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Article is interesting on the whole (I have no experience with "professional" work, and would love for suggestions as to how to be more familiar), but I latched

Article is interesting on the whole (I have no experience with "professional" work, and would love for suggestions as to how to be more familiar), but I latched onto this nugget: > Our vision at Meanwhile is to build the world's largest life insurer as measured by customer count, annual premiums sold, and total assets under management. We aim to serve a billion people, using digital money to reach policyholders and automation/AI to serve them profitably. We plan to do with 100 people what Allianz and others do with 100,000. Completely separate from the potential ethical issues and economic implications of putting 100k people out of a job, I see one very concrete moral problem: that the only way to provide dispute resolution and customer service to 1B people with only 100 employees is by depriving them of any chance to interact with a human, and forcing all interaction with the company to go through AI. That, to me, is deeply disturbing, and very very difficult to justify.

DiggyJohnson 1y ago
I don't think there an ethical responsibility to worrying about your competitor's labor. That would lead to stagnation and it's own sort of ethical issues.
- John23832 1y ago
  You misread. The poster is speaking about the ethical handling of customer service.
  - bee_rider 1y ago
    This comment is replying to the sentiment: > Completely separate from the potential ethical issues and economic implications of putting 100k people out of a job, […] I’m pretty sure. Although, the original comment was basically putting that issue aside, so I’m not sure what there is to say about it.
    - throw10920 1y ago
      You got that right, and yes, I was putting that issue aside, although my counterpoint to GGP argument would be "the ethical issues aren't from the competitor's perspective, it's from the perspective of the whole workforce, industry, and/or economy as a whole".
      - thwarted 1y ago
        The impact to the whole workforce, industry and/or economy as a whole is a second order effect of the real ethical issue of providing a worse service for so cheap it's almost free such that the market won't bear significantly better service provided by humans. As I see it, the ethical concerns are not about specific people being out of a job, but with setting an expectation that it's not worth providing real, useful service (using actual people) because to do so would be a cost higher than phoning it in with AI.
        ghaff 1y ago
        I've had travel insurance from time to time and the consensus in online forums seems to be Allianz. But, in spite of anecdotal stories, relatively few people have any real world experience with the claims process. So it's really hard to tell what the true story is especially given that different people have different tolerances for out of pocket costs--especially below extreme amounts related to evacuation and the like.
- klank 1y ago
  I don't think it's as easy as hand waving it away as "your competitor's labor". Your competitors labor is your community, it's people. I believe we all have an ethical responsibility to that. For the points you brought up, why is stagnation for the purposes of upholding an ethical position a bad thing? And yes, by definition, worrying about ethical responsibility would lead to ethical issues. That's the whole point.
  - vasco 1y ago
    So should we all be farming and collecting berries? Most advancements since have put people out of jobs in "competitors" that didn't adapt. Still the unemployment rate isn't 99.9%. Yet we displaced whole industries many times over the centuries. Obviously people move to better jobs and find other things to do. There's nothing particularly good about sitting on a computer denying people insurance all day, why not have a computer do it?
    - klank 1y ago
      If it is a choice between progress unfettered by concern for your "competitor's labor" or farming berries, I choose berries. However, I believe there's a middle ground and endeavor to find it. Based on your response it doesn't appear as though you believe a middle ground exists.
      - vasco 1y ago
        Choosing berries (ie not progressing to "protect jobs" - no jobs are protected, we have close to full employment worldwide) is choosing avoidable deaths. Child mortality rate in a "choose berries" world is just one example that makes me triggered by those that have that position. And you get nothing in return for protecting those jobs, as I said, the world is "employed" and we've killed many industries already over the centuries. You're protecting nothing.
        klank 1y ago
        I believe in, and am searching for the middle ground. I am not interested in discussing hypothetical extremes. I do not believe they are relevant.
- aprilthird2021 1y ago
  The whole ugly turn of AI hypemen claiming its somehow morally okay for everyone to lose their jobs all at once makes me think the Luddites were right all along
sieabahlpark 1y ago
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jajko 1y ago
Nothing new or revolutionary, just the usual race to the cost bottom with corresponding quality bottom. Author ignores the fact that any normal market there are variously priced insurances, yet somehow not all people flock to the cheapest one, in contrary (at least where I live). Higher fees mean ie less stressful life when dealing with insurer.
lostlogin 1y ago
I agree. And then I recall my last few interactions with insurance companies. Dealing with a machine is unlikely to be worse.
- throw10920 1y ago
  My last few interactions with an insurance company were moderately annoying but far from terrible - I would absolutely loathe having those replaced by a machine, given the terrible quality of every AI "assistant" I've ever used.
