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I'm not sure I understand why AI is supposed to make anything better, at least under the regulatory regime we have right now. 1. AI doesn't do anything new. It

I'm not sure I understand why AI is supposed to make anything better, at least under the regulatory regime we have right now. 1. AI doesn't do anything new. It's just human thinking done better in the best case scenario. So the plus side is that we may come up with ideas that a human might have come up with 10-15 years later. However, a lack of ideas is not the problem we face at all. We have solutions to nearly every problem we face. We have enough wealth to implement nearly every solution we have. The real issue we face is that the wealth is concentrated in certain hands that do not want it to make it to others' hands, and those who are capable of implementing the solutions we have prioritize maximizing the wealth they capture with those solutions. AI, as long as it remains in private wealth focused hands, will only serve to turbo charge these issues. 2. Under the current regulatory regime the responsibility of what AI does wrong is not clear. Much like how Uber, and the other gig economy companies leveraged the opportunities created by the spread of the smartphone to create a regulatory innovator, whose only real purpose was to dismantle regulations and impose costs on 3rd parties and capture profits for themselves, AI will and is initially again being used as little more than a legal innovation, using the gray area in terms of legal responsibility as an advantage to do things a company would never have a human employee do or to allow companies to use other people's works without paying for it, and not getting sued for the theft. Expect AI to continue spreading into more legal gray areas as companies take advantage of the lack of clarity on legal responsibility to raid and pillage our economy and societies.

