Ken Scott Baron Podcast

Some experts predict that AI will lead to significant job displacement, as machines will be able to perform many tasks that are currently done by humans. However, other experts argue that AI will create new jobs and opportunities, particularly in the fields of data analysis and machine learning.

You might not know it, but an artificial intelligence algorithm used to screen applicants has decided that you are too risky. Maybe it inferred you wouldn’t fit the company culture or you’re likely to behave in some way later on that might cause friction (such as joining a union or starting a family). Its reasoning is impossible to see and even harder to challenge.

It doesn’t matter that you practice safe digital privacy: keeping most personal details to yourself, avoiding sharing opinions online and prohibiting apps and websites from tracking you, A.I. predicts how you’ll behave at work, based on patterns it has learned from countless other people like you and me.

A.I. banks can use algorithms to decide who gets a loan, learning from past borrowers to predict who will default. Some police departments have fed years of criminal activity and arrest records into “predictive policing” algorithms that have sometimes sent officers back to patrol the same neighborhoods.

Social media platforms use our collective clicks to decide what news — or misinformation — each of us will see. In each case, we might hope that keeping our own data private could protect each of us from unwanted outcomes. A.I. only needs to know what people like you have done before.

As we adapt to living with A.I. as a larger part of our lives, we need to exert collective control over all of our data, to determine if it’s used to benefit or harm us

A while ago, protections meant people might be more willing to share their data with third parties, and these differential privacy algorithms are now quite common. Apple iPhones are built with these algorithms to collect information about user behavior and trends, without ever revealing what data came from whose phone. The 2020 U.S. census used differential privacy in its reporting on the American population to protect individuals’ personal information.

Palantir is building an A.I. system to identify and track people for deportation by combining and analyzing many data sources together getting around the obstacle posed by differential privacy.

Even without knowing who any one person is, the algorithm can likely predict the neighborhoods, workplaces and schools where undocumented immigrants are most likely to be found. A.I. algorithms called Lavender and Where’s Daddy? have been reportedly used in a similar way to help the Israeli military determine and locate targets for bombardment in Gaza.

In climate change, one person’s emissions don’t alter the atmosphere, but everyone’s emissions will destroy the planet. Your emissions matter for everyone else. Similarly, sharing one person’s data seems trivial, but sharing everyone’s data — and tasking A.I. to make decisions using it — transforms society.

Everyone sharing his or her data to train A.I. is great if we agree with the goals that were given to the A.I. It’s not so great if we don’t agree with these goals; and if the algorithm’s decisions might cost us our jobs, happiness, liberty or even lives.

We need to build institutions and pass laws that give people affected by A.I. algorithms a voice over how those algorithms are designed, and what they aim to achieve. The first step is transparency.

Use of A.I. should be required to disclose their objectives and what their algorithms are trying to maximize — whether that’s ad clicks on social media, hiring workers who won’t join unions or total deportation counts.

The second step is participation. The people whose data are used to train the algorithms — and whose lives are shaped by them — should help decide their goals. Like a jury of peers who hear a civil or criminal case and render a verdict together, we might create citizens’ assemblies where a representative randomly chosen set of people deliberates and decides on appropriate goals for algorithms.

That could mean workers at a firm deliberating about the use of A.I. at their workplace, or a civic assembly that reviews the objectives of predictive policing tools before government agencies deploy them. These are the kinds of democratic checks that could align A.I. with the public good, not just private power.

The future of A.I. will not be decided by smarter algorithms or faster chips. It will depend on who controls the data — and whose values and interests guide the machines. If we want A.I. that serves the public, the public must decide what it serves.

There is a fight between Democratic activists, who have called on Congressional leaders to fight Trump and his administration more, and the leaders themselves — who, until recently, were very publicly ambivalent about the demands of the mobilized left wing of the party.

Senator Schumer publicly rebuked the “fight Trump” wing of the party back in March when he refused to shut down the government.

Democrats need to engage in an all-out fight for the country. And so,House minority leader Jeffries and several other Democratic representatives attended No Kings Day rallies.

Democrats are energized to participate in politics right now. It looks like 5–6 million people turned out nationwide to stand up for democracy and protest Trump on Saturday. That is a big shift in organization and energy to the left from the 2024 Biden and Harris campaigns (and an increase in turnout since the first No Kings Day in June).

