For over seventy years, mathematicians and scientists have been exploring and expanding the possibilities of artificial intelligence (AI). Now, in an era of “big data,” AI has seeped into almost every sector of society, including healthcare.[1] The use of AI tools, if left unchecked, could create unintended consequences, such as denying people access to services or impairing civil rights.[2] In an effort to address these issues, the White House recently released a plan called Blueprint for an AI Bill of Rights, which would guide the development of artificial intelligence (AI) systems in a way that would help protect people’s rights, while enhancing equity and racial justice.
The blueprint contains five guiding principles, along with recommendations on implementation.
- Safe and Effective Systems. This involves the creation of systems “designed to proactively protect you from harms stemming from unintended, yet foreseeable, uses or impacts of automated systems.”
- Algorithmic Discrimination Protections. This occurs when AI systems advance “unjustified different treatment or impacts disfavoring people” based on traits such as race, ethnicity, age, sex, or disability. The White House recommends including “proactive equity assessments” in the AI design.
- Data Privacy. The goal is to protect individuals from abusive data practices through “built-in protections” and ensuring that people have power over the usage of their personal data. In sensitive domains, such as healthcare, automatic systems that “collect, use, share, or store data” should meet enhanced data protections.
- Notice and Explanation. People should be able to know when an AI system is being used and understand how it impacts their lives. This means AI developers should provide a user-friendly document with descriptions of the AI and role the automation plays.
- Human Alternatives, Consideration, and Fallback. The White House recommends that people are provided with the option of opting out of automated systems and that they should be able to access a human when appropriate.
The Center for Medicare Advocacy welcomes the creation of AI standards that would potentially protect people’s rights while increasing transparency and accountability. The Center is aware that when AI-powered decision-making tools are used by Medicare Advantage plans to make coverage decisions, those decisions may be more restrictive than Medicare coverage criteria, potentially leading to premature terminations of coverage or continuation of care for beneficiaries.[3] Earlier this year, the Center published a report which further outlined our growing concerns around Medicare Advantage’s use of AI. The Center continues to investigate AI-powered decision coverage issues that potentially impede people’s access to needed healthcare.
October 13, 2022 – C. St. John
[1] Anyoha, R. The History of Artificial Intelligence. Science in the News. (Aug. 28, 2017). Available at: https://sitn.hms.harvard.edu/flash/2017/history-artificial-intelligence/
[2] The White House. Blueprint for an AI Bill of Rights. The White House. (Oct. 4, 2022). Available at: https://www.whitehouse.gov/ostp/ai-bill-of-rights/
[3] St. John, C. “When Artificial Intelligence in Medicare Advantage Impedes Access to Care: A Case Study.” The Center for Medicare Advocacy. (April 21, 2022). Available at: https://medicareadvocacy.org/ai-plus-ma-equals-bad-care-decisions/