Happy New Disruption!

On December 30, 2011, in Uncategorized

Automation and the End of Work

At years end 2011, MIT’s Technology Review pointed to “5 Disruptive Technologies Happening Now.” They were: E-books, 3D printers, digital CCTV, DNA sequencing machines, and artificial intelligence (AI). The first two are apotheoses of automation: They take humans largely out of the loop. The fifth—AI—will take us out completely, eventually. Before long you’ll be able to print-your-own Christmas presents, taking out all the people in the manufacturing, wholesaling, and retailing loop.

For well over a decade I have written and spoken about the permanent loss of jobs to automation. In that time, millions of jobs have indeed been lost to it, and families and lives have been destroyed. Why don’t our government leaders also think about these crystal clear trends and plan accordingly? Why is academia perpetually asleep at the switch of social change—What earthly good do the social sciences produce?

There is much to recommend automation. It could enable us to feed, house, and clothe the whole world if we could only get past our hateful ideologies. But if we do not factor automation’s impact on jobs in to our planning, people will get hurt.

Unfortunately, there’s more. It appears that the broken, inequitable, and utterly unconscionable US health insurance system also destroys jobs by crippling innovation.

The last book on the subject of The End of Work that was worthy of any note was economist Jeremy Rifkin’s excellent 1996 book by that name. There are a couple of recent books on the subject, which I have not yet read, but one review seems to indicate they grasp at the straw of “No matter how much the machines take over, there will always be something left over for humans to do.” Perhaps the something will be to hunt down and punish the people who, by perpetuating such shortsightedness, contribute to the unfolding human tragedy. Unfortunately, even that job may be denied us: There’ll probably be an app for hunting them down. It would be trivial to write such an app, given that there’s already a smartphone app that alerts pedestrians to approaching vehicles, which is quite a feat. By reducing accidents, this app should reduce ER visits and hospitalization—and should therefore further reduce the demand for healthcare workers.

Medical Tourism

The appearance of an app for medical tourism should be enough to suggest the medical tourism business has traction. If you still need convincing, the December issue of Medical Tourism Magazine should clinch it. It gives a sense of how fast medical tourism is growing and, if you are a healthcare provider, of its potential impact on your practice. Needless to say, the magazine has no comment on the potential US job losses. It reports, for example, a Northwestern University study suggesting that the US would save $144 million by sending 7,500 patients to hospitals in Turkey, and that while an un(health)insured Memphis filmmaker opted for triple bypass heart surgery in India because he could not afford to have it in the US, even his fellow Americans insured with New Era Life Insurance Group may also opt to travel just as far in order to be fully covered for treatment at four hospitals in Taiwan.

Good for Turkish, Indian, and Taiwanese healthcare workers; at least, until they are replaced by machines and apps.

Whether to counter the threat from medical tourism or just try out a potentially lucrative new business model (I don’t know), Johns Hopkins does for PepsiCo workers who need orthopedic surgery what Cleveland Clinic does for Lowe’s workers who need heart surgery—that is to say, it offers a form of domestic medical tourism so workers can receive care at top-class hospitals while their employers save some money and perhaps have healthier and happier workers.

(I will be writing more about Medical Tourism in my February column in H&HN Daily.)


Through automation, patients are increasingly able to take care of themselves. With the elder explosion, boomers will need many more medical devices to help them at home, so a new Qualcomm device that links disparate home medical monitoring devices is an important advance.

The most ubiquitous home medical device is the cellphone/smartphone, through which Africa is taking to mHealth (mobile health—healthcare through cellphones) in a big way. mHealth will be everywhere eventually. Initially, much of it will provide work for live clinicians who will need to be at the end of the line for the patient, but eventually, there will be apps for that.

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Perhaps we need something like a “Jobs Impact Statement” for new technologies even as they are in the early concept stages. Until something more formal and rigorous comes along, Health Futures Digest will continue to warn of such impacts. Early in the new year, your humble editor and publisher will be moving back to Hawaii, and will be looking for new sponsors.

Happy New Year!



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