[HN Gopher] ChatGPT Health is a marketplace, guess who is the pr...
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       ChatGPT Health is a marketplace, guess who is the product?
        
       Author : yoaviram
       Score  : 195 points
       Date   : 2026-01-08 14:40 UTC (2 days ago)
        
 (HTM) web link (consciousdigital.org)
 (TXT) w3m dump (consciousdigital.org)
        
       | Forgeties79 wrote:
       | There's no real smoking gun here showing what they are taking,
       | storing, and using (or how they're using it). But I do agree that
       | nobody should dive in to this until that's better understood as
       | it is likely they are not following HIPAA and will not respect
       | your privacy. Definitely not when there's money on the table.
       | Given their track record the concern is warranted.
        
       | zkmon wrote:
       | Google did that, Facebook did that and every other company who
       | boasted their user-base numbers did that. They sold user
       | attention and harvested user data. Nothing new here.
        
       | seydor wrote:
       | ChatGPT mostly refuses to talk health issues , while i have found
       | Gemini is reasonably cooperative when asking for things like
       | symptoms and treatments .
       | 
       | This makes me not wanting to try out their new offering.
        
         | pruetj wrote:
         | Is that foreshadowing of ChatGPT redirecting users to ChatGPT
         | Health in some way? Base product no longer answers everything,
         | now I need to pay an add-on fee to talk about health related
         | things?
        
           | kmoser wrote:
           | I doubt it. It's probably a CYA thing. There are a whole
           | bunch of hot-button topics ChatGPT won't talk about, not
           | because OpenAI will ever try to monetize them but because
           | they're fodder for lawsuits.
        
         | astura wrote:
         | What sorts of things did it refuse to talk to you about? I've
         | talked with it about my health extensively and uploaded lab
         | reports which it happily interpreted.
        
           | seydor wrote:
           | it reads the lab report but every one of its answers is
           | prefaced with a refusal. It does provide some information but
           | insists on general answers.
           | 
           | Example phrases it uses: "I can't give medical advice or tell
           | you what to do based on this report". "I will keep this
           | general and informational, not personalized medical
           | instructions."
        
             | astura wrote:
             | Weird, This is not my experience at all. For example,
             | here's chat gpt giving me an incorrect diagnosis (the
             | anemia is due to a genetic condition, not iron deficiency).
             | 
             | =============
             | 
             | You said: MyChartPLUS - Test Details.pdf PDF Can you
             | interpret these blood test results ChatGPT said: Here's an
             | interpretation of the blood test results you provided:
             | 
             | White Blood Cell Count (WBC) Value: 9.2 (Normal: 3.8 - 10.8
             | Thousand/uL)
             | 
             | Within the normal range, indicating no immediate signs of
             | infection or inflammation.
             | 
             | Red Blood Cell Count (RBC) Value: 5.29 (Normal: 3.8 - 5.1
             | Million/uL)
             | 
             | Elevated (High). This could indicate dehydration, stress,
             | or other conditions like polycythemia.
             | 
             | Hemoglobin Value: 10.9 (Normal: 11.7 - 15.5 g/dL)
             | 
             | Low. Suggests anemia, possibly due to iron deficiency or
             | chronic disease.
             | 
             | Hematocrit Value: 36.0% (Normal: 35.0 - 45.0%)
             | 
             | Within the normal range, but on the lower side, supporting
             | the presence of mild anemia.
             | 
             | Mean Corpuscular Volume (MCV) Value: 68.1 (Normal: 80.0 -
             | 100.0 fL)
             | 
             | Low. Indicates microcytic anemia, often due to iron
             | deficiency.
             | 
             | Mean Corpuscular Hemoglobin (MCH) Value: 20.6 (Normal: 27.0
             | - 33.0 pg)
             | 
             | Low. Suggests hypochromia (paler red blood cells), often
             | associated with iron-deficiency anemia.
             | 
             | Mean Corpuscular Hemoglobin Concentration (MCHC) Value:
             | 30.3 (Normal: 32.0 - 36.0 g/dL)
             | 
             | Slightly low. May reflect reduced hemoglobin in red blood
             | cells, consistent with iron-deficiency anemia.
             | 
             | Red Cell Distribution Width (RDW) Value: 15.8% (Normal:
             | 11.0 - 15.0%)
             | 
             | Elevated. Indicates variability in red blood cell size,
             | common in iron-deficiency anemia.
             | 
             | Platelet Count Value: 397 (Normal: 140 - 400 Thousand/uL)
             | 
             | Normal, but on the higher side of the range.
             | 
             | Other Key Metrics Absolute Neutrophils, Lymphocytes,
             | Monocytes, Eosinophils, Basophils: All within normal
             | ranges, suggesting no significant abnormalities in immune
             | cell populations.
             | 
             | Anisocytosis (1+): Indicates variation in red blood cell
             | size.
             | 
             | Hypochromasia (1+): Suggests pale red blood cells,
             | supporting iron-deficiency anemia.
             | 
             | Summary These results suggest iron-deficiency anemia,
             | characterized by low hemoglobin, low MCV, low MCH, and high
             | RDW. The elevated red blood cell count may reflect
             | compensatory mechanisms or mild dehydration.
             | 
             | Your provider recommends a heart-healthy, low-fat diet,
             | which is great for overall health. However, addressing the
             | anemia might also involve increasing dietary iron or taking
             | iron supplements.
             | 
             | If you have symptoms such as fatigue, shortness of breath,
             | or dizziness, it's advisable to follow up with your
             | healthcare provider for further management.
             | 
             | =============
             | 
             | Later on (months later) I gave it a different lab report
             | that contained iron as well, and without the iron
             | deficiency red herring it guessed correctly.
             | 
             | =============
             | 
             | You said: lab.pdf PDF ChatGPT said: Here's what jumps out
             | from your lab report. lab
             | 
             | Lipids (fasting) Total cholesterol 139, LDL 72, non-HDL 94
             | - these are excellent / low-risk numbers.
             | 
             | Triglycerides 141 - normal (borderline-ish but still under
             | 150).
             | 
             | HDL 45 (flagged low) - for women the lab's cutoff is >=50,
             | so it's "low" by that reference range, but your overall
             | atherogenic profile (LDL/non-HDL) is still very strong.
             | 
             | CBC: clear microcytic anemia pattern These are the key
             | pieces:
             | 
             | Hemoglobin 10.5 (low) and Hematocrit 34.9 (low) - anemia.
             | 
             | MCV 67.8 (low) + MCH 20.4 (low) - red cells are small and
             | low-hemoglobin (microcytic, hypochromic pattern).
             | 
             | RBC count 5.15 (slightly high) + RDW 15.8 (high) and
             | morphology showing anisocytosis - this combo is important.
             | 
             | Iron studies: not iron-deficiency looking Ferritin 109
             | (normal)
             | 
             | Iron 83 (normal)
             | 
             | % saturation 24 (normal)
             | 
             | TIBC 343 (normal)
             | 
             | That's not the classic pattern of iron deficiency (where
             | ferritin is usually low and iron saturation often low). lab
             | 
             | What this combination often suggests With microcytosis +
             | anemia + a relatively high RBC count and normal
             | ferritin/iron, one of the more common explanations
             | clinicians consider is a hemoglobin variant/thalassemia
             | trait (especially beta-thal trait), though this is not a
             | diagnosis by labs alone.
             | 
             | There are other possibilities too (less common, but part of
             | the "microcytic anemia with normal iron" differential), so
             | the right next step is targeted follow-up testing rather
             | than guessing.
             | 
             | What I'd ask your clinician about next Repeat CBC (to
             | confirm) + reticulocyte count
             | 
             | Peripheral smear review (if not already done beyond the
             | automated morphology flags)
             | 
             | Hemoglobin electrophoresis (or HPLC) to evaluate for beta-
             | thalassemia trait/hemoglobin variants
             | 
             | If electrophoresis is normal but suspicion remains: alpha-
             | thalassemia testing can be considered (often not seen on
             | standard electrophoresis)
             | 
             | If there's any reason to suspect it: lead level (uncommon,
             | but classic cause of microcytosis)
             | 
             | When to seek urgent care vs routine follow-up Routine
             | follow-up is usually fine, but get urgent evaluation if you
             | have:
             | 
             | chest pain, fainting, severe shortness of breath at rest
             | 
             | black/tarry stools, heavy ongoing bleeding, or rapidly
             | worsening symptoms
             | 
             | If you tell me whether you've had heavy periods, recent
             | pregnancy/postpartum, GI symptoms, or a known family
             | history of anemia/thalassemia, I can help you interpret
             | which follow-up path is most likely to be useful--but even
             | without that, the "microcytic anemia + normal iron studies"
             | piece is the main thing to bring to your ordering
             | clinician.
             | 
             | =============
        
         | trollbridge wrote:
         | It's quite easy to "jailbreak" by asking it to discuss
         | hypotheticals, help you write accurate information for a
         | fictional account, etc.
        
         | ramoz wrote:
         | Ive had fairly complex health issues and have never had issues
         | with ChatGPT - other than I worry about the vast majority
         | people in my scenario who do not understand AI.
         | 
         | AI can enable very misleading analysis and misinformation when
         | a patient drives the conversation a certain way. Something I've
         | observed in the community I'm a part of.
         | 
         | Not talking about acid reflux or back pain.
        
         | levocardia wrote:
         | "While I can't provide medical advice..." is the 2025 version
         | of "As a large language model trained by OpenAI..."
        
