with Alexandria. Euclid, the mathematician, studied there. Eratosthenes, who quite amazingly calculated the circumference of the earth, he carried out those calculations in Alexandria. There were leaders in the fields of astronomy, of anatomy and medicine, of geography, of philosophy, of literary theory. They were all active in Alexandria under the patronage of the Ptolemaic kings.

COWEN: Am I correct in thinking that the era was quite weak in philosophy in some ways? There’s no great name. Maybe it’s all lost manuscripts. It seems to be a bit like China, infrastructure intensive. They build amazing things. It’s commercial, but they’re not really thinkers.

WILKINSON: I think that would be a misrepresentation. Alexandria under the Ptolemies didn’t produce a Socrates or a Plato. It is true. What its scholars did was to synthesize strands of philosophy from ancient Greek thought, ancient Egyptian thought, Babylonian thought, ancient Hebrew philosophy and religion. It was a melting pot. It maybe didn’t throw up the big name, but it was a very fertile ground for the exchange and the interchange of ideas.

COWEN: Say I try to read Diodorus. There’s a lot of detail, but it’s not to me very interesting. It just seems much worse than Herodotus, who is profound and in a way a step back. Maybe that’s not representative.

WILKINSON: I think there are a lot more scholarly works, both surviving and lost, that were composed in ancient Alexandria that would be more surprising and more revelatory than those that you’ve just mentioned.

COWEN: What was it exactly that was so special about the intellectual, and scientific, and productive environment of Alexandria and environs? Was it that the Egyptians were there, or the mix of Greeks and Egyptians, or something else? What?

WILKINSON: I think there are three factors, really. One is certainly the Egyptian context. I don’t think those intellectual advances that were made in Alexandria could have been made anywhere else. Let’s take anatomy, for example. In the Greek world in general, there was a taboo on cutting up human bodies. Of course, ancient Egypt had a long tradition of mummification, which involved dissecting human corpses. If you were an anatomist and you wanted to make discoveries about how the organs functioned, the only place you could do that at this time was ancient Egypt. The same is true, actually, in many other branches of science. The Egyptian traditions of scholarship and of learning really laid the foundations for Greek thinkers to take them to the next level.

The second aspect was the wonderful infrastructure that was put in place by the Ptolemies to lure scholars to Alexandria. They were paid handsomely. They had access to the world’s best library. They had all of the facilities at their disposal. There was really no better place to be than Alexandria.

The third factor was really the kleptomania of the Ptolemaic rulers. They were not just bibliophiles, but they wanted to acquire a copy, preferably the original, of every book and manuscript circulating in the ancient Greek world. To that end, they indulged in downright thieving. They sent a word, for example, to Athens, which was one of the great centers of scholarship, a rival center of learning, and requested copies of books from Athens’ city library. The copies arrived in Alexandria. They were then seized by the Ptolemaic authorities and kept for Alexandria’s own library. They were only too happy to pay the fine because they had the books. It was a combination of factors that really led Alexandria to being the greatest center for scholars and for scholarship.

II. From the Ptolemaic Empire to Rome

COWEN: Given all the successes, what should I think of as the limiting principle behind rule here? It stretches as far as what we would call Cyprus today, but it never becomes a very large area, right? Now, it doesn’t become the next Roman Empire. Why doesn’t it?

WILKINSON: At its greatest extent, the Ptolemaic Empire includes much of the coast of modern-day Libya, certainly Cyprus, the Nile Valley, parts of present-day Lebanon, and Syria and Turkey, and some islands in the Aegean. It’s not as big as the Roman Empire would later be. What are its constraining factors? Partly, it’s a lack of ambition. Not a lack of ambition, moderate ambition.

The Ptolemies really want to rule Egypt, which is regarded as the jewel in Alexander the Great’s crown. It’s the most prosperous part of his empire. The other territories that they conquer in a ring around Egypt are really only there as a defensive buffer zone to protect Egypt. They have no particular ambition to create a world empire as Alexander the Great did. That was one constraining factor.

They are also not the only players in the ancient world. There are other powerful dynasties of kings in Asia and in the Greek mainland who have territorial designs of their own. It keeps these various powers in equilibrium, and it stops one of them becoming dominant, really, until the Romans upend the whole system. I suppose, yes, those are the two constraining factors, ambition and competition.

COWEN: Do you think the Romans had the ambition in a way Ptolemaic Egypt did not?

WILKINSON: Yes, I do. I think the Romans were motivated by a real desire to conquer. Ancient Roman military leaders were only as good as their last victory on the battlefield. You see that in the later days of the Republic and the beginning of the empire. Whereas in ancient Egyptian tradition, certainly, military success was not the benchmark of a successful reign. It was something that you needed to do in order to protect your own borders. There were other achievements—honoring the gods, building great temples, presiding over a glittering civilization—that were considered equally important.

