Politics. If there is a city that knows a little bit about Artificial Intelligence, it is Washington, D.C.
Since President Bill Clinton left town, all it takes is a strong opinion to move the levers of power in the direction of your personal preference. President George W. Bush read John Barry’s The Great Influenza and ordered up pandemic preparedness plans that haunt us 20 years later.
In similar fashion, the White House has embraced regulation of Artificial Intelligence, referring here to the algorithmic processes not the dimwittedness of high-ranking political figures, as an urgent matter for the entire government.
While acknowledging the benefits of things like Machine Learning and AI, the White House released an Executive Order last week calling for regulation due to “substantial risks.”
It also, in a manner like the federal government’s warm embrace of research on potentially dangerous pathogens, calls for a federal government-centric research effort.
This fear is imminently sellable to political figures, many of whom work in offices saving excel spreadsheets in the 97-03 version. That fear has some merit, as Elon Musk has pointed out, if models are trained on bad information but, outside of image and video manipulations it does not present a threat to the average American.
Of course, neither did a wayward pathogen in 2005.
Policy. The use of Artificial Intelligence, Machine Learning and Large Language Models has been the subject of policy inquiry for almost five years now. In April 2019, the Food and Drug Administration issued one of its first discussion papers. In January 2021, it released an action plan. In May it issued two more discussion papers.
Health and Human Services established on Office of the Chief Artificial Intelligence Officer in 2021.
The Senate has held hearings on transparency and consumer protections which so far have netted a desire to apply existing laws to the extent necessary. In other words, there is reason to think that laws that prohibit fraud, unauthorized use of image and/or demonstrated safety and efficacy are sufficient.
The EO, then, comes on as a bit aggressive, especially in its rather bizarre invocation of the Defense Production Act.
Currently the use of AI in health care has been focused on claims submission and payment – the interest of nearly all innovation in health care since c. 1965. Other uses designed to streamline the business side of the house, like scheduling and staffing are developing quickly.
The EO seems to be concerned with AI in clinical delivery which seems quite far off given the barriers imposed by state and federal statutes on things like supervision, not to mention tort law.
The EO is also focused on issues of health equity. Most information on this issue has been presented in the media so it is hard to know what problem the White House is trying to address. The general gist seems to be that minority populations might be disadvantaged by the models because they have historically been treated differently.
As a policy document, the EO is likely to be mostly ignored except by those who attended the star-studded Senate hearing in May, like Mark Zuckerberg. Given recent history on the relationship between Big Tech and White House, you can be forgiven if you think they are up to no good.
Power. Coming to the aid of the White House has been former President Barack Obama who featured a discussion on Artificial Intelligence in last week’s Democracy Forum in Chicago. The former president has also endorsed the EO effort on Twitter and has helpfully distilled some of the underlying issues.
The long-standing sweet spot for the Democratic party and especially Presidents Barack Obama and Joe Biden, has been organized labor. Part of the objective, based on comments at the Chicago event by Mary Kay Henry of the SEIU, and former President Obama himself is that AI might disrupt the labor force by eliminating certain jobs. Health care, having never been automated just a little bit is likely to face the most change.
Invigorating the labor base is an absolute necessity given President Biden’s polling numbers. An added benefit of having former President Obama help carry the message is the not-so-subtle reminder of his policy influence, designed to perhaps assuage concerns over President Biden’s age and mental acuity.
Which I suppose is why the White House confirmed last week that former President Obama helped develop the Executive Order over the last five months.
Have a great rest of your weekend.
Emily Evans
Managing Director – Health Policy
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