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Hi there, and welcome back to Fast Companys Plugged In. Last year, I left Twitter gradually, then all at once. Throughout 2024, Elon Musks wildly irresponsible stewardship of his social networkI refuse to call it Xleft me increasingly disengaged. But the role he played in Donald Trumps reelection proved to be my breaking point. As of this week, its been a year since my last tweet. Now, I cant claim to have abandoned Twitter entirely. Im still lurking, though only sporadically. When my reporting for a story leads me thereits certainly one of the principal places people talk about AII go. Add up all my activity, and it amounts to maybe 2% of the time I once spent on the service. (Strangely enough, when I do check in, my feed is flooded with tweets from Theranos founder Elizabeth Holmes, whos still in federal prison but seemingly using the platform as an exercise in reputational repair.) Largely weaning myself off the social network that served as my principal online hangout for more than 15 years has been an unalloyed blessing. Before I stopped tweeting, I felt increasingly embarrassed by my participation in a club led by Musk. The 12 months since then have been his most indefensible to date, from the pointless humanitarian nightmare inflicted by DOGE cuts to the U.S. Agency for International Development (USAID) to Grok going Nazi. Being appalled from a distance has been far preferable to tweeting my way through it. The fact that Im a happy ex-Twitter addict isnt just a moral stance. For all of Musks still-unfulfilled blather about turning Twitter into an everything app, the site is shrinking. Thats true in a literal, daily-active-users sense, where its now at risk of being consistently surpassed by Metas Threads. However, Im thinking more of Twitters cultural relevance. The site that once aspired to be the pulse of the planet is clinging to the residue of what it once was. The tweets still flow, but the spark of life is gone. Thats not a universally held opinion, of course. If theres a case for staying on Twitter, its the one outlined by The Arguments Jerusalem Desmas in a piece titled, well, The case for staying on Twitter. Calling it the most influential public square we have, she maintains that departing the site for an alternative such as Threads, Bluesky, or Mastodon amounts to deplatforming yourself. If Twitter were a public square, her argument might be airtight. But public squares arent private enterprises operated to serve their owners interests. Twitter is. Thats true even before you consider Musks whim-based management, which has gamed the conversation in ways that consistently make it worse. That said, I may have stayed on Twitter as long as I did in part because nothing else out there seemed any closer to being the internets one true forum. Certainly not its most populous rival, Threads: Every time Meta changes its mind about whether it wants to discourage or boost conversations about news and politics, its a reminder that the company is algorithmically shaping the discourse. One of the lessons Ive learned over the past year is that we dont need a single, defining hub of Twitter-style conversation. Why resign yourself to tolerating Musks vision for social networking when you can assemble your own? Instead of choosing between Threads, Bluesky, and Mastodon, Ive been posting to all three simultaneously using Openvibe. Im also having fun with two apps that weave Bluesky and Mastodon posts together with items from RSS feeds and other sources: Flipboards Surf and Iconfactorys Tapestry. And sometimes I use two fine single-service third-party apps: Graysky for Bluesky and Icecubes for Mastodon. My new social network-of-networks is smaller than the one I once had on Twitter, where I peaked at around 95,000 followers. The quality of the conversation is excellent, though, in part because the vast majority of people whose tweets I once cared about are active on the services I use now. And Musk doesnt get to pull any of the levers, though he does pop up as a charactermost recently when Bluesky was awash in glee over Joyce Carol Oates eviscerating him on Twitter. Its to all the Twitter rivals credit that theyre partaking in the open ecosystem reflected in the various apps Im running. (Bluesky and Mastodon are all in, while Threads is still dipping its toe.) Meanwhile, Musk has doubled down on Twitters long-standing policy of preventing people from using the service in any way except via its official apps and website. The services walled-off nature is yet another reason why it feels like its fading away. I stopped