Billionaires with $1 salaries – and other legal tax dodges the ultrawealthy use to keep their riches

Source: The Conversation – USA (2) – By Ray Madoff, Professor of Law, Boston College

Who pays the most taxes? Javier Zayas Photography/Moment via Getty Images

Ray Madoff, a Boston College law professor, has written a new book: “The Second Estate: How the Tax Code Made an American Aristocracy.” She recently spoke to Kara Miller, host of the podcast “It Turns Out,” about how the American tax system has changed over the past 40 years, widening inequality. Below is a condensed and edited version of the interview.

Miller: Mark Zuckerberg was the lowest-paid employee at Meta in 2024, and he made US$1. But he is not the only very rich person who has collected $1 for a year’s work. Why would incredibly rich CEOs make only $1 a year when they could pay themselves millions?

Madoff: The reason is taxes. Income from work is the most heavily taxed type of income, as it is subject to both income and payroll taxes. A self-employed person who makes a modest income of $60,000 will pay over $13,000 of it in payroll and income taxes. Meanwhile, high-income earners who earn a $400,000 salary can pay about 30% of their income in payroll and income taxes.

So the first step in avoiding taxes is avoiding salary, and that is what our richest Americans often do.

Ray Madoff on the ‘It Turns Out’ podcast.

Elon Musk received a salary of $0 from Tesla in 2024. Jeff Bezos earns $81,840 a year of income, low enough to get the child tax credit, which he took in 2021. One of our higher-paid billionaires is Warren Buffett, and he only gets $100,000 a year in salary and bonus combined.

All of these people are keeping their taxes down by keeping their salaries down. They are not avoiding compensation altogether, however, as they are well paid through the growing value of their stock. In 2024, Bezos’ wealth increased by $80 billion, Zuckerberg’s by $113 billion, Musk’s by $213 billion. Even better, they can enjoy this growing wealth entirely free of income tax and reporting.

You make the case that part of the reason that these individuals have been able to accumulate wealth so quickly is because of the tax system. How has the tax system enabled their wealth to continue to grow so quickly?

Historically, the tax system has operated as a bulwark against concentrations of wealth. And in this way, it has served to legitimate our capitalist system by showing how it can work to extract large amounts of money from our wealthiest citizens for the common good.

The cover of a book is shown with the title 'The Second Estate: How the Tax Code Made an American Aristocracy.'

University of Chicago Press

However, over the past 40 years or so there have been a number of changes that have allowed the wealthy to avoid taxes altogether on their investments and inheritances. One area where this has particularly been the case is when it comes to investment in stocks. Prior to 1982, companies could only directly share profits with shareholders by issuing dividends. These dividends were taxed at the highest rate. In 1982, however, a subtle change to the SEC rules allowed companies to purchase their own stock on the open market. This may sound innocuous, but it led to a massive transformation.

Now, instead of issuing dividends, companies can purchase shares, which boosts the value of the stock. So any shareholders who do not need to sell can make a profit from their stock going up in value and do not need to pay taxes on this profit.

At some point, one might expect that the ultrawealthy would have to sell their shares to finance their lifestyle. Do they? In selling those shares, wouldn’t they have to pay a capital gains tax?

For most of us, when we own property or stock that has increased in value, it doesn’t mean anything to us unless we sell it. But those with great wealth can access that wealth without paying taxes by simply borrowing against their assets. And that is what our richest Americans do.

Billionaires like Larry Ellison and Elon Musk borrow huge sums of money to support their lifestyle, pledging their stock as collateral. This borrowing is entirely tax-free and comes at good rates. In addition, in recent years the growth in stock value more than compensates for any interest that might accrue. To pay the interest and pay back the loans, they simply borrow again.

Does this mean the people with the most money are not contributing to the common expenses of the government? What about through the estate tax?

One would think that the estate tax would do a good job here. After all, it is a 40% tax on all transfers by gift or at death in excess of approximately $15 million. However, this tax no longer accomplishes what it once did.

During the George W. Bush presidency, 18 wealthy families launched a campaign to repeal the federal estate tax. It labeled the estate tax the “death tax,” calling it an unfair double-taxation that harms family farms and businesses. Chester Thigpen, who owned a Christmas tree farm, was the face of this movement. He argued that the estate tax took away his right to pass his Christmas tree farm to his children.

Ripped $100 bill against a blue background
The mighty $100 bill.
dem10/Getty

This narrative was completely false. The estate tax has many provisions to protect family farms and businesses. And Thigpen was misled; he was never subject to the estate tax, as his estate was much smaller than the exclusion amount.

But much of the public began to believe that the estate tax – or the “death tax” – was unfair. Though there is nominally an estate tax today, Congress has not enacted a single provision to close loopholes in 35 years. As a result, loopholes abound that allow the wealthy to shelter their money from taxation. These mechanisms are so effective that even though the wealthiest 1% of Americans own $50 trillion, the entire amount collected by the estate tax in 2024 was about $30 billion, an amount that Musk has gained and lost in a day.

Now, the estate tax serves as a cover for the richest Americans, who are served better by preserving a tax that makes it look like they pay taxes.

If the richest Americans do not pay taxes, who does the brunt of the burden fall to?

In terms of our yearly income tax, the brunt of the burden falls on high-income earners, people earning hundreds of thousands of dollars a year. These people can be paying up to 50% of what they make in payroll and income taxes. Confused, they think their interests align with the ultrawealthy more than regular workers. In fact, people who earn a lot through their job – from doctors to executives – are carrying the largest burden, alongside lower-wage workers.

Popular statistics make it seem as though the richest Americans are paying the majority of taxes. One such statistic is that the top 1% pay 40% of the income taxes, while 40% of Americans pay no income tax at all. The top 1% here refers to income earners.

Remember, the very richest Americans do not acquire their wealth through taxable income and are just as likely to be a part of the 40% of the lowest earners who pay no income tax.

In reality, 30% of U.S. wealth is now controlled by the richest 1% of Americans, and our current rules provide no assurances that they will ever pay taxes on their growing wealth.

The Conversation

Ray Madoff 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. Billionaires with $1 salaries – and other legal tax dodges the ultrawealthy use to keep their riches – https://theconversation.com/billionaires-with-1-salaries-and-other-legal-tax-dodges-the-ultrawealthy-use-to-keep-their-riches-271714

Unpaid caregiving work can feel small and personal, but that doesn’t take away its ethical value

Source: The Conversation – USA (3) – By Jen Zamzow, Instructor, University of California, Los Angeles; Concordia University Irvine

Work and family are both central to many people’s sense of identity and how they hope to make a difference. Kobus Louw/E+ via Getty Images

As child care costs outpace wages, more families are facing difficult decisions about whether to scale back work in order to care for loved ones. Caregiving remains the top reason women ages 25-54 leave the workforce.

And it’s not just parents who struggle. Nearly 60 million Americans provide care for an adult family member, and two-thirds say they have trouble balancing their jobs with their caregiving responsibilities. Nearly 1 in 4 working caregivers reported either missing work or being less productive because of their care duties.

When the demands become too much to juggle, some people quit their jobs, cut back on their hours or turn down promotions in order to provide unpaid care. For many households, that’s a financial strain; others save money that way. But even so, the decision can feel heavy – like leaving behind a sense of purpose that extends beyond the family.

These choices force deeper questions: What counts as meaningful work? What do we owe to others, and what’s reasonable to expect of any one person?

For many people, work and family are central to identity and how they hope to make a difference in the world. Men and women struggling with whether to step back from a career may wonder whether doing so is the best use of skills or training. Do we owe the world something “bigger”? As much as we care about loved ones, caregiving can feel too small and personal to matter.

As someone who writes and teaches about ethics and social policy, I believe philosophy can help people see these decisions more clearly. Ethics doesn’t give tidy answers or eliminate the tension between work and care, but it can help us understand their moral value.

‘Too small’?

Today, American culture often measures moral worth in terms of results and impact – where doing good means doing more. In this context, stepping back from a professional career to care for a loved one can feel like a failure of ambition or responsibility.

