Imagine if you could get a prescription drug for a medical condition online without traveling to see a doctor, or even speaking with one.

That's the promise behind the trendy men's health startup Hims, which says its online platform is making medical care more available for men with stigmatized health issues such as impotence and hair loss.

You've probably seen the splashy ads featuring stylized eggplants and cacti (a winking nod to Hims' work in erectile dysfunction), and even the rapper Snoop Dogg. With these high-profile campaigns, the San Francisco telemedicine startup has vaulted to prominence, and is reportedly nearing a $1 billion valuation.

But Hims' approach triggered concerns among some doctors working with the company after the startup led an effort to expand the number of patients that physicians could treat with generic Viagra online, according to secret messages among clinicians and a person familiar with the matter.

The clinicians are employed by Hims' independent medical partner, an organization called Bailey Health. But the move prompted worries among some doctors that Hims might be pressuring them to write more prescriptions in a more lenient manner. Erectile dysfunction can also be a sign of more concerning health conditions, which might not be diagnosed or treated in an online visit, according to an outside expert.

This story is based on secret messages among clinicians and internal documents reviewed by Business Insider, as well as conversations with current and former Bailey Health doctors. Business Insider also spoke with Melissa Baird, Hims' chief product and operations officer, and Dr. Peter Stahl, a Hims medical consultant. Requests for comment from Bailey Health were not returned by two individuals there.

Hims said in a statement that "this narrative is patently false" and said that the level of patient care and safety on its platform was "best in class." Hims also emphasized the distinct and separate status of Bailey Health.

"Any claims that are made to the contrary are categorically false, and intentionally aim to undermine the credibility of safe, effective protocols set forth in telemedicine and the medical community at large," the statement said. "hims has always made clear to physicians that each physician must prescribe according to his or her own, independent clinical judgement and that the safety of patients is paramount. There are no penalties or negative repercussions of any kind for any physician based upon their prescribing rates."

The concerns raised at Hims provide a unique window into the issues that may crop up as more medical-care services move online and companies toe the line between e-commerce and medicine, serving patients who are also customers.

Many see these types of telemedicine companies as the future of healthcare, and investors have poured hundreds of millions of dollars into startups selling prescription products online, including birth-control pills, migraine medications, and contacts.

Startups raising private funds are typically under pressure from their venture investors to show significant growth. And the Silicon Valley mantra of "move fast and break things" presents issues in the healthcare industry, where people's health and well-being are on the line.

Read more: Investors are betting $660 million that companies that ship Viagra and hair loss pills to your door is the future of medicine

A disruptive model

Erectile dysfunction is a common problem, and brand-name Viagra is notoriously expensive. At about $50 a pill, it regularly brought in more than $1 billion in annual revenue, and one year it generated as much as $2.1 billion for Pfizer.

Hims burst onto the scene in late 2017 and quickly began selling the generic, cheaper form of Viagra when it became available. Led by founder and CEO Andrew Dudum, the startup also offers hair-loss products and creams, and gummy vitamins that don't require a prescription. The business has also expanded, with a push into women's health and a UK launch.

Dudum pitches Hims' online-only approach as a convenient, inexpensive, and destigmatizing route to medical care. People don't like going to the doctor, he has said, let alone for an uncomfortable or taboo condition.

Instead, customers detail their medical history and symptoms in a detailed online form, which is then reviewed by a doctor. If the physician gives the OK for a prescription, Hims mails the patient the pills in a nondescript package. The clinician can also refer a patient to see an in-person physician.

Under Hims' original protocols, doctors likely would not have prescribed to patients with certain risky health conditions, including diabetes and blood pressure outside a certain range. The new protocols allow doctors to prescribe to such patients but, because they are guidelines, do not require it.

Hims said its original erectile-dysfunction protocols were overly conservative and excluded men who could be helped safely online.

Baird told Business Insider that the move to relax standards, made in July 2018, had not substantively changed the percentage of patients treated, and she denied that it had prompted significant concerns among doctors.

"I wouldn't say it was out of the realm of normalcy for any fairly fundamental change within a company you do every day," Baird said. She compared it to a design change on a popular website.

"Facebook changes its UI. Everybody gets really upset for a couple of days," she said.

Yutong Yuan / BI Graphics

But objections to the more lenient guidelines persisted until at least late last year. Bailey Health doctors use the messaging tool Slack to communicate, and one clinician posted a poll asking about the new guidelines.

Multiple Bailey Health employees said the change "has made patient care deteriorate considerably" and asked to go back to the previous policy, according to the poll, which was obtained by Business Insider. Business Insider confirmed that two physicians who participated in the poll work for Hims' medical partner.

Business Insider began reporting this story in December, and has contacted 19 individuals for it. Some refused to speak with us. Business Insider is not identifying those who did in order to allow them to speak freely without fear of professional repercussions.

Participants in a separate group chat, which was private and not hosted on a company system, voiced serious worries about the protocol change and other company practices for months after the new policy went into effect. They also said Hims was pressuring doctors to write more prescriptions, including by monitoring individual doctors' prescribing, according to the group messages and a source familiar with the matter.

Baird said the company does not have the ability to track how many patients are being turned down for generic Viagra or other drugs by individual doctors. Bailey Health currently employs 140 US doctors, according to a Hims public-relations contact, and Baird said Hims tracks the rejection rate only on an aggregate basis across the company. The rates at which clinicians refer patients to in-person doctors, which Hims' Baird said was the same as the rejection rate, are "encrypted at the individual level," Hims said in a statement.

Hims told reporters last year that it rejects about 30% to 40% of patients seeking generic Viagra. But Baird told Business Insider in January that the company's rejection rate was never that high, instead citing a range of 10% to 20%.

Hims said in a later statement that rejection rates have fluctuated each week between 15% and 45% of customers, the result of the evolving treatment protocols, the increasing volume of users, and changing patient demographics. And Baird said in a later conversation that the effect on the rate after the guidelines were loosened last summer is "not even something we can evaluate."

Two other online healthcare companies said their rejection rates for erectile dysfunction are higher. Lemonaid Health said it often tells about 45% of patients to get care elsewhere. Roman said more than half of people who begin an online visit for erectile dysfunction are rejected but wouldn't give a precise figure.

Hims said its rejection rates shouldn't be compared to other companies.

