Question: One aspect that you did not discuss on the cancer issue is how early(ier) diagnoses AND TREATMENT may be affecting morbidity and mortality. I don't know if the "JAMA" article discusses this but it would certainly be a consideration to any conclusion one might make about whether there is a real increase in cancer vs. a perceived increase in cancer based on outcome.
One of the biggest reasons to be against self-driving cars is how cheap they make driving, which can massively increase pollution as well as decrease the ability for better public transit options to take hold (much better on safety AND pollution). Not to mention, fully autonomous drivers can easily go wrong and cause massive traffic problems, with nobody to really hold responsible. Everyone has seen videos of confused Waymos driving around completely empty, causing traffic and pollution to serve nobody.
When Self-driving Cars are really working in all circumstances, owning a car becomes meaningless. For most people being driven to their desired destination simply becomes a service like public transport as an additional option. Think of all the space in our cities blocked by parked cars that sit there more than 95 percent of the time.
I would alsopoint out that Uber and Lyft drivers trolling for rides in major cities are also major problems for traffic. It is not just a Waymo problem.
A trip to NY city will provide ample evidence of this as more than half the uber and Lyft cars travel around the city empty looking to capture a rider.
Most of the uber and Lyft vehicles actually burn gasoline as opposed to an EV contributing to ground level pollution in the city. The same can be said for Taxis in NY. Accountability is an issue but at least there is significant data associated with Waymo and other driverless cars including reams of video. Though some Driver operated cars have video and sensor data it is not as widely available and depends on the driver and the age of the vehicle.
Reducing traffic seems like one of the most effective uses of self-driving technology. Driverless buses and trains allowing increased frequency would reduce traffic, and avoiding toxic human-driver behavior such as tailgating, aggressive merging and so forth. All things being equal driverless technology could plausibly be much better for traffic. Air-pollution can can already be solved by electric cars, so that doesn’t seem like a good objection. You’re also not addressing the safety issues pointed out as being most impressive.
I would also point out that Uber and Lyft drivers trolling for rides in major cities are also major problems for traffic. It is not just a Waymo problem.
A trip to NY city will provide ample evidence of this as more than half the uber and Lyft cars travel around the city empty looking to capture a rider.
Most of the uber and Lyft vehicles actually burn gasoline as opposed to an EV contributing to ground level pollution in the city. The same can be said for Taxis in NY. Accountability is an issue but at least there is significant data associated with Waymo and other driverless cars including reams of video. Though some Driver operated cars have video and sensor data it is not as widely available and depends on the driver and the age of the vehicle.
I agree that self driving cars are much safer than Human drivers..but you need to be careful in comparing Waymo to drivers …Waymo is restricted to certain urban areas, these areas my have an inherently lower fatality rate than the country as a whole..a better comparison would be to limit the analysis to the areas served by Waymo.
There is a technical nuance here that I feel you really should highlight. Waymo's approach to self-driving cars is safe and effective. Tesla self driving cars are the poison pill that could wreck the public opinion. Unfortunately it's not obvious to the average person as drinking bleach vs Moderna vaccine since the complexity of the underworking of how self-driving is accomplished is hidden.
I do agree overall that mass adoption of self-driving cars would be an overall boon to Americans.
Self driving cars could be a boon for the minimally cognitively impaired and those with other disabilities who are limited to transportation access. It could increase to services that are not home based. I would like to see trials on expanding into suburbs and perhaps into rural areas.
As far the explosion in diagnostics, this is all very true. There is preponderance of overdiagnosis....cancer, autism, etc. etc. This crowds out the needs of those who have demonstrable illness which we can actually do something about.
The thing about those 40K deaths is we could already avoid a huge percentage of them with relatively small interventions like speed cameras and daylighting. The fact that we choose not to do this is a real indictment of our society. Nobody, and I really mean nobody, was willing to inconvenience drivers to save those people before self driving cars. So I am not sure why they'd be willing to inconvenience drivers after. The revealed preference of America is that inconveniencing drivers is never worth it no matter what.
I’m less against the idea of self-driving technology in suburban areas, but one of my concerns about it in cities is congestion. It’s not like the addition of one autonomous vehicle results in one human-driven car - hired or not - coming off the road. More cars in cities makes the quality of life worse.
Also one of the other causes of traffic fatalities is the increased height and weight of cars on the road compared with 30 years ago if Waymo’s technology endgame is to be another feature in a F-150 Raptor with raised struts, how much of the self-driving safety benefits are cannibalized by the inherent danger of those vehicle designs?
You could easily see increasing real diagnoses and lower death rates if improvements in treatment are saving those lives. Breast cancer, especially HER+ versions, have seen some pretty great targeted therapies in the last couple decades. Saved my wife’s life!
