It looks like we have a breakthrough here with perhaps a new type of law or at least some baby steps to get there. I have said for the last 2 years we may need a “Department of Algorithms” to legally file and enforce laws. This is coming and it’s just a matter of time until some folks come out of tech denial and accept the fact.
“Department of Algorithms – Do We Need One of These to Regulate Upcoming Laws?
Somebody the other day was talking about an former analyst they hired from a health insurance carrier, in other words one who does the business intelligence and feeds management the daily status of affairs on company business. The analyst’s job was to runs algorithms against other algorithms she uses for research. (there’s that word again). Further comments were made to the effect that the health insurance company changes the algorithms for claim, eligibility, according to how loud the public cried. Until tolerance levels raise to the point of almost being intolerable, nothing changed.
If you think all your claims are handled by a human, well guess again, they are not, they are algorithmically scored and processed, sometimes by contracted 3rd parties who charge a transaction fee for this service, so your health care claims are not 100% handled in house. Nobody seems to want to accept this or see this is reality so this is why we have swords and daggers and the health insurance companies have machines guns, real simple. Who’s wins that battle most of the time?
They love, feed and thrive financially on the ignorance of others.
How to Fight Algorithmically “Scored” Health Care Claim Denials – Line Up and Deliver Your Own Data
It’s in the data and the algorithms and the “snow” job that algorithms can create, and those who do not understand the concept, don’t know how to do battle and unfortunately this is about 90% of what we have in Congress today, and why we keep losing and why nobody does much other than starting a blog to ask for ideas – they have no clue on the impact of technology with healthcare and financial institutions today, who use these to the max and generate big profits. You can’t fight principles and values against algorithms as they run 24/7, we don’t go 24/7 and need sleep. In the link below, the folks over at Xconomy agree with me on this fact.
Intellectual Property Technology Has Arrived – Digital Algorithmic Formats Needed Now to Enforce and Protect
In the meantime I can perhaps hope that maybe this law will involve some algorithms so it has teeth and not just big bundles of text that nobody has time to read. Digital laws would require some algorithmic business plans to be filed so we can determine how the insurance carriers arrive at their figures, beyond what is filed with the SEC, as those are reports and perhaps not the formulas on how their business models are run, remember Harry Markopoulos and how he stated that the SEC didn’t know how to handle or what to do with the data he gave them? BD
Moved to action by the proposed Anthem Blue Cross premium increases, Senator Dianne Feinstein, Democrat of California, said Friday that she would introduce legislation to create a “national Medical Insurance Rate Authority” to prevent unfair rate increases by private insurers.
Anthem recently informed policyholders that premiums would increase by as much as 39 percent, prompting outrage among public officials in California and Washington.
Feinstein to Propose Federal Supervision of Insurance Rates - Prescriptions Blog - NYTimes.com
According to the market-research group Datamonitor, medical inflation is the reason for yearly increases of 8% in health insurance premiums. The steady progress in the development of new drugs, therapies and equipment used to diagnose medical conditions and the resulting costs are an obvious reason for this. This is understandable and everyone wants the latest in diagnostics and treatments. Equipment becomes obsolete with time and invariably the very words newer and improved mean a rise in cost.ReplyDelete