It’s truly grim; but this story about the good work that ‘AI’ is putting in to ensuring that health insurance denials have a veneer of algorithmic plausibility. Aside from the 90% error rate; there appears to be an ugly secondary story about what a “medicare advantage” plan actually is vs. the original. Anyone familiar with whether that’s as much of a stealth privatization as it appears?
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Let me guess: it’s also really racist like all other techbro AI?
Doctors and nurses don’t need replacing any more than school bus drivers. They need proper pay and conditions and out support.
The AI future is just another example of capital being used against workers to make the world worse a bit at a time.
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Medicare Advantage (“Part C”) plans already deny more prior authorization requests than “original” (Parts A & B) Medicare. In addition, providers can game the system via Dx up-coding.
Advantage basically is privatized Medicare. Plan sponsors get paid a fixed amount of $$$ per patient (“capitated”) from Medicare, but then get to distribute it according to their own criteria.
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