  - kurthr 1y ago
    Similarly, I was just forced to talk to an insurance company and the only way I got any response was by talking to a human. The more robotic they are, instead of working around known issues, the more likely we are to get to a satisfactory solution (e.g. don't overcharge me and then do nothing about it).
    - throw10920 1y ago
      Right. I wouldn't say that my interactions with those people were great, but they weren't nearly as bad as any of the automated systems that I've used. Also, I think you may have made a typo that negated the meaning of some of your comment (but I believe I can understand what you meant anyway).
- alabastervlog 1y ago
  My knee-jerk reaction is to think that the prospect of an insurance company handing support over to machines is a terrible development. But it was already the case that they just arbitrarily do WTF ever they want, that outside a small set of actions that "bots" can perhaps handle fine they aren't going to do anything for you, and that the only way to get actual support for a real problem involves something being sent from a .gov email address or on frightening letterhead. So... not really any different? You already basically have to threaten them (well, have someone scarier than you threaten them) to get any real support, this wouldn't be different.
xp84 1y ago
> dispute resolution, customer service, etc There's a huge assumption in your comment -- that having 100,000 employees necessarily guarantees (or even makes likely) that you will have some human to help you. More likely, those 100,000 humans are mostly working on sales and marketing, and the few allocated to support are all incentivized to avoid you, and to send you canned answers. A reasonably decent AI would be better at customer support than most companies give, since it'll have the same rules and policies to operate with, but will most likely be able to speak and write coherently in the language I speak.
- globie 1y ago
  [flagged]
- bee_rider 1y ago
  Apparently 172,824 people die per day, https://worldpopulationreview.com/countries/deaths-per-day https://worldpopulationreview.com/countries/deaths-per-day So actually 100,000 employees put it surprisingly close to just having one case handled per day per employee. Of course, a ton of people don’t have life insurance. And also, a lot of deaths are pretty straightforward.
- throw10920 1y ago
  > There's a huge assumption in your comment -- that having 100,000 employees necessarily guarantees (or even makes likely) that you will have some human to help you. That's not an assumption. I know that I, and many others, have been able to get a human on the phone every time we needed one. Regardless of the number of those humans actually working claims, in the current system, it is "enough". I also know that it's impossible to give that level of service when you have 1 employee for every 10 million customers. That's really all that you need in order to make the judgement that you're not going to get a human. Side-note: I did a quick search, and found that Allstate has 23k reps that actually handle claims and 55k employees total, so almost half of their workforce does claims and disputes. They also have 10% market share of the US's ~340 million people, so that's, at most, 1 rep per 1500 employees. That's much better odds than 1 for every 10 million. > A reasonably decent A And there's the problem - that AI doesn't exist. You're speculating about a scenario that simply hasn't been realized in the real world, and every single person that I've talked to who has interacted with an AI-based "support representative" has had a bad experience.
energy123 1y ago
Ethical issues of putting people out of a job? Please. This mindset has to be called out because it directly causes suffering via creating a societal permission structure for politicians to protect interest groups with protectionist trade policy and internal pork barreling policy. Economic productivity putting people out of jobs is both good and necessary and it is unethical to work against it.
- ImPostingOnHN 1y ago
  > it directly causes suffering via creating a societal permission structure for politicians to protect interest groups with protectionist trade policy and internal pork barreling policy What part of that is suffering, if it enables 100k constituents to put food on the table?
  - matwood 1y ago
    The problem is that it's a misallocation of human capital which slows progress for all of society. We should be providing social safety nets for people, not fake jobs.
    - ImPostingOnHN 1y ago
      > We should be providing social safety nets for people, not fake jobs. I agree with you (except in classifying the genuine effort of my fellow people to be "fake jobs" just because a computer can do some of the work) and believe making a resilient, trustworthy, proven system for the former is a prerequisite to withdrawing the latter, to avoid suffering. Unfortunately for us, the barrier to the former is ideological in nature and imposed by the elite few in power now, before any matters of capital allocation (human or financial) come into play.
      - justinrubek 1y ago
        Nobody has classified genuine effort as fake. But what good is genuine effort when it can be done much more easily without it? There's no shame whatsoever in this. At least, I don't think we should add any to the situation.
guywithahat 1y ago
I don't see it as inherently a problem; AI can (theoretically) be a lot more fair in dealing with claims, and responds a lot sooner. That said I suspect the founder is seriously overestimating the number of highly intelligent, competent people he can hire, and underestimating how much bureaucratic nonsense comes with insurance, but that's a problem he'll run into later down the road. Sometimes you have to hire three people with mediocre salaries because the sort of highly motivated competent person you want can't be found for the role.
