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It's April 30th. Remember tonight to leave out Ramen and Sprite for Justin Timberlake.

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( @grumpycakes On the occasion of her birth, the start of a story about birthdays, and getting everything you want, even though it's nothing you know how to ask for. Happy Birthday, Mel!)

-Another Year Around the Sun-

“Are you-  Are you going to get that?”

Tony squinted at the schematic floating in the air in front of him.  “Does it look like I’m going to get that?” he asked, taking a careful sip of his coffee. It burned the entire way down, and he exhaled on a cough.  “Jesus, this is foul.”

“Yep.” Bruce gave him a slight smile from behind his safe, boring cup of tea.  “Just like you like it.”

Tony saluted him with the cup.  “Just like I like it,” he agreed.  His phone stopped buzzing, and he gave it a look, nursing his coffee along with his grudge.  As expected, it started vibrating again a moment later, shaking against the top of the workbench.  “Jay, put him on the block list.”

“He will simply call the main line,” Jarvis said, with the sort of infinite patience only his AI could manage.

“And I expect you to hang up on him,” Tony said.  

Bruce leaned across the workbench.  “It’s-”  He glanced up at Tony, his brows drawing up tight in an expression of concern.  “Are you, I mean, is there-”

Tony took another sip of his coffee, letting the cup hang in front of his face as he punched the surface of his phone with one finger.  The call connected, and there was a single second of silence, and then-

“HAPPY BIRTHDAY TO THE BIRTHDAY BOY, HAPPY BIRTHDAY JUST TO YOU,” Rhodey howled into the phone with the sort of glee only a long time friend could muster when doing something unforgivable.  On the other side of the workbench, Bruce rocked back on his stool, his eyes going wide with shock. “WE HEAR THAT YOU’RE THE BIRTHDAY BOY, SO WE’RE SINGING LOUD AND TRUE, EVERYONE WILL KNOW THAT YOU’RE A SPECIAL BOY, IT’S THE LEAST THAT WE COULD DOOOOOOOOOOOOOOOOO-”

“Die in a fire,” Tony said, and hung up on him.

Bruce was clutching his tea with both hands, his shoulders up around his ears, his expression horrified.  “What was-”

“There was a diner down the street from MIT,” Tony said, making a minute adjustment to the schematic with a flick of his fingers.  “And they sang that hellish ditty if you told them someone in your party was having a birthday.”

“Okay,” Bruce said, drawing out the word.  

“Yeah, well it turns out that if you pre-tip the staff a twenty, they’ll sing it any time you ask.  Such as every Sunday morning.  When you’ve dragged your hungover, barely functional best friend into said diner with the promise of pancakes and coffee, and instead betray him with singing waiters who are just enjoying seeing him suffer.”  Tony took a sip of coffee.  “It was my birthday every single Sunday for two solid months.”

Bruce put down his cup.  “Okay,” he repeated.  “Why did you continue-”

“Honestly, I probably wanted the attention,” Tony mused.  “And the pancakes.”  His phone rang again, and he picked it up, putting it on speaker with a flick of his thumb.  “How did you pass the military psych evaluation?  In that you are clearly a sociopath?”

“Happy birthday,” Rhodey said, his voice full of glee.  

“Actually, not my birthday,” Tony said, trying not to smile.  “I had it legally changed specifically to avoid these sorts of betrayals.”

“Great, I can now call you randomly every day until I find the new one,” Rhodey said.  “Gonna be our daily tradition.”

“I am blocking your number,” Tony said.  “And by ‘blocking you,’ I mean, I am going to hack my way into every single cellular service in this country and make sure you get a busy signal any time you call anyone for any reason at any time.”

“A normal, rational response from a well-balanced man,” Rhodey mused.

“Says the man who memorized a song deliberately designed for trauma and has used it to harass me annually for literally my entire adult life,” Tony said.  “Why would you memorize that?  Why would you do that to yourself, let alone me?”

