How BrewDog showed the limits of community capitalism

Source: The Conversation – UK – By Kingsley Omeihe, Senior lecturer of Marketing and Small Business, University of the West of Scotland

Graffixion/Shutterstock

When brewery and pub chain BrewDog invited customers to become shareholders through its “Equity for Punks” scheme, it appeared to represent a new model of capitalism. It invited beer enthusiasts to invest in the company and become small shareholders. This allowed the Scottish firm to present itself as a community built around rebellion, identity and participation.

For a time, the BrewDog model looked remarkably successful – the company was once valued at £2 billion. But after its sale to American cannabis and alcohol firm Tilray for just £33 million, it is clear that there is more to the story.

The real story here is not about one craft brewer. It is about a broader shift in modern capitalism, where companies increasingly use narratives to mobilise communities and raise capital. But at the same time, the institutional rules of finance still determine who gets what and when.

BrewDog raised substantial capital (said to be £75 million) from thousands of small investors who were already loyal to the brand. Instead of relying exclusively on banks, venture capital or institutional investors, the company mobilised its own community to fund growth. Customers became shareholders, while the firm strengthened its reputation as a disrupter within the industry.

Then came the bar closures, job losses and BrewDog’s sale to Tilray. These developments suggest that small investors from the Equity for Punks programme will see little financial return.

In general, supporters tend to see themselves as partners in an entrepreneurial journey. Yet legally they remain minority investors. And minority investors occupy a very specific position within the institutional architecture of capitalism.

The BrewDog story is a reminder that markets run on stories as well as money. The effect of this has been to blur the boundary between customer and investor.

We believe that people rarely invest only because of spreadsheets. Our research on entrepreneurship shows that economic behaviour is shaped by trust, narratives and shared identity as much as by financial indicators. And the American sociologist Mark Granovetter argued that markets are “embedded” in social networks, meaning that people invest in people – and in their stories.

This resonates with our broader research on how economic exchanges, including investments and purchases, are also often sustained through these factors. BrewDog’s Equity for Punks model captured this dynamic perfectly.

But there’s also a question around what it really means to be part of a community when the balance sheet starts to matter.

Cold beer, cold reality

Community narratives may mobilise people to invest their money, but a body of strict rules and regulations shapes the outcome. Three points here are particularly important.

First, while the equity-public model undoubtedly has appeal, it’s also true that companies operate within legal frameworks that determine ownership rights and the order in which creditors are repaid if the company is liquidated or sold.

Second, lenders and structured investors typically enjoy protections that small retail investors, like BrewDog’s punks, do not.

Third, corporate finance works through a hierarchy, so it should be recognised that this places creditors ahead of shareholders when companies face financial stress. Shareholders are last in line to recoup their money from a company – after lenders, tax authorities, employees and suppliers.

When customers invest in companies they admire, they often interpret their role differently from conventional shareholders. Under BrewDog’s Equity for Punks programme, thousands of customers bought small stakes in the company not just for potential financial returns.

This point resonates with our research on how businesses and communities interact. It shows that economic behaviour is often shaped by the rules, expectations and relationships that surround markets. In practice, this means that people do not make decisions based only on prices or profits.

interior of brewdog pub filled with drinkers and diners.
BrewDog’s fortunes have changed, with recent pub closures and layoffs.
photocritical/Shutterstock

None of this suggests bad faith on the part of companies like BrewDog. It simply reflects the fact that markets operate through institutions.

Episodes like the BrewDog one serve as a reminder of a basic feature of modern capitalism. That is, when financial pressure appears, institutional rules take over.

All that being said, community-driven investment models will probably become more common. Digital platforms make it easier than ever for firms to mobilise supporters around shared narratives and identities. But at the same time, the institutional rules that govern corporate finance have not evolved at the same pace as these new forms of participatory capitalism.

If modern capitalism increasingly invites people to invest not only their money but also their faith, the gap between narrative and institutional reality will become harder to ignore. Communities may power the stories that fuel entrepreneurship. But when the balance sheet tightens, it is still institutional rules that decide who gets paid.

BrewDog did not respond to a request to respond to the claims made in this article.

The Conversation

The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

ref. How BrewDog showed the limits of community capitalism – https://theconversation.com/how-brewdog-showed-the-limits-of-community-capitalism-278122

Why drawing eyes on food packaging could stop seagulls stealing your chips

Source: The Conversation – UK – By Laura Kelley, Associate Professor, Centre for Ecology and Conservation, University of Exeter

Animals generally respond defensively when they see eyes staring at them. Stephen A. Waycott/Shutterstock

The increasingly urban lifestyles of seagulls in the UK and around Europe has made them experts at grabbing food from unsuspecting outdoor diners. Herring gulls in particular are gaining a reputation for food theft in seaside towns like Falmouth in Cornwall, where I live.

On a day out at the beach last summer, I watched as one rummaged through an unattended bag and hopped off with a packet of crisps. Sadly, the gull didn’t hang around long enough for me to see whether it successfully opened the packaging.

Watching this kind of behaviour led me and my colleague Neeltje Boogert to explore new ways of deterring these resourceful birds. Our new research shows that displaying a pair of eyes on food packaging can be enough to stop some gulls from pinching your food.

This builds on our previous work which showed herring gulls approach food more slowly when someone is looking at them directly, compared with if they are looking away.

Many animals – both wild and domesticated – are very aware of eyes, which can indicate the presence of a predator or be used to communicate intent. Direct eye contact often conveys aggression, while looking away indicates a lack of threat.

Animals generally respond defensively when they see eyes staring at them. This is probably an instinctive tendency, since avoiding being eaten by a predator can be a split-second response.

Some animals may have evolved markings to exploit this behaviour. So-called eyespots are found on many insects, amphibians and fish, and they come in a variety of colour, size and pattern combinations.

Exactly how eyespots might deter predators has been hotly debated by scientists for over a century. They may increase predator wariness by being mistaken for predator eyes, or divert attacks to less important parts of the body.

Given that evolution suggests eyes are a good way of increasing animal wariness, the idea of mimicking nature by using fake eyes to deter other animals has been tried in a variety of settings.

In Botswana, livestock are at risk of being eaten by ambush predators such as lions and leopards, which causes conflict with farmers. To test whether eyespots could reduce the risk of predation, experimenters painted pairs of eyes or crosses on the rumps of cattle, or left them unmarked. This was repeated across multiple cattle herds, and any attacks on cattle were recorded.

During the study, 19 cattle were killed by lions or leopards – but none of the cattle with eyespots on their rumps were among them. They were also attacked less than either cattle with crosses or unmarked cattle, suggesting that eyespots can be an effective deterrent for a wide range of animals.

Put off by the eyes

For our study of herring gulls, we tested this idea in coastal towns in Cornwall where gulls are known to take food from people eating outside. We stuck pairs of eyes onto food takeaway boxes and presented individual gulls with a choice of two boxes placed two metres apart on the ground: one box with eyes and one plain box.

Gulls appeared to be put off by the eyes, as they were slower to approach and less likely to peck at these boxes, compared with the ones without eyes.

