6 ms·
This sounds like excellent evidentiary material for a future insurer or government health provider to decide you're uninsurable, not eligible for a job, and so
by trollbridge 10mo ago
This sounds like excellent evidentiary material for a future insurer or government health provider to decide you're uninsurable, not eligible for a job, and so on.
And the great thing about it is that you already signed all your rights away for them to do this exact thing, when we could have had an open world with open models run locally instead where you got to keep your private health information private.
- SecretDreams 10mo agoSystem working as intended!
- lotsofpulp 10mo agoIf an insurer is able to reduce (or recoup) costs from likelier risks, then the remaining insureds benefit from lower premiums. If the goal is providing subsidies (i.e. wealth transfers), then insurance is not the way to do it. That is the government’s role.
- alpinisme 10mo agoInsurance that is maximally responsive to patient health changes in terms of cost (ie making healthier people pay less) ends up being an inefficient way of just having people pay for their healthcare directly. And it naturally means the people with highest premiums are the least likely to be able to afford it (the elderly, the disabled, those with chronic conditions that make them less likely to maintain high earning jobs steadily, etc)
- Workaccount2 10mo agoThe obvious retort to this is: "If I focused on my health, ate clean and exercised daily, why should I also be subsidizing Billy "video-games-are-my-exercise" fatass's chronic health conditions?" This is why there is a hyperfixation on shifting blame away from (failing) individuals. The logic breaks when Billy has to admit he just hates exercising. And yes, before you comment, I know "maybe Billy has (condition outside all control) so it's not on him". Please, see what I just said in the previous statement.
- OverTheTetons 10mo agoIs the obvious retort to this: I don't think we should play arbiter for who has and hasn't lived a healthy enough life to still believe they should get healthcare?
- Analemma_ 10mo agoYeah, I think what Workaccount2 is not realizing is that there's no bottom to "you have higher risk factors, why should I pay for you?", and so once you start down that way you may not like where it ends up. Some hobbies have higher injury rates, why should I pay for your health care if you choose to play those? Some parts of the country have lower life expectancies, why should I pay for your health care if you choose to live there?
- Workaccount2 10mo agoThe actual realization, which usually comes years after the realization that there is no bottom, is that there is no top either. The battle along the spectrum of privatizing gains (lower healthcare premiums for a healthy lifestyle - high premiums for unhealthy lifestyle) vs socializing losses (paying $20/mo to get $1200/mo of care - paying $1200/mo for $0/mo of care) is constant and boundless in either direction.
- ben_w 10mo agoBut there is a bound in both directions? On end, it's "national insurance", functionally equivalent to fully-tax-funded healthcare like the NHS or the German system with several providers competing but regulated to near identical results, but moreso as the UK and Germany also has private care; on the other, it's the absence of insurance.
- Workaccount2 10mo agoThis is a macro problem larger than health insurance, and exists everywhere from employee bonuses, high school group project grades, handicap parking, gas prices, Everest summits, to gas prices. Those might all seem wildly disconnected, but they all have systems of unfair allocation to compensate for unequal outcomes. Generally national healthcare programs are entirely dependent on young healthy people paying into the system despite rarely needing it, and then hopefully enough dieing quick deaths or having multiple children to cover their costs. These rebalancing systems are artificial and humans are generally terrible at managing them.
- IanCal 10mo ago> Insurance that is maximally responsive to patient health changes in terms of cost (ie making healthier people pay less) ends up being an inefficient way of just having people pay for their healthcare directly. That's true for predictable costs, but not true for unpredictable ones - which is the point of most insurance (housing, car, etc). The point and use of insurance is to move risk to entities that can bear it. Utility is non-linear with money, and so you easily have situations where spending X times more on something "costs" you more than X times if measured in how useful the money is to you. Typically, as you have more money, each further dollar doesn't provide as much benefit as the last (sometimes things are lumpy, the difference between "not quite enough to pay rent" and "just enough to pay rent" is huge, but broadly this is true). Going from $1000 to $10000 is more impactful than $1001000 to $1010000. That means that moving the other way, each additional dollar spent has a greater personal cost to you. Therefore, sharing unlikely but high expenses can mean that your expected cost is the same (if there's no profit/middleman) or a bit higher, but your expected personal cost is lower.
- SpicyLemonZest 10mo agoWe agree that insurance is not the right way to handle health as a product, since some people predictably need much more medical treatment than others. But it’s how the US has chosen to do it, so we have to do it in a way that works. Correctly identifying a systemic issue won’t pay your medical bills.