Questions about new online models

Hims' subscription-based model has proven attractive to venture-capital investors such as Peter Thiel's Founders Fund, Joshua Kushner's Thrive Capital, and 8VC. Hims clocked in at a $500 million valuation last fall, according to PitchBook, and a funding round in the works could bring that figure to more than $1 billion, a Recode report said.

These new online models can help patients by making it easier for them to get care, but there are concerns about divorcing erectile-dysfunction consultations from the wider medical system, said Dr. Hossein Sadeghi-Nejad, a urologist and the president of the Sexual Medicine Society of North America, which promotes high standards in treating human sexual dysfunction.

Sadeghi-Nejad said he's not familiar with Hims specifically.

Because erectile dysfunction can be the first sign of other health conditions, treating it might include lifestyle changes, such as limiting or quitting alcohol, seeking counseling, using an erectile-dysfunction medication, using a medical device, or undergoing surgery.

For instance, Sadeghi-Nejad said medications that lower blood pressure, called beta blockers, can also cause erectile dysfunction. A cardiologist doing a full, in-person evaluation might adjust a patient's blood-pressure medication, rather than prescribe Viagra, he said.

"But if it's done as part of this whole prescribing system, what are the odds the doctor will say, 'Mr. Sadeghi, go see a cardiologist and then call me?'" he asked.

Yutong Yuan / BI Graphics

Viagra is taken before sexual activity to increase the blood flow that makes erections possible. Viagra, like all prescription drugs, has risks, but they are mostly considered limited. And Viagra isn't thought to have long-term side effects.

Concerns raised in a secret group chat

Hims had been selling generic Viagra, known as sildenafil, for just over half a year when a change was made. In mid-2018, Hims led an effort to change the guidelines for doctors working with the company to make it easier for them to prescribe the drug to more people.

Hims confirmed that its guidelines changed to make generic Viagra available to more people but said on Friday that it would only share the guidelines if this reporter signed a confidentiality agreement. The company said it could not provide specific information about the guidelines because it could "compromise the integrity of the telemedicine visit."

The original protocols for doctors who treat patients through Hims' platform recommended that the doctors avoid treating individuals with certain health conditions, including diabetes or blood pressure outside a certain range, according to Stahl. Both diabetes and heart problems can be linked to erectile dysfunction, and erectile dysfunction can be a sign of more harmful medical problems for individuals with those conditions.

That was no longer the case under the new protocols. Afterward, clinicians took to a secret, private group chat to voice their significant concern. Roughly 10 employees were included on the chat, with up to five actively participating, two participants confirmed to Business Insider.

The doctors work for Bailey Health, the independent medical partner of Hims. But to the secret-group-chat participants, the distinction didn't make much of a difference. This separate structure is common among health companies because many states outlaw businesses practicing medicine.

The participants were especially concerned about whether Hims was pressuring doctors to write more prescriptions in a more lenient way.

One doctor who works at Bailey Health and was included in the secret group messages acknowledged some pressure to write more prescriptions but said it comes as more of a suggestion. The company doesn't encourage unsafe practices or fire those who don't comply, the doctor said. Clinicians emphasized in interviews that they practiced according to their independent medical judgment.

And Bailey physicians are paid by the hour, not by the prescription, according to Hims and others.

"Doctors have no pressure to prescribe," Hims' Baird said.

An internal poll about the guidelines

If Bailey doctors were initially bothered by the protocol change, it was just the short-term confusion that can come with any organizational change, Baird told Business Insider.

Business Insider began reporting on Hims in December. In late December, a clinician set up a poll about this subject on Bailey Health's internal Slack messaging system. The survey asked whether the new guidelines for erectile dysfunction patients were clear, and appeared to be open to all Bailey Health clinicians.

None of the employees who participated said yes. Five said "no, they're not" clear and 10 said "it has made patient care deteriorate considerably in the past several months."

Meanwhile, 16 responded in support of the company going back to the prior policy. Clinicians could choose more than one answer, and there was some overlap between the groups. The above reflects the results as of the time Business Insider viewed them.

Baird also said the company would not interfere with prescribing decisions, including the duration of prescriptions given to patients. Hims has made longer-duration prescriptions of generic Viagra, including six-month and 12-month supplies, available for patients. Asked whether Hims ever urges doctors to prescribe these longer-duration supplies more, Baird said the company did not.

"Sometimes the urology advisers will chime in, and say you know, it's a little extra to be making them come back every three months," she said, calling longer-duration prescriptions more standard in in-person doctor's offices. "But Hims itself never says anything about the duration of prescription."

In an email sent to Bailey Health staff late last year, Baird reminded them that "our advisors" had said that six-month and 12-month prescriptions were allowed.

"I am not, in any way, critiquing or suggesting the longer duration prescriptions, but about 6 months ago we were around 25% 6 month prescriptions and now we are almost 0," she wrote. "That makes me think that perhaps some newer docs either aren't aware of the advisory board's suggestion or people have just fallen into habit -- as can happen when you are seeing a bazillion patients :)."

How the change was made

The process by which Hims changed the erectile-dysfunction protocols was another subject of controversy in the private doctor group chat viewed by Business Insider.

The initial guidelines had been formed when the company was much smaller, and they were perceived as being too stringent by Hims' vice president of medical affairs, Dr. Adrian Rawlinson, and by Hims' medical advisory board, Baird said. Rawlinson didn't immediately respond to a message seeking comment on his role in changing the guidelines.

Among the factors playing into the move was "the fact that we were just in a better place overall to be able to handle more patients," Baird said.

The protocols were changed by a group of physicians, including the medical board and Bailey doctors, in July 2018, she said.

Hims had just closed a $50 million fundraising round that summer and was already trying to raise more money. It took until late January to raise the most recent round, which amounted to $100 million, according to a Recode report.

Stahl, the director of male reproductive and sexual medicine at NewYork-Presbyterian Hospital/Columbia University Medical Center, said he was a hired consultant who provided recommendations to Hims, including on the erectile-dysfunction guidelines. He said he hadn't been involved in actually making the changes, which he said had been made by Bailey Health's advisory board.

Among his advice had been changes to approaches that appeared "medically incorrect," he said. Stahl also said it's not any riskier to prescribe Viagra to people with diabetes than to those who don't have it.

