Martin Ford’s popular 2015 book, Rise of the Robots, only came to my attention with the extra reading time offered by current stay at home policy. I’m sorry I hadn’t read it before and would love to see it updated to 2020.
The extent of AI’s impact on our economy, job markets and income disparity was already much greater in 2015 than I suspected was true now. The impact on factory workers and other rote physical work is well recognized and, in many areas, already fait accompli. Office work, including much now done by college graduates, and even computer and software jobs are quickly disappearing. In the last 20 years the investment business has realized greatly increased profits while employing many fewer people; legal work formerly done by young attorneys is done faster, more accurately and far more cheaply by computer; programming and computer system analysis is likewise often better done by machines.
Young people making educational and career decisions would be well advised to read this book. Ford views much education related debt to be wasted, never to retrieved.
A long chapter examines robots and AI in health care. New jobs will be abundant in health care but most will be menial and low paid such as elder care. Certain professional areas will be almost entirely replaced: pharmacy; radiology film reading; pathology slide reading. Optimal treatment plans in oncology and some other areas will replace current professional decisions. Ford feels there will be a need for many nurse practitioner type jobs: a professional who can interact with patients and input information from the patient into the system. Most basic acute problems and much chronic disease follow up can be handled at this level, replacing the primary care physician, a field most MD’s avoid anyway.
In the course of the book Ford digresses into societal problems. He reviews our dysfunctional medical system controlled by for profit decisions which are often dangerous to health and which divert huge amounts of money into profits for drug companies, specialty physicians and medical centers. Specific issues of abuse include billings of twenty times or more Medicare allowable; drug and equipment advertising; no negotiated drug prices by Medicare; the conflict of interest in fee for service medicine where the medical center or physician profits from extra studies and procedures. The result is that new technology often is greatly overused with lots of expense but little patient value.
He recognizes that American society is not ready for Medicare for All even though many analysts conclude it is the best system. A simple viable alternative is successful in several European countries: the government sets all-payer maximum rates (he suggests 120% of Medicare.) but this still does not resolve drug prices and fee for service abuses. He would ban advertising (as does most of the rest of the world) and set drug prices.
Incremental change to a poor quality, hugely overpriced American medical system may soon be off the table. If the economic consequences of COVID are as dire as many predict there will be no money for this wasteful approach. Medical, and to be fair, other hugely profitable businesses have shown little altruism in the past and have manipulated government and a gullible public. I think they will fight to keep as much as they can. Amusingly, and I am not a Bernie fan, his policies might be what would allow America to best endure the upcoming years.
Jack's What Really Matters Blog 
Thanks, Jack: Your briefs are always interesting to read. Did you attend Regis School? If so, did you know Anthony Fauci? This idea pop into my heard and I have wanted to ask you. You and Debbie have a great location to shelter in place–stay well and safe, Bev
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Tony was my classmate– good guy: smart (probably 5-10th in class, but 1st at Cornell Med), friendly, hard working, captain of basketball team. I knew him but we were not close.
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Medical care is grossly overpriced and remarkably unavailable in so many segments of our country, and yes, jobs that pay well are increasingly in short supply irrespective of how hard the individual works or the excellence with which they have been trained. The great profits that are being reaped by the richest of the rich, large institutions, etc. are fostered many ways but robotics and AI are major contributors. Many of us live off those profits through our retirement fund investments and direct investments, and many of us live well and pass on large sums to our family. Yes, we have worked hard and spent cautiously, but still, almost everyone in the upper income brackets benefits directly from the seemingly heartless shift to greater use of robotics and AI. As with so many things, however, the genie is out of the box, and I see no prospects of things going back except under extreme changes in our culture. Hope you both are well and staying safe-are you safer in Hawaii or CA?
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We’re staying on Kauai for a while until things calm down in San Diego, Sharron.
In Ford’s commentary he suggests that a yearly grant (perhaps $10,000) to each person whose income/net worth is below a certain high level might be the simplest and fairest method of handling the worsening situation we are now in where more wealth continues to accrue to capital and less to workers. The book offers an extensive discussion of this approach. It seems reasonable to me.
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Also… I think we all acquiesce to the replacement of workers by robotics EVERY DAY. I have friends who refuse to use self-checkout at groceries because they say it is just a way for the company to replace workers-true! As I become older, I long for the day when I could pull into a gas station and have my gas pumped, window washed, and if needed, tires and oil checked, but no more. No matter how infirm or inept I am (as in pumping up a low tire), that service is not available. Consider with the vast number of aging Americans whether we would be willing to pay a bit more to have some more service-I would, but no one is listening. Recently, amidst the pandemic, a local gas station announced that they were returning to pumping gas and all the rest for those wanting those services. However, they also announced that they intend to keep on the extra workers even after the pandemic recedes because people need the jobs and customers like the service. Of course, these are low paying jobs but jobs still. Now we are almost eliminating bank tellers. Physicians assistants are increasingly being used to minimize the use of the services of physicians-THAT is a money saving device, no doubt. What next? Robotics and AI have replaced myriad well paying jobs and now are eliminating even the menial jobs. So, what are people supposed to do for a living? Guess being a maid or a gardener for the very rich who glean money from these moves are jobs that will never disappear. Something to ponder.
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All what you say is true. Ford views it as inevitable; therefore the $10,000 per year person so all can survive and people can use time to create skills, art and anything else of value rather than beg for food and housing.
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Great blog, Jack, good hearing from you again. Sue
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Thanks Sue. Hope you are well.
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Hi Jack,
Thank you for your thoughts. I always enjoy reading your blog. This book sounds like it’s worth reading. I just downloaded the audio book.
We look forward to seeing you and Deb when you return.
Best,
Jim
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good to hear from you, Jim
think your kids might be ready for this book- they seem like they’re ahead of their years
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