Health Care and Steerable AI

December 4, 2023

green-dino_thumb_thumb_thumbThis essay is the work of a dumb dinobaby. No smart software required.

Large language models are powerful tools that can be used for the betterment of humanity. Or, in the hands of for-profit entities, to get away with wringing every last penny out of a system in the most opaque and intractable ways possible. When that system manages the wellbeing of millions and millions of people, the fallout can be tragic. TechDirt charges, “’AI’ Is Supercharging our Broken Healthcare System’s Worst Tendencies.”

Reporter Karl Bode begins by illustrating the bad blend of corporate greed and AI with journalism as an example. Media companies, he writes, were so eager to cut corners and dodge unionized labor they adopted AI technology before it was ready. In that case the results were “plagiarism, bull[pucky], a lower quality product, and chaos.” Those are bad. Mistakes in healthcare are worse. We learn:

“Not to be outdone, the very broken U.S. healthcare industry is similarly trying to layer half-baked AI systems on top of a very broken system. Except here, human lives are at stake. For example UnitedHealthcare, the largest health insurance company in the US, has been using AI to determine whether elderly patients should be cut off from Medicare benefits. If you’ve ever navigated this system on behalf of an elderly loved one, you likely know what a preposterously heartless [poop]whistle this whole system already is long before automation gets involved. But a recent investigation by STAT showed the AI consistently made major errors and cut elderly folks off from needed care prematurely, with little recourse by patients or families. … A recent lawsuit filed in the US District Court for the District of Minnesota alleges that the AI in question was reversed by human review roughly 90 percent of the time.”

And yet, employees were ordered to follow the algorithm’s decisions no matter their inanity. For the few patients who did win hard-fought reversals, those decisions were immediately followed by fresh rejections that kicked them back to square one. Bode writes:

“The company in question insists that the AI’s rulings are only used as a guide. But it seems pretty apparent that, as in most early applications of LLMs, the systems are primarily viewed by executives as a quick and easy way to cut costs and automate systems already rife with problems, frustrated consumers, and underpaid and overtaxed support employees.”

But is there hope these trends will be eventually curtailed? Well, no. The write-up concludes by scoffing at the idea that government regulations or class action lawsuits are any match for corporate greed. Sounds about right.

Cynthia Murrell, December 4, 2023

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