- QuercusMax 1y ago
  You're incredibly naive if you think AI will be used to pay out claims more fairly instead of being used as a deny-bot.
  - robertlagrant 1y ago
    You can use people to deny as well. Or non-AI automation; just some business rules in a normal system.
    - QuercusMax 1y ago
      United Healthcare was in the news last year because they had an AI claims "approval" process with a 90% error rate, all in favor of the insurance company. It's easy to describe a business process with written down rules, and those are easy to find in legal discovery. It's much easier to obfuscate with an AI model, because "nobody knows what it's actually doing - it's AI!".
      - sokoloff 1y ago
        It was not a 90% error rate (or at least that’s not a claim I read). It was that 90% of appeals of those decisions were decided (at least partially) in favor of the appeal. That could be 1000 decisions, 10 appeals, and 9 reversals. I am personally 7 for 8 in lifetime wins in my city's parking ticket appeals process. That doesn't mean that I think that 7 out of 8 tickets my city issues are incorrect.
CGMthrowaway 1y ago
> the only way to provide dispute resolution and customer service to 1B people is by depriving them of any chance to interact with a human, and forcing all interaction with the company to go through AI. The Catholic church has 1B "customers" and seems to be doing ok with human-to-human interaction without the need (or desire) for AI. They do so via ~ 500K priests and another 4M lay ministers
- nawgz 1y ago
  This comment is confusing. The Catholic church does not have 100 employees.
  - CGMthrowaway 1y ago
    I didn't read "the only way..." as having the condition of 100 or less employees. In fact the 100 employees is mentioned in an earlier sentence that explicitly says they are using AI to accomplish such a low employee count. The comment I was replying to seems to imply AI was the only way to serve 1B people, without regard for the number of employees.
    - throw10920 1y ago
      It absolutely does not imply that. You read it wrong. It's very clear from the context that I'm talking about serving 1B people with only 100 employees.
    - bee_rider 1y ago
      I think there must be an implied “with so few employees” in there. I mean, the problem apparently appears when going from 100,000 to 100. The comparison to the Church seems not really super useful, their business model is pretty different.
- deleted 1y ago
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crazygringo 1y ago
> that the only way to provide dispute resolution and customer service to 1B people with only 100 employees is by depriving them of any chance to interact with a human, and forcing all interaction with the company to go through AI. That, to me, is deeply disturbing, and very very difficult to justify. I don't know. Given the human beings I've interacted with in customer support, and the number of times I've had to escalate because they were quite simply "intelligence-challenged" who couldn't even understand my issues, I'm not sure this is a bad thing. In my limited experience with AI agents, they've been far more helpful and far faster, they actually seem to understand the issue immediately, and then either give me the solution (i.e. the obscure fact I needed in a support PDF that no regular rep would probably ever have known) or escalate me immediately to the actual right person who can help. And regular humans will stonewall you anyway, if that's corporate policy. And then you go to the courts.
- ben_w 1y ago
  While I get the vibes, and have had experience of human customer support being very weird on a few occasions, replacing mediocre humans with mediocre AI isn't a win for customers getting actual solutions. And right now, the LLMs aren't really that smart, they're making up for low intelligence by being superhumanly fast and able to hold a lot of context at once. While this is better than every response being from a randomly selected customer support agent (as I've experienced), and when they don't even bother reading their own previous replies when the randomiser puts the same person in the chain more than once, it's not great. LLM customer support can seem like a customer win to start with, when the AI is friendlier etc., but either the AI is just being more polite about the fixed corporate policy, or the LLM is making stuff up when it talks to you.
  - throw10920 1y ago
    I think there's an interesting implication here: that the actually good (for the customer) support experience is a real human who has access to a RAG where they can look up company documents/policies/procedures, but still be able to use their human brain to make judgement calls (and, of course, they have to be willing to, y'know, read the notes left by the previous rep).
burningChrome 1y ago
>> that the only way to provide dispute resolution and customer service to 1B people with only 100 employees is by depriving them of any chance to interact with a human. Real world evidence supporting your argument: United Health Group is currently embroiled in a class action lawsuit pertaining to using AI to auto-deny health care claims and procedures: The plaintiffs are members who were denied benefit coverage. They claim in the lawsuit that the use of AI to evaluate claims for post-acute care resulted in denials, which in turn led to worsening health for the patients and in some cases resulted in death. They said the AI program developed by UnitedHealth subsidiary naviHealth, nH Predict, would sometimes supersede physician judgement, and has a 90% error rate, meaning nine of 10 appealed denials were ultimately reversed. https://www.healthcarefinancenews.com/news/class-action-lawsuit-against-unitedhealths-ai-claim-denials-advances https://www.healthcarefinancenews.com/news/class-action-laws...
