Yes indeed the algorithms keep rolling and out there as you probably are well aware of by now that automation is what health insurance relies on and when systems fail, everything stops. This was already around before Obamacare was created but just not as big as 2-3 years ago the complexities of math models and algorithmic formulas were not accelerated to the point to where they are today.  We all get frustrated and angry and want to “fix” it, and there are technologists working to fix Healthcare.Gov, around the clock. 

The problem here is that the complexities that built over the years are failing.  Software and algorithmic formulas build upon themselves.  It’s the way it works and has from when software was invented.  We have layer after layer after layer of computer code out there now and we still strive and add more layers and layers of code on top of around 30 years worth of code accumulation.  Certainly some of it has been updated with new code and had software engineers improve a lot of original code work, but we still have layers and layer and layers to deal with.

Now we have software analytics which is supposed to make us more efficient and help make more money but the models don’t work so well anymore.  We all remember the days when people were denied care over diseases they had and the public outbursts that came out to get care for people  The Affordable Care Act is attempting to get rid of that and the law does say now that people with existing health issues can’t be denied insurance coverage.  This is a huge undoing of how health insurers profited for years and it’s clashing with the math and the formulas with the law.  The law is doing the right thing and that is one common part of the law that everyone agrees with whether they like Obamacare or not is the fact that pre-existing conditions cannot deny one from having insurance.  I have talked to people that hate Obamacare but they will support and speak positively about that imageportion of the law, as it addresses ethics and doing the right thing. 

So moving on we have very complex IT Infrastructures to deal with today and many folks way over confident on where software and analytics can take us and those who are just flat out digital illiterates on how to build such systems and think anyone can create a software fix.   If you read the news, it’s all over the place and band aid partial solutions pop up up all over but have not been the “big fix” everyone wants.  In this clip below I think Mike Osinski sums it up pretty well describing the “real” world and the “virtual” world…in the real world, people need healthcare and the virtual world of algorithms seems to be on a head on collision with this fact.  He wrote the software years ago that all the banks used and abused for sub prime loans and he’s now out of the software business.

 

By the way you can scroll down to the footer to watch the full video that describes and tells you what math models and algorithms are all about today and how segmentation works.  I wrote a couple posts here recently on that topic. The entire video and it’s well worth watching as it’s the best message format that I have found that tells the layman how this works.  Health insurance is a bunch of algorithms clashing out there right now in one form or another. 

President Obama Defines Inequality As A Real Problem in the US That Needs to Be Addressed–Most of It Is Modeled By Banks and Companies With Power and Code to Move and Gain Money and Restrict Access–The System “Is” Rigged…
Insurance Business Still Clashing With Obamacare Relating to Policy Cancellations, Quantitative Driven Analytics and Pricing Collisions: “ACA Static Law” Versus “Non Static” Mathematical Insurance Profit Models…

Here’s another short clip…if you are close to the money, “you are a genius” Mike states…”you become so isolated from the real world”…and we seem to have a lot of this out there today with tech firms.  Again he no longer writes code.  I think we see this out there today and recent news articles have been reflecting this when referencing inequality.

Quantitative Methods with markets and healthcare are failing as former Goldman Quant Emanuel Derman, who teaches at Columbia states below. “You are dealing with people and people don’t work that way”…take a look and see how many Quants insurers are looking for to create new models today…insurance is the financial world. 

And now a look at studies and this is a clip from the first video in my footer, “Context is Everything”…Professor Siefe discusses the formats and reporting of some of what we see and react to today.

He talks about false positives and that lives everywhere.  Insurance companies such studies to help evaluate what type of treatments they will approve.  He talks about how the public doesn’t understand math and the formulas behind it.  Researchers too end up believing numbers that don’t have value. 

President Obama’s Decision to Extend Insurance Polices Will Help Consumers While Insurers Bring Out Their Quants to Re-Design Their Business Intelligence Profit Models-And Are We Over Segmented In Practice?

We are using math to fool ourselves.  You don’t have to look far to see abuse of formulas and we are seeing this with some big math projects as again the incentive is there to “sell you a formulas that can make nonsense believable”…”the perfect butt” example is great…but think about this and the similarities you see out there in one article after another when journalists interview a data base and create “national news”…”it must be real because it has a square root in the formula”..”just the fact that the formula exists makes it believable and worth media attention” ..”numerical nonsense is everywhere”…watch the entire video in the footer..

So again we come back around to insurers and yesterday I read an an article that insurers are “terrified” they will go out of business with allowing a delay of payment for health insurance payments…sure it’s an area to be concerned about but it’s not going to shut down any insurance company as the bigger portions of their policies are with employers and the individual policies are the minority, see what I mean about reporting and numbers?   I understand companies are in the business to make a profit and it should be done accurately and without ethic bias, but it’s not what we have out there today.  You can read about the United Healthcare case with firing doctors, and to me I say “what’s the model being used”…this is where items a such have to go someday to get to reality..it might be flawed or it might have substance..

Mathematics is a game to win says Cathy O’Neil and she tells you how the thinking goes with modeling and remember Quants are doing modeling and writing code…this is a clip from here “Weapons of Math Destruction” lecture series…what are health product models?  “People are very good at re-connecting de-identified data there’s no such thing as anonimized data” …she gives a great talk about insurance models here and how we all segmented…”you are understood by a model and put into a bin”…she says what we have today is not really insurance.

So the long and short of a lot of the issues is “flawed models” from insurers to the website and so on.  So when you think about big data you can’t ignore the models and the subsequent analytics that touted and reported.  We do need the search for accuracy and ethics in models, as the folks smarter than me have stated in the clips, we go off into a virtual world to where nothing is making sense as we are humans and it doesn’t work the way all models predict.  The hard part is figuring out where the true and value lies out there today with the over marketed world of formulas and math, as we want the good ones that work without the destruction of the bad models that hurts consumers. 

If we don’t get there, this stands to be the biggest mathematical attack on consumers ever seen along with the continued growing of inequality in the US as banks and insurers have pretty much morphed into just big software companies that control a lot of money and access.   If you liked the clips you view the entire videos in the footer or hop on over to the Algo Duping page where I have a few more videos and links on the topic.  BD 

Not Obamacare That is Failing, It’s the Models and Subsequent Algorithms that Execute Within IT Infrastructures Intersecting, Changing And Conflicting– The Affordable “Complexities” Act…

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