“You say that like I could possibly forget it, it’s an ear worm,” Rhodey mused.  “And I heard it every Sunday for like three months.”

“Whose fault is that?”

“Should’ve done less Saturday night drinking, and we wouldn’t have had to do Sunday morning penance.”

“You are the worst, you are a terrible friend, I don’t know why I even talk to you.  I have replaced you.  I have other friends now, better friends.  Know what Bruce gave me for my birthday?” Tony asked, gesturing at Bruce, who was staring down at his tablet, trying to hide his smile behind the rim of his cup.  “Coffee.  Terrible coffee, but coffee.”

“Your favorite,” Rhodey said.  “Hey, Bruce!”

“Hey,” Bruce said, raising his voice to be heard.  “You coming for the party on Saturday?”

“Be there with bells on,” Rhodey said. “Can we hang out in a corner somewhere and avoid the frightening rich people that always end up at Tony’s parties?”

“God, please,” Bruce said, wincing.  

“You’re no longer invited,” Tony told Rhodey.  “Disinvited.  I’m sending a drone to shred your invitation.”

“It was an email.”

“Even easier,” Tony said.  He spun in a circle, one hand sliding through the air and pulling up a keyboard.  “Worldwide computer virus.  Targeting you and only you and your invitation.”

“How do you not know how your invitations went out?”Rhodey asked. “Was this entire party set up by a planner or something?” 

“Of course not, that would be stupid,” Tony said.

Bruce took a sip of tea. “Stark Industries’ PR department planned this entire party.”

There was a beat of silence.  “Tony…” 

“I don’t need the disapproving voice out of you, and it’s not your problem, you’re uninvited,” Tony said, his fingers dancing over a holographic keyboard.  “If you show up, you will be escorted off of the premises by someone, probably Nat, I owe her a favor, she likes throwing men around..”

“That’s a shame, I’ll just have to keep your birthday present.”

Tony’s fingers stilled.  “What did you get me?”

“Doesn’t matter.  I’m uninvited.”

“You have a chance to buy your way back into my good graces,” Tony said.  “What’d you get me?”

“A terrible bootleg Iron Man shirt I found in a street market in Guatemala,” Rhodey said.  

Tony braced a hand on the workbench, considering that.  “Terrible good or terrible bad?”

“Terrible terrible,” Rhodey said.

“What the hell is terrible terrible?  What do you think that even means?”

“It’s TERRIBLE terrible, and it’s a shame you’ll never see it and find out.”

“Fine!”  Tony tossed his hands in the air, ignoring the way Bruce was laughing.  “You’re re-invited.”

“Ooooooooh.”  Rhodey hummed to himself for a moment.  “I’ll check, but I have a very busy social calendar, I’m not really sure I can squeeze in another party this late, should’ve gotten an invitation out to me a lot sooner if you wanted-”

“Shut up,” Tony said, grinning at his schematic.  “You absolute embarrassment.  You need to show up, Pepper says that Nicholetta Hertz has asked if you’re going to be there three separate times.”

“Nicholetta-”

“She was at the product release thing last fall?” Tony shifted some parts around in midair.  “Tall?  Gave the keynote speech?  Wore a halter top dress and a pair of Converse high tops?”

There was a beat of a pause.  “She wanted to know if I was coming?”

“Asked three times,” Tony said.  “Pepper asked me to check if you were dating anyone.  I told her that you’re a loser who is apparently getting into birdwatching-”

“It’s fucking interesting and god forbid I go outside without a gun strapped to me-”

“So no, you’re not dating anyone.”  Tony paused, grinning.  “Nicholetta likes to hike.”

“Don’t try to match make, you’re bad at it.”

Tony straightened up, his head snapping in Bruce’s direction.  “Did you hear that?” he asked, gesturing at the phone.  “Did you-  I can’t be the only one who heard that.”

Bruce braced his chin on one hand. “I, I heard it,” he said.  “And I might, possibly, agree with it.”

