9 ms·

Talking about it, sharing our stories, making sure people get just how shitty it really is happens to be a great way to set an expectation for change. And ther

Talking about it, sharing our stories, making sure people get just how shitty it really is happens to be a great way to set an expectation for change. And there is this: The change, if there is to be one, will have to come from us. A whole lot of us. Most great things do. This idea of using an LLM in some meaningful way is as laughable as watching the world burn while people squabble over baubles and trinkets is maddening.

fnordpiglet 3y ago
Talking about it doesn’t help people who are sick. It’s something we’ve done for decades and we are no closer to universal health care. We can continue to talk and bemoan the state of things. But when you’re sick, you personally, the great mass talking about how shitty it is that you’re sick matters not one bit. No one doubts change would come from us - but if there is to be a change, it’ll be over a sea of misery. Sitting around taking a medical ethics stance that everyone must die unless a licensed medical professional billed you with correct billing codes to an insurance company is on the surface absurd. People received and gave medical advice and care without both of those things for almost all of humans existence, yet here we all are, the world didn’t end. It would be a hell of a lot better if medical care weren’t rationed by death panels, but it is rationed by the death panels of Congress. I take it you’re on the “LLM can’t do anything but hallucinate.” However an awful lot of folks use LLM for quite a lot successfully already. I’ve found in the space of medical advice GPT4 is already fairly sophisticated. I wouldn’t use it without double checking it’s output, but I can ask it fairly complex questions about physiology, biochemistry, medicines, and many other subjects and it almost always provides a concise, detailed, and insightful answer. I’ve not yet found it hallucinating so long as I don’t ask it questions that are essentially information retrieval questions (who wrote the paper about blah will often induce a wrong answer, while, say, what medicines shouldn’t be mixed with ibuprofen will not). I personally believe LLM’s are not the answer as well, but I believe LLMs are a major missing piece in the assembly of partial answers we’ve built to date. I think LLM’s combined with information retrieval, optimizers, constraints systems, goal based agents, and other classical AI and information techniques forms a powerful combination greater than the sum of its parts. And I definitely think the way to scale medical care is for most medical questions that don’t need an expert to be serviced by a machine. The vast majority of our medical systems time is taken up by people with colds, GERD, and other questions and conditions that can be handled without a human.
- ddingus 3y ago
  We haven't been talking seriously for decades. Anyway, people will try this, others will get hurt or killed, and I along with others will get our "I told you so" moment, which will get added to the "when the fuck do we make health care a priority" advocacy library and the fight goes on. Fact is, far too many people ignore health care. When that changes, we will see progress.
  - fnordpiglet 3y ago
    That’s untrue: https://pnhp.org/a-brief-history-universal-health-care-efforts-in-the-us/ https://pnhp.org/a-brief-history-universal-health-care-effor... There have been meaningful efforts that keep reverting to insurance schemes since the late 1800s, with the first real legislative passage in 1915. Universal healthcare has actually been pretty popular and enjoyed broad support. Most people are acutely aware of health care and the lack of it. In fact it typically ranks near the top in the concerns for most Americans: https://www.pewresearch.org/politics/2023/06/21/inflation-health-costs-partisan-cooperation-among-the-nations-top-problems/ https://www.pewresearch.org/politics/2023/06/21/inflation-he... The issue is more the business lobby against expansion of health care and the insurance lobby against expansion of universal solutions like single payer and Medicare / VA expansion to everyone. In fact the concerns aren’t false - insurance and the billing industry are huge employers of relatively low skilled but well paid workers.
    - ddingus 3y ago
      We haven't had conversations with real teeth yet. I agree with what you said. Changes to this state of affairs will only come from us. Otherwise, they have position and are fat 'n happy. This means we need to speak in more basic terms. Expensive terms.

fnordpiglet 3y ago

Talking about it doesn’t help people who are sick. It’s something we’ve done for decades and we are no closer to universal health care. We can continue to talk and bemoan the state of things. But when you’re sick, you personally, the great mass talking about how shitty it is that you’re sick matters not one bit. No one doubts change would come from us - but if there is to be a change, it’ll be over a sea of misery. Sitting around taking a medical ethics stance that everyone must die unless a licensed medical professional billed you with correct billing codes to an insurance company is on the surface absurd. People received and gave medical advice and care without both of those things for almost all of humans existence, yet here we all are, the world didn’t end. It would be a hell of a lot better if medical care weren’t rationed by death panels, but it is rationed by the death panels of Congress. I take it you’re on the “LLM can’t do anything but hallucinate.” However an awful lot of folks use LLM for quite a lot successfully already. I’ve found in the space of medical advice GPT4 is already fairly sophisticated. I wouldn’t use it without double checking it’s output, but I can ask it fairly complex questions about physiology, biochemistry, medicines, and many other subjects and it almost always provides a concise, detailed, and insightful answer. I’ve not yet found it hallucinating so long as I don’t ask it questions that are essentially information retrieval questions (who wrote the paper about blah will often induce a wrong answer, while, say, what medicines shouldn’t be mixed with ibuprofen will not). I personally believe LLM’s are not the answer as well, but I believe LLMs are a major missing piece in the assembly of partial answers we’ve built to date. I think LLM’s combined with information retrieval, optimizers, constraints systems, goal based agents, and other classical AI and information techniques forms a powerful combination greater than the sum of its parts. And I definitely think the way to scale medical care is for most medical questions that don’t need an expert to be serviced by a machine. The vast majority of our medical systems time is taken up by people with colds, GERD, and other questions and conditions that can be handled without a human.

ddingus 3y ago
We haven't been talking seriously for decades. Anyway, people will try this, others will get hurt or killed, and I along with others will get our "I told you so" moment, which will get added to the "when the fuck do we make health care a priority" advocacy library and the fight goes on. Fact is, far too many people ignore health care. When that changes, we will see progress.
- fnordpiglet 3y ago
  That’s untrue: https://pnhp.org/a-brief-history-universal-health-care-efforts-in-the-us/ https://pnhp.org/a-brief-history-universal-health-care-effor... There have been meaningful efforts that keep reverting to insurance schemes since the late 1800s, with the first real legislative passage in 1915. Universal healthcare has actually been pretty popular and enjoyed broad support. Most people are acutely aware of health care and the lack of it. In fact it typically ranks near the top in the concerns for most Americans: https://www.pewresearch.org/politics/2023/06/21/inflation-health-costs-partisan-cooperation-among-the-nations-top-problems/ https://www.pewresearch.org/politics/2023/06/21/inflation-he... The issue is more the business lobby against expansion of health care and the insurance lobby against expansion of universal solutions like single payer and Medicare / VA expansion to everyone. In fact the concerns aren’t false - insurance and the billing industry are huge employers of relatively low skilled but well paid workers.
  - ddingus 3y ago
    We haven't had conversations with real teeth yet. I agree with what you said. Changes to this state of affairs will only come from us. Otherwise, they have position and are fat 'n happy. This means we need to speak in more basic terms. Expensive terms.