Food cartons with and without the fake eyes.
Food cartons with and without the fake eyes.
Laura Kelley, CC BY

We also wanted to know whether gulls would, over time, figure out that the eyes on boxes were not really threatening. To test this, we presented 30 gulls with one takeaway box either with or without eyes, but did this three times for each gull over a short amount of time.

Around half the birds never pecked at the box with eyes, whereas the other half quickly approached and pecked. This suggests there could be a sustained effect from the fake eyes for some gulls that do not realise they are being tricked.

We now want to test this in a more realistic setting, by teaming up with food vendors and asking them to use takeaway boxes with eyes on. While this might only ever deter half of gulls from stealing food, perhaps when paired with other deterrents – including shouting – it can have an impact on the amount of food theft.

Eye-like markings have already been used to exclude birds from certain areas, including keeping starlings away from crops, seabirds from fishing nets and raptors from airports.

Video: SciShow Psych.

Humans respond to eyes too

It’s interesting to note that people, like gulls and many other animals, also pay attention to eyes. Images of human eyes have been found to reduce bicycle theft, reinforce honesty, and even increase charitable donations – all by creating the impression of being watched. This is probably because we are a social species, and tend to act more honestly if we feel we might be judged by an onlooker.

But as with herring gulls, the effect on human behaviour is inconsistent. Images of eyes can nudge behaviour in certain situations, but they don’t work on everyone.

Whether protecting chips, bicycles or cattle, the next step is to understand why some animals (and people) do not find eyes aversive. But already, the evidence is clear that fake eyes can offer a cheap, simple way to mitigate conflict with humans and other animals.

The Conversation

Laura Kelley receives funding from the Royal Society.

ref. Why drawing eyes on food packaging could stop seagulls stealing your chips – https://theconversation.com/why-drawing-eyes-on-food-packaging-could-stop-seagulls-stealing-your-chips-278269

Type 1 diabetes linked to higher dementia risk – new study

Source: The Conversation – UK – By Craig Beall, Associate Professor in Experimental Diabetes, University of Exeter

Pressmaster/Shutterstock.com

As increasing numbers of people with type 1 diabetes live into old age, a large new study has found they face almost three times the risk of developing dementia compared to people without the condition – raising urgent questions about how the disease affects the brain over time.

To put this in context, of the 283,772 people in the study, 5,442 had type 1 diabetes. Of those, 144 people went on to get dementia. That is 2.6% of that group.

Of those without diabetes, only 0.6% went on to develop dementia. Once the researchers had accounted for factors like age and education level, the overall increased risk was about three times higher.

A similar trend appeared for type 2 diabetes. Those people had roughly a twofold higher risk.

It is important to note that this data was taken from a health registry. This gives imperfect data, as some people will have undiagnosed diabetes and others will be misdiagnosed with the wrong type of diabetes. Some dementia cases may also have been missed. The follow-up period in this study was also relatively short at roughly two and a half years.

However, the data follows trends similar to that seen in a smaller Swedish study, published in 2025. In this study, those with type 1 diabetes had a roughly twofold higher risk of dementia. This study also had a longer follow-up of 14 years.

Why type 1 diabetes, specifically?

This raises the question of why type 1 diabetes appears to carry a higher risk of dementia. There are a number of reasons, including that those with type 1 diabetes may have lived with diabetes for more years than type 2 diabetes. Type 1 diabetes can occur in younger people, and having a chronic disease for more years increases the risk for other conditions.

There is also the rollercoaster of blood sugar levels. The peaks and troughs are typically more extreme in type 1 diabetes.

It is particularly the low blood sugar levels that are dangerous. Very low blood sugar can harm the brain by putting stress on its nerve cells. Those with type 1 diabetes have roughly twice as many bouts of low blood sugar compared to type 2 diabetes.

Also, after a low, rapid and extreme high blood sugar further worsens brain cell health. A recent study in mice found that having high blood sugar after a low blood sugar episode may cause even more harm – especially to the hippocampus, the part of the brain that helps with learning and memory.

One of the main reasons for the extreme variation in blood sugar seen in type 1 diabetes is insulin. Compared to tablet-controlled type 2 diabetes, multiple daily insulin injections always carry an increased risk of low blood sugar.

Despite careful monitoring and carbohydrate counting, accurately managing blood sugar using insulin is difficult. Patches that continuously monitor blood sugar and insulin pumps (devices that automatically infuse insulin) have helped to reduce but not eliminate hypoglycaemia. However, the link between insulin and dementia runs deeper.

The insulin connection

Insulin levels are controlled by how much hormone gets made and how quickly it is broken down. In the case of breakdown, this is controlled by a molecule called insulin-degrading enzyme. Despite the name, this molecule also breaks down a protein strongly linked with dementia, called amyloid beta.

If there’s too much insulin, the enzyme focuses on insulin first. This means less amyloid beta gets broken down, so it can build up in the brain.

This is bad as amyloid is a sticky protein that clumps together in the brain to make amyloid plaques. These clumps are thought to damage the way brain cells communicate, eventually causing an increasing number of brain cells to die. The brain begins to shrink, impairing cognition.

These plaques are linked strongly with Alzheimer’s disease specifically. And type 1 diabetes is associated with an increased risk of developing Alzheimer’s.

There is also an increased risk of developing vascular dementia, the type caused by poor blood supply to the brain. This is because high blood sugar damages blood vessels throughout the body, including the brain.

Despite these rather gloomy links, there is cause for some optimism. Diabetes is now more treatable than ever. Many older people with type 1 diabetes have lived with the disease for 60, 70 or even 80 years.

There are many classes of drugs for all forms of diabetes. With combinations, there are over 50 different treatments available.

Some diabetes drugs may lower the risk of dementia. For example, metformin – the main treatment for type 2 diabetes – can reduce dementia risk by more than 10%. It works by helping the body use insulin more effectively.

Whether the brain benefits of this drug also occur in those without diabetes is currently being tested in the Metformin in Alzheimer’s Disease Prevention trial. This drug is increasingly used in people with type 1 diabetes, particularly those with reduced insulin sensitivity.

There are mixed results on whether weight-loss drugs reduce dementia risk. A large trial showed limited to no benefit of oral weight-loss drugs on dementia progression in people with mild cognitive impairment and Alzheimer’s.

Another study using the weight-loss drug liraglutide, however, showed some benefit. This smaller drug – potentially more able to get into the brain – helped to better protect cognition in people with mild-to-moderate Alzheimer’s.

These drugs are increasingly being used in type 1 diabetes, as early evidence suggests they help blood sugar control. Whether this can also protect the brain in type 1 diabetes remains to be determined.

However, physical activity can lower the risk of dementia. A 2025 study found that the more people exercised, the lower their risk of developing dementia. Around 30 minutes of exercise each week decreased risk by about 40%. Those who were the most active, doing over 140 minutes per week, had nearly 70% decreased risk.

Staying active and tailoring diabetes treatment over time may help reduce the higher risk of dementia in people with type 1 diabetes. The continuing progress in stem cell therapies for type 1 diabetes gives further reason for optimism.