COWEN: How is it that all this ends, or at least starts to decline? What’s the mechanism?

WILKINSON: It begins with the finances. The Ptolemaic Empire becomes overstretched. It has to invest hugely in its armed forces in order to fend off not just the growing predations of Rome, but actually its closer neighbors as well. That leads to higher taxes. There’s a series of climatic shocks, poor Niles leading to poor harvests. It’s a perfect storm. The economy goes south pretty quickly. The only solution that the Ptolemies can see is to go cap in hand to Roman moneylenders to bail out the Egyptian economy. That then really gives Rome leverage over Egypt.

That all gets bound up in the republican politics of Rome and in the rivalry between Caesar and his rivals, and then ultimately Octavian, who becomes the first emperor, Augustus. Egypt goes from being a great civilization, confident of itself, to being a pawn in other people’s power play. Ultimately, Rome is able to march into Alexandria, overthrow Cleopatra, and seize Egypt for itself. It’s a salutary lesson for our own time that a civilization can appear to the outside world to be magnificent, and wealthy, and successful, but actually the seeds of its own destruction are usually lying there somewhere just waiting for the conditions to germinate. [...]

COWEN: How important a figure is Cleopatra in this whole history? Is it just marketing, and Shakespeare, and Elizabeth Taylor, or was she really at the center of what was happening? Did she matter?

Whoops! The Singularity has been put on hold

OpenAI and Anthropic are effectively telling the market they can't solve every problem with a generic AI coworker.

You don't pour billions into massive forward-deployed joint ventures if you think the next model release is going to take care of it.

In the cloud supercycle,… https://t.co/WdvxuAV6VJ pic.twitter.com/sKdgvGqh2O

— a16z (@a16z) May 27, 2026

From the article linked in the 16oz tweet:

If you're starting a company, The Yellow Brick Road is the most obvious path to go down, but it's the most dangerous. Take a high performing model, plug in some off-the-shelf connectors (like G Drive, Slack, Salesforce, Notion, GitHub), and ship some sort of agentic orchestration layer on top of that. Magic!

The problem with this is that this is what the labs are doing with Cowork and Codex. Obviously, they own the model, which gives them better margins, control, and the ability to exert pricing power on anyone who's downstream from them. But maybe most importantly also own the architectural choices that define what their products are built to solve well. They've been deliberate so far about the model plus tool calls pattern, and this is exactly what horizontal low-step-count work on the road requires. Even if a startup could somehow outperform Codex or Claude Code, the labs have massive distribution arms and the biggest brand halo in AI.

If you're an AI app company running that playbook with the same connectors, no sub-agents or configuration below it, and no distribution, you're likely walking down the road to nowhere.

H/t Gary Marcus

Living in Troy, New York

I lived in Troy from the fall of 1978 to 1998 or 1999. I moved there to take a job at the Rensselaer Polytechnic Institute (RPI) and when I failed to make tenure I stuck around doing things and stuff, including playing in two bands, The Out of Control Rhythm and Blues Band, and the New African Music Collective (NAMC). You can read about my time at RPI in this post. I also worked for MapInfo, a software company started by three RPI undergraduates. Here's a story about something that happened there.

Danger, Will Robinson!

The Devil Wears Prada 2 [Media Notes 182]

I saw the original The Devil Wears Prada back in 2006, when I came out in theaters, and then again in 2022 on one of the streaming platforms. I can’t say that I remember much about it, but if it looked as good as The Devil Wears Prada 2, which I watched in a theater, then I probably liked it. Why? Because the current film is gorgeous and gorgeousness certainly counts for something in a movie. It surely counts for something, even something important. But I can’t carry the whole film.

And neither can a vibe. I’m talking about Meryl Streep as Miranda Priestly, the haughty editor of Runway magazine, a high-class fashion magazine. As soon as the film gets going you know that somewhere down the line that this b*tch Lady Boss will reveal herself to have, if not a heart of gold, at least one filled with crème brûlée. How do you know this? Because you’ve seen lots of movies and that’s how these roll. But you can’t hang the whole damn movie on that unveiling so that the revelation eclipses whatever events brought it about. That’s what Prada 2 does and, I’m willing at this point to assume, the original as well.

Somewhere within view of the end, Priestly is talking with Emily (played by Emily Blunt), a former assistant and explaining why she never promoted her within the magazine. She tells her: “You don't have what it takes. I'm sorry, but you're not a visionary. You're a vendor.” I know what the words mean, but in this context I’m afraid they don’t compute.