- sergius 1y ago
  Not to mention the creation of a single point of failure for a critical service...
  - polynomial 1y ago
    Right, but in this case the critical service isn't providing "health" for users, it's extracting profit from them (from the transactions) for the shareholders. THAT'S the critical service this company cybernetically fulfills.
- thenewwazoo 1y ago
  > 90% error rate, meaning nine of 10 appealed denials were ultimately reversed. This is a fantastic illustration of selection bias. It stands to reason that truly-unjustified (some hidden variable) denials would be appealed at a higher rate and therefore the true value is something less than 90%. That's not to say UHG are without blame, I just thought this was really interesting.
  - tkluck 1y ago
    Your scientific take is useful in the case where selection bias is unavoidable and needs to be corrected for. This case is not like that; if the insurance agency wants to dispute the 90% false denial rate, it would be trivial for them to take a random sample of _all_ cases, go through the appeal process for those, and publish the resulting number without selection bias. As long as that doesn't happen, the most logical conclusion for us outside observers is: the number is probably not so much lower than 90% that it makes a difference.
deleted 1y ago
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Y_Y 1y ago
Can we imagine a world where the claims are adjudicated by an uninterested party (as far as possible)? I don't want the insurance company to decide a contractual issue, that's ridiculous. At the moment they're kept honest by the law and by public opinion (which varies by country), but the principal-agent problem is too big to ignore.
- sokoloff 1y ago
  Life insurance claims seem fairly unambiguous to adjudicate.
jjk7 1y ago
The AI: > if (claim) reject()
siliconc0w 1y ago
AI adjudication of healthcare is fine but there needs to be extremely steep consequences for false negatives and a truly independent board of medical experts to appeal to. If a large panel agrees the denial was wrong, a penalty of 10-100x the cost of procedure would be assessed depending on the consequence of the denial.
- throw10920 1y ago
  Yes, I agree. My point was contingent on the current state of affairs - until we can change that, then AI remains a terrible idea.
- reassess_blind 1y ago
  No one is going to accept a claim rejection from AI. Everyone will want to dispute, which will have to go to a human to review. At the end of the day I don’t see how 100 people is realistic.
  - mring33621 1y ago
    Fine! You win! We'll send the appeals through Mechanical Turk. Happy now?
  - bcyn 1y ago
    This reaction is primarily an emotional one. Why is a human rejecting a claim better than an AI rejecting a claim? Presumably the AI will one day -- if not today -- be more accurate in following decisioning logic than humans, who will continue to make human errors.
    - potato3732842 1y ago
      The AI won't reject a claim because that's easier than doing the paperwork to approve the claim and it's 4:30 on a Friday. It also won't approve it because despite not putting the "magic words" on the form it's clear from the situation that you'll get approved regardless and it's a waste of the company's labor to have you file an appeal that they then have to review. I'm not sure which case is more common though.
DrScientist 1y ago
This comment is at the heart of many of the challenges tech companies face - they can scale the serving of content - but struggle to scale the content moderation and/or dispute resolution. It's a common problem with automation - the focus is often on accelerating the 'happy' path, only to realise dealing with the exceptions is where the real challenges lie. One tried and trust way around that is to cherry pick customers as part of your strategy. You sell insurance to people who will never claim ( and hence dispute), and shun those likely to. However such market segmentation results in no insurance for people who would need it and the people who don't wondering why they are buying it - ie optimal efficiency for an insurance company is to simply offer no value at all. ie you could argue the whole value proposition of an insurance company is to pool, not segmented risk, and critically to provide fair arbitration ( protecting the majority of the pool from those that would do insurance fraud, while still paying out ). Buying 'peace of mind' requires a belief in a fair dealing insurer - that's the key scale challenge - not pricing or sales.
watwut 1y ago
I will tell it even more plainly - the plan is to find clever ways how to not pay insurance claims in an automated way.
wnc3141 1y ago
A few more things 1) these digital (or AI) first substitutes for traditional firms almost always rely on dark patterns to hit their metrics. 2) Having many firms serve a market is always better for consumers as well instead of a single firm. (with a few notable exceptions) 3) In terms of large scale, its impossible to scale efficiently across countries as you navigate new political and economic structures.
ttoinou 1y ago
Couldn't they have contractors doing that ? Be it sub insurance companies or freelancers. > Completely separate from the potential ethical issues and economic implications of putting 100k people out of a job Less work is... good ? Ethics are positive here. More work, more pain
- throw10920 1y ago
  > Couldn't they have contractors doing that ? Be it sub insurance companies or freelancers. That's a huge assumption that has no supporting evidence. > Less work is... good ? Ethics are positive here. More work, more pain No. Work allows people to earn money and survive. Ethics are not obviously positive. Up for debate, but this is not the place.

