Live data from Hacker News

Alphabet is spending billions to become a force in health care

economist.com

201–210 of 227 posts

Re: Alphabet is spending billions to become a force in health care

#201

Earlier quoted context omitted.

Do you life with something chronic? Something were not a lot of people are doing research and we're there was no real discovery in the last 20 years? Because I do and you know how scattered the field of medicine is? There is one realistic way of getting more people with chronic issues new threatments and it's data. Lots and lots of it. IF someone can pull that of while protecting the individuals I believe it's alphab…

>Do you life with something chronic? Something were not a lot of people are doing research and we're there was no real discovery in the last 20 years? I do, but I can think of no more obvious examples of a Faustian pact than having Alphabet get involved in this field.

Easy for me: Facebook, apple, lots and lots of small and normal size companies without even any ethics committee or regulation bodies.

Re: Alphabet is spending billions to become a force in health care

#202

Earlier quoted context omitted.

you dont disappear. you become embedded. they are metaphorically assigning you a number and stripping you of an identity. It is dehumanizing. At the end of the day, it's just you by a different name. Instead of owning it and claiming "we have this information on Gehlitio" they say things like "We have these generalizations about anybody who happens to use HN, speaks in English, bought X Y and Z, subscribes to A, "

I wonder how this will play out in court when a neural net that underpins the tech of a company also can't properly handle health data. Start over? The right to be forgotten would have to be built into it all right from the get go, wouldn't it? Neural nets embed things, like you said. If Facebook pivoted towards being a hub for healthcare data as oracle seems want to do, could they use all of their facial recognition…

>I'm thinking of the equivalent of github's co-pilot spitting out comments alongside the code

yes exactly. I am having trouble articulating my underlying point but this is along the lines of it.

A facial recognition algorithm is ultimately saying "you look similar to this specific set of people". If the training set was 1 person, for example, then the algorithm would pretty much just be saying "you look like this photo of this 1 person". Scaling that up does not improve privacy - it only blends you into a population. Additionally, it is distilling out the things about you that separate you from that population (things that make you, you) since those distinguishing features are exactly what the model needs to use as the line to draw on whether or not new data points are similar to the population set or not.

Re: Alphabet is spending billions to become a force in health care

#203
post #145

Earlier quoted context omitted.

That's the possible upside. The possible downside is "if you ever search for a disease in Chrome, or on your Android device, or at google.com, we will notify your insurance company who will raise your rates".

So if one of my friends has Crohn's and I search for it to understand what I should be aware of, my rates would go up? HIPAA specifically prohibits the sharing of medical information unless needed for care. If there is any one here that we should be annoyed at it's the insurance companies. Hospitals are losing money and the insurance companies are posting record profits.

HIPAA only applies to "covered entities" and "business associates". Covered entities are health care providers, health plans, and health care clearinghouses. Business associates are parties that a covered entity engages to help carry out the covered entities functions.

If you give your medical information to someone/something that is not a covered entity or business associate they do not have to follow HIPAA rules.

More information here [1].

[1] https://www.hhs.gov/hipaa/for-professionals/covered-entities...

Re: Alphabet is spending billions to become a force in health care

#204

Earlier quoted context omitted.

This is also an heavily regulated industry in terms of patient data protection, software quality, part availability, etc. It will be interesting to see how big tech will deal with having an overbearing regulator breathing down their neck.

How so in terms of software quality?

The FDA have pretty strict standards in terms of project management. Of course it depends on the "class" of the medical device we are talking about. But if the software is used for diagnostics, you will need a whole battery of controls (test, documentation, processes, etc).

Re: Alphabet is spending billions to become a force in health care

#206
post #22

Can't wait to get banned from healthcare with no recourse unless I'm lucky enough to frontpage HN. Sarcasm aside I can't think of a company I'd trust less than Alphabet (maybe Meta) with managing healthcare.

You trust the current companies that made up the current healthcare situation in the US more?

relatively yes. Its not to say they have earned my trust...

Re: Alphabet is spending billions to become a force in health care

#207

Earlier quoted context omitted.

I'm not convinced, even with the best of intentions. In fact, I am convinced of the opposite: A) Universal Health program would result in terrible quality health care B) It would lead to longer wait times, and less choices C) It would be insanely costly to fund. We've been busy printing a lot of $. Increased the Federal deficit from $21T to $30 since COVID and there isn't a good way to fund a bloated system in USA, c…

> C) It would be insanely costly to fund. How could it be even more expensive than our current inefficient, half-baked, worst of both worlds system, which is more expensive than socialized systems in other nations? And more expensive per capita, not simply overall.

