4 ms·

>> Those massive gains have yet to considered reliable enough to be considered trusthworthy. We're using them at Generic Health Insurance Megacorp in productio

>> Those massive gains have yet to considered reliable enough to be considered trusthworthy. We're using them at Generic Health Insurance Megacorp in production - lots of enterprises are. If you are in the IT industry, it might be useful to spend some lab time with ML. Possibly you have a misconception of ML and/or confuse it with AI.

crankylinuxuser 8y ago
So, long story short, when groups were talking about governmental death panels, they in actuality were black box AIs that we have no understanding of, yet they make the core decisions and recommendations? Indeed...
- ineedasername 8y ago
  I think the phrase "governmental death panels" is a rather loaded politically partisan phrase. Any system of insuring folks includes people who decide what treatments will be approved and what won't. And in the realm of universal health care systems where decisions like that must be made (as they're made an any insurance company) Something like the UK's quality-adjusted life year (QALY) is, if imperfect, not a wholly unreasonable concept that doesn't include black box AI.
- module0000 8y ago
  Geezus, not that type of health insurance. We're an insurance provider over a century old, blue cross and blue something or other. We're not in the business of death panels, and we have similar feelings towards the tin-foil-hat wearing masses that Catholic priests likely have towards people who assume since some priests are pedophiles, they must all be pedophiles. Some insurance companies(in the minority) are driven by greed and have a reputation that reflects that. Not all priests are pedos, and not all(or any that I've heard of) insurance providers are murderous thugs trying to extract every last cent of wealth from their customers. We're a non-profit organization for that matter. If we somehow extracted a ton of wealth, we wouldn't be allowed to keep it anyway. We have some strict(and irritating for profit-centric people) governance... one of the more interesting pieces of governance is called the "85/15 rule", which roughly translated, means that if we take in $100 dollars, the government mandates we use $85 of them to pay your costs, and $15 to pay our staff, light bills, and any other expense we have. If we end up only using $80 to pay your costs, we have to refund the remaining $5 to your group plan. Here's the obvious secret about health insurance that people like to have conspiracy theories about..I can't speak for other institutions in other countries, however...our stance is really simplistic: you can't pay premiums if you are not alive, therefore it is in our mutual interest for you to remain alive. All the conspiracy theories such as "but you don't want that cancer patient in your insurance group plan!" are just that..conspiracy theories. We absolutely do want that person in the group, because then that group's rates go up! The costs for that patient's care are more or less fixed(and known), built on the assumption of a terminal outcome. We're going to pay for it anyway, and try to make that miserable experience as pleasant as possible for everyone involved. That type of service is how you get repeat business, and a good reputation. This likely falls on deaf ears. Feel free to return to the zealous insurance hatred, and I'm going to return to writing code. Not for death panel machines. Promise.
  - crankylinuxuser 8y ago
    Thank you for responding, firstly. I'll only make a small comment about Catholic priests, since I was at one time a Catholic. The problem wasn't just some of the priesthood was into pedophilia, but that when the church was made aware, actively covered it up. > one of the more interesting pieces of governance is called the "85/15 rule" If I remember correctly, that was passed via the PPACA. And it is also in jeopardy with the continual "repeal and replace (with nothing)" procedures since the PPACA's passage and SCOTUS failed challenge to dismiss. I believe there is a current federal court case with 20 states or so suing on grounds of constitutionality. And with the makeup of