Lawmakers ask: Is AI going to help or hurt U.S. health care?

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The U.S. health care system will become the world leader in using artificial intelligence (AI) programs to improve health care, with oversight from Congress and the White House, a Republican leader said.

But now that system is in crisis and congressional leaders should work to remedy the situation before launching a review of novel technologies, said a Democratic counterpart.

On Sept. 3, the House of Representatives Energy & Commerce Committee’s Health Subcommittee opened the hearing, “Examining Opportunities to Advance American Health Care through the Use of Artificial Intelligence Technologies," held in Washington, D.C., and webcast online.

Rep. Morgan Griffith (R-Kentucky)

“Applications of AI and machine learning have increased across the health care sector in recent years and will only play a more pronounced role in the daily lives of all Americans moving forward in the health care space,” said subcommittee Chair Rep. Morgan Griffith (R-Virginia).

“Today, AI is being deployed by innovators to empower patients along their personal health care journey, support health care providers, and reduce unnecessary administrative burdens,” he said. “I look forward to learning more about these real world applications from our panel of experts today.

“I also believe as AI applications advance, it is critical that Congress continues to examine this landscape to ensure proper safety and proper oversight,” Griffith said. “These AI applications can be hugely beneficial to patients and providers, but they are to assist, they are to assist, and not to replace, the clinical workforce today.”

Improving the patient experience

In his opening statement, Griffith mentioned examples of how AI already is in use in health care.

Pharmaceutical companies are using AI to improve core scientific research functions and develop life-saving treatments and cures, along with expediting clinical trials to bring safe and effective medicines to market quicker, he said.

Physicians in hospitals are reducing their documentation time, allowing them more time with patients. “That's right, they get to spend more time with their patients. What a novel idea,” Griffith said.

In health care technology, companies making medical devices use machine learning to better understand certain diseases and advance innovations to deliver more clinically appropriate and effective care interventions, Griffith said.

The administration of President Donald J. Trump has targeted waste, fraud and abuse, and Medicare’s Innovation Center is using AI to root out improper spending. The Food and Drug Administration (FDA) is using AI to shorten its review process. The National Institutes of Health has developed an AI algorithm to match volunteer patients and trials, cutting down administrative time, and that likely will get better, Griffith said.

“With all these innovative advancements being leveraged across the American health care ecosystem, it is paramount that we ensure proper oversight is being applied, because the application of AI and machine learning is only going to increase,” Griffith said. “We must ensure that these tools continue to empower and not replace the providers that serve our communities across the nation. These tools should help improve the patient experience and ultimately access to care, particularly in rural areas like the one that I represent in Virginia's Ninth Congressional District.”

AI in medical reviews

The hearing memo had additional examples and some facts and figures about the use of AI in health care. For example, AI use cases are growing in the U.S. Department of Health and Human Services (HHS). FDA approved 223 AI-enabled medical devices in 2023, up from 160 in 2022 and just six in 2015. There are 21 AI-developed drugs that had completed Phase I trials as of December 2023, with a success rate of 80% to 90%, compared with 40% for traditional methods.

The memo noted recent reports of AI used by Medicare Advantage plans to deny patient prior authorization requests. In clinical use, the U.S. Centers for Disease Control and Prevention (CDC) is using AI to detect tuberculosis from chest X-rays and for examining sources of water and food contamination.

‘Rome is burning’

Rep. Diana DeGette (D-Colorado)

In the lawmakers’ opening statements, no one disagreed about the growing use of AI and the need for smart regulation. But the time to review that is when the American health care is “not in crisis mode,” said subcommittee Ranking Member Rep. Diana DeGette (D-Colorado). She laid the blame at the feet of HHS Secretary Robert F. Kennedy, Jr., accusing him of “dereliction of duty and incompetence.”

“My friends, right now, Rome is burning, Rome is burning,” DeGette said. “More important than this is the peril that the Trump administration's policies have put my constituents and the constituents of every single person on this panel into. All of our constituents are at risk because of the risky and dangerous and unscientifically based principles of RFK JR and his advisers.”

The most recent example is last week’s firing of CDC Director Susan Monarez, PhD, DeGette said, but it is not the only one. Since the president took office, an estimated 20,000 people have been fired from HHS, putting on hold research into cancer, pediatric diseases, and other ailments, she said.

The subcommittee should be inquiring of Kennedy, Monarez and others “to shed light on this administration's unprecedented interference in public health and science.” Then it’s time to revisit health care legislation that had bipartisan support at the end of 2024, when tech billionaire Elon Musk became critical of it, stifling congressional action, DeGette said.

“Everybody in this room on both sides of the aisle should be embarrassed about Congress' work. I know I am,” DeGette said. “We've only had just one hearing, a budget hearing with a presidential appointee of this administration during this entire Congress. Inaction in the face of incompetence and malice, that is complicity, and we've got to stop that. We've got to investigate the misdeeds of this administration. We've got to follow the investigations where they lead. We have to insulate scientific judgment from politics and ideology. And as the Health Subcommittee of Energy and Commerce, we must base our decisions on science, Mr. Chairman, I hope we can start doing that as of today.”

A supplement, not a replacement

Rep. Brett Guthrie (R-Kentucky)

Energy & Commerce Committee Chair Rep. Brett Guthrie (R-Kentucky) praised the administration’s national AI action plan to bolster U.S. leadership in AI development and deployment.

AI must be used in a human-centric, responsible and safe manner, Guthrie said.

“I want to emphasize that AI, in no way is intended to overtake the jobs of hardworking Americans,” he said. “It is instead an opportunity to enhance the work conducted by humans across our health care system, improving the quality and efficiency of care, reducing time-consuming and costly administrative task and burdens, enhancing the provider patient relationship, and expediting the discovery of new treatments and cures.”

There also are reports about potential safety concerns due to improper personal use of AI, and with the positive effects, appropriate safety precautions also are needed, Guthrie said.

‘Chaos’ in health care

Rep. Frank Pallone (D-New Jersey)

Energy & Commerce Committee Ranking Member Rep. Frank Pallone (D-New Jersey) returned to Kennedy, claiming he is dismantling HHS and waging a war on public health. That has “created chaos in our nation’s health care system,” Pallone said. He also cited the workforce reductions at HHS and CDC, and additional restrictions on the COVID-19 vaccine for adults.

“This administration's path of destruction threatens America's health,” Pallone said. He recounted his recent demands for subcommittee hearings on Kennedy’s actions, requests “met with silence.”

“Republicans would rather sit on the sidelines as Kennedy moves ahead with advancing his dangerous pseudoscience agenda,” Pallone said. “Secretary Kennedy must testify before this committee to answer questions and be held accountable for threatening public health by abusing his authority, propagating disinformation and politicizing science. It's time that Republicans take these threats seriously and join us in holding Secretary Kennedy accountable.”

‘Devastating consequences’

Pallone also noted the effects of AI in health care, particularly mental health. He cited reports of negative interactions with AI chatbots that encouraged teens to take their own lives.

“But I'm concerned that the expanded use of AI in healthcare has generated significant risks that we simply cannot ignore,” Pallone said. “Congress must recognize and address the complex, ethical, legal, economic and social concerns raised by using AI in our healthcare system. Without adequate oversight, these new technologies can lead to devastating consequences for patients. Medical care could be delayed and insurance coverage denied, preventing Americans from getting the care they need to live. There's also the threat of personal health information and data privacy breaches.

“While AI tools can support health care providers, their advice and recommendations should not serve as a substitute for the nuanced judgment of health care professionals and should not come at the expense of patient safety,” he said.