Medicare Starts Rationing Treatments Next Year Using AI

Saturday, August 30, 2025

A pilot program in six states will use a tactic employed by private insurers like United HealthCare that has been heavily criticized for delaying and denying medical care.

Posted by C0RI0LANUS at 07:33 PM | 52 COMMENTS | permalink | Comment on This Entry |

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Similar cold-blooded algorithms used by health insurers like UHC have been the subject of several high-profile lawsuits, which have asserted that the technology allowed the companies to swiftly deny large batches of claims and cut patients off from care in rehabilitation facilities. The AI companies selected to oversee the program would have a strong financial incentive to deny claims. Medicare plans to pay them a share of the savings generated from rejections. Congratulations Republican voters for being the engine of our destruction. When the hospitals in your rural areas begin to close or when Medicare denies you or a loved one treatment, who will you blame? Bill Clinton? Joe Biden? Which liberal or Democrat? Who?

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Comments

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Last year greedy oligarch UHC CEO Brian Thompson paid the ultimate price for coldly putting profits over people. The number of patients UHC denied coverage for must be in the tens of thousands. Those poor people loyally paid their United Healthcare premiums for years, only to be denied treatment just so UHC could enrich itself further. Next year AI contractors will enrich themselves denying treatment to Medicare patients in the same way as UHC.

#1 | Posted by C0RI0LANUS at 2025-08-29 01:06 AM | Reply | Newsworthy 1

... United HealthCare ...

imo, the company name is an oxymoron.

"HealthCare"

imo, hardly.

More like, trying to suck as much money out of healthcare as they can....

But, that's just my opinion. YMMV.

I had dental insurance with that corporation at one point.

I called their "customer service," and I asked a simple question, ~how can I increase the coverage of my insurance?~ I was bounced around from person to person. No one seemed to want to answer my simple question.

After a while of playing their game, I decided to change my dental insurance company.

No issues or customer service problems since then.

#2 | Posted by LampLighter at 2025-08-29 01:22 AM | Reply | Newsworthy 1

#2: Hi LL: Had you see any of these reports?

www.cthealth.org

www.fiercehealthcare.com

ctmirror.org

#3 | Posted by C0RI0LANUS at 2025-08-29 02:22 AM | Reply

So it begins.

Our debt balloons so we can pay contractors to make our lives miserable.

#4 | Posted by jpw at 2025-08-29 02:47 AM | Reply

"So it begins.

Our debt balloons so we can pay contractors to make our lives miserable.

#4 | POSTED BY JPW "

This has been visible for decades. So what you will about him...Paul Ryan had been calling this out going back into the W administration. His proposed solutions were a mixed bag, but he was among a group sounding the alarm.

#5 | Posted by BellRinger at 2025-08-29 02:55 AM | Reply

No doubt a racist allotment from a racist nation.

#6 | Posted by fresno500 at 2025-08-29 04:00 AM | Reply

#6: Racism underlies why the US is the only developed nation in the world not to have universal healthcare for its citizens.

Link: www.nytimes.com

Now comes AI rationing and cruel triage into Medicare so contractors can make money.

#7 | Posted by C0RI0LANUS at 2025-08-29 04:22 AM | Reply | Newsworthy 3

Death panels via AI brought to you by Trump.
Did you really vote for this, MAGAts?
Why, yes, you did.
Bon appetit, suckas!

#8 | Posted by Doc_Sarvis at 2025-08-29 05:12 AM | Reply | Newsworthy 1

#7
The "donors" are getting the government they bought.

#9 | Posted by Doc_Sarvis at 2025-08-29 05:58 AM | Reply

So what you will about him...Paul Ryan had been calling this out going back into the W administration. His proposed solutions were a mixed bag, but he was among a group sounding the alarm.
#5 | Posted by BellRinger

Yes, and his proposed solution on the Romney/Ryan ticket in 2012 was functionally the same as this plan.

The Republican plan was vouchers, aka handouts, with the cost savings happening because the handout wasn't enough to pay for the cost of care.

The new Republican plan cuts out the middleman and simply denies coverage for the care.

The end result is the same: People on Medicaid don't get medically indicated care.

And you're happy with that outcome.

#10 | Posted by snoofy at 2025-08-29 11:14 AM | Reply

#11 | Posted by C0RI0LANUS at 2025-08-29 10:54 PM | Reply | Newsworthy 1

Republicans opposing "Obamacare" bleated about "death panels!!!" like the useless sheep they are

#12 | Posted by hamburglar at 2025-08-29 11:51 PM | Reply | Newsworthy 1

... will use a tactic employed by private insurers like United HealthCare ...

Yeah, there's a health insurance provider that seems to care about patient outcome over profits.