If ambition is measured by observable progress, caregiving is especially vulnerable to being misread as “leaning out.” Many of the daily tasks of caregiving – feeding, bathing, dressing and driving to appointments – can seem inconsequential. The end result of much of this work is invisible: You wind up in the same place you were before. For all the work that goes into sustaining life, there aren’t many “impressive outcomes” to point to.

A brunette man with glasses holds an infant in one arm as he reaches into a sink in a cluttered kitchen.
Doing the dishes brings you back to where you started, but it also keeps life going.
AJ_Watt/E+ via Getty Images

In fact, one of care’s most important benefits lies in preventing outcomes: avoiding injuries, medication errors, hospital admissions, developmental delays, cognitive decline, loneliness, depression and so on. These “nonevents” are easy to overlook. In public health, this is sometimes referred to as the “preparedness paradox”: The better prevention works, the less visible its effects.

Appreciating the full value of care means considering what would happen without it. If the answer is that there would be more risk, more crises or more downstream costs, then care is making a difference. Health care ethicists, for example, use this kind of counterfactual reasoning to evaluate harm and benefit, asking how a patient would have fared without an intervention. Caregiving that reduces vulnerability and prevents suffering is a genuine moral achievement.

Still, helping a handful of people can look minor compared to careers measured by reach or scale. Good care requires a level of presence and attentiveness that just can’t be scaled.

But that isn’t a failure. “Smallness” is actually part of the point: Care is personal – and “personal” doesn’t mean morally trivial.

In fact, there’s a rich philosophical tradition that puts meeting the needs of the people we’re responsible for at the very heart of moral life. Relationships are core to who we are. In care ethicists’ view, attachments to other people are not distractions from morality but expressions of what it means to live a good human life.

Close relationships make special claims on us. Ties with particular people carry moral weight, not just emotions – they give genuine reasons to act. As philosopher Samuel Scheffler notes, it makes little sense to say we value a relationship if we don’t think it places any demands on us. Caring about another person’s needs is part of what it means to care about them.

Attending to a loved one’s needs and interests honors those special claims and imbues care tasks with extra meaning – showing someone that we believe they’re worth our time and attention. Caring for loved ones might be modest in reach, but making another person feel truly seen and valued can make a deep impact.

‘Too personal’?

Even if care isn’t “too small” to matter, it might still seem too personal to matter much to the wider world. But while care is certainly personal, it’s also socially significant.

A young Asian woman reaches around to hug an older Asian woman from behind, as they sit in a sun-lit room.
Seen in the right light, caregiving work shouldn’t feel ‘small.’
travelism/E+ via Getty Images

As care ethicists like Joan Tronto and Eva Kittay argue, caring for particular people reveals something universal about the human condition: Everyone is dependent and sustained by care at different points in our lives. Former first lady Rosalynn Carter captured it simply: “There are only four kinds of people in the world – those who have been caregivers, those who are currently caregivers, those who will be caregivers and those who will need caregivers.”

Understanding dependency as a shared human condition helps explain why care is foundational to collective well-being. Unpaid caregiving in the U.S. is worth an estimated US$1.1 trillion annually, making it one of the largest sources of social support.

However, care has value beyond its economic impact. Care makes family, community and civic life possible, with benefits that reach well beyond the household. As economist Nancy Folbre writes in “The Invisible Heart”: “Parents who raise happy, healthy, and successful children create an especially important public good” – one that will benefit employers, neighbors and fellow citizens.

Treating care as a private matter rather than a shared social good has consequences. It places the moral and practical weight of caregiving on individual families – most often on women. I believe this narrow view unfairly shifts responsibility and also distorts value, limiting society’s sense of what matters.

Policy changes could ease the strain on caregivers but wouldn’t remove the personal choices families face every day. Even in a more supportive system, I believe Americans would need ways of thinking about work and care that give a fuller account of their value. Caregiving’s broader public benefits are diffuse and hard to measure. But recognizing that care sustains not only families but communities too is a reminder that paid work and unpaid care are not opposites. They are both ways to contribute to the common good.

Of course, loved ones’ needs can often be met without career changes. But when families need to make tough choices, it helps to have a fuller picture. Care ethics is not a demand for perfect caregiving or self-sacrifice; it’s an argument that care matters and that people deserve support as they respond to real limits. Stepping back from work to care doesn’t have to mean stepping back from contributing to the world – it changes where contribution happens.

The Conversation

Jen Zamzow has received funding from UC Berkeley’s Greater Good Science Center, as part of its “Spreading Love Through the Media” initiative, supported by the John Templeton Foundation.

ref. Unpaid caregiving work can feel small and personal, but that doesn’t take away its ethical value – https://theconversation.com/unpaid-caregiving-work-can-feel-small-and-personal-but-that-doesnt-take-away-its-ethical-value-265025

Hacked phones and Wi-Fi surveillance have replaced Cold War spies and radio waves in the delusions of people with schizophrenia

Source: The Conversation – USA – By Alaina Vandervoort Burns, Assistant Clinical Professor of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles

Everyday tech of modern life can take on sinister dimensions for people with thought disorders. Busà Photography/Moment via Getty Images

A young woman starts to become suspicious of her cellphone. She notices it listing Wi-Fi networks she does not recognize, and the photos on her contact cards seem to mysteriously change at random times. One day she tries to make a call and just hears static on the line. She begins to think that someone – or an entire organization – has hacked her phone or placed spyware in it, and she wonders what crime she is being framed for.

Built-in laptop webcams, unfamiliar Wi-Fi networks, targeted ads on search engines and personalized algorithms on social media sites: Most people have come to accept and ignore the quirks and drawbacks of daily contact with the internet and devices such as cellphones and computers. But for people with severe mental illness, new technologies are fertile ground for the start of false ideas that can lead eventually to a break with reality.

Psychiatrists like me help people who are bothered by their thoughts, behaviors or emotional states. For the past 10 years I’ve been working closely with people who have schizophrenia.

Schizophrenia, sometimes referred to as a type of thought disorder, is a chronic condition in which alterations in brain function change the way one perceives the world. People with schizophrenia can become hyperaware of their surroundings, often interpreting things they see or hear as being hostile and directed toward them even when there’s no real danger.

Over time, people with schizophrenia can develop delusions: beliefs that are fully held even though they are not based in reality and even when there is evidence to the contrary.

With technology and the internet now such an integral part of daily life, it’s no wonder that people with schizophrenia have incorporated new technologies into their delusional beliefs. In my recent research, my colleagues and I set out to explore the ways modern tech influences the content of delusions for people today.

Old delusional themes expressed in new ways

Most delusions are persecutory, meaning a person believes they are being watched, followed or monitored. Other delusional forms involve the belief that a person has special powers, is being controlled by outside forces, or that a spouse is unfaithful even when they are not.

Prior research has shown that these themes are consistent among people with schizophrenia, but the sociopolitical context in which a person lives shapes the form in which they are expressed.

For example, Americans living during World War II developed persecutory delusions involving Germans, while those living during the Cold War focused on communists. People with thought disorders have incorporated important events such as the fall of the Berlin Wall and the O.J. Simpson trial into delusional frameworks.

Surveillance camera with red lens glowing in the dark.
New technologies offer new raw material for persecutory delusions to work with.
hernan4429/iStock via Getty Images Plus

The past three decades have seen incredible strides in technological advances and easy access to the internet. How have these old themes become repackaged and expressed in the digital age?

For this research, my colleagues and I reviewed medical records of 228 people with thought disorders who participated in a specialized day treatment program between 2016 and 2024.

We identified any mention of delusional thought content and examined the ways in which these beliefs incorporated new technology. We also analyzed the data to see whether certain people were more likely to express delusions tied to technology, or if there was a change in the frequency of these delusions over time.

Delusions of persecution via common tech

Over half of our study’s participants mentioned new technology or the internet when describing delusional beliefs. Most commonly, people felt they were being persecuted via their electronics – that their Wi-Fi networks, computers or cellphones had been hacked or implanted with tracking devices. One person reported believing that neighbors had access to their Wi-Fi network and were monitoring their activities, while another worried that family members had put tracking devices on their phone.