There’s nothing in the movie that gives meaning to the idea of a visionary editor of a fashion rag. We’re supposed to believe that that’s what Miranda is because, well, that’s what the plot requires of her, and that’s what she thinks of herself. That’s not enough. In The Aviator (2004) Martin Scorsese shows us what made Howard Hughes a visionary. Francis Ford Coppola does the same for failed auto maker Preston Tucker in Tucker: The Man and His Dream (1988). For that matter, the 2024 documentary, Martha, shows us that Martha Stewart was a visionary, and the first Lady Boss to become a billionaire. None of that, whatever it is, made it into the Prada films.

What we see are gorgeous clothes in beautiful settings. I hardly even noticed the “plot” in this film, which is about Runway being taken over by tech billionaire who has no interest in fashion. All he cares about is generating clicks he can sell to advertisers and settling his girlfriend, the afore-mentioned Emily, in as the new editor. The plot is foiled by Andy (Anne Hatheway), also from the old days (and the original film). What I’ll remember, however, is a beautiful light blue sport jacket in a subtle windowpane plaid worn by Nigel (Stanley Tucci), fashion director for the magazine.

No, I’m afraid there are no visionaries in the movie. Just vendors. High class vendors perhaps, but still vendors. All that talk about beauty and art doesn’t change that.

Three from the festival

Building a machine God

Cade Metz, At the Epicenter of A.I., Pope Leo’s Warnings Are Dismissed, NYTimes, May 26, 2026.

Jeremy Nixon is the 33 cofounder of A.G.I. House in San Francisco, which is a so-called “hacker house.”

Many of the founders and important researchers at Anthropic and OpenAI joined the earliest gatherings at A.G.I. House. Mr. Nixon is now founder and chief executive of a start-up called the Infinity Artificial Intelligence Institute, which is trying to automate the creation of A.I.

Mr. Nixon said he has met a generation of scientists who shunned traditional religion in favor of technology. After growing up with books like “The God Delusion” — in which the evolutionary biologist Richard Dawkins painted God as a false belief contradicted by empirical evidence — he and his peers saw A.I. as an alternative that was more real and far more powerful.

A.I. has started to crack math problems that humans struggled with for decades, he said, and it will soon cure diseases in the same way. “Practically speaking, it will achieve the outcomes that many religions claim their deities would be able to achieve,” he said.

This is an increasingly common belief among researchers in Silicon Valley. They insist they are on their way to building a more powerful species — or even a new God.

“People are matter-of-factly saying that they are looking to build a machine God,” said Rayan Krishnan, the chief executive of Vals AI, a San Francisco company that tracks the performance of the latest A.I. technologies. “They are not saying that ironically or in jest. They are saying it as a matter of fact.”

What Chris Olah said at the Vatican:

“What is actually happening inside them?” he said. “We find structures that mirror results from human neuroscience. We find evidence of introspection. We find internal states that functionally mirror joy, satisfaction, fear, grief and unease.”

Mr. Nixon thought Mr. Olah’s speech was far more spiritual than the words delivered by the pope, even if Mr. Olah was making claims that were not necessarily based on science. Though Mr. Olah hinted that chatbots may have working lives of their own, Mr. Nixon said, they are still very much dependent on humans to do anything, as Mr. Olah noted.

“A.I. is still controlled by people who are trying to make money or solve some mathematical problem or what have you,” Mr. Nixon said.

But what is clear, he added, is that A.I. researchers are trying to build technologies that have jobs, feel joy and pain, and exhibit all sorts of qualities that match and even exceed the traits that make us human. He believes it could happen within the decade. [...]

“A.I. and its capabilities represent something analogous to the Second Coming,” he said.

There's more at the link.

Popeyes in the food court at Newport Mall

Walking is good for creative thinking

Marily Oppezzo and Daniel L. Schwartz, Give Your Ideas Some Legs: The Positive Effect of Walking on Creative Thinking, Journal of Experimental Psychology: Learning, Memory, and Cognition, 2014, Vol. 40, No. 4, 1142–1152. http://dx.doi.org/10.1037/a0036577  

Abstract: Four experiments demonstrate that walking boosts creative ideation in real time and shortly after. In Experiment 1, while seated and then when walking on a treadmill, adults completed Guilford’s alternate uses (GAU) test of creative divergent thinking and the compound remote associates (CRA) test of convergent thinking. Walking increased 81% of participants’ creativity on the GAU, but only increased 23% of participants’ scores for the CRA. In Experiment 2, participants completed the GAU when seated and then walking, when walking and then seated, or when seated twice. Again, walking led to higher GAU scores. Moreover, when seated after walking, participants exhibited a residual creative boost. Experiment 3 generalized the prior effects to outdoor walking. Experiment 4 tested the effect of walking on creative analogy generation. Participants sat inside, walked on a treadmill inside, walked outside, or were rolled outside in a wheelchair. Walking outside produced the most novel and highest quality analogies. The effects of outdoor stimulation and walking were separable. Walking opens up the free flow of ideas, and it is a simple and robust solution to the goals of increasing creativity and increasing physical activity.