"I think that telemedicine is new, and I think the instinct to be conservative makes sense in certain scenarios," Stahl said. But that "can also serve as a barrier to appropriate and effective medical care, and can be an access barrier."

Stahl acknowledged that there was some pushback from Bailey Health clinicians after the guideline changes were announced, including about cardiovascular safety and patients with diabetes. Ultimately, physicians will use their medical judgment when deciding what to prescribe, he said.

Part of the reason for this controversy is that there aren't yet expert guidelines on how to treat erectile dysfunction online. The latest guidelines from the American Urological Association recommend a physical exam, which can't be done through a platform like Hims.

"There is not currently a consensus statement with regard to how to treat erectile dysfunction on a telemedicine platform," Stahl said. "Those meetings I'm sure will happen very shortly but they haven't happened yet. So you know, everyone is doing their own thing."

Want to tell us about your healthcare experience? Email the author at This email address is being protected from spambots. You need JavaScript enabled to view it..

Jerry George, the former LA bureau chief of The National Enquirer, told CNN on Thursday night that the feud between Amazon CEO Jeff Bezos and American Media Inc. (AMI), the publishing arm of the tabloid was "baffling."

The tabloid, which previously published an exposé into an affair between Bezos and TV anchor Lauren Sanchez, claimed it possessed sexually explicit photos of Bezos. The Amazon CEO subsequently launched an investigation headed by his security chief, Gavin de Becker, into the origin of AMI's exposé.

On Thursday, Bezos published a blog post detailing what he alleged to be an "extortion and blackmail" plot by AMI. Using emails as evidence, Bezos revealed AMI's plan to extort him by threatening the Amazon founder with compromising personal photos unless they quashed the investigation.

"Rather than capitulate to extortion and blackmail, I've decided to publish exactly what they sent me, despite the personal cost and embarrassment they threaten," Bezos said on his blog post.

Read more: People are praising Jeff Bezos and calling him a 'genius' after he slammed the National Enquirer and accused them of blackmail in a shocking blog post

George said that in light of the fight between the world's richest man and AMI, he believed the media company may have taken things too far and acted prematurely.

"I think they thought they were smarter than they are, and I think now the reality is hitting them and they're freaking out."

George added that AMI's threats were "nothing short of extortion" and that it "looks like a crime."

The Amazon CEO also appeared to hint in his blog post that powerful forces motivated by politics may have been at play. National Enquirer owner David Pecker, a known longtime associate of President Donald Trump, has been accused of purchasing the rights to numerous Trump-related scandals in order to bury the story.

Trump regularly rails against Bezos, the owner of The Washington Post, for its reporting on his presidency. George noted that there may have been a correlation between Trump, AMI, and Bezos.

"For years, Donald Trump has had a hard-on for Bezos," George said. "Professional jealousy, the acquisition of Amazon ... so it's no surprise that he turned to his good buddy, David Pecker ... to do a hatchet job on him."

Beyond the praise, the subject matter and the parties involved — AMI CEO David Pecker and Bezos — created the perfect storm on social media. The Huffington Post's headline really kicked things off.

Still, some tried to come up with their own headlines.

And some just questioned if life could really be real.

AMI's overall strategy was brought into question.

Some pointed to the plot similarities of a certain superhero movie.

Then, there was this awkward LinkedIn connection.

Tech news essentially stopped on Thursday, as all were consumed with the Bezos blog post.

And with all the jokes out there now, there will likely be some regret tomorrow.

Politics, as they say, makes for strange bedfellows. So too, it seems, does web hosting.

The National Enquirer, which Amazon CEO Jeff Bezos accused Thursday of trying to extort and blackmail him, appears to host its website on the servers of Amazon Web Services, the tech giant's cloud computing unit.

Read this:Amazon CEO Jeff Bezos accuses National Enquirer publisher of 'extortion' over naked photos in extraordinary blog post

The underlying IP addresses for the Enquirer's site are assigned to Amazon. Records associated with those addresses list Amazon as their owner.

Ryan Huber, a security architect at enterprise messaging company Slack, highlighted the connection in a post on Twitter. Business Insider confirmed the connection.

"Dear Mr Bezos, I'm just gonna leave this here," he said in a tweet.

Representatives for Amazon and American Media, the parent company of the Enquirer, did not immediately respond to a request for comment or confirmation about their business connection.

Last month, the Enquirer published an exposé of Bezos' affair with former TV anchor Lauren Sanchez. In response, Bezos launched an investigation into how information about his relationship, including racy texts, were leaked to the Enquirer. Bezos' investigator has suggested that the leaks could have been politically motivated.

In an extraordinary blog post, Bezos said that American Media, the parent company of the Enquirer threatened to published additional racy photos of him and Sanchez unless he agreed to disavow the notion that the Enquirer's piece was motivated by politics. Bezos said that would have been a "lie."

Jeff Bezos on Thursday all but charged that the National Enquirer's exposure of his affair with former TV anchor Lauren Sanchez was a politically motivated hit job, possibly orchestrated by or as a favor to President Trump.

In a stunning open letter posted on Medium in which he accused American Media (AMI), the Enquirer's parent company, of extortion and blackmail, Bezos referred to several motives and characters that could form the outline of a conspiracy. Bezos never explicitly connected the dots himself, but presented the facts in a way that a reader would be hard pressed to miss them.

Bezos' blog post described efforts by Enquirer publisher AMI to get him to clear the tabloid's exposé of having any political agenda or origin.

AMI, according to Bezos, had alerted him that the Enquirer had a collection of racy photos of him and Sanchez. The tabloid threatened to publish them, Bezos said, unless he put out a statement that he and the investigator he hired to look into the Enquirer's story about his affair "have no knowledge or basis for suggesting that AMI's coverage was politically motivated or influenced by political forces."

"If we do not agree to affirmatively publicize that specific lie, they say they'll publish the photos, and quickly," Bezos charged.

Read this:Amazon CEO Jeff Bezos accuses National Enquirer publisher of 'extortion' over naked photos in extraordinary blog post

Bezos doesn't flat-out say that the Enquirer's piece was politically motivated. He's saying he would be lying if he said he believed it wasn't politically motivated. He's essentially saying that he either knows or has reason to suspect that the Enquirer's story about his affair was, in fact, politically motivated.

Representatives for AMI did not immediately respond to an email seeking comment on Bezos' post.

