Two Types of People: Busy and Not Busy

For a while now I have used expressions like "Busy, but it is better than the alternative." when asked the ubiquitous "How are you?" With unemployment the way it is I think that many people can identify with that. I have also mentioned to people that I view being overly busy as the plague of modern life. Of course, not everyone is overly busy. There are plenty of people who have nothing to do but wish that they did.

This morning I had a thought which took me back to this article at Forbes.

http://www.forbes.com/sites/quickerbettertech/2011/07/18/9-2-unemployment-blame-microsoft/

The article is remarkably brutal in its honesty. It describes that people aren't being hired for jobs because they aren't needed. They aren't needed, because there are other options, many of which are based on technology. It goes on to say that you will get hired if you can demonstrate an advantage over those alternatives. To get hired, you have to be able to do something the software/automation/offshoring can't.

How do these things link together? I see two links. Being better than the competition, in many fields, requires a lot of effort. One of the big advantages of computers is that they can work constantly. They don't need to sleep or eat. They don't get sick. They also don't get bored or distracted. Even if you can do something that the computer hasn't mastered, they have changed the work environment so that now you can, and are expected to, be working virtually all the time. If you do something the computer can compete in, you definitely can't give it the advantage of working longer hours.

The second link is that computers and automation are capable of taking over many different tasks. When they do, they make the skills for that task nearly obsolete for humans. Humans that have those skills need to try to retrain to something else. That's a problem because retraining humans is a fairly slow process. This can put the skills that aren't yet automated in very high demand, and increase the odds of shortages in those areas. Lack of people with competitive skills means the few have to do everything. Hence, they work more time than they might otherwise want to.

Of course, if the only skills you have become automatable and you don't push down the retraining path, for one reason or another, you fall into a group that has virtually nothing to do. At least not anything productive. There are things that can keep you from being completely bored. You can play games and the machines can take on the role of entertaining you, but each day you become less and less likely to find yourself needed for productive work as the bar of automation moves steadily upward.

Hence, we move toward a world where there are only two types of people. There are the employed who are incredibly busy and who can barely stay on top of their tasks, and the unemployed who lack much of anything to do and are likely to be unable to change that.

Doc in a Box

This is something I have been thinking about for a while, but recent events have turned now into the time to put my thoughts together. In case you hadn't heard, Watson, the computer that beat the top humans at Jeopardy!, now has a job. (http://gizmodo.com/5839257/ibms-watson-gets-its-first-real-job and http://www.hpcwire.com/hpcwire/2011-09-15/can_supercomputing_help_cure_health_care_.html) IBM had said that they wanted to aim the DeepQA technology that made Watson what it was at the medical field for diagnosis and now they have done it. The second article above describes how this could help out with problems we have in healthcare. Martin Ford, the author of The Lights in the Tunnel, has an op-ed in the Washington Post where he goes through some implications of this (http://www.washingtonpost.com/opinions/dr-watson-how-ibms-supercomputer-could-improve-health-care/2011/09/14/gIQAOZQzXK_story.html). The insight on the recent Supreme Court decision is really significant, but I don't think Martin goes far enough when he is looks at how this could play out in the future. (Probably because if he said what I'm going to say here people would laugh at him and the piece would not have been published.) He mentions a situation where you have people with lower levels of training who can talk patients through things and then input information to Watson for diagnosis. I think the humans just get in the way here, especially given what I have heard about the caliber of most medical assistants.

What I see happening instead is the creation of a "Doc in a Box" chain of diagnostic clinics. These would be similar to the diagnostic clinics that are popping up around the US today with the one exception that they don't have humans in them. To make this happen, I'm going to call on three things: Watson's DeepQA, Microsoft's Situated Interaction, and remote sensing.

The first demonstration of Situated Interaction was the virtual receptionist. This technology greets you and runs the small waiting room associated with each office. As "exam rooms" become available, patients are directed toward them. The situated interaction requires video so I expect every inch of this place is being monitored all the time. In fact, the monitoring in the waiting room could be part of the input for diagnosis as well because it extends the baseline for observation.

