• Fedizen@lemmy.world
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    6 days ago

    It should be illegal for anyone but a doctor to deny a claim. This isn’t even going to be AI, its just going to be a program that denies everything.

  • kent_eh@lemmy.ca
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    7 days ago

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

    Because that’s where we are now.

  • billwashere@lemmy.world
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    7 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()
    
    
  • TuffNutzes@lemmy.world
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    7 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.ca
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      6 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.

  • FlyingCircus@lemmy.world
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    6 days ago

    I’m so tired of living under capitalism. Can you all please get some fucking class consciousness so we can get out of this hellscape?

  • humanspiral@lemmy.ca
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    6 days ago

    This is definitely the wrong “motive structure” for administrative decisions from agency supposed to provide healthcare. Proof of grift as a goal.

    By all means, use AI assistance to determine claims validity. But the AI service should be paid per query, or to licence whole model for unlimited use with medicare paying for the computers/gpus. Medicare should be choosing a model that is accurate instead of one that is paid to deny everything, because Homer Simpson’s birdy automation can do that ultra cheap.

    • traceur301@lemmy.blahaj.zone
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      6 days ago

      Taking claim validity away from the doctor that’s actually in charge of the patient’s care is already fucked. AI cost cutting doesn’t belong in medicine full stop. It shouldn’t be a for-profit “industry” in the first place. We’re so fucked nobody can even think about this without insane, anti-human framing coloring everything

      • humanspiral@lemmy.ca
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        6 days ago

        Private medical insurance is corrupt as starting point. A public health insurance/payer system can still be subject to ineligible or fraudulent claims. Every medical provider demand for money automatically accepted is not the perfect model either. Systems, AI or not, should avoid improper denials is a standard only possible in public health systems.

    • floofloof@lemmy.ca
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      7 days ago

      The ethics of sabotaging AI are even less murky than the ethics of what Luigi did. We need tech Luigis.

    • Blackmist@feddit.uk
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      6 days ago

      Violence is like duct tape. If it hasn’t solved your problem, you didn’t use enough of it.

      • finitebanjo@lemmy.world
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        6 days ago

        Just keep hitting your laptop, I’m sure it will turn on again eventually.

        Violence can solve a problem if you have the correct targets, maybe.

    • NatakuNox@lemmy.world
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      8 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

  • D_C@sh.itjust.works
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    8 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.world
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      7 days ago

      That’s the best possible outcome.

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

  • ☂️-@lemmy.ml
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    7 days ago

    so no healthcare for anyone anymore? just insurance companies paying themselves now.

  • buddascrayon@lemmy.world
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    7 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.