Meanwhile Democrats lead by 3 in the House generic ballot, according to the average at FiftyPlusOne.news, and they’ve increased their vote margin in the average special election since January by 15 points.

In the September Strength In Numbers/Verasight poll, voters who were most likely to say they’ll vote next year were 9 points friendlier to Democrats in the House.

Among the most engaged voters (those saying they are definitely or very likely to vote), the margin is still D+5 (50–45). Voters were asked to rate their interest in the election on a scale from 1 to 10: Among the 10-out-of-10 voters, Democrats lead 55–41 (just 4% undecided) in the generic ballot.

But in the sense that No Kings is evidence to party leadership that Democrats want them to publicly fight for democracy and sensible government, I’d say it’s very important. And if you compare how leadership is acting now (holding firm on day 21 of a government shutdown) to where they were six months ago, I’d say we are in a better place.

Also, party identification age distributions have changed over the last 50 years. Gallup just released its quarterly estimate of national party identification on Oct. 20. Now Democrats hold a 7-point lead on party ID now, their highest since before Joe Biden was elected president.

Moreover that 7-point lead is actually larger than the equivalent Democratic Party ID advantage during Trump’s first term:

This quarter’s D+7 reading is close to the lead Democrats had for most of the past decade, including in 2012 during Barack Obama’s re-election:

This is very different from the party registration data of a few months ago when the NYT said it was a “crisis“ for Democrats. Avise back then was to take the catastrophic framing with a grain of salt, since by mid-year, the data was pretty stale (not a lot of people register to vote in the off year), and so was likely hiding the shift toward Democrats we were seeing in polls.

So, don’t clutch the pearls just now, don’t agonize, organize.

Joblessness for Black workers is rising again, two years after reaching a record low. It’s a troubling indicator: A rise in black unemployment is often considered an early warning sign for the overall economy, as Black workers are frequently the first to be laid off during economic downturns.

The administration’s efforts to reshape the federal government have serious implications for federal workers and their families—especially Black workers.

For decades, the federal government has provided stable employment, excellent benefits, and key protections in hiring and promotions that supported a robust Black middle class.

This time, the administration’s assault on diversity programs and cuts to the federal work force could make it even more difficult for Black workers to recover when conditions improve.

The African American unemployment rate has surged over the past four months, from 6 to 7.5 percent, while the rate for white people ticked down slightly to 3.7 percent. On top of a slowing economy, the White House’s actions have disproportionately harmed Black workers, economists said.

Since the 1970s, the rate for Black people has run about twice the rate for white people. Because of inferior educational opportunities, the legacy of mass incarceration and discrimination over generations, Black people confront greater challenges in the job market.

In 2023, conditions for Black workers looked as healthy as ever. Unemployment reached a low of 4.8 percent. Wages rose at their fastest pace since data collection began in the 1990s, and median Black household wealth reached the highest level on record.

Conditions started to deteriorate in 2024 after pandemic-era subsidies expired. Hiring slowed, and high prices weighed heavily on low-income earners. Black households were the only racial group last year in which median income fell and the poverty rate rose, according to the Census Bureau.

Job losses are concentrated among Black women working in professional services such as human resources, according to Ms. Wilson’s analysis of federal data. A hiring freeze and mass layoffs in the federal work force, which have continued during the government shutdown and now exceed 200,000, have also fallen disproportionately on Black workers.

The hiring freeze is an impediment to young workers trying to get their foot in the door, too.

State and local governments have picked up some of the slack from federal agencies. But competition for those jobs has gotten tougher with more laid-off public-sector workers looking for positions.

The Los Angeles Black Worker Center, has pushed local governments to hire more Black workers because unionized public-sector jobs have historically provided an on-ramp to stable employment.

The federal backlash against diversity, equity and inclusion practices may be making it more difficult for Black workers to get hired in the private sector, too. The administration ordered that group not to pursue racial equity anymore.

Lower interest rates could offer some relief. Representative Ayanna Pressley, Democrat of Massachusetts, wrote to Jerome H. Powell, chair of the Federal Reserve, in early September demanding that the central bank take stronger action to support full employment for Black workers. Fed officials lowered rates later in the month for the first time this year and suggested that more cuts were likely.