The Conversation

Craig Beall currently receives funding from Diabetes UK, Breakthrough T1D, Steve Morgan Foundation Type 1 Diabetes Grand Challenge, Medical Research Council, NC3Rs, Society for Endocrinology and British Society for Neuroendocrinology.

ref. Type 1 diabetes linked to higher dementia risk – new study – https://theconversation.com/type-1-diabetes-linked-to-higher-dementia-risk-new-study-278474

Why the gender wealth gap is still so stubborn – and what it means for women’s wellbeing

Source: The Conversation – UK – By Madeline Nightingale, Research Leader in the Education, Employment and Skills Research Group, RAND Europe

OlhaTsiplyar/Shutterstock

Inequality in wealth between men and women has not always received the same attention as similar disparities in employment and earnings. This is perhaps because wealth – things like property, savings and investments – is seen as a private matter. This issue has become known as the “gender wealth gap” and it is a damaging and persistent feature of the economy.

This gap in wealth appears to be growing rather than shrinking. Back in 2019, the UK government published a gender equality roadmap that highlighted the gender pension gap as a key issue. But it did not mention inequalities in other forms of wealth, such as personal investments in stocks, bonds, property and business wealth.

And a recent gender equality strategy from the European Union emphasised the need for women to “thrive” in investing or entrepreneurship, but did not even mention the gender wealth gap. Despite its marginal position in the debate, the gender wealth gap matters enormously for women and girls, shaping their income, financial independence and long-term security.

Estimating the size of the gap is made difficult by the lack of data – most data sets collect information on wealth at the household rather than the individual level. But we know from our own research involving disaggregated data from countries like Germany that assets are often not shared or equally distributed between members of the same household.




Read more:
Why your personality might be affecting your salary – and how it shapes the gender pay gap


According to a 2025 estimate from feminist thinktank the Women’s Budget Group, the gender wealth gap in the UK stood at 21%. This was higher than the gender pay gap, which was estimated to be 13%.

There are also differences in the type of assets held by men and women, with men more likely to hold riskier assets including investments and business wealth. These tend to generate higher returns. And over the course of a lifetime, gender disparities in wealth accumulation grow, peaking at retirement age.

The causes of gender wealth gaps can be mutually reinforcing. Women’s lower engagement in paid work (lower employment rates and shorter hours) is a trend that is closely linked to their greater role in unpaid care and domestic work. This is a key factor in the gender wealth gap. So policies and initiatives to reduce gaps in employment and pay will certainly help.

The confidence question

However, research also points to other factors at play. A consistent finding across countries is that women have lower rates of financial literacy than men and lower confidence in their financial knowledge and skills.

A prime example of this showed up in an experimental study from the Netherlands. This found that women were more likely than men to select the “don’t know” option on survey questions about financial knowledge. But when this option was removed, they often selected the correct answer.

The drivers of this low confidence partly reflect differences in early socialisation, with boys on average receiving more pocket money than girls. Women are thought to be more risk-averse when investing, which could be a result of lower financial confidence (as well as of having less income to invest overall).

Women on average also receive less wealth in the form of inheritance and gifts than men, particularly at younger ages. And timing matters, due to the way in which wealth compounds over the years. Crucially, women on average have less business wealth than men – and female founders face greater barriers when trying to secure funding for their companies, for instance.

aerial shot of a woman looking at an investment app on her phone.
Financial education starting in school could encourage more women to start investing.
M M Vieira/Shutterstock

It’s true that wealth may be shaped by individual choices that are beyond the purview of governments and regulators. But these choices are not made in a vacuum. Initiatives can shape the context in which decisions are made, paving the way towards a more equal future.

Large-scale, accessible programmes are needed to increase financial literacy and confidence, including in schools. Greater representation of female high-earners and employers could also encourage an investment ecosystem where women would feel more welcome. According to a European study, female CEOs tend to employ more women – but drawing women into higher-paying sectors needs to start early at school level too.

There is no magic bullet that will dramatically reduce the gender wealth gap quickly. But there are things that can be done, and there is a compelling need to act. Without targeted initiatives, women who break down the workplace glass ceiling to become high achievers and high earners could find that they are still disadvantaged compared to their male peers.

The Conversation

Madeline Nightingale led a project funded by the European Institute for Gender Equality (EIGE), which examined gender wealth gaps.

Elizabeth Kadar worked on a project commissioned by the European Innovation Council and SMEs Executive Agency (EISMEA), which mapped the gender investment gap in Europe.

ref. Why the gender wealth gap is still so stubborn – and what it means for women’s wellbeing – https://theconversation.com/why-the-gender-wealth-gap-is-still-so-stubborn-and-what-it-means-for-womens-wellbeing-277931

Trump’s new child care subsidy rules compound an already dire situation for providers and families

Source: The Conversation – USA (2) – By Beth Kania-Gosche, Professor of Education, Missouri University of Science and Technology

Students play with toys in a basin of soapy water at a child care center in New Britain, Conn., in March 2025. Mark Mirko/Connecticut Public via Getty Images

I live in the small city of Rolla, Missouri, where half the child care centers have closed in the past six years. In the past year, my state has lost 1,771 child care slots due to closures.

This problem isn’t isolated to Rolla – child care providers are closing in other rural areas. Some of the challenges these centers face are widespread. U.S. child care workers typically earn little money, yet child care costs are high for many families.

Approximately 1.4 million children whose families are low-income benefit from child care subsidies, which means the federal and state government partially cover the cost of child care. States typically receive federal funding that they match and then give to subsidize individual children’s care at child care centers.

In early January 2026, the Trump administration announced that it had temporarily frozen federal child care subsidy payments to all states because of fraud concerns in Minnesota.

A group of states – Minnesota, New York, California, Illinois and Colorado – then sued the Trump administration. A federal judge ruled on Jan. 26 that the administration must deliver nearly US$10 billion in federal child care subsidies to these states.

The new policy also creates new verification rules – like stricter proof of parents’ employment – that are making it more time-consuming and complicated to receive subsidies.

Despite the lawsuit, these other new subsidy rules remain in place – meaning that, among other things, child care providers have to do more paperwork and receive reimbursement from the federal government later than they typically do.

A woman leans over three babies and toddlers who are sitting on the floor among plastic toys. One of them is crying.
A child care worker cares for young children in the infant room at TLC for Tots day care center in Nampa, Idaho, in November 2024.
Melina Mara/The Washington Post via Getty Images

An already tough situation

Already, many child care providers are struggling to keep their doors open.

I am a professor and the chair of the education department at Missouri University of Science and Technology. I help prepare my students – future teachers – to become the next generation of educators. Part of my job is also supporting our campus child development center, which cares for babies and young children of staff, faculty and students.

Across the nation, over 14 million children potentially need child care, but only 10 million slots exist.

Even if parents can find child care, its high cost can be prohibitive, sometimes leading to young parents with low-paying jobs leaving the workforce.

