In September 2022, the White House hosted a conference that focused on nutrition, health, and hunger in America. Dariush Mozaffarian, one of the main organizers of the event, is a cardiologist and Dean of the Tufts School of Nutrition. He and his students developed a new food pyramid. It took three years and used taxpayer funds to complete.

Here is a portion of the results of that study highlighted in the Tufts Food Compass

And – in case you missed it – several weeks ago, during a TV interview, Kellogg’s CEO Gary Pilnick stated that those struggling to pay for food should just eat cereal for dinner, sparking outrage about companies profiting from inflation with some even calling for a boycott of Kellogg’s products.

Smile! You’re being filmed & recorded

Word is out (in some circles) that AI assisted medical diagnosis is coming to a medical group near you. Doctors using algorithms to diagnose medical conditions is particularly troublesome for patients with sub-clinical conditions and symptoms that don’t fit an easy identification. That, however, is just a preview of what one physician has called “a new horror show.”

There is also a plan afoot to video and record patient visits. Imagine your pelvic or prostate exam videoed! The hacking and misuse potential is troubling to say nothing of the general embarrassment level for patients.

This implementation can be blocked if enough states wake up to the potential abuse and become pro-patient for a change. The following states require two-party consent to a meeting being recorded. They are California, Delaware, Florida, Illinois, Maryland, Massachusetts, Montana, Nevada, New Hampshire, Pennsylvania, and Washington.

One way to start pushing back as a patient if you live in any of the all-party consent states, is to notify your doctors that you do not consent to having your visits recorded and you want that noted in your records. You will probably need to remind them at the time of scheduling and when you walk in for the exam. Patient resistance before this even gets off the ground could slow or limit implementation. *

Want to know what a medical doctor who bravely contributes to a well-respected website thinks? Here is his take: “For starters –I understand this is already in beta format. I’ve heard about it through the grapevine from doctors who are already involved.

“There will be cameras and microphones in the exam room. Recording both the audio and video of everything that is done. The AI computer systems will then bring up the note for the visit from thin air – after having watched and listened to everything in the room. Please note – I believe every one of these systems is done through vast web services like AWS. That means your visit and private discussions with your doctor will be available on the internet.

“This is already being touted to ‘maximize efficiency’ and ‘improve billing.’ My understanding from those that have been experimented upon as physicians, is that as you are completing the visit, the computer will then begin demanding that you order this or that test because AI is also a diagnostician and feels that those tests are critical.

It will also not let you close the note until you have queried the patient about surveillance stuff like vaccines and a colonoscopy; even for visits for stubbed toenails. And unlike now when you can just turn that stuff off, it is in control and watching and listening to your every move. The note will not be completed until it has sensed you discussing these issues with your patient and satisfied that you pushed hard enough.

“I understand also that there is a huge move to begin the arduous task of having AI take over completely things like reading x-rays and path slides. Never mind the medicolegal issues with this – i.e. does the AI have malpractice insurance? Does it have a medical license? Who does the PCP talk to when there is sensitive material to discuss with a radiologist, as in new lesions on a mammogram etc.? Are we to discuss this with Mr. Roboto?

“There are days I am so, so glad I’m going to likely retire long before all of this really comes to fruition. All I can say is live as healthy a life as you can. Your medical system is very soon going to throw a rod.”

The Cart Before the Horse

The Cart

Although the details have yet to be ironed out, Connecticut plans to cancel $1 billion in medical debt by investing $6.5 million in funds from the 2021 American Rescue Plan Act. They have formed a partnership with RIP Medical Debt to abolish approximately $650 million in medical debt for eligible state residents. For every $100 invested, RIP Medical Debt abolishes $10,000 of debt.

Connecticut residents would be eligible if their medical debt equals 5% or more of their annual income or if their household income is less than 400% of the federal poverty line. Residents affected by the initiative would be notified that their medical debt is eliminated. A contract has not been finalized, and a timeline for implementation has not been announced.

Last fall, the Biden administration outlined plans to develop federal rules barring unpaid medical bills from affecting patients’ credit scores. The regulations, if enacted, potentially would help tens of millions of people who have medical debt on their credit reports, eliminating information that can depress consumers’ scores and make it harder for many to get a job, rent an apartment, buy a house, or secure a car loan.

The Horse

According to KFF research data, medical debt remained a significant issue in the U.S., including among people with health insurance. In 2021, 23% of U.S. adults had one or more unpaid and past due bills from a medical service provider.

Among adults, 24% say they had medical or dental bills that were past due or that they could not pay, and a total of 41% had some type of health care debt, including on credit cards or owed to family members. “Medical debt and other forms of financial instability affect people and households across the income spectrum and can cause individuals to forgo needed care.” Medical debt has become a defining feature of the U.S. health care system.

What? We can’t find a way to offer universal healthcare for Americans but the powers that be can find a way to take medical debt away? What if we didn’t have to go into debt at all for seeking health and medical services?

Wishing You a Happy Spring

*Related to the concern about storing patient date – audio and visual – here is the latest from UnitedHealth: UnitedHealth’s recent cyberattack underscores this fact: no entity is immune to the threat of cybercrime. This breach resulted in the potential theft of sensitive patient data to be used for what? To simply annoy or challenge UnitedHealth’s ungodly control of our health or worse? For now, no one knows.

Photo credits: The Joker – aadesh-thapa, Doctor – sasun-bughdaryan, Happy Spring – theo-onic.