Hey look at this
* “AI” Hurts Consumers and Workers -- and Isn’t Intelligent https://techpolicy.press/ai-hurts-consumers-and-workers-and-isnt-intelligent/
* #MITPress's Direct to Open opens access to eighty-two new books in 2023 https://mitpress.mit.edu/mit-presss-direct-to-open-d2o-achieves-second-year-goal-opens-access-to-eighty-two-new-books-in-2023/
* 'Where Should I Live?' https://billmckibben.substack.com/p/where-should-i-live
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#20yrsago Evaporating #Danube reveals sunken Nazi ships https://web.archive.org/web/20050306100802/http://news1.iwon.com/odd/article/id/344868|oddlyenough|08-04-2003::11:05|reuters.html
#15yrsago #Heinlein’s dystopian juvenile novels https://web.archive.org/web/20110611035337/http://www.tor.com/blogs/2008/08/juviedystopias
#15yrsago Nature #Neuroscience article on neurological basis for #magic, co-written by Teller of #PennAndTeller https://web.archive.org/web/20080828052922/http://www.nature.com/nrn/journal/vaop/ncurrent/full/nrn2473.html
#15yrsago nostr:npub1sqfnxau480pnvm0t258kdrj5u2u72zwm2kh7tk3qf6lxtqkwvlmqgn5skr forces spoon-bender Geller to eat crow over bogus copyright claim https://web.archive.org/web/20080819004846/http://gadgets.boingboing.net/2008/08/05/psychic-spoonbender.html
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America's largest hospital chain has an algorithmic death panel: HCA's administrators berate doctors over "missed hospice opportunities."
https://mamot.fr/@pluralistic/110837352708868589
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Hey look at this
* “AI” Hurts Consumers and Workers -- and Isn’t Intelligent https://techpolicy.press/ai-hurts-consumers-and-workers-and-isnt-intelligent/
* #MITPress's Direct to Open opens access to eighty-two new books in 2023 https://mitpress.mit.edu/mit-presss-direct-to-open-d2o-achieves-second-year-goal-opens-access-to-eighty-two-new-books-in-2023/
* 'Where Should I Live?' https://billmckibben.substack.com/p/where-should-i-live
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I'm kickstarting the audiobook for "The Internet Con: How To #SeizeTheMeansOfComputation," a #BigTech disassembly manual to disenshittify the web and bring back the old, good internet. It's a #DRMFree book, which means #Audible won't carry it, so this crowdfunder is essential. Back now to get the audio, Verso hardcover and ebook:
http://seizethemeansofcomputation.org
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America's largest hospital chain has an algorithmic death panel: HCA's administrators berate doctors over "missed hospice opportunities."
https://mamot.fr/@pluralistic/110837352708868589
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Today's threads (a thread)
Inside: America's largest hospital chain has an algorithmic death panel; and more!
Archived at: https://pluralistic.net/2023/08/05/any-metric-becomes-a-target/
#Pluralistic
1/
I'm kickstarting the audiobook for "The Internet Con: How To #SeizeTheMeansOfComputation," a #BigTech disassembly manual to disenshittify the web and bring back the old, good internet. It's a #DRMFree book, which means #Audible won't carry it, so this crowdfunder is essential. Back now to get the audio, Verso hardcover and ebook:
http://seizethemeansofcomputation.org
2/
Today's threads (a thread)
Inside: America's largest hospital chain has an algorithmic death panel; and more!
Archived at: https://pluralistic.net/2023/08/05/any-metric-becomes-a-target/
#Pluralistic
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Morgenson is an incisive commentator on for-profit looting. Her recent book *These Are the Plunderers: How Private Equity Runs—and Wrecks—America* (co-written with #JoshuaRosner) is a must-read:
https://pluralistic.net/2023/06/02/plunderers/#farben
--
Image:
Seydelmann (modified)
CC BY 3.0
https://creativecommons.org/licenses/by-sa/3.0/deed.en
eof/
Incentives matter. In a private market, it's *always* more profitable to deny care than to provide it, and any metric we bolt onto that system to prevent cheating will immediately become a target. For-profit healthcare is an oxymoron, a prelude to death panels that will kill you for a nickel.
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This is the true "#AISafety" risk. It's not that a chatbot will become sentient and take over the world - it's that the original artificial lifeform, the limited liability company, will use "AI" to accelerate its murderous shell-game until we can't spot the trick:
https://pluralistic.net/2023/06/10/in-the-dumps-2/
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The risk is real. A 2020 study in the *#JournalOfHealthcareManagement* concluded that the cash incentives for shipping patients to palliatve care "may induce deceiving changes in mortality reporting in several high-volume hospital diagnoses":
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This is the true "#AISafety" risk. It's not that a chatbot will become sentient and take over the world - it's that the original artificial lifeform, the limited liability company, will use "AI" to accelerate its murderous shell-game until we can't spot the trick:
https://pluralistic.net/2023/06/10/in-the-dumps-2/
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But while cutting staff and leaving hospitals to crumble are inarguable malpractice, the palliative care scam is harder to pin down. By using "AI" to decide when patients are beyond help, HCA can employ #EmpiricismWashing, declaring the matter to be the factual - and unquestionable - conclusion of a mathematical process, not mere profit-seeking:
https://pluralistic.net/2023/07/26/dictators-dilemma/#garbage-in-garbage-out-garbage-back-in
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But this empirical facewash evaporates when confronted with whistleblower accounts of hospital administrators who have no medical credentials berating doctors for a "missed hospice opportunity" when a physician opts to keep a patient under their care despite the algorithm's determination.
