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The cost blowout in healthcare isn't due to diagnosis or care but administrative costs. All these diagnostic AIs won't significantly reduce the cost of healthca

• fluffycat 8y ago
  They could be actually better and much faster than humans for initial diagnosis. This has far greater implications, e.g. early detection actually reduces big burden from system.
  • easytiger 8y ago
    That has been available since the 1970s. Healthcare is not a very complex compsci issue for 80% of cases. The problem is presentation of symptoms is highly subjective and needs highly complex interpretation that no AI will ever be able to achieve and deal with the liability conundrum
    • fluffycat 8y ago
      No one claims AI will be the authority, it is good for finding candidates much earlier. We never had devices that has success rate of specialists on several eye problems in one go, definitely not in 70s. I don't understand what you are arguing against to be honest.
    • leesec 8y ago
      >that no AI will ever be able to achieve The Luddites are back! We'll see how this prediction holds up in 30 years.
      • wsgeorge 8y ago
        That user talked about "liability"
      • johnnycab 8y ago
        The jury is out on whether the Luddites were indeed troglodytes[1]. If you were to apply the 30 year nostalgia rule in 2049, then we might be hankering for the present, where 'AI' and the surrounding issues are still in their infancy. However, a pragmatic approach would suggest that any form of AI and it's derivatives, would be assistive in the medical field and play a hybrid role, rather than being a panacea[2]. [1] https://news.ycombinator.com/item?id=17667375 https://news.ycombinator.com/item?id=17667375 [2] https://towardsdatascience.com/why-ai-will-not-replace-radiologists-c7736f2c7d80?gi=9b02ec38347d https://towardsdatascience.com/why-ai-will-not-replace-radio...
    • est31 8y ago
      > liability conundrum So many programs and devices are used where someone would be liable if they malfunctioned. In a production line for example, if something goes wrong and it has to be turned off, every hour costs $$$ to the production plant owner. Similarly for robots: there have been cases where industrial robots have killed people. Accidents with machines can happen in so many industries. If the machine is wrong in 0.2% of cases, that's a risk that can be calculated. If its rate of misdiagnoses is equal to the rate of a human expert, then replacing non-experts with it will improve patient experience. Of course, there might be super experts whose patients would be worse off if they were treated by an AI.
• Udik 8y ago
  The cost blowout is a US thing, diagnostic AIs can be used anywhere. And even if the prices weren't affected (which doesn't seem plausible), this can hugely increase the availability and the timeliness of a reliable diagnosis.
  • orbifold 8y ago
    Its not a US thing, other countries such as Germany deal with it by making their hospital doctors work insane hours (manditatory 24 hour shifts on weekends from time to time (400-600€ extra for that unless you are in training, then you just have to do it), one assistant doctor for a psych ward over night) and by introducing collective bargaining. So regardless of whether you are a heart surgeon or a dermatologist you will be paid based on seniority and rank not individual performance. Unions in have for the most part colluded with industry, resulting in an inflation adjusted decrease in average salary over the last 30 years. Paperwork takes up the majority of time for a station doctor, they do a few rounds a day and the rest is spent booking treatments and billing for their patients in their internal 80-90s IT infrastructure.
    • bookofjoe 8y ago
      >It's not a US thing, other countries such as Germany deal with it by making their hospital doctors work insane hours (mandatory 24-hour shifts on weekends from time to time (400-600€ extra for that unless you are in training, then you just have to do it), one assistant doctor for a psych ward overnight) In fact, it IS "a US thing": • Most major teaching hospitals mandate 24-hour weekend shifts for residents; • One "assistant" aka resident doctor for a psych ward overnight is standard Retired neurosurgical anesthesiologist here who's been there and done that many, many times....
• nightfly 8y ago
  I really don't believe we want more automation in this area. Think of Youtube or Google play store moderation, do you want that for medical billing? And I doubt even 10% of medical costs could be contributed to regular administrative overhead.
  • midnightclubbed 8y ago
    Depending on the type of procedure/practice a quick google search indicates somewhere north of 20% is administration. https://www.nytimes.com/2018/07/16/upshot/costs-health-care-us.html https://www.nytimes.com/2018/07/16/upshot/costs-health-care-... Every time I visit the doctors in the US there is a trail of paperwork produced. Outside of basic checkups (where you don't dare mention any niggling health issues because your instantly going to get billed consultation fees) there is always a back and forth between the patient, doctors office and insurance over what the doctors office is asking to be paid and what the insurance says it is prepared to pay. This is an enormous time wasting game - the doctors (or their medical group) ask for much more than the procedure cost to perform knowing full well that the insurance company will push back with a lower accepted payment and the patient will sat in the middle having to negotiate between the two. Removing the pricing game would lower costs substantially (and vastly reduce the time wasted by regular Americans calling their insurance/doctors trying to sort out their individual billing messes). Having lived in both the USA and the UK there is no question in my mind that the US health care system is a dysfunctional mess. In my experience the only place the US system has an advantage is that the healthcare providers are very (too) willing to send a patient for tests/scans to check for every eventuality and are happy to prescribe whatever medicine is 'best' for an ailment. In the UK a fit person with a common cold would get sent home and told to not waste the doctors time, in the US you'll get a consultation and a dose of Z-Pack (and hey if I'm paying for my insurance I should use it when I get sick, shouldn't I).
