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'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

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101–110 of 168 posts

Re: 'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

#101

Earlier quoted context omitted.

> AI requires a small upfront cost, then can do the job of thousands of people That's the same with every efficiency improvement. Efficiency improvements (like AI) aren't zero sum. When production costs go down, competition forces prices to also go down, which then leads to more wealth for everyone not just the capital owners (even if it disproportionately benefits capital owners). People are made redundant and then…

You are assuming over the coming years that most parties so displaced simply shift to other parts of the economy as lucrative and are able to take advantage of those benefits. You are also assuming collusion explicit or implicit and the wealth of remaining buyers doesn't just keep prices high. EG you you have 100 people who can't afford steam off a hotdog and 100 customers with n units of disposable income per day. Y…

> You are assuming over the coming years that most parties so displaced simply shift to other parts of the economy as lucrative and are able to take advantage of those benefits.

That's how it's always been historically, but you are right that I can't predict it'll be the same in the future, especially when it comes to AGI.

> You are also assuming collusion explicit or implicit and the wealth of remaining buyers doesn't just keep prices high.

Collusion to fix prices can't happen in highly competitive markets with declining production costs, because of game theory reasons. You always get this graph[1] unless you have regulatory capture such as with insulin supply in the US. Or unless you have a labor-heavy cost base such as with the education industry.

[1] https://pbs.twimg.com/media/E314pxwXMAI2ZIn?format=png&name=...

The risk with AI is that it won't be highly competitive. As a general rule, only in a monopoly-like situations can you have abnormal profits. That's where the global wealth tax comes into play, among other policies targeted at monopolistic practices.

Re: 'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

#102
post #87

Earlier quoted context omitted.

The problem is that "skilled healthcare" is essentially a cartel which uses artificial scarcity to increase the price. You can see the counter-example in Cuba, which has an incredibly high number of MD's per capita compared to other countries, and achieves very good healthcare results, especially in the context of other metrics of development and economy. There are so pitifully few health care practitioners compared…

What about nursing? That seems to be the flip side where there isn't the protection of the cartel around doctors, so wages get driven to the floor and we see scarcity due to cost of living and mismanagement.

Nurses might not get paid what they are worth in all cases, but they have amazing job security.

Ironically it's probably easier to replace a lot of what doctors do with AI than what nurses do.

Re: 'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

#103
post #33

Earlier quoted context omitted.

" For those thinking that AI will reduce healthcare costs by improving efficiency, I point you to the 'electronic medical records' hype of 15 years ago. Are per capita healthcare costs any lower now? " Can you elaborate? In countries like Denmark or Estonia electronic medical records are well used among doctors and patients.

In the US, the cost of health care has not significantly decreased since the introduction of rules, regulations and government money pushing healthcare organizations to implement and use EHR systems. I would say all of the intervention by the US federal government has made everything much worse. The EHR vendors (I'm looking at you, Epic) managed to consume the money thrown at the problem and yet have only moderately…

Lack of timely access to accurate information is and was a huge problem, that can be solved by electronic health records.

Whether or not the currently implementation is worth the cost/benefit ratio is debatable.

I envision a scenario though, where all EHR vendors integrate with Apple/Google, and someone’s phone can give access to their healthcare data, maybe even involuntarily in the event of an emergency.

Re: 'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

#104
post #87

Earlier quoted context omitted.

A naïve readthrough would lead one to that conclusion perhaps but the elephant in the room here is capitalism. Pragmatically, any "good enough" solution will be used to replace skilled care to improve patient throughput and thus the bottom line.

The problem is that "skilled healthcare" is essentially a cartel which uses artificial scarcity to increase the price. You can see the counter-example in Cuba, which has an incredibly high number of MD's per capita compared to other countries, and achieves very good healthcare results, especially in the context of other metrics of development and economy. There are so pitifully few health care practitioners compared…

We've already got NPs and PAs "picking up the slack" in the US. Prices are still outrageous for folks without health insurance and healthcare outcomes continue to decline. Adding another half-assed tool to the chain isn't how this gets fixed.

Re: 'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

#105
post #87

Earlier quoted context omitted.

A naïve readthrough would lead one to that conclusion perhaps but the elephant in the room here is capitalism. Pragmatically, any "good enough" solution will be used to replace skilled care to improve patient throughput and thus the bottom line.

The problem is that "skilled healthcare" is essentially a cartel which uses artificial scarcity to increase the price. You can see the counter-example in Cuba, which has an incredibly high number of MD's per capita compared to other countries, and achieves very good healthcare results, especially in the context of other metrics of development and economy. There are so pitifully few health care practitioners compared…

Artificial scarcity? Maybe. There aren't but so many households with children that fit inside the venn diagram of can afford med school, has the intellectual capacity and bloody-mindedness to actually finish med school, and is interested in going to med school.