- lotsofpulp 10mo agoThat is not how the US has chosen to do it. The ACA prohibits using anything other than age, location, and tobacco use for premium pricing, and the ACA prohibits denying coverage (resulting in a wealth transfer from healthy to sick). Even the age rating factor is capped at 3, so there are also massive wealth transfers from young to old. Mathematically, health insurance premiums in the US are more tax than insurance premium.
- trollbridge 10mo agoThe ACA doesn't prevent some magical fairy-dust AI from pricing premiums, though, which is currently all the rage amongst insurers. (Not because AI will be accurate or anything, but because it offers a completely opaque pricing process.)
- avalys 10mo agoWhy not? If the only factors allowed to be used in settings premiums are age, location and smoking status, then those are the only parameters that could be input to an AI model, no?
- kyboren 10mo agoWarning: I am not in this industry and the below is speculation: AIUI the idea is to predict the "correct" price for an individual premium, Y, which is restricted to being the result of some insurance model function, f(), that is itself restricted to the domain of age (A), location (L), and smoking status (S): Y = f(A, L, S) My impression was that the idea was that this would handicap insurers' natural desire to price premiums individually and have a smoothing effect on prices over the population. But why is location useful for insurers to price premiums? I assume because healthcare has different costs in different locations, and different utilization rates: People living in coal mining towns or near oil refineries may be expected to use more healthcare and thus cost more to insure. Thus, you can imagine insurers building a price map (like a heat map) overlay for the state/country, plotting each applicant on it, and checking the "color" there as part of their model function. So they are effectively embedding out-of-band information (prices and utilization rates for locations) into the model function f() itself. What "AI", or large-parameter Deep Neural Networks, fundamentally change here is: - They can approximate any effectively computable function, the same class of functions that a programmer can write and execute on a computer[0]. - They can be scaled up to an arbitrarily large number of parameters, i.e. an arbitrarily precise approximation limited only by the number of parameters and the amount and quality of model training data. - Absolutely critically: They are programmed implicitly, through brute-force training on input-output pairs, rather than explicitly, with some programmer writing an explicit series of instructions to compute the function. This last point is probably the most important. Large insurers previously had sophisticated models for f() hand-built by math whizzes, but they were limited in the amount of out-of-band information they could encode into that function by the limited cognitive and programmatic capacity of a human team. But now with DNNs you can scalably encode unlimited out-of-band information into the function f(), while also totally obscuring how you're computing that location-based price adjustment. The result, in extremis, is that f() is not some fancy algorithm cooked up by a few dozen math whizzes. Instead f() becomes a fancy database, allowing the tuple (A, L, S) to act merely as an index to an individualized premium Y, which defeats the entire purpose of restricting the domain of their model function. [0]: https://en.wikipedia.org/wiki/Universal_approximation_theorem https://en.wikipedia.org/wiki/Universal_approximation_theore...
- monooso 10mo agoNot a US citizen, so a genuine question: do US health insurance companies have a track record of passing on such savings to consumers? That has not been my impression as an outside observer.
- lotsofpulp 10mo agoHealth insurance companies in the US are not allowed to deny coverage, and can only price premiums based on age (highest premium capped at 3x lowest premium, location, and tobacco use. https://www.healthcare.gov/coverage/pre-existing-conditions/ https://www.healthcare.gov/coverage/pre-existing-conditions/ https://www.healthcare.gov/how-plans-set-your-premiums/ https://www.healthcare.gov/how-plans-set-your-premiums/ Health insurance premiums in the US are more tax than insurance. They also have low single digit profit margins with less than desirable shareholder returns (many are non profit in the first place), so they don’t have much room to lower premiums without also reducing healthcare expenses. The insurance business in general is very competitive and not very profitable, so an insurer that tries to collect outsized premiums will usually suffer a loss of business.
- monooso 10mo ago> The insurance business in general is very competitive and not very profitable... Knowing several Americans, and how much they pay for health insurance (and are still required to pay for some things "out of pocket"), this is incredible to me. And that's before you even get to the process of making a claim. Such a broken system.