#13 | Posted by LampLighter at 2025-08-30 07:43 PM | Reply

AI can't even get Taco Bell orders correct but yeah, let's trust our healthcare decisions to the technology.

#14 | Posted by johnny_hotsauce at 2025-08-31 12:23 AM | Reply

@#14 ... but yeah, let's trust our healthcare decisions to the technology. ...

Yeah.

It seems to depend upon how, and that is specific, how the AI has been trained via the data it has been given.

The question then seems to become, how will our current environment of ~healthcare for a profit~ affect the training of those AI bots?

#15 | Posted by LampLighter at 2025-08-31 12:29 AM | Reply

LAMP

That and can a doctor's decision override an AI decision?

#16 | Posted by Twinpac at 2025-08-31 12:58 AM | Reply

Jeff is a ------- imbecile

#17 | Posted by LegallyYourDead at 2025-08-31 03:31 PM | Reply

Going back to the early 90's, every small or medium sized company I did accounting work reported their annual group health insursnce renewal rate increased 5 to 15 percent...or more.

Every company always substantial increases.

That showed me it was inevitable health care costs are guaranteed to become a crisis at some point.

Obama's ACA health care accelerated it.

This problem has been a long time coming.

Double digit increases year after year something's gotta give.

#18 | Posted by BillJohnson at 2025-09-01 07:55 AM | Reply

I wrote that...not AI.

#19 | Posted by BillJohnson at 2025-09-01 07:57 AM | Reply

" Obama's ACA health care accelerated it."

You clearly don't know what you're talking about.

In the decade before Obamacare, medical inflation was over 4 times actual inflation. The trajectory was frightening.

Obamacare bent the trajectory downwards, and gave health plan Trustees (like me) some breathing room.

You're LITERALLY CLAIMING THE OPPOSITE OF WHAT HAPPENED.

#20 | Posted by Danforth at 2025-09-01 01:08 PM | Reply

Dan,

I double checked and found that, overall, rates did drop after ACA.

But my main point is this has been building for decades. Everywhere I worked, group plans climbed year after year often in the double digit.

I knew small businesses and self-employed who said ACA hurt them.

Health insurance costs have been rising faster than almost everything else for decades. The ACA didn't start that. Didn't fix it either.

#21 | Posted by BillJohnson at 2025-09-01 02:42 PM | Reply

BullJohnson is a troll, just like BullBringer.

He's only here to repeat the same lies and bullshht.

Every time he posts.

#22 | Posted by ClownShack at 2025-09-01 02:51 PM | Reply

" But my main point is this has been building for decades. Everywhere I worked, group plans climbed year after year often in the double digit"

Yes. THAT'S WHY we needed Obamacare.

And don't look now, but you just admitted the facts disproved your claim.

In reality, the rate of medical inflation radically DECREASED due to O'Care.

One of the reasons I know is, I was against Obamacare from the start, but admitted I would have to give props if the frightening medical inflation trajectory was favorably altered.

It was, and for that I have always given the credit to Obamacare.

Meanwhile, you're lying about it. The central tenet of your claim is bulllschittt.

#23 | Posted by Danforth at 2025-09-01 02:54 PM | Reply

"I knew small businesses and self-employed who said ACA hurt them."

Duh

There is your reason why your health care should NOT be dependent on you having a job or your ability to work.

This is why American businesses cannot compete with foreign "sweat shops".

The "sweat shops" don't have to care about your health or whether you live or die.

Your benefits there is that you get to eat and have a place to sleep and poop.

#24 | Posted by donnerboy at 2025-09-01 02:56 PM | Reply

" Health insurance costs have been rising faster than almost everything else for decades. The ACA didn't start that. Didn't fix it either."

What's higher, moron ... a 5% rise, or a 15% rise?

Actual Math only.

#25 | Posted by Danforth at 2025-09-01 02:59 PM | Reply

"I knew small businesses and self-employed who said ACA hurt them."

That's because of the mandate, not because of (the usual) leaps in premiums.

Plus, the self-employed get to write off 100% of the premiums against taxable income, including a spouse's premiums.

#26 | Posted by Danforth at 2025-09-01 03:03 PM | Reply

Plus, the self-employed get to write off 100% of the premiums against taxable income, including a spouse's premiums.

#26 | POSTED BY DANFORTH

Good point.

And since we are all pretty much required to have health care to stay healthy so we can stay active and work and be productive citizens to be able to pay those taxes that should actually apply to everyone. It would be another step in the right direction.

#27 | Posted by donnerboy at 2025-09-01 03:27 PM | Reply

Doctors offices will have to have good prompt writers to get the claims through AI.

Much like the current job application hellscape where Employees have to have good AI resumes to get past the AI screeners Doctors offices will need good AI claims to get past the AI denials with an ever escalating battle to see who can develop and get around the newest prompts.

