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ChatGPT Health is a marketplace, guess who is the product?

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Re: ChatGPT Health is a marketplace, guess who is the product?

#171
post #62

Earlier quoted context omitted.

Not a US citizen, so a genuine question: do US health insurance companies have a track record of passing on such savings to consumers? That has not been my impression as an outside observer.

you're correct. UHC is so hated because they're a "pharmacy benefits manager." - an organization that exists soley to make your life so miserable you give up on getting your medication.

Aetna has their own scumminess. Want the convenience of 90 day refills? Have to use their mail order service. They'll refuse to authorize >30 day supplies of medication through any other pharmacy.

Re: ChatGPT Health is a marketplace, guess who is the product?

#172

The HHS is asking for recommendations on how to leverage AI for healthcare: https://www.hhs.gov/press-room/hhs-ai-rfi.html This is probably part of an effort to position them a potential vendor to help the government with this.

As an interventional radiologist, I want it to be easier to see images from outside hospitals. Epic has nearly solved the problem of seeing outside medical records. Yet, I still can't see the images for the CT scan you had from the hospital across the street unless I call the file room and get the images transferred.

I imagine once data sharing is more robust, it would be easier to validate AI models (at least specifically for radiology).

Re: ChatGPT Health is a marketplace, guess who is the product?

#173
post #136

Earlier quoted context omitted.

The ACA doesn't prevent some magical fairy-dust AI from pricing premiums, though, which is currently all the rage amongst insurers. (Not because AI will be accurate or anything, but because it offers a completely opaque pricing process.)

Why not? If the only factors allowed to be used in settings premiums are age, location and smoking status, then those are the only parameters that could be input to an AI model, no?

Warning: I am not in this industry and the below is speculation:

AIUI the idea is to predict the "correct" price for an individual premium, Y, which is restricted to being the result of some insurance model function, f(), that is itself restricted to the domain of age (A), location (L), and smoking status (S):

  Y = f(A, L, S)
My impression was that the idea was that this would handicap insurers' natural desire to price premiums individually and have a smoothing effect on prices over the population.

But why is location useful for insurers to price premiums? I assume because healthcare has different costs in different locations, and different utilization rates: People living in coal mining towns or near oil refineries may be expected to use more healthcare and thus cost more to insure.

Thus, you can imagine insurers building a price map (like a heat map) overlay for the state/country, plotting each applicant on it, and checking the "color" there as part of their model function. So they are effectively embedding out-of-band information (prices and utilization rates for locations) into the model function f() itself.

What "AI", or large-parameter Deep Neural Networks, fundamentally change here is:

   - They can approximate any effectively computable function, the same class of functions that a programmer can write and execute on a computer[0].

   - They can be scaled up to an arbitrarily large number of parameters, i.e. an arbitrarily precise approximation limited only by the number of parameters and the amount and quality of model training data.

   - Absolutely critically: They are programmed implicitly, through brute-force training on input-output pairs, rather than explicitly, with some programmer writing an explicit series of instructions to compute the function.
This last point is probably the most important.

Large insurers previously had sophisticated models for f() hand-built by math whizzes, but they were limited in the amount of out-of-band information they could encode into that function by the limited cognitive and programmatic capacity of a human team.

But now with DNNs you can scalably encode unlimited out-of-band information into the function f(), while also totally obscuring how you're computing that location-based price adjustment.

The result, in extremis, is that f() is not some fancy algorithm cooked up by a few dozen math whizzes. Instead f() becomes a fancy database, allowing the tuple (A, L, S) to act merely as an index to an individualized premium Y, which defeats the entire purpose of restricting the domain of their model function.

[0]: https://en.wikipedia.org/wiki/Universal_approximation_theore...

Re: ChatGPT Health is a marketplace, guess who is the product?

#174
post #164
post #37

Earlier quoted context omitted.

That's awesome that it's helped you so much, chronic back pain is awful. Is it possible though, that this could be interpreted as a failure of the trainer to come up with a successful treatment plan for you? "Sudden" relief after 10 years of therapy just because you changed the program seems like they were just having you perform the wrong exercises no?