tweeting because I couldnt stand having my online identity wed to Musks any longer. Now Im sorry I didnt divorce myself from his mess earlier. Well never get the lovable Twitter of yore back, but Im too busy enjoying my post-Twitter social networking life to be all that wistful. Youve been reading Plugged In, Fast Companys weekly tech newsletter from me, global technology editor Harry McCracken. If a friend or colleague forwarded this edition to youor if you’re reading it on fastcompany.comyou can check out previous issues and sign up to get it yourself every Friday morning. I love hearing from you: Ping me at hmccracken@fastcompany.com with your feedback and ideas for future newsletters. I’m also on Bluesky, Mastodon, and Threads, and you can follow Plugged In on Flipboard. More top tech stories from Fast Company The secret to phone detoxingHint: You’ve got it in the bag, kiddo. Read More Creators are suffering from a mental health crisis, new study showsOne in 10 creators in North America reported having suicidal thoughts tied to their work, a rate that’s nearly double the national average. Read More If AI won’t follow the rules, should the media even try?With AI scraping content and ignoring paywalls, publishers face a brutal choice: play defense, go on offense, or get left behind. Read More Michael Caine and Matthew McConaughey are getting AI voice clones with ElevenLabsCaine said in a statement that ElevenLabs is ‘using innovation not to replace humanity, but to celebrate it.’ Read More Why did SoftBank sell off its Nvidia stake?The move underscores CEO Masayoshi Son’s contrasting views of the futures of Nvidia and OpenAI. Read More Meet your new AI tutorTry new learning modes in ChatGPT, Claude, and Gemini. Read More
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Is there such a thing as being too attractive? For fitness influencers, it turns out there might be. Contrary to popular belief, new research suggests that being too good-looking can actually be a disadvantage, particularly in the online fitness space. The study, coauthored by researchers at the University of Dayton and University of Oregon, found that the more attractive the influencer, the lower the engagement they received on their social media posts. The reason? It all comes down to a sense of relatability, and what researchers have termed the beauty backfire effect.” In the study, researchers showed 299 U.S. adults mock Instagram posts featuring a highly attractive female fitness influencer, a moderately attractive one, or a text-only control. The halo effect and pretty privilege are both widely studied phenomena where peoples good looks often work to their advantage. Yet the highly attractive influencer scored lowest on both relatability and engagement. Participants also reported a dip in self-esteem after viewing her post. The moderately attractive influencer, on the other hand, boosted participants confidence. It makes sense. When attempting to conjure up motivation to get off the sofa and go to the gym, scrolling through posts of rock-hard abs and fit-fluencers barely breaking a sweat can sometimes have the opposite effect. Researchers also linked this to social comparison theory. We are all guilty of comparing ourselves to others. Sometimes that comparison can be motivating, other times it can be discouraging. If a fitness influencer is too attractive, the body ideal they are selling no longer feels attainable. In a follow-up study, researchers found that highly attractive female fitness influencers faced stronger backlash than equally attractive men. This backfire effect is also most apparent in the fitness space. When the same experiment was conducted with finance influencers, appearance didnt have as much of an impact. Relatability is often an influencers most valuable currency. Social media has evolved from overly polished posts and curated feeds to a focus on authenticity. Today, people gravitate toward influencers with day jobs, tuning in to watch them go about their normal lives, rather than mega-influencers partying with celebrities or jet-setting every other week whose lives feels out of reachor out of touch. The last study backs this up. While the beauty backfire effect can undermine influencers trying to grow their followings, its not unavoidable. If those deemed highly attractive pair their posts with modest captions, talking about their struggles or insecurities, the relatability gap closes. If theyre boastful or adopt self-congratulatory language, the gap widens again. If you’re having trouble racking up the likes on social media, it could just be that you’re too good-looking.