About a quarter of participants reported delusional beliefs surrounding social media. For example, people believed that celebrities were communicating with them directly through social media posts, that they were receiving encoded messages through suggested playlists, or that social media algorithms were linked directly to their thoughts.

Some participants felt they were being monitored through hidden cameras or microphones implanted in their homes or even in their bodies. Several reported what’s known as the “Truman Show delusion” – the belief that their lives are staged and recorded, their daily activities broadcast as a reality TV show.

hand holds phone with emojis, hearts, likes etc rising in a cloud around it
The universe of social media figured in a number of delusions.
d3sign/Moment via Getty Images

With each passing year of the 21st century, we found participants were significantly more likely to express delusions connected to technology.

Stretching the bounds of past realities

Our study confirms that common delusional themes, such as persecution, have become repackaged for the digital age. Interestingly, people often described fears that were based on misunderstanding how technology works – or fails to work. A Wi-Fi router that needed to be reset, a familiar app with a new logo, and text messages that disappeared over time were all cause for suspicion.

The issue that has become hardest for me to grapple with as a psychiatrist is how any of us can distinguish delusional beliefs from reality, given things we never could have imagined would be possible just 10 years ago are now commonplace. Although social media algorithms are not currently linked to our thoughts, is it such a stretch to imagine that in a few short years they may be?

Given recent advances in AI, our collective perception of reality is likely to be further distorted in the years to come. We will all need to find ways to anchor ourselves in a common truth and determine what’s real – and what isn’t.

The Conversation

Alaina Vandervoort Burns 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. Hacked phones and Wi-Fi surveillance have replaced Cold War spies and radio waves in the delusions of people with schizophrenia – https://theconversation.com/hacked-phones-and-wi-fi-surveillance-have-replaced-cold-war-spies-and-radio-waves-in-the-delusions-of-people-with-schizophrenia-271620

Trump’s second term is reshaping US science with unprecedented cuts and destabilizing policy changes

Source: The Conversation – USA – By Kenneth M. Evans, Fellow in Science, Technology, and Innovation Policy, Baker Institute for Public Policy, Rice University

Before 2025, science policy rarely made headline news. Through decades of changing political winds, financial crises and global conflicts, funding for U.S. research and innovation has remained remarkably stable, reflecting the American public’s strong support for investing in basic science.

In his first year back in office, President Donald Trump’s relentless attempts to overhaul the federal support system for research and development has put science policy back above the fold.

As a policy scholar, I study how American presidents treat science and technology. Trump is far from the first president to be deeply skeptical of the academic research community. But his second-term actions have set a new precedent for the level of mutual distrust and its consequences for scientists.

Unlike Trump’s first term, which lacked a coherent science policy beyond its attempted across-the-board cuts to federal research agencies, his current administration has used science policy as a vehicle for its ideological goals. Policy levers historically used to drive science in the national interest have instead been repurposed to punish universities, limit freedom of inquiry and promote private sector interests.

Given science and technology’s critical importance to the nation’s economic growth, industrial competitiveness and national security, it’s worth taking a look back at science policy in 2025, a year of unprecedented reform – and resilience.

Science gets a voice

The conservative Heritage Foundation’s Project 2025, which provided much of the blueprint for Trump’s second term, recommended the president “increase the prominence” of the director of the White House Office of Science and Technology Policy. To that end, then-President-elect Trump named Michael Kratsios as Office of Science and Technology Policy director and his chief scientific adviser weeks before taking office, tasking him with “(blazing) a trail to the next frontiers of science.”

Michael Kratsios stands behind Trump, seated and holding up a signed document
As head of the White House Office of Science and Technology Policy, Michael Kratsios’ role is to advise President Trump on science-related matters.
Roy Rochlin/Hill & Valley Forum via Getty Images

Kratsios, a high-ranking alum of the first Trump administration and protégé of billionaire tech investor Peter Thiel, shares Trump’s skepticism of universities. His tenure in the White House has so far been marked by highlighting the failures of the U.S. science policy system rather than its successes. For Kratsios, American science is suffering from an outdated and morally corrupt incentive system too reliant on research universities.

Kratsios arrived at the White House with a clear vision for redesigning America’s 80-year-old social compact for science in line with Trump’s political agenda. In under a year, he helped push through four major science policy reforms.

Gold Standard Science” recommits the U.S. to scientific integrity and adds political oversight into agency operations.

Another sweeping executive order works to centralize federal grantmaking and align research activities with presidential priorities.

The White House AI Action Plan supports AI upskilling and reskilling workforce programs and catalyzes private sector innovation through deregulation.

And Project Genesis, branded as a successor to the Manhattan Project and Apollo program, leverages public datasets and the computing infrastructure of the Department of Energy’s national labs to advance AI for science.

Taken together, Trump’s second-term science policy reflects several emerging trends in U.S. research policy: the public’s growing distrust of higher education, the private sector’s accelerating investment in fundamental research, and the government’s increasing appetite for state interventions to increase scientific and industrial competitiveness.

A broken partnership

Science has always been a system of patronage. Since the end of World War II, the U.S. government has served as the primary patron of fundamental research at American universities.

The year 2025 has laid bare the fragility of this setup, where research universities sit at the center of the U.S. innovation system. The Trump administration spent the year inventing and deploying new strategies to pause, terminate and severely curtail grants to academic institutions, testing the limits of executive authority over budget decisions.

hands hold up cardboard sign 'DOGE HANDS OFF US GOVT' in front of NIH building
Demonstrators protested funding cuts at NIH in May.
Kayla Bartkowski/Getty Images

The chaos of canceled awards, court challenges and reinstatements prompted NSF and NIH to get creative. Rushing to spend their appropriations before the end of the fiscal year on Oct. 1, they distributed over 20% fewer grants but paid out more money up front to multiyear awards – a fundamental change to how agencies have spent money.

In parallel, Trump proposed massive spending cuts to federal research agencies as part of his administration’s stated effort to dismantle the administrative state.

A budget impasse between the White House and House Democrats over certain Medicaid expansion subsidies led to a historic 43-day government shutdown. To end the shutdown, Congress opted to punt its final budget for this fiscal year to the end of January 2026 through what’s known as a continuing resolution. The stopgap law keeps budget levels unchanged from the prior year but makes it nearly impossible for agencies to plan for the following year.

Trump’s outright attacks on higher education aren’t the only source of uncertainty about next year’s science budget. The White House’s push to cap overhead costs at 15% and the university endowment tax passed this past summer in what the GOP calls the “One Big Beautiful Bill” have universities scrambling to balance the books.

Students caught in the crossfire

For many students and early-career scientists, the Trump administration’s actions toward higher education pose an existential threat to their research careers in the United States. As universities tighten their belts, they’re significantly reducing available spots in Ph.D. programs.

back of a graduating crowd with 'PROTECT INTERNATIONAL STUDENTS' on top of mortarboard
Students at Harvard, one of Trump’s biggest targets for reform, responded to policies that affected international students.
Selcuk Acar/Anadolu via Getty Images

Trump’s immigration policies and anti-DEI actions have further jeopardized the career viability of international students and scholars and students from minority or historically marginalized groups. A battery of executive orders, immigration reforms and enforcement have upended the lives of thousands of young scientists. International student enrollment in U.S. colleges and universities dropped by an estimated 17% this fall.

The effects of these actions extend far beyond the elite universities targeted by Department of Justice investigations, undermining American soft power and placing a generation of future U.S.-based scientists at risk.

The ghost of DOGE lingers

The early days of Trump’s second term will likely be remembered for Elon Musk’s outsize influence inside the White House and the launch of the Department of Government Efficiency. DOGE was tasked with reigning in the federal bureaucracy and rooting out alleged “billions and billions in fraud, waste and abuse.”