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Tabel is the only doc on record willing to discuss this, but 26 other doctors talked to Morgenson on background about the practice, asking for anonymity out of fear of retaliation from the nation's largest hospital chain, a "Wall Street darling" with $5.6b in earnings in 2022.
HCA already has a reputation as a slaughterhouse that puts profits before patients, with "severe understaffing":
and rotting, undermaintained facililties:
https://www.nbcnews.com/health/health-care/roaches-operating-room-hca-hospital-florida-rcna69563
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But while cutting staff and leaving hospitals to crumble are inarguable malpractice, the palliative care scam is harder to pin down. By using "AI" to decide when patients are beyond help, HCA can employ #EmpiricismWashing, declaring the matter to be the factual - and unquestionable - conclusion of a mathematical process, not mere profit-seeking:
https://pluralistic.net/2023/07/26/dictators-dilemma/#garbage-in-garbage-out-garbage-back-in
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Tabel is the only doc on record willing to discuss this, but 26 other doctors talked to Morgenson on background about the practice, asking for anonymity out of fear of retaliation from the nation's largest hospital chain, a "Wall Street darling" with $5.6b in earnings in 2022.
HCA already has a reputation as a slaughterhouse that puts profits before patients, with "severe understaffing":
and rotting, undermaintained facililties:
https://www.nbcnews.com/health/health-care/roaches-operating-room-hca-hospital-florida-rcna69563
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Only one of HCA's doctors was willing to go on record about its death panels: #GhasanTabel of #RiversideCommunityHospital (motto: "Above all else, we are committed to the care and improvement of human life"). Tabel sued Riverside after the hospital retaliated against him when he refused to follow the algorithm's orders to send his patients for palliative care.
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#GoodhartsLaw holds that "When a measure becomes a target, it ceases to be a good measure." Give an MBA within HCA a metric ("get patients out of bed quicker") and they will find a way to hit that metric ("send patients off to die somewhere else, even if their doctors think they could recover"):
https://en.wikipedia.org/wiki/Goodhart%27s_law
Incentives matter! Any corporate measure immediately becomes a target.
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Tell Warners to decrease costs, and they will turn around and declare the #WritersStrike to be a $100m "cost savings," despite the fact that this "savings" comes from ceasing production on the shows that will bring in all of *next year's* revenue:
Incentivize a company to eat its seed-corn and it will *chow down*.
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#GoodhartsLaw holds that "When a measure becomes a target, it ceases to be a good measure." Give an MBA within HCA a metric ("get patients out of bed quicker") and they will find a way to hit that metric ("send patients off to die somewhere else, even if their doctors think they could recover"):
https://en.wikipedia.org/wiki/Goodhart%27s_law
Incentives matter! Any corporate measure immediately becomes a target.
26/
Incentives matter. When HCA hospitals send patients to die somewhere else to die, it jukes their stats, reducing the average length of stay for patients, a key metric used by HCA that has the twin benefits of making the hospital seem like a place where people get well quickly, while freeing up beds for more profitable patients.
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Writing for NBC News, #GretchenMorgenson describes how HCA Healthcare - the nation's largest hospital chain - outsourced its death panels to #IBMWatson, whose algorithmic determinations override MDs' judgment to send patients to palliative care, withdrawing their care and leaving them to die:
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Today, doctors are being proletarianized, joining the ranks of nurses, physicians' assistants and other health workers. In 2012, 60% of practices were doctor-owned and only 5.6% of docs worked for hospitals. Today, that's up by 1,000%, with 52.1% of docs working for hospitals, mostly giant corporate chains:
https://prospect.org/health/2023-08-04-when-mds-go-union/
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The paperclip-maximizing, grandparent-devouring transhuman colony organism that calls itself a Private Equity fund is endlessly inventive in finding ways to increase its profits by harming the rest of us. It's not just hospices - it's also palliative care.
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In most states, it's illegal for practices to be owned by non-MDs, and historically, only a small fraction of MDs worked for hospitals, subject to administration by businesspeople rather than doctors.
That was radically altered by private equity's entry into healthcare, with waves of consolidation that saw local hospitals merged into massive national chains, and private practices scooped up and turned into profit-maximizers, not health-maximizers:
https://prospect.org/health/2023-08-02-qa-corporate-medicine-destroys-doctors/
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Today, doctors are being proletarianized, joining the ranks of nurses, physicians' assistants and other health workers. In 2012, 60% of practices were doctor-owned and only 5.6% of docs worked for hospitals. Today, that's up by 1,000%, with 52.1% of docs working for hospitals, mostly giant corporate chains:
https://prospect.org/health/2023-08-04-when-mds-go-union/
22/
In most states, it's illegal for practices to be owned by non-MDs, and historically, only a small fraction of MDs worked for hospitals, subject to administration by businesspeople rather than doctors.
That was radically altered by private equity's entry into healthcare, with waves of consolidation that saw local hospitals merged into massive national chains, and private practices scooped up and turned into profit-maximizers, not health-maximizers:
https://prospect.org/health/2023-08-02-qa-corporate-medicine-destroys-doctors/
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