“Man’s got sense, I always said that the man’s got sense,” Rhodey said.  “Don’t try to match make.”

“Fine, I’ll tell Pepper you’re not interested.”

“No, Pepper can do all the match making she wants,” Rhodey said.

Bruce was laughing, Tony could tell he was laughing, and he decided for the sake of his friendship that he wasn’t going to acknowledge it.  “Saturday.  Seven PM.  If you don’t have the literal worst t-shirt I’ve ever seen in my life, I’m going to sell something to the US Air Force that you will regret for the rest of your long, painfully long career.”

“TERRIBLE terrible,” Rhodey said.  “I’ll be there by six, I need to mock your outfit for at least half an hour before the rest of your guests show up.”

“Luckily, if my outfit is that bad, you’re bringing me the perfect thing to wear.  To my own birthday party.  In front of the New York elite, every superhero I can stand, and a bunch of the most vindictive reporters in the country.” Tony ripped a piece of the holographic schematic free and tossed it across the workshop.  “It’ll be great.  We should just take pictures of every person as they first catch sight of the terribleness.”

“I love a party with a theme,” Rhodey said.  “Saturday.  Six PM.  Bruce, wanna spend the rest of the night watching Tone try to guess who all his guests are.”

“It’s, uh, it’s a problem when you don’t set your own guest list,” Bruce agreed.

“Hanging up on you now,” Tony said.  

“HAAAAAAAAAPPY BIIIIIRTHDAAAA-” Rhodey started, and Tony hung up on him.

He braced both hands on his workbench, his chin dipping in a nod.  “I need better friends,” he said.

Bruce nodded.  “Don’t think that’s going to happen,” he said, his voice apologetic.  His eyes tipped up, and he smiled.  “But…”

Tony turned, following his gaze, just in time to see Steve bounce his way down the stairs.  He hit the ground, his feet skidding as he headed for the lab door.  Almost against his will, Tony smiled, watcihng with affection as Steve punched in his door code and tossed it open.  

He grinned at Tony, his cheeks flushed and his hair still damp from a morning shower.  “Happy Birthday!”

Tony grinned at him.  “It’s way too early for that much enthusiasm, Cap.”

“Get used to it.”  Steve strode across the room, snagging a sweatshirt off of the hook as he passed it.  “Let’s go!”

He tossed the sweatshirt at Tony, and Tony’s hands came up to catch it with more instinct than grace.  But he managed not  to end up with it draped over his head, and he counted that as a win.  “Go?  Go where?”

“Birthday,” Steve said, stopping as the bots rolled up to him.  With a grin, he gave each of them a quick high five.  “Hello, boys, Bruce is babysitting today, you’re all going to be good for him, right?”

“They will not,” Bruce said, smiling down at his tablet.

“First of all, if there’s any bot sitting to be done, Jarvis is going to be doing it,” Tony started, tossing the sweatshirt onto the workbench. It didn’t land in his coffee.  He was doing great today.  “And second, go WHERE?  I have a prototype processing, the fabrication units are working on the next phase of the build, and I have six other projects to-”

Steve came around the end of the workbench, his long legs eating up the distance, all of the bots trailing behind him like the stupidest little Disney parade.  “Bruce.”

“Bruce?” Tony parroted.

Bruce raised his cup, still looking at his tablet.  “Bruce.”

“Doctor Banner and I have the situation well under control,” Jarvis said, his tone crisp.  “Should your expertise be required, we shall reach out to you immediately, but you are not nearly as indispensable to this part of the project as you might like to imagine.”

Tony’s eyebrows arched.  “Rude.”

“Bruce has got the workshop, Pepper’s handling the business side of things, Thor’s camped out on the tower roof and promised he’ll take care of any Avengers problems, Natasha is leading Fury on a wild goose chase through Vatican City right now,” Steve said.  

