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  3. It was only a matter of time....

It was only a matter of time....

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  • G Gary Stachelski 2021

    ... until the misuse of AI algorithms put people's lives at risk. "For the largest health insurer in the US, AI's error rate is like a feature, not a bug." UnitedHealth uses AI model with 90% error rate to deny care, lawsuit alleges | Ars Technica[^]

    P Offline
    P Offline
    PIEBALDconsult
    wrote on last edited by
    #2

    It's almost like a John Grisham novel.

    1 Reply Last reply
    0
    • G Gary Stachelski 2021

      ... until the misuse of AI algorithms put people's lives at risk. "For the largest health insurer in the US, AI's error rate is like a feature, not a bug." UnitedHealth uses AI model with 90% error rate to deny care, lawsuit alleges | Ars Technica[^]

      Sander RosselS Offline
      Sander RosselS Offline
      Sander Rossel
      wrote on last edited by
      #3

      They should hold people personally accountable. Organizations are literally destroying the world and governments be like "but they're companies, so we can't do anything." Sure, sue companies for damages, which is almost always less than what they made, while the CEO's still get their bonuses. Lax governments are the only reason people like Zuckerberg or whoever is (or was) CEO at Shell are still doing business instead of having lifelong sentences in jail. In case of UnitedHealth, people made an active decision to go with this model, make huge profits, and :elephant: their customers. It's fraud, theft and in case of a health insurer something like attempted murder at large scale.

      Best, Sander Azure DevOps Succinctly (free eBook) Azure Serverless Succinctly (free eBook) Migrating Apps to the Cloud with Azure arrgh.js - Bringing LINQ to JavaScript

      N D O J 4 Replies Last reply
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      • Sander RosselS Sander Rossel

        They should hold people personally accountable. Organizations are literally destroying the world and governments be like "but they're companies, so we can't do anything." Sure, sue companies for damages, which is almost always less than what they made, while the CEO's still get their bonuses. Lax governments are the only reason people like Zuckerberg or whoever is (or was) CEO at Shell are still doing business instead of having lifelong sentences in jail. In case of UnitedHealth, people made an active decision to go with this model, make huge profits, and :elephant: their customers. It's fraud, theft and in case of a health insurer something like attempted murder at large scale.

        Best, Sander Azure DevOps Succinctly (free eBook) Azure Serverless Succinctly (free eBook) Migrating Apps to the Cloud with Azure arrgh.js - Bringing LINQ to JavaScript

        N Offline
        N Offline
        Nelek
        wrote on last edited by
        #4

        Hell yeah. You nailed it.

        M.D.V. ;) If something has a solution... Why do we have to worry about?. If it has no solution... For what reason do we have to worry about? Help me to understand what I'm saying, and I'll explain it better to you Rating helpful answers is nice, but saying thanks can be even nicer.

        1 Reply Last reply
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        • G Gary Stachelski 2021

          ... until the misuse of AI algorithms put people's lives at risk. "For the largest health insurer in the US, AI's error rate is like a feature, not a bug." UnitedHealth uses AI model with 90% error rate to deny care, lawsuit alleges | Ars Technica[^]

          D Offline
          D Offline
          dandy72
          wrote on last edited by
          #5

          So maybe the AI's 90% error rate is an improvement over UnitedHealth's own people...

          J G 2 Replies Last reply
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          • Sander RosselS Sander Rossel

            They should hold people personally accountable. Organizations are literally destroying the world and governments be like "but they're companies, so we can't do anything." Sure, sue companies for damages, which is almost always less than what they made, while the CEO's still get their bonuses. Lax governments are the only reason people like Zuckerberg or whoever is (or was) CEO at Shell are still doing business instead of having lifelong sentences in jail. In case of UnitedHealth, people made an active decision to go with this model, make huge profits, and :elephant: their customers. It's fraud, theft and in case of a health insurer something like attempted murder at large scale.

            Best, Sander Azure DevOps Succinctly (free eBook) Azure Serverless Succinctly (free eBook) Migrating Apps to the Cloud with Azure arrgh.js - Bringing LINQ to JavaScript

            D Offline
            D Offline
            dandy72
            wrote on last edited by
            #6

            Sander Rossel wrote:

            Lax governments are the only reason people like Zuckerberg or whoever is (or was) CEO at Shell are still doing business instead of having lifelong sentences in jail.

            So what should Zuckerberg be jailed for, exactly? I'm not saying I disagree. I'm just saying I don't know how to define the specific crime that would lead to his conviction.