       | aurareturn wrote:
       | Do users find value in it? Thats the ultimate question. I think
       | it is a resounding yes.
        
         | MattRix wrote:
         | Users found value in leaded gasoline too.
        
           | glemion43 wrote:
           | Which is not a helpful argument in this discussion.
           | 
           | It's to blunt and feels more ignorant.
        
             | PunchTornado wrote:
             | If you have nothing to say, but insult the other, better
             | not to post.
        
               | glemion43 wrote:
               | I clearly say something.
               | 
               | I evaluate transparent his argument
        
             | MattRix wrote:
             | I think the argument that "value to users is the only thing
             | that matters" is the blunt one. My point is that most
             | situations are much more nuanced than that.
        
       | DudeOpotomus wrote:
       | Dystopian and frankly, gross. Its amazing to me that so many
       | people are willing to give up control over their lives and in
       | this case, their bodies, for the smallest inkling of ease.
       | 
       | The only thing you have control of in this world is your body
       | (men only, women have already been denied body autonomy in the
       | US), so giving this to the very entities that "do harm" as
       | opposed to those who pledge to "do-no-harm", is straight up
       | bonkers.
       | 
       | It's not the data or the use of said data for the intended
       | purpose. There is a law of sorts in life that says what ever they
       | promise, it will be broken. The data and its intended purpose
       | will be perverted and ultimately used as a weapon against the
       | very people who provided the data.
        
         | azan_ wrote:
         | > Dystopian and frankly, gross. Its amazing to me that so many
         | people are willing to give up control over their lives and in
         | this case, their bodies, for the smallest inkling of ease.
         | 
         | I've read people with chronic conditions reporting that chatgpt
         | actually helped them land correct diagnosis that doctors did
         | not consider so people are not just using that for "inkling of
         | ease".
        
           | DudeOpotomus wrote:
           | Yes, trading your privacy and autonomy for perceived ease is
           | how they are going to steal your future and your freedom.
        
             | azan_ wrote:
             | Please read my comment again. If you lived with chronic
             | pain that multiple doctors failed to correctly diagnose and
             | ChatGPT actually suggested correct diagnosis then you
             | wouldn't call it just perceived ease, but something that
             | made your life much, much better. I'm doctor and I'm all
             | for empowering patients (as long as they consult ChatGPT
             | output with actual doctors). It's very easy to criticize
             | people resorting to llms if you do not have any rare
             | debilitating condition that's not correctly diagnosed.
        
               | Forgeties79 wrote:
               | What they seem to be saying is "this is how they get
               | you," which I agree with. Whether or not it's immensely
               | helpful is not being debated. There's a very serious cost
               | no matter what.
        
               | DudeOpotomus wrote:
               | With all due respect, you are thinking like a good
               | person, a human being who spent decades of their life to
               | learn how to care for people. You took a pledge to Do-no-
               | Harm. You are looking at these tools as tools.
               | 
               | The owners and future owners of said data do not care
               | about anything other than profits and exploitation. They
               | do not care about the patient, the doctor let alone the
               | consequences of their doings. They took a pledge to make-
               | profits regardless of the harm. A position fundamentally
               | opposed to that of the medical doctor.
        
               | cm2012 wrote:
               | I'll take a mysterious and amorphous future risk of
               | privacy violations any day over current chronic pain.
        
               | Forgeties79 wrote:
               | It's not mysterious and amorphous. We have seen the
               | results with social media for what? 15 years now? This is
               | a known issue with clear parallels. And health data is
               | _way_ riskier to have floating around.
        
         | lotsofpulp wrote:
         | How is someone seeking for a way to deal with an inherited or
         | environmentally caused illness giving up control of their body?
        
           | wiseowise wrote:
           | Don't forget that majority of the commenters on this platform
           | live in a country that views suffering in pain from incurable
           | disease as a "god intended way" (and a horse dose of
           | morphine). Take it with a grain of salt.
        
             | ImPostingOnHN wrote:
             | Setting aside that you're factually incorrect, this sort of
             | negative stereotyping of others based on their nationality
             | (or ethnicity, or race) is inappropriate, especially on
             | this forum. We don't need more bigotry here.
        
           | DudeOpotomus wrote:
           | You will be assigned an individualized risk figure that will
           | determine whether or not you are given coverage and
           | treatment. Those decisions will happen without you or any MDs
           | involvement. You will never know it happened and it will
           | follow you for the rest of your life and your children's
           | lives.
        
         | wiseowise wrote:
         | > Dystopian and frankly, gross. Its amazing to me that so many
         | people are willing to give up control over their lives and in
         | this case, their bodies, for the smallest inkling of ease.
         | 
         | You have to be extremely privileged to say something like this.
         | 
         | a) nobody is giving up control of their lives
         | 
         | b) get off your high horse, son
        
         | glemion43 wrote:
         | Blah blah blah.
         | 
         | I have a more niche genetic issue and I'm glad for you that you
         | can think like this but no one cares enough to do the proper
         | research for my problem.
         | 
         | If ml, massive compute, Google/chatgpt health do something in
         | this direction (let's be honest anything) I'm glad for it.
        
           | DudeOpotomus wrote:
           | You will be denied coverage and treatment because you
           | volunteered your personal data with zero controls over its
           | use and your rights. \
        
             | lotsofpulp wrote:
             | Denied by who? Most developed nations will not, including
             | the US. Either way, that's a separate problem solved by
             | legislation or increased wealth transfers. Denying people
             | information doesn't help.
        
               | DudeOpotomus wrote:
               | A truly naive understanding of American business and
               | politics.
        
           | threetonesun wrote:
           | Do you believe that ChatGPT is doing the the research? I'm
           | all in favor of better access and tools to research but at
           | least in the US all of the research is being defunded, we're
           | actively kicking researchers out of the country, and a bunch
           | of white billionaires are proposing this as an alternative,
           | based on training data they won't share.
           | 
           | This is a product feature that invalidates WebMD and the
           | like. It does not solve any health problems.
        
       | kaffekaka wrote:
       | Once again, glad to live in Europe.
        
         | _qua wrote:
         | If you lived in the US and you didn't like this product, you
         | can just choose to not use it. What benefit do you as a citizen
         | of Europe derive from having this withheld from you?
        
           | b3kart wrote:
           | > you didn't like this product, you can just choose to not
           | use it
           | 
           | This is an over-simplification. I might like the product, but
           | not be aware of the various ways it violates my privacy.
           | Having laws that make it more risky for companies to do
           | nefarious things makes me more confident that if a product is
           | available in the EU market it doesn't do obviously bad
           | things.
        
           | trollbridge wrote:
           | "You can just choose not to use it", sure, until signing a
           | consent form to use ChatGPT becomes mandatory for a doctor
           | visit, just like all kinds of other technology (like having a
           | cell phone to verify SMS, for example) is basically essential
           | now to function in society.
        
             | gordian-mind wrote:
             | Doctors in Europe already use LLMs to treat you.
        
               | stevekemp wrote:
               | That sounds like the kind of hallucinated statement you
               | might expect from ChatGPT.
               | 
               | Which doctors, in which countries, are using LLMs to
               | treat patients?
        
               | lurking_swe wrote:
               | i'm not the person you replied to. but a quick google
               | search is just as much effort (on your part) as replying
               | with a sassy "this sounds like a hallucination". A low
               | value comment in my opinion.
               | 
               | I found this:
               | 
               | https://www.who.int/europe/news/item/19-11-2025-is-your-
               | doct...
               | 
               | Quote:
               | 
               | > "AI is already a reality for millions of health workers
               | and patients across the European Region," said Dr Hans
               | Henri P. Kluge, WHO Regional Director for Europe. "But
               | without clear strategies, data privacy, legal guardrails
               | and investment in AI literacy, we risk deepening
               | inequities rather than reducing them."
        
           | Forgeties79 wrote:
           | I get some of us here in the US have a near-allergic reaction
           | to regulations or prohibition of any kind, but come on man.
           | At some point you have to acknowledge we need the government
           | to protect us from corporate greed, even on rare occasion.
           | "Just don't use it" is not a real argument when basically
           | everyone is now expected to use LLM's at work and beyond
        
             | _qua wrote:
             | Well, I've really love being protected from cookies. Has
             | done wonders for my experience on the web.
        
           | kaffekaka wrote:
           | It is not that "this product is withheld from me". It is that
           | we have laws to protect against abusive corporations. ChatGPT
           | Health not being launched in EU is because OpenAI themselves
           | realized it abuses peoples privacy.
        
       | nusl wrote:
       | I find it ironic that the article is warning against AI use while
       | it uses an AI-made cover image. Surely they find the same fault
       | with copyright issues and AI art? Right?
        
         | tigerBL00D wrote:
         | There's some irony in that, sure. But at the heart of the
         | matter is privacy. It's about what you input into the chat, not
         | about the output.
        
         | atmosx wrote:
         | It's not against AI. It's against privacy issues arising though
         | data mining & double speech.
        
       | bwb wrote:
       | ChatGPT has made a material difference in my ability to
       | understand health problems, test results, and to communicate with
       | doctors effectively. My wife and I were talking last night about
       | how helpful it was in 2025. I hope that it continues to be good
       | at this.
       | 
       | I want regulators to keep an eye on this and make smart laws. I
       | don't want it to go away, as its value is massive in my life.
       | 
       | (One example, if you are curious: I've been doing rehab for a
       | back injury for about 10 years. I worked with a certified
       | trainer/rehab professional for many years and built a program to
       | keep me as pain-free as possible. I rebuilt the entire thing with
       | ChatGPT/Gemini about 6 weeks ago, and I've had less pain than at
       | any other point in my life. I spent at least 12 hours working
       | with AI to test and research every exercise, and I've got some
       | knowledge to help guide me, but I was amazed by how far it has
       | come in 12 months. I ran the results by a trainer to double-check
       | it was well thought out.)
        
