View this post on the web at [link removed]

Welcome to You’re Probably Getting Screwed, a weekly newsletter and video series from J.D. Scholten and Justin Stofferahn about the Second Gilded Age and the ways economic concentration is putting politics and profits over working people.
Apple CEO Tim Cook told [ [link removed] ] CNBC’s Jim Cramer in 2019 that Apple’s “greatest contribution to humanity” would be on the issue of health. This was four years after Apple had, to much fanfare, launched its Apple Watch, which included health tracking features. While that wearable device was the company’s foundational step into our healthcare system, it was not a final one. In the years after the launch of the Apple Watch, Cook’s company has embarked on a series of acquisitions key to achieving the vision the CEO shared with Cramer.
In 2016, Apple acquired Gliimpse [ [link removed] ], a personal health data startup that allowed users to pull their own medical information into one location to be managed and shared. In 2017 they bought Beddit [ [link removed] ], a company that made a sleep tracking device that could upload data to an Apple Watch application. That same year Apple acquired Lattice [ [link removed] ], an AI startup whose machine learning technology could be used in medical research. In 2019, following Cook’s comments to Cramer, Apple acquired Tueo Health [ [link removed] ], a small startup that was developing an app that could monitor asthma symptoms in sleeping children. All of this is in addition to Apple’s longstanding control via their app stores, which is mostly discussed in the smartphone context but also exists with their watches.
The purchase of small startups has been a key part of Apple’s overall acquisition strategy, much of which is not public. The American Economic Liberties Project has tracked [ [link removed] ] 126 acquisitions made by Apple since 2000, but Cook has said [ [link removed] ] the company acquires a company every couple of weeks, with a focus on smaller startups that can provide Apple with talent and intellectual property. In 2019 Apple had a six month stretch [ [link removed] ] where it gobbled up 20 to 25 companies. This acquisition strategy is part of how Big Tech has created kill zones that stifle innovation by snuffing out competitors well before they can gain any foothold in a market.
As the wearable technology industry has grown [ [link removed] ] from $20 billion in 2015 to over $70 billion today, Apple has cornered the market. While sales have slipped recently, the Apple Watch dominates the smartwatch market (which is also the most significant segment of the wearable technology market). The watch is so popular Apple sold more units [ [link removed] ] than the entire Swiss watch industry in 2020. Apple is not the only Big Tech firm trying to corner the wearables market though, as Google purchased Fitbit in 2021.
The data generated by these devices fits neatly into the surveillance economy [ [link removed] ] Big Tech has created and provide firms with plenty of valuable data. In 2022, Mozilla estimated that [ [link removed] ] the market for “body-centric” data will grow to between $500-$600 billion by 2032 which includes electronic health records, mobile health data and biometrics. Wearables offer tech giants a new avenue [ [link removed] ] for harvesting massive troves of personal data all within a regulatory regime much looser than traditional healthcare players. While hospitals, health plans and medical providers are subject to the Health Insurance Portability and Accountability Act (HIPAA) and its patient privacy protections, Big Tech is not. In the words of the Mozilla report, “This unchecked data accumulation has led to data breaches, rising insurance costs, workplace discrimination, and more.”
Major insurers have jumped into bed with Big Tech and the wearable craze. UnitedHealth Group has rewards tied to Fitbit [ [link removed] ] use that could save an individual as much as $1,500 or if you want to stick to Apple products, UGH will provide a free six-month [ [link removed] ] subscription to Apple Fitness+. While the adoption of wearables has been an opportunity for individuals to save money, there is a future where data such as heart rate, activity levels and sleep patterns are used to deny coverage or raise premiums [ [link removed] ], creating the kind of personalized pricing [ [link removed] ] that former FTC Chair Lina Khan and Fordham Law professor Zephyr Teachout have warned about.
Now Big Tech’s health gambit could get a major boost from Uncle Sam. Several weeks ago Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. told [ [link removed] ] the House Subcommittee on Health that HHS will be embarking on a massive advertising campaign to encourage Americans to use wearable technology, something he said was central to the Make America Healthy Again (MAHA) agenda he is spearheading. Kennedy’s goal is that all Americans will be using wearables in the next four years. This would be up from the roughly one-third of Americans currently using these devices according [ [link removed] ] to the NIH. Think of all the extra data this taxpayer-funded Big Tech advertising scheme will generate!