Bezos suggested that Trump and the Saudis may have been involved

But Bezos went further than that, suggesting that AMI may have published the story as a favor to or at the direction of either Donald Trump or the Saudia Arabian government.

Michael Cohen, Donald Trump's former lawyer, admitted to working with AMI to hush up stories of Trump's affairs with two women. Associated Press/Craig Ruttle Trump has repeatedly made clear his ire over the coverage of him in The Washington Post, which Bezos owns, the latter noted. Meanwhile, David Pecker, AMI's chairman, has long been accused of using the Enquirer for political purposes, Bezos said. AMI helped Trump lawyer Michael Cohen suppress the stories of two of Trump's affairs during the 2016 presidential election campaign by either purchasing one, in one case, or, in the other, helping to arrange a deal for Cohen to purchase them, according to the government's criminal complaint against Cohen to which he pleaded guilty.

Bezos doesn't accuse Trump of orchestrating a political hit on him, but comes close.

"It's unavoidable that certain powerful people who experience Washington Post news coverage will wrongly conclude I am their enemy," Bezos wrote "President Trump is one of those people, obvious by his many tweets."

In one such tweet, shortly after the Enquirer story was published, Trump to delight in the revelation about "Jeff Bozo being taken down."

Twitter

White House representatives did not immediately respond to emails seeking comment about Bezos' post.

Bezos also suggested that Saudi Arabia may have been working against him behind the scenes. AMI has reportedly explored business ties with Saudi Arabia and published a magazine last year solely devoted to fawning coverage of Mohammed bin Salman, its crown prince, Bezos noted. The Post, in the meantime, has been "unrelenting" in covering the death — allegedly by Saudi agents — of Jamal Khashoggi, a former columnist at The Post, a Saudi citizen, and an outspoken critic of bin Salman, Bezos said.

AMI was "unnerved" when Bezos' investigation into the story touched on the publishing company's Saudi connections, he claimed.

"Several days ago, an AMI leader advised us that Mr. Pecker is 'apoplectic' about our investigation," Bezos said. "For reasons still to be better understood, the Saudi angle seems to hit a particularly sensitive nerve."

Representatives at the Saudi embassy in Washington did not immediately respond to an email seeking comment.

Presidents have used the press to go after critics

Were Trump to have been involved in the publication, it wouldn't be the first time a president or his staff has used the press to go after a critic. White House officials under George W. Bush leaked the name of then-undercover CIA analyst Valarie Plame after her husband, former ambassador Joe Wilson, wrote an opinion piece for The New York Times discrediting the idea that Iraq had obtained bomb-making materials from Niger.

Thirty years earlier, Richard Nixon ordered his Plumbers investigative unit to try to discredit Daniel Ellsberg in the press after he leaked the Pentagon Papers, a top-secret history of the Vietnam War.

It's the position of the National Enquirer, it seems, that it would be in the public interest to publish intimate photos of Jeff Bezos — including at least one racy selfie — because they would reflect on his business judgment as CEO of Amazon.

That's according to Bezos himself, in a defiant blog post claiming that the National Enquirer, and its publisher, David Becker, were engaging in "extortion and blackmail" over those photos. To support his claims, Bezos published what appear to be e-mails from lawyers representing the National Enquirer, and its parent company, AMI.

"With millions of Americans having a vested interest in the success of Amazon, of which your client remains founder, chairman, CEO, and president, an exploration of Mr. Bezos' judgment as reflected by his texts and photos is indeed newsworthy and in the public interest," said one of these e-mails, in part.

In the blog post, Bezos indicated that he's having none of it, saying that Amazon's status as one of the most valuable and influential companies in the world should be proof enough of his business acumen.

Writes Bezos:

"AMI's claim of newsworthiness is that the photos are necessary to show Amazon shareholders that my business judgment is terrible.I founded Amazon in my garage 24 years ago, and drove all the packages to the post office myself. Today, Amazon employs more than 600,000 people, just finished its most profitable year ever, even while investing heavily in new initiatives, and it's usually somewhere between the #1 and #5 most valuable company in the world.I will let those results speak for themselves."

However, amid this unfolding drama, it's worth noting that this episode could very well have big ramifications for Amazon shareholders. Jeff Bezos and his wife, MacKenzie, are in the process of divorcing, and have no prenuptial agreement.

This divorce carries two big risks for Amazon shareholders, legal experts recently told Business Insider. First, the divorce itself could distract Bezos from his duties as CEO of Amazon and owner of the Washington Post. Second, MacKenzie could become one of Amazon's largest shareholders, affecting the balance of power at the company.

Both of those risks could be exacerbated if things get messy between Jeff and MacKenzie Bezos ahead of the finalization of the divorce. While it remains to be seen how this will play out, Bezos' stand on this matter is unlikely to help in that regard.

Apparently, former AOL CEO Tim Armstrong takes his spirit animals seriously.

In a bizarre memo published by CNBC that was sent to friends and family to explain his latest venture — the dtx company — Armstrong wrote: "Our spirit animal is the wolf, as we believe the strength of the wolf is in the pack, and the strength of the pack is in the wolf. We also love wolf because it is 'Flow' backwards and we are building a Flow State culture."

The dtx company — which stands for "direct to everything" — aims to help "empower consumers and companies to build direct relationships," according to the memo.

Read more: Former AOL CEO Tim Armstrong launched a new company that wants to help Instagram brands grow and put on Coachella-like 'experiences'

Armstrong said that the "x" in "dtx" is symbolic because it's "two arrows meeting in the middle as we believe in two-way or no way." He also emphasized that the spelling be lowercased, saying "we are lowercase because our partners are UPPERCASE."

To date, dtx has already invested in a half dozen companies, including health beverage company Dirty Lemon, bra-maker Third Love, and manicure company OIive & June.

Armstrong also told CNBC that he wants to launch 'experiences' involving direct-to-consumer brands, which he envisions to be a mix between the Consumer Electronics Show in Las Vegas and Coachella.

Read the full Armstrong memo in CNBC's report.

On Thursday, Amazon CEO Jeff Bezos wrote a Medium blog post revealing the emails that he alleges were sent to blackmail him.

In the email, AMI, the publisher of the National Enquirer, threatened to publish personal photos of Bezos and former news anchor Lauren Sanchez, including a naked selfie of Bezos.