But the administration’s actions beyond work-force cuts and anti-D.E.I. policies, could create additional hurdles for Black workers. The Department of Labor’s proposed rollback of minimum-wage and overtime protections for domestic workers, for example, would hurt their incomes. Home care aides for the elderly are overwhelmingly Black and Hispanic women.

And despite the claim that immigrants take jobs from Black people, rising joblessness among Black workers suggests that mass deportations of migrants haven’t arrested the trend.

immigrants fill labor shortages, complement the native workforce, and create jobs through entrepreneurship and increased economic demand. Instead of displacing U.S.-born workers, immigrants often take jobs that native-born workers are unwilling or unable to do, or they fill high-skill positions that are in high demand.

Democrats and the Working Class

Democrats are spending tens of millions of dollars to understand the working class that once defined their party. They face an identity crisis at the very moment they are trying to attract blue-collar voters who no longer think the political left sees them — or cares. Why did the working class switch sides?

To find a way forward, Democrats might want to look back to when they first lost the working class and the New Deal coalition fractured. While some Democratic challenges have changed, too many struggles remain all too familiar.

Remember in 1970, after Nixon expanded the Vietnam War and the National Guard killed four Kent State students, the antiwar movement radicalized like never before.

Workmen watched protesters chanting support for the other side fighting their kin and kind in Vietnam. IIn a clash that engulfed Lower Manhattan and came to be known as the hard hat riot, masses of workmen pummeled student protesters.

The icons of Franklin Roosevelt’s coalition had attacked the left’s future. It shocked power brokers. The New Left was at war with the Old.

Vietnam concerned not only how one lived but also how one might die. It chafed many working families to see student protesters lecture Americans with less status about social justice while their boys went to war in students’ place. For weeks, two breeds of Democrats were now in the streets, clashing over social values and who felt valued.

This was a class war boiling beneath the emerging culture wars.

Many Americans wanted not only respect for soldiers and the flag but also for motherhood, elders, the workingman. Once celebrated, blue-collar workers were now dismissed as reactionary, racist and ignorant suckers.

So, some Republicans saw their chance to win that Democratic base.

By the 1972 campaign, labor sought to salvage blue-collar Democrats. But at the Democratic convention, George McGovern became the standard-bearer. The New Left had won the party.

At the convention, delegates were diverse by race and sex — but not by class. The party establishment shifted Democrats’ emphasis from social class to social identity. Republicans from Ronald Reagan to President Trump framed campaigns as common touch versus out of touch.

Nixon won 49 states with nearly all his electoral gains being with blue-collar voters. The Republican presidential nominee won the labor vote for the first time since tracking began.

Enough of history! Democrats’ question today is: will Hispanic voters, in particular, ultimately drift rightward as so-called ethnic whites once did?

Trump got the white working class and Latino men. Most of Mr. Trump’s increased Latino support was within the working class. Democrats belatedly recognized that demographics — and a multiracial electorate — did not assure a progressive destiny.

In 2020, when protests and riots took place in many American cities, Representative Jim Clyburn of South Carolina warned that the mind-set “burn, baby, burn” had “destroyed our movement back in the ’60s.”

But Democrats are not fated to relive mistakes that confuse some activists’ causes for whom they claim to represent or the views of radical youth for the views of the young or to forget that politicians can win big, boisterous crowds and still lose America.

Blue-collar America has changed. It’s less unionized, less white, less reliant on manufacturing. But most Americans still lack a bachelor’s degree and would find it difficult to pay a $1,000 emergency expense.

American intellectuals have long struggled to fathom the average American. One study showed that Democrats’ ability to accurately comprehend the other side “actually gets worse with every additional degree they earn.”

And it seems, too often, that leading Democrats who seek some populist fire misunderstand how Democrats got burned. More than two-thirds of swing voters who chose Mr. Trump strongly agreed that Democrats held wrongheaded positions on immigration, crime and identity politics.

Economic populism, including Bernie Sanders’s and Alexandria Ocasio-Cortez’s Fighting Oligarchy tour, is the easy part. A populism that ignores most Americans’ social outlook has never proved able to win a majority outside dire economic times.