         | metalliqaz wrote:
         | Anything you say can and will be used against you.
        
           | JKCalhoun wrote:
           | You bring up an interesting point.
           | 
           | How is it we have come to a place in society where we second-
           | guess everything we type? But perhaps also where we go (with
           | our "tracking devices" in our pockets...).
           | 
           | I mean, obviously the internet is what changed everything.
           | But it is like you have a megaphone strapped to your face
           | whenever you connect to a site and make a comment.
           | 
           | Maybe this is not a good thing.
        
           | bwb wrote:
           | I've been on the web since it was born. When will this
           | happen? :)
           | 
           | How is this manifesting in reality?
        
         | trollbridge wrote:
         | This sounds like excellent evidentiary material for a future
         | insurer or government health provider to decide you're
         | uninsurable, not eligible for a job, and so on.
         | 
         | And the great thing about it is that you _already signed all
         | your rights away for them to do this exact thing_ , when we
         | could have had an open world with open models run locally
         | instead where you got to keep your private health information
         | private.
        
           | SecretDreams wrote:
           | System working as intended!
        
           | lotsofpulp wrote:
           | If an insurer is able to reduce (or recoup) costs from
           | likelier risks, then the remaining insureds benefit from
           | lower premiums.
           | 
           | If the goal is providing subsidies (i.e. wealth transfers),
           | then insurance is not the way to do it. That is the
           | government's role.
        
             | alpinisme wrote:
             | Insurance that is maximally responsive to patient health
             | changes in terms of cost (ie making healthier people pay
             | less) ends up being an inefficient way of just having
             | people pay for their healthcare directly.
             | 
             | And it naturally means the people with highest premiums are
             | the least likely to be able to afford it (the elderly, the
             | disabled, those with chronic conditions that make them less
             | likely to maintain high earning jobs steadily, etc)
        
               | Workaccount2 wrote:
               | The obvious retort to this is:
               | 
               | "If I focused on my health, ate clean and exercised
               | daily, why should I also be subsidizing Billy "video-
               | games-are-my-exercise" fatass's chronic health
               | conditions?"
               | 
               | This is why there is a hyperfixation on shifting blame
               | away from (failing) individuals. The logic breaks when
               | Billy has to admit he just hates exercising.
               | 
               | And yes, before you comment, I know "maybe Billy has
               | (condition outside all control) so it's not on him".
               | Please, see what I just said in the previous statement.
        
               | OverTheTetons wrote:
               | Is the obvious retort to this:
               | 
               | I don't think we should play arbiter for who has and
               | hasn't lived a healthy enough life to still believe they
               | should get healthcare?
        
               | Analemma_ wrote:
               | Yeah, I think what Workaccount2 is not realizing is that
               | there's no bottom to "you have higher risk factors, why
               | should I pay for you?", and so once you start down that
               | way you may not like where it ends up. Some hobbies have
               | higher injury rates, why should I pay for your health
               | care if you choose to play those? Some parts of the
               | country have lower life expectancies, why should I pay
               | for your health care if you _choose_ to live there?
        
               | Workaccount2 wrote:
               | The actual realization, which usually comes years after
               | the realization that there is no bottom, is that there is
               | no top either.
               | 
               | The battle along the spectrum of privatizing gains (lower
               | healthcare premiums for a healthy lifestyle - high
               | premiums for unhealthy lifestyle) vs socializing losses
               | (paying $20/mo to get $1200/mo of care - paying $1200/mo
               | for $0/mo of care) is constant and boundless in either
               | direction.
        
               | ben_w wrote:
               | But there is a bound in both directions?
               | 
               | On end, it's "national insurance", functionally
               | equivalent to fully-tax-funded healthcare like the NHS or
               | the German system with several providers competing but
               | regulated to near identical results, but moreso as the UK
               | and Germany also has private care; on the other, it's the
               | absence of insurance.
        
               | Workaccount2 wrote:
               | This is a macro problem larger than health insurance, and
               | exists everywhere from employee bonuses, high school
               | group project grades, handicap parking, gas prices,
               | Everest summits, to gas prices.
               | 
               | Those might all seem wildly disconnected, but they all
               | have systems of unfair allocation to compensate for
               | unequal outcomes.
               | 
               | Generally national healthcare programs are entirely
               | dependent on young healthy people paying into the system
               | despite rarely needing it, and then hopefully enough
               | dieing quick deaths or having multiple children to cover
               | their costs. These rebalancing systems are artificial and
               | humans are generally terrible at managing them.
        
               | ImPostingOnHN wrote:
               | The _entire purpose_ of health insurance is spreading
               | risk across a wide and diverse risk pool.
               | 
               |  _> why should I also be subsidizing Billy  "video-games-
               | are-my-exercise" fatass's chronic health conditions?"_
               | 
               | Nobody is asking you to: enrolling in insurance is a
               | choice in the USA.
               | 
               | Also, replace "chronic health conditions" with
               | "unavoidable inherited genetic risk factors". We don't
               | want Billy to be screwed for life just because he was
               | born to a suboptimal combination of parents.
        
               | Workaccount2 wrote:
               | The most cataclysmic thing that could happen to
               | healthcare would be chronically healthy individuals
               | creating their own health insurance.
        
               | ImPostingOnHN wrote:
               | Not really (in fact that doesn't even make sense), but in
               | any case, I think you replied to the wrong post. Your
               | reply doesn't seem to have anything to do with the post
               | it replied to
        
               | Workaccount2 wrote:
               | You said enrolling in insurance was a choice. If everyone
               | with a BMI under 22 who did at least an hour of cardio a
               | week had their own health insurance club, they would be
               | doing excellent with cheap premiums and great care, while
               | everyone else drowned in medical debt as their plans
               | collapsed.
               | 
               | The choice right now is all or nothing. There is no
               | choice for healthy people to only share a plan with other
               | healthy people. If there was, everyone else, especially
               | the least healthy, would be totally screwed.
        
               | ImPostingOnHN wrote:
               | I am still having trouble understand how that pertains to
               | the post to which it replied. Here are those 2 points
               | again:
               | 
               | 1. In the US, enrolling in health insurance is currently
               | a choice (I'm can't tell whether your hypothesis about
               | healthy people is agreeing or disagreeing with this
               | point).
               | 
               | 2. We don't want Billy to be screwed for life just
               | because he was born to a suboptimal combination of
               | parents.
               | 
               | Would you mind clarifying the connection here, please?
        
               | Workaccount2 wrote:
               | 1. I'm saying the choice is faux. Healthy people will
               | have _dramatically_ lower medical bills throughout their
               | life, so why shouldn 't they get discounted health
               | insurance? Which leads to your second point which I
               | already addressed in my initial post:
               | 
               | 2. >This is why there is a hyperfixation on shifting
               | blame away from (failing) individuals. The logic breaks
               | when Billy has to admit he just hates exercising.
        
               | duskdozer wrote:
               | It also fails to take into account the fact that eating
               | clean and exercising daily doesn't eliminate your risk of
               | getting cancer at age 40 or having your car's brakes fail
               | randomly.
        
               | Workaccount2 wrote:
               | Its dumb to create an insurance program using anecdotes.
               | 
               | The system can accommodate (and frankly is the ideal many
               | people strive for) some health nut getting long drawn out
               | cancer battle at 41. Its rare enough to be noise in the
               | giant money payout pool.
               | 
               | Obesity and it's litany of health effects are not rare,
               | and next to age, are a dominating signal drawing money
               | from the pool.
        
               | alpinisme wrote:
               | In some respects, the ideal world is one in which
               | everyone's premiums are tied to a free and easy Apple
               | Watch-like device that silently tracks exercise, blood
               | sugar at a frequency that can tell when you ate a big
               | dessert, air quality (and the presence of smoke or
               | pollution), blood alcohol content, whether you are in
               | speeding cars, whether you are participating in dangerous
               | sports, etc. Such a system would directly confront
               | individuals with the cost of their behaviors in an
               | economic way, probably leading many or even most people
               | to improve their habits in the aggregate.
               | 
               | But such a system comes at other costs that most people
               | intuitively feel infringes on core values they have.
               | 
               | Edit to add: this system would actually have some great
               | advantages over an "existing conditions" tax in that now
               | you pay low rates until you have diabetes, all during the
               | time you are leading the unhealthy lifestyle. But once
               | you have it you are not rewarded for starting to exercise
               | and eat healthy and get it under control. In the
               | hypothetical scenario above, you'd be punished
               | economically during the period you were building bad
               | habits and you would be able to restore sane costs after
               | course correction
        
               | FireBeyond wrote:
               | > "If I focused on my health, ate clean and exercised
               | daily, why should I also be subsidizing Billy "video-
               | games-are-my-exercise" fatass's chronic health
               | conditions?"
               | 
               | Then why are you not asking your insurer why they cover a
               | lot less preventative health or other options. For
               | example, Kaiser flat out refuses to prescribe GLP-1s for
               | weight loss, others insurers are the same with gym
               | subsidies or not covering nutritionists.
               | 
               | But they'll happily pay for your gastric bypass.
        