SCOTUS now, has a good chance of having the whole law deemed unconstitutional. > Here's the obvious secret about health insurance that people like to have conspiracy theories about..I can't speak for other institutions in other countries, however...our stance is really simplistic: you can't pay premiums if you are not alive, therefore it is in our mutual interest for you to remain alive. All the conspiracy theories such as "but you don't want that cancer patient in your insurance group plan!" are just that..conspiracy theories. We absolutely do want that person in the group, because then that group's rates go up! The costs for that patient's care are more or less fixed(and known), built on the assumption of a terminal outcome. We're going to pay for it anyway, and try to make that miserable experience as pleasant as possible for everyone involved. That type of service is how you get repeat business, and a good reputation. My anger, as well as many other peoples' anger, is the fact that this system is opaque. I go to a doctor, and have procedure/drug prescribed, and there's this song and dance about "preapproval", "permission" and all other sorts of roadblocks. Whether the medical insurance company is for/non profit doesn't matter too much to me. All I know is that the medical insurance is sitting between me and my doctor and making decisions about my care without a medical degree and no patient-doctor association. And the moment medical insurance is taken out, the prices go up by 10 fold. That's mot the medical insurance companies' fault... But that's the end result for us. And medical insurance companies become de-facto arbiters of patients' health. Again, when questions are shoved in this black box, magic answers come out. And what I was criticizing is that the use of AI in this context means that the decisions are now truly black-boxed, rather than just a process of actuarilists (sp?). That was subpoena-able and discoverable. The fact that some neural network algo was trained on GBs of data and outputs magic weights of "accept or deny" is an anathema. Those decisions should be understandable. Those decisions should be defensible (as long as we have a profit-based medical system). Even decision trees would show traceability of how an input got the appropriate result. And if there were questionable or illegal things in there, then they could be challenged or changed. > This likely falls on deaf ears. Feel free to return to the zealous insurance hatred, and I'm going to return to writing code. Not for death panel machines. Promise. Not at all. I do have grievances with how the US does medical, and insurance is only one part of the whole. I come from a point that we should have health provided by tax dollars. We as a nation already spend triple what France does peer capita, yet only a small fraction gets care. Simply put, too many people slip through the cracks. I wouldn't say it's a zealous hatred. It's a well informed long-stewing anger that people who are ill can't get help/fixed. Thank you for the discussion :)
mentalhealth 8y ago
Going all in on the "unintelligible black box" model of health insurance, I see.
- dang 8y ago
  Would you please stop being rude to others in HN comments? I'm sure you can express your substantive points without this. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html Also, please don't make single-purpose accounts on HN.
  - mentalhealth 8y ago
    I agree that this was a bit flippant (though accurate), but if you took the time to look through my posting history over the last nearly five years, you'd learn why I made this account in the first place: https://news.ycombinator.com/item?id=7004159 https://news.ycombinator.com/item?id=7004159 Because I was literally harassed out of a previous job for discussing my views here on HN. I am an actual medical professional; discussions of this industry on HN are full of people with zero knowledge or experience hypothesizing on the topic; you regularly fail to censure them, but censure the people who are involved and are able to conduct substantive discourse. I'm disabling this account and leaving. Enjoy your echo chamber, and know that you persist it through your direct action.