Democrats cannot merely buy back the working class.

There are also progressive headwinds. Democrats who identify as socially liberal rose to 69 percent from 39 percent over the past two decades.And since the 1970s, loud voices from popular culture to politics have encouraged an orthodox social liberalism that has weighed down swing-state Democratic candidates.

Which inspires yet another question: Have Democrats lost enough to win? Jimmy Carter and Bill Clinton — led Democrats out of a similar wilderness. For even when Mr. Trump’s presidency ends, the challenges will persist.

Democrats need to stop walking into the same old trap, and supplement defense of democracy with a viable strategy to lure back enough non-college-educated voters to win elections. Both white voters and voters of color without degrees typically care more about the economy than democratic norms.

First, Trump is not focused on the kitchen table issues he ran on. Second, he has cut government programs that provide security for ordinary Americans in order to finance huge tax cuts for big business. Third, he’s making America weak again in the process.

The New Christianity

A disclaimer, I am an atheist but do go to church (Unitarian Universalist). I don’t espouse, as Karl Marx did, that "Religion is the opium of the masses". I do think we have to be careful about extreme dogma.

Religious conservatism now is more intentional and mission-driven and a post-secular formation. The Christian right’s bargain with the current administration could look less corrupting and more necessary.

The Kirk service was more religious than political, with a portrait of the slain father and husband emphasizing his faith over his political activism — but his memorial unfortunately was still a fundamentally right-wing and Republican affair. The good is still very good. Erika Kirk’s act of forgiveness should be remembered for a very long time.

It was a statement of evangelical resilience and an indicator of enduring religious influence within the G.O.P.. But controlling a political coalition is not the same thing as converting a culture..

Traditional Christianity in the past was seen as an overly ideological and factional persuasion by many Americans. There was some distance between partisan conservatism and Christian faith.

But if the Republican Party becomes identified with Christian revivalism and vice versa, then any Christian renewal could hit a ceiling outside the distinctive culture of the G.O.P.

Then there’s also the question of how much the ongoing requirements of the administration are still influencing conservative Christianity for the worse. The new religious conservatism as a mind-set that seeks an “assertive common good Christianity” that aspires to “anchor society in the stability and order that flow from Christian ethics.” There are a lot of Christians who think of their faith’s public witness in this way — as a moral and spiritual answer to the dissolving influences of the 21st century

But there are also versions of religious conservatism that cheerfully participate in our era’s very online cycles of scapegoating while forgetting the key moral concerns of religious conservatism from abortion to foreign aid to the public morals of our politicians.

And there is also very clearly the public Christians have to constantly prove that they, too, are tough enough and mean enough, willing to cross the line or play the bully or break the moral norm if that’s what it takes to stand by the boss or stick it to the libs.

And so it is today. We are enduring vengeance. Far too few experience Christian kindness. It is a great tragedy of our time that so many Christians see a divine plan on what’s happening today/

Unitarian Universalism embraces peace, love, and understanding that goes beyond individual belief systems.

The administration’s attacks on the Smithsonian Museum for being too “woke” in its exhibits are part of a broader effort to control America’s story. But, for example, Bryan Stevenson, a lawyer and the founder of the Equal Justice Initiative, has created institutions that confront the nation’s painful past to preserve an honest vision of history.

Everyone has been trying to figure out what the Trump years mean for America, in particular about civil rights and the criminal justice system.

The world has changed since Jan. 20. In this country we’re in the midst of a critically important narrative struggle about who we are, what our priorities are as a nation and how we get to a better future. Our courts and the larger society are retreating from that commitment to full equality and justice.

History is becoming a real battlefield. In August, the White House announced a sweeping review of Smithsonian exhibitions and collections. What’s going on here? Why is history so important?

When we are honest about history, we learn things, we discover things and we prepare for things differently. In Johannesburg, for example, the apartheid museum is so honest about the legacy of something so devastating.

In Berlin, you can’t go 200 meters without seeing a monument or a memorial dedicated to the victims of the Holocaust. There's this reckoning with history. There are no Adolf Hitler statues in Berlin. There are no monuments to the perpetrators of the Holocaust.