               | IanCal wrote:
               | > Insurance that is maximally responsive to patient
               | health changes in terms of cost (ie making healthier
               | people pay less) ends up being an inefficient way of just
               | having people pay for their healthcare directly.
               | 
               | That's true for predictable costs, but not true for
               | unpredictable ones - which is the point of most insurance
               | (housing, car, etc). The point and use of insurance is to
               | move risk to entities that can bear it.
               | 
               | Utility is non-linear with money, and so you easily have
               | situations where spending X times more on something
               | "costs" you _more_ than X times if measured in how useful
               | the money is to you.
               | 
               | Typically, as you have more money, each further dollar
               | doesn't provide as much benefit as the last (sometimes
               | things are lumpy, the difference between "not quite
               | enough to pay rent" and "just enough to pay rent" is
               | huge, but broadly this is true). Going from $1000 to
               | $10000 is more impactful than $1001000 to $1010000.
               | 
               | That means that moving the other way, each additional
               | dollar spent has a greater personal cost to you.
               | 
               | Therefore, sharing unlikely but high expenses can mean
               | that your expected cost is the same (if there's no
               | profit/middleman) or a bit higher, but your expected
               | _personal_ cost is _lower_.
        
             | SpicyLemonZest wrote:
             | We agree that insurance is not the right way to handle
             | health as a product, since some people predictably need
             | much more medical treatment than others. But it's how the
             | US has chosen to do it, so we have to do it in a way that
             | works. Correctly identifying a systemic issue won't pay
             | your medical bills.
        
               | lotsofpulp wrote:
               | That is not how the US has chosen to do it. The ACA
               | prohibits using anything other than age, location, and
               | tobacco use for premium pricing, and the ACA prohibits
               | denying coverage (resulting in a wealth transfer from
               | healthy to sick).
               | 
               | Even the age rating factor is capped at 3, so there are
               | also massive wealth transfers from young to old.
               | 
               | Mathematically, health insurance premiums in the US are
               | more tax than insurance premium.
        
               | trollbridge wrote:
               | The ACA doesn't prevent some magical fairy-dust AI from
               | pricing premiums, though, which is currently all the rage
               | amongst insurers. (Not because AI will be accurate or
               | anything, but because it offers a completely opaque
               | pricing process.)
        
               | avalys wrote:
               | Why not? If the only factors allowed to be used in
               | settings premiums are age, location and smoking status,
               | then those are the only parameters that could be input to
               | an AI model, no?
        
               | kyboren wrote:
               | Warning: I am not in this industry and the below is
               | speculation:
               | 
               | AIUI the idea is to predict the "correct" price for an
               | individual premium, Y, which is restricted to being the
               | result of some insurance model function, f(), that is
               | itself restricted to the domain of age (A), location (L),
               | and smoking status (S):                 Y = f(A, L, S)
               | 
               | My impression was that the idea was that this would
               | handicap insurers' natural desire to price premiums
               | individually and have a smoothing effect on prices over
               | the population.
               | 
               | But why is location useful for insurers to price
               | premiums? I assume because healthcare has different costs
               | in different locations, and different utilization rates:
               | People living in coal mining towns or near oil refineries
               | may be expected to use more healthcare and thus cost more
               | to insure.
               | 
               | Thus, you can imagine insurers building a price map (like
               | a heat map) overlay for the state/country, plotting each
               | applicant on it, and checking the "color" there as part
               | of their model function. So they are effectively
               | embedding out-of-band information (prices and utilization
               | rates for locations) into the model function f() itself.
               | 
               | What "AI", or large-parameter Deep Neural Networks,
               | fundamentally change here is:                  - They can
               | approximate any effectively computable function, the same
               | class of functions that a programmer can write and
               | execute on a computer[0].             - They can be
               | scaled up to an arbitrarily large number of parameters,
               | i.e. an arbitrarily precise approximation limited only by
               | the number of parameters and the amount and quality of
               | model training data.             - Absolutely critically:
               | They are programmed implicitly, through brute-force
               | training on input-output pairs, rather than explicitly,
               | with some programmer writing an explicit series of
               | instructions to compute the function.
               | 
               | This last point is probably the most important.
               | 
               | Large insurers previously had sophisticated models for
               | f() hand-built by math whizzes, but they were limited in
               | the amount of out-of-band information they could encode
               | into that function by the limited cognitive and
               | programmatic capacity of a human team.
               | 
               | But now with DNNs you can _scalably_ encode unlimited
               | out-of-band information into the function f(), while also
               | totally obscuring _how_ you 're computing that location-
               | based price adjustment.
               | 
               | The result, in extremis, is that f() is not some fancy
               | algorithm cooked up by a few dozen math whizzes. Instead
               | f() becomes a fancy database, allowing the tuple (A, L,
               | S) to act merely as an index to an individualized premium
               | Y, which defeats the entire purpose of restricting the
               | domain of their model function.
               | 
               | [0]: https://en.wikipedia.org/wiki/Universal_approximatio
               | n_theore...
        
               | avalys wrote:
               | That's not how courts and laws work. If you cheat and use
               | other illegal factors to compute a premium for each
               | person, and then create an AI model that effectively
               | looks up your illegally calculated premium of each person
               | by their location, they're going to reach the obvious
               | conclusion - you are calculating a premium using illegal
               | factors.
        
             | monooso wrote:
             | Not a US citizen, so a genuine question: do US health
             | insurance companies have a track record of passing on such
             | savings to consumers?
             | 
             | That has not been my impression as an outside observer.
        
               | lotsofpulp wrote:
               | Health insurance companies in the US are not allowed to
               | deny coverage, and can only price premiums based on age
               | (highest premium capped at 3x lowest premium, location,
               | and tobacco use.
               | 
               | https://www.healthcare.gov/coverage/pre-existing-
               | conditions/
               | 
               | https://www.healthcare.gov/how-plans-set-your-premiums/
               | 
               | Health insurance premiums in the US are more tax than
               | insurance. They also have low single digit profit margins
               | with less than desirable shareholder returns (many are
               | non profit in the first place), so they don't have much
               | room to lower premiums without also reducing healthcare
               | expenses.
               | 
               | The insurance business in general is very competitive and
               | not very profitable, so an insurer that tries to collect
               | outsized premiums will usually suffer a loss of business.
        
               | monooso wrote:
               | > The insurance business in general is very competitive
               | and not very profitable...
               | 
               | Knowing several Americans, and how much they pay for
               | health insurance (and are still required to pay for some
               | things "out of pocket"), this is incredible to me. And
               | that's before you even get to the process of making a
               | claim.
               | 
               | Such a broken system.
        
               | zdragnar wrote:
               | Ostensibly, the Affordable Care Act was supposed to
               | reduce the average family's premiums by $2,500 a year.
               | 
               | When that didn't happen, the story changed to that number
               | being how much more premiums would have risen.
               | 
               | Insurance premiums have only gone up as far as I can
               | remember, though there's a ton of variables at play here.
               | Inflation is an obvious one, plus continual introduction
               | of more and more costly treatments- biologic injections,
               | cancer therapies and so forth. The unfortunate increase
               | in obesity rates in my lifetime (along with all the
               | health complications) has been a significant contributor
               | as well.
               | 
               | It all adds up.
        
               | alright2565 wrote:
               | The individual mandate part of the ACA was the part
               | designed to reduce premiums. You need healthy
               | participants in any health insurance scheme to subsidize
               | unhealthy people.
               | 
               | That was eliminated by a Republican bill, the Tax Cuts
               | and Jobs Act of 2017.
        
               | kjkjadksj wrote:
               | FWIW the state of california has its own individual
               | mandate.
        
               | zdragnar wrote:
               | Yes, and that was years after the ACA took full effect
               | and the rates did not decrease.
               | 
               | Most people get insurance through their employer, and
               | most employer plans (at medium to large companies) are
               | self funded by the company and merely administered by
               | insurance companies.
               | 
               | That means the healthy participants had no effect on
               | those plans whatsoever. Even at peak, the individual
               | mandate had only cut the number of uninsured by half, and
               | the effect on rates was negligible.
        
               | tzs wrote:
               | > Insurance premiums have only gone up as far as I can
               | remember, though there's a ton of variables at play here.
               | 
               | An interesting thing about rising health costs is that it
               | has happened at roughly similar rates in most first world
               | countries for the last 50+ years.
               | 
               | For example in 1990 the UK, FR, and US were paying 2.0,
               | 2.2, and 2.6 times their 1980 costs per capita. By 2000
               | that was 4.1, 4.1, and 4.2. By 2018 (the last year I had
               | data for when I calculated this a few years ago) it was
               | 10.6, 7.5, and 10.2.
               | 
               | Here's the 2000 to 2018 increase for those and some
               | others: DE, FR, CA, IT, JP, UK, US were 2.1, 1.8, 2.0,
               | 1.7, 2.6, 2.6, 2.3.
               | 
               | When politicians in the US talk about rising health care
               | costs they usually put the blame on recent policies from
               | opposing politicians. That so many first world countries
               | with so many different health care systems all have seen
               | similar increases for the last 50+ years suggests that it
               | is due to something they all have in common and that
               | government policy doesn't affect it much.
        
               | lotsofpulp wrote:
               | In 2010, it was already known the proportion of old to
               | young was increasing, and the proportion of doctors was
               | decreasing.
               | 
               | Prices were always going to increase.
        
               | butvacuum wrote:
               | you're correct. UHC is so hated because they're a
               | "pharmacy benefits manager." - an organization that
               | exists soley to make your life so miserable you give up
               | on getting your medication.
        
