Automated Intelligence, or A. I., seems to be everywhere. New applications for A. I. are being found daily. There are certainly some drawbacks to A. I., such as social media advice that has led to some suicides, but for the most part A. I. represents a powerful new tool in our playbook.

The latest breakthrough attributed to A. I. is medical assistance in diagnosing rare diseases.

Alex Janin, writing for The Wall Street Journal, tells us of some remarkable discoveries made possible by A. I. in diagnosing rare conditions that previously stumped medical professionals. He says, “Patients and families are turning to AI to help pinpoint conditions. AI can be especially adept at flagging potential rare and hard-to-diagnose diseases, which may otherwise go undetected for years because doctors don’t often see them.”

“I have been a little slack-jawed a couple of times by the difference” AI has made in helping to spot uncommon conditions, said Dr. Sarah Diekman, a doctor who specializes in a subset of nervous-system disorders like POTS. “I’ve seen patients who’ve had this for 50 years, and I was the first person to diagnose.” Now, she said, patients who identified POTS with the help of AI chatbots are coming to her within months of their first symptoms.

Fidji Simo, the former chief executive of Instacart, has been public about her battle with POTS and stepped down from her post as Open AI’s No. 2 executive in July, citing her health. In an interview with The Wall Street Journal, she said she believes today’s AI tools would have helped her get a diagnosis, which took roughly nine months, much more quickly.

Data-center-driven diagnoses can be even more accurate than doctors’. In a study published last year in a JAMA journal, researchers took 90 complex rare-disease cases that had already been solved and tested AI chatbots’ abilities to suggest the right diagnosis. The two chatbots got the diagnoses right in 13% and 10% of cases, respectively, compared with 5.6% of cases that doctors had diagnosed through a review of patients’ medical records.

However, some caution is warranted. I am personally aware of at least one study that showed AI scored only 77% on a test of common orthopedic conditions compared to 100% by doctors. For most common ailments, it’s best to use human physicians. But for cases that stump the doctors, the use of AI may be beneficial.

AI can be especially good at finding patterns, such as links between physical features in medical imaging and words in medical literature or case reports, doctors and researchers said. That can help spot rare diseases, especially in rural or nonspecialty clinics where doctors may be confronting them for the first time, said Dr. Matthew G. Hanna, a breast pathologist who chairs the College of American Pathologists’ AI committee. AI may help provide suggestions for them about what types of tests to run, or what potential treatments could help, Hanna added.

Yet there are limits, doctors said. Clinical geneticist Dr. Xiao P. Peng, who helped confirm Hinken’s family’s diagnoses, said the tools still make mistakes and are better at generating possible leads, translating complex medical jargon and compiling research than making diagnoses.

This doctor agrees. It’s not time to fire your family physician or specialist. Years of experience are still very valuable in the treatment of all patients. AI is just a new useful tool in the doctor’s handbag, not a replacement for his or her wisdom and experience.

The Affordable Care Act, better known now as ObamaCare, was promoted to the public by Democrats as the solution for rising healthcare costs. But polls today show Americans are increasingly worried about the cost of healthcare and many have dropped their ObamaCare coverage because they can’t afford it.

Anna Wilde Mathews, healthcare analyst for The Wall Street Journal, tells us millions of Americans dropped their ACA plans after higher subsidies expired and now struggle to pay their medical bills. ACA enrollment fell by about 2.6 million as of February after enhanced federal subsidies expired.

To call the Affordable Care Act unaffordable is nothing new. I called it that in a blog post I wrote over ten years ago in 2015 (The Affordable Care Act is Unaffordable). The truth is ObamaCare has been a train wreck since the day it was passed without a single Republican vote. Why? Because it never lived up to its promises. Democrats, especially President Obama, was so eager to push new healthcare legislation that would move the country closer to socialized medicine that he told lies to sell the new legislation.

In my 2014 book The ObamaCare Train Wreck, I listed the broken promises made by President Obama:

• “I will sign a universal health care bill into law by the end of my first term as president that will cover very American.” (June 23, 2007)
• “I can make a firm pledge under my plan, no family making less than $250,000 a year will see any form of tax increase. Not you income tax, not your payroll tax, not your capital gains taxes, not any of your taxes.” (September 12, 2008)
• “We’ll lower premiums by up to $2500 for a typical family per year. . . We’ll do it by the end of my first term as president of the United States.” (June 5, 2008)
• “I will not sign a plan that adds one dime to our deficits.” (September 9, 2009)
• “If you like your doctor, you will be able to keep your doctor, period. If you like your healthcare plan, you’ll be able to keep your healthcare plan, period. No one will take it away, no matter what.” (June 15, 2009)
• On December 15, 2009, President Obama asserted the bill would “finally reduce the costs of health care.”

There isn’t space here to list the many ways these promises have been broken, but suffice it to say that all of these promises were broken. (The details can be found in my book.)