thesuitonym 3y ago
You don't understand because you think we have a society built around making life better for everyone. It's not. Our society currently is optimized for one thing: Making sure the rich stay rich, and the poor stay poor. In that respect, AI is amazing. AI requires a small upfront cost, then can do the job of thousands of people for the pay of less than one. It works 24 hours, and will never ask for more money. And it works exactly to the specification you set, and will never, ever do anything to help your customers.
- BobaFloutist 3y ago
  >you think we have a society built around making life better for everyone. You know, I don't think they do think that? I think they think that's what society should be, though.
- infamouscow 3y ago
  > Making sure the rich stay rich, and the poor stay poor. It doesn't explain how Sears managed themselves into bankruptcy, handing everything to the likes of Amazon despite having all the money in the world, comparatively. It also doesn't explain how EVs are taking off. I've seen multiple conspiratorial documentaries about why the oil companies will never allow EVs to ever take hold.
- asdajksah2123 3y ago
  I disagree with this. There's a lot of evidence that modern society has made things much better for everyone. That doesn't mean that there aren't negative influences in modern society. The rich wanting to get richer is definitely one of the major ones that is particularly powerful right now. But that's why society is a process. You gotta fight back and moderate the negative influences, and boost the more positive ones. I think the question whether AI will fall on either the positive or negative side of the ledger is wrong in itself. AI will provide a lever to magnify whichever direction society and people were going in anyways independent of AI. It's a tool, and hopefully a really powerful tool, but it's not a God. It can be used equally for good and bad. And if you believe, like I do (and by all appearances you do too), that our current society is balanced to benefit bad actors over good actors (where bad/good are being defined in terms of benefiting society overall), the magnifying effect of AI is likely to magnify the net negative. The one advantage of something new like AI coming around is that, I believe, the primary reason open democratic societies allow themselves to become tilted in favor of bad actors is because of complacency...it's usually a slow shift rather than a single big change. The arrival of a major chance like AI forces society and everyone in it to once again take stock of where society stands. This gives us an opportunity to change the tilt of our society to promote good actors again, before AI truly starts having an impact, which gives us an opportunity to ensure AI magnifies a net benefit, rather than a net negative, for society. And frankly I think we are closer to having that reckoning than we've ever been in my few decades on this planet, so overall I'm optimistic about AI. But again, whether we benefit or suffer with AI will be independent of AI itself.
a_gnostic 3y ago
There are no solutions, only tradeoffs. The over-reliance on one size fits all "solutions" are what got us into this mess, and AI will prove just another bandaid with its' own problems, until we realize this.
- skohan 3y ago
  Yes and no - sometimes you need tailored complex care from a professional. Sometimes you need routine treatment, but it's going to take 3 months to get an appointment with the given specialist, or maybe in the case of rural areas there isn't even one within 1000km of you. A lot of good can be done by extending "one size fits all" solutions for simple things there's just no capacity for
  - forgetfreeman 3y ago
    A naïve readthrough would lead one to that conclusion perhaps but the elephant in the room here is capitalism. Pragmatically, any "good enough" solution will be used to replace skilled care to improve patient throughput and thus the bottom line.
    - skohan 3y ago
      The problem is that "skilled healthcare" is essentially a cartel which uses artificial scarcity to increase the price. You can see the counter-example in Cuba, which has an incredibly high number of MD's per capita compared to other countries, and achieves very good healthcare results, especially in the context of other metrics of development and economy. There are so pitifully few health care practitioners compared to what we need in most developed countries I don't think too many jobs are going to be at risk any time soon if AI picks up some of the slack.
      - losteric 3y ago
        What about nursing? That seems to be the flip side where there isn't the protection of the cartel around doctors, so wages get driven to the floor and we see scarcity due to cost of living and mismanagement.
idopmstuff 3y ago
1. AI is broadly accessible. While it definitely has its downsides, I think there's a valid argument to be made that access to AI medical advice is better than access to no medical advice. 2. AI can hold vastly more knowledge in its "head" than a doctor. There are many rare conditions that a doctor rarely sees. That doctor doesn't have enough time to spend researching these kinds of things for their patients, but an AI might be able to analyze their medical records/test results/etc. and come up with possible diagnoses that a regular primary care physician couldn't. If these diagnoses go to the PCP for evaluation (as opposed to going straight to the patient), what is the downside or harm?
- malcolmgreaves 3y ago
  > valid argument to be made that access to AI medical advice is better than access to no medical advice. This is not true. And it's where I believe your whole response takes a wrong turn. Why is it wrong? Because of risk of harm. Giving out wrong information can easily kill people. Or permanently insure them. There's a tremendous amount of harm that can occur if you do things wrong in medicine. When you attach "an AI said X" to something, it adds the appearance of authority. This makes it incredibly dangerous. Folks that don't know enough will believe that the "advice" is true because it "comes from an AI" (and how could an AI be wrong? It's advanced! It's smart! It _can't be wrong_ because the company is using it instead of a real Doctor, and _they wouldn't want to harm me with something that can be wrong_...right?) For example, let's take COVID. If you had GPT say "go take hydroxychloroquine for COVID", you'd end up with a lot of people getting harmed by (1) taking a drug that's not going to help them when they _think_ it would (so they're not going to do something else for treatment, because they incorrectly think they're already being treated) and (2) there's always side effects to taking _any drug_, and these side effects may actually cause _more harm_ than doing nothing.
  - idopmstuff 3y ago
    I agree with what you're saying here - absolutely, bad medical advice from AI (or anywhere) can cause harm. What I disagree with is the way that you're drawing the conclusion that there isn't even a valid argument to be made for using AI. To be clear, I didn't say we absolutely should do this - the part of my post you quoted is where I said there's an argument for it (i.e. we should have the discussion and evaluate). If an AI says take hydroxychloroquine for COVID then absolutely that will cause harm. But that theoretical possibility isn't enough to determine whether an AI should be a source of medical advice - you have to actually evaluate whether/how often it will do that. If .0001% of the time it says to do that and the rest of the time it gives good advice on how to treat COVID at home and what symptoms to look out for that would cause you to need to call an ambulance, then the harms are probably greatly outweighed by the benefits. This is especially true in the case that I argued - where the alternative is no medical advice, because people don't have access to doctors. Lots of people died at home of COVID when they could have been saved at a hospital - we have to consider what the benefits to them might be in addition to what the detriments of AI giving bad advice could be. The last thing I'll say is that your position seems to be that if a source of medical advice sometimes gives bad advice, we should not use it. The problem is that based on that position, people should not go to doctors. Doctors are humans who make mistakes - plenty of evidence of that to go around. All of these points that you've made apply to human doctors: > Giving out wrong information can easily kill people. Or permanently insure them. There's a tremendous amount of harm that can occur if you do things wrong in medicine. > When you attach "[a doctor] said X" to something, it adds the appearance of authority. > If you had [a doctor] say "go take hydroxychloroquine for COVID", you'd end up with a lot of people getting harmed I want to point out that there absolutely were doctors who told patients to take hydroxychloroquine. This is all to say that I think you have to weigh relative harms and benefits. Should someone with access to top tier medical care get advice from an AI? Almost certainly not. Somebody who has access to no medical care or to the sort of doctor who prescribes hydroxychloroquine? As I said initially, it's not necessarily a hard yes but there is certainly an argument to be made that it's a yes.
cmiles74 3y ago
Right now, the only products I've seen leveraging LLMs are the tools from Nuance[1] that fill in physician notes. Arguably this is not an improvement; physician notes are already an incomprehensible garble of cut-and-paste content (often from other systems).[2] But at least it is unlikely to negatively impact patient care. So far, AFAICT, the drive is to cut costs by saving the time the physician spends with the EHR. This has been a goal of the EHR systems for as long as they've existed as it saves money. There is a lot of press releases about products that do more but it's not at all clear to me that these products being widely used. The UnitedHealthcare example in this article is interesting in that is was being used in production. OTOH, it sounds much more like something evaluating business rules or some heuristics rather than an LLM or even an ML based solution. [1]: https://blogs.microsoft.com/blog/2023/08/22/microsoft-and-epic-expand-ai-collaboration-to-accelerate-generative-ais-impact-in-healthcare-addressing-the-industrys-most-pressing-needs/ https://blogs.microsoft.com/blog/2023/08/22/microsoft-and-ep... [2]: https://ehrintelligence.com/news/ehr-clinical-note-length-continues-to-grow-despite-coding-changes https://ehrintelligence.com/news/ehr-clinical-note-length-co...
- to11mtm 3y ago
  > The UnitedHealthcare example in this article is interesting in that is was being used in production. OTOH, it sounds much more like something evaluating business rules or some heuristics rather than an LLM or even an ML based solution. I'm fairly certain that at least one insurance company VP out there is using the LLM/ML hype to trumpet what is actually a statistical model evaluation. OTOH if it provides cost savings does the business truly care what it is? Especially if they can spin it as 'The computer makes more informed decisions thanks to AI'.
  - tcbawo 3y ago
    It helps keep doctors treating patients instead of bogged down in documentation and bureaucracy. More time for patients and less stressed-out doctors means better outcomes.
- MandolieJhay 3y ago
  [dead]
codr7 3y ago
2) is pretty much the definition of a modern startup if you ask me. Precious few actually make a positive difference. Obviously that's not the story they'll tell you, or even themselves, but once you start scratching the surface you'll find that they're all about squeezing profits and pushing costs just like everyone else.
MandolieJhay 3y ago
[dead]
sporkland 3y ago
> I'm not sure I understand why AI is supposed to make anything better It's probably because you don't understand how the world works. Most things aren't revolutions they just allow us to good things more often and cheaper and so create wide spread "wealth". In this case imagine a doctor who isn't magically better than all doctors combined, but instead is the best of all doctors and specialists and performs very consistently and is available on 24/7 basis. It didn't revolutionize everything but I imagine the collective impact on health and lifespans will be tremendous.
userinanother 3y ago
“ Expect AI to continue spreading into more legal gray areas as companies take advantage of the lack of clarity on legal responsibility to raid and pillage our economy and societies.” This is exactly what’s happening, it doesn’t even need ai just an algorithm that allows companies to have an excuse for denying care. If there is no human in the loop nobody is responsible. You can’t send an AI to jail so they can just abuse the system. Judges need to force companies to stop using algorithms and allow approve all expenses when an algorithm is found to be illegal or potentially illegal and that will end the practice quickly. The burden of proof should be on the algorithm writer to show its legal