               | FireBeyond wrote:
               | Aetna has their own scumminess. Want the convenience of
               | 90 day refills? Have to use their mail order service.
               | They'll refuse to authorize >30 day supplies of
               | medication through any other pharmacy.
        
               | DANmode wrote:
               | These comments (on UHC, Aetna) always strike me the same
               | way as complaining about the lack of inflight meal,
               | 
               | baggage fees,
               | 
               | or lack of WiFi,
               | 
               | on, say, Spirit Airlines.
               | 
               | You looked at the list of insurers/jobs offering health
               | insurance carriers,
               | 
               | selected the cheapest, or second-cheapest option,
               | 
               | and you're surprised they're harder to work with?
               | 
               | How?
        
               | FireBeyond wrote:
               | Oh yes, because the vast majority of employers in the US
               | say "pick whatever healthcare plan you want from whatever
               | carrier you want, we'll make it work" and not "You'll get
               | what you're given and be glad for it".
               | 
               | Even in tech spaces with money to throw around, that just
               | means that maybe your partner and dependent's premiums
               | will be covered/negligible, or that your deductible will
               | be low.
               | 
               | You're still going to be fucked by their policies,
               | though.
        
               | DANmode wrote:
               | You've highlighted why I do not work for the vast
               | majority of employers in the US.
               | 
               | Pay me enough in cash to secure my own wellness with
               | whatever organizations I choose, or: next, please.
        
               | vjvjvjvjghv wrote:
               | "passing on such savings to consumers"
               | 
               | Absolutely not. They inflate prices by 200% and then give
               | you 20% "savings" back. The whole idea of a health
               | insurance company as publicly traded corporation is
               | totally insane. They are designed to extract maximum
               | profit from wherever they can get. The is no incentive to
               | save money for patients. Any savings go to shareholders.
        
               | lotsofpulp wrote:
               | There are plenty of health insurers that are not publicly
               | traded, and in fact are non profit, and yet they have the
               | same premiums as the publicly traded ones. See Kaiser,
               | Providence, Cambia, Regence, and the dozens of other BCBS
               | affiliated plans.
               | 
               | If your claims were true, then the publicly traded
               | businesses would have no customers.
        
               | vjvjvjvjghv wrote:
               | I would argue the non profit insurers are as profit
               | oriented as the publicly traded ones.
        
               | Buttons840 wrote:
               | > There are plenty of health insurers
               | 
               | Yeah. And they all ultimately have to be paid by my
               | health premiums.
               | 
               | When I visit my parents, and they have the TV on, and I
               | see 3 90-second advertisments for prescription drugs
               | every single commercial break, I remind myself that, no
               | matter what, we have to keep funding these commercials.
               | Whatever the US decides to do for healthcare, I guarantee
               | these commercials will continue to be paid for.
               | 
               | I also guarantee that pharmacy company executives, and
               | insurance company executives will continue to make
               | millions of dollars a year. We have to keep paying them
               | as well.
               | 
               | The huge bureaucracy of insurance workers who decide what
               | is and isn't approved, that all will have to be paid for
               | as well.
               | 
               | I used to work for a company that did background checks
               | on doctors, we had different customers in every state,
               | every state had their own companies and their own system
               | for maintaining and verifying doctors licenses. These
               | different companies in each state have to be paid. I made
               | good money as a programmer doing background checks for
               | these various companies and my paycheck also ultimately
               | came from your medical premiums.
               | 
               | I think we need to stop and appreciate the patriotic duty
               | we all have to pay high premiums and medical costs,
               | because every time we do we're propping up a huge portion
               | of US workers. -- Just kidding. The truth is a lot of
               | companies need to go out of business before things get
               | cheaper.
        
           | simianwords wrote:
           | Can you explain the exact way in which this is possible? It's
           | not legal to be denied jobs based on health. Not to deny
           | insurance
        
             | Flatterer3544 wrote:
             | And how would you know what they base their hiring upon?
             | You would just get a generic automated response..
             | 
             | You would not be privy to their internal processes, and
             | thusfar not be able to prove wrong doing. You would just
             | have to hope for a new Snowden and that the found
             | wrongdoings would actually be punished this time.
        
               | simianwords wrote:
               | Do corporations use my google searches as data to hire
               | me?
        
               | anal_reactor wrote:
               | Not yet. But Google itself would ask you for your resume
               | if you happened to search for a lot of things related to
               | programming.
        
               | LPisGood wrote:
               | Yes, I remember a friend that interned there a couple
               | times showed me that. One of them was "list comprehensive
               | python" and the Google website would split in 2 and give
               | you some really fun coding challenges. I did a few, and
               | you get 4(?) right you get a guaranteed interview I
               | think. I intended to come back and spend a lot of time on
               | an additional one, but I never did. Oops
        
               | anal_reactor wrote:
               | I think I only did three or something and I didn't hear
               | back from them. Honestly my view of Google is that they
               | aren't as cool as they think they are. My current
               | position allows me to slack off as much as I want and
               | it's hard to beat that, even if they offer more money
               | (they won't in the current market).
        
               | Aurornis wrote:
               | "Ask you for your resume" is a funny way of saying "Show
               | an advertisement to invite people to apply for a job"
        
               | well_ackshually wrote:
               | Do you have any proof they don't? Do you have any proof
               | the "AI System" that they use to filter out candidates
               | doesn't "accidentally" access data ? Are you willing to
               | bet that Google, OpenAI, Anthropic, Meta, won't sell
               | access to that information?
               | 
               | Also, in some cases: they absolutely do. Try to get hired
               | in Palantir and see how much they know about your
               | browsing history. Anything related to national security
               | or requiring clearances has you investigated.
        
               | raw_anon_1111 wrote:
               | As if any company that did that is a company I would want
               | to work for.
               | 
               | For instance back when I was interviewing at startups and
               | other companies where I was going to be a strategic hire,
               | I would casually mention how much I enjoyed spending time
               | on my hobbies and with my family on the weekend so
               | companies wouldn't even extend an offer if they wanted
               | someone "passionate" who would work 60 hours a week and
               | be on call.
        
               | two_tasty wrote:
               | I certainly understand this perspective.
               | 
               | But is it really so hard to imagine a world where your
               | individual choice to "opt-out" or work for companies that
               | don't use that info is a massive detriment to your
               | individual life? It doesn't have to be every single
               | company doing it for you to have no _practical_ choice
               | about it (if you want to make market rate for your
               | services.)
        
               | raw_anon_1111 wrote:
               | I live my life by the "Ben Kenobi" principal. I'm 51,
               | when things go completely to shit, I'll just go out and
               | live as a hermit somewhere.
        
               | ares623 wrote:
               | Ah the ol' "fuck you got mine" approach
        
               | linkregister wrote:
               | The last time I went through the Palantir hiring process,
               | the effort on their end was almost exclusively on
               | technical and cultural fit interviews. My references told
               | me they had not been contacted.
               | 
               | Calibrating your threat model against this attack is
               | unlikely to give you any alpha in 2026. Hiring at tech
               | companies and government is much less deliberate than
               | your mental model supposes.
               | 
               | The current extent of background checks is an API call to
               | Checkr. This is simply to control hiring costs.
               | 
               | As a heuristic, speculated information to build a threat
               | model is unlikely to yield a helpful framework.
        
               | bossyTeacher wrote:
               | >the effort on their end was almost exclusively on
               | technical and cultural fit interviews
               | 
               | How could you possibly know if they use other undisclosed
               | methods as part of the recruitment? You are assuming
               | Palatir would behave ethically. Palantir, the company
               | that will never win awards based on ethics
        
               | smsm42 wrote:
               | Probably not directly, that would be too vulnerable. But
               | they could hire a background check company, that could
               | pay a data aggregator to check if you searched for some
               | forbidden words, and then feed the results into a threat
               | model...
        
               | Aurornis wrote:
               | I'm kind of amazed that so many people in this comment
               | section believe their Google searches and ChatGPT
               | conversations are being sold and used.
               | 
               | Under this conspiracy theory they'd have to be available
               | for sale somewhere, right? Yet no journalist has ever
               | picked up the story? Nobody has ever come out and
               | whistleblown that their company was buying Google
               | searches and denying applicants for searching for naughty
               | words?
        
               | bko wrote:
               | I don't get it, if you're medically unfit for a job, why
               | would you want the job?
               | 
               | For instance, if your job is to be on your feet all day
               | and you can barely stand, then that job is not for you. I
               | have never met employers that are so flush in
               | opportunities of candidates that they just randomly
               | choose to exclude certain people.
               | 
               | And if it's insurance, there's a group rate. The
               | difference only variable is what the employee chooses out
               | of your selected plans (why make a plan available if you
               | don't want people to pick that one?) and family size.
               | It's illegal to discriminate of family size and that does
               | add up to 10k extra on the employer side. But there are
               | downsides to hiring young single people, so things may
               | balance out.
        