Re: 'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

#106

I got a new job recently and I have been saying this is what I will be doing, writing AI to deny claims, AS A JOKE. We pay taxes so the government can pay to subsidize these healthcare corps that just serve to funnel money to its already rich shareholders. Healthcare is a pathetic broken mess and it will never get better.

> We pay taxes so the government can pay to subsidize these healthcare corps that just serve to funnel money to its already rich shareholders.

Americans are about 4% of people but gets 25% of world GDP. There's 333 Mega Americans, with 8 GigaPeople in the world. Most Americans are doing just fine financially in comparison to the rest of the world.

To make things fair, then the wealth of the richest US citizens (about 55% of equity ownership by value[1]) should to be spread to the rest of the world, not spread to other Americans by US taxation changes.

I'm from New Zealand. Our ownership of US shares is likely reasonably fair. NZ has three billionaires[3] (not one inherited their wealth). We are still a relatively wealthy country, but our median income is about 60% of the US median income. I'm not sure what % of NZers would be classified as in poverty by US standards.

40% of US equities are owned by foreigners. If we assume rich foreigners use Cayman Islands and Luxembourg for their ownership, then from [2] a third of that 40% is rich foreigners. Probably better to assume wealth distribution is similar to US so 55% of that 40% is wealthy foreigners.

[1] https://www.taxpolicycenter.org/taxvox/who-owns-us-stock-for...

[2] https://home.treasury.gov/news/press-releases/jy0613

[3] https://en.wikipedia.org/wiki/List_of_New_Zealanders_by_net_...

Re: 'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

#107
post #87

Earlier quoted context omitted.

The problem is that "skilled healthcare" is essentially a cartel which uses artificial scarcity to increase the price. You can see the counter-example in Cuba, which has an incredibly high number of MD's per capita compared to other countries, and achieves very good healthcare results, especially in the context of other metrics of development and economy. There are so pitifully few health care practitioners compared…

We've already got NPs and PAs "picking up the slack" in the US. Prices are still outrageous for folks without health insurance and healthcare outcomes continue to decline. Adding another half-assed tool to the chain isn't how this gets fixed.

The US is not the only country with healthcare needs. There are plenty of developed nations with public health care systems which primarily suffer from scarcity rather than cost to patient, and AI could help with that.

Re: 'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

#108

I'm not sure I understand why AI is supposed to make anything better, at least under the regulatory regime we have right now. 1. AI doesn't do anything new. It's just human thinking done better in the best case scenario. So the plus side is that we may come up with ideas that a human might have come up with 10-15 years later. However, a lack of ideas is not the problem we face at all. We have solutions to nearly ever…

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Re: 'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

#109
post #59

> Even when users successfully appealed these AI-generated determinations and win, they’re greeted with follow up AI-dictated rejections just days later, starting the process all over again. Wait, what? Does that mean they can just take your money and reject your request to cover treatment until you die even if you had every right to do so?

Yep, and ever since a certain insurance provider has switched to an AI system, I've had nearly all my Type 1 Diabetic prescriptions rejected (that I've had no problem getting for over a decade). Then it takes hours on the phone for every prescription to finally get one approved. Rinse and repeat every 3 months.

We’ve had a flex spending account (HSA wasn’t an option) that we were only putting as much in as we were sure we’d spend, rejecting a very high rate of payments this year, even from doctor’s offices (WTF do you think that’s for?!) and demanding documentation, seemingly with no rhyme or reason. Seems like they’re actively trying to keep us above the roll-over limit so they can steal our money, which isn’t something we’ve experienced with health flex accounts in the past.

Wonder if we’re “beneficiaries” of the AI revolution. Or just an “if” statement triggering off a random number.

Re: 'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

#110

I'm not sure I understand why AI is supposed to make anything better, at least under the regulatory regime we have right now. 1. AI doesn't do anything new. It's just human thinking done better in the best case scenario. So the plus side is that we may come up with ideas that a human might have come up with 10-15 years later. However, a lack of ideas is not the problem we face at all. We have solutions to nearly ever…

Right now, the only products I've seen leveraging LLMs are the tools from Nuance[1] that fill in physician notes. Arguably this is not an improvement; physician notes are already an incomprehensible garble of cut-and-paste content (often from other systems).[2] But at least it is unlikely to negatively impact patient care. So far, AFAICT, the drive is to cut costs by saving the time the physician spends with the EHR.…

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