How child care subsidies work

Placing an infant in an early childhood or day care center can cost parents annually an average of $15,000. These costs can rise up to more than $28,000 in places like Washington, D.C.

While subsidies can help offset the high cost of child care, only approximately 15% of children whose families are eligible for subsidies receive them.

The federal government distributes subsidies to designated state agencies that are responsible for contracting with providers and verifying family eligibility. States must match some of these funds. Parents then apply through their state to receive a subsidy.

Families generally pay the rest of their child care center costs on a sliding scale.

The exact requirements for receiving child care subsidies vary across states, both when it comes to families and providers. Often, states require that parents are working or are in school, and that they make less than a certain income.

In New York, a family of four could qualify if they earn up to nearly $110,000 each year. In Florida, a family of four could earn as much as about $56,000 a year and qualify.

The amount families receive in subsidies also varies, but getting them could save a family approximately $10,000 a year in a place like Seattle.

Getting a child care spot isn’t a guarantee

It can be difficult for families to apply for and receive child care subsidies. It requires extensive paperwork, and families often have to spend hours on the phone and deal with confusing instructions about how to receive the benefits.

In some states, there is a wait list to receive a child care subsidy.

In March 2026, Missouri started a child care subsidy waitlist. Before, families used to be able to receive child care subsidies immediately after approval, if they could find a provider. Now, families must wait until funding becomes available.

Providers may be reluctant to accept subsidies to help pay for a child’s care, in part because of the additional work of submitting a child’s attendance records to the state and verifying other information. Some providers simply cannot afford to gamble on delayed payments, which happened during the 2025 federal shutdown, for example.

In Missouri, child care center providers had their subsidy payments delayed for months when the state simply switched to a new system to process payments in 2023 and 2024.

Some states, including Arkansas and Oregon, have also cut their own funding for child care subsidies over the past few years.

Rural and other underserved communities are particularly hard hit by any subsidy delays and cuts.

When there is high demand for child care, there is little incentive for providers to accept subsidies and receive state reimbursement six weeks later, after they file extensive paperwork. The alternative for some providers is to largely enroll wealthier families to pay the full cost of care.

The math doesn’t work

The child care industry faces other challenges.

Despite some recent wage increases, child care workers are among the lowest-paid professionals in the U.S. They earn, on average, about $15 an hour, depending on where they live. They often do not receive other benefits like insurance or retirement.

Child care workers earn so little in part because child care centers typically run on thin margins. They often do not make a profit, unless they are part of a large, national chain, like Bright Horizons.

Most child care providers are small businesses, whether they are run out of a designated center or someone’s private home. Unlike K-12 public school districts, these child care providers typically do not receive any government funding.

If a child care provider raises the wages of child care workers too much, and subsequently increases its tuition rates, most families cannot afford to send their kids there – especially babies.

At the child care center on my campus, for example, raising child care worker wages from $15 to $17 an hour would cost over $85,000 annually. We would need to raise tuition rates by $1,000 per year, per child, to offset that cost.

The younger the children that a center has in a program, the more child care workers it needs to employ. In Missouri, for example, state regulations require that there is one caregiver for every four babies in a child care center.

A person wearing a green shirt holds a sign that says in purple and black 'I spend $21,000 a year on child care.'
People hold signs lamenting high child care costs as they attend a news conference on universal child care in November 2024 in New York City.
Michael M. Santiago/Getty Images

No clear way forward

There are 16,000 fewer child care providers in the country than there were before the COVID-19 pandemic.

The federal government distributed $53 billion to support the child care industry during the pandemic in 2020 and 2021. Nearly all child care providers received money as part of this funding. But the money that kept some centers afloat during that time has now been spent.

Now, it remains difficult for many families to find affordable child care within a reasonable distance.

While the Trump administration’s freeze on child care subsidies may never take effect, the stricter verification rules are already making an impossible situation for families a whole lot worse. And if subsidies are cut off as well, more American families will simply be unable to afford child care.

The Conversation

Beth Kania-Gosche is the Missouri University of Science & Technology education department chair. Part of the department includes the on campus Child Development Center, which is contracted with Missouri DESE to receive childcare subsidy. The Child Development Center also received state covid relief funds for childcare. She is the current president of the Missouri Association of Colleges for Teacher Education.

ref. Trump’s new child care subsidy rules compound an already dire situation for providers and families – https://theconversation.com/trumps-new-child-care-subsidy-rules-compound-an-already-dire-situation-for-providers-and-families-275295

Global copper demand outstrips supply, threatening electrification and industrial growth

Source: The Conversation – USA (2) – By Morgan Bazilian, Professor of Public Policy and Director of the Payne Institute, Colorado School of Mines

Capstone Copper’s Pinto Valley Mine in Miami, Arizona. Jim West/UCG/Universal Images Group via Getty Images

Demand for copper is surging because of demand from new technologies, but suppliers are struggling to keep up, and they are likely to fall further behind in the coming years, resulting in shortfalls globally. Even though copper prices are at historically high levels, the financial risk involved in mining means that prices will need to go much higher before mining companies see profit in addressing the supply shortage.

Those are the key findings from our March 2026 analysis of the global copper market.

Copper is an essential material that is used in generating and distributing electrical power; cables, wires, motor windings, transformers and cooling equipment in data centers; and advanced manufacturing of consumer and defense products.

It’s so important that in 2025, the U.S. Geological Survey designated copper as a mineral “vital to the U.S. economy and national security.”

Copper is abundant in the ground, but there’s not enough being extracted to be able to meet the demand. That’s because investors want higher and more reliable returns than copper mines currently offer, and the industry faces complex permitting processes and can’t find enough workers. Our analysis found that for new technologies to continue to develop, and for the global economy to continue to grow, even higher prices are ahead.

Few options other than mining

In the United States, the increased effort to build data centers for artificial intelligence systems has created a massive need for copper. Car manufacturers require some copper for internal combustion vehicles and four to five times more for the batteries and other parts of electric vehicles. In addition, as global temperatures increase, demand for power-hungry air conditioning in many emerging and developing economies has been growing, too, requiring copper inside the equipment and more wiring to power them.

Recycling existing copper could help reduce the amount needed from new mines, but it would not be enough to meet the rising demand. Even under generous assumptions, we found that recycling might provide 35% of the global copper supply by 2050, with mining producing the remaining 65%.

Substituting another material for copper won’t really work either – at least in the short-to-medium term. Copper has an unmatched combination of physical properties such as electrical conductivity, durability and flexibility – which is why it became popular for so many purposes in the first place.

Aluminum could replace it in some cases, but not all – and that would amount to only about 2% of total copper use.

Fiber optics can also replace copper at times. Their glass fibers can carry more data more quickly than copper wires, but they can’t also carry power. New copper substitutes, like ultra-conductive aluminum, carbon nanotubes, and niobium phosphide, are promising but still in their infancy.

Complicated circumstances

The only other way to get more copper is to mine more of it. But building a new mine can take 20 to 30 years – a period during which investors are spending money but not yet getting returns, and a time when costs can rise significantly from preliminary estimates.