               | rafterydj wrote:
               | I believe existing laws carve out exceptions for medical
               | fitness for certain positions for this very reason. If I
               | may, stepping back for a second: the reason privacy laws
               | exist, is to protect people from bad behavior from
               | employers, health insurance, etc.
               | 
               | If we circumvent those privacy laws, through user
               | licenses, or new technology - we are removing the
               | protections of normal citizens. Therefore, the bad
               | behavior which we already decided as a society to ban can
               | now be perpetrated again, with perhaps a fresh new word
               | for it to dodge said old laws.
               | 
               | If I understand your comment, you are essentially
               | wondering why those old laws existed in the first place.
               | I would suggest racism or other systemic issues, and
               | differences in insurance premiums, are more than enough
               | to justify the existence of privacy laws. Take a normal
               | office job as an example over a manual labor intensive
               | job. No reason at all that health conditions should
               | impact that. The idea of not being hired because I have a
               | young child, or a health condition, that would raise the
               | group rate from the insurer passing the cost to my
               | employer (which would be in their best interest to do) is
               | a terrible thought. And it happened before, and we banned
               | that practice (or did our best to do so).
               | 
               | All this to say, I believe HIPAA helps people, and if
               | ChatGPT is being used to partially or fully facilitate
               | medical decision making, they should be bound under
               | strict laws preventing the release of that data
               | regardless of their existing user agreements.
        
               | purrcat259 wrote:
               | > And how would you know what they base their hiring
               | upon?
               | 
               | GDPR Request. Ah wait, regulation bad.
        
               | Aurornis wrote:
               | This fails the classic conspiracy theory test: Any
               | company practicing this would have to be large enough to
               | be able to afford to orchestrate a chain of illegal
               | transactions to get the data, develop a process for using
               | it in hiring, and routinely act upon it.
               | 
               | The continued secrecy of the conspiracy would then depend
               | on every person involved in orchestration this privacy
               | violation and illegal hiring scheme keeping it secret
               | forever. Nobody ever leaking it to the press, no
               | disgruntled employees e-mailing their congress people, no
               | concerned citizens slipping a screenshot to journalists.
               | Both during and after their employment with the company.
               | 
               | To even make this profitable at all, the data would have
               | to be secretly sold to a lot of companies for this use,
               | and also continuously updated to be relevant. Giant
               | databases of your secret ChatGPT queries being sold
               | continuously in volume, with all employees at both the
               | sellers, the buyers, and the users of this information
               | all keeping it perfectly quiet, never leaking anything.
        
             | trollbridge wrote:
             | How are you ever going to prove this?
             | 
             | You just get an automated denial from the ATS that's based
             | on the output from AI inference engine.
        
             | DetectDefect wrote:
             | > It's not legal to be denied jobs based on health.
             | 
             | There is a vast gap between what is not legal and what is
             | actually actionable in a court of law, which is well known
             | to a large power nexus.
        
           | matt3D wrote:
           | These strawman arguments lack nuance.
           | 
           | If the person can use AI to lead a noticeably better life,
           | something that may have been impossible previously due to
           | economic circumstance, then the first order benefits outweigh
           | the second order drawbacks.
           | 
           | I'm not disputing what you're saying, I just think that
           | treating it like a zero sum game every time the conversation
           | comes up is showing an immense amount of privilege.
           | 
           | You, me, the parent commenter; we're all dying, we don't have
           | time to optimise for the best outcome.
        
           | beepbopboopp wrote:
           | This is an argument against the general data collection
           | internet NOT chatGPT.
        
         | atmosx wrote:
         | I agree. LLMs cannot and should not replace professionals but
         | there are huge gaps that can be filled by intro provided and
         | the fact that you can dig deeper into any subject is huge.
         | 
         | This is probably a field that MistralAI could use privacy and
         | GDPR as leverage to build LLMs around that.
        
           | phatfish wrote:
           | One of the big issues I have with LLMs that when you start a
           | prompting session with an easy question it all goes great. It
           | bring up points you might not have considered and appears
           | very knowledgeable. Fact checking at this stage will show the
           | LLM is invariably correct.
           | 
           | Then you start "digging deeper" on a specific sub-topic, and
           | this is where the risk of an incorrect response grows. But it
           | is easy to continue with the assumption the text you are
           | getting is accurate.
           | 
           | This has happened so many times with the
           | computing/programming related topics i usually prompt about,
           | there is no way I would trust a response from an LLM on
           | health related issues I am not already very familiar with.
           | 
           | Given that the LLM will give incorrect information (after
           | lulling people with a false sense of it being accurate), who
           | is going to be responsible for the person that makes
           | themselves worse off by doing self diagnosis, even with a
           | privacy focused service?
        
             | JKCalhoun wrote:
             | That's a good point--and I have probably fallen victim to
             | it as well: the "sliding scale" of an LLM's authority.
             | 
             | Like you, I fact-check it (well, search the internet to see
             | if others validate the claims/points) but I don't do so
             | with _every_ response.
        
             | atmosx wrote:
             | The responsibility falls always to the patient. That's true
             | with doctors are as well: you visit two doctors they give
             | you different diagnosis, one tells to go for surgery, the
             | other tells you it's not worth the hassle. Who can decide?
             | The patient does.
             | 
             | LLMs are yet another powerful tool under our belt, you know
             | it's hallucinating so be careful. That said, even asking
             | specialized info about this or that medical topic can be a
             | great thing for patients. That's why I believe it's a good
             | thing to have specialized LLMs that can tailor responses on
             | individual health situations.
             | 
             | The problem is the framework and the implementation end
             | goal. IMO state owned health data is a goldmine for any
             | social welfare system and now with AI they can make use of
             | it in novel ways.
        
         | jsheard wrote:
         | On the other hand, sometimes you end up like this guy. Are you
         | feeling lucky?
         | 
         | https://arstechnica.com/health/2025/08/after-using-chatgpt-m...
        
           | wiseowise wrote:
           | Natural selection at work. I don't see anything suspicious
           | here.
        
           | glemion43 wrote:
           | The man in the article did not use it as a research help and
           | did not verify it with experts.
           | 
           | So what's your argument?
        
           | vjvjvjvjghv wrote:
           | You could also list plenty of horror stories where people
           | went to medical professionals and got screwed over. There is
           | this myth that people can go to doctors and get perfect
           | attention and treatment. Reality is far from that
        
             | datsci_est_2015 wrote:
             | There's the concept of "personal advocacy" when receiving
             | healthcare. Unfortunately, you'll only get the best
             | outcomes if you continually seek out treatment with
             | diligence and patience.
             | 
             | But framing it as a "myth [of] perfect attention and
             | treatment" sounds a bit like delegitimizing the entire
             | healthcare industry in a way that makes me raise my
             | eyebrow.
        
               | cm2012 wrote:
               | Id say the Healthcare industry works hard but is probably
               | working at like 20% of their possible productivity due to
               | systemic issues.
        
               | datsci_est_2015 wrote:
               | How do you measure productivity? Profit per employee has
               | never been higher, probably, as PE and other rent-seeking
               | leeches (residency caps) have wrapped their fingers
               | around the throat of the industry.
               | 
               | Positive outcomes per patient is probably also higher,
               | due to research and technology advances. So many lives
               | saved that would have been written off just a decade or
               | two ago (e.g. spina bifida).
               | 
               | But I agree with you that there's a hypothetical universe
               | where seeking healthcare as an American doesn't suck, I
               | just don't know if "productive" is the right word to
               | describe it.
        
               | willparks wrote:
               | Yes, there's been a tension between personal advocacy and
               | the system for a long time. Doctors roll there eyes when
               | a patient mentions they self diagnosed on WebMD. LLM's
               | will accelerate self diagnosis immensely. This has the
               | potential to help patients, but it is just a starting
               | point. Of course, it should be verified from actual
               | trained doctors.
        
               | datsci_est_2015 wrote:
               | Agreed, I described it elsewhere in this thread as
               | K-shaped outcomes.
        
               | vjvjvjvjghv wrote:
               | "But framing it as a "myth [of] perfect attention and
               | treatment" sounds a bit like delegitimizing the entire
               | healthcare industry in a way that makes me raise my
               | eyebrow."
               | 
               | It doesn't delegitimize the whole industry. It points out
               | real problems. A lot of patients are not given enough
               | attention and don't get the correct treatment because the
               | doctors didn't listen but rushed through things.
        
               | datsci_est_2015 wrote:
               | I was criticizing the rhetoric, not the sentiment. I'm
               | skeptical of an argument when it flies too close to what
               | I associate with irrationality and pseudoscience,
               | especially considering what's happened in medicine over
               | the past 5 years.
               | 
               | The "myth [of] perfect attention and treatment" is an
               | easy strawman for grifters and conmen to take advantage
               | of: see RFK Jr.
        
             | lionkor wrote:
             | Are medical professionals not usually held accountable,
             | globally speaking?
        
               | ipaddr wrote:
               | Lawsuits against medical professionals are difficult in
               | many cases impossible for the average person to win. They
               | are held less accountable compared to other professions.
        
             | arter45 wrote:
             | A big part of the legal implications of LLMs and AI in
             | general is about accountability.
             | 
             | If you are treated by a human being and it goes sideways,
             | you could sue them and/or the hospital. Now, granted, you
             | may not always win, it may take some time, but there is
             | some chance.
             | 
             | If you are "treated" by an LLM and it goes sideways, good
             | luck trying to sue OpenAI or whoever is running the model.
             | It's not a coincidence that LLM providers are trying to put
             | disclaimers and/or claims in their ToS that LLM advice is
             | not necessarily good.
             | 
             | Same goes for privacy. Doctors and hospital are regulated
             | in a way that you have a reasonable, often very strong,
             | expectation of privacy. Consider doctor-patient
             | confidentiality, for example. This doesn't mean that there
             | is no leak, but you can hold someone accountable. If you
             | send your medical data to ChatGPT and there is a leak, are
             | you going to sue OpenAI?
             | 
             | The answer in both cases is, yes, you should probably be
             | able to sue an LLM provider. But because LLM providers have
             | a lot of money (way more than any hospital!), are usually
             | global (jurisdiction could be challenging) and, often, they
             | say themselves that LLM advice is not necessarily good
             | (which doctors cannot say that easily), you may find that
             | way more challenging than suing a doctor or a hospital.
        