As to the over-diagnosis and over-detection: I would be curious as to a breakdown on this.
How much of this testing is done by emergency rooms? In the experience of my family, it is easy to get funneled through the emergency room when needed hospital admission or re-admission, and once in the emergency room, get a large amount of very expensive testing done, with the tacit view that you and the doctor that sent you to the hospital probably don't have a very good idea what is wrong. Lots of expensive wild goose chases (and delays in treatment for the actual problem).
How much testing is done simply to satisfy the insurance company? Or as a prevention of malpractice suit in case of highly unlikely outcomes? Which sooner or later means detection of things that may not have needed pursuing at all.
My point here is that, while individual patients or their doctors may sometimes make the decision to go wild with their testing just out of an abundance of medical worry, I wonder what percentage of cost and unnecessary diagnosis comes from other scenarios.
Why do you keep saying "accident"? The vast majority of crashes occur due to choices in physical and regulatory design. You don't need new technology to dramatically reduce fatalities. However, the new technology is welcome, but does need a thoughtful regulatory framework. E.g. existing land use regulations kill people (in addition to other negative externalities) on roads because in most places mobility is impossible without driving. Self driving regulations should take heed to the mistakes of generations past to encourage more pro-social outcomes.
I don’t think the analogy between vaccines and self-driving cars is apt, for a couple of reasons.
What people don’t understand about autonomy is how strong the Pareto Principle is here. It seems like driverless cars are “almost there”, but the cases they can’t handle are really, REALLY hard. I’m a believer that artificial general intelligence is possible in principle, but I don’t think we’re anywhere near autonomous driving technology that can make a car go anywhere a human can drive it.
Additionally, some companies (Tesla is one, Waymo isn’t) are submitting innocent bystanders to their experimentation with unconscionably little concern for safety protocols. If this were a vaccine, would you be okay with the drug company inoculating random people without their knowledge or consent? I’m fine with cities banning driverless cars from companies that don’t meet a very high standard of caution in how they verify and roll out new updates.
Last, autonomous cars are vastly more expensive than vaccines. Even if the perfect driverless car existed, it would take probably 1,000 to 10,000 times more money to replace the human-driven fleet than it would to vaccinate everybody. The number of lives saved might be the same, but the cost matters. At that price, you have to seriously consider whether you could save even more lives with different spending priorities.
Couple of thoughts on your provocations: the risk of going first, the vulnerability needed for common ground and the role or behavior of reputation. It takes a long time to earn and shape but can be wiped out or destroyed instantly. With all the accidents, deaths and scenes of self-inflicted traffic jams or honk fest reputation of Cruise, and in general autonomous vehicles was swiftly torn down. Doesnt help that SF and other cities can feel like living laboratories. If you dont know what is the product you’re the product could be, if you dont know who are the mice, in the experiment, you are? Similar pattern for vaccines. Which makes pulling dull edged policy levers that alter the flow of the above a scary proposition. Many orgs and elected officials struggle to successfully co-create w communities, in general, which undermines how to establish, communicate any ‘living in beta’ change, renovation, alteration etc. 2cents. Thx for the work you do to put these together.
Question: One aspect that you did not discuss on the cancer issue is how early(ier) diagnoses AND TREATMENT may be affecting morbidity and mortality. I don't know if the "JAMA" article discusses this but it would certainly be a consideration to any conclusion one might make about whether there is a real increase in cancer vs. a perceived increase in cancer based on outcome.
One of the biggest reasons to be against self-driving cars is how cheap they make driving, which can massively increase pollution as well as decrease the ability for better public transit options to take hold (much better on safety AND pollution). Not to mention, fully autonomous drivers can easily go wrong and cause massive traffic problems, with nobody to really hold responsible. Everyone has seen videos of confused Waymos driving around completely empty, causing traffic and pollution to serve nobody.
When Self-driving Cars are really working in all circumstances, owning a car becomes meaningless. For most people being driven to their desired destination simply becomes a service like public transport as an additional option. Think of all the space in our cities blocked by parked cars that sit there more than 95 percent of the time.
I would alsopoint out that Uber and Lyft drivers trolling for rides in major cities are also major problems for traffic. It is not just a Waymo problem.
A trip to NY city will provide ample evidence of this as more than half the uber and Lyft cars travel around the city empty looking to capture a rider.
Most of the uber and Lyft vehicles actually burn gasoline as opposed to an EV contributing to ground level pollution in the city. The same can be said for Taxis in NY. Accountability is an issue but at least there is significant data associated with Waymo and other driverless cars including reams of video. Though some Driver operated cars have video and sensor data it is not as widely available and depends on the driver and the age of the vehicle.