DiggyJohnson 1y ago

I don't think there an ethical responsibility to worrying about your competitor's labor. That would lead to stagnation and it's own sort of ethical issues.

John23832 1y ago
You misread. The poster is speaking about the ethical handling of customer service.
- bee_rider 1y ago
  This comment is replying to the sentiment: > Completely separate from the potential ethical issues and economic implications of putting 100k people out of a job, […] I’m pretty sure. Although, the original comment was basically putting that issue aside, so I’m not sure what there is to say about it.
  - throw10920 1y ago
    You got that right, and yes, I was putting that issue aside, although my counterpoint to GGP argument would be "the ethical issues aren't from the competitor's perspective, it's from the perspective of the whole workforce, industry, and/or economy as a whole".
    - thwarted 1y ago
      The impact to the whole workforce, industry and/or economy as a whole is a second order effect of the real ethical issue of providing a worse service for so cheap it's almost free such that the market won't bear significantly better service provided by humans. As I see it, the ethical concerns are not about specific people being out of a job, but with setting an expectation that it's not worth providing real, useful service (using actual people) because to do so would be a cost higher than phoning it in with AI.
      - ghaff 1y ago
        I've had travel insurance from time to time and the consensus in online forums seems to be Allianz. But, in spite of anecdotal stories, relatively few people have any real world experience with the claims process. So it's really hard to tell what the true story is especially given that different people have different tolerances for out of pocket costs--especially below extreme amounts related to evacuation and the like.
klank 1y ago
I don't think it's as easy as hand waving it away as "your competitor's labor". Your competitors labor is your community, it's people. I believe we all have an ethical responsibility to that. For the points you brought up, why is stagnation for the purposes of upholding an ethical position a bad thing? And yes, by definition, worrying about ethical responsibility would lead to ethical issues. That's the whole point.
- vasco 1y ago
  So should we all be farming and collecting berries? Most advancements since have put people out of jobs in "competitors" that didn't adapt. Still the unemployment rate isn't 99.9%. Yet we displaced whole industries many times over the centuries. Obviously people move to better jobs and find other things to do. There's nothing particularly good about sitting on a computer denying people insurance all day, why not have a computer do it?
  - klank 1y ago
    If it is a choice between progress unfettered by concern for your "competitor's labor" or farming berries, I choose berries. However, I believe there's a middle ground and endeavor to find it. Based on your response it doesn't appear as though you believe a middle ground exists.
    - vasco 1y ago
      Choosing berries (ie not progressing to "protect jobs" - no jobs are protected, we have close to full employment worldwide) is choosing avoidable deaths. Child mortality rate in a "choose berries" world is just one example that makes me triggered by those that have that position. And you get nothing in return for protecting those jobs, as I said, the world is "employed" and we've killed many industries already over the centuries. You're protecting nothing.
      - klank 1y ago
        I believe in, and am searching for the middle ground. I am not interested in discussing hypothetical extremes. I do not believe they are relevant.
aprilthird2021 1y ago
The whole ugly turn of AI hypemen claiming its somehow morally okay for everyone to lose their jobs all at once makes me think the Luddites were right all along

sieabahlpark 1y ago

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jajko 1y ago

Nothing new or revolutionary, just the usual race to the cost bottom with corresponding quality bottom. Author ignores the fact that any normal market there are variously priced insurances, yet somehow not all people flock to the cheapest one, in contrary (at least where I live). Higher fees mean ie less stressful life when dealing with insurer.

lostlogin 1y ago

I agree. And then I recall my last few interactions with insurance companies. Dealing with a machine is unlikely to be worse.