#28 | Posted by TaoWarrior at 2025-09-01 03:36 PM | Reply

TAO.

It seems to me that everyone now needs to have access to their own personal AI.

If you don't have access to your own personal AI (to at least defend you from "bad guy" AI) then you are at a disadvantage and already falling behind and will soon fall off the ladder/curve completely.

#29 | Posted by donnerboy at 2025-09-01 03:42 PM | Reply

I'm afraid a good guy with an AI is just as mythical as a good guy with a gun.

That said I've been playing with AI a bit just so I'm not completely behind the curve. I still trust my own logic and thinking more than AI but it does have me beat in speed.

#30 | Posted by TaoWarrior at 2025-09-01 03:51 PM | Reply

From Google AI:

Before the ACA (Pre-2010)
Consistently High Inflation: Medical inflation, measured by the Price Index for Personal Consumption Expenditures (PCE) for health care services, was consistently at or above 3% per year in the early 2000s.
After the ACA (Post-2010)
Slowing Inflation: Health care services price growth saw a significant decline after 2010, reaching a near-historical low point of under 1% in 2015.
Periods of Low Inflation:
The period between late 2014 and early 2016 saw particularly low healthcare inflation, a rate not seen since 1961.
Rebounding Inflation: From 2015 onward, healthcare inflation began to rebound, increasing from under 1% to nearly 2% by early 2018.
Long-Term Comparison Medical Care vs. Overall Inflation:
Medical care prices generally grew faster than overall consumer prices throughout the period from 2000 to 2024.
Growth in Out-of-Pocket Expenses: While overall medical inflation slowed after the ACA, out-of-pocket healthcare expenses increased at an average of 3.4% a year before the ACA (2000-2009) and a slower 1.9% a year after (2010-2018).

So, the ACA was instrumental in a 44% reduction in medical inflation.

(Math: 3.4 minus 1.9 equals 1.5; divided by 3.4 = 44%)

#31 | Posted by Danforth at 2025-09-01 04:24 PM | Reply

"medical inflation."

Apologies: I should have said out-of-pocket medical expenses. My error.

The effect on the inflation was, obviously, greater than my claimed 44%.

#32 | Posted by Danforth at 2025-09-01 04:27 PM | Reply

Dan,

"Plus, the self-employed get to write off 100% of the premiums against taxable income, including a spouse's premiums"

So they don't pay income taxes on it.

It's still an expense.

This self employed business owner told me his policy was taken from him because it had a high deductible and he had to pay for a more expensive policy.

#33 | Posted by BillJohnson at 2025-09-01 04:27 PM | Reply

Dan,

He had to pay a bigger insurance invoice that took more out of cash flow.

#34 | Posted by BillJohnson at 2025-09-01 04:38 PM | Reply

A problem with ACA is it didnt address run away medical expenses.

That would have killed ACA.

Still, that is a serious problem.

Not addressing it, is like a dog chasing its tail running faster and faster and faster.

#35 | Posted by BillJohnson at 2025-09-01 04:55 PM | Reply

Well isn't this just fkn great. I'm finally eligible for Medicare next year, and the Trump Administration is going to make it just as crappy as my private insurance.

#36 | Posted by Whatsleft at 2025-09-01 05:47 PM | Reply

I'm afraid a good guy with an AI is just as mythical as a good guy with a gun.

There ARE good guys with guns. Unfortunately there is also too many bad guys with guns too. I do believe that's the conundrum.

You cannot uninvent them.

#37 | Posted by donnerboy at 2025-09-01 06:11 PM | Reply

"A problem with ACA is it didnt address run away medical expenses."

But it did, based on Medical Loss Ratio. Some consumers (including me) got a rebate.
www.healthinsurance.org

Again, you don't know what you're talking about. The trajectory of Medical Inflation was bent toward sanity under the ACA. That's basic math.

#38 | Posted by Danforth at 2025-09-01 06:18 PM | Reply | Newsworthy 1

AI will be used as a weapon.

I believe it already is.

And yeah.. I don't count on AI or a gun to protect me or "save" me. AI can give you just that little edge you need tho. Everyone needs an edge.

But just like guns are not gonna save us from ourselves neither is AI.

#39 | Posted by donnerboy at 2025-09-01 06:20 PM | Reply

@#35 ... A problem with ACA is it didnt address run away medical expenses.

That would have killed ACA.

Still, that is a serious problem. ...

I agree it is still a serious problem.

One that the ACA had been starting to address. While the ACA did not reverse medical expenses, it had been shown to reduce the rate of increase (the so-called 2nd-derivative).