If industrial and economic growth is to stay on track in the 2030s, new mines would need to be in the financing and permitting processes right now. But they aren’t.

Even Resolution Copper, which started decades ago trying to develop a mine in Arizona outside Phoenix, has more work to do before being able to start mining. Since 1995, the project’s developers have spent several billion dollars on planning, permitting and legal cases.

Once in place, it could meet as much as 25% of U.S. copper demand from a high-concentration body of ore located near existing truck and rail lines.

Evaluating the environmental and community effects of proposed mining projects is essential, but in many countries there are overlapping levels of review that have different, and variable, timelines. And many parts of the process can be appealed to courts by opponents or supporters. That increases costs and imposes time delays for mine developers – and means consumers will have to wait longer, and pay more, for copper-intensive products and services.

Yet even though copper prices are near historic highs – over US$13,000 per ton on the London Metals Exchange – the profit margins are still too low and price swings are too volatile for companies to forecast reliable returns on the risky investment of building new mines.

Two large metal frames sit in a rocky landscape.
Metal structures on the site of Resolution Copper’s proposed underground copper mine in Arizona, in a place that has been sacred to Native American people for thousands of years.
Jim West/UCG/Universal Images Group via Getty Images

Global inequalities

Copper is produced in a handful of countries but used widely around the world.

That leaves copper vulnerable to national policies about imports and exports, leading to trade disruptions and price shocks.

Countries with low and middle per-capita income are likely to require substantial amounts of copper to grow their economies. Right now, wealthy countries like the U.S. and members of the European Union have about 440 pounds (200 kilograms) per person in existing physical infrastructure – electrical wiring, plumbing systems, architectural elements and transportation. But that figure is 20 pounds (9 kilograms) per person in Africa and less than 2 pounds (1 kilogram) per capita.
in India.

A large metal structure sits near a pile of rock.
A copper mine in Miami, Ariz.
Jim West/UCG/Universal Images Group via Getty Images

Shortages are likely

To get a picture of what might be possible if there were a significant global effort to increase copper availability, we evaluated several optimistic scenarios. We looked at faster permitting for new mines, higher recycling rates and smoother mining processes than those currently in place. But even then, economic development drove demand to grow far faster than the available supply.

Existing mines will have decreasing amounts of ore available and will produce less copper in 2050 than they do in 2025. Yet even if all known copper deposits with known mine-opening dates go into production as scheduled copper supplies will not keep up with demand.

Our best-case scenario has global mine production at about 30 million metric tons of copper a year by 2050. But to keep pace with global economic development, the world will need 37 million metric tons of mined copper a year by then.

To meet that additional need, more mines will need to be opened, and extra production developed – including extracting residual copper from old mine debris that was previously viewed as having too little copper to be worth processing.

An aerial view of a large industrial operation with a water pit and gravel roads.
The open-pit Cobre Panama copper mine in Donoso, Panama.
AP Photo/Matias Delacroix

A role for government

We found that more copper could be made available more quickly if permitting were streamlined in ways that preserve environmental standards but offer companies proposing new mines some predictability for regulatory approval.

If society wants more copper, faster, then people must accept that higher, more stable prices are part of the solution. Speculative trading contributes to price volatility, which complicates financial projections that are central to deal-making and makes it more expensive to invest in the large, long-term and irreversible expenses that new mines require.

Higher copper prices will ripple through the economy, raising costs for construction, energy and technology. But pretending those costs can be avoided doesn’t make them disappear. Underinvestment across the supply chain from mines to processing today shows up as bottlenecks tomorrow, including delayed grid upgrades and constrained digital growth.

The Conversation

Adam Charles Simon is a co-founder of VectOres Science, Inc.

Morgan Bazilian does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

ref. Global copper demand outstrips supply, threatening electrification and industrial growth – https://theconversation.com/global-copper-demand-outstrips-supply-threatening-electrification-and-industrial-growth-276843

Pittsburgh’s air pollution estimated to claim 3,000+ lives per year − and EPA rollbacks aren’t helping

Source: The Conversation – USA (2) – By Philip Landrigan, Professor of Biology, Boston College

Pittsburgh’s air pollution not only led to increased deaths, but it also had other negative effects, from lowered IQ in children to adverse birth outcomes. G Fiume/Getty Images Sport via Getty Images

In October 1948, a thick haze rolled into Donora, Pennsylvania, a steel town in the Monongahela Valley, south of Pittsburgh. For five days, toxic fumes from a zinc smelter – a plant that turns zinc ore into pure zinc metal – poured out of the factory’s stacks, became trapped in the valley and thus blanketed Donora. The air was filled with sulfur oxides, heavy metal dust and airborne particulates.

Firefighters carried 60-pound oxygen tanks door to door to relieve elderly and asthmatic victims. Nurses attended to mill workers in the infirmary, laying patients on the floor as hospital beds filled to capacity. Funeral homes ran out of space. The disaster eventually claimed 20 lives and caused chronic lung disease in many more.

In a old black and white photo, two nurses administer oxygen to patients in tented hospital beds.
In 1948, 40 patients were hospitalized in Donora, Pa., due to a smoke and fog disaster that led to the death of 20 residents.
Bettmann/Bettman Collection via Getty Images

This was one of the first clear demonstrations in the U.S. that air pollution could kill. Today, new global health research quantifying the risks of pollution exposure helps explain why disasters like Donora were so deadly, and why similar health threats persist.

As a public health researcher and a public health physician, we recently published a study in the journal Annals of Global Health on the health impacts of air pollution in southwestern Pennsylvania that shows the Pittsburgh area as a hot spot for pollution.

A turning point

Research triggered by the Donora disaster uncovered that air pollution causes serious health issues, including chronic heart disease, stroke, chronic obstructive pulmonary disease, lung cancer and diabetes in adults, and can lead to premature birth, low birth weight, stillbirth, asthma and impaired lung development in children.

Emerging evidence indicates that air pollution is also associated with dementia in adults and with IQ loss, attention-deficit/hyperactivity disorder and autism spectrum disorder in children.

Before the Donora disaster, the federal government did not regulate air quality. Pollution was legally viewed as a local nuisance – the unavoidable price of progress.

But the tragedy in Donora forced policymakers, scientists and the public to recognize that air pollution is a serious threat to health. Donora thus laid the groundwork for the Clean Air Act, the federal air pollution law initially enacted in 1963, then strengthened in 1970 and again in 1990. It also catalyzed the nation’s first air pollution research programs.

Pollution persists

Despite this progress, air pollution is still responsible for an estimated 200,000 deaths across the U.S. each year. These deaths are not evenly distributed. Instead, they are concentrated in pollution hot spots.

A riverside steel plant emits smoke from its smokestacks.
Because of its heavy industry and lack of local enforcement of the Clean Air Act, Pittsburgh is still one of the most polluted regions of the country.
Drew Angerer/Getty Images News via Getty Images

Our research shows southwestern Pennsylvania, the region around Donora and including Pittsburgh, is one of these hot spots.