In January, the National Enquirer, a long-time ally of President Donald Trump, had published an exposé on the affair between Bezos and Sanchez. After that, Bezos hired investigators to look into who leaked his personal photos and texts.

AMI threatened to publish these photos unless Bezos and Gavin De Becker, Bezos' security boss leading that investigation into the exposé, make a public statement that they "have no knowledge or basis for suggesting that AMI's coverage was politically motivated or influenced by political forces." AMI also said it would keep those photos.

"Of course I don't want personal photos published, but I also won't participate in their well-known practice of blackmail, political favors, political attacks, and corruption. I prefer to stand up, roll this log over, and see what crawls out," Bezos wrote.

Here is the email that Bezos says he received from AMI, describing the photos it had obtained.

From:Howard, Dylan [This email address is being protected from spambots. You need JavaScript enabled to view it.] (Chief Content Officer, AMI)Sent:Tuesday, February 5, 2019 3:33 PMTo:Martin Singer (litigation counsel for Mr. de Becker)Subject:. Jeff Bezos & Ms. Lauren Sanchez Photos

CONFIDENTIAL & NOT FOR DISTRIBIUTION

Marty:

I am leaving the office for the night. I will be available on my cell — 917 XXX-XXXX.

However, in the interests of expediating this situation, and with The Washington Post poised to publish unsubstantiated rumors of The National Enquirer's initial report, I wanted to describe to you the photos obtained during our newsgathering.

In addition to the "below the belt selfie — otherwise colloquially known as a 'd*ck pick'" — The Enquirer obtained a further nine images. These include:

· Mr. Bezos face selfie at what appears to be a business meeting.

· Ms. Sanchez response — a photograph of her smoking a cigar in what appears to be a simulated oral sex scene.

· A shirtless Mr. Bezos holding his phone in his left hand — while wearing his wedding ring. He's wearing either tight black cargo pants or shorts — and his semi-erect manhood is penetrating the zipper of said garment.

· A full-length body selfie of Mr. Bezos wearing just a pair of tight black boxer-briefs or trunks, with his phone in his left hand — while wearing his wedding ring.

· A selfie of Mr. Bezos fully clothed.

· A full-length scantily-clad body shot with short trunks.

· A naked selfie in a bathroom — while wearing his wedding ring. Mr. Bezos is wearing nothing but a white towel — and the top of his pubic region can be seen.

· Ms. Sanchez wearing a plunging red neckline dress revealing her cleavage and a glimpse of her nether region.

· Ms. Sanchez wearing a two-piece red bikini with gold detail dress revealing her cleavage.

It would give no editor pleasure to send this email. I hope common sense can prevail — and quickly.

Dylan.

And here are emails Bezos says he received from the National Enquirer publisher, laying out the terms for witholding publication of the photos:

From:Fine, Jon [This email address is being protected from spambots. You need JavaScript enabled to view it.] (Deputy General Counsel, AMI)Sent:Wednesday, February 6, 2019 5:57 PMTo:Martin Singer (Mr de Becker's attorney)Subject:Re: EXTERNAL* RE: Bezos et al / American Media et al

Marty -

Here are our proposed terms:

1. A full and complete mutual release of all claims that American Media, on the one hand, and Jeff Bezos and Gavin de Becker (the "Bezos Parties"), on the other, may have against each other.

2. A public, mutually-agreed upon acknowledgment from the Bezos Parties, released through a mutually-agreeable news outlet, affirming that they have no knowledge or basis for suggesting that AM's coverage was politically motivated or influenced by political forces, and an agreement that they will cease referring to such a possibility.

3. AM agrees not to publish, distribute, share, or describe unpublished texts and photos (the "Unpublished Materials").

4. AM affirms that it undertook no electronic eavesdropping in connection with its reporting and has no knowledge of such conduct.

5. The agreement is completely confidential.

6. In the case of a breach of the agreement by one or more of the Bezos Parties, AM is released from its obligations under the agreement, and may publish the Unpublished Materials.

7. Any other disputes arising out of this agreement shall first be submitted to JAMS mediation in California

Thank you,

Jon

Deputy General Counsel, Media

American Media, LLC

Jon P. Fine

Deputy General Counsel, Media

O: (212) 743-6513 C: (347) 920-6541

This email address is being protected from spambots. You need JavaScript enabled to view it.

February 5, 2019

Via email:

This email address is being protected from spambots. You need JavaScript enabled to view it.

Martin D. Singer

Laveley & Singer

Re: Jeff Bezos / American Media, LLC, et al.

Dear Mr. Singer:

I write in response to your February 4, 2019, letter to Dylan Howard, and to address serious concerns we have regarding the continuing defamatory activities of your client and his representatives regarding American Media's motivations in its recent reporting about your client.

As a primary matter, please be advised that our newsgathering and reporting on matters involving your client, including any use of your client's "private photographs," has been, and will continue to be, consistent with applicable laws. As you know, "the fair use of a copyrighted work, including such use by reproduction in copies . . . for purposes such as criticism, comment, news reporting . . . is not an infringement of copyright." 17 USC Sec. 107. With millions of Americans having a vested interest in the success of Amazon, of which your client remains founder, chairman, CEO, and president, an exploration of Mr. Bezos' judgment as reflected by his texts and photos is indeed newsworthy and in the public interest.

Beyond the copyright issues you raise, we also find it necessary to address various unsubstantiated defamatory statements and scurrilous rumors attributed to your client's representatives in the press suggesting that "strong leads point to political motives"1 in the publication of The National Enquirer story. Indeed, you yourself declared the "politically motivated underpinnings" of our reporting to be "self-evident" in your correspondence on Mr. de Becker's behalf to Mr. Howard dated January 31, 2019.

Once again, as I advised you in my February 1 response to your January 31 correspondence,American Media emphatically rejects any assertion that its reporting was instigated, dictated or influenced in any manner by external forces, political or otherwise.Simply put, this was and is a news story.

Yet, it is our understanding that your client's representatives, including the Washington Post, continue to pursue and to disseminate these false and spurious allegations in a manner that is injurious to American Media and its executives.

Accordingly, we hereby demand that you cease and desist such defamatory conduct immediately. Any further dissemination of these false, vicious, speculative and unsubstantiated statements is done at your client's peril.Absent the immediate cessation of the defamatory conduct, we will have no choice but to pursue all remedies available under applicable law.