           | mhb wrote:
           | Did he also drive into a lake following Google Maps' driving
           | directions?
        
           | JKCalhoun wrote:
           | "...a 60-year-old man who had a "history of studying
           | nutrition in college" decided to try a health experiment: He
           | would eliminate all chlorine from his diet..."
           | 
           | You can see already that this can easily go sideways. This
           | guy is already exploring the nether regions of self-
           | medication.
           | 
           | It would be ideal if LLMs recognized this and would not
           | happily offer up bromine as a substitute for chlorine, but I
           | suspect this guy would have greedily looked for other shady
           | advice if LLMs had never existed.
        
           | bwb wrote:
           | You have to use your head, just like online forums or with
           | doctors :)
           | 
           | I've had doctors tell me to do insane things. Some that
           | caused lasting damage. Better to come with a trust-but-verify
           | attitude to humans and AI.
        
         | narmiouh wrote:
         | I don't think one can deny the benefits here. The detractors
         | here are like don't build a side walk coz someone may trip and
         | fall or don't plant trees in your front yard coz of what
         | happened to the Texas governor.
         | 
         | Most would likely agree that everything needs a balanced
         | approach, bashing a service completely as evil and fully
         | advocating people to stay away vs claiming the service is
         | flawless (which the OP isn't doing btw) aren't either a
         | balanced position.
         | 
         | Think different doesn't have to mean think extreme.
        
         | ryan_n wrote:
         | That's awesome that it's helped you so much, chronic back pain
         | is awful. Is it possible though, that this could be interpreted
         | as a failure of the trainer to come up with a successful
         | treatment plan for you? "Sudden" relief after 10 years of
         | therapy just because you changed the program seems like they
         | were just having you perform the wrong exercises no?
        
           | narmiouh wrote:
           | We have to also understand that the trainer didn't get to
           | spend 12 hours of researching every minutia or do a trial and
           | error study to get to where OP got to. This doesn't
           | necessarily mean the trainer failed, just that they were
           | constrained by time, which OP wasn't. And I think that is the
           | essence of this tech, when used wisely, I can lead to results
           | like these which you can't get despite having access to the
           | best talent for a limited time. Only the well afforded can
           | afford a full time trainer/therapist.
        
             | ryan_n wrote:
             | Absolutely, I didn't mean any disrespect towards any of the
             | professionals helping OP with their back issues. It can be
             | an incredibly hard thing to treat.
        
           | bwb wrote:
           | The trainer was a godsend, got me to ~95% pain-free, and
           | taught me all kinds of things. He is amazing.
           | 
           | But 2025 was maybe down to 90% pain-free, and I want to get
           | stronger. So I did a big rewrite of my entire workout plan
           | and checked everything. AI wasn't perfect, but it was amazing
           | when you already know some.
           | 
           | It is still a tool I had to direct, and it took a few days of
           | work. But I'm amazed at where it got me to. It took the
           | injury into consideration and my main sport, and built around
           | that. In the past I tried do this online and couldn't do it
           | given the numerous factors involved. It was not perfect, but
           | over the course of a few days, I was able to sort it out (and
           | test with a trainer on the approach a few weeks after).
           | 
           | I've been 100% pain free for 6 weeks in a way I haven't felt
           | in a long time.
        
             | DrammBA wrote:
             | Without getting into your specific injury or sport, what
             | was the biggest change compared to the trainer's program?
             | 
             | Was it something unexpected like "exercise this seemingly
             | unrelated muscle group that has nothing do with your injury
             | but just happens to reduce pain by 75% for some
             | inexplicable reason"?
             | 
             | Or was it something more mundane like "instead of
             | exercising this muscle every day, do it every other day to
             | give it time to rest"?
        
         | jmyeet wrote:
         | This kind of comment scares me because it's an example of
         | people substituring professional advice for an LLM where LLMs
         | are known to hallucinate or otherwise simply make stuff up. I
         | see this all the time when I write queries and get the annoying
         | Gemini AI snippet on a subject I know about and often I'll see
         | the AI make provably and objectively false statements.
        
           | travisgriggs wrote:
           | I have this same reaction.
           | 
           | But I also have to honestly ask myself "aren't humans also
           | prone to make stuff up" when they feel they need to have an
           | answer, but don't really?
           | 
           | And yet despite admitting that humans hallucinate and make
           | failures too, I remain uncomfortable with ultimate trust in
           | LLMs.
           | 
           | Perhaps, while LLMs simulate authority well, there is an
           | uncanny valley effect in trusting them, because some of the
           | other aspect of interacting with an authority person are
           | "off".
        
           | simianwords wrote:
           | You are exaggerating. LLMs simply don't hallucinate all that
           | often, especially ChatGPT.
           | 
           | I really hate comments such as yours because anyone who has
           | used ChatGPT in these contexts would know that it is pretty
           | accurate and safe. People also can generally be trusted to
           | identify good from bad advice. They are smart like that.
           | 
           | We should be encouraging thoughtful ChatGPT use instead of
           | showing fake concern at each opportunity.
           | 
           | Your comment and many others just try to signal pessimism as
           | a virtue and has very less bearing on reality.
        
             | ipaddr wrote:
             | LLM give false information often. The ability for you to
             | catch incorrect facts is limited by your knowledge and
             | ability and desire to do independent research.
             | 
             | LLMs are accurate with everything you don't know but are
             | factually incorrect with things you are an expert in is a
             | common comment for a reason.
        
               | simianwords wrote:
               | No they don't give false information often.
        
               | ipaddr wrote:
               | Do you double check every fact or are you relying on
               | yourself being an expert on the topics you ask an llm? If
               | you are an expert on a topic you probably aren't asking
               | ab llm anyhow.
               | 
               | It reminds me of someone who reads a newspaper article
               | about a topic they know and say its most incorrect but
               | then reading the rest of the paper and accepting those
               | articles as fact.
        
               | tempest_ wrote:
               | Gell-Mann Amnesia
        
               | mythrwy wrote:
               | "Often" is relative but they do give false information.
               | Perhaps of greater concern is their confirmation bias.
               | 
               | That being said, I do agree with your general point.
               | These tools are useful for exploring topics and answers,
               | we just need to stay realistic about the current accuracy
               | and bias (eager to agree).
        
               | ziml77 wrote:
               | They do. To the point where I'm getting absolutely
               | furious at work at the number of times shit's gotten
               | fucked up and when I ask about how it went wrong the
               | response starts with "ChatGPT said"
        
               | tempest_ wrote:
               | I have them make up stuff constantly for smaller rust
               | libraries that are newish or dont get a lot of use.
        
               | mythrwy wrote:
               | I just asked chatGPT.
               | 
               | "do llms give wrong information often?"
               | 
               | "Yes. Large language models produce incorrect information
               | at a non-trivial rate, and the rate is highly task-
               | dependent."
               | 
               | But wait, it could be lying and they actually don't give
               | false information often! But if that were the case, it
               | would then verify they give false information at a non
               | trivial rate because I don't ask it that much stuff.
        
               | pgwhalen wrote:
               | As I used LLMs more and more for fact type queries, my
               | realization is that while they give false information
               | sometimes, individual humans also give false information
               | sometimes, even purported subject matter experts. It just
               | turns out that you don't actually need perfectly true
               | information most of the time to get through life.
        
             | avalys wrote:
             | All we can do is share anecdotes here, but I have found
             | ChatGPT to be confidently incorrect about important details
             | in nearly every question I ask about a complex topic.
             | 
             | Legal questions, question about AWS services, products I
             | want to buy, the history a specific field, so many things.
             | 
             | It gives answers that do a really good job of simulating
             | what a person who knows the topic would say. But details
             | are wrong everywhere, often in ways that completely change
             | the relevant conclusion.
        
               | Jarwain wrote:
               | I don't think that LLM's do a significantly worse job
               | than the average human professional. People get details
               | wrong all the time, too.
        
           | bwb wrote:
           | You have to use critical thinking + it helps to have some
           | info on the subject + it shouldn't be used to perform self-
           | surgery :)
           | 
           | I spent about 12 hours over 2 days, checking, rechecking, and
           | building out a plan. Then I did 2-hour sessions on YouTube,
           | over several weeks, learning the new exercises with proper
           | form (and that continues as form is hard). Followed by an
           | appointment with a trainer to test my form and review the
           | workout as a hole (which he approved of). No trainer really
           | knows how this injury will manifest, so a lot is also helped
           | because I have 10 years of exp.
           | 
           | This isn't a button click, and now follow the LLM lemming.
           | This is a tool like Google search but better.
           | 
           | I could not have done this before using the web. I would have
           | had to read books and research papers, then try to understand
           | which exercises didn't target x muscle groups heavily, etc. I
           | just couldn't do that. The best case would have been a
           | trainer with the same injury, maybe.
        
         | datsci_est_2015 wrote:
         | It seems like outcomes are probably K-shaped: those who are
         | capable of critical thinking and deciding what type of
         | information should be confirmed by a healthcare professional
         | and what type of information is relatively riskless to consume
         | from ChatGPT should have positive outcomes.
         | 
         | Those who are prone to disinformation and misinterpretation may
         | experience some very negative health outcomes.
        