throw10920 1y ago
My last few interactions with an insurance company were moderately annoying but far from terrible - I would absolutely loathe having those replaced by a machine, given the terrible quality of every AI "assistant" I've ever used.
- kurthr 1y ago
  Similarly, I was just forced to talk to an insurance company and the only way I got any response was by talking to a human. The more robotic they are, instead of working around known issues, the more likely we are to get to a satisfactory solution (e.g. don't overcharge me and then do nothing about it).
  - throw10920 1y ago
    Right. I wouldn't say that my interactions with those people were great, but they weren't nearly as bad as any of the automated systems that I've used. Also, I think you may have made a typo that negated the meaning of some of your comment (but I believe I can understand what you meant anyway).
alabastervlog 1y ago
My knee-jerk reaction is to think that the prospect of an insurance company handing support over to machines is a terrible development. But it was already the case that they just arbitrarily do WTF ever they want, that outside a small set of actions that "bots" can perhaps handle fine they aren't going to do anything for you, and that the only way to get actual support for a real problem involves something being sent from a .gov email address or on frightening letterhead. So... not really any different? You already basically have to threaten them (well, have someone scarier than you threaten them) to get any real support, this wouldn't be different.

xp84 1y ago

> dispute resolution, customer service, etc There's a huge assumption in your comment -- that having 100,000 employees necessarily guarantees (or even makes likely) that you will have some human to help you. More likely, those 100,000 humans are mostly working on sales and marketing, and the few allocated to support are all incentivized to avoid you, and to send you canned answers. A reasonably decent AI would be better at customer support than most companies give, since it'll have the same rules and policies to operate with, but will most likely be able to speak and write coherently in the language I speak.

globie 1y ago
[flagged]
bee_rider 1y ago
Apparently 172,824 people die per day, https://worldpopulationreview.com/countries/deaths-per-day https://worldpopulationreview.com/countries/deaths-per-day So actually 100,000 employees put it surprisingly close to just having one case handled per day per employee. Of course, a ton of people don’t have life insurance. And also, a lot of deaths are pretty straightforward.
throw10920 1y ago
> There's a huge assumption in your comment -- that having 100,000 employees necessarily guarantees (or even makes likely) that you will have some human to help you. That's not an assumption. I know that I, and many others, have been able to get a human on the phone every time we needed one. Regardless of the number of those humans actually working claims, in the current system, it is "enough". I also know that it's impossible to give that level of service when you have 1 employee for every 10 million customers. That's really all that you need in order to make the judgement that you're not going to get a human. Side-note: I did a quick search, and found that Allstate has 23k reps that actually handle claims and 55k employees total, so almost half of their workforce does claims and disputes. They also have 10% market share of the US's ~340 million people, so that's, at most, 1 rep per 1500 employees. That's much better odds than 1 for every 10 million. > A reasonably decent A And there's the problem - that AI doesn't exist. You're speculating about a scenario that simply hasn't been realized in the real world, and every single person that I've talked to who has interacted with an AI-based "support representative" has had a bad experience.

energy123 1y ago

Ethical issues of putting people out of a job? Please. This mindset has to be called out because it directly causes suffering via creating a societal permission structure for politicians to protect interest groups with protectionist trade policy and internal pork barreling policy. Economic productivity putting people out of jobs is both good and necessary and it is unethical to work against it.

ImPostingOnHN 1y ago
> it directly causes suffering via creating a societal permission structure for politicians to protect interest groups with protectionist trade policy and internal pork barreling policy What part of that is suffering, if it enables 100k constituents to put food on the table?
- matwood 1y ago
  The problem is that it's a misallocation of human capital which slows progress for all of society. We should be providing social safety nets for people, not fake jobs.
  - ImPostingOnHN 1y ago
    > We should be providing social safety nets for people, not fake jobs. I agree with you (except in classifying the genuine effort of my fellow people to be "fake jobs" just because a computer can do some of the work) and believe making a resilient, trustworthy, proven system for the former is a prerequisite to withdrawing the latter, to avoid suffering. Unfortunately for us, the barrier to the former is ideological in nature and imposed by the elite few in power now, before any matters of capital allocation (human or financial) come into play.
    - justinrubek 1y ago
      Nobody has classified genuine effort as fake. But what good is genuine effort when it can be done much more easily without it? There's no shame whatsoever in this. At least, I don't think we should add any to the situation.

guywithahat 1y ago

I don't see it as inherently a problem; AI can (theoretically) be a lot more fair in dealing with claims, and responds a lot sooner. That said I suspect the founder is seriously overestimating the number of highly intelligent, competent people he can hire, and underestimating how much bureaucratic nonsense comes with insurance, but that's a problem he'll run into later down the road. Sometimes you have to hire three people with mediocre salaries because the sort of highly motivated competent person you want can't be found for the role.