As I advised previously, we stand by the legality of our newsgathering and reporting on this matter of public interest and concern. Moreover, American Media is undeterred from continuing its reporting on a story that is unambiguously in the public interest — a position Mr. Bezos clearly appreciates as reflected in Boies Schiller January 9 letter to American Media stating that your client "does not intend to discourage reporting about him" and "supports journalistic efforts."

That said, if your client agrees to cease and desist such defamatory behavior, we are willing to engage in constructive conversations regarding the texts and photos which we have in our possession. Dylan Howard stands ready to discuss the matter at your convenience.

All other rights, claims, counterclaims and defenses are specifically reserved and not waived.

Sincerely,

Automakers like GM and Ford are banking on the the assumption that if they can lower the cost per mile of self-driving taxis to $1 or less, demand will skyrocket. But a new analysis in the Harvard Business Review suggests their model may be flawed.

Why it matters: Carmakers are tearing apart their traditional businesses— exiting underperforming markets, closing factories and laying off workers — while diverting investment into future mobility technologies. But if self-driving taxi fleets don't take off as expected, their financial plans could be at risk.

What they're saying: Ride-hailing costs around $3 per mile today, according to GM, but only accounts for 1% of miles traveled. The driver represents most of that cost.

Yes, but: Authors Ashley Nunes and Kristen Hernandez see it differently.

Consumer subsidies will be needed to realize the life-saving benefits of AVs, they conclude.

The bottom line: Self-driving cars need to be affordable to serve those who need them most, and to keep carmakers' strategies afloat.

Go deeper: Here come the robotaxis

Amazon CEO Jeff Bezos has accused American Media Inc. (AMI), the publisher of the National Enquirer, of attempting to extort him over leaked naked photos.

In January 2019, the National Enquirer published an exposé into an affair between the billionaire tech exec and the former news anchor and helicopter pilot Lauren Sanchez, and said that it had seen explicit photos of him.

In an extraordinary blog post published on Medium on Thursday, Bezos said AMI subsequently attempted to extort him over these photos. He said the publisher threatened to publish the photos unless he stopped an investigation into the leaks. And it also demanded that he disavow the idea that AMI's investigation into his personal life might have been politically motivated, Bezos said.

"Rather than capitulate to extortion and blackmail, I've decided to publish exactly what they sent me, despite the personal cost and embarrassment they threaten," Bezos wrote.

Spokespeople for AMI and Amazon did not immediately respond to Business Insider's requests for comment.

See also: Read all the emails Jeff Bezos says the National Enquirer sent to 'blackmail' him

Bezos insinuates the National Enquirer may have been politically motivated

AMI has long been accused of having political motives for its news coverage.

Its owner, David Pecker, is an ally of President Donald Trump and has previously engaged in buying negative stories about Trump in order to bury them (a process called "catch and kill"). As such, there has been some speculation that the National Enquirer exposé on Bezos was at least partially motivated by the long-running feud between Trump and Bezos, who owns The Washington Post.

Gavin de Becker, Bezos' security boss who is leading the investigation into the exposé, had previously said "strong leads point to political motives." De Becker has "whatever budget he needed" to carry out this investigation, Bezos wrote.

Bezos doesn't outright say he believes the National Enquirer exposé was politically motivated. But he hints at it, beginning his blog post by recapping AMI's "catch and kill" practices and saying his ownership of The Washington Post means "powerful people who experience ... news coverage will wrongly conclude I am their enemy."

He also hints at a potential Saudi Arabian connection to his investigation into AMI, writing: "Several days ago, an AMI leader advised us that Mr. Pecker is 'apoplectic' about our investigation. For reasons still to be better understood, the Saudi angle seems to hit a particularly sensitive nerve."

"A few days after hearing about Mr. Pecker's apoplexy, we were approached, verbally at first, with an offer. They said they had more of my text messages and photos that they would publish if we didn't stop our investigation," he added.

AMI's alleged emails have been published

Bezos' comments represent an extraordinary intervention from the 55-year-old CEO into the tabloid scandal. Bezos had so far refrained from commenting, even as de Becker gave media interviews, and he rarely talks to the press.

Bezos' post also contains what he said are copies of the emails sent by AMI, which include explicit descriptions of the intimate photos.

"In the AMI letters I'm making public, you will see the precise details of their extortionate proposal: They will publish the personal photos unless Gavin de Becker and I make the specific false public statement to the press that we 'have no knowledge or basis for suggesting that AMI's coverage was politically motivated or influenced by political forces,'" Bezos wrote.

"If we do not agree to affirmatively publicize that specific lie, they say they'll publish the photos, and quickly. And there's an associated threat: They'll keep the photos on hand and publish them in the future if we ever deviate from that lie."

These are, Bezos said, some of the terms AMI tried to get him to agree to in return for not publishing the photos:

"1. A full and complete mutual release of all claims that American Media, on the one hand, and Jeff Bezos and Gavin de Becker (the "Bezos Parties"), on the other, may have against each other.

"2. A public, mutually-agreed upon acknowledgment from the Bezos Parties, released through a mutually-agreeable news outlet, affirming that they have no knowledge or basis for suggesting that AM's coverage was politically motivated or influenced by political forces, and an agreement that they will cease referring to such a possibility.

"3. AM agrees not to publish, distribute, share, or describe unpublished texts and photos (the "Unpublished Materials")."

Bezos added that his lawyers believe AMI has no right to publish the photos in any case because he took the original photos in question, giving him the claim to ownership.

China's Online Games Ethics Committee has approved a pair of mobile games published by Tencent, meaning the the world's largest video game publisher will finally be able to release new games in its home country for the first time since March of last year.

China spent much of 2018 reorganizing its approval process for new media coming into the country, leading to an extended freeze on new releases. China established a new regulatory body, the Online Games Ethics Committee, in response to concerns from Chinese officials who feared that video games were sparking addiction and impacting the productivity of the country's youth.

Chinese regulators maintain strict standards when judging whether games, films, and other media are too violent or offensive for release within the country. The Online Games Ethics Committe approved 80 games in its first round of reviews in late December 2018, and after four rounds of approvals, a total of 352 games have been cleared for release. The South China Morning Post reports that Chinese regulators hope to get back to their standard rate of between 2,000 and 3,000 annual approvals.