            Sander RosselS 1 Reply Last reply
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            • Sander RosselS Sander Rossel

              They should hold people personally accountable. Organizations are literally destroying the world and governments be like "but they're companies, so we can't do anything." Sure, sue companies for damages, which is almost always less than what they made, while the CEO's still get their bonuses. Lax governments are the only reason people like Zuckerberg or whoever is (or was) CEO at Shell are still doing business instead of having lifelong sentences in jail. In case of UnitedHealth, people made an active decision to go with this model, make huge profits, and :elephant: their customers. It's fraud, theft and in case of a health insurer something like attempted murder at large scale.

              Best, Sander Azure DevOps Succinctly (free eBook) Azure Serverless Succinctly (free eBook) Migrating Apps to the Cloud with Azure arrgh.js - Bringing LINQ to JavaScript

              O Offline
              O Offline
              obermd
              wrote on last edited by
              #7

              One flaw of our corporate laws is that executives are almost always shielded from liability. This needs to change.

              Sander RosselS J 2 Replies Last reply
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              • D dandy72

                Sander Rossel wrote:

                Lax governments are the only reason people like Zuckerberg or whoever is (or was) CEO at Shell are still doing business instead of having lifelong sentences in jail.

                So what should Zuckerberg be jailed for, exactly? I'm not saying I disagree. I'm just saying I don't know how to define the specific crime that would lead to his conviction.

                Sander RosselS Offline
                Sander RosselS Offline
                Sander Rossel
                wrote on last edited by
                #8

                Zuckerberg was an example, but with all the privacy laws Facebook ignored time and again, I'm sure he's bound for some jail time. I mean, the guy had to defend himself Facebook in front of Congress! Facebook is accused of illegally harvesting tons of data, influencing elections and even inciting genocide. Probably not only Zuck, but other board members as well.

                Best, Sander Azure DevOps Succinctly (free eBook) Azure Serverless Succinctly (free eBook) Migrating Apps to the Cloud with Azure arrgh.js - Bringing LINQ to JavaScript

                J 1 Reply Last reply
                0
                • O obermd

                  One flaw of our corporate laws is that executives are almost always shielded from liability. This needs to change.

                  Sander RosselS Offline
                  Sander RosselS Offline
                  Sander Rossel
                  wrote on last edited by
                  #9

                  Exactly! :thumbsup:

                  Best, Sander Azure DevOps Succinctly (free eBook) Azure Serverless Succinctly (free eBook) Migrating Apps to the Cloud with Azure arrgh.js - Bringing LINQ to JavaScript

                  1 Reply Last reply
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                  • G Gary Stachelski 2021

                    ... until the misuse of AI algorithms put people's lives at risk. "For the largest health insurer in the US, AI's error rate is like a feature, not a bug." UnitedHealth uses AI model with 90% error rate to deny care, lawsuit alleges | Ars Technica[^]

                    J Offline
                    J Offline
                    jschell
                    wrote on last edited by
                    #10

                    Which like a lot of this stuff is just not really relevant. The fact that an algorithm was doing it doesn't change that they were doing it before that. Following article would suggest that the above is actually an improvement. Inside UnitedHealth’s Effort to Deny Coverage for a Patient’s Care — ProPublica[^] "But data from state and federal regulators shows that insurers reject about 1 in 7 claims for treatment."

                    G 1 Reply Last reply
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                    • Sander RosselS Sander Rossel

                      They should hold people personally accountable. Organizations are literally destroying the world and governments be like "but they're companies, so we can't do anything." Sure, sue companies for damages, which is almost always less than what they made, while the CEO's still get their bonuses. Lax governments are the only reason people like Zuckerberg or whoever is (or was) CEO at Shell are still doing business instead of having lifelong sentences in jail. In case of UnitedHealth, people made an active decision to go with this model, make huge profits, and :elephant: their customers. It's fraud, theft and in case of a health insurer something like attempted murder at large scale.

                      Best, Sander Azure DevOps Succinctly (free eBook) Azure Serverless Succinctly (free eBook) Migrating Apps to the Cloud with Azure arrgh.js - Bringing LINQ to JavaScript

                      J Offline
                      J Offline
                      jschell
                      wrote on last edited by
                      #11

                      Sander Rossel wrote:

                      Organizations are literally destroying the world

                      What alternative are you suggesting for humans?

                      Sander RosselS 1 Reply Last reply
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                      • Sander RosselS Sander Rossel

                        Zuckerberg was an example, but with all the privacy laws Facebook ignored time and again, I'm sure he's bound for some jail time. I mean, the guy had to defend himself Facebook in front of Congress! Facebook is accused of illegally harvesting tons of data, influencing elections and even inciting genocide. Probably not only Zuck, but other board members as well.

                        Best, Sander Azure DevOps Succinctly (free eBook) Azure Serverless Succinctly (free eBook) Migrating Apps to the Cloud with Azure arrgh.js - Bringing LINQ to JavaScript

                        J Offline
                        J Offline
                        jschell
                        wrote on last edited by
                        #12

                        Sander Rossel wrote:

                        and even inciting genocide.