For science, DOGE’s cost-cutting crusade meant hollowing out agency expertise, ripping up contracts and searching for keywords from Sen. Ted Cruz’s list of woke science topics, such as climate change, DEI, misinformation or even “women,” in grant applications to terminate.

In practice, DOGE made little measurable progress toward Musk’s target of $1 trillion in reduced spending. Instead, DOGE closed shop in November 2025, eight months before its charter was set to expire.

DOGE’s well-publicized flop masks its less visible but more pernicious legacy: Instead of disappearing, it has been institutionalized. Trump’s budget director, Russell Vought, who spent 2025 taking aim at the federal workforce, is leveraging DOGE’s network to continue its core mission. Through forced relocations, layoffs, a deferred resignation program and the legal gray area of the shutdown, Vought is pushing science-mission agencies to reform their grant review processes and align new grants with Trump’s priorities.

By the start of December 2025, over 200,000 civil servants had left the federal workforce, including nearly 5,000 from NASA, 600 from NSF and at least 14,000 from the Department of Health and Human Services, the parent department of NIH.

The politics of science advice

In the 80 years following Vannevar Bush’s 1945 report to President Harry Truman, Science, the Endless Frontier, scientists have found themselves outside the president’s inner circle more than inside it. Even Bush, despite his legendary stature in science policy then and now, left the White House just two years later, frustrated by Truman’s unwillingness to take his advice.

With only occasional exceptions, when the interests of the president and the scientific community aligned, science advisers have rarely captured the attention of presidents in the decades since.

Kratsios seems to have Trump’s ear. The future of U.S. science rests not on whether government-sponsored research will survive the next three years. Instead, it rides on U.S. higher ed’s ability to regain the trust of the American public – and the White House.

The Conversation

Kenneth Evans receives funding from the National Science Foundation, the American Institute of Physics, and the Clinton Foundation. He is affiliated with Rice University’s Baker Institute for Public Policy

ref. Trump’s second term is reshaping US science with unprecedented cuts and destabilizing policy changes – https://theconversation.com/trumps-second-term-is-reshaping-us-science-with-unprecedented-cuts-and-destabilizing-policy-changes-271079

The #iwasfifteen hashtag and ongoing Epstein coverage show how traffickers exploit the vulnerabilities of teens and tweens

Source: The Conversation – USA (3) – By Anne P. DePrince, Professor of Psychology, University of Denver

Marina Lacerda was among the alleged victims of convicted sex trafficker Jeffrey Epstein who spoke at a news conference outside the U.S. Capitol on Sept. 3, 2025. Andrew Harnik/Getty Images News

The release of information about the powerful cadre of men associated with convicted sex offender and accused sex trafficker Jeffrey Epstein – known as the Epstein files – has been a long time coming.

Under the Epstein Files Transparency Act, which President Donald Trump signed into law in November 2025, the Justice Department must release its documents related to Epstein by Dec. 19, 2025.

But information has been trickling out for months, including more than 20,000 of Epstein’s emails released by members of Congress in November.

In the firestorm of reactions that followed, conservative media figure Megyn Kelly made comments that minimized the victimization of teenagers.

In response to her remarks, a new hashtag, #iwasfifteen, went viral, as celebrities and others took to social media to share photos of themselves as teenagers.

I’m a clinical psychologist who studies intimate violence – from child abuse to domestic violence and sexual assault. After more than two decades in this field, I wasn’t surprised to hear someone minimize the abuse of adolescents. My research and the work of other researchers across the country have shown that victims who disclose their abuse are often met with disbelief and blame.

What did surprise me was how the viral #iwasfifteen hashtag shed light on the dynamics of abuse, pointing to the vulnerabilities that traffickers exploit and the harms they cause.

Abusive tactics in sex trafficking of minors

Unlike stereotypes of teens being kidnapped out of parking lots, people who traffic minors use a range of tactics and build relationships with the teens and tweens they’re targeting. Getting young people to trust and depend on the traffickers is part of entrapping them.

One in-depth 2014 analysis revealed these strategies in action. Researchers looked at more than 40 social service case files of minors who were trafficked and interviewed social service workers.

The researchers found it was common for traffickers to use flattery or romance to entrap adolescents. Some built trust with the teens by helping them out of difficult situations. Meanwhile, the traffickers normalized sex and prostitution as they isolated their victims from their friends and family – all of which echoes the grooming described by victims of Epstein and his accomplice Ghislaine Maxwell.

The research also showed that traffickers kept tight control over the teens, using economic and emotional manipulation. They took their money, blackmailed and shamed them, and threatened harm if they were to leave. As in the Epstein case, many traffickers compelled victims to take part in the trafficking itself, such as by recruiting their friends.

The same kinds of manipulation show up in other studies nationally. A 2019 study found that across more than 1,400 cases, a third of traffickers used threats and psychological coercion to control victims.

Another research team looked across 23 studies of minors who were sex trafficked in the United States and Canada. They found that the youth, who were mostly girls, were entrapped by traffickers who pretended to love or care for them, only to manipulate and abuse them.

The tactics identified by researchers and the reports of how Epstein trapped victims on his island reveal that all the strategies used by traffickers have one thing in common: They create ever more dependence of the victim on the trafficker.

Dependence and betrayal

Adolescence is a time of rapid change – change that traffickers exploit. From the tween through the teen years, young people are forming their identities and learning about romantic relationships, all while their brains are still developing.

During this period of rapid change, they are starting to differentiate and seek autonomy. Yet they remain dependent on the adults in their lives for everything from their psychological needs, such as love, to basic physical needs, such as food and housing.

When victims of trafficking depend – financially, psychologically or physically – on the very person abusing them, it’s a betrayal trauma. In these scenarios, victims depend on the abuser, so they cannot simply leave the situation. Instead, they have to adapt psychologically.

One way to adapt is to minimize awareness of the abuse – or what psychologists call betrayal blindness. In the short term, minimizing awareness of the abuse helps the victim endure the abuse. This could be the difference between life and death for a victim whose abuser might harm them if they try to leave or report the abuse – or for a teen who doesn’t have anywhere else to turn for basic survival.

In the long term, though, betrayal traumas are linked with a host of harms that may affect how victims see themselves and the world around them. Compared with other kinds of traumas, betrayal traumas are linked to more severe psychological and physical health problems.

Betrayal trauma often leads to shame, self-blame and fear and can leave survivors alienated from and distrusting of others. Survivors may also be less likely to disclose abuse perpetrated by someone they trusted. They may even have difficulty remembering what happened to them, which can worsen self-doubt and self-blame.

Making sense of the far-reaching impacts of betrayal trauma can be difficult for survivors – and others who hear their stories later.

projected image of a woman holding a photo of her younger self. Text underneath reads, 'I was 16 when I met Epstein.'
Images of alleged Epstein survivors holding photographs of their teenage selves were projected onto the FBI building in Washington, D.C., on Nov. 17, 2025.
Tasos Katopodis/Getty Images Entertainment via Getty Images

Myths and public opinion of victims

When sex traffickers target minors, they use strategies that give others reason to doubt victims. Most people are regularly exposed to misinformation about sexual violence and trafficking through popular media, and that misinformation plays in the perpetrators’ favor.

Researchers started documenting myths about intimate violence decades ago. Since then, research shows that erroneous views of rape, child abuse and sex trafficking persist in media – with consequences for victims.

These myths and misconceptions often seep into the conversation unnoticed, such as when even well-intentioned reporting refers to the girls trafficked by Epstein as “underaged women.” But calling tweens and teens “women” minimizes the age difference with the perpetrators. It also masks the vulnerability of children and adolescents who were victimized by adults.

Myths can include beliefs that intimate violence is rare and always physically violent, and that victims all respond the same way. Myths also tend to minimize the perpetrator’s role while shifting blame to victims for what was done to them, particularly if victims had mental health problems or used substances.

Changing the conversation

With so many myths out there, #iwasfifteen showed one way to change the usual conversation from blaming victims to exposing the ways that abusers exploit tweens and teens. Meeting myths about sex trafficking with research is crucial to putting responsibility where it belongs, on those who traffic youth and perpetrate abuse.