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E-Commerce
On July 29, 2025, at 9:45 a.m., Christine Ressy was supposed to be undergoing surgery to remove kidney stones. Instead, Ressy, a 49-year-old hairdresser in New York City, found herself holding back tears in the waiting room of a Manhattan hospital. Unless she paid half of her $10,933 bill prior to surgery, her doctor simply could not operate, she had been told. Because Ressy was uninsured, she had hoped to receive a cash-pay discount or find some other way to negotiate costs. She wanted to see an itemized receipt after her surgery before paying up, and had prepared a $500 cash deposit. She had done all this on the advice of her most trusted advocate: ChatGPT. Ressy’s conversations with ChatGPT about the cost of her surgery spanned more than 28,000 words. The platform assured her that she was allowed to push back against medical cost estimates, offering scripts for phone calls and email drafts to send billing departments. In the hospital, Ressy messaged ChatGPT again. “Im crying beyond tears,” she wrote. She was willing to pay, but did not want to do so upfront. The staff is “pressuring me,” she said. What should she do? “You are not the problem here,” ChatGPT responded, sending Ressy a yellow heart emoji. Ressy was simply a “patient asking to be treated fairly,” the AI platform said. “They are pressuring you at your most vulnerableand that is wrong.” Ressy went to the check-in desk and repeated a new ChatGPT script: This time, she wanted documentation that she had, as instructed, arrived two hours early for surgery, had offered a good faith deposit, and that the hospital would not be admitting her. One of the medical billers overheard Ressy, then mentioned the phrase “charity care.” Ressy was previously told on the phone that she made too much to qualify for any financial assistance. Now, the biller brought Ressy to the billing office and gave her a document to sign. Two hours after her scheduled appointment, Ressy went into surgery. Three months later, the only money Ressy has paid is the $500 she brought as a deposit. She never received a bill for her surgery, and she is currently negotiating the cost of her anesthesia. “I didn’t know I had any of these options,” Ressy tells Fast Company. “ChatGPT said it’s legal, it’s necessary, and it’s expected to negotiateI didn’t know that.” Ressy is one of a growing number of people using ChatGPT and other AI tools to untangle the convoluted finances of the American healthcare system. As insurers invest in artificial intelligence, many patients feel the system is increasingly lacking in humanity. A ProPublica report found that Cigna denied 300,000 requests over a two-month period in 2023, with physicians spending an average of 1.2 seconds on each case. Cigna, UnitedHealthcare, and Humana are all facing class-action lawsuits that allege the insurers’ AI models denied patients lifesaving care, with denials that ran counter to doctors’ recommendations. Patients often are informed of these denials in confusing form letters that leave patients scrambling mere daysor even hoursbefore scheduled treatments. Now, thousands of patients are using platforms to appeal rejected claims, according to Alicia Graham, the CEO of AI startup Claimable. Others, like Ressy, are asking for scripts to help them negotiate the cost of care. Jessica Cunningham, a mother of four and content creator in Southern California, tells Fast Company she runs all of her family’s hospital bills through ChatGPT to make sure they are not being overcharged. In a confounding system, seemingly controlled by bots and byzantine policies, AI can feel like a lifeline. “It makes me feel like I have the smartest person in the world looking out for me,” Gordon says. “They don’t know what to do next” With its opaque pricing and convoluted policies, it’s easy to feel confused by the American healthcare system. A Gallup poll found that just 17% of Americans are aware of the cost of healthcare procedures before receiving care. Trying to navigate the medical system is an exhausting process, with more than 80% of patients and caregivers telling the Patient Insight Institute that they spent five or more hours a week on administrative tasks. Eighteen percent said they spent “too many hours to count.” Then there is the financial burden: according to a 2022 survey, four in ten Americans are in medical debt. Erin Bradshaw, the executive vice president of the Patient Advocacy Foundation, says that by the time people reach out to the nonprofit, they are already overwhelmed. Most are not aware that many hospitals are open to negotiating costs, nor that hospitals have charitable or discount programs. Even if patients are aware of these options, few know who to contact or what to say. “Often the barrier is they don’t even know what to do next, because you’re dealing with a health crisis to begin with,” Bradshaw says. Decoding hospitals and insurers’ policies can feel like trying to read another language. One of the most powerful aspects of AI platforms is their ability to analyze vast amounts of text nearly instantaneously, with ChatGPT reading hundreds of words in just a few seconds. Often, people simply surrender when the process becomes too overwhelming. If AI platforms can provide support for patientseven if it’s just by scanning documents and suggesting questions to askit can be a great tool for self-advocacy, Bradshaw says. At the same time, Bradshaw and other healthcare experts caution against relying solely on AI. Part of their caution is due to privacy concerns. Artificial intelligence is able to provide better results with more information, so if you upload your bills and medical records, you will likely get more fine-tuned responses. However, this