QuercusMax 1y ago
You're incredibly naive if you think AI will be used to pay out claims more fairly instead of being used as a deny-bot.
- robertlagrant 1y ago
  You can use people to deny as well. Or non-AI automation; just some business rules in a normal system.
  - QuercusMax 1y ago
    United Healthcare was in the news last year because they had an AI claims "approval" process with a 90% error rate, all in favor of the insurance company. It's easy to describe a business process with written down rules, and those are easy to find in legal discovery. It's much easier to obfuscate with an AI model, because "nobody knows what it's actually doing - it's AI!".
    - sokoloff 1y ago
      It was not a 90% error rate (or at least that’s not a claim I read). It was that 90% of appeals of those decisions were decided (at least partially) in favor of the appeal. That could be 1000 decisions, 10 appeals, and 9 reversals. I am personally 7 for 8 in lifetime wins in my city's parking ticket appeals process. That doesn't mean that I think that 7 out of 8 tickets my city issues are incorrect.

CGMthrowaway 1y ago

> the only way to provide dispute resolution and customer service to 1B people is by depriving them of any chance to interact with a human, and forcing all interaction with the company to go through AI. The Catholic church has 1B "customers" and seems to be doing ok with human-to-human interaction without the need (or desire) for AI. They do so via ~ 500K priests and another 4M lay ministers

nawgz 1y ago
This comment is confusing. The Catholic church does not have 100 employees.
- CGMthrowaway 1y ago
  I didn't read "the only way..." as having the condition of 100 or less employees. In fact the 100 employees is mentioned in an earlier sentence that explicitly says they are using AI to accomplish such a low employee count. The comment I was replying to seems to imply AI was the only way to serve 1B people, without regard for the number of employees.
  - throw10920 1y ago
    It absolutely does not imply that. You read it wrong. It's very clear from the context that I'm talking about serving 1B people with only 100 employees.
  - bee_rider 1y ago
    I think there must be an implied “with so few employees” in there. I mean, the problem apparently appears when going from 100,000 to 100. The comparison to the Church seems not really super useful, their business model is pretty different.
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crazygringo 1y ago

> that the only way to provide dispute resolution and customer service to 1B people with only 100 employees is by depriving them of any chance to interact with a human, and forcing all interaction with the company to go through AI. That, to me, is deeply disturbing, and very very difficult to justify. I don't know. Given the human beings I've interacted with in customer support, and the number of times I've had to escalate because they were quite simply "intelligence-challenged" who couldn't even understand my issues, I'm not sure this is a bad thing. In my limited experience with AI agents, they've been far more helpful and far faster, they actually seem to understand the issue immediately, and then either give me the solution (i.e. the obscure fact I needed in a support PDF that no regular rep would probably ever have known) or escalate me immediately to the actual right person who can help. And regular humans will stonewall you anyway, if that's corporate policy. And then you go to the courts.

ben_w 1y ago
While I get the vibes, and have had experience of human customer support being very weird on a few occasions, replacing mediocre humans with mediocre AI isn't a win for customers getting actual solutions. And right now, the LLMs aren't really that smart, they're making up for low intelligence by being superhumanly fast and able to hold a lot of context at once. While this is better than every response being from a randomly selected customer support agent (as I've experienced), and when they don't even bother reading their own previous replies when the randomiser puts the same person in the chain more than once, it's not great. LLM customer support can seem like a customer win to start with, when the AI is friendlier etc., but either the AI is just being more polite about the fixed corporate policy, or the LLM is making stuff up when it talks to you.
- throw10920 1y ago
  I think there's an interesting implication here: that the actually good (for the customer) support experience is a real human who has access to a RAG where they can look up company documents/policies/procedures, but still be able to use their human brain to make judgement calls (and, of course, they have to be willing to, y'know, read the notes left by the previous rep).

burningChrome 1y ago

>> that the only way to provide dispute resolution and customer service to 1B people with only 100 employees is by depriving them of any chance to interact with a human. Real world evidence supporting your argument: United Health Group is currently embroiled in a class action lawsuit pertaining to using AI to auto-deny health care claims and procedures: The plaintiffs are members who were denied benefit coverage. They claim in the lawsuit that the use of AI to evaluate claims for post-acute care resulted in denials, which in turn led to worsening health for the patients and in some cases resulted in death. They said the AI program developed by UnitedHealth subsidiary naviHealth, nH Predict, would sometimes supersede physician judgement, and has a 90% error rate, meaning nine of 10 appealed denials were ultimately reversed. https://www.healthcarefinancenews.com/news/class-action-lawsuit-against-unitedhealths-ai-claim-denials-advances https://www.healthcarefinancenews.com/news/class-action-laws...

