Beyond the $2.5 Billion: The Urgent Need for AI Information Oversight in Healthcare

Recent industry reports from Becker’s Healthcare highlight a massive shift: insurers like UnitedHealth and Elevance are betting over $2.5 billion on AI to automate everything from prior authorizations to member navigation. By 2026, systems like 'Avery' are expected to reach 20 million members.

While the efficiency gains are touted at 70%, as a researcher in Administrative Chrononormativity, I must ask: Who is auditing the data behind these gains?

Efficiency without equity is simply the automation of erasure. My work with the EACAD and DACLAC has already uncovered significant 'blind spot' data, such as the 38% of LGBTQIA+ elders who fear they won't qualify for services. If these $2.5 billion systems are trained on exclusionary historical data, they will continue to penalize Black and LGBTQ+ communities at scale.

At The Policy Nexus, we advocate for a new standard: AI information oversight. We must move toward frameworks that ensure the 'administrative clocks' of the future are as inclusive as the diverse populations they serve.

The Efficiency Trap: Taylorism and the Roots of Administrative Chrononormativity

In the world of public policy, we are taught to worship at the altar of the One Best Way. We strive for systems that are streamlined, predictable, and, above all, efficient. But as we dig into the intellectual foundations of public administration, we find that our modern obsession with standardized timelines began with Frederick Winslow Taylor.

The Birth of the Stopwatch Culture

In the late 19th century, Taylor transformed the factory floor into a laboratory. By using a stopwatch to break down human movement into measurable units, he birthed scientific management (or Taylorism). His goal was noble in a vacuum: to eliminate the greatest misfortune of the era, inefficiency.

Taylor’s 1911 masterpiece essay, The Principles of Scientific Management, established the rules that still govern our bureaucracies today:

• Every action must be timed and optimized.

• There is only one right way to perform a task.

• Management thinks and schedules; the worker executes.

The Policy Nexus: When Efficiency Becomes Exclusion

While Taylorism helped build the modern industrial state, it also hard-coded a specific philosophy into our policy DNA: Chrononormativity.

In my research, I define "administrative chrononormativity" as the use of standardized timelines and normative life cycles to dictate policy eligibility and success. When Taylor synchronized the factory to a single rhythm, he created a system that only worked for the standard body and the standard life.

When we apply Taylorist efficiency to public health or social services today, we often see the following:

1. Policy deadlines that assume everyone has the same clock (e.g., rigid enrollment or reporting windows).

2. Measuring the success of a human service by how quickly a case is closed, rather than by the quality of the outcome.

3. The Erasure of Non-Normative Lives: Systems designed for a linear, "9-to-5" life cycle often fail those in queer communities, aging populations, or underserved groups whose lives don't follow a Taylorist conveyor belt.

Reimagining the Best Way

Frederick Winslow Taylor died in 1915, but his "stopwatch" still haunts our administrative hallways. Terms like Total Quality Management (TQM) and Six Sigma are the direct descendants of his steel-mill experiments.

As public administrators, our challenge in 2026 isn't just to be efficient; it's to be equitable. We must ask:

Who is being timed? And whose life cycle is being erased by the standard we've created?

If we want to build a truly inclusive public sector, we have to move beyond the one-best-way and start designing policies that respect and support the diverse, non-linear rhythms of the communities we serve.

Figure 1: Definition of Scientific Management. Source: Gilbreth, F. B. (1912). Primer of Scientific Management. Harper and Brothers. (Public Domain).

Figure 2: Drawing of Fredrick W. Taylor from the Pickens Sentinel-Journal, September 7, 1911.

 

Our lives > Their data

We are the pulse of the future. It’s time to prioritize people over power-hungry centers. 🛑💻

Rebuilding the Civic Compact: Addressing the Trust Gap in Higher Education

The relationship between public universities and the communities they serve is reaching a critical inflection point. As institutional costs rise and perceptions of political bias take hold, the trust gap between higher education and the public continues to widen.

I recently attended a webinar that explored these very tensions, offering a roadmap for how institutions can move from technical compliance toward genuine relational bureaucracy. The discussion featured a distinguished panel of leaders who have spent decades navigating the intersection of academic mission and public accountability:

• E. Gordon Gee: Former President of West Virginia University and a seminal voice in university leadership.

• David Rosowsky: Senior Advisor to the President at Arizona State University and expert in the "New American University" design.

• Stephen M. Gavazzi: Director of CHRR at The Ohio State University and a leading researcher on the land-grant mission.

Key Themes: Why Trust is Faltering

The panel identified several core drivers of the current disconnect:

1. Rising Costs: The financial burden on students and families creates a transactional rather than transformational relationship.

2. Perceived Bias: A growing sentiment that universities are no longer neutral spaces for diverse perspectives.

3. The Erasure of the Public Compact: A shift away from the foundational land-grant philosophy of serving the specific needs of local citizens.

Re-Envisioning the Land-Grant Mission

A central takeaway from the conversation was the need for a reinterpretation of the compact. As policy administrators, we must ask: How do we ensure our institutions are not just in the community but also of the community?

