Robot Doctors and Internet Professors

by Benjamin Studebaker

A few days ago, I wrote a piece on the American healthcare and higher education systems, noting that they both suffer from rising costs because the consequences of failing to obtain these services are very dire. I argued that while it is quite unfair to deny healthcare or education to people on the basis of their economic background, there are limits to the supply of these services available–limited numbers of hospital beds, doctors, professors, and university places. Consequently, I claimed it made sense for the state to ration access to these services, ensuring that poor people who can make splendid use of them have access by denying access to those who cannot derive the same benefits. It makes little sense to give a university place to a 95-year old over a poor 20-year old, or to attempt to prolong the poor-quality life of a 95-year old at the expense of saving a poor 5-year old. However, it was suggested to me that this argument might rest on a false assumption–namely, that the supply of college education and healthcare might not be supply constrained, or, at the very least, might soon cease to be. I’d like to consider this objection in further detail.

Remember the robot economy? Regular readers might. A little over a year ago, I was considering the extensive effects on both the economy and society that automation has the potential to have. The robot economy might fundamentally change the game in healthcare and education–indeed, there’s a case that it already can. Healthcare and education are, in large part, all about communicating highly specialized knowledge and to patients and students and processing research data.

The internet already can make a vast difference–computers can keep and transfer records far more efficiently and effectively than human beings, and if we were to put this data in the cloud, it could be used to give doctors up to the second information on the efficacy of various drugs and treatments over large population samples. But perhaps where the internet shows its greatest potential already is in education. Why should the student or the state spend tens of thousands of dollars on tuition and dorms when it’s possible to conduct college courses online? We have the beginnings of this already–MIT gives course materials away for free. We could go further with this, creating something like a college MMO (massively multiplayer online) game. A single professor of great distinction or lecturing prowess could give the same lecture over the web to the entire student population at the same time. No longer would there be a significant different in quality among the universities, everyone would have access to the same resources. Discussion sections and seminars could similarly be carried out in online chat rooms.

There would be limitations, of course, and we should note them:

  1. If a hundred thousand students are all taking the same class at the same time from the same professor, none of them are going to get any individual attention from him or visit him during his office hours.
  2. To whatever extent college also serves latent functions aside from educating  (perhaps it is a personal growth experience, has social value independent of the classes, is a good networking environment, is conducive to dating and reproduction), those advantages would be lost on students attending courses over the web.
  3. If this allowed students to continue living with their parents, it may stymie their development in relevant ways, by reducing their range of exposure, their changes of meeting good potential mates, etc.

That said, there’s no reason to think that every student would have do college online, so long as online collegiate degrees are treated with the same seriousness as degrees earned in person. If it is a choice for some people between online college and no college at all, online is surely preferable. Indeed, it is probably better to learn online from a top-notch professor than it would be to learn in person from a poor one.

This is merely the internet we’re talking about here–once the robots arrive, the possibilities for removing or greatly reducing impediments to increasing the supply of education and medical care expand exponentially. It takes about 30 years for our society to grow a doctor, and doctors have human limitations and consequently must specialize in single areas. Even then, human doctors diverse levels of competence and medical malpractice does happen. Imagine if we could instead have robots read all the medical research that has ever been conducted, remember it all at once with perfect clarity, and diagnose patients on that basis? We could build entire doctor factories.

The trouble with all of this is that there is really only one thing that a human intellectual can do that a robot cannot–conduct original research. Original research has produced everything that is good in our society (including the aforementioned internet and robots), but unfortunately those successes come at immense costs. Most original research done by smart people is ultimately useless. New drugs cost billions of dollars to invent, we’ve been chucking money at cancer for ages, and while every self-respecting person in the humanities (myself included) thinks his own work is of the utmost importance, many a discerning professor can identify at least one methodology he thinks is so intellectually unsound as to be not worth funding. Yet, we need academics to do research all the same. If it’s possible to teach classes over the web and treat people with robots, skinflint states are going to shutter their lesser universities and hospitals are going to do away with their doctors. The internet and the robots will have seriously harmed the very people presently developing them. So what can we do about that?

If we’re going to attempt to tech our way out of the healthcare and higher education malaise we find ourselves in rather than transition to European rationing, we’re going to need a sizable national financial commitment to funding research. That means paying lots of smart people to stick their faces in books, hang out in labs, and, for the most part, get very little done. This commitment will have to made with full knowledge that most of the research that we fund will be a waste of time. It will be easy for opponents to find cases in which zany academics conduct wholly frivolous research, easy for them to paint intellectuals as parasites, as clever welfare queens. Can our society resist the emotional appeal of that kind of argument? If not, a lot of smart people would come to find themselves jobless, seriously compromising the rate at which our society progresses technologically (and also giving smart people a profound sense of anomie, never a good idea).

While the robot economy can ensure universal access to higher education and medical care, by de-linking research from these fields, it makes researchers’ jobs less secure. If we no longer hire academics to teach but instead to just research and publish, there’s much cause for concern that we might either hire far too few for this purpose or hire the wrong mix, especially if the state backs out and leaves research to the private sector. There are so many kinds of research that have the potential to be socially useful without in any way being obviously profitable. That said, call me a cautious optimist nonetheless–universal free healthcare and education are really big pluses. So let’s get working on those bots!

As for my rationing idea? In the absence of robot doctors and an online university system that has the public’s confidence, rationing systems like those already operating in Europe are still superior to the American status quo of ever-increasing costs and band-aid policies.