This liberated them, empowered them to create a new democracy that is trusted, respected, vibrant and that’s growing. It doesn’t mean that all the problems have been eliminated, but it does mean that they have recovered something really important, discovered something important.

Slavery, liberation and segregation needs to allow us to liberate us from the burden that that history creates — that burden that still hangs over us, the fog that that history has created that no one is trying to address.

America should celebrate its history. There are lots of things about America that are worth celebrating, but it should also acknowledge the mistakes it’s made. The mistake with trying to whitewash history is that we just continue and sustain the problems that that history has created.

We need to create a world where the children of our children are no longer burdened by this history of racial bias, where there are no more presumptions of dangerousness and guilt that get assigned to people based on their color, where everyone is free to live kind of a life of value and opportunity without restraint because of their color. And we won’t get there if we don’t address some of these harms.

For decades in this country, we had really qualified women and really qualified people of color being denied opportunities for leadership because they were women, because they were Black, because they were brown. That was unfair. It was wrong.

Also, now courts tolerate more racial bias in cases, more extreme misconduct by police and prosecutors, and they look for procedural reasons not to address substantive constitutional violations. That proceduralism became a fence to keep the courts from having to talk about really hard issues.

We are living where the rule of law is not operating in a way to protect people who have been historically vulnerable, historically victimized by power and abuse, and are, in fact, being utilized in a way that will add to that abuse, add to that exclusion.

Judges in state courts who refuse to enforce federal law are no longer fearful that a federal court will overturn them. They’re not worried that the U.S. Supreme Court will intervene.

The composition of the court right now makes it an institution that if you’re trying to advance racial justice, if you’re trying to advance human rights. It is not a very welcoming or hospitable place.

If a court says that states can do whatever they want to do to maintain political power, to disenfranchise Black and brown people, then that will take us back decades. It will fundamentally negate all of that progress.

Should the Court have the authority to undermine the objectives of the president? And that will be a fundamental question this court has to decide — one that will shape the future of this country.

Truth has the power to be resurrected, even in the face of lies and difficult dark days it can triumph!

In March, Democrats shrank from confrontation under the threat of a government shutdown. Now voters’ growing disenchantment with the government and the unpopularity of the megabill gives Democrats a chance to fight and win as another funding deadline looms.

By demanding action on popular policies, Democrats could execute a delicate maneuver where they avoid blame for a shutdown while benefiting from the negotiations to end it.

Backing off to avoid a shutdown would depress the Democratic base and signal capitulation to an increasingly authoritarian regime.

One instructive precedent comes from the 1995-96 shutdown, when right-wing Republicans took control of both houses of Congress for the first time in 40 years. A battered Mr. Clinton later pleaded with reporters that he was still “relevant,” which sounds a lot like today’s congressional Democrats.

Yet when the shutdown ended in early 1996, Mr. Clinton had won big. How? Clinton boiled down his dozens of wordy policy positions to what his aides called “M.M.E.E.” — Medicare, Medicaid, education and the environment. Intense focus on those four popular Democratic positions powered Mr. Clinton’s shutdown comeback and his re-election that fall.

Democrats have a big edge on what’s seen as the No. 1 problem in America: affordability. According to a new CBS News poll, a paltry 36 percent of Americans approve of the way the administration is handling inflation.

On health, Democrats should demand an extension of the popular tax credits that make Obamacare more affordable for millions of Americans, which are scheduled to expire next year. They should insist on restoring funding for popular National Institutes of Health grants, particularly for cancer research.

Democrats should insist on the availability of vaccines, a position supported by 78 percent of adults in a recent NBC News poll.

On tariffs, Democrats should demand that almost all tariffs be approved by Congress/

Democrats should demand the restoration of Mr. Trump’s $500 million cuts in aid to local law enforcement and fund thousands of new officers while they’re at it. They could effectively argue that it’s better to spend money preventing crime than having troops pick up cigarette butts on the National Mal

All of this could be pursued while establishing that the president cannot rescind appropriations without congressional approval, including a filibuster-proof Senate vote.

While a CBS News poll shows 47 percent approve of his “goals,” only 37 percent like his “approach.” That doesn’t bode well for his management of a shutdown.