The trainer was a godsend, got me to ~95% pain-free, and taught me all kinds of things. He is amazing. But 2025 was maybe down to 90% pain-free, and I want to get stronger. So I did a big rewrite of my entire workout plan and checked everything. AI wasn't perfect, but it was amazing when you already know some. It is still a tool I had to direct, and it took a few days of work. But I'm amazed at where it got me to. It…

Without getting into your specific injury or sport, what was the biggest change compared to the trainer’s program?

Was it something unexpected like "exercise this seemingly unrelated muscle group that has nothing do with your injury but just happens to reduce pain by 75% for some inexplicable reason"?

Or was it something more mundane like "instead of exercising this muscle every day, do it every other day to give it time to rest"?

Re: ChatGPT Health is a marketplace, guess who is the product?

#175
post #12

ChatGPT has made a material difference in my ability to understand health problems, test results, and to communicate with doctors effectively. My wife and I were talking last night about how helpful it was in 2025. I hope that it continues to be good at this. I want regulators to keep an eye on this and make smart laws. I don't want it to go away, as its value is massive in my life. (One example, if you are curious:…

It doesn’t even have to be that well-read (although it is),

it just has to listen to your feedback more than 11 minutes per visit,

so it can have a chance at effectively steering you…

Re: ChatGPT Health is a marketplace, guess who is the product?

#176

Earlier quoted context omitted.

you're correct. UHC is so hated because they're a "pharmacy benefits manager." - an organization that exists soley to make your life so miserable you give up on getting your medication.

Aetna has their own scumminess. Want the convenience of 90 day refills? Have to use their mail order service. They'll refuse to authorize >30 day supplies of medication through any other pharmacy.

These comments (on UHC, Aetna) always strike me the same way as complaining about the lack of inflight meal,

baggage fees,

or lack of WiFi,

on, say, Spirit Airlines.

You looked at the list of insurers/jobs offering health insurance carriers,

selected the cheapest, or second-cheapest option,

and you’re surprised they’re harder to work with?

How?

Re: ChatGPT Health is a marketplace, guess who is the product?

#177

The HHS is asking for recommendations on how to leverage AI for healthcare: https://www.hhs.gov/press-room/hhs-ai-rfi.html This is probably part of an effort to position them a potential vendor to help the government with this.

> This is probably part of an effort to position them (...)

who is "them" referring to in this sentence?

Re: ChatGPT Health is a marketplace, guess who is the product?

#179
post #12

ChatGPT has made a material difference in my ability to understand health problems, test results, and to communicate with doctors effectively. My wife and I were talking last night about how helpful it was in 2025. I hope that it continues to be good at this. I want regulators to keep an eye on this and make smart laws. I don't want it to go away, as its value is massive in my life. (One example, if you are curious:…

This sounds like excellent evidentiary material for a future insurer or government health provider to decide you're uninsurable, not eligible for a job, and so on. And the great thing about it is that you already signed all your rights away for them to do this exact thing , when we could have had an open world with open models run locally instead where you got to keep your private health information private.

These strawman arguments lack nuance.

If the person can use AI to lead a noticeably better life, something that may have been impossible previously due to economic circumstance, then the first order benefits outweigh the second order drawbacks.

I’m not disputing what you’re saying, I just think that treating it like a zero sum game every time the conversation comes up is showing an immense amount of privilege.

You, me, the parent commenter; we’re all dying, we don’t have time to optimise for the best outcome.

Re: ChatGPT Health is a marketplace, guess who is the product?

#180

Earlier quoted context omitted.

By the same logic, an inmate in prison is benefiting from incarceration because they are receiving food and housing. Obviously, the costs of being imprisoned is greater than any "enrichment" from it, and this is exactly the case with Windows and almost all technology.

I would you my statement about relatively free markets addresses that. Businesses that expand their licensing agreements with Microsoft aren't doing it because they are being coerced.

"Free" market coercion is probably the only reason companies like Microsoft are still in business.
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