More expensive per capita and still excludes millions of people who need healthcare but can't afford it.

Re: Alphabet is spending billions to become a force in health care

#208
post #73

Earlier quoted context omitted.

I'm not convinced, even with the best of intentions. In fact, I am convinced of the opposite: A) Universal Health program would result in terrible quality health care B) It would lead to longer wait times, and less choices C) It would be insanely costly to fund. We've been busy printing a lot of $. Increased the Federal deficit from $21T to $30 since COVID and there isn't a good way to fund a bloated system in USA, c…

Regarding (A) and (C), this is the obligatory reminder that: * The US spends more public money on health care, per capita, than other wealthy nations, while also spending much much more private money than other wealthy nations * By many measures, the US gets worse outcomes (e.g. life expectancy) The conclusion that many draw from this is that perhaps a single-payer health care system in the US could dramatically lowe…

Wait times are just as bad in the US, and often worse, than other first world nations.

Re: Alphabet is spending billions to become a force in health care

#209
post #61
post #40

Earlier quoted context omitted.

> IMO, the Pacific coast states need to reject national health care, create a health-care pact between states that slowly grows larger by adding new states. If another state doesn't want to join, then, so be it. It blows my mind that they don’t do this. During most of the 20th century, Democrat-run states wanted to tax Republican California to pay for social programs. So doing things at the national level was critica…

How do you avoid the obvious adverse selection problem? California can't prevent the most expensive people in the country from moving there, and the system we're talking about would be a powerful incentive for those people to do so.

I think you're overstating just how "obvious" this adverse selection problem is, because we haven't seen this play out historically. It sounds like a purely theoretical problem.

Canada established its single payer system provincially, one-by-one, and they didn't have this adverse selection problem. Saskatchewan was the first Province to offer single payer in 1947, followed by Alberta in 1951, etc. By 1961, all Provinces had some form of a single payer healthcare system.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3110239/

> Taxpayer-funded medicare in Canada did not appear at a single point in time: it emerged over a quarter century from 1962, when physician services were covered across Saskatchewan, to 1987, when the demise of optional “full billing” in Ontario began.

So at any given point in time between 1962 and 1987, there was (in theory) this adverse selection problem among certain provinces; and yet that was never really a major problem in Canada. Even to this day, the Canada Health Transfer which provides block funding to Provinces by the Federal government for the purpose of funding these single payer systems covers ~22% of the cost (https://www.cmaj.ca/content/192/45/E1408).

Additionally, even in present day, the European Union has open borders and free immigration between member states, and certain member states have far more generous welfare systems than others, and you still don't have this adverse selection problem, at least in a manner that meaningfully renders those welfare systems unsustainable. Even domestically, we didn't really see dramatic net migration from states that refused to take the Medicaid expansion to those that did.

The reality is that people don't choose where to live strictly on the basis of which state provides taxpayer funded healthcare. In fact, those that are most likely to do that (poor people) are likely already covered by Medicaid or heavily subsidized ACA plans (https://www.kff.org/policy-watch/millions-of-uninsured-ameri...).

And even if one were to engage with the purely theoretical problem, there are ways to mitigate the adverse selection, e.g. by requiring a minimum number of years of residency in order to qualify. This is what US States do today to establish residency for the purpose of in-state university tuition. Given the plethora of historical (and current) data points that suggests that this isn't really a problem, States can choose to cross that bridge if/when they get there.

Re: Alphabet is spending billions to become a force in health care

#210
post #85

Earlier quoted context omitted.

It's a solved problem in the sense that it exists, and works[1] and it is available in a lot more places than Canada. [1] "works" is an interesting point because it isn't clearly defined, and usually means different things to different people. Ever experience of the system is "unique" - there is this mix of human patient with human provider with finite resources with medical knowledge with time. So there are plenty o…

But the US isn't "healthcare based on your wealth". You have Medicaid for the poor, heavily subsidized Obamacare for the people who don't get it through their employer (hello $100/month plan!) and Medicare for the retired. I mean my cousin in the US whose kid has cystic fibrosis get better care through Medicaid than our other cousin in Canada who can't even get access to the latest drugs.

> heavily subsidized Obamacare for the people who don't get it through their employer (hello $100/month plan!)

That $100/month plan will include high deductibles and copays. A weekend visit to an urgent care for a kidney stone will still cost a couple hundred dollars out of pocket.

Post reply on HN