And if Mr. Trump vetoes the appropriations bill, extending the shutdown, he’ll just tick off the millions of Americans who use government services in hundreds of ways, further weakening Republicans heading into the midterms.

Democrats should not deter from at least trying to do their duty. They should heed the advice that the retired Supreme Court justice Oliver Wendell Holmes Jr. offered to Roosevelt when he took office in 1933, amid a crisis of democracy: “Form your battalion and fight!”

Source: New York Times

The anxiety greatly increased in October 1957, when Americans learned of the Soviet Union’s successful launch of the world’s first satellite, Sputnik 1. The vivid evidence of the technological superiority in rocketry of our Cold War enemy provoked a remarkably rapid response.

In 1958, by a bipartisan vote, Congress passed and President Dwight Eisenhower signed the National Defense Education Act, one of the most consequential federal interventions in education in the nation’s history. Together with the National Science Foundation and the National Institutes of Health, it made America into the world’s undisputed leader in science and technology.

Nearly 70 years later, that leadership is in peril, the single remaining U.S. institution among the top 10 is Harvard, in second place, far behind the Chinese Academy of Sciences. If this does not constitute a Sputnik moment, it is hard to imagine what would.

Now the leaders of American universities have done little more than duck and cover.

The N.D.E.A. reflected the widespread realization that something had to be done in schools and universities besides teaching students to hide under their desks. The country urgently needed more experts.

The act also played a significant role in diversifying the nation’s campuses by providing low-interest loans to applicants in need, incidentally challenging policies that had restricted admission for disfavored groups, such as Jewish, Asian, Black, Polish and Italian students.

What began as a project of national security blossomed into a generator for limitless curiosity, creativity and critique. The result of the huge influx of tax dollars was institutions that not only trained scientists, medical researchers and weapons engineers but also cultivated sociologists, historians, philosophers and poets.

By the 1990s, American universities had become global cultural icons — envied for their intellectual breadth, celebrated for their academic freedom and eagerly sought after by international students who viewed them as the apex of open inquiry and prestige.

But now, science research has been curtailed; postdoctoral fellowships have been abruptly canceled; laboratories have been shuttered and visas denied. The damage to scientific enterprise extends beyond our borders, whether it’s from the cancellation of nearly $500 of funding for mRNA research under the health secretary, Robert F. Kennedy Jr. or the purging of data on which climate researchers around the world depend. We will never know what diseases might have been cured or what advances in technology might have been invented had the lights not gone out in the labs.

Should the administration be determined to reshape the intellectual life and values of faculty members and students alike, then recovery will be impossible.

Our situation is not hopeless any more now than it was in 1957. The United States has won so many Nobel Prizes — far more than every other country, including China — not only because of generous funding but also because of an intellectual culture that encourages and rewards innovation and risk-taking, and because we have attracted gifted researchers from all over the world.

In following our values and principles, we must create a community with a culture that welcomes diverse perspectives and supports constructive debate about how values and science are intertwined. Remember the Tuskegee experiment led many African Americans to develop a lingering, deep mistrust of public science officials and vaccines.

Source: Stephen Greenblatt New York Times

It is increasingly clear that the world is no longer persuaded by America’s approach to economic policy. Other nations are not, for the most part, retaliating against the administration’s policies by imposing higher tariffs on American goods. But they also are not imposing higher tariffs on goods imported from countries other than the United States. The rest of the world is rejecting protectionism.

In reality, the United States is walking out of the system it created. While other nations regret its departure, they are not inclined to follow in its self-destructive footsteps. Fears of a global trade war have not materialized because the leaders of other nations have recognized that by raising tariffs, they would be hurting their own countries.

The World Trade Organization reported last month that “a broader cycle of tit-for-tat retaliation that could be very damaging to global trade has so far been avoided.”

Higher tariffs are supposed to protect US manufacturers from unfair foreign competition, leading American consumers to buy more goods produced in American factories, which in turn would expand domestic employment.

But the number of Americans with factory jobs has declined by 28,000. Companies are canceling or delaying their expansion plans. Spending on factory construction has declined.

And a federal appeals court ruled in August that many of the new tariffs are illegal. This will be sent to the Supreme Court.

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Many of the products “Made in America” include a significant share of parts and materials made in other countries.