“I wondered where she’d gone last night,” Tony said.  He blinked.  “Wait.  You’ve just sidelined my work, my company, my superheroing and the less than secret spy organization that spends a third of its time trying to annoy me.  That’s like, four of the five things that try to kill me on a regular basis.”

“He’s the man with the plan,” Bruce said, sipping his tea.

Tony was pretty sure this shouldn’t be a turn on.  He was pretty sure it was anyway.  “So that just leaves-”

“Coulson just dumped a 8000 piece puzzle onto the kitchen island,” Steve said, his arms crossed over his chest.  “And Clint’s going to find it in-”  His head cocked to the side as he considered.  “Jarvis?”

“He is currently on the elevator now,” Jarvis said.  “Three minutes.  Twelve seconds.  And counting.”

“Thank you, Jarvis.”  Steve grinned at Tony, wide and bright and perfect, and Tony went a tiny bit dizzy for a second.  “Five out of five.”

“Clint hates puzzles,” Tony pointed out.

“Yes, he does.  He also can’t resist color matching and shape recognition.  He’s going to be saying curse words in languages no one here even knew existed,” Steve said.  He straightened up, and reached out, picking up the sweatshirt.  “Birthday.  Let’s go.  I’ve got plans.”

Tony considered the sweatshirt.  Considered Steve.  “What kind of plans?”

“Best birthday ever,” Steve said, and he said it with such conviction that if Tony wasn’t already head over heels in love with him, that would’ve sealed the deal.  Steve held the sweatshirt out to him, a bribe or a peace offering, Tony couldn’t tell.  But he held it out, with a quick, hopeful little smile.  “Don’t you trust me?”

“I mean, I did before you said those exact words and now I’m sure that it’s a terrible idea,” Tony said, just to hear him laugh.  He took the sweatshirt, being careful not to grab Steve’s hand instead.  That would’ve been just embarrassing.  “Can I eat breakfast at least?”

Steve wrapped an arm around his shoulders, force marching him towards the door.  “That’s step one!”

Tony looked back over his shoulder.  “Help.”

Bruce gave a little wiggle of his fingers.  “Haaaaaaaappy Birthday,” he sang.

“This is going to be terrible,” Tony said, and he was honestly looking forward to it.

#avengers #scifigrl47 #8000 pieces??? #poor Clint

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You wouldn’t last an hour in the asylum where they raised me

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Brad Boimler & Beckett Mariner in Star Trek: Strange New Worlds 2x07

Ensign’s log, stardate 58460.1. The Cerritos has just entered the orbit of Krulmuth-B. Home of the Krulmuth-B portal, one of my all-time favorite portals.

#star trek

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E P I S O D E   P O S T E R S  { s p n }  Season 3

↳ Part 12; ( x )

#supernatural

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oh yes it's that time of year

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Just a reminder about fatphotoref.com—it exists!! I'll be updating with new photos next week and hopefully more regularly after that. Request access by going to bit.ly/fpraccess 💙🧜‍♀️ happy mer may!

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#I’ve always liked this one a lot #tumblr heritage

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every person can feel freddie’s presence in their souls when they sing MAMAAAAAA UUHHHH, I DONT WANNA DIE, I SOMETIMES I WISH I’VE NEVER BEEN BORN AT ALL with all the air in their lungs i’m not joking

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Chris Evans behind the scenes of the May 2016 Rolling Stone shoot

#chris evans

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I also want to see how Brooklyn reacts. Are there people still there who remember little Bucky and Steve? Are there murals of Bucky? How do they depict him? Do they CLAIM him for their own? Do people get in fights when other people trash talk Bucky Barnes?

And, he should be getting the most cutting edge mental health treatments available. Where is his psilocybin treatment? What about EMDR? What about all the fan mail he gets from veterans who were also traumatized who see themselves in him? Who opens that? Does anyone show it to Bucky?