Some of Tencent's most successful games released worldwide during 2018 still remain barred from release in China. Regulators have also prevented Tencent from monetizing popular games that were already tested in the Chinese market, including "Fortnite: Battle Royale" and "PlayerUnknown's Battlegrounds," both of which have millions of players on a monthly basis. The freeze on popular new releases has hit Tencent's bottom line hard too; the company's share price dropped nearly 30% during the freeze.

Read more:Video game addiction has sparked a culture war in China — and it's having huge repercussions for the world's biggest video game maker

In a proactive response to criticism in China, Tencent began using facial recognition software to verify player identities in September 2018. Tencent's age-verification process uses an official government database to confirm player identities with their photo and personal information. Players under the age of 18 are limited to playing just two hours a day, while those under the age of 12 are limited to one hour a day.

Despite restrictions from the government, China remains the largest video game market on the planet. Chinese gamers spent more than $34 billion on video games in the past year, according to New Zoo.

During a routine sweep of the outer solar system, the Hubble Space Telescope caught a new and mysterious "dark vortex" in the clouds of Neptune, according to NASA.

The space agency jointly announced the storm's discovery on Thursday with the Space Telescope Science Institute (STScI), which picks targets for the telescope to study based on submissions by scientists around the world.

The new storm shown in the image below is enormous. Measuring about 6,800 miles across, it could stretch from New York City to the tip of South America and swallow perhaps 20% of Earth's surface area.

The Hubble Space Telescope photographed a "dark tempest" storm on Neptune in September 2018.NASA/ESA/A. Simon (GSFC)/M.H. Wong and A. Hsu (UC Berkeley); Business Insider

The storm appears to be confined to Neptune's northern hemisphere, near a patch of bright-white "companion" clouds, according to a press release from STScI. Such clouds form because the storm plows through surrounding air high above the storm, cooling it off and causing it to freeze. In this cause, that frozen material is almost certainly methane.

"These clouds are similar to clouds that appear as pancake-shaped features when air is pushed over mountains on Earth (though Neptune has no solid surface)," the STScI said.

This marks the fourth such dark storm ever discovered on Neptune. Whereas Earth's worst storms typically last no more than days or weeks, Neptune's newest dark vortex is expected to last years. (Jupiter's Great Red Spot is the current record-holder for longest-lived gigantic storm, having existed for at least 400 years, but it's shrinking.)

Neptune is known for its dark storms.

The first two were spotted when NASA's nuclear-powered Voyager 2 probe sailed past the gassy planet in 1989 — the first and so far only flyby of the world. The tempests that Voyager spotted are seen in the image at the top of this post.

Read more: The coolest feats of space exploration since NASA's Apollo 8 moon mission

Since 1993, Hubble has detected four more of the storms, including the latest one, which appeared in a routine image sweep in September 2018. (The finding was just announced this week.)

Most recently, Hubble helped find a dark storm in 2015 and study it through 2017. Results of that research suggest the clouds are made of deadly (and stinky) hydrogen sulfide.

This series of Hubble Space Telescope images taken over 2 years tracks the demise of a giant dark vortex on the planet Neptune. The oval-shaped spot has shrunk from 3,100 miles across its long axis to 2,300 miles across over the Hubble observation period. Credits: NASA, ESA, and M.H. Wong and A.I. Hsu (UC Berkeley)

That storm was expected to drift north toward Neptune's equator and break up. But its actual behavior floored scientists: It instead moved in the opposite direction, toward the South Pole, then slowly faded away.

"We have no evidence of how these vortices are formed or how fast they rotate," Agustín Sánchez-Lavega, a scientist at the University of the Basque Country in Spain who worked on the project, said in a February 2018 release.

By comparing the images used for that study to the latest NASA images, scientists gleaned new clues that may help solve the mystery. In the older images, "increased cloud activity" came years before the sixth and most recent dark storm appeared and was detected.

"The images indicate that the vortices probably develop deeper in Neptune's atmosphere, becoming visible only when the top of the storm reaches higher altitudes," NASA and STScI said in their releases.

Planet Uranus with a giant polar cap of seasonal weather.NASA/ESA/A. Simon (GSFC)/M.H. Wong and A. Hsu (UC Berkeley); Business Insider

In its latest round of deep-space observations of planets, Hubble also spied a "giant polar cap" or "hood" on Uranus. . Scientists think the feature may be caused by seasonal changes in weather on the planet.

"These images are part of a scrapbook of Hubble snapshots of Neptune and Uranus that track the weather patterns over time on these distant, cold planets," NASA said.

The agency added: "Just as meteorologists cannot predict the weather on Earth by studying a few snapshots, astronomers cannot track atmospheric trends on solar system planets without regularly repeated observations. Astronomers hope that Hubble's long-term monitoring of the outer planets will help them unravel the mysteries that still persist about these faraway worlds."

For a few moments last week it might have looked like the tech industry's very own World War III was breaking out, as Apple briefly kicked iPhone users who work at Facebook and Google off much of their own software as part of a privacy dispute.

Why it matters: Hostilities ended as quickly as they began — but the flareup reminded the world of just how completely, and complexly, the technologies and businesses of these giants are connected.

The most valuable companies in the world — Apple, Google, Facebook, Amazon — mostly stayed in their own lanes as they grew into giants. But now they're increasingly clashing as their growing ambitions bump into one another.

Driving the news: Apple was furious when it learned Facebook was abusing rules governing internal apps and quickly kicked the company out of the program, breaking Facebook's ability to test new apps and use internal iPhone apps.

The big picture: Once upon a time, Amazon was largely a retail store, Apple sold hardware, Google was a search engine, and Facebook was an online social network.

Google and Amazon had vastly different origins but are increasingly rivals.

Amazon and Apple have fought but are finding more common ground.

Google and Facebook together control the lion's share of the online ad business.

Facebook and Amazon have the least interplay among the tech giants.

History lesson: These relationships have never stood still.

The bottom line: Tension is likely to outweigh cooperation, especially as each of the four companies seeks to convince regulators that the others are the ones in need of reining in.

For a trucker to get in touch with a retailer who needs their goods moved, the process is traditionally cumbersome.

