³ÉÈËXÕ¾

³ÉÈËXÕ¾ NEWSRADIO OPINION

Ross: Artificial Intelligence bringing a non-human approach to health care

Nov 15, 2023, 7:38 AM | Updated: 1:05 pm

Nurse patient...

Nurse attends to patient. (Getty Images)

(Getty Images)

I’m at the age where after a doctor’s visit I’ll get a form letter basically saying — we just paid one of your medical bills, please prove it’s legitimate.

The medical insurance companies are trying to control fraud of course, but it makes you feel like a criminal for daring to see a doctor. I accept it – like I accept my TSA patdowns at the airport.

However, this system is now taking a disturbing turn– thanks to AI.

An article from Kaiser Health News tells the story of Judith Sullivan, who was in a nursing home recovering from surgery when she got a letter from her Medicare Advantage plan informing her that they would stop paying for her nursing care because she was well enough to go home.

And it turns out that her insurer, United Healthcare – full disclosure, also my insurer – uses an Artificial Intelligence tool to predict when patients should be ready to go home. The A-I examines millions of medical records, finds patients with the same medical issues, and then estimates how long it should take you to recover.

It’s similar to the way the IRS flags potential tax cheats.

They want to flag hospitals that might try to make an extra buck by keeping perfectly healthy people strapped in their beds.

Well, speaking as someone who’s had to recover from major surgery, I’d have bolted from the hospital the moment I came to… if it hadn’t been for the tubes stitched to my body. Why would anyone hang around a hospital longer than they have to? Unless they REALLY love the Jell-O?

United Health wouldn’t answer questions about the case… but obviously this is how those plans can charge lower premiums. They cut expenses.

More Dave: To celebrate the new I-90 ramp meters, a return of the Zipper Merge song!

In Judith Sullivan’s case, there’s a semi-happy ending – her nursing home agreed to keep her for another 18 days, even though her insurance wouldn’t pay.

So she’s back at home and is healthy enough to sue her Medicare Advantage plan to reimburse her for the bill, which came to $10,406.36.

So far, however, the courts have sided with the company. I’m guessing that like most of us, she didn’t read the fine print in her insurance plan.

But come January, new federal rules will require that if your Medicare Advantage plan cuts you off, you have to be cut off by a human being who knows your case, not by an oblivious computer. That’s reassuring, right?

By the way, according to the article, had Judith stuck with regular government Medicare instead of buying a private Medicare Advantage plan… yes, her premiums might have been higher, but the recovery time would probably have been paid for.

Listen to Seattle’s Morning News with Dave Ross and Colleen O’Brien weekday mornings from 5 – 9 a.m. on ³ÉÈËXÕ¾ Newsradio, 97.3 FM. Subscribe to the podcast here.

Dave's Commentary

Dave Ross on ³ÉÈËXÕ¾ Newsradio 97.3 FM
  • to ³ÉÈËXÕ¾ Newsradio weekdays at 5am for Dave Ross on Seattle's Morning News.

³ÉÈËXÕ¾ Newsradio Opinion

...

MyNorthwest Video

Video: Jake & Spike Interview Hydroplane Champ Andrew Tate

Hydroplane Champion Andrew Tate joins Jake and Spike from the pit ahead of the legendary races! Listen to the Jake and Spike Show every weekday from 12pm – 3pm on ³ÉÈËXÕ¾ Newsradio 97.3 FM. Listen to ³ÉÈËXÕ¾ Newsradio 97.3 FM or go to MyNorthwest.com to learn more!

2 days ago

...

MyNorthwest Video

Video: Why Do Young Women Lean Left and Men Don’t?

Angela Poe Russell stopped by SMN to lead a discussion on why young female voters in Seattle are veering left more, and why young men are going the opposite direction. Listen to Seattle’s Morning News w/ Charlie Harger and Manda Factor every weekday at 5am on ³ÉÈËXÕ¾ Newsradio 97.3 FM or go to MyNorthwest.com to […]

2 days ago

...

MyNorthwest Video

Video: Seattle Mayor Bruce Harrell Speaks Before the Primary

Mayor Bruce Harrell joins the Gee & Ursula Show ahead of next week’s Primary Election to discuss the housing affordability crisis and more. Listen to the Gee and Ursula Show every weekday at 9am on ³ÉÈËXÕ¾ Newsradio 97.3 FM. Listen to ³ÉÈËXÕ¾ Newsradio 97.3 FM or go to MyNorthwest.com to learn more!

2 days ago

...

MyNorthwest Video

Video: The Truth in Job Advertising and Accountability Act

Eric Thompson stopped by Seattle’s Morning News to talk about the prevalence of “ghost job” listings and his push to draft legislation to crack down on them. Listen to Seattle’s Morning News w/ Charlie Harger and Manda Factor every weekday at 5am on ³ÉÈËXÕ¾ Newsradio 97.3 FM or go to MyNorthwest.com to learn more!

2 days ago

...

MyNorthwest Video

Video: Ryan Mello Talks First 6 Months in Office

Pierce County Executive Ryan Mello joined the Gee & Ursula Show after 6 months in office to give an update. Listen to the Gee and Ursula Show every weekday at 9am on ³ÉÈËXÕ¾ Newsradio 97.3 FM. Listen to ³ÉÈËXÕ¾ Newsradio 97.3 FM or go to MyNorthwest.com to learn more!

2 days ago

Photo: Two river otters. WDFW recently reported a child was involved in an animal attack when an ot...

Gee Scott and Ursula Reutin Show

‘I think there’s some liability’: ³ÉÈËXÕ¾ hosts debate who’s at fault for Bremerton otter attack

The mother of a young child who was violently attacked by a river otter at the Bremerton Marina last year has filed a lawsuit against the Port of Bremerton

3 days ago

Ross: Artificial Intelligence bringing a non-human approach to health care