Plus, he would be getting hit on all the time. Women, men, all sexes and genders. He’s famous, attractive, dangerous, and wounded. He’d be like catnip for a certain subsection of the population. Does he ever take them up on it? Do they post about it online after or do they respect his privacy? The hydra records that were released had every stat on him and now everyone knows exactly how big his dick is because some asshole turned it into a meme?

Do jerks try to attack him just because they want to test themselves? Are there multiple videos online of mma fighters and teenagers trying to test their mettle against a long suffering and very annoyed Bucky Barnes?

i want so much minutiae about bucky as the winter soldier… i want all of those classified files to be real so i can read them. i wanna know every single thing they documented… how long it took to break him and how long to put him together, how they trained him, how they punished him, what they experimented on him, how they attached the arm, how sensitive it was, what they fed him, how they kept him clean, how much he was allowed to speak, how many missions did he actually have, how much would he remember between missions, how many languages he knew and how he learned them, how much was he even aware of while he was doing it, did he even know he was human or did he think he was something else, how the soviets treated him compared to the americans, how many handlers he had, which one was his favourite, did he have favourites. did he like things and just know not to mention it or was he unable to even access whether he liked or didn’t like something.

i want fake journalism about this. i want medical journals about prosthetics and philosophical debates about agency and history books needing to be revised. whistleblowers exposing decades-old corruption in europe and investigative documentaries exposing the truth about the winter soldier and horror thrillers depicting a young soldier being captured and brainwashed. warring op-eds calling him a monster and a traitor vs those calling him a hero and a tragedy, and bucky thinking he’s probably all of the above. strange stories told by retired military officials from china and civilians from cuba, about a blue-eyed man who spoke their languages perfectly, who didn’t know how to smile but who gave scraps of food to stray dogs. stories their families had chalked up to trauma or old age or exaggeration, that when all pieced together create a very different picture of the man the media was calling a terrorist.

like bucky deserves privacy but the world would not give it to him. the winter soldier being a headline and an academic issue and a medical wonder and a folk tale and a ghost story and then maybe, eventually, a person.

#Bucky Barnes

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Job title: Tardigrade Veterinarian

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Mansons Creations

#octopus #wow #art

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spn x funny msgs

#supernatural

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Cigna’s nopeinator

I'm touring my new, nationally bestselling novel The Bezzle! Catch me THURSDAY (May 2) in WINNIPEG, then Calgary (May 3), Vancouver (May 4), Tartu, Estonia, and beyond!

Cigna – like all private health insurers – has two contradictory imperatives:

To keep its customers healthy; and

To make as much money for its shareholders as is possible.

Now, there's a hypothetical way to resolve these contradictions, a story much beloved by advocates of America's wasteful, cruel, inefficient private health industry: "If health is a "market," then a health insurer that fails to keep its customers healthy will lose those customers and thus make less for its shareholders." In this thought-experiment, Cigna will "find an equilibrium" between spending money to keep its customers healthy, thus retaining their business, and also "seeking efficiencies" to create a standard of care that's cost-effective.

But health care isn't a market. Most of us get our health-care through our employers, who offer small handful of options that nevertheless manage to be so complex in their particulars that they're impossible to directly compare, and somehow all end up not covering the things we need them for. Oh, and you can only change insurers once or twice per year, and doing so incurs savage switching costs, like losing access to your family doctor and specialists providers.

Cigna – like other health insurers – is "too big to care." It doesn't have to worry about losing your business, so it grows progressively less interested in even pretending to keep you healthy.

The most important way for an insurer to protect its profits at the expense of your health is to deny care that your doctor believes you need. Cigna has transformed itself into a care-denying assembly line.