In the exam room you have a virtual doctor. This is a combination of Situated Interaction with DeepQA. You sit in a chair that has the ability to take blood pressure, temperature, pulse, weight, and other basic vitals. The patient and the machine talk through everything a medical assistant, nurse, and final provider would normally do. That could include medical history, but honestly, this system works best if medical history has been put into a generalized database already. That generalized database can also make Dr. Watson extremely effective as it will have petabytes of previous diagnosis and outcomes to mine.

In addition to the normal vitals, I see this room having a whole array of more complex sensing capabilities. Samples or breath, blood, saliva, skin swabs, and whatever else could be taken. It should also be equipped with cameras that go beyond the visible. IR is easy and inevitably has diagnostic benefits, especially after it has been used with a few million patients. Other basic scanning technologies could be included as well. X-ray seems pretty easy though you have to be careful about exposure. You could probably do some other interesting things similar to MRIs. If they sit there for a while there might even be something useful you could get from detecting background radiation interacting with their bodies. Of course, cameras with high resolution could look at regions of the skin as well as in eyes, ears, nose, and mouth and they could do it with a lot more sensitivity than the human eye and easily go beyond the basic visible part of the spectrum to include near IR and UV.

I expect this system would be able to do a good job on day one. By the end of a year or two, it will put human doctors to shame when it comes to basic diagnosis, because it will have statistics based on this advanced sensing of every single customer that has visited. To really complete the circle, outcomes should be linked in as well. If the treatment is pharmaceutical, the Doc in the Box dispenses drugs, payment is done electronically and the patient is off.

Non-pharmaceutical treatment will take longer to get into this format. Robots aren't going to put in stitches for a while. They won't set bones for a while either, even if they can see what needs to be done. That will come, but it adds 5-10 years. In the mean time, I can easily see a setup where most primary care is done in a way where the only human involved is the patient. Of course, a patient might want to see a human practitioner and they certainly should be allowed to. However, that should become a luxury and have a price associated with that fact. This type of system could make basic healthcare have a very low marginal cost. So low that you could probably provide it to everyone in the country without causing the nation to go bankrupt.

Jobs and Exports

Today I heard two interesting facts about our economy for the July/August 2011 time frame. First, unemployment was flat. We aren't seeing new jobs. Second, exports were at an all time high. Here are some links with evidence, plots, and further analysis.

http://www.economicpopulist.org/content/big-fat-zero-jobs-august-2011-and-unemployment-still-91

http://seekingalpha.com/article/292427-exports-surge-to-new-all-time-high-in-july

To me this just called out that automation is making it so that companies don't have to hire humans to do things. After all, companies and making and even exporting more goods than even, but they aren't employing additional humans to do it.

That was just based on the brief sound bite of these two statistics. Looking at the plots though you can see this isn't just for right now. Look at what has happened with exports since the end of the recession in mid-2009. They have climbed from just over $120 trillion to just under $180 trillion. That's 50% growth in about 2-years. No wonder corporate profits are doing well.

Now look at the jobs numbers for that same period of time. Both unemployment and job counts are basically flat. Exports rose 50% with virtually no new hires.

I've heard people describe that some of the fact that employment hasn't gone up with efficiency is because of globalization and free trade. Those inevitably were significant factors in and around 2000. That doesn't explain this though. That's a rise in exports. That isn't stuff produced in other countries, that is stuff produced here and sold abroad. That is that part of free trade that really comes back to benefit us.  There definitely are people benefiting. The problem is that those benefiting represent a very small fraction of the population and no matter how hard an average person works, it will be virtually impossible to break into that group. Unless you have the capital to buy robots to make stuff for you, humans simply can't compete for large scale manufacturing today. There are likely other areas they can't compete in today either and there will be more in the future.