information does not necessarily remain private, as most AI platforms save and collect user data. It’s a stark departure from the privacy-obsessed world of medicine, where Health Insurance Portability and Accountability Act (HIPAA) demands strict protection of sensitive health information. Also complicating matters is AI platforms’ quirk of offering up occasionally inaccurate information. Different states and healthcare systems have vastly different policies. What works in one siuation might not apply in another, no matter what ChatGPT says. And sometimes, AI platforms are just straight-up wrong. Earlier this year, for example, CNN reported that the FDA’s AI platform was making officials’ jobs more difficult by misrepresenting research and hallucinating nonexistent studies. That does not mean patients should avoid AI altogether. They just need to check its sources, ensuring the original documents actually support platforms’ statements. Alternatively, experts advise seeking out platforms trained specifically to answer these types of questions. Courage to take action In January, the Marshall Allen Project launched the “Marshall Allen Clone,” or MAC. The journalist Marshall Allen, author of “Never Pay the First Bill (And Other Ways to Fight The Healthcare System and Win),” spent his career publishing investigations that helped patients better navigate the healthcare system.After Allen died unexpectedly in 2024, the Marshall Allen Project built MAC, an AI tool trained on Allen’s reporting. The free platform offers personalized answers to people like Ressy struggling to negotiate costs or untangle their options. “The general AI does a really good job of giving people a great starting point,” Andrew Gordon, a healthcare researcher who volunteers with the Marshall Allen Project, tells Fast Company. What sets the MAC apart is its training on the intricacies of the system. When a patient is advocating for themselves for the first time, Gordon says, feeling secure in the accuracy of this advice can be especially powerful. “It’s a North Star, it’s confidence, and it’s courage to take action,” Gordon adds. Other organizations are building even more specific AI tools. Claimable, a startup that launched in 2024 and one of Fast Company‘s 2025 World Changing Ideas, uses AI to generate and submit appeals for patients who have been denied healthcare coverage. The startup is a seed stage company with investors including Walkabout Ventures and Quiet Capital. In less than a year, Claimable has recovered nearly $20 million for patients. Cofounder Alicia Graham tells Fast Company she was drawn to the idea after finding out that up to 99% of people whose claims are denied never file an appeal. Yet, when patients do push back against these denials, a sizable portion up to 80% win, allowing access to treatments previously out of financial reach. To use Claimable, which costs $39.95 per appeal, patients upload their medical and insurance information and answer a handful of questions. (Unlike most AI platforms, Claimable privately protects this information, in compliance with HIPAA.) The platform generates an appeal, drawing on specific insurance policies, local legislation, and relevant medical research. This kind of tedious work can take hours. Claimable creates a letter in minutes, then submits the appeal to the necessary parties. Michael Henry was one of the many patients who did not realize he could appeal rejected claims until he heard about Claimable. Henry, a chief of human resources in Battle Creek, Michigan, had started rationing his GLP-1 shots in late 2024 when Blue Cross Blue Shield Michigan announced it would no longer cover medications such as Saxenda, Wegovy, and Zepbound. Henry tried another weight-loss drug, but it did not work. He did not want to pay $1,200 a month. So, instead of injecting himself weekly, Henrywho was previously diagnosed as prediabeticcut his shots to every other week, rationing out his remaining medication. By July, Henry was almost out. He was listening to an episode of “On the Pen,” a podcast about GLP-1s, featuring an interview with Zach Veigulis, another Claimable cofounder. Henry collected his documents and filled out Claimable’s questionnaire. The next day, he got a call from his doctors’ office. He had been approved. Henry picked up his medication later the same day. The United States is still in the early days of patients using AI to navigate the $5 trillion healthcare system. AI is not always the solution. Not every appeal is approved and not every attempt at negotiation succeeds. Artificial intelligence does not address patients’ fundamental concerns about the healthcare system, from its opaque pricing to confusion and suspicion around denials. Americans on all sides of the negotiation seem ready to let AI take the reins when it comes to healthcare. Disturbingly, this could mean that artificial intelligence platforms working with insurers will be financially incentivized to deny patients’ claims. A pilot program that is set to launch in January, for example, will use AI platforms to review prior authorizations of treatments. The platforms will be paid a share of the money saved by rejecting treatment. The ideal future of health insurance would be a system free from concerns of systemic bias, or at least one that does not require superhuman computing capabilities to understand. But as insurers implement new technology, AI can at least offer patients a new tooland a new confidenceto push back against a system that leaves many feeling powerless. “The more people that appeal, the better,” Claimable cofounder Gordon says. “The more people challengeif they feel they’ve been unjustly deniedthe better for everyone.”
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