Dr Debby Day is a Cigna whistleblower. Dr Day was a Cigna medical director, charged with reviewing denied cases, a job she held for 20 years. In 2022, she was forced out by Cigna. Writing for Propublica and The Capitol Forum, Patrick Rucker and David Armstrong tell her story, revealing the true "equilibrium" that Cigna has found:

https://www.propublica.org/article/cigna-medical-director-doctor-patient-preapproval-denials-insurance

Dr Day took her job seriously. Early in her career, she discovered a pattern of claims from doctors for an expensive therapy called intravenous immunoglobulin in cases where this made no medical sense. Dr Day reviewed the scientific literature on IVIG and developed a Cigna-wide policy for its use that saved the company millions of dollars.

This is how it's supposed to work: insurers (whether private or public) should permit all the medically necessary interventions and deny interventions that aren't supported by evidence, and they should determine the difference through internal reviewers who are treated as independent experts.

But as the competitive landscape for US healthcare dwindled – and as Cigna bought out more parts of its supply chain and merged with more of its major rivals – the company became uniquely focused on denying claims, irrespective of their medical merit.

In Dr Day's story, the turning point came when Cinga outsourced pre-approvals to registered nurses in the Philippines. Legally, a nurse can approve a claim, but only an MD can deny a claim. So Dr Day and her colleagues would have to sign off when a nurse deemed a procedure, therapy or drug to be medically unnecessary.

This is a complex determination to make, even under ideal circumstances, but Cigna's Filipino outsource partners were far from ideal. Dr Day found that nurses were "sloppy" – they'd confuse a mother with her newborn baby and deny care on that grounds, or confuse an injured hip with an injured neck and deny permission for an ultrasound. Dr Day reviewed a claim for a test that was denied because STI tests weren't "medically necessary" – but the patient's doctor had applied for a test to diagnose a toenail fungus, not an STI.

Even if the nurses' evaluations had been careful, Dr Day wanted to conduct her own, thorough investigation before overriding another doctor's judgment about the care that doctor's patient warranted. When a nurse recommended denying care "for a cancer patient or a sick baby," Dr Day would research medical guidelines, read studies and review the patient's record before signing off on the recommendation.

This was how the claims denial process is said to work, but it's not how it was supposed to work. Dr Day was markedly slower than her peers, who would "click and close" claims by pasting the nurses' own rationale for denying the claim into the relevant form, acting as a rubber-stamp rather than a skilled reviewer.

Dr Day knew she was slower than her peers. Cigna made sure of that, producing a "productivity dashboard" that scored doctors based on "handle time," which Cigna describes as the average time its doctors spend on different kinds of claims. But Dr Day and other Cigna sources say that this was a maximum, not an average – a way of disciplining doctors.

These were not long times. If a doctor asked Cigna not to discharge their patient from hospital care and a nurse denied that claim, the doctor reviewing that claim was supposed to spend not more than 4.5 minutes on their review. Other timelines were even more aggressive: many denials of prescription drugs were meant to be resolved in fever than two minutes.

Cigna told Propublica and The Capitol Forum that its productivity scores weren't based on a simple calculation about whether its MD reviewers were hitting these brutal processing time targets, describing the scores as a proprietary mix of factors that reflected a nuanced view of care. But when Propublica and The Capitol Forum created a crude algorithm to generate scores by comparing a doctor's performance relative to the company's targets, they found the results fit very neatly into the actual scores that Cigna assigned to its docs:

The newsrooms’ formula accurately reproduced the scores of 87% of the Cigna doctors listed; the scores of all but one of the rest fell within 1 to 2 percentage points of the number generated by this formula. When asked about this formula, Cigna said it may be inaccurate but didn’t elaborate.

As Dr Day slipped lower on the productivity chart, her bosses pressured her bring her score up (Day recorded her phone calls and saved her emails, and the reporters verified them). Among other things, Dr Day's boss made it clear that her annual bonus and stock options were contingent on her making quota.

Cigna denies all of this. They smeared Dr Day as a "disgruntled former employee" (as though that has any bearing on the truthfulness of her account), and declined to explain the discrepancies between Dr Day's accusations and Cigna's bland denials.