                        Not sure about the rest of that but Facebook the company is not guilty of that. People that posted on Facebook wanted that. That is that old nasty freedom of speech problem where everyone wants it for themselves but do not want it for anyone else.

                        Sander RosselS 1 Reply Last reply
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                        • O obermd

                          One flaw of our corporate laws is that executives are almost always shielded from liability. This needs to change.

                          J Offline
                          J Offline
                          jschell
                          wrote on last edited by
                          #13

                          How exactly? For example if your 16 year old son kills a neighbor should you go to jail for life? Are you not responsible for your son? If you go to jail does your son go to jail too? In comparison if a large company has a division chief in India and that person, not the CEO, decides to save some money so his financial picture gets better (kickbacks, promotion, whatever) and decides to dump toxic chemicals in a river should the CEO go to jail? What if it is just one truck driver who would rather dump in the river, a one hour trip, versus an 8 hour trip to the regulated site and then spend the next 7 hours getting high, should the CEO go to jail for that? ExxonMobil, as an example, has 60,000 employees. Should the CEO oversee the activities of every single one of them every day? That only allows the CEO 1.4 seconds a day to supervise each one. That is going to make it rather hard to get anything done. At some point adults, because they are adults, are responsible for their own actions.

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                          • D dandy72

                            So maybe the AI's 90% error rate is an improvement over UnitedHealth's own people...

                            J Offline
                            J Offline
                            jschell
                            wrote on last edited by
                            #14

                            Certainly appears possible. See my other post that states "1 in 7".

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                            • D dandy72

                              So maybe the AI's 90% error rate is an improvement over UnitedHealth's own people...

                              G Offline
                              G Offline
                              Gary Stachelski 2021
                              wrote on last edited by
                              #15

                              not quite. The article said that 90% of UHC denials were overturned due to faulty logic, not following Medicare coverage laws, not following doctor's specific instructions and endangering the health and welfare of the patient. (Mainly seniors who were in hospice or nursing care to treat long term recoveries for injuries or sickness) However, the denials were generating hundreds of millions of dollars in claims not paid. So there was no incentive to correct the faulty denials of payment. The upper management of UHC went as far as to threaten, demote and fire employees who were going against the AI generated denials and approving the payments. In the 1970's and 80's it was the green bar computer printout that overrode people's good sense. "The computer said so." Today it is being replaced by "The AI said so."

                              J 1 Reply Last reply
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                              • J jschell

                                Which like a lot of this stuff is just not really relevant. The fact that an algorithm was doing it doesn't change that they were doing it before that. Following article would suggest that the above is actually an improvement. Inside UnitedHealth’s Effort to Deny Coverage for a Patient’s Care — ProPublica[^] "But data from state and federal regulators shows that insurers reject about 1 in 7 claims for treatment."

                                G Offline
                                G Offline
                                Gary Stachelski 2021
                                wrote on last edited by
                                #16

                                I would beg to differ. The article you linked to is a single case where a claim was in question. The article I originally linked to was describing an entire class of senior patients that had coverage, had a valid claim but payments were being denied and questioned by the AI. These patients were recovering from hip fractures, ankle fractures, Pneumonia, Covid. The claim was accepted and the rules said they could have up to 100 days of care to recover. After 7 to 14 days UHC began denial of payments. It would dispute treatments, refuse to talk to doctors, argue with the diagnosis and treatment. This was done not at the start of the claim, which all parties agreed was correct and valid. Families were forced to either pay out of pocket to continue with care or see the senior sent home to make it on their own. The law suit was the result of several patients dying. While it might be true that management at UHC would have pressured their people to cut care early. It appears that they now point to an AI which is supposed to be infallible and challenge you, your lawyers and doctors to prove otherwise. Meanwhile, no payment and the patient suffers.

                                J 1 Reply Last reply
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                                • J jschell

                                  Sander Rossel wrote:

                                  and even inciting genocide.

                                  Not sure about the rest of that but Facebook the company is not guilty of that. People that posted on Facebook wanted that. That is that old nasty freedom of speech problem where everyone wants it for themselves but do not want it for anyone else.

                                  Sander RosselS Offline
                                  Sander RosselS Offline
                                  Sander Rossel
                                  wrote on last edited by
                                  #17

                                  Just saying they're accused, not that they're guilty. And even if they were guilty, it's not said that certain individuals are guilty. Maybe their moderation team was understaffed or in disarray for some good reason. But punishments should be given if there's a leaked internal memo that says "Let's incite genocide today. Cheers, Zuck"

                                  Best, Sander Azure DevOps Succinctly (free eBook) Azure Serverless Succinctly (free eBook) Migrating Apps to the Cloud with Azure arrgh.js - Bringing LINQ to JavaScript

                                  J 1 Reply Last reply
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                                  • J jschell

                                    Sander Rossel wrote:

                                    Organizations are literally destroying the world

                                    What alternative are you suggesting for humans?