thesuitonym 3y ago

You don't understand because you think we have a society built around making life better for everyone. It's not. Our society currently is optimized for one thing: Making sure the rich stay rich, and the poor stay poor. In that respect, AI is amazing. AI requires a small upfront cost, then can do the job of thousands of people for the pay of less than one. It works 24 hours, and will never ask for more money. And it works exactly to the specification you set, and will never, ever do anything to help your customers.

BobaFloutist 3y ago
>you think we have a society built around making life better for everyone. You know, I don't think they do think that? I think they think that's what society should be, though.
infamouscow 3y ago
> Making sure the rich stay rich, and the poor stay poor. It doesn't explain how Sears managed themselves into bankruptcy, handing everything to the likes of Amazon despite having all the money in the world, comparatively. It also doesn't explain how EVs are taking off. I've seen multiple conspiratorial documentaries about why the oil companies will never allow EVs to ever take hold.
asdajksah2123 3y ago
I disagree with this. There's a lot of evidence that modern society has made things much better for everyone. That doesn't mean that there aren't negative influences in modern society. The rich wanting to get richer is definitely one of the major ones that is particularly powerful right now. But that's why society is a process. You gotta fight back and moderate the negative influences, and boost the more positive ones. I think the question whether AI will fall on either the positive or negative side of the ledger is wrong in itself. AI will provide a lever to magnify whichever direction society and people were going in anyways independent of AI. It's a tool, and hopefully a really powerful tool, but it's not a God. It can be used equally for good and bad. And if you believe, like I do (and by all appearances you do too), that our current society is balanced to benefit bad actors over good actors (where bad/good are being defined in terms of benefiting society overall), the magnifying effect of AI is likely to magnify the net negative. The one advantage of something new like AI coming around is that, I believe, the primary reason open democratic societies allow themselves to become tilted in favor of bad actors is because of complacency...it's usually a slow shift rather than a single big change. The arrival of a major chance like AI forces society and everyone in it to once again take stock of where society stands. This gives us an opportunity to change the tilt of our society to promote good actors again, before AI truly starts having an impact, which gives us an opportunity to ensure AI magnifies a net benefit, rather than a net negative, for society. And frankly I think we are closer to having that reckoning than we've ever been in my few decades on this planet, so overall I'm optimistic about AI. But again, whether we benefit or suffer with AI will be independent of AI itself.