This isn't new for Cigna. Last year, Propublica and Capitol Forum revealed the existence of an algorithmic claims denial system that allowed its doctors to bulk-deny claims in as little as 1.2 seconds:

https://www.propublica.org/article/cigna-pxdx-medical-health-insurance-rejection-claims

Cigna insisted that this was a mischaracterization, saying the system existed to speed up the approval of claims, despite the first-hand accounts of Cigna's own doctors and the doctors whose care recommendations were blocked by the system. One Cigna doctor used this system to "review" and deny 60,000 claims in one month.

Beyond serving as an indictment of the US for-profit health industry, and of Cigna's business practices, this is also a cautionary tale about the idea that critical AI applications can be resolved with "humans in the loop."

AI pitchmen claim that even unreliable AI can be fixed by adding a "human in the loop" that reviews the AI's judgments:

https://pluralistic.net/2024/04/23/maximal-plausibility/#reverse-centaurs

In this world, the AI is an assistant to the human. For example, a radiologist might have an AI double-check their assessments of chest X-rays, and revisit those X-rays where the AI's assessment didn't match their own. This robot-assisted-human configuration is called a "centaur."

In reality, "human in the loop" is almost always a reverse-centaur. If the hospital buys an AI, fires half its radiologists and orders the remainder to review the AI's superhuman assessments of chest X-rays, that's not an AI assisted radiologist, that's a radiologist-assisted AI. Accuracy goes down, but so do costs. That's the bet that AI investors are making.

Many AI applications turn out not to even be "AI" – they're just low-waged workers in an overseas call-center pretending to be an algorithm (some Indian techies joke that AI stands for "absent Indians"). That was the case with Amazon's Grab and Go stores where, supposedly, AI-enabled cameras counted up all the things you put in your shopping basket and automatically billed you for them. In reality, the cameras were connected to Indian call-centers were low-waged workers made those assessments:

https://pluralistic.net/2024/01/29/pay-no-attention/#to-the-little-man-behind-the-curtain

This Potemkin AI represents an intermediate step between outsourcing and AI. Over the past three decades, the growth of cheap telecommunications and logistics systems let corporations outsource customer service to low-waged offshore workers. The corporations used the excuse that these subcontractors were far from the firm and its customers to deny them any agency, giving them rigid scripts and procedures to follow.

This was a very usefully dysfunctional system. As a customer with a complaint, you would call the customer service line, wait for a long time on hold, spend an interminable time working through a proscribed claims-handling process with a rep who was prohibited from diverging from that process. That process nearly always ended with you being told that nothing could be done.

At that point, a large number of customers would have given up on getting a refund, exchange or credit. The money paid out to the few customers who were stubborn or angry enough to karen their way to a supervisor and get something out of the company amounted to pennies, relative to the sums the company reaped by ripping off the rest.

The Amazon Grab and Go workers were humans in robot suits, but these customer service reps were robots in human suits. The software told them what to say, and they said it, and all they were allowed to say was what appeared on their screens. They were reverse centaurs, serving as the human faces of the intransigent robots programmed by monopolists that were too big to care.

AI is the final stage of this progression: robots without the human suits. The AI turns its "human in the loop" into a "moral crumple zone," which Madeleine Clare Elish describes as "a component that bears the brunt of the moral and legal responsibilities when the overall system malfunctions":

https://estsjournal.org/index.php/ests/article/view/260

The Filipino nurses in the Cigna system are an avoidable expense. As Cigna's own dabbling in algorithmic claim-denial shows, they can be jettisoned in favor of a system that uses productivity dashboards and other bossware to push doctors to robosign hundreds or thousands of denials per day, on the pretense that these denials were "reviewed" by a licensed physician.

If you'd like an essay-formatted version of this post to read or share, here's a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:

https://pluralistic.net/2024/04/29/what-part-of-no/#dont-you-understand

#oh look #it’s my insurance company #fantastic #not that they aren’t all bastards #pluralistic #cigna