Medicine has a well-established model for distributing liability across physicians and tools: whoever caused the failure bears the liability. AI vendors have quietly opted out of it — and the contracts they're asking health systems to sign reflect that.

OpenAI and Anthropic both launched enterprise healthcare AI offerings last month. OpenAI's is more complete — a ready-to-use product for clinicians plus an API for developers. Anthropic's is developer-focused, with connectors to healthcare databases like CMS and ICD-10. Both will eventually offer the full stack. The question is what you need now.

Blue Cross Blue Shield of Massachusetts just posted a $400 million loss—the worst in their history. The culprit? GLP-1 medications that could eventually save insurers billions. The costs hit today, the savings arrive years later, and health systems are caught in the middle.

The New York Times built one of the best digital products in media—yet its real revenue and profit have fallen by more than half. That’s what disruption actually looks like: the work moves elsewhere while the industry shrinks. Healthcare is now entering the same pattern, driven by consumer tech, GLP-1s, and safer mobility. We’re heading toward better health—and a smaller healthcare system.