To be clear, there is plain old grift [ [link removed] ] at play. President Trump’s pick for Surgeon General is Dr. Casey Means, who co-founded Levels, a biowearables and health tracking company that stands to benefit [ [link removed] ] from wider adoption of wearables. Her brother, Calley Means, is a wellness influencer and senior advisor to Kennedy who co-founded TrueMed. The company helps people utilize tax-advantaged accounts such as Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) to purchase items like wearable technology, supplements, and fitness equipment. Because of Calley’s status as a “special employee” he has not had to divest from his private business interests.
Even if Big Tech surveillance and grift were not concerns, widespread wearable use might not be a helpful goal. A recent study [ [link removed] ] found that a six-question survey developed by NASA in the 1980s outperformed the systems used by wearables in determining the intensity of a workout. In other words, trusting your body was better than Big Tech quantifying it. The constant tracking of one’s health metrics can build healthy habits in some cases, but can also have negative impacts [ [link removed] ] on mental health in others. The costs of these devices can also be prohibitive [ [link removed] ] and further exacerbate existing health inequities.
This is not a call to ditch your wearable. Even if Kennedy’s goal is worthwhile, it is another example of how MAHA will be little more than an empty slogan if it does not address monopoly power. Further innovation is important in this industry. The American Medical Association has warned [ [link removed] ] that devices that yield inaccurate readings for things like hypertension or atrial fibrillation could result in unnecessary or harmful treatment, not to mention the opportunities for inaccurately raising your healthcare costs. Improved accuracy won’t occur if tech firms like Apple continue to acquire potentially innovative startups before anyone has heard about them. For example, a key claim [ [link removed] ] in the Department of Justice (DOJ) antitrust lawsuit against Apple’s monopoly over smartphones is that it throttles innovation.
Instead of an advertising campaign for Big Tech, MAHA needs an antimonopoly campaign. With Congress unlikely to pass any comprehensive data protections, states can step in. Washington, Nevada and Connecticut have all recently passed [ [link removed] ] laws meant to safeguard consumer health data, which could help cut at the heart of the business model that makes healthcare such a lucrative play for Big Tech. States can also move to prohibit surveillance pricing [ [link removed] ] like legislation [ [link removed] ] in New York and California would do. Making the Federal Trade Commission and the Department of Justice permanent members [ [link removed] ] of the MAHA Commission that President Trump recently established is another worthwhile step. And this is just regarding wearables, monopolies are found all across our health system so call your legislator today, otherwise your morning run could be used to screw you.
YOU’RE PROBABLY (ALSO) GETTING SCREWED BY:
Private Equity
Private equity has already cornered minor league baseball, but now it’s beginning to stick its tentacles into youth sports, because what better way to treat future generations than commercializing them! Here is a comedic take on this dystopian reality.
UnitedHealth
We’ve covered [ [link removed] ] the way this sprawling health giant is screwing you (also, see above). It is an insurance company that just so happens to be the largest employer of doctors in the country! But that is not all. According to a deep dive [ [link removed] ] by The American Prospect, UHG has 2,694 subsidiaries and affiliates!
Dialysis Monopoly
Speaking of healthcare, More Perfect Union digs into the two companies that control the dialysis industry.
Artificial Intelligence
Another week, another concerning bit of news about AI. A survey by Common Sense Media [ [link removed] ] finds that 72% of US teens use AI for companionship. Half talk to an AI friend every day and yet a third say AI has said something that makes them feel uncomfortable. Meanwhile the industry lobbies Congress to prevent any guardrails from being created.
Salary Caps
Major League Baseball Commissioner Rob Manfred is on a crusade to convince players and fans that the magical solution to all the sports problems is a salary cap. David Berri writes in The Sling [ [link removed] ], that for all the claims by team owners that a salary cap is necessary to ensure parity, baseball already has plenty of it. For example, the three best teams in baseball right now are 18th, 8th and 24th in payroll and do not include the Yankees or Dodgers. Instead Berri writes, “Owners have consistently called for a cap on pay for the obvious reason they want to pay their workers less.”
SOME GOOD NEWS
Legislator Takes on Surveillance Pricing
California Assemblymember Chris Ward has introduced legislation that would prohibit the use of surveillance pricing or “digital price discrimination” as he also calls it. Ward authored an opinion piece [ [link removed] ] on the issue that is worth a read.
This isn’t about dynamic pricing, where prices fluctuate with demand. This about charging you more because of who you are or who a computer model thinks you are. That’s profiling and exploitation.
BEFORE YOU GO
Before you go, I need two things from you: 1) if you like something, please share it on social media or the next time you have coffee with a friend. 2) Ideas, if you have any ideas for future newsletter content please comment below. Thank you.
Break Em Up,
Justin Stofferahn

Unsubscribe [link removed]?