Research shows that the more people buy into myths, the more likely they are to blame victims or not believe them in the first place, including in sex trafficking.

And it’s not only the unsuspecting public that falls for this misinformation. When victims don’t conform to common myths, even law enforcement officers, who are trained to investigate intimate violence, are less likely to believe them.

In this way, the psychological consequences of betrayal trauma – from minimizing the abuse to psychological distress – can feed into myths that people have about intimate violence. Suddenly, it’s easier for friends, family, juries and others to blame victims or not believe them at all.

And, of course, that’s what perpetrators have often told victims all along: No one will believe you. It’s not surprising, then, that victims may take years to come forward, if ever.

The Conversation

Anne P. DePrince has received funding from the Department of Justice, National Institutes of Health, State of Colorado, and University of Denver. She has received honoraria for giving presentations and has been paid as a consultant. She has a book with Oxford University Press. She is an Advisory Group Member of the National Crime Victim Law Institute and a Senior Advisor to the Center for Institutional Courage.

ref. The #iwasfifteen hashtag and ongoing Epstein coverage show how traffickers exploit the vulnerabilities of teens and tweens – https://theconversation.com/the-iwasfifteen-hashtag-and-ongoing-epstein-coverage-show-how-traffickers-exploit-the-vulnerabilities-of-teens-and-tweens-270349

School shootings dropped in 2025 – but schools are still focusing too much on safety technology instead of prevention

Source: The Conversation – USA (2) – By James Densley, Professor of Criminal Justice, Metropolitan State University

A person mourns at a makeshift memorial outside the Barus and Holley engineering building on the campus of Brown University in Providence, R.I., on Dec. 14, 2025. Bing Guan/AFP via Getty Images

Active shootings represent a very small percentage of on-campus university violence.

But among those that do happen, there are patterns. And as law enforcement officials continue to investigate the Dec. 13, 2025, Brown University shooting, similarities can be seen with other active shooter cases on college campuses that scholar James Densley has studied. “They tend to happen inside a classroom, and there tends to be multiple victims,” Densley explains.

The Brown University tragedy, in which a shooter killed two students and injured nine more, marks the fourth deadly shooting at a U.S. university in 2025.

The Department of Education in Rhode Island, where Brown University is located, said on Dec. 16 that it is urging local elementary and secondary schools to review safety protocols.

Amy Lieberman, the education editor at The Conversation U.S., spoke with Densley about how schools have been given what he describes as an “impossible mandate” to try to prevent shootings.

A group of officials wearing green and blue FBI and law enforcement shirts and vests stand inside a room, seen through glass doors with dark paneling.
Members of the FBI’s evidence response team work at the scene of the Brown University shooting on Dec. 13, 2025.
Kyle Mazza/Anadolu via Getty Images

What is the overall trajectory of school shootings over the past few years?

K-12 school shootings appear to be trending downward, at least in the past two years. But we actually saw the largest jumps in this type of violence in the three to five years leading up to 2024, which trends closely with the broader rise in homicide and violent crime we saw in the pandemic era.

In 2025, there have been 230 school shooting incidents in the U.S. – still a staggeringly high number. This compares with 336 school shootings in 2024, 352 in 2023, 308 in 2022, and 257 in 2021.

How this relates to an increase in schools trying to institute security measures to prevent shootings is an open question. But it’s true that many schools are experimenting with certain solutions, like cameras, drones, AI threat detection, weapons scanners, panic apps and facial recognition, even if there is only weak or emerging evidence about how well they work.

Schools are treated as the front line, because the larger, structural solutions are too difficult to confront. It is much easier to blame schools after a tragedy than to actually address firearm access, grievance pathways – meaning how a person becomes a school shooter – and the other societal problems that are creating these tragedies.

How have schools responded to the rise of school shootings in recent years?

Schools are being asked to solve a societal gun violence problem that they didn’t create and they cannot control. Even the best-run school cannot eliminate all risks when causes accumulate outside of their purview. These attacks are rare but catastrophic, and they create an impossible mandate for schools because when they occur, schools are told it reflects a failure in their preparation. Educators are expected to be teachers, social workers, threat assessors and first responders. It normalizes fear and shifts the responsibility downward.

There is a growing school safety industry that markets fear as a solvable, technical problem. It promises faster ways to detect weapons, for example, but the evidence base for those products is thin, proprietary or nonexistent. One example is an AI detection software that mistook a bag of Doritos for a gun, resulting in a large police response.

Schools are pressured to buy something from these companies to show they are doing something. But some of these systems create false positives, and, more importantly, they shift attention away from human relationships. Technology alone cannot resolve grievances, replace trust and create belonging, but most schools are focused on technology as a means of prevention.

How effective are other prevention systems schools have put in place?

If a school shooter is an outsider trying to attack the building, having a single point of entry, access control or multiple locks on doors creates time and space, which are essential for delaying an attacker until law enforcement can arrive, thus mitigating casualties.

But the evidence shows that nearly all school shooters are either current or former students at the school. They are very familiar with entry and exit points, and they are potentially already inside the building before the school can act on a potential threat of violence.

So, what happens if a school locks down, but you are actually locking the shooter in a room with their potential victims? What if students are forced to hide when it would be safer to run? What if you have a door that locks only from the inside and a student or staff member uses that room to bully or sexually assault another student? We’re building schools to protect against the rare events, but we are not mitigating the more common problems they face.

Students are being asked to practice preventing their own deaths in active shooter drills and learn in environments designed around worst-case scenarios. In general, interpersonal violence and spillover of community violence, like gang-related shootings, are the most common form of school shooting. Most shootings at schools occur in parking lots or at sports events, but we do very little to prepare for those types of scenarios.

Are there any benefits, then, to schools having certain non-tech safety measures in place, like making sure every person has an ID?

Of course, you don’t want strangers walking around in a school building. The fact that someone coming to the school has to get their ID scanned and wear a badge makes perfect sense, not just to prevent shootings but to also prevent theft and assaults and other risks.

The paradox is that school shooters tend to be children already affiliated with the school, and when someone walks in already firing, checkpoints and metal detectors are useless. Historically, several mass shootings in K-12 schools have started outside of the building then moved inside. The issue is not slipping past barriers but overwhelming them in seconds with irresistible force.

A group of people stand in a circle together and hold candles.
People hold candles and sing together on Dec. 14, 2025, at a vigil in Lippitt Memorial Park in Providence, R.I., for the recent mass shooting at Brown University.
Ben Pennington/The Boston Globe via Getty Images

Absent policy change, what is the clearest way to prevent school shootings, according to current evidence?

Evidence shows that we often see signs of a crisis or withdrawal beforehand from school attackers. And that is why school-based behavioral threat assessment and management is so important. It is really about noticing changes in behavior and having the authority to intervene early. This is not about profiling people or relying on law enforcement alone. It is about having a structured, team-based process for identifying concerning behavior, assessing risk and coordinating appropriate supports – such as counseling – to prevent harm before it occurs. So often in these cases, people had a gut feeling that something was off with a particular student, but they didn’t know what to share or who to share it with.

For decades we’ve invested far more in responding to school shootings once they occur rather than in preventing them. You can lock doors and run drills, but no school can become a fortress.

Attackers leak warning signs in advance. Real prevention is about creating human systems that get upstream of this.

The Conversation

James Densley has received funding from the National Institute of Justice, the Joyce Foundation, and the Sandy Hook Promise Foundation.

ref. School shootings dropped in 2025 – but schools are still focusing too much on safety technology instead of prevention – https://theconversation.com/school-shootings-dropped-in-2025-but-schools-are-still-focusing-too-much-on-safety-technology-instead-of-prevention-272140

A, B, C or D – grades might not say all that much about what students are actually learning

Source: The Conversation – USA (2) – By Joshua Rowe Eyler, Assistant Professor of Teacher Education, University of Mississippi

Letter grades have long been part of the fabric of the American educational system. iStock/Getty Images Plus

Grades are a standard part of the American educational system that most students and teachers take for granted.