sergius 1y ago
Not to mention the creation of a single point of failure for a critical service...
- polynomial 1y ago
  Right, but in this case the critical service isn't providing "health" for users, it's extracting profit from them (from the transactions) for the shareholders. THAT'S the critical service this company cybernetically fulfills.
thenewwazoo 1y ago
> 90% error rate, meaning nine of 10 appealed denials were ultimately reversed. This is a fantastic illustration of selection bias. It stands to reason that truly-unjustified (some hidden variable) denials would be appealed at a higher rate and therefore the true value is something less than 90%. That's not to say UHG are without blame, I just thought this was really interesting.
- tkluck 1y ago
  Your scientific take is useful in the case where selection bias is unavoidable and needs to be corrected for. This case is not like that; if the insurance agency wants to dispute the 90% false denial rate, it would be trivial for them to take a random sample of _all_ cases, go through the appeal process for those, and publish the resulting number without selection bias. As long as that doesn't happen, the most logical conclusion for us outside observers is: the number is probably not so much lower than 90% that it makes a difference.

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Y_Y 1y ago

Can we imagine a world where the claims are adjudicated by an uninterested party (as far as possible)? I don't want the insurance company to decide a contractual issue, that's ridiculous. At the moment they're kept honest by the law and by public opinion (which varies by country), but the principal-agent problem is too big to ignore.

sokoloff 1y ago
Life insurance claims seem fairly unambiguous to adjudicate.

jjk7 1y ago

The AI: > if (claim) reject()

siliconc0w 1y ago

AI adjudication of healthcare is fine but there needs to be extremely steep consequences for false negatives and a truly independent board of medical experts to appeal to. If a large panel agrees the denial was wrong, a penalty of 10-100x the cost of procedure would be assessed depending on the consequence of the denial.

throw10920 1y ago
Yes, I agree. My point was contingent on the current state of affairs - until we can change that, then AI remains a terrible idea.
reassess_blind 1y ago
No one is going to accept a claim rejection from AI. Everyone will want to dispute, which will have to go to a human to review. At the end of the day I don’t see how 100 people is realistic.
- mring33621 1y ago
  Fine! You win! We'll send the appeals through Mechanical Turk. Happy now?
- bcyn 1y ago
  This reaction is primarily an emotional one. Why is a human rejecting a claim better than an AI rejecting a claim? Presumably the AI will one day -- if not today -- be more accurate in following decisioning logic than humans, who will continue to make human errors.
  - potato3732842 1y ago
    The AI won't reject a claim because that's easier than doing the paperwork to approve the claim and it's 4:30 on a Friday. It also won't approve it because despite not putting the "magic words" on the form it's clear from the situation that you'll get approved regardless and it's a waste of the company's labor to have you file an appeal that they then have to review. I'm not sure which case is more common though.

DrScientist 1y ago

This comment is at the heart of many of the challenges tech companies face - they can scale the serving of content - but struggle to scale the content moderation and/or dispute resolution. It's a common problem with automation - the focus is often on accelerating the 'happy' path, only to realise dealing with the exceptions is where the real challenges lie. One tried and trust way around that is to cherry pick customers as part of your strategy. You sell insurance to people who will never claim ( and hence dispute), and shun those likely to. However such market segmentation results in no insurance for people who would need it and the people who don't wondering why they are buying it - ie optimal efficiency for an insurance company is to simply offer no value at all. ie you could argue the whole value proposition of an insurance company is to pool, not segmented risk, and critically to provide fair arbitration ( protecting the majority of the pool from those that would do insurance fraud, while still paying out ). Buying 'peace of mind' requires a belief in a fair dealing insurer - that's the key scale challenge - not pricing or sales.

watwut 1y ago

I will tell it even more plainly - the plan is to find clever ways how to not pay insurance claims in an automated way.

wnc3141 1y ago

A few more things 1) these digital (or AI) first substitutes for traditional firms almost always rely on dark patterns to hit their metrics. 2) Having many firms serve a market is always better for consumers as well instead of a single firm. (with a few notable exceptions) 3) In terms of large scale, its impossible to scale efficiently across countries as you navigate new political and economic structures.

ttoinou 1y ago

Couldn't they have contractors doing that ? Be it sub insurance companies or freelancers. > Completely separate from the potential ethical issues and economic implications of putting 100k people out of a job Less work is... good ? Ethics are positive here. More work, more pain

throw10920 1y ago
> Couldn't they have contractors doing that ? Be it sub insurance companies or freelancers. That's a huge assumption that has no supporting evidence. > Less work is... good ? Ethics are positive here. More work, more pain No. Work allows people to earn money and survive. Ethics are not obviously positive. Up for debate, but this is not the place.