Because of its steel mills, coke ovens – which burn coal to produce fuel for steel production – steep valleys that trap pollution and a history of inadequate local enforcement of the Clean Air Act, the Pittsburgh metropolitan area continues to rank among the nation’s most polluted regions.

Breaking down the new data

Fine particle air pollution, known as PM2.5, doesn’t just dirty the air in Pittsburgh and surrounding communities. It can kill people and harm children before they are even born.

To understand the full toll, we conducted an epidemiological study. Using NASA satellite images to measure pollution levels in each census tract, we linked that data to death and birth records from the Pennsylvania Department of Health.

The findings were stark. In 2019, between 3,085 and 3,467 deaths in southwestern Pennsylvania – roughly 11% to 12.5% of all adult deaths that year – were likely attributable to PM2.5 pollution. The damage extended to newborns as well: We estimated pollution caused 229 premature births, 177 infants with low birth weight and 12 stillbirths.

Using existing scientific data showing that every small increase in air pollution is linked to a measurable drop in children’s IQ, we applied that formula to Pittsburgh’s pollution levels across all 24,604 children born there in 2019. That calculation produced an estimated collective loss of more than 60,000 IQ points across the group. That’s an average of approximately 2.5 IQ points per child.

Children playing in water along a riverfront park in Pittsburgh.
Fine particulate air pollution was responsible for the loss of 2.5 IQ points per child born in Pittsburgh in 2019.
Jeff Swensen/Getty Images News via Getty Images

Importantly, many of the harms we saw in Pittsburgh occurred at PM2.5 levels below EPA’s air quality standard of 9 micrograms per cubic meter. This indicates that even low-level PM2.5 exposures carry significant risks to health.

Our findings arrive at a pivotal moment for U.S. air policy. EPA Administrator Lee Zeldin has announced his intention to raise the allowable limit for PM2.5, relax enforcement of the Clean Air Act and repeal the greenhouse gas endangerment finding, which allows the EPA to regulate the emissions that drive climate change.

The EPA has also eliminated its long-standing practice of counting the economic benefits of pollution control. According to new calculations, the EPA will count only the costs of pollution control while stripping out the economic value of lives saved – a metric known as the “value of a statistical life” that agencies have long used to justify health regulations.

What happens next?

During the first Trump administration, environmental rollbacks and a lack of pollution prevention efforts led to an estimated 20,000 deaths per year, according to the Environmental Protection Network, a nonprofit organization consisting of EPA alumni who volunteer their expertise to protect environmental integrity and public health. The deaths were clustered mostly in Southern and Midwestern states with heavy industry and lax pollution rules. States that had already put strong pollution controls in place were able to cushion the blow of the federal cutbacks.

Public health researchers point to local enforcement of the Clean Air Act as a way to limit health impacts of federal agency rollbacks. Allegheny County has legal authority under the Clean Air Act to set and enforce pollution standards stricter than federal minimums, but has not consistently used that authority.

Community and advocacy groups, including the Clean Air Council and PennEnvironment, have pushed the county health department to adopt stricter standards and increase permit enforcement. The Allegheny County Health Department holds regular public meetings where air quality rules and enforcement priorities are subject to review.

As the regulatory landscape shifts, the data from communities like southwestern Pennsylvania will be critical to understanding and documenting what is lost due to air pollution.

The Conversation

The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

ref. Pittsburgh’s air pollution estimated to claim 3,000+ lives per year − and EPA rollbacks aren’t helping – https://theconversation.com/pittsburghs-air-pollution-estimated-to-claim-3-000-lives-per-year-and-epa-rollbacks-arent-helping-277461

Gender conformity starts young – and boys and girls fall in line in different ways

Source: The Conversation – USA – By Adam Stanaland, Assistant Professor of Psychology, University of Richmond

The messages children receive about how to properly perform their gender carry into adulthood. Fotografia Basica/iStock via Getty Images Plus

Many people have felt the subtle pressure to be “man enough” or “woman enough” in the eyes of others. And research has shown this pressure can have personal and social consequences.

When men feel their manhood is challenged, they can respond with compensatory aggression and other harmful behaviors. When women step outside stereotypical femininity – or even just consider doing so – they often receive backlash.

As researchers who study how gender stereotypes and norms affect people in often unexpected ways, we wondered about the processes by which children feel motivated to conform to stereotypical gender norms. When does this start, and how might it manifest?

In recently published research we conducted with our colleague Andrei Cimpian, we found that when children perceive that their sense of being a “normal” or “proper” member of their gender group is threatened, they feel pushed to conform to stereotypical gender roles in different ways, with lasting consequences.

Two children in dresses sitting on curb on a neighborhood, skateboards before them
Children begin learning how to negotiate gender stereotypes and norms early on.
Petri Oeschger/Moment via Getty Images

Girl questions and boy questions

Borrowing from research on adults, we decided that the best way to assess children’s motivation to conform to gender norms was to challenge their status as a “typical” member of their gender group.

To do this, we asked 147 children ages 5 to 10 in New York City to play two games: a “Girl Questions Game” and a “Boy Questions Game.” Each featured difficult trivia about topics that are stereotypically gendered, such as “Which of these flowers is a poppy flower?” (Girl Questions Game) and “Which of these football teams was the 2016 champion?” (Boy Questions Game).

We randomly assigned children to receive feedback suggesting their performance was either gender-typical or gender-atypical, the latter of which was our version of a threat to their gender conformity. For example, a boy in this threat condition received feedback that he had aced the Girl Questions Game but flopped the Boy Questions Game.

Next, we assessed how they responded to this feedback. Would the boy publicly share or hide his achievement in a “Girl Questions Game Book of Winners”? Would he proudly wear a “Girl Questions Game Winner” sticker, or would he prefer to switch stickers? Would he be worried about what his peers would think?

Responding to gender conformity threats

We found three distinct ways children responded to threats to their gender conformity.

First, girls and boys of all ages were extra concerned about not fitting in with their gender group. This means they anticipated more rejection from their peers and reported lower self-esteem.

Second, certain children actively tried to demonstrate that they fit in with their gender group. Younger girls ratcheted up their femininity, while older boys ratcheted up their masculinity. For example, older boys would tell us they liked action figures more than dolls, or that they wanted to retry the Boy Questions Game over the Girl Questions Game.

This is in line with previous research showing that many young girls are immersed in “princess culture” and are especially motivated to prove their femininity, though this declines with age. In contrast, older boys increasingly learn as they age that masculinity is a precarious social status that is hard-won and must be actively proven.

Third, boys of all ages avoided seeming atypical from their gender group, actively distancing themselves from anything feminine. We didn’t see girls distancing themselves from anything masculine in the same way.

This response mirrors a cultural double standard in the U.S.: Girls are often encouraged to be athletic, assertive or like “tomboys,” while boys face no socially acceptable equivalent in the other direction. There is no benign male version of tomboy. The closest word is “sissy,” which is not typically considered a compliment.