a_gnostic 3y ago

There are no solutions, only tradeoffs. The over-reliance on one size fits all "solutions" are what got us into this mess, and AI will prove just another bandaid with its' own problems, until we realize this.

skohan 3y ago
Yes and no - sometimes you need tailored complex care from a professional. Sometimes you need routine treatment, but it's going to take 3 months to get an appointment with the given specialist, or maybe in the case of rural areas there isn't even one within 1000km of you. A lot of good can be done by extending "one size fits all" solutions for simple things there's just no capacity for
- forgetfreeman 3y ago
  A naïve readthrough would lead one to that conclusion perhaps but the elephant in the room here is capitalism. Pragmatically, any "good enough" solution will be used to replace skilled care to improve patient throughput and thus the bottom line.
  - skohan 3y ago
    The problem is that "skilled healthcare" is essentially a cartel which uses artificial scarcity to increase the price. You can see the counter-example in Cuba, which has an incredibly high number of MD's per capita compared to other countries, and achieves very good healthcare results, especially in the context of other metrics of development and economy. There are so pitifully few health care practitioners compared to what we need in most developed countries I don't think too many jobs are going to be at risk any time soon if AI picks up some of the slack.
    - losteric 3y ago
      What about nursing? That seems to be the flip side where there isn't the protection of the cartel around doctors, so wages get driven to the floor and we see scarcity due to cost of living and mismanagement.

idopmstuff 3y ago

1. AI is broadly accessible. While it definitely has its downsides, I think there's a valid argument to be made that access to AI medical advice is better than access to no medical advice. 2. AI can hold vastly more knowledge in its "head" than a doctor. There are many rare conditions that a doctor rarely sees. That doctor doesn't have enough time to spend researching these kinds of things for their patients, but an AI might be able to analyze their medical records/test results/etc. and come up with possible diagnoses that a regular primary care physician couldn't. If these diagnoses go to the PCP for evaluation (as opposed to going straight to the patient), what is the downside or harm?

malcolmgreaves 3y ago
> valid argument to be made that access to AI medical advice is better than access to no medical advice. This is not true. And it's where I believe your whole response takes a wrong turn. Why is it wrong? Because of risk of harm. Giving out wrong information can easily kill people. Or permanently insure them. There's a tremendous amount of harm that can occur if you do things wrong in medicine. When you attach "an AI said X" to something, it adds the appearance of authority. This makes it incredibly dangerous. Folks that don't know enough will believe that the "advice" is true because it "comes from an AI" (and how could an AI be wrong? It's advanced! It's smart! It _can't be wrong_ because the company is using it instead of a real Doctor, and _they wouldn't want to harm me with something that can be wrong_...right?) For example, let's take COVID. If you had GPT say "go take hydroxychloroquine for COVID", you'd end up with a lot of people getting harmed by (1) taking a drug that's not going to help them when they _think_ it would (so they're not going to do something else for treatment, because they incorrectly think they're already being treated) and (2) there's always side effects to taking _any drug_, and these side effects may actually cause _more harm_ than doing nothing.
- idopmstuff 3y ago
  I agree with what you're saying here - absolutely, bad medical advice from AI (or anywhere) can cause harm. What I disagree with is the way that you're drawing the conclusion that there isn't even a valid argument to be made for using AI. To be clear, I didn't say we absolutely should do this - the part of my post you quoted is where I said there's an argument for it (i.e. we should have the discussion and evaluate). If an AI says take hydroxychloroquine for COVID then absolutely that will cause harm. But that theoretical possibility isn't enough to determine whether an AI should be a source of medical advice - you have to actually evaluate whether/how often it will do that. If .0001% of the time it says to do that and the rest of the time it gives good advice on how to treat COVID at home and what symptoms to look out for that would cause you to need to call an ambulance, then the harms are probably greatly outweighed by the benefits. This is especially true in the case that I argued - where the alternative is no medical advice, because people don't have access to doctors. Lots of people died at home of COVID when they could have been saved at a hospital - we have to consider what the benefits to them might be in addition to what the detriments of AI giving bad advice could be. The last thing I'll say is that your position seems to be that if a source of medical advice sometimes gives bad advice, we should not use it. The problem is that based on that position, people should not go to doctors. Doctors are humans who make mistakes - plenty of evidence of that to go around. All of these points that you've made apply to human doctors: > Giving out wrong information can easily kill people. Or permanently insure them. There's a tremendous amount of harm that can occur if you do things wrong in medicine. > When you attach "[a doctor] said X" to something, it adds the appearance of authority. > If you had [a doctor] say "go take hydroxychloroquine for COVID", you'd end up with a lot of people getting harmed I want to point out that there absolutely were doctors who told patients to take hydroxychloroquine. This is all to say that I think you have to weigh relative harms and benefits. Should someone with access to top tier medical care get advice from an AI? Almost certainly not. Somebody who has access to no medical care or to the sort of doctor who prescribes hydroxychloroquine? As I said initially, it's not necessarily a hard yes but there is certainly an argument to be made that it's a yes.

