It was only a matter of time....
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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."
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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."
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.
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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.
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"
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Sander Rossel wrote:
Organizations are literally destroying the world
What alternative are you suggesting for humans?
Well, of course there's the alternative of not destroying the world. Not sure what you expected :~
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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."
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.
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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"
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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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Well, of course there's the alternative of not destroying the world. Not sure what you expected :~
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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.
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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.
Gary Stachelski 2021 wrote:
I would beg to differ.
From my link and what I already posted... "More than 200 million Americans are covered by private health insurance. But data from state and federal regulators shows that insurers reject about 1 in 7 claims for treatment." Please explain how I misread that.
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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.
A lot of these companies are fined because they do things that are illegal. It's just that people are never held personally accountable. Shell, and maybe some other fossil fuel giants, in the 60's/70's/80's, hid documents that said they were destroying the world and published documents that said the opposite instead. Unfortuantely, I believe their attempt at mass extinction has expired, so as far as I know they're not even fined. Facebook massively sold their user's data even though they said they weren't. They were fined for a record amount. Same for Tata Steel over here in The Netherlands. Said they were very careful with toxic waste and fumes. Turned out they weren't and people who live in close viccinity to the factory have, on average, a shorter lifespan and more cancer than the average Dutch person. I mean, back then we didn't know about the health risks (although I'm pretty sure they did), but when we learned and asked them to lessen their output, they simply didn't. As far as I'm concerned ignorance turns into mass murder right there. I don't care whether it's technically legal. There's such a thing as "good faith". Telling your mom you didn't eat the last cookie even though you did isn't punishable (by law, at least). Telling the world you're not warming up the earth by multiple degrees ultimately causing mass extinction could, maybe, if we try a litte, not be in "good faith" and therefore, punishable. Of course you could argue we need fuel, we use Facebook and we need steel, and we keep on buying it and using it, so we are to blame (as well). Unfortunately, it's not like we have a lot of alternatives and we're often kept in the dark. The solution? I don't have one, I'll be honest. Strict government regulation and supervision and personal accountability. As long as no one is personally accountable there will be very few incentive to change, as long as the money keeps rolling in. And in that sense, the government has failed us as well, and is often even an accomplice.
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