Tariffs have been applied indiscriminately. The average effective tariff rate for the United States has soared to 18.6 percent from 2.5 percent. The new level is far higher than in any other developed nation.

Countries are not raising tariffs on other trading partners. The European Union, to take just one example, has not only refrained from significant retaliation against the United States. It also has not emulated Mr. Trump by imposing tariffs on low-income Asian nations in an attempt to bolster the prospects of European manufacturers.

Brazil’s president, Luiz Inácio Lula da Silva, said “If the United States doesn’t want to buy, we will find new partners,” he said. “The world is big, and it’s eager to do business with Brazil.”

Other nations continue to pursue trade established by the United States decades ago because they continue to see trade, managed judiciously, as a path to greater prosperity.

Source nytimes.com.

You can pay more for traditional Medicare, or opt for a plan offered by a private insurer and risk drawn-out fights over coverage. Patients are leery andI think it’s the back door into privatizing traditional Medicare.

Private insurers often require a cumbersome review process that frequently results in the denial or delay of essential treatments that are readily covered by traditional Medicare.

The Centers for Medicare and Medicaid Services plans to begin a pilot program that would involve a similar review process for traditional Medicare, the federal insurance program for people 65 and older as well as for many younger people with disabilities. The pilot would start in six states next year.

The federal government plans to hire private companies to use artificial intelligence to determine whether patients would be covered for some procedures, like certain spine surgeries or steroid injections.

Similar algorithms used by insurers 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 A.I. 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.

The government said the A.I. screening tool would focus narrowly on about a dozen procedures, which it has determined to be costly and of little to no benefit to patients.

Abe Sutton, the director of the Center for Medicare and Medicaid Innovation, said that the government would not review emergency services or hospital stays. Mr. Sutton said the government experiment would examine practices that were particularly expensive or potentially harmful to patients. “This is what prior authorization should be,” he said.

The government may add or subtract to the list of treatments it has slated for review depending on what treatments it finds are being overused, he said.

People enrolled in traditional Medicare who live in Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington State will be included in the experiment, which is expected to start in January and last for six years.

It’s basically the same set of financial incentives that has created issues in Medicare Advantage and drawn so much scrutiny,

Typically, these A.I. models scan a patient’s records to determine if a requested procedure meets an insurer’s criteria. For instance, before authorizing back surgery, the system might search for proof that a patient first tried physical therapy or received an MRI showing a bulging disc.

Insurers defend these tactics as being effective in reducing inappropriate care, such as by preventing someone from getting back surgery at tremendous cost instead of another treatment that would work just as well. Government officials said that any denials would be done by “an appropriately licensed human clinician, not a machine.”

A group of House Democrats, including Representative Alexandria Ocasio-Cortez of New York, warned in a letter to government officials in late July that giving for-profit companies a “veto” over care “opens the door to further erosion of our Medicare system.”

Private plans under Medicare Advantage have become increasingly popular, with a little more than half of older Americans and people with disabilities eligible for the program and some 34 million enrolled.

But many are willing to forgo some of the additional benefits the private plans offer, like dental checkups and gym memberships, to avoid having to jump through numerous hoops to get care.

The American Medical Association wrote in a letter that doctors view prior authorization “as one of the most burdensome and disruptive administrative requirements they face in providing quality care to patients.” Most patients who appeal are successful, but a vast majority never appeal.

In announcing the new model, Dr. Mehmet Oz, the administrator of the Medicare agency, said the goal was to root out fraud, waste and abuse.

But if the algorithm used to authorize those procedures proves to save the government money C.M.S. may feel justified in broadening the program to include services that are not such “low-hanging fruit.”

How insurers make their decisions remains opaque. A spokesman for Health and Human Services, which oversees the Medicare agency, declined to identify which companies had submitted applications for the contract.

Contractors hired by the government are supposed to watch over payments to ward against inappropriate or wasteful coverage. Those reviews generally happen after someone has received a treatment.

The new model relies on an additional set of private companies for traditional Medicare that have a very clear incentive to deny care.

The companies represent “a whole new bounty hunter,” said David A. Lipschutz, the co-director for the Center for Medicare Advocacy, one of the groups that has urged government officials to abandon the program.

Source: NYT