The Senate Finance Committee contemplated the future yesterday: artificial intelligence and its potential applications to health care.
And it turns out the future looks an awful lot like the past and present: Democrats want regulations. And the industry wants money.
âThere are a lot of reasons to be optimistic,â Finance Committee Chair Ron Wyden (D-Ore.) said. But, he warned, algorithms need regulation and accountability to make sure they arenât producing bad or biased recommendations that deny care or lead to inappropriate care.
He expressed outrage at the results of led by Ziad Obermeyer, a University of California at Berkeley associate professor, who found that one commercial algorithm recommended less health care for Black patients based on historical cost data.
âHow does such a flawed system make its way into general use?â Wyden said. âNobodyâs watching. No guardrails. No guardrails to protect the patients from flawed algorithms and AI systems.âÂ
Itâs unclear whether this algorithm is still being marketed, Obermeyer testified later.
The hearing marked Congressâs latest attempt to wrap its head around the newest AI systems, which can mimic some forms of human reasoning to make predictions and calculations, or generate text and images that look deceptively human-created.
Wyden touted his âAlgorithmic Accountability Act,â a bill intended to force companies to assess their own products and require the Federal Trade Commission to collect and report data on AI systems. But Republicans indicated that they donât want to move quickly on the emerging technology.Â
AI is already prevalent in health care; doctors use the systems to distill patient visits into clinical notes and to point out potentially cancerous lesions or polyps, for example. Accordingly, thereâs big Washington muscle behind the algorithms: CNBC â from 158 to over 450 â in the number of organizations lobbying on AI regulations.
Industry leaders â and the committeeâs Republicans â didnât explicitly refute the need for regulations at Thursdayâs hearing. But their vision for it was more constrained and, in one instance, raised the question: Can tech watchmen watch the tech watchmen?
Take Sen. Bill Cassidy (R-La.), who mused at the end of the hearing that AI models could wind up rating AI models. Asking for responses from witnesses, he reminded them to âplease be tight with your answersâ â and cut them off soon after most told him that humans needed to evaluate the models.
âPractically, that seems like thatâs going to be incredibly cumbersome,â he informed University of Chicago Provost Katherine Baicker. âThat seems impossible,â he told Mark Sendak, co-leader of Dukeâs Health AI Partnership, about the researcherâs proposals on the need for local human oversight of algorithms.
The committeeâs senior Republican, Sen. Mike Crapo (Idaho), acknowledged in a statement the importance of âtransparencyâ in AI systems. But he also decried the idea of quickly legislating on AI through âone-size-fits-all, overly rigid, and unduly bureaucratic laws.â
While proposals to regulate AI were contentious, one idea drew support from Republicans, the panelâs witnesses and even some Democrats: the need for industry to be paid for its innovations.
âAs game-changing AI-enabled devices and other technologies emerge, Medicare coverage and payment policies must keep pace,â Crapo said in his statement.
Sen. Bob Menendez (D-N.J.) noted that according to recent research, Medicare reimburses âfewer than 20â AI services, before asking whether more payments would be useful. Other senators also indicated support for more cash to the industry.
Peter Shen, head of digital and automation at Siemens Healthineers, proposed that tech manufacturers submit cost data to Medicare and receive five years of payments. Otherwise, the governmentâs âinconsistent, unpredictableâ approach would stifle innovation, he argued.
Sendak said health providers lack infrastructure and training to use AI, noting the billions of dollars the government spent to encourage them to adopt electronic health records. âWe need similarly bold action now,â he said in written testimony.
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