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

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

#161

Post by honkycat »

robocat wrote: post #106
honkycat wrote: post #14

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…

Nice citations. Finish your thought. What's your point?

Do you honestly think the average American lives better than the average Kiwi? That is an adorable thought lol.

Check out the latest Channel 5 documentary to see how many Americans live. We have some mega-wealthy people but also have extreme poverty and even our middle class often does not have health insurance.

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

#162

Post by skohan »

forgetfreeman wrote: post #159
skohan wrote: post #154

Earlier quoted context omitted.

> due to lack of training sometimes they miss things that an MD would have caught. It goes the other way as well. My aunt is an RN and she loves to tell the story about the time that a doctor was in such a rush one time she had to call his attention to the fact that his patient was dead.

Here's a fun question: would that be due to gross inattention on the doctor's part or gross overwork due to patient/provider ratios being skewed into bizarro world by cost-cutting measures on the part of the hospital?

Yes both of which could be helped by augmenting the healthcare system with AI to relieve practitioners from repetitive, menial tasks

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

#163

Post by forgetfreeman »

skohan wrote: post #162
forgetfreeman wrote: post #159

Earlier quoted context omitted.

Here's a fun question: would that be due to gross inattention on the doctor's part or gross overwork due to patient/provider ratios being skewed into bizarro world by cost-cutting measures on the part of the hospital?

Yes both of which could be helped by augmenting the healthcare system with AI to relieve practitioners from repetitive, menial tasks

You mean like how healthcare providers were relieved by advancing legions of PAs and NPs into general medicine? If that approach worked we would have seen improvements to healthcare metrics by now. We haven't.

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

#164

Post by scrubs »

cmiles74 wrote: post #68
asdajksah2123 wrote: post #23

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.…

"So far, AFAICT, the drive is to cut costs by saving the time the physician spends..."

In mental health a lot of providers don't even file on customer's insurance. Patient pays cash/charge and the patient is stuck with filing claims. Providers washed their hands of that dirty work.

During my last job (large firm large metropolitan city) employer subcontracted for covid testing erecting a large tent to handle 8 covid exams at once. Here's the procedure:

- you badge in; subcontractor used our hw/network.

- you them give them your name and DOB, which the PC already told them

- they write your name on specimen collection tube, and send you to bay X. The nurse at bay X sees you coming

- at the bay you are asked for your name and dob again. And you badge in again.

That level of duplication can only arise as a function of billing my then employer for extra non productive labor or fraud cya protection. Either way it's damn annoying.

At my last doc appointment I spent the first 20 mins answering THEIR BILLING questions: was my name xyz? Did my insurance change? Etc. No services have been rendered yet.

And despite all the IT for billing and PC displays displaying common sense health tips, there was no display of how long one would wait for the doc. It was a blind date: maybe they'd show; maybe you had better things to do.

In sum, whatever crappy IT health care has, it's to help them, not customers. God damn: they made the paper work hell they live in and, as I say, mental health care patients are stuck with the dirty work because they can't stand it anymore.

My wife spends 2hrs a week yelling at aetena. She's pretty sure they decline claims out of willful stupidity or nefarious greed. I would not be surprised to hear crappy AI involved.

I absolutely hate that business.

I was solicited multiple times for interviews by health insurance corps. I told them NFW. Their pay sucks. Their concept of quality improvement sucks. They suck.

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

#165

Post by skohan »

forgetfreeman wrote: post #158
skohan wrote: post #143

Earlier quoted context omitted.

Presumably you would structure such a medical system such that lower level practitioners would know enough to know when to escalate to an MD. 90% of medicine is stuff like people going to the doctor with the flu to get a sick note to stay home from work and instructions to rest and drink fluids. I don't think you need an MD for that.

You've literally described the current healthcare system in the US. Minute Clinic/NPs/PAs providing front line care. It doesn't appear to be working well based on how our country's healthcare system ranks against other industrialized nations.

I don't live in the US anymore, so it's hard for me to speak to the US healthcare system, but as an outsider it seems to me that the problems with the system stem from the incentive structure, and won't be fixed by any technology.

It seems to me the US healthcare system sits in this weird gap where it's not funded by private individuals, but it's also not publicly funded (excluding medicare/medicade/VA/tricare etc)

So it doesn't benefit from efficiencies of a single-payer system like the UK has, and it doesn't have to obey proper market forces either, since you have a bunch of for-profit entities in the middle, but the costs are obfuscated from the consumer unless you're unlucky enough not to have employer-funded health insurance.

So until you fix those core issues, I don't see how technological advancements are going to have much of an effect either positive or negative.

It's an orthogonal issue.

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

#166

Post by ysofunny »

w1ntermute wrote: post #43

From the article linked by Techdirt: “executives have sought to almost entirely subordinate clinical case managers’ judgment to the computer’s calculations” Sounds like the issue is the executives. What does this have to do with “AI”? Also, the company that built this tech (naviHealth) was started in 2012. Their product existed long before large language models were created.

[flagged]

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

#167

Post by mindslight »

cryptonector wrote: post #138
mindslight wrote: post #100

Earlier quoted context omitted.

I'm all for reforms to move towards a more market based system. But one has to recognize that at this point we're nearing a century of anti-market meddling - a quick search says 1943 is when healthcare started getting bundled with employment! And talking about a "free" market is a red herring. There's no reason to believe that the current industry actually wishes to converge on uniform prices with upfront transparenc…

> And talking about a "free" market is a red herring. There's no reason to believe that the current industry actually wishes to converge on uniform prices with upfront transparency [...] Adam Smith himself noted that capitalists seek rent. That doesn't mean that capitalism is all bad. The healthcare industry almost certainly does not want a free market, but so what, it's about whether the state makes it so there's a…

I didn't say "capitalism is bad". I pointed out that the state of the current market players are so far from what you'd expect in a "free" market, that pushing to make the market incrementally more free is likely to do the exact opposite by increasing the coercive powers of the already-entrenched interests.

Once the health "insurance" cartels are put out of business, providers are legally required to publish uniform price schedules and ahead of time quotes, pharmaceuticals can be freely bought across borders, mandatory prescriptions are eliminated, residencies are funded privately, etc, then maybe there is a chance at a freed market fostering a functioning market. But not one step before then.

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

#168

Post by forgetfreeman »

skohan wrote: post #165
forgetfreeman wrote: post #158

Earlier quoted context omitted.

You've literally described the current healthcare system in the US. Minute Clinic/NPs/PAs providing front line care. It doesn't appear to be working well based on how our country's healthcare system ranks against other industrialized nations.

I don't live in the US anymore, so it's hard for me to speak to the US healthcare system, but as an outsider it seems to me that the problems with the system stem from the incentive structure, and won't be fixed by any technology. It seems to me the US healthcare system sits in this weird gap where it's not funded by private individuals, but it's also not publicly funded (excluding medicare/medicade/VA/tricare etc) S…

I don't disagree on any particular point except the notion that a medical AI represents an advancement. That claim would have to be studied extensively over decades.
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