To rebuild this civic trust, the panelists suggested that higher education must prioritize data-driven excellence and transparent engagement, realigning university goals with the lived experiences of the public.

Continued Learning and Resources

For those interested in the critical policy analysis of higher education’s role in society, I highly recommend the following resources discussed by the panel:

• Watch: Link 

• Read: Land-Grant Universities for the Future and What’s Public About Public Higher Ed? by Gavazzi and Gee.

• Analyze: Morrill Act 250: Reinterpreting the Public Research University Compact as Civic Trust in America’s Third Century by Gavazzi, Gee, and Rosowsky.

The Policy Nexus Perspective: Rebuilding trust is not a marketing problem; it is a governance challenge. It requires us to evaluate our administrative timelines and structures to ensure they are inclusive of the very public they were designed to serve.

Agentic AI & The Discretion Gap: Are We Automating Administrative Judgment?

The conversation often focuses on efficiency as we rush to adopt agentic AI tools like Google’s Project Astra, which not only answer questions but also take independent actions. We talk about AI partners that can schedule our lives and manage our professional logistics. But in the public sector, we have to ask a harder question: When an AI agent takes an action, who is exercising discretion?

 

Recently, my colleague Annie Bui (DPA-C) shared a fascinating look at the future of these universal AI assistants. Her post sparked a vital question about how these tools fit into our daily professional lives as public administrators and researchers.

                                      View the original discussion on LinkedIn 

As a DPA student and public commissioner, I look at these tools through the lens of Administrative Chrononormativity. Institutional timelines are already rigid; they often exclude those with non-normative life cycles, caregivers, low-income residents, and those navigating the complexities of the behavioral health system.

If we move toward an agentic state where AI agents manage scheduling, service delivery, and follow-ups, we risk two major failures:

1. As Michael Lipsky famously argued, the discretion of a human bureaucrat is often the only thing that makes a cold system human. Is it possible for an AI partner to make an exception for a grandmother who arrives five minutes late to a clinic due to a bus delay?

2. Agentic AI moves in milliseconds. If our administrative systems begin to move at that speed, we further marginalize anyone who lives outside the "normative" digital clock. This isn't just a tech issue; it's a social justice issue.

The Nexus

We shouldn't fear the technology, but we must frame it correctly. An AI can be a powerful assistant, but it cannot be an administrator. Administrative discretion is a legal and ethical responsibility, one that requires a human soul to weigh the nuances of equity and community health. 

As we integrate these partners, we must ensure we aren't just building a faster bureaucracy but a more responsive one. Are we designing for the traveler’s convenience or the citizen’s due process?

Safety Tips for Peaceful Protesting

Today, millions are making their voices heard to advocate for a more equitable and secure future. The decisions made in the halls of power impact us all, and active participation is the most effective tool we have to ensure our leadership remains accountable to the people.

We are incredibly proud of the Field Team 6 partners hosting events today. With over 30 in-person registration drives underway, we are working to ensure every individual has the opportunity to claim their seat at the table.

Participation doesn’t end at the rally; it culminates at the ballot box. By registering and voting this November, we can shape a legislature that prioritizes transparency and reflects our shared values. Your voice is essential to holding our systems of governance to the highest standard.

We wanted to share some resources to help you stay safe.

ACLU: Know your rights as a protestor

TPN: Digital safety guide

Human Rights Campaign: Prepare for a peaceful protest

 

We all believe in the power of peaceful protest, and these guides help ensure that you and those around you remain safe and impactful.

If you capture any moments that you’d like to share with the Policy Nexus community, please upload them HERE.

Thank you for being the energy that keeps our democracy active and accountable.

Moving at the Speed of Trust: Reforming Mandated Reporting through SBX

Administrative Artifact

Sigma Beta Xi (SBX) is a community-anchored organization in the Inland Empire, founded in 1998 by Dr. Corey Jackson to provide professional mentoring and advocacy for youth and families of color. SBX serves as the primary model for relational bureaucracy, moving public service away from "Power Over" (surveillance and policing) toward "Power With" (partnership and support). I say this because SBX is currently executing a $7.5M state-funded pilot program to reform mandated reporting laws. 

This initiative ensures that families are not penalized for the "sludge" of poverty but are supported through community-led intervention. Let me explain: This project addresses temporal sovereignty. Instead of forcing families to comply with rigid, punitive "institutional clocks" that often lead to child removal, SBX builds the capacity of the family to thrive on its own terms.

Temporal Tension

In May 2024, 22 fathers in Riverside County graduated from the PEI Fatherhood Initiative. This success was possible because the program didn't "fail" a father for a missed appointment due to a work conflict or transportation barrier; it adjusted to the human reality.

“Speed of Trust” Graduation

This trust-based co-production results in higher retention, lower recidivism, and the preservation of the family unit, proving that flexible, community-anchored timelines are the key to health equity.

Relational Bureaucracy: A Lever to Enhance Social Equity

This video features a message from Assemblymember Dr. Corey Jackson, the founder of SBX, whose work on mandated reporting and family preservation is the central case study for your presentation.

"This isn't just a graduation; it's a successful strike against administrative chrononormativity."