Had the ACA been allowed to continue, instead of being cut-off at the knees by the GOP, the ACA may have reached the goal of reducing medical costs.

But, now, thanks to the GOP, we will never know, and are still subject to what your alias calls a serious problem of medical costs.

#40 | Posted by LampLighter at 2025-09-01 06:47 PM | Reply

Lower Costs, Better Care: Reforming Our Health Care Delivery System (2014)
www.cms.gov

... Fixing America's health care system doesn't stop with guaranteeing that everyone has coverage. To address the rising costs of health care, we must improve the way that health care is delivered, including the coordination and safety of care.

The Affordable Care Act includes tools to improve the quality of health care that can also lower costs for taxpayers and patients. This means avoiding costly mistakes and readmissions, keeping patients healthy, rewarding quality instead of quantity, and building on the health information technology infrastructure that enables new payment and delivery models to work. ...

Already we have made significant progress:

Health care spending is slowing

According to the annual Report of National Health Expenditures, total U.S. health spending grew 3.7 percent in 2012. This marks the slowest four years on record in overall health expenditures and for the second straight year, overall health costs grew slower than the economy as a whole. ...

#41 | Posted by LampLighter at 2025-09-01 06:51 PM | Reply

"A problem with ACA is it didnt address run away medical expenses."

There is only one person brave enough to address runaway medical expenses and he is currently awaiting trial for the assassination of the psychopath and mass murderer CEO of United HealthGroup.

#42 | Posted by snoofy at 2025-09-01 07:01 PM | Reply

Is there any reason to believe this will be implemented better inside Medicare compared to UHC?

Doesn't this just prove that the ills and evils of private health insurance ends up inside a single payer system all the same?

#43 | Posted by eberly at 2025-09-01 07:04 PM | Reply

"Is there any reason to believe this will be implemented better inside Medicare compared to UHC?"

Better for patients, or better for profits?

#44 | Posted by snoofy at 2025-09-01 07:32 PM | Reply

@#43 ... Doesn't this just prove that the ills and evils of private health insurance ends up inside a single payer system all the same? ...

What about UHC is single payer?

I had UHC for dental coverage.

A couple years ago, I called their customer service, asking how to increase my maximum $1000 yearly coverage to $2000.

I was bounced around from customer service rep to customer rep for 45 minutes, no one seeming to be able to answer that simple question.

As a result, I switched to a different dental insurance provider.

That dental insurance provider has been quite good in their customer service.

So, maybe UHC has a problem that it needs to address. I dunno. That is their issue now.

I've moved on to a health insurance company that seems to care.

That aside, healthcare for a profit in the US will only result in rising prices as the billionaire-financed private equity firms buy up more and more of our health system.

#45 | Posted by LampLighter at 2025-09-01 07:38 PM | Reply

-What about UHC is single payer?

It's the private carrier.

Medicare, the subject of this story, is the single payer.

Medicare, a single payer, is adopting a technology used by the private sector.

#46 | Posted by eberly at 2025-09-01 09:41 PM | Reply

Medicare, a single payer, is adopting a technology used by the private sector.

"A technology," lol.

#47 | Posted by snoofy at 2025-09-01 09:45 PM | Reply

@#46 ... Medicare, a single payer, is adopting a technology used by the private sector. ...

But is medicare adapting the technology for the same reasons that the private sector adapts the technology?

The cited article seems to say so.

So, if that turns out to be the case, as you seem to say, the Trump admin looks to be using Medicare cuts to further diminish the health of Americans, in order to pay for its billionaire tax-cuts..

#48 | Posted by lamplighter at 2025-09-01 09:53 PM | Reply

As long as it overwhelmingly kills Republican voters, I see no reason not to support these cuts.

Give the people what they voted for.

#49 | Posted by snoofy at 2025-09-01 10:05 PM | Reply

There is only one person brave enough to address runaway medical expenses and he is currently awaiting trial for the assassination of the psychopath and mass murderer CEO of United HealthGroup.
#42 | POSTED BY SNOOFY A

Obama isn't currently awaiting trial for an assassination.

Everyone knows that ObamaCare was a setup to make the health insurance industry rich.
It never was designed to bring down prices or improve coverage.
Anyone who claimed this is an idiot.

How as this ...
media.washtimes.com

Transformed into this
media.washtimes.com

Going to save money?

#50 | Posted by oneironaut at 2025-09-01 10:10 PM | Reply

Apparently you didn't understand that he was referring to Luigi Mangione.

#51 | Posted by Alexandrite at 2025-09-01 10:11 PM | Reply

It never was designed to bring down prices or improve coverage.

It was designed to allow people to GET coverage that otherwise could not. That worked.

#52 | Posted by Alexandrite at 2025-09-01 10:12 PM | Reply