The reasons for the rise of healthcare costs are many, but the underlying fault with ObamaCare is that it is a “one size fits all” system where everyone must purchase the same coverage regardless of their individual needs. This is so extreme that men must pay premiums that include mammograms and woman must pay for prostate exams. No joke!

The solution to our rising healthcare costs is market-based reforms that push the right incentives and reward good health. This is doable except Democrats will resist anything that threatens to eliminate their precious ACA – because what they really want is socialized medicine. While ObamaCare is not yet socialized medicine, it is a large step in that direction. Medicare for All – the Bernie Sanders system being promoted by socialist candidates now – is even further in that direction. If you think our system is bad now, just wait until the Democrats deliver on their Medicare for All promises.

(Note: For more on Medicare for All see recent posts listed on my home page.)

Surveys tell us that many Americans are upset with the cost of healthcare. Democrats in particular are using this dissatisfaction in their campaigns to convince people to vote Democratic. They’re also complaining about “affordability” and blaming the problem on the Trump administration. There’s a common theme in both of these issues.

You wouldn’t call an arsonist to put out a fire – but both of the above problems were created by the arsonists – the Democratic Party! Inflation got out of control during the Biden administration and the cost of healthcare is directly related to the passage of ObamaCare during the Obama administration. While Republicans have failed to correct these problems to the satisfaction of the American people, they can’t expect Democrats to have the solutions when they caused the problems in the first place!

Further evidence that Democrats can’t solve these problems is a recent bill introduced in the Congress by Rep. Lloyd Doggett (D- Texas) and co-sponsored by more than 40 House Democrats that would sharply reduce government payments to Medicare Advantage plans. Medicare Advantage plans are privately managed policies for Medicare enrollees. They are extremely popular since they provide greater benefits at lower costs than traditional Medicare.

But Mr. Doggett introduced the bill because he said it would “level the playing field” between traditional Medicare and Medicare Advantage plans. In other words, they want to make these plans less attractive and more costly! Why would they want to do something that would make healthcare more expensive?

John C. Goodman, writing for The Wall Street Journal, gives us the explanation.

“It is no secret that many congressional Democrats dislike private health insurance even though private insurers were heavily involved in designing ObamaCare. Politicians on the left often speak about the desirability of a “public option.” But Medicare has already had a competing public option for more than two decades. It’s called traditional Medicare, and it has been losing the competition. More than half of all Medicare enrollees are in private plans. For all its faults, Medicare Advantage is arguably the best healthcare program we have. It’s much better than the ObamaCare exchange plans and most employer plans. Mr. Doggett is attacking this overall well-functioning program while ignoring our nation’s worst program: Medicaid.

Goodman goes on to explain that one of the great ironies in U.S. healthcare is that the private insurance industry is largely responsible for administering both the best and worst health insurance programs we have. What Mr. Doggett calls the “giant private insurance companies that profiteer off Medicare” are mostly the same companies that are administering Medicaid.

If private companies run both programs, why is one so much better? Goodman says the answer lies in how the program is structured. Medicare Advantage gets four things right:

First, it is the only program in our entire healthcare system in which a doctor who discovers a patient’s previously unknown health problem can send that information to the insurer (in this case Medicare). This results in a higher premium payment for the health plan to cover the higher expected cost of care.

Second, because of a sophisticated risk-adjustment program, Medicare Advantage plans are the only plans in our healthcare system that actually want sick people as enrollees. No employer, commercial insurer or ObamaCare marketplace plan wants a sick enrollee.

Mr. Doggett insists that Medicare Advantage plans seek to enroll only the healthy, but the reverse is true. Significantly more low-income beneficiaries were enrolled in Medicare Advantage plans (68% vs. 32%) in 2023. In 2021, such plans were also the preferred choice of black (59%) and Hispanic (67%) enrollees relative to whites (43%). These minorities are known to have above-average medical needs.

Third, Medicare Advantage is the only program in our healthcare system in which health plans can specialize in the treatment of specific conditions such as diabetes, congestive heart failure or HIV. This allows them to create focused factories that are increasingly skilled at providing care. By contrast, in the ObamaCare marketplace, health plans are forced to be all things to all people.

Finally, Medicare Advantage plans make money by keeping people healthy. Long before the price of insulin became a political issue, some plans were discounting the out-of-pocket cost to diabetics. While the political focus today is on $35 insulin, some Medicare Advantage plans make insulin available free in special-needs plans for diabetics. Keeping diabetics out of emergency rooms is cost-effective medicine.

Yet, Democrats want to destroy this popular, cost-effective, healthcare program by making it more like traditional, more-costly and less popular traditional Medicare. Remember, these are the same people who sold us on the concept of ObamaCare with the promise it would lower healthcare costs for every family and guarantee “if you like your doctor, you can keep your doctor” in the immortal words of President Obama.

You can’t expect the same people who created the problem to fix it. There’s an old saying that applies here: “Fool me once, shame on you, fool me twice, shame on me.”