                                    Sander RosselS Offline
                                    Sander RosselS Offline
                                    Sander Rossel
                                    wrote on last edited by
                                    #18

                                    Well, of course there's the alternative of not destroying the world. Not sure what you expected :~

                                    Best, Sander Azure DevOps Succinctly (free eBook) Azure Serverless Succinctly (free eBook) Migrating Apps to the Cloud with Azure arrgh.js - Bringing LINQ to JavaScript

                                    J 1 Reply Last reply
                                    0
                                    • G Gary Stachelski 2021

                                      not quite. The article said that 90% of UHC denials were overturned due to faulty logic, not following Medicare coverage laws, not following doctor's specific instructions and endangering the health and welfare of the patient. (Mainly seniors who were in hospice or nursing care to treat long term recoveries for injuries or sickness) However, the denials were generating hundreds of millions of dollars in claims not paid. So there was no incentive to correct the faulty denials of payment. The upper management of UHC went as far as to threaten, demote and fire employees who were going against the AI generated denials and approving the payments. In the 1970's and 80's it was the green bar computer printout that overrode people's good sense. "The computer said so." Today it is being replaced by "The AI said so."

                                      J Offline
                                      J Offline
                                      jschell
                                      wrote on last edited by
                                      #19

                                      Gary Stachelski 2021 wrote:

                                      The article said that 90% of UHC denials were overturned due to faulty logic,...

                                      The article I posted specifically said the following "But data from state and federal regulators shows that insurers reject about 1 in 7 claims for treatment." 1 in 7 is a higher rejection rate. And that is based on the non AI process.

                                      1 Reply Last reply
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                                      • Sander RosselS Sander Rossel

                                        Just saying they're accused, not that they're guilty. And even if they were guilty, it's not said that certain individuals are guilty. Maybe their moderation team was understaffed or in disarray for some good reason. But punishments should be given if there's a leaked internal memo that says "Let's incite genocide today. Cheers, Zuck"

                                        Best, Sander Azure DevOps Succinctly (free eBook) Azure Serverless Succinctly (free eBook) Migrating Apps to the Cloud with Azure arrgh.js - Bringing LINQ to JavaScript

                                        J Offline
                                        J Offline
                                        jschell
                                        wrote on last edited by
                                        #20

                                        Sander Rossel wrote:

                                        But punishments should be given if there's a leaked internal memo that says

                                        What law exactly? In the US States (not the feds) have laws about incitement to riot. You know standing on a stage and telling people they should go out and hang someone. But that is about the person that says that. Not the person that built the stage. Or the one that built the microphone. Or the company that built the street that allows the people to congregate.

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                                        • Sander RosselS Sander Rossel

                                          Well, of course there's the alternative of not destroying the world. Not sure what you expected :~

                                          Best, Sander Azure DevOps Succinctly (free eBook) Azure Serverless Succinctly (free eBook) Migrating Apps to the Cloud with Azure arrgh.js - Bringing LINQ to JavaScript

                                          J Offline
                                          J Offline
                                          jschell
                                          wrote on last edited by
                                          #21

                                          Sander Rossel wrote:

                                          there's the alternative of not destroying the world.

                                          How exactly are you suggesting that should happen? Laws are almost always (perhaps always) enacted in reaction to some behavior that in the past was in fact legal. In the case cited by the OP the it fails to mention that the number of cases that healthcare companies refuse are already high. AI does not seem to have made that more so. It is just a way to blame something else. (Myself I have also read of cases where there company should have rejected the claim. For example when someone claims that they should pay for a very high priced experimental therapy that has not even been proven to actually work.) Unlike what you suggested doing things like the above is not illegal. They are not breaking any law. So only way it can happen in the future is to pass a new law. Even when liability is found it is often a failure to follow a regulation. Which is a civil not a criminal issue. So it could never result in jail time. In either case, at least in the US, those who actually are responsible for the failure must still be proven to have done so intentionally (which is also accepted part of the law.) And given the complexities of many laws even figuring out whether something is wrong can be difficult. So again, what is the exact solution that you are proposing that would prevent problems like this from happening in the future? -------------------------------------------------------- Myself I recognize that if we could find some very intelligent extraterrestrials or perhaps some elves or angels and we let them run the world then it would be good. But otherwise we are just going to have to muddle through as humans.

                                          Sander RosselS 1 Reply Last reply
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