crankylinuxuser 8y ago

So, long story short, when groups were talking about governmental death panels, they in actuality were black box AIs that we have no understanding of, yet they make the core decisions and recommendations? Indeed...

ineedasername 8y ago
I think the phrase "governmental death panels" is a rather loaded politically partisan phrase. Any system of insuring folks includes people who decide what treatments will be approved and what won't. And in the realm of universal health care systems where decisions like that must be made (as they're made an any insurance company) Something like the UK's quality-adjusted life year (QALY) is, if imperfect, not a wholly unreasonable concept that doesn't include black box AI.
module0000 8y ago
Geezus, not that type of health insurance. We're an insurance provider over a century old, blue cross and blue something or other. We're not in the business of death panels, and we have similar feelings towards the tin-foil-hat wearing masses that Catholic priests likely have towards people who assume since some priests are pedophiles, they must all be pedophiles. Some insurance companies(in the minority) are driven by greed and have a reputation that reflects that. Not all priests are pedos, and not all(or any that I've heard of) insurance providers are murderous thugs trying to extract every last cent of wealth from their customers. We're a non-profit organization for that matter. If we somehow extracted a ton of wealth, we wouldn't be allowed to keep it anyway. We have some strict(and irritating for profit-centric people) governance... one of the more interesting pieces of governance is called the "85/15 rule", which roughly translated, means that if we take in $100 dollars, the government mandates we use $85 of them to pay your costs, and $15 to pay our staff, light bills, and any other expense we have. If we end up only using $80 to pay your costs, we have to refund the remaining $5 to your group plan. Here's the obvious secret about health insurance that people like to have conspiracy theories about..I can't speak for other institutions in other countries, however...our stance is really simplistic: you can't pay premiums if you are not alive, therefore it is in our mutual interest for you to remain alive. All the conspiracy theories such as "but you don't want that cancer patient in your insurance group plan!" are just that..conspiracy theories. We absolutely do want that person in the group, because then that group's rates go up! The costs for that patient's care are more or less fixed(and known), built on the assumption of a terminal outcome. We're going to pay for it anyway, and try to make that miserable experience as pleasant as possible for everyone involved. That type of service is how you get repeat business, and a good reputation. This likely falls on deaf ears. Feel free to return to the zealous insurance hatred, and I'm going to return to writing code. Not for death panel machines. Promise.
- crankylinuxuser 8y ago
  Thank you for responding, firstly. I'll only make a small comment about Catholic priests, since I was at one time a Catholic. The problem wasn't just some of the priesthood was into pedophilia, but that when the church was made aware, actively covered it up. > one of the more interesting pieces of governance is called the "85/15 rule" If I remember correctly, that was passed via the PPACA. And it is also in jeopardy with the continual "repeal and replace (with nothing)" procedures since the PPACA's passage and SCOTUS failed challenge to dismiss. I believe there is a current federal court case with 20 states or so suing on grounds of constitutionality. And with the makeup of SCOTUS now, has a good chance of having the whole law deemed unconstitutional. > Here's the obvious secret about health insurance that people like to have conspiracy theories about..I can't speak for other institutions in other countries, however...our stance is really simplistic: you can't pay premiums if you are not alive, therefore it is in our mutual interest for you to remain alive. All the conspiracy theories such as "but you don't want that cancer patient in your insurance group plan!" are just that..conspiracy theories. We absolutely do want that person in the group, because then that group's rates go up! The costs for that patient's care are more or less fixed(and known), built on the assumption of a terminal outcome. We're going to pay for it anyway, and try to make that miserable experience as pleasant as possible for everyone involved. That type of service is how you get repeat business, and a good reputation. My anger, as well as many other peoples' anger, is the fact that this system is opaque. I go to a doctor, and have procedure/drug prescribed, and there's this song and dance about "preapproval", "permission" and all other sorts of roadblocks. Whether the medical insurance company is for/non profit doesn't matter too much to me. All I know is that the medical insurance is sitting between me and my doctor and making decisions about my care without a medical degree and no patient-doctor association. And the moment medical insurance is taken out, the prices go up by 10 fold. That's mot the medical insurance companies' fault... But that's the end result for us. And medical insurance companies become de-facto arbiters of patients' health. Again, when questions are shoved in this black box, magic answers come out. And what I was criticizing is that the use of AI in this context means that the decisions are now truly black-boxed, rather than just a process of actuarilists (sp?). That was subpoena-able and discoverable. The fact that some neural network algo was trained on GBs of data and outputs magic weights of "accept or deny" is an anathema. Those decisions should be understandable. Those decisions should be defensible (as long as we have a profit-based medical system). Even decision trees would show traceability of how an input got the appropriate result. And if there were questionable or illegal things in there, then they could be challenged or changed. > This likely falls on deaf ears. Feel free to return to the zealous insurance hatred, and I'm going to return to writing code. Not for death panel machines. Promise. Not at all. I do have grievances with how the US does medical, and insurance is only one part of the whole. I come from a point that we should have health provided by tax dollars. We as a nation already spend triple what France does peer capita, yet only a small fraction gets care. Simply put, too many people slip through the cracks. I wouldn't say it's a zealous hatred. It's a well informed long-stewing anger that people who are ill can't get help/fixed. Thank you for the discussion :)

mentalhealth 8y ago

Going all in on the "unintelligible black box" model of health insurance, I see.

dang 8y ago
Would you please stop being rude to others in HN comments? I'm sure you can express your substantive points without this. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html Also, please don't make single-purpose accounts on HN.
- mentalhealth 8y ago
  I agree that this was a bit flippant (though accurate), but if you took the time to look through my posting history over the last nearly five years, you'd learn why I made this account in the first place: https://news.ycombinator.com/item?id=7004159 https://news.ycombinator.com/item?id=7004159 Because I was literally harassed out of a previous job for discussing my views here on HN. I am an actual medical professional; discussions of this industry on HN are full of people with zero knowledge or experience hypothesizing on the topic; you regularly fail to censure them, but censure the people who are involved and are able to conduct substantive discourse. I'm disabling this account and leaving. Enjoy your echo chamber, and know that you persist it through your direct action.