           | JKCalhoun wrote:
           | I agree with that. The question I suppose is whether an LLM
           | can detect, perhaps by the question itself, if they are
           | dealing with someone (I hate to say it) "stable".
           | 
           | Anyone asking how to commit suicide, as a recent example,
           | should be an obvious red flag. We can get more nuanced from
           | there.
        
             | tedmiston wrote:
             | > The question I suppose is whether an LLM can detect,
             | perhaps by the question itself, if they are dealing with
             | someone (I hate to say it) "stable".
             | 
             | GPT-5 made a major advance on mental health guardrails in
             | sensitive conversations.
             | 
             | https://www.theverge.com/news/718407/openai-chatgpt-
             | mental-h...
             | 
             | https://openai.com/index/strengthening-chatgpt-responses-
             | in-...
        
         | JKCalhoun wrote:
         | I also think health (and car-problem diagnosis) are excellent
         | tasks for LLMs.
         | 
         | The you-are-the-product thing, and privacy, has me wondering
         | when Apple will step in and provide LLM health in a way we can
         | trust.
         | 
         | I know I say that and I face the slings and arrows of those
         | distrusting Apple, but I still believe they're the one big
         | company out there that knows that there is money in being the
         | one guy that _doesn 't_ sell your data.
        
         | rconti wrote:
         | It can be helpful, but also untrustworthy.
         | 
         | My mother-in-law has been struggling with some health
         | challenges the past couple of months. My wife (her daughter)
         | works in the medical field and has been a great advocate for
         | her mother. This whole time I've also been peppering ChatGPT
         | with questions, and in turn I discuss matters with my wife
         | based on this.
         | 
         | I think it was generally correct in a lot of its assertions,
         | but as time goes on and the situation does it improve, I
         | occasionally revisit my chat and update it with the latest
         | results and findings, and it keeps insisting we're at a turning
         | point and this is exactly what we should expect to be
         | happening.
         | 
         | 6 weeks ago, I think its advice was generally spot on, but
         | today it's just sounding more tone-deaf and optimistic. I'd
         | hate to be _relying_ on this as my only source of advice and
         | information.
        
           | codexjourneys wrote:
           | Totally agree, it can be a bit of an echo chamber. I had an
           | infection post-dental-work. Bing Chat insisted I had swollen
           | lymph nodes from a cold that would resolve on their own, then
           | decided I had a salivary gland infection. After a follow-up
           | with a real-world ENT, it was (probably accurately) diagnosed
           | as a soft-tissue infection that had completely resolved on
           | two rounds of antibiotics. The AI never raised that
           | possibility, whereas the ENT and dentist examined me and
           | reached that conclusion immediately.
           | 
           | I do think AI is great for discussing some health things
           | (like "how should I interpret this report or test result?"),
           | but it's too echo chamber-y and suggestion-prone for accurate
           | diagnosis right now.
        
             | bwb wrote:
             | Ya I wouldn't trust it for diagnosis at this point. But it
             | can help you get pointed in the right direction so human,
             | tests, and the scientific process can try to figure out the
             | rest.
             | 
             | Doctors struggle with diagnosis as well. I have stories and
             | I bet everyone has stories about being passed from doctor
             | to doctor to doctor, and none of them talk to each other or
             | work holistically.
        
         | DANmode wrote:
         | It doesn't even have to be that well-read (although it is),
         | 
         | it just has to listen to your feedback more than 11 minutes per
         | visit,
         | 
         | so it can have a chance at effectively steering you...
        
         | alphazard wrote:
         | > I want regulators to keep an eye on this and make smart laws.
         | 
         | Unfortunately any regulation should be expected to further the
         | interests of the entrenched medical companies. The regulation
         | track record includes: a cartel controlling the supply of
         | doctors, impossible barriers to entry for pharmaceuticals, and
         | high insurance premiums, which often don't result in material
         | coverage.
         | 
         | The reason ChatGPT has been such a boon for medical issues is
         | that it is just acting as a general purpose research assistant.
         | It wasn't designed for medicine, it wasn't designed as a
         | medical product or device. It doesn't conform to the
         | conventional wisdom that medical information is a different
         | kind of thing. It acts as if good medical outcomes are just
         | engineering problems (which they are) and is happy to present
         | information to help solve them. It's not worried about
         | accidentally giving out "medical advice" or stepping on a
         | doctor's toes. Once it is programmed to start worrying about
         | those things (as a result of regulation), you can bet it will
         | become less useful.
        
         | bossyTeacher wrote:
         | >my ability to understand health problems
         | 
         | How do you know that this understanding is correct? To me,
         | epistemologically, this is not too different from gaining your
         | health knowledge from a homeopath or gaining your physics
         | knowledge from a Flat Earther. You are in no position to
         | discern the validity of your "knowledge".
        
           | zemvpferreira wrote:
           | It's a lot easier to double-check, cross-reference, or test
           | the validity of advice given by a gpt. It has no authority,
           | no persuasion mechanisms, and its opinions are there in plain
           | text ready to be picked apart. You can ask it for references
           | and non-confrontationally challenge it on the things you're
           | sceptical about. It generally avoids woo in my experience
           | though it's hardly always correct in specific advice, it can
           | definitely point you in productive directions. Which is
           | completely different from discussing anything health with a
           | homeopath, who at best will try to get you to avoid
           | productive treatment and at worst poison you.
        
       | SecretDreams wrote:
       | LLMs for medical info are good, but they're easily abuseable.
       | I've got a friend who is an anxious mom. They use gpt/Gemini to
       | "confirm" all of their suspicions and justify far more
       | doctor/medical visits than is at all reasonable, while also
       | getting access to more recurring antibiotics than is reasonable.
       | LLMs are basically giving them the gun powder to waste the
       | doctor's time and slam an already stressed medical system when
       | all their kids need most of the time is some rest and soup.
        
         | hsuduebc2 wrote:
         | Yeah, it's a very powerful tool, and it needs to be used
         | carefully and with intent. People on Hacker News mostly get
         | that already, but for ordinary users it's a full-on paradigm
         | shift.
         | 
         | It moved from: A very precise source of information, where the
         | hardest part was finding the right information.
         | 
         | To: Something that can produce answers on demand, where the
         | hardest part is validating that information, and knowing when
         | to doubt the answer and force it to recheck the sources.
         | 
         | This happened in a year or two so I can't really blame. The
         | truth machine where you doesn't needed to focus too much on
         | validating answers changed rapidly to slop machine where
         | ironically, your focus is much more important.
        
           | SecretDreams wrote:
           | > This happened in a year or two so I can't really blame. The
           | truth machine where you doesn't needed to focus too much on
           | validating answers changed rapidly to slop machine where
           | ironically, your focus is much more important.
           | 
           | Very much this for the general public. I view it as
           | borderline* dangerous to anyone looking for confirmation
           | bias.
        
             | hsuduebc2 wrote:
             | Yea. Especially with absolutele garbage that is gooogle ai
             | summary, which is just slightly worse than their "AI mode".
             | I never saw anything hallucinate that much. It is much
             | worse that it is included in every search and it have the
             | google "stamp of quality" which was usually mark of well
             | functioning product.
        
               | hsuduebc2 wrote:
               | And tiny text at the bottom which shows only after
               | clicking "show more" statement "Al responses may include
               | mistakes" will certainly not fix that.
               | 
               | At least wording should be "is making mistakes" rather
               | vaguely stating that it may occasionally in some cases
               | produce mistake. Mistake can also be perceived as wrongly
               | placed link and not absolutely made up information.
        
               | SecretDreams wrote:
               | It's funny because their thinking* Gemini with good
               | prompting is solid, but the injected summaries they give
               | could easily be terrible if the people doing the querying
               | is lacking a certain base knowledge on the query.
        
         | ramoz wrote:
         | Yea, I'm in a particular health community. A lot of anxious
         | individuals, for good reason, end up posting a lot of nonsense
         | they derived from self-influenced chatgpt conversations.
         | 
         | That said, when used as a tool you have power over - ChatGPT
         | has also freed up some of my own anxiety. I've learned a ton
         | thanks to ChatGPT as well. It's often been more helpful than
         | the doctors and offers itself as an always-available counsel.
        
       | redmattred wrote:
       | The HHS is asking for recommendations on how to leverage AI for
       | healthcare: https://www.hhs.gov/press-room/hhs-ai-rfi.html
       | 
       | This is probably part of an effort to position them a potential
       | vendor to help the government with this.
        
         | aabajian wrote:
         | As an interventional radiologist, I want it to be easier to see
         | images from outside hospitals. Epic has nearly solved the
         | problem of seeing outside medical records. Yet, I still can't
         | see the images for the CT scan you had from the hospital across
         | the street unless I call the file room and get the images
         | transferred.
         | 
         | I imagine once data sharing is more robust, it would be easier
         | to validate AI models (at least specifically for radiology).
        
         | andersonpico wrote:
         | > This is probably part of an effort to position them (...)
         | 
         | who is "them" referring to in this sentence?
        
       | kmoser wrote:
       | This sounds like it will be one of those products which starts
       | out as an optional service, but eventually becomes required to
       | use if you want to participate in the overall healthcare system.
        
       | hereme888 wrote:
       | My level of trust for data:
       | 
       | 1) Claude
       | 
       | 2) OpenAI
       | 
       | 3) Grok
       | 
       | 4) Gemini
        
       | glemion43 wrote:
       | Me and I hope they are selling me something to fix my RLS
       | 
       | I would give a lot of money to do so
        
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