• leesec 8y ago
  > All these diagnostic AIs won't significantly reduce the cost of healthcare nor improve quality. Thanks but this sounds ridiculous to me. Doctors are people too who really do get paid and really do make mistakes. Using AI to learn from the best of the best will improve results overall, and automating tasks that expensive doctors did will reduce cost. Yes we need to handle the exploding and ridiculous administrative costs, but clearly there can be gains on both fronts of this battle.
  • evrydayhustling 8y ago
    Agree that it's silly to write off potential gains, but it's also important to recognize that consumer costs of healthcare aren't driven by supply costs. It may be easy for administrative and insurance layers to claim the surplus created by AI. This is an important factor in how we choose to build products out of AI advances. If your product replaces a part of a service chain that is not either right next to the transaction or in a competitive part of the supply chain, it might only help incumbents aggregate more power and charge more rent. If you can deploy in a way that improves the competitive landscape, you not only distribute gains more but probably keep more leverage as a solution. This is harder for AI than many technology areas because incumbents tend to have more data and regulatory protection on that data. Health care might be the boss level for that problem.
• bufferoverflow 8y ago
  Another high cost of healthcare source is the lack of competition on price. You have zero idea how much each procedure costs. Imagine going to a supermarket where there are no price tags, and you must buy the items once you pick them off the shelf. It's madness.
  • wsgeorge 8y ago
    That's funny. I'm not familiar with the US, but are costs not disclosed at all until after they're incurred?
    • jarito 8y ago
      That's generally true in the states, but it is even worse. You as the patient don't see the actual price before the procedure (unless you ask). After the work is done, you then get a statement saying how much the procedure cost, what your insurance paid and what you owe. All those numbers are opaque and negotiable. Even better, it is common for insurance and the provider to continue sending you bills for months after even common procedures like child birth. It's a total mess.
      • mikeash 8y ago
        Even if you ask, they may not be able to tell you. Many places are just not set up to be able to give that information beforehand.
        • logosmonkey 8y ago
          Yeah, mostly a hospital could tell you what they will probably charge but they don't have all the variables to come up with what the actual negotiated charge will be nor what your co-pay would be.
      • logosmonkey 8y ago
        Oh and just wait until you get to the sleazy methodology for charging those rates. Childbirth for instance, the room will be billed to the Mother for the days before the birth. So the Mother probably meets their deductible, then as soon as the child is born the room and all the things in it get billed to the child who now has a new deductible to hit before the insurance company has to pay their full amount.
• dragonwriter 8y ago
  > What we really need is automated administration and billings to really move the needle Right, because every other developed countries gets similar outcomes at lower costs (poor capita, per GDP, or on any other reasonable basis for comparison) because they are far ahead of us on automated administration and billing. There might be countries where that's what's needed, but in the US there's clearly a lot of lower hanging fruit that doesn't require any new technology.
  • PButtNutter 8y ago
    Yeah, so I work at a huge health tech company. A lot of the issue is actually private insurance. Currently in the US the largest health insurance provider is actually medicare/medicaid. When a patient with medicare goes to the doctor, the government says "This is what we will pay for that procedure, no exceptions." The hospital has a choice to either accept that rate, or to lose out on the massive medicare market. Private health insurances plans have vastly fewer subscribers, and don't have the power to negotiate prices like the government does. But regardless, why is health care and insurance a for-profit industry? It creates incentives to put profits ahead of people's health.
    • dragonwriter 8y ago
      > Currently in the US the largest health insurance provider is actually medicare/medicaid. Medicaid is more 50 different insurance providers (it's run by each state—with separate programs for, at least, D.C., Puerto Rico, and Guam, and it's not even a single insurer in every state, e.g., California uses a number of county-level managed care plans as well as a traditional fee-for-service plan.) And all of them are separate from Medicare. Which also is less of a single insurer with common coverage policies than it seems on the face (even excluding Medicare Advantage, which is just publicly subsidized private insurance), since whether any given procedure in reasonable and necessary and therefore covered in any given geogrpahical area in Medicare depends on local coverage determinations made by the private insurer that is the Medicare Administrative Contractor for that region and claim type (there are separate contractors, with different geogrpahical regions, for regular part A&B claims, home health and hospice claims, and durable medical equipment claims.)