But what if students didn’t have just one shot at acing a midterm, or even could talk with their teachers about what grade they should receive?

Alternative grading has existed in the U.S. for decades, but there are more educators trying out forms of nontraditional grading, according to Joshua Eyler, a scholar of teacher education. Amy Lieberman, education editor at The Conversation U.S., spoke with Eyler to better understand what alternative grading looks like and why more educators are thinking creatively about assessing learning.

Why are some scholars and educators reconsidering grading practices?

For more than 80 years, students at least in seventh grade through college in the U.S. have generally earned one grade for a particular assignment, and a student’s cumulative grades are then averaged at the end of the semester. The final grade gets placed on a student’s transcript.

In some ways, all of the attention is on the grade itself.

Some educators, including me, are trying to rethink the way we grade. Traditional grading is not always an accurate – or the best – way to demonstrate mastery and learning.

Many college faculty across the U.S., as well as some K-12 teachers and districts, are currently experimenting with different approaches and models of grading – typically doing this work on their own but sometimes also in coordination with their schools.

A group of young people are seen from behind walking in front of lockers and carrying backpacks.
High school students walk down the halls of Bonny Eagle High School in Standish, Maine, in 2020.
Shawn Patrick Ouellette/Portland Press Herald via Getty Images

Why is this idea now gaining steam?

Scholars have been researching grades for many decades – there are foundational papers from the early 20th century that scholars today still discuss.

More recently, alternative grading picked up steam in the past 15 to 20 years. Researchers like me have been focused on how grades affect learning.

Grades have been found to decrease students’ intrinsic motivation, and an overemphasis on grades has been shown to alter learning environments at all levels, leading to academic misconduct – meaning cheating.

Grades have also been shown to cultivate a fear of failure among students, at all ages, and inhibit them from taking intellectual risks and expressing creativity. We want students to be bold, creative thinkers and to try out new ideas.

Are there other challenges that alternative grading is trying to correct?

Grades mirror and magnify inequities that have always been a part of American educational systems.

Students who come from K-12 schools with fewer resources, for example, often do not have many textbooks. They often have few, if any, AP courses. These students can develop what researchers call “opportunity gaps.” They do not have the same educational opportunities that students at schools with more resources have.

When students from low-resourced high schools go to college, they can receive worse grades than kids who come from better-resourced schools receive – typically because of these opportunity gaps.

Some people would say that this means these students with low grades are not ready for college. In reality, the grades reflect these students’ past educational experiences – not their potential in college. Once those less-than-stellar grades appear on these students’ transcripts in their first and second years of college, it becomes really hard for students to hit milestones that they need to reach for particular majors.

If we thought about learning a bit differently, those students might have a better shot at reaching their goals.

What do alternative grading models look like in practice?

There are a lot of different grading approaches people are trying, but I would say in the past 10 to 15 years, the movement has really exploded and there is a lot of discussion about it throughout higher education.

With standards-based grading, a biology teacher, for example, would set out a certain number of content- and skill-based standards that they want students to achieve – like understanding photosynthesis. The student’s grade is based on how many of those standards they show competency in by the end of the semester.

A student could show competency in a variety of ways, like a set of exam questions, homework problems or a group project. It is not limited to one type of assessment to demonstrate learning. This grading approach acknowledges that learning is a deeply complicated process that unfolds at different rates for different students.

Other models could look like offering unlimited retakes on tests. Students may have to qualify for the retake by correcting all of the questions they got wrong on a previous exam. Or, teachers set up new assignments that draw on older standards students have previously met, so students have a second shot.

Portfolio-based grading is common in the arts and in writing programs. A student has a lot of time to turn in an assignment and then get feedback on it from their teacher – but no grade. The student eventually puts together a portfolio with the best of their assignments, and the portfolio as an entirety receives a grade.

Another method is called collaborative grading, or ungrading, where students don’t get grades throughout the semester. Instead, they get feedback from their teachers and complete self-assessments. At the end of the semester, the student and teacher collaboratively determine a grade.

What is stopping alternative grading from becoming more widespread?

There have been bursts of activity with grading reform over the past 100 years. The 1960s are a great example of such a period of activity. This is when gradeless colleges like The Evergreen State College were founded.

Social media has helped this particular recent iteration gain traction, as educators can more easily communicate with other people who are grading in different ways.

We are seeing the beginnings of a movement where individuals are trying to do something on this issue. But the issue has not yet drawn together coalitions of people who agree they want change on grading.

Alternative forms of grading have caught on in some private schools, and they have not gained traction in other private schools. The same is true with public schools. Some challenges include logistical support from administrations in K-12 and colleges, teacher buy-in and parental support – especially in K-12 settings.

There is nothing more baked into the fabric of education than the idea of grades. Talking about reforming grading shakes this foundation a little, and that is why it is important to discuss what the alternatives are.

The Conversation

Joshua Rowe Eyler 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. A, B, C or D – grades might not say all that much about what students are actually learning – https://theconversation.com/a-b-c-or-d-grades-might-not-say-all-that-much-about-what-students-are-actually-learning-269066

My prescription costs what?! Pharmacists offer tips that could reduce your out-of-pocket drug costs

Source: The Conversation – USA (3) – By Sujith Ramachandran, Associate Professor of Pharmacy Administration, University of Mississippi

Out-of-pocket costs to fill prescriptions can vary widely. Malte Mueller/fStop via Getty Images

Even when Americans have health insurance, they can have a hard time affording the drugs they’ve been prescribed.

About 1 in 5 U.S. adults skip filling a prescription due to its cost at least once a year, according to KFF, a health research organization. And 1 in 3 take steps to cut their prescription drug costs, such as splitting pills when it’s not medically necessary or switching to an over-the-counter drug instead of the one that their medical provider prescribed.

As pharmacy professors who research prescription drug access, we think it’s important for Americans to know that it is possible to get prescriptions filled more affordably, as long as you know how before you go to the pharmacy.

Cost of copays ranges widely

When you have health insurance and have to pay for a prescription drug at the pharmacy, you’re usually covering the cost of your copay. This is the amount patients or their caregivers are expected to pay after insurance covers the rest of the tab.

If you get your health insurance through Medicaid, the government program that covers low-income Americans and people with disabilities, you should not have to pay anything at all to obtain prescription drugs. If there is a copay, it should be low – probably less than US$5.

And if you’re insured through Medicare, the government program that mainly covers people who are 65 and older, or get your coverage through a private health insurance company, it’s important to understand what to expect when you visit a pharmacy.

Most private insurance companies charge US$5 to $50 for prescription drug copays. The copays are tiered based on what the drug costs. Brand-name and specialty medications have higher copays; older generics have lower copays.

Some generic drugs and vaccines may even require no copay at all. While a copay is a flat fee, it can change over the course of the year based on whether or not you have met your deductible. The deductible is the amount of money you have to pay out of pocket before your insurance starts covering your prescriptions. Before your deductible is fully paid, you may be responsible for the full cost of your medications. After you’ve met your deductible for the year, you will only be required to pay the copay.

As newer, more expensive drugs enter the market, cost-sharing at the pharmacy has increasingly shifted from a copay to coinsurance.

In contrast with a flat copay, coinsurance means your insurance company will cover a certain percentage of the drug’s cost, and you’ll pay the rest. Since the patient’s share is based on a percentage of the medication’s price, coinsurance often results in higher out-of-pocket costs than copays do.

New help for patients with Medicare coverage

Two new government programs could help make prescription drugs more affordable for millions of older Americans.

Starting in 2026, people who are insured through Medicare will pay no more than $2,100 out of pocket on prescription drugs over the year. That cap may be much lower than $2,100 due to a quirk in Medicare’s rules. Prescriptions filled after someone has paid the maximum allowable amount will cost them nothing at all.

In addition, the government launched the Medicare Prescription Payment Plan in 2025. This program, which is available to people over 65, helps spread what patients spend out of pocket on prescription drugs throughout the year, making that expense more predictable and easier to budget for.

