Medicare patients in half a dozen states will have some of their health claims automatically reviewed by AI models.
    • NatakuNox@lemmy.worldEnglish
      37·
      13 days ago

      The fact that there’s shares to be had for denying care is crazy. They know denying care is their business! Meaning that the money they didn’t spend on your care doesn’t go back into the pot for everyone in your group, they are pocketing some of the money whenever they deny someone. That’s it. They don’t help anyone but themselves. There should be a requirement that insurance companies publicly announce how much money they made from denying care

  • favoredponcho@lemmy.zipEnglish
    681·
    13 days ago

    As I get older and need the healthcare system more, I have had this realization that except for cosmetic surgery no one uses healthcare that they don’t need. Like, no one is out there trying to scam their insurance company out of a free colonoscopy. They get that procedure because they don’t want to die. Rejecting claims should be illegal. The goal of the healthcare system should be to treat people. Insurance is the wrong paradigm to manage healthcare because implicitly it’s built around rationing resources.

    We don’t do this with food, and yet healthcare is a basic need. What do we do as a society to meet our food needs? We scale up. We plant megatons of crops. We build new technologies to be able to produce more. Why with healthcare do we not do the same? Med schools should accept more than 2% of applicants. The number of doctors in the US is kept artificially low. Also, let people interested in medicine attend abbreviated university programs. Skip the 4 year bachelors and get your med school degree directly in 5-6 years like they do in the UK. Redirect all the overhead and money spent on insurance to building hospitals and hiring doctors.

    • pivot_root@lemmy.worldEnglish
      292·
      13 days ago

      The goal of the healthcare system should be to treat people.

      The goal of a good healthcare system is to treat people. The goal of ours is to treat the rich to another yacht. Healthcare providers bill far above cost for profit, knowing that either the insurance or the patient will have no choice but to eat the cost. Insurance providers use high healthcare costs to justify high policy prices and then do unethical shit to avoid paying out.

      The hospitals make money. The insurance company makes money. The shareholders and corporate owners make money. The people needing healthcare get screwed.

      The system is, unfortunately, working as intended for those who benefit from it being the way it is.

    • andros_rex@lemmy.worldEnglish
      10·
      13 days ago

      Med schools should accept more than 2% of applicants.

      The problem is a lack of residencies, and there’s been lobbying to keep the number of residencies low, to keep doctor wages high.

    • jumping_redditor@sh.itjust.worksEnglish
      06·
      13 days ago

      Cystic acne treatment is frequently covered by insurance and the same treatment is desirable to those that suffer from normal acne. Emotional support animals required doctors notes and were desirable for free admittance on planes. Ozempic as a weight loss drug. Topical steroid treatments for treating inflammation. Glasses to see better than 20/20.

      There are all kinds of medical treatments (relatively) healthy people would want if they were affordable and knew they existed.

      • localhost001@lemmy.worldEnglish
        1·
        12 days ago

        Perhaps so, but it should be up to a medical professional (doctor) whether or not those treatments are appropriate for the patient. Not for-profit companies run by sociopathic executives. (Although in this case we are talking about state-run Medicare using private companies’ AI to make the determination.)

  • D_C@sh.itjust.worksEnglish
    511·
    13 days ago

    Well I’m sure it’ll be all fair and definitely not
    DENIED
    DENIED
    DENIED
    DENIED
    DENIED CHACHING
    DENIED CHACHING
    CHACHING
    CHACHING
    CHACHING

    Oh no, that’ll deffo not happen. No way!!!

    • ameancow@lemmy.worldEnglish
      6·
      13 days ago

      That’s the best possible outcome.

      The more likely outcome is a lot of people are going to die or suffer needlessly.

    • Goodmorningsunshine@lemmy.worldEnglish
      32·
      12 days ago

      This is why I’m so thankful for mortality and chose not to have children. Please, universe, let reincarnation not be a thing.

  • buddascrayon@lemmy.worldEnglish
    25·
    13 days ago

    Officials assert that the AI tools will only be used to judge claims for about a dozen different types of procedures it deems to be wasteful and providing little benefit, including steroid shots to relieve pain, per the NYT.

    Yeah cause people on medicare aren’t likely to need steroid shots for things like joint pain or anything. Anyone 65 and older should start saving their money now to pay for their steroid shots that are going to start costing them a couple hundred bucks a pop.

    • cheers_queers@lemmy.zipEnglish
      22·
      13 days ago

      As someone who lives with constant pain, calling pain relief of any kind “wasteful” enrages me. See if pain relief has “little benefit” when im done with you, mufucka

  • kent_eh@lemmy.caEnglish
    24·
    13 days ago

    Is there a name for the next step beyond perverse incentives?

    Because that’s where we are now.

    • buddascrayon@lemmy.worldEnglish
      16·
      13 days ago

      This is the point. They want to erase any legacy either of them left. Trump is a petty little asshole who is still mad that Obama made fun of him once.

  • TuffNutzes@lemmy.worldEnglish
    19·
    12 days ago

    So bribe the private sector to deny all claims routed through them first for government healthcare and then claim ‘gUbmEnT dEAtH pANEls!’ are the problem.

    • humanspiral@lemmy.caEnglish
      1·
      12 days ago

      So bribe the private sector to deny all claims routed through them first

      The AI models getting paid most the most they deny is private sector grift built in here.

  • billwashere@lemmy.worldEnglish
    19·
    12 days ago

    You don’t need AI for that….

    
#!/usr/bin/env python3

def main():
    try:
        _ = input("Enter reasoning for claim: ")  # read but ignore the input
        print("denied")                # always respond "denied"
    except (EOFError, KeyboardInterrupt):
        # Even if input is interrupted, still respond "denied"
        print("denied")

if __name__ == "__main__":
    main()