Child wearing pink butterfly wings and holding a wand in a forested area
Boys are often not given much leeway to express their femininity.
Maskot/Getty Images

Building secure gender identities

Our findings show that the seeds of adult gender conformity – including some of its most harmful expressions, such as certain men’s aggression and some women’s anxiety around pursuing careers in male-dominated fields – are planted early.

Boys as young as 5 already recognize that femininity is something to avoid. By middle childhood – around age 7 – they seem to understand that masculinity is a status that must be actively proven and defended, a mindset that can manifest as aggression, sexual violence and resistance to seeking help in adulthood.

For girls, our findings suggest that they are motivated to prove stereotypical femininity at younger ages, but this may dissipate with age. This may be because girls are sometimes encouraged to pursue achievement in historically “masculine” domains, such as sports and in STEM. Or they may realize that masculinity affords men – and boys – success in these fields, so they seek to move away from femininity and toward masculinity.

However, it’s possible that girls in other settings are more pressured to perform femininity and avoid masculinity – that is, to engage in feminine stereotypes – in ways we were not able to capture in our study. It’s also unclear to us why girls’ responses to perceived threats to gender conformity may weaken with age, given that adult women are affected by these threats. Our future goal is to further test how gender conformity develops in more diverse geographic and cultural contexts, as well as among more gender-diverse children.

All said, we believe middle childhood may thus present a critical window for intervention. Programs that help children, especially boys, build secure identities that don’t depend on gender performance could help them have a healthier relationship with gender norms. In this way, children may be less vulnerable to responding to perceived threats to their gender conformity in ways that harm them through adulthood.

Nevertheless, what’s clear is that children don’t simply observe gender norms – they internalize them, actively defend them, and begin to do this earlier than people think.

The Conversation

The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

ref. Gender conformity starts young – and boys and girls fall in line in different ways – https://theconversation.com/gender-conformity-starts-young-and-boys-and-girls-fall-in-line-in-different-ways-275996

Information is a battlefield: 4 questions you can ask to judge the reliability of news reports and social posts about the US-Iran war

Source: The Conversation – USA – By Andrea Hickerson, Dean and Professor, School of Journalism and New Media, University of Mississippi

Staff members watch as Defense Secretary Pete Hegseth speaks during a press briefing at the Pentagon on March 2, 2026. AP Photo/Mark Schiefelbein

Historically, when the U.S. has undertaken military action against foreign governments, journalists have relied heavily on government sources and rallied “’round the flag,” often uncritically sharing official narratives about U.S involvement. This has been evident during periods of U.S. military engagements in Vietnam, Iraq and Afghanistan.

Recently, however, the Pentagon has restricted access for legacy news organizations. And on March 14, 2026, Brendan Carr, chairman of the Federal Communications Commission, replied to a social media post from President Donald Trump complaining about reporting on U.S. involvement in Iran. Carr threatened to deny license renewals to broadcasters not operating in the “public interest.”

“The People of our Country understand what is happening far better than the Fake News Media!” Trump asserted in his original Truth Social post.

This hostile relationship between journalists and a presidential administration is only part of the story about what is or isn’t happening on the ground in Iran and the Middle East.

In times of conflict, information about military activity can be seen as another domain of conflict, much like air, land and sea. Countries, including Iran, have long tried to manipulate information to persuade or influence what people think outside the region.

A preprint, not yet peer-reviewed study authored by academics affiliated with the U.S. Air Force and the U.S. Air Force Academy describes increased government funding and attention to “cognitive warfare,” or efforts to influence what people think through strategic messaging.

A common call to action from advocacy and educational groups in politicized situations where misinformation weighs heavy is to teach media literacy. Conventional wisdom holds that if people only knew how to read the news and look for bias, they would understand a situation more clearly.

As a journalism scholar and educator, I agree that media literacy is valuable. But it’s also time-consuming. It’s impractical to complete a full training or curriculum when faced with immediate current events. As an abbreviated measure to assess the current Middle East conflict, readers can start with the premise that information is contested and an extension of the battlefield.

Key questions to ask

This assumption reframes news not as something that finds a reader by chance, but as something someone wants a reader to see. It primes readers’ critical thinking.

Then readers can consider some key questions:

Why does the author of this information want me to see this?

The obvious answer is that they think it’s important, but what are they focused on? Military progress? One actor in the conflict? Civilian responses? Public opinion? Diplomacy? Asking these questions helps assess what is left out and helps readers resist the temptation to extrapolate details they can’t know from a single news story.

What information does this person or organization have access to?

Because Iran is inaccessible to many journalists, readers must be especially careful about reporting purporting to know or show what is going on inside Iran. For sure, information is coming out via citizen reports and social media, but it is hard to verify and interpret.

An aerial view of dozens of graves.
Graves dug for coffins of students killed in a bombing on a girls elementary school in Minab, Iran, are seen during a mass funeral on March 3, 2026.
Stringer/Anadolu via Getty Images

Relatedly, and especially when consuming content from social media, readers can ask:

What about an author’s personal experience may inform their interpretation of events?

Media produced for and by diasporas – people displaced from their country of origin by choice or force – is a good source for contextualized and expert information about conflicts in their country of origin. But diasporas can also be deeply political and strategic in what they share. As a general consumer, readers don’t need to get to the bottom of the veracity of the information they share. Readers can simply be aware of disaporas’ positions so they can factor this into their interpretation and understanding of the conflict.

What do different people or organizations have to gain or lose by people widely seeing specific information?

If information is a battlefield, actors will make strategic choices in what they will share with the public. Sometimes they will shield information from the public or deny information. However, undesirable and unflattering information occasionally gets out and circulated, as was the case when a missile struck an Iranian elementary school.

Politicians will want to show they are winning. Journalists may want to show they are being a watchdog on the government. Readers can consider the goals of both the authors and the sources they cite when trying to orient themselves around the information they share.

Transparent fact-checking

Beyond media literacy, there are several potential short cuts to finding accurate information about immediate events in Iran.

First, readers can look for opinions and commentary from established experts on the Middle East, Iran, oil, the military and other related fields. Too many readers claim expertise after reading a few popular articles or listening to a podcast.

Instead, they can look for people who have been observing and researching the region for years – people whose work has been already validated by peer review. As a starting place, readers can look for subject matter experts on the social network LinkedIn or search for research on Google Scholar. Readers can also see whether authors of older popular books are writing about contemporary events on websites or blogs.

Cars drive by a building with a picture of a U.S. flag and air carrier on it.
Vehicles pass a billboard in Tehran, Iran, on Feb. 22, 2026, depicting a U.S. aircraft carrier with damaged fighter jets on its deck.
AP Photo/Vahid Salemi

Think tanks that produce research reports may also be helpful, but sometimes think tanks with neutral-sounding names are politically affiliated. A close read of the “About Us” page and perusing the list of funders can offer some helpful clues.

Finally, perhaps the most efficient way to evaluate what is happening in Iran is to follow fact-checking and open-source reporting organizations. These groups often do a better job showing their assessment work and linking to evidence than do traditional news outlets, which focus on narrative structure and a cohesive final product.