It's even more frustrating for a small trucking company or a trucker who owns their own vehicle. In those cases, they will contact a "voice brokers," who call up warehouses and ask if there's anything that they can carry. About 15% to 25% of the time, trucks end up carrying nothing.

And then there's the cut that brokers take from arranging the loads, which is around 10% to 15% of the total cost to move a shipment across the country. The whole process can take hours.

That inefficient process is on the wane as freight brokerage apps become the way retailers find their truck drivers, and vice versa. And Convoy, one of the leaders in freight brokerage technology, announced a major milestone in completely removing humans in matching truckers and shippers.

A Seattle-based company, Convoy announced on Tuesday that they can now match truck drivers and loads 100% autonomously in top markets.

"People thought it was something that could never be done," Ziad Ismail, Chief Product Officer at Convoy, told Business Insider. "People thought that you really needed phone calls and faxes."

Read more:Walmart's company truck drivers are among the best-treated in the industry — and they're getting a pay raise next month

Convoy counts Google's investment arm, Amazon CEO Jeff Bezos, and Salesforce.com CEO Marc Benioff among its investors. It was recently valued at $1 billion.

Convoy accomplished this in part through its huge userbase — more than 35,000 trucking companies, 100,000-plus drivers, and more than 500 shippers. Ismail said this allows Convoy to understand which truckers and companies prefer which sort of jobs.

By automating the process, Ismail said Convoy can more quickly match its trucker userbase to jobs that are fit for them, and vice versa.

"Trucking is more than a hundred years old as an industry, and very little innovation has happened in it," Ismail said. "Today, every truck driver has a mobile phone with a data plan. This is really a moment where we can reinvent the trucking industry and build something different."

Uber Freight, Transfix, and NEXT Trucking are other startups in this space that match truckers to ideal freight loads. With the advent of these services, there's naturally the question of what happens to America's 17,000-odd freight brokers.

But the founders of these apps say the value that can come from removing the middle man is significant.

Read more:The US has a major truck driver shortage — but the co-founder of a trucking startup that's attracted $80 million in funding says there are 3 other problems that are making the shortage seem worse than it is

Uber Freight, for instance, allows truck drivers to rate shippers in the app to ensure that retailers pay drivers for keeping them waiting at warehouses, called detention time. Convoy also expedites the process in which truckers are paid for detention.

"There are faxes, there are phone calls, there are emails," Ismail said. "The less time (truck drivers and shippers) can spend on that stuff, the more time they can spend on building their business and helping their business thrive."

Google is studiously promoting Donald Trump's State of the Union address later today.

Why is that important? Well, the US president accused Google of doing precisely the opposite in a series of attacks on the search giant last year.

Trump poured gas on unfounded claims that Google harbors liberal bias in August 2018, when he tweeted an explosive video with the hashtag "#StopTheBias."

The footage claimed to show that Google had promoted President Barack Obama's State of the Union speeches but ignored Trump's addresses to Congress for the past two years.

Read more: Google dismantled Trump's latest attack on the search engine

But it was widely debunked at the time— both in a statement from Google and internet archives showing that the search engine did indeed promote live coverage of Trump's State of the Union address last year.

Fast forward nearly six months, and Google is giving the president airtime again.

Under the search bar on its US homepage, Google links to a live YouTube stream of the address, with the words: "Watch President Trump's State of the Union address. Tonight on YouTube at 9p ET."

Google

Perhaps the only slight irony is the State of the Union plug appears under a doodle celebrating the Chinese New Year. This might be an unwelcome sight for Trump supporters backing the president in his ongoing trade war with Xi Jinping's regime.

Google, in particular, has been a lightning rod for Republican anger over Silicon Valley's perceived liberal bias.

Trump has repeatedly targeted the company, saying search results are "RIGGED" against him, as have Republicans, including House Minority Leader Kevin McCarthy.

Google CEO Sundar Pichai was questioned about the issue during a Congress hearing in December. "I lead this company without political bias and work to ensure that our products continue to operate that way," Pichai told lawmakers. "To do otherwise would go against our core principles and our business interests."

Stripe, a Silicon Valley online payment company which in September hit a massive $20 billion valuation, has become embroiled in an investigation into US President Donald Trump's inaugural committee, The New York Times reports.

Citing two people familiar with the inquiry, the Times said federal prosecutors issued a subpoena demanding that officials on the inaugural committee — which organised Trump's inauguration ceremony — hand over documents about donors, finances, and activities.

They also requested all documents linked to contractors and vendors connected to the inauguration. $107 million was raised for Trump's inauguration, an unusually high amount which raised eyebrows at the time.

Read more: How Trump's inaugural committee spent the record $107 million worth of donations to celebrate his election

Accoring to the Times, the subpoena specifically asks for documentation on Stripe, which designed technology to help process credit card transactions.

Although it's not immediately clear what exactly Stripe's involvement was, one of its notable investors is Josh Kusher, brother to Trump's son-in-law Jared Kushner.

Josh Kushner is the founder and managing partner of VC Thrive Capital, which sunk $30 million into Stripe in 2014. In the past, it has backed big players including Spotify, Twitch, and Instagram. Josh Kushner is not named in the subpoena and his spokesman declined to comment to the Times.

Stripe's rise has been meteoric, it managed to more than double its valuation in two years. It originally had a reputation for working mostly with startups, but as it's grown in size, so have its clients.

Business Insider contacted Stripe for comment.

Google dropped more than 2.6% in premarket New York trading on Tuesday , signaling a loss in market capitalization of almost $21 billion, after parent company Alphabet reported a staggering 26% increase in costs.

While Google's sales rose 23% in the fourth quarter, payments to partners rose at a faster clip. Meanwhile, losses from its collection of subsidiary businesses, including Waymo and Verily, were the steepest in two years, nearly doubling year over year.

Shares of Facebook, Amazon and Netflix also fell at least 0.2% in premarket trading.

"Following Facebook's better than expected Q4 results, optimism was running high for another set of strong figures from Alphabet," said Jasper Lawler, Head of Research at London Capital Group. "Whilst earnings beat Wall Street's expectations, the firm's massive shopping spree spooked investors."

Elsewhere in markets, stock benchmarks are mixed Tuesday, amid thin Asian trading ahead of a busy week of US events. Here's the roundup:

Here's what's coming up in markets this week: