Reasonably Optimistic

When UnitedHealthcare CEO Brian Thompson was killed on a Manhattan sidewalk in December 2024, the nation was stunned. But the act of violence exposed the fury simmering beneath America’s health care debate. For many, the system feels impossibly expensive, confusing and unfair — especially when compared to other countries.

Host Megan McArdle is joined by Dr. Ashish Jha — physician, public health expert and former White House covid-19 response coordinator — to unpack what’s really going on inside the U.S. health care system. They explore why costs are so high and what it would actually take to build a system that works better for everyone.

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Until recently, universities were widely seen as places for asking questions, debating ideas and accessing upward mobility. Now, they’re just as likely to be seen as battlegrounds in the culture wars. As public trust eroded and political scrutiny intensified, a bigger question emerged: When did this shift happen? And more importantly, can it be repaired?

Host Megan McArdle is joined by Daniel Diermeier, chancellor of Vanderbilt University. He is trying to answer those questions not just in theory but in practice. Drawing on his experience leading a university, Diermeier shares where he thinks universities have gone off course, what needs to change and what’s still worth protecting — and whether they can once again become places where more people feel they belong.

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How can the U.S. lead in rebuilding industrial capacity? Christian Keil believes the answer lies with American dynamism. He is a partner at a16z, who sees technology as a key to our future. Even through uncertain times and sharp competition from China. He joins host Megan McArdle to discuss his experience — from innovating satellite technology during his time at Astranis to now investing in companies through venture capital. He also gives more detail on his recently published the report "More Perfect," which explores how technology has shaped and will reshape America.

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On Feb. 28, the U.S. and Israel initiated strikes on Iran. What comes next? Host Megan McArdle sits down with Washington Post Columnist David Ignatius to discuss Iran's response, whether the U.S. can sustain a prolonged conflict, what the war signals to adversaries like China and the economic risks of a closed Strait of Hormuz.

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We hear a lot about what artificial intelligence can do. We hear a lot less about what it takes to run it. The explosion of AI depends on massive data centers — and massive amounts of energy. Rep. Jake Auchincloss (D-Mass.) joins host Megan McArdle to discuss how his views on AI have evolved, and to explore how his state — and the nation — can meet the energy and infrastructure demands of the AI boom.

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