Attack of the Killer Algorithms-Occupy Wall Street Part 4 Health Insurance Style - One More App For Folks Who Are Tired of Flawe
Posted Nov 03 2011 1:49am
I have been wanting to address this for a while and yet we have one more contest to entice consumers to use an application to improve their health. What is really funny about these contests is that almost none of the folks who write them will ever use it themselves, in other words nobody will eat their own dog food here and developer want to make a few bucks. We also have the other side with the naïve folks that think apps cure all evils and they don’t.
If we had consumers that were motivated and had information that was not flawed or skewed with marketing maybe this wouldn’t be so bad, but geez, nobody gets this. When it comes time to create a simple personal health record, which I think is great, nothing wrong there as all to have life saving information and a simple history to help the doctors treating you. The absolute basics are allergies and medications for starters and then additional information from there is great, like past surgeries, illnesses, etc. That information is helpful all the way around.
Now here’s where all of this becomes work. You have services that bring in your medical claims and make that information available and guess what, we have errors and the consumer today should not be responsible to do all the extensive leg work to fix all of this. This is one big reason why consumers don’t want to mess with it at all. When you have flawed data in claims going back 20 years or so and you have to fix it that’s a lot of work so insurers can have “perfect” history data files on you.
The next step is their analytics and there’s some good that comes from some of it as it is not all bad, but when some of the new areas of predictive behavior comes in and you are scored and assessed with an algorithm that is only 60% correct and it is take down to an individual level, we have a problem. This is “flawed data discrimination and it’s happening all over.We thought we were done with that years ago, right…wrong…same crap just done by the numbers today. If you want to take numbers and crunch them to run reports, fine as we see those all the time, but again when refined down to a personal level with who knows what type of algorithm, we have problems. I can understand there has to be some filtering but today we have companies with business analytics that have it down to some very specific parameters of which some are needed but some are not needed.
This is what is happening today and the reasons for the madness and frustration. We don’t get the “whole truth” and are judged “on the curve” and when you are talking healthcare and money, “that curve is not good enough” for consumers or anyone; however “curves” lead to profit and that’s the issue. Here’s a good example of WellPoint giving you some new web algorithms so you can “fix yourself” and God forbid some of these mistakes get into the MIB as you may be screwed for life if they don’t fix it as all insurers take those records as gospel. I know a couple of people who cannot get insurance as they can’t get their files corrected at the MIB and their doctors are dead who would normally help them so they are screwed.
Take someone looking for a job that doesn’t have their resume that is in the exact format to get through the “job application algorithms”. If nobody adjusts it to make it through, they end up in the endless circle of resumes that go nowhere. You still need a human in this process and an algorithm cannot do the entire process. I’m sure some of the folks in the Occupy Wall Street group have been through this scenario. A human never gets to see it and the applicant never gets to talk to a human. You cannot believe all the reports you see today as marketing has come in to spin the numbers. We are too trusting and still think that math will prove accuracy 100%, it does not. This is called computer coding and one can write for “accurate” results or “desired” results and the 2 are not always the same.
When you get your insurance claim denied, chances are the algorithm did it as it looks at data only, not a human and they run 24/7 on servers all the time. This is a good place to put the trailer again for Sicko and look again. The woman in the ambulance example was a great example of an algorithm that denied payment. As she says when was she supposed to approve it…algorithm doesn’t know but data was lacking…algorithm says claim denied.
There’s another part in the movie to where a woman’s money was rescinded on a claim already paid..why…algorithm says you forgot to include reporting a yeast infection you had several years ago! It’s the algorithms folks. If their data is not flawed or contains errors, then how come this happens…automated mailings and somehow the envelope stuffer algo had a problem that day. Things like this happen but if there’s information in your file you have to prove them wrong, even though you entered none of the data they are looking at.
Let’s take a look outside of healthcare for a moment…how about this Quant on Wall Street who for 3 years used flawed software with clients…and knew it…and didn’t fix it…I figured he/she had to be somewhat flagrant for the SEC to make this catch.
Let’s come back around to the MIB who has been collecting information about us for years, before there were computers. They used to do just that but with modern times and marketing, guess what, they sell too and now records contain more than just healthcare information.
Here’s a screenshot from one of their web pages and guess what the “problem applications” are…it’s us…we are problems in their eyes if we don’t match the exact parameters. Does this not make you feel real good to know that when you apply for insurance or their services are used for any reason that just going in the door that “we are potential problems”. It’s pretty disgusting but that’s how the analytics sales folks make their pitch.
Now I like analytics and how smart it can make us too, but I can also see when they are abused. Again we have people out there that think a set of algorithms can solve everything for decision making…not.
Well now that you have been given your claim information with errors possibly, we have other folks now writing software to help you work with it. Are consumers jumping on the bandwagon to learn yet more software to fix errors and get into the confusing pricing of healthcare….nope. Do I even have any interest myself in doing this…nope…and I deal with and learn a lot of software. Does this grab my attention…nope. Well I guess I’m like every other consumer out there that says give me some value and this stuff isn’t doing it.