Poynter, a nonprofit journalism institute, recently detailed the work of Factnameh, run by an Iranian fact-checker in exile. Bellingcat and Indicator are two excellent open-source reporting organizations that use public data to investigate whether actual events match circulating narratives.

And sometimes traditional news organizations do similar types of investigations, such as this example of The Associated Press debunking video misinformation in Iran.

The transparent methods of fact-checking and open-source sites can also serve as interactive exercises in media literacy. Both Bellingcat and Indicator regularly showcase information validation tools that readers can use.

Regardless of how much effort readers choose to spend on evaluating the accuracy of reporting on Iran, none of us are watching the battle from the sidelines.

The Conversation

Andrea Hickerson does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

ref. Information is a battlefield: 4 questions you can ask to judge the reliability of news reports and social posts about the US-Iran war – https://theconversation.com/information-is-a-battlefield-4-questions-you-can-ask-to-judge-the-reliability-of-news-reports-and-social-posts-about-the-us-iran-war-278384

Health insurance jargon can be frustrating and confusing – here’s how to navigate it

Source: The Conversation – USA (3) – By Jamie Hartmann-Boyce, Assistant Professor of Health Promotion and Policy, UMass Amherst

Sorting through the nuances of copays, deductibles, premiums and other jargon can be frustrating. Tfilm/Moment via Getty Images

Since the Affordable Care Act subsidies expired at the end of 2025, Americans have undoubtedly been encountering a great deal of confusing information surrounding health care costs and insurance plans.

From five-figure deductibles to premiums higher than people’s mortgages, costs are rising across the board.

With this comes difficult decisions around health care plan enrollment. No one can know exactly what their health care needs will be in any given year, so people are forced to hedge their bets in choosing plans.

What plan you pick has a huge impact on what you will end up paying.

However, many Americans don’t understand key health insurance terms. For example, people who’ve completed fewer levels of education and people without health insurance are less likely to understand the jargon. This can get in the way of picking the right plans.

As scholars of health policy, evidence-based health care and health economics, we believe understanding these terms can help you pick what plan might be the best for you.

Frequently encountered health insurance terms

The first of these is your health insurance premium. This is the amount you pay each month for having health insurance coverage, whether or not you use any services. Premiums can be expensive, but they are predictable. Once your premium is set for the year, it won’t change.

What’s much harder to predict is how much of each medical bill you will have to pay yourself, known as out-of-pocket costs. These are sometimes also referred as “patient cost-sharing” or “copays.” These typically come in three forms: deductibles, coinsurance and copayments.

A deductible is how much you need to spend on your health care in a given year before your insurance starts covering any costs. Under plans with a deductible, you pay the full cost of health care services first – essentially as if you did not have health insurance – until your total spending reaches the deductible amount. Once you reach that threshold, your insurance will start paying for your additional medical costs.

But in most plans, even once you hit your deductible, your insurance will still not cover the full cost of your care. You will continue to pay a portion of the bill through coinsurance, which is the percentage of the cost of care that you are responsible for paying. For example, if your coinsurance rate is 20% and you receive care that costs US$500, you would pay $100 (20% of $500).

What often makes coinsurance confusing is that while the coinsurance rate – the percentage – is usually listed on your health insurance card, you still need to know the total cost of your care to calculate how much you will owe. That cost is difficult to know in advance because reliable health care prices are difficult to find and health care needs – and the services required to treat them – can be unpredictable.

Insurance claim form concept
Reliable up-front health care pricing is difficult to find.
teekid/E+ via Getty Images

Then there are copayments. This is a fixed amount you pay for a health care encounter, such as $20 for a primary care visit or $150 for an emergency department visit. In everyday language, people sometimes use copay to refer to any amount a patient pays out of pocket. Technically, however, a copayment refers only to a fixed fee paid for a health care service.

Whether through deductibles, coinsurance or copayments, these out-of-pocket amounts can add up quickly. To protect patients, especially those who need a lot of care and could otherwise face devastating medical bills, federal regulations require health insurers to limit how much patients can be asked to pay out of pocket each year for covered services.

This amount is called the out-of-pocket maximum. This is sometimes also called the out-of-pocket cap or out-of-pocket limit. Once your total out-of-pocket spending reaches that limit, your insurance must pay 100% of the cost of additional covered services for the rest of the year.

Additional factors to consider

These insurance rules can become even more complicated. Many plans have multiple different deductible amounts, coinsurance rates, copayments and even out-of-pocket maximums, depending on several factors. For example, in family plans, each person may have their own deductible or out-of-pocket maximum, but there may also be thresholds and limits that apply to the family as a whole. Cost-sharing can also vary by the type of care you receive. For instance, inpatient hospital care may be subject to a different set of cost-sharing rules than outpatient care.

Another important factor is whether your health care provider has a contract with your insurance company. Providers who have such a contract are called in-network providers. Those who do not are called out-of-network providers. Some insurance plans further divide in-network providers into tiers.

Providers in Tier 1 are the most preferred by the insurance plan, often because they agreed to provide services at relatively lower prices. Other in-network providers may be placed in Tier 2. Costs to you tend to be lowest for services from Tier 1 providers, higher for services from Tier 2 providers and highest for services from out-of-network providers. Some insurance plans may not cover out-of-network care at all.

There are often trade-offs between these elements – low premiums look great on the face of it, but any money you save by paying lower premiums is often offset by significant out-of-pocket costs, limited options for in-network providers, or both.

The problem, of course, is that it’s impossible to predict how much health care you might need. If you could somehow know you weren’t going to need much health care in the following year, then a low-premium, high-deductible plan would make sense.

If, on the other hand, you knew you were going to receive a catastrophic diagnosis or be in a life-altering car accident, you would want to opt for a plan that might include higher premiums but lower copays.

Gambles and trade-offs

If everyone knew all the medical care they needed could be provided by any general doctor, they might not care much about what or who was in-network. But if they knew they were going to need specialist surgery for a rare type of tumor, for example, offered at only one center out of state, they would want to consider what counts as in-network – or the costs of going out of network – in substantially more detail.

In many other countries, people don’t face the same burden. In nations with universal health coverage, understanding health insurance jargon isn’t a matter of financial survival. Because coverage is guaranteed, people do not have to agonize every year over choosing a health plan based on countless variables.

But until meaningful change comes about in the U.S., the best many Americans can do is understand health insurance jargon so they can choose plans that work best for them.


The Conversation

Jamie Hartmann-Boyce receives research funding from the National Institutes of Health, the Food and Drug Administration, the Truth Initiative, and Cancer Research UK.

Michal Horný consults to VBID Health. He receives funding from Arnold Ventures and the National Institutes of Health. He received speaker honoraria and/or travel support from Health Care Cost Institute, Georgetown University, Brown University, Charles University (Czech Republic), Masaryk University (Czech Republic), and the Czech Academy of Sciences (Czech Republic).

ref. Health insurance jargon can be frustrating and confusing – here’s how to navigate it – https://theconversation.com/health-insurance-jargon-can-be-frustrating-and-confusing-heres-how-to-navigate-it-277355