Well, this has been a long time coming. Something like 15 -16 years, if memory serves me correctly. At my age, that is always suspect. Honest. Trust me.

One of many accomplishments President Obama gave us was the Affordable Care Act health insurance. Two of the best things about the ACA were the affordability, especially with the subsidies, and that people with pre-existing conditions could not be refused insurance. That alone makes it worth while in my oh-so-humble opinion.

From the day the ACA passed, Republicans have been rather bellicose they had a new and improved health insurance ready, and it would be presented to the public in a couple of weeks. Well, after all these years’ worth of “two-weeks” the very stable genius has come up with a marvelous solution—send everyone $2,000 and let them buy what they want. 

I can see a couple of things wrong with that before I’ve finished my first cuppa the morning: 1. they won’t find any insurance willing to take pre-existing conditions for that amount of money and 2. people will spend the money on frivolous things like groceries which they also can’t afford but the effect on their families is more immediate. 

Believe me, I don’t want to have to go out into the open market and look for insurance. Nothing would please the insurance companies more than to have this become law. The system will be gamed, if not by the big companies, by all the start-ups that will come along to help take your money, but deny you benefits. (When did I become such a cynical old lady?)

I hope this bill, if it passes, does not affect you, or anyone you know. Healthcare should be a right of everyone in this country, not just the fortunate few.  

Speaking of health and insurance coverage, how would you feel, let along think, about having a computer diagnose your illness?

Because MDs went to school for several years to learn medicine, and how to best practice it to get and keep their patients healthy, and now find themselves in the examining room with their medically ignorant congressman/congresswoman standing just behind and to the side of them, telling them what they can and cannot prescribe. Medicine D, M, and Z are authorized, but none of the others especially if one of the others will help the patient even though the others are what common sense and good medicine tell the MD s/he needs to prescribe.

MDs have left not just certain states, but the entire country to go to other countries where they are not just allowed to practice good medicine but are expected to practice good medicine. This has left many areas, especially rural areas and towns in what are called medical deserts. 

And now, our doctors who have stayed, are over worked. And when those people living in a medical desert need help, they may have to deal with Dr. Computer for diagnosis, and prescriptions. My PCP belongs to a clinic which is part of a hospital, which in turn belongs to an ever-larger hospital network. Do I need to make an appointment? Ask my medical team a non-emergency question? I must log into a data base. Then I must choose from a menu, and ever more, if I need to send a message, I must do it through Grace, the database’s AI. Of course, she only understands a portion of what I’m asking, because I refuse to take my simple request down to one syllable words, with no more than four words per sentence. Eventually she gives me a command to type the word Message in the box, and then, I am given the new screen which says she will forward my message to my medical team. 

I am not fond of a lot of AI, and yet, I am very fond of some of it. I can take a picture of a duck in my pond, click on the correct button in my phone, and find out what kind of duck it is. Same with plants. And I’ve just discovered I can click on a 3D button next to my photo, a light scrolls up the picture, and voila! it’s in 3D. It’s amazing. Of course, I’m relatively confident that Auto-Correct is also AI. And we all know what I think of that, don’t we?

A friend tells me there is nothing to fear in AI, it’s only a tool. But who is using the tool? How are they using it? I just finished reading The Worlds I See: curiosity, exploration, and discovery at the dawn of AI by Dr. Fei-Fei Li, professor of computer science, Stanford University, and founding director, Stanford Institute for Human-Centered AI.

Li’s book is a double memoir. It is the memoir of her family coming to America from China when she was in high school, and her memoir of fascination with physics and how she became one of the movers and shakers of the founding of AI. I found it well written, riveting in the way she wrote about herself and family and seamlessly moved into school and profession. After finishing her book, I have less fear of AI, though there are some out there who would use it if given the opportunity, in nefarious ways. 

Because of the work she has done with the medical community, I think I have less fear of Dr. Computer than I may otherwise have, but my fear of Grace, and having to go through her is extant. I easily envision Grace telling me, I must allow all my information into the AI database or I cannot continue. I have no problem seeing Grace tell a patient they do not qualify to talk to Dr. Computer as they have a pre-existing condition of in-grown toenails. Dr. Computer, if one can ever get to her/him, does not have history with the patient. I well remember years ago when I told my gynecologist that I got headaches that would bring an elephant to its knees every month, and he said, “take Tylenol.” Yeah, doc, did you read my chart? I’m freaking allergic to Tylenol! (Last time I went to him.) But my PCP said, “I know you. You do not have an addictive personality. Here’s a prescription for Percodan (four pills) and Imitrex (two pills). The next time you get the headache, take an Imitrex. If not gone in 20 minutes, take the second Imitrex. If not gone in 20 minutes, take a Percodan.” Ten minutes after the second Imitrex, I nearly passed out at the sudden cessation of pain. Quickest way he’d ever found to determine if my headaches were migraines (they were) or something more testing would be needed on (not). How do you talk with a Computer?

So, in order to get your $2,000 check, how many new and existing insurance companies will send you to Dr. Computer, the only MD on their approved list at your rate of pay, who will hang up once s/he tells you to take Aspirin (I think Tylenol is on RFK’s s**t list now.) and if you call back to remind the AI that you’re allergic, or have tried it, another visit is logged against you. 

The Orange Pustule said something the other day about his moral authority being the only check on his actions he needs. Once again, I’m terrified of the hands who wields AI.

If you enjoy TED Talks, check this one out, Fei-Fei Li, AI pioneer.

And, yes, there are entertainments in AI that brings smiles. At least I think it’s AI. 

Great Blue Heron helps himself to our little frogs. Claw and beak in real time out my office window.