Let’s go a little further, would you venture to see HHS Secretary Sibelius using such software…I would love to be wrong but I don’t think she would touch it at all as she is very busy like the rest of us and who has time!! It’s always for “those guys over there” and the software developers just want to make a buck. Doctors have had this battle longer than we have as consumers with flawed data and all the “rating” web sites and their flawed data. I jus wrote another chapter on that flawed data today. When I found my former MD who had been dead for 8 years still listed and taking new patients…Houston we have a problem.
Sometimes we struggle to get insurance and boy does it not make us mad to see wasted money with situations like the City of Buffalo who didn’t keep their algorithms going in the right direction and paid out $2 million on deal employees with insurance premiums. But when it comes back to the consumer…nope you wrong as we have our data and we are right…just because it’s on the computer screen does not make it accurate.
I’m going to pitch my favorite mathematician/professor again from NYU and if you have not heard this radio interview, do it. He’s right with flawed data and marketing and once you listen up you may not be as gullible next time someone throws numbers and reports in your face, and oh by the way, read his book too if you can.
So when it comes to Occupy Wall Street, how do those folks fight this battle? How do we all fight it? You can’t see those algorithms, you can’t touch them and most of the time you can’t talk to them so what do you do…it’s frustration at the highest level. So this is the movement on their part, how do they address this? They belong on Wall Street as Washington is too digitally illiterate to realize they need greater technologies to make laws and get their data sorted for them. I have several posts around this blog about the Congressional lack of digital literacy. Here’s one flaming example… as we just talked about all that flawed data we have in our health information going back years…these two folks think this should all be put out on the web and as taxpayers we should pay millions to have this done? They think money grows on trees for IT infrastructure project. Law enforcement should have access but this shows 2 really bad digitally illiterates with these 2 senators.
So what do you do when you have algorithms at one end and digital illiteracy at the other that can’t make laws! You go sit on Wall Street where all the code was written that re-arranged the money in this country and the world. I get a kick out of journalists that don’t get this and I guess there’s some more digital illiteracy or maybe putting the OMG ratings in front of good reporting so they can keep their jobs.
There has to be some level of forgiveness with the parameters of how the algorithms run, otherwise we have ethics problems and they are everywhere you turn today. At the Los Angeles CareNow Free Clinic, he summed it up well seeing a woman with advanced breast cancer who did not have insurance and perhaps it could have been caught earlier. By the way he had to be there as a “consultant” as the California medical board could not get their “algorithms” together to allow doctors from out of state to volunteer.
This system of algorithms for care is not working and the Occupy Wall Street folks are right on the money with the healthcare side of this and we all hate it. We don’t care if insurers are making profits for shareholders and it’s almost time that President Obama pull a “Roosevelt” as in at the end of World War II to where Schering was so corrupt that the US government took over all their US assets. It’s drastic but where else are we headed with all of this…can someone give me a better answer as we are constantly uncovering inconsistencies with mathematical formulas today and nobody is minding the shop?
Back in August of 2009 I made a post about needing a US Department of Algorithms to ensure everybody’s math was correct and maybe that time has come. I have sure had a lot of folks agree on that topic as with the complex sophisticated systems we have today, nobody knows when accuracy leaves off and marketing comes in to sell us a bill of goods.
If you listen to the President of late, he says the the same thing “its in the math”, so how do the folks at the Occupy movement take a solid stand, other than the fact that as humans we all know something is not right and it’s time to ask questions and get answers on how the math moves all the money around to create the 99% and 1% groups we have today.
If you want to give consumers something of value with healthcare, get those bar codes out there so we can find recalls with an app and either save a life or prevent illness when recalls occur and stop the insanity of trying to fix all of us with an app that we and the folks who also develop the app are not going to use.
Below is an article I wrote where a man died implanted with a device that was not pulled and used in surgery and it failed. I call this a good app that will have consumer interests and is not one of “its for those guys over there” apps. Stop with the insanity of apps that have little or no value and save some money. Parts 1, 2 and 3 of the “Attack” are listed below. We have folks that don’t listen to consumers when it comes to consumer IT. If you start with something that has value for consumers other apps will follow and this is the ticket. BD
The Robert Wood Johnson Foundation (RWJF) has announced a $100,000 contest for a health IT application that will help consumers use published quality data to choose among physician groups and hospitals in 16 areas around the country.
These 16 communities--ranging in size from rural counties to metropolitan areas to whole states such as Maine, Minnesota, and Wisconsin--have all been involved in RWJF's Aligning Forces for Quality program since 2006. The 10-year, $300 million initiative focuses on improving the quality and reducing the cost of healthcare. An important facet of the program is the public reporting of data on the cost and quality of individual hospitals and medical practices (but not individual physicians)