- zdragnar 10mo agoOstensibly, the Affordable Care Act was supposed to reduce the average family's premiums by $2,500 a year. When that didn't happen, the story changed to that number being how much more premiums would have risen. Insurance premiums have only gone up as far as I can remember, though there's a ton of variables at play here. Inflation is an obvious one, plus continual introduction of more and more costly treatments- biologic injections, cancer therapies and so forth. The unfortunate increase in obesity rates in my lifetime (along with all the health complications) has been a significant contributor as well. It all adds up.
- simianwords 10mo agoCan you explain the exact way in which this is possible? It’s not legal to be denied jobs based on health. Not to deny insurance
- Flatterer3544 10mo agoAnd how would you know what they base their hiring upon? You would just get a generic automated response.. You would not be privy to their internal processes, and thusfar not be able to prove wrong doing. You would just have to hope for a new Snowden and that the found wrongdoings would actually be punished this time.
- simianwords 10mo agoDo corporations use my google searches as data to hire me?
- anal_reactor 10mo agoNot yet. But Google itself would ask you for your resume if you happened to search for a lot of things related to programming.
- deleted 10mo ago[deleted]
- LPisGood 10mo agoYes, I remember a friend that interned there a couple times showed me that. One of them was “list comprehensive python” and the Google website would split in 2 and give you some really fun coding challenges. I did a few, and you get 4(?) right you get a guaranteed interview I think. I intended to come back and spend a lot of time on an additional one, but I never did. Oops
- anal_reactor 10mo agoI think I only did three or something and I didn't hear back from them. Honestly my view of Google is that they aren't as cool as they think they are. My current position allows me to slack off as much as I want and it's hard to beat that, even if they offer more money (they won't in the current market).
- matt3D 10mo agoThese strawman arguments lack nuance. If the person can use AI to lead a noticeably better life, something that may have been impossible previously due to economic circumstance, then the first order benefits outweigh the second order drawbacks. I’m not disputing what you’re saying, I just think that treating it like a zero sum game every time the conversation comes up is showing an immense amount of privilege. You, me, the parent commenter; we’re all dying, we don’t have time to optimise for the best outcome.
- newyankee 10mo agothere is also no easy way to build a perfect health AI without giving up some privacy. Now there will always be risks, but this is why I think China might overtake everyone else in Healthcare AI at the least
- xigoi 10mo agoIf the tool that allows you to have a “noticeably better life” is heavily subsidized by venture capital, you have turned yourself into a ticking bomb.
- beepbopboopp 10mo agoThis is an argument against the general data collection internet NOT chatGPT.
- carlosjobim 10mo agoWhat do you consider the purpose of life to be? To me being in good health is immensely more important than health insurance, a government health plan, or a job. I know that neither health insurers nor any government agency nor anybody else have even 0,0000000000000001% as much interest in my health, well being and survival as I do. When it is the matter of my health and my life, I care as much about what an insurer or employer thinks as I would care about what the Ayatollah of Iran thinks. Or what you think. Ie: Those opinions are without any value at all.
- paulryanrogers 10mo agoMost of us cannot afford to pay the full cost of healthcare for an emergency or major intervention. Medical bankruptcy is an increasingly common phenomenon. So if insurers can cut you off based on your ChatGPT queries or test results then you may find yourself in serious debt, homeless, without medical care, etc
- carlosjobim 10mo agoMoney is imaginary. Health is health. Sacrificing your health and your life in order to hedge against a completely hypothetical situation is not a dignified existence. Bankruptcy is of course much preferable to not having your health. Even having to argue this is bizarre. We are not human batteries in the Matrix. Our purpose is not to please institutions or destroy our own lives for fear of hypothetical situations. Don't you understand that you only have one life and one body. That's it. You have 70 or 80 years with one body and one mind. That is the only thing which matters.
- nrb 10mo agoHealth is imaginary, life is imaginary, this is all imaginary. There’s no point in drawing an arbitrary line in the sand for what our purpose is or lecturing us on what we should be focusing on. We have seen, again and again, business encroach on our quality of life and it does warrant skepticism and alertness about their motivations.
- kouteiheika 10mo ago> when we could have had an open world with open models run locally instead where you got to keep your private health information private But we can have that? If you have powerful enough hardware you can do it, right now. At very least until the anti-AI people get their way and either make the models' creators liable for what the models say or get rid of the "training is fair use" thing everyone depends on, in which case, sure, you'll have to kiss legal open-weight models goodbye.
- mrcincinnatus 10mo agoPrecisely right. Related. https://www.socialcooling.com/ https://www.socialcooling.com/