Early data indicates that very few Americans are enrolled in the Medicare Prescription Payment Plan. Patients insured through private companies do not have similar opportunities.

Consumers should find out if they qualify for state or federal programs on their medications.

Coupons and discount cards

What if you can’t afford a copay for your prescription drug?

Before giving up on ever getting it, ask the pharmacist about your options.

It may be worth trying to use a free online tool, such as RxAssist, sponsored by the Robert Wood Johnson Foundation, or a discount card from GoodRx, which is a publicly traded company.

GoodRx cards are free. They help people compare local pharmacy prices and to locate coupons that make prescriptions more affordable.

GoodRx works by searching for the lowest available price for the prescription at various pharmacies. Other copay coupons provided by the drug manufacturer may also work similarly by lowering the cost of the medication. On some occasions, the cash price at the pharmacy may actually be cheaper than the copay, and the pharmacist should be able to help you navigate these options.

Here’s what you should know before giving GoodRx a try:

  1. GoodRx collects individual data on patients, raising significant privacy concerns.

  2. Some pharmacies do not accept GoodRx. You may have to visit more than one pharmacy to be able to activate its discounts.

  3. These cards may make the most sense for uninsured or underinsured patients, but do not always help those who have insurance because you might not get a better price. What’s more, if you use a discount card, the amount you pay may not count toward your insurance deductible for the year.

You should weigh the caveats closely depending on your circumstance.

A male pharmacist scanning a pharmacy product for his customer.
Your pharmacist can help you navigate the various discount offerings.
CG Tan/E+ via Getty Images

Prescription assistance programs

Prescription assistance programs provide another cost-saving tool for Americans.

Drugmakers, nonprofits and government agencies sponsor those programs, which help patients who are uninsured or underinsured – even if they are on Medicare – fill prescriptions either at a discount or for free.

These programs include manufacturer-specific programs as well as charitable pharmacies like Dispensary of Hope, NOVA Scripts Central and the Patient Advocate Foundation. Qualifying criteria vary for these programs, but typically you must have a low income and be a citizen or a legal U.S. resident.

The Patient Access Network Foundation and RxAssist, two nonprofits that help Americans pay their medical bills, also offer helpful tools to identify programs that could work for you.

Assistance from these programs could cut your copay or even provide a prescription drug at no cost.

Separately, the Trump administration announced in November 2025 that a new White House prescription drug pricing program will soon begin to connect consumers to companies that have agreed to sell certain prescription drugs at a big discount.

Many experts don’t expect the program, known as TrumpRx, to help people who have health insurance. Instead, it could be most likely to help those with no insurance at all. The new government program is slated to begin to roll out in 2026.

Direct-to-consumer models

Beyond coupons and assistance programs, a more radical shift is in the works: direct-to-consumer platforms and cash-payment models.

In 2025, several manufacturers offered to sell medications directly to patients on websites and patient portals at cash prices. For example, the drug manufacturer Eli Lilly is offering its popular weight-loss medication, Zepbound, on its website.

These websites have out-of-pocket costs that can run upward of $300 a month, making them too high for many, if not most, Americans to afford. And insurance companies have so far refused to cover them.

To be sure, the systems underlying these programs are still being built. We believe that the Trump administration would need to make a bigger effort to make it easier for millions of Americans to be able to afford filling their prescriptions.

The Conversation

Sujith Ramachandran received funding from Robert Wood Johnson Foundation, and provides consulting services for the National Community Pharmacists Association for work related to this topic.

Adam Pate 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. My prescription costs what?! Pharmacists offer tips that could reduce your out-of-pocket drug costs – https://theconversation.com/my-prescription-costs-what-pharmacists-offer-tips-that-could-reduce-your-out-of-pocket-drug-costs-268067

Gazing into the mind’s eye with mice – how neuroscientists are seeing human vision more clearly

Source: The Conversation – USA – By Bilal Haider, Associate Professor of Biomedical Engineering, Georgia Institute of Technology

Mice have complex visual systems that can clarify how vision works in people. Westend61/Getty Images

Despite the nursery rhyme about three blind mice, mouse eyesight is surprisingly sensitive. Studying how mice see has helped researchers discover unprecedented details about how individual brain cells communicate and work together to create a mental picture of the visual world.

I am a neuroscientist who studies how brain cells drive visual perception and how these processes can fail in conditions such as autism. My lab “listens” to the electrical activity of neurons in the outermost part of the brain called the cerebral cortex, a large portion of which processes visual information. Injuries to the visual cortex can lead to blindness and other visual deficits, even when the eyes themselves are unhurt.

Understanding the activity of individual neurons – and how they work together while the brain is actively using and processing information – is a long-standing goal of neuroscience. Researchers have moved much closer to achieving this goal thanks to new technologies aimed at the mouse visual system. And these findings will help scientists better see how the visual systems of people work.

The mind in the blink of an eye

Researchers long thought that vision in mice appeared sluggish with low clarity. But it turns out visual cortex neurons in mice – just like those in humans, monkeys, cats and ferrets – require specific visual features to trigger activity and are particularly selective in alert and awake conditions.

My colleagues and I and others have found that mice are especially sensitive to visual stimuli directly in front of them. This is surprising, because mouse eyes face outward rather than forward. Forward-facing eyes, like those of cats and primates, naturally have a larger area of focus straight ahead compared to outward-facing eyes.

Microscopy image of stacks of neurons
This image shows neurons in the mouse retina: cone photoreceptors (red), bipolar neurons (magenta), and a subtype of bipolar neuron (green).
Brian Liu and Melanie Samuel/Baylor College of Medicine/NIH via Flickr

This finding suggests that the specialization of the visual system to highlight the frontal visual field appears to be shared between mice and humans. For mice, a visual focus on what’s straight ahead may help them be more responsive to shadows or edges in front of them, helping them avoid looming predators or better hunt and capture insects for food.

Importantly, the center of view is most affected in aging and many visual diseases in people. Since mice also rely heavily on this part of the visual field, they may be particularly useful models to study and treat visual impairment.

A thousand voices drive complicated choices

Advances in technology have greatly accelerated scientific understanding of vision and the brain. Researchers can now routinely record the activity of thousands of neurons at the same time and pair this data with real-time video of a mouse’s face, pupil and body movements. This method can show how behavior interacts with brain activity.

It’s like spending years listening to a grainy recording of a symphony with one featured soloist, but now you have a pristine recording where you can hear every single musician with a note-by-note readout of every single finger movement.

Using these improved methods, researchers like me are studying how specific types of neurons work together during complex visual behaviors. This involves analyzing how factors such as movement, alertness and the environment influence visual activity in the brain.

For example, my lab and I found that the speed of visual signaling is highly sensitive to what actions are possible in the physical environment. If a mouse rests on a disc that permits running, visual signals travel to the cortex faster than if the mouse views the same images while resting in a stationary tube – even when the mouse is totally still in both conditions.

In order to connect electrical activity to visual perception, researchers also have to ask a mouse what it thinks it sees. How have we done this?

The last decade has seen researchers debunking long-standing myths about mouse learning and behavior. Like other rodents, mice are also surprisingly clever and can learn how to “tell” researchers about the visual events they perceive through their behavior.

For example, mice can learn to release a lever to indicate they have detected that a pattern has brightened or tilted. They can rotate a Lego wheel left or right to move a visual stimulus to the center of a screen like a video game, and they can stop running on a wheel and lick a water spout when they detect the visual scene has suddenly changed.

Mouse drinking from a metal water spout
Mice can be trained to drink water as a way to ‘tell’ researchers they see something.
felixmizioznikov/iStock via Getty Images Plus

Mice can also use visual cues to focus their visual processing to specific parts of the visual field. As a result, they can more quickly and accurately respond to visual stimuli that appear in those regions. For example, my team and I found that a faint visual image in the peripheral visual field is difficult for mice to detect. But once they do notice it – and tell us by licking a water spout – their subsequent responses are faster and more accurate.

