Occasional thoughts and musings…
AI agents will scale in healthcare when they create a labor dividend—either eliminating admin overhead or letting each scarce clinician produce more. Reimbursement models must shift from human minutes to AI-driven outcomes.
State AI rules are regulating software like a risky human, creating 50 versions of compliance. A federal framework could separate assistive from autonomous agents, letting FDA handle high-risk use while safe harbors accelerate adoption.
Healthcare AI is stuck in "middle to middle"—helping clinicians draft and summarize, but not prescribing. Level-5 autonomy requires moving from probabilistic language to deterministic actions with verifiable plans and safety gates.
The Trump Administration's Health Tech Ecosystem plan could kill the paper clipboard with IAL2 identity, digital insurance cards, and FHIR clinical summaries. The rails exist—now 60+ industry partners must ship before voluntary becomes mandatory.
Diagnostic AI aces OSCEs but stops before writing scripts. Autonomous prescribing for titrations, refills, and simple infections could unlock Level-5 care. FDA already approves closed-loop insulin—lisinopril adjustments should follow the same path.
HHS is 23% of the federal budget—deficit reduction demands healthcare reform. Decoupling employment from insurance through MA for All or expanded ICHRA could restore consumer choice, portability, and accountability while addressing market distortions.
Be Curious, Not Judgmental 