Reducing traffic seems like one of the most effective uses of self-driving technology. Driverless buses and trains allowing increased frequency would reduce traffic, and avoiding toxic human-driver behavior such as tailgating, aggressive merging and so forth. All things being equal driverless technology could plausibly be much better for traffic. Air-pollution can can already be solved by electric cars, so that doesn’t seem like a good objection. You’re also not addressing the safety issues pointed out as being most impressive.
I would also point out that Uber and Lyft drivers trolling for rides in major cities are also major problems for traffic. It is not just a Waymo problem.
A trip to NY city will provide ample evidence of this as more than half the uber and Lyft cars travel around the city empty looking to capture a rider.
Most of the uber and Lyft vehicles actually burn gasoline as opposed to an EV contributing to ground level pollution in the city. The same can be said for Taxis in NY. Accountability is an issue but at least there is significant data associated with Waymo and other driverless cars including reams of video. Though some Driver operated cars have video and sensor data it is not as widely available and depends on the driver and the age of the vehicle.
I agree that self driving cars are much safer than Human drivers..but you need to be careful in comparing Waymo to drivers …Waymo is restricted to certain urban areas, these areas my have an inherently lower fatality rate than the country as a whole..a better comparison would be to limit the analysis to the areas served by Waymo.
There is a technical nuance here that I feel you really should highlight. Waymo's approach to self-driving cars is safe and effective. Tesla self driving cars are the poison pill that could wreck the public opinion. Unfortunately it's not obvious to the average person as drinking bleach vs Moderna vaccine since the complexity of the underworking of how self-driving is accomplished is hidden.
I do agree overall that mass adoption of self-driving cars would be an overall boon to Americans.
Yes a big part of cancer is more testing, but as we’re losing funding for cancer research the number of Americans who have to live with that diagnosis and now have nowhere to turn is a massive problem https://open.substack.com/pub/americaninequality/p/the-next-cancer-catastrophe-is-political?r=6x58d&utm_medium=ios
Self driving cars could be a boon for the minimally cognitively impaired and those with other disabilities who are limited to transportation access. It could increase to services that are not home based. I would like to see trials on expanding into suburbs and perhaps into rural areas.
As far the explosion in diagnostics, this is all very true. There is preponderance of overdiagnosis....cancer, autism, etc. etc. This crowds out the needs of those who have demonstrable illness which we can actually do something about.
The thing about those 40K deaths is we could already avoid a huge percentage of them with relatively small interventions like speed cameras and daylighting. The fact that we choose not to do this is a real indictment of our society. Nobody, and I really mean nobody, was willing to inconvenience drivers to save those people before self driving cars. So I am not sure why they'd be willing to inconvenience drivers after. The revealed preference of America is that inconveniencing drivers is never worth it no matter what.
I’m less against the idea of self-driving technology in suburban areas, but one of my concerns about it in cities is congestion. It’s not like the addition of one autonomous vehicle results in one human-driven car - hired or not - coming off the road. More cars in cities makes the quality of life worse.
Also one of the other causes of traffic fatalities is the increased height and weight of cars on the road compared with 30 years ago if Waymo’s technology endgame is to be another feature in a F-150 Raptor with raised struts, how much of the self-driving safety benefits are cannibalized by the inherent danger of those vehicle designs?
You could easily see increasing real diagnoses and lower death rates if improvements in treatment are saving those lives. Breast cancer, especially HER+ versions, have seen some pretty great targeted therapies in the last couple decades. Saved my wife’s life!
As to the over-diagnosis and over-detection: I would be curious as to a breakdown on this.
How much of this testing is done by emergency rooms? In the experience of my family, it is easy to get funneled through the emergency room when needed hospital admission or re-admission, and once in the emergency room, get a large amount of very expensive testing done, with the tacit view that you and the doctor that sent you to the hospital probably don't have a very good idea what is wrong. Lots of expensive wild goose chases (and delays in treatment for the actual problem).
How much testing is done simply to satisfy the insurance company? Or as a prevention of malpractice suit in case of highly unlikely outcomes? Which sooner or later means detection of things that may not have needed pursuing at all.
My point here is that, while individual patients or their doctors may sometimes make the decision to go wild with their testing just out of an abundance of medical worry, I wonder what percentage of cost and unnecessary diagnosis comes from other scenarios.
Why do you keep saying "accident"? The vast majority of crashes occur due to choices in physical and regulatory design. You don't need new technology to dramatically reduce fatalities. However, the new technology is welcome, but does need a thoughtful regulatory framework. E.g. existing land use regulations kill people (in addition to other negative externalities) on roