Medical AI's cost-benefit dilemma

There's a basic question hanging over the clinical AI tools that are already flooding the health care system: Who exactly are they working for?Why it matters: We're approaching a world where AI may make the kinds of decisions that clinicians have been responsible for, without ethical concerns or other factors inherent to human decision-making. Driving the news: Bob Wachter, chair of the Department of Medicine at the University of California, San Francisco, outlined the stakes in a Substack post titled "Healthcare's Alignment Problem: A Preexisting Condition."Decision support tools will be saddled with the same problem that human providers face: There's rarely one "right" decision in medicine, and choosing a course of action is heavily dependent on weighing factors such as cost against what's best for the patient. "If the machine is spring-loaded to optimize care for every individual, we've put our entire system, indeed our society, on a path toward bankruptcy. But make cost-effectiveness the default setting, and 'AI death panels' will reenter the public discourse within a week," Wachter writes.Between the lines: The widespread deployment of AI-enabled tools means algorithms could …

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