cmiles74 3y ago

Right now, the only products I've seen leveraging LLMs are the tools from Nuance[1] that fill in physician notes. Arguably this is not an improvement; physician notes are already an incomprehensible garble of cut-and-paste content (often from other systems).[2] But at least it is unlikely to negatively impact patient care. So far, AFAICT, the drive is to cut costs by saving the time the physician spends with the EHR. This has been a goal of the EHR systems for as long as they've existed as it saves money. There is a lot of press releases about products that do more but it's not at all clear to me that these products being widely used. The UnitedHealthcare example in this article is interesting in that is was being used in production. OTOH, it sounds much more like something evaluating business rules or some heuristics rather than an LLM or even an ML based solution. [1]: https://blogs.microsoft.com/blog/2023/08/22/microsoft-and-epic-expand-ai-collaboration-to-accelerate-generative-ais-impact-in-healthcare-addressing-the-industrys-most-pressing-needs/ https://blogs.microsoft.com/blog/2023/08/22/microsoft-and-ep... [2]: https://ehrintelligence.com/news/ehr-clinical-note-length-continues-to-grow-despite-coding-changes https://ehrintelligence.com/news/ehr-clinical-note-length-co...

to11mtm 3y ago
> The UnitedHealthcare example in this article is interesting in that is was being used in production. OTOH, it sounds much more like something evaluating business rules or some heuristics rather than an LLM or even an ML based solution. I'm fairly certain that at least one insurance company VP out there is using the LLM/ML hype to trumpet what is actually a statistical model evaluation. OTOH if it provides cost savings does the business truly care what it is? Especially if they can spin it as 'The computer makes more informed decisions thanks to AI'.
- tcbawo 3y ago
  It helps keep doctors treating patients instead of bogged down in documentation and bureaucracy. More time for patients and less stressed-out doctors means better outcomes.
MandolieJhay 3y ago
[dead]

codr7 3y ago

2) is pretty much the definition of a modern startup if you ask me. Precious few actually make a positive difference. Obviously that's not the story they'll tell you, or even themselves, but once you start scratching the surface you'll find that they're all about squeezing profits and pushing costs just like everyone else.

MandolieJhay 3y ago

[dead]

sporkland 3y ago

> I'm not sure I understand why AI is supposed to make anything better It's probably because you don't understand how the world works. Most things aren't revolutions they just allow us to good things more often and cheaper and so create wide spread "wealth". In this case imagine a doctor who isn't magically better than all doctors combined, but instead is the best of all doctors and specialists and performs very consistently and is available on 24/7 basis. It didn't revolutionize everything but I imagine the collective impact on health and lifespans will be tremendous.

userinanother 3y ago

“ Expect AI to continue spreading into more legal gray areas as companies take advantage of the lack of clarity on legal responsibility to raid and pillage our economy and societies.” This is exactly what’s happening, it doesn’t even need ai just an algorithm that allows companies to have an excuse for denying care. If there is no human in the loop nobody is responsible. You can’t send an AI to jail so they can just abuse the system. Judges need to force companies to stop using algorithms and allow approve all expenses when an algorithm is found to be illegal or potentially illegal and that will end the practice quickly. The burden of proof should be on the algorithm writer to show its legal