These improvements come at a cost: If the image unexpectedly appears in a different location, the mice are slower and less likely to respond to it. These findings resemble those found in studies on spatial attention in people.

My lab has also found that particular types of inhibitory neurons – brain cells that prevent activity from spreading – strongly control the strength of visual signals. When we activated certain inhibitory neurons in the visual cortex of mice, we could effectively “erase” their perception of an image.

These kinds of experiments are also revealing that the boundaries between perception and action in the brain are much less separate than once thought. This means that visual neurons will respond differently to the same image in ways that depend on behavioral circumstances – for example, visual responses differ if the image will be successfully detected, if it appears while the mouse is moving, or if it appears when the mouse is thirsty or hydrated.

Understanding how different factors shape how cortical neurons rapidly respond to visual images will require advances in computational tools that can separate the contribution of these behavioral signals from the visual ones. Researchers also need technologies that can isolate how specific types of brain cells carry and communicate these signals.

Data clouds encircling the globe

This surge of research on the mouse visual system has led to a significant increase in the amount of data that scientists can not only gather in a single experiment but also publicly share among each other.

Major national and international research centers focused on unraveling the circuitry of the mouse visual system have been leading the charge in ushering in new optical, electrical and biological tools to measure large numbers of visual neurons in action. Moreover, they make all the data publicly available, inspiring similar efforts around the globe. This collaboration accelerates the ability of researchers to analyze data, replicate findings and make new discoveries.

Technological advances in data collection and sharing can make the culture of scientific discovery more efficient and transparent – a major data informatics goal of neuroscience in the years ahead.

If the past 10 years are anything to go by, I believe such discoveries are just the tip of the iceberg, and the mighty and not-so-blind mouse will play a leading role in the continuing quest to understand the mysteries of the human brain.

The Conversation

Bilal Haider receives funding from NIH and the Simons Foundation.

ref. Gazing into the mind’s eye with mice – how neuroscientists are seeing human vision more clearly – https://theconversation.com/gazing-into-the-minds-eye-with-mice-how-neuroscientists-are-seeing-human-vision-more-clearly-268334

The next frontier in space is closer than you think – welcome to the world of very low Earth orbit satellites

Source: The Conversation – USA – By Sven Bilén, Professor of Engineering Design, Electrical Engineering and Aerospace Engineering, Penn State

The closer a satellite − like this telecommunications one − orbits to Earth, the more atmospheric drag it faces. janiecbros/iStock via Getty Images Plus

There are about 15,000 satellites orbiting the Earth. Most of them, like the International Space Station and the Hubble Telescope, reside in low Earth orbit, or LEO, which tops out at about 1,200 miles (2,000 kilometers) above the Earth’s surface.

But as more and more satellites are launched into LEO – SpaceX’s Starlink internet constellation alone will eventually send many thousands more there – the region’s getting a bit crowded.

Which is why it’s fortunate there’s another orbit, even closer to Earth, that promises to help alleviate the crowding. It’s called VLEO, or very low Earth orbit, and is only 60 to 250 miles (100 to 400 kilometers) above the Earth’s surface.

As an engineer and professor who is developing technologies to extend the human presence beyond Earth, I can tell you that satellites in very low Earth orbit, or VLEO, offer advantages over higher altitude satellites. Among other benefits, VLEO satellites can provide higher-resolution images, faster communications and better atmospheric science. Full disclosure: I’m also a co-founder and co-owner of Victoria Defense, which seeks to commercialize VLEO and other space directed-energy technologies.

Advantages of VLEO

The images from very low Earth orbit satellites are sharper because they simply see Earth more clearly than satellites that are higher up, sort of like how getting closer to a painting helps you see it better. This translates to higher resolution pictures for agriculture, climate science, disaster response and military surveillance purposes.

End-to-end communication is faster, which is ideal for real-time communications, like phone and internet service. Although the signals still travel the same speed, they don’t have as far to go, so latency decreases and conversations happen more smoothly.

Much weather forecasting relies on images of clouds above the Earth, so taking those pictures closer means higher resolution and more data to forecast with.

Because of these benefits, government agencies and industry are working to develop very low Earth orbit satellites.

The holdup: Atmospheric drag

You may be wondering why this region of space, so far, has been avoided for sustained satellite operations. It’s for one major reason: atmospheric drag.

Space is often thought of as a vacuum. So where exactly does space actually start? Although about 62 miles up (100 kilometers) – known as the the von Kármán line – is widely considered the starting point, there’s no hard transition where space suddenly begins. Instead, as you move away from Earth, the atmosphere thins out.

Where space begins is relatively arbitrary, but most consider it to be about 62 miles (100 kilometers) high.

In and below very low Earth orbit, the Earth’s atmosphere is still thick enough to slow down satellites, causing those at the lowest altitudes to deorbit in weeks or even days, essentially burning up as they fall back to Earth. To counteract this atmospheric drag and to stay in orbit, the satellite must constantly propel itself forward – like how riding a bike into the wind requires continuous pedaling.

For in-space propulsion, satellites use various types of thrusters, which provide the push needed to keep from slowing down. But in VLEO, thrusters need to be on all, or nearly all, of the time. As such, conventional thrusters would quickly run out of fuel.

Fortunately, the Earth’s atmosphere in VLEO is still thick enough that atmosphere itself can be used as a fuel.

Innovative thruster technologies

That’s where my research comes in. At Penn State, in collaboration with Georgia Tech and funded by the U.S. Department of Defense, our team is developing a new propulsion system designed to work at 43 to 55 miles up (70 to 90 kilometers). Technically, these altitudes are even below very low Earth orbit – making the challenge to overcome drag even more difficult.

Our approach collects the atmosphere using a scoop, like opening your mouth wide as you pedal a bike, then uses high-power microwaves to heat the collected atmosphere. The heated gas is then expelled through a nozzle, which pushes the satellite forward. Our team calls this concept the air-breathing microwave plasma thruster. We’ve been able to demonstrate a prototype thruster in the lab inside a vacuum chamber that simulates the atmospheric pressure found at 50 miles (80 km) high.

This approach is relatively simple, but it holds potential, especially at lower altitudes where the atmosphere is thicker. Higher up, where the atmosphere is thinner, spacecraft could use different types of VLEO thrusters that others are developing to cover large altitude ranges.

Our team isn’t the only one working on thruster technology. Just one example: The U.S. Department of Defense has partnered with defense contractor Red Wire to develop Otter, a VLEO satellite with its version of atmosphere-breathing thruster technology.

Another option to keep a satellite in VLEO, which leverages a technology I’ve worked on throughout my career, is to tie a lower-orbiting satellite to a higher-orbiting satellite with a long tether. Although NASA has never flown such a system, the proposed follow-on mission to the tether satellite system missions flown in the 1990s was to drop a satellite into much lower orbit from the space shuttle, connected with a very long tether. We are currently revisiting that system to see whether it could work for VLEO in a modified form.

Other complications

Overcoming drag, though the most difficult, is not the only challenge. Very low Earth orbit satellites are exposed to very high levels of atomic oxygen, which is a highly reactive form of oxygen that quickly corrodes most substances, even plastics.

The satellite’s materials also must withstand extremely high temperatures, above 2,732 degrees Fahrenheit (1,500 degrees Celsius), because friction heats it up as it moves through the atmosphere, a phenomenon that occurs when all spacecraft reenter the atmosphere from orbit.

The potential of these satellites is driving research and investment, and proposed missions have become reality. Juniper research estimates that $220 billion will be invested in just the next three years. Soon, your internet, weather forecasts and security could be even better, fed by VLEO satellites.

The Conversation

Sven Bilén founder and co-owner of Victoria Defense, which seeks to commercialize VLEO and other space technologies. He receives funding from DARPA and NASA related to VLEO technologies.

ref. The next frontier in space is closer than you think – welcome to the world of very low Earth orbit satellites – https://theconversation.com/the-next-frontier-in-space-is-closer-than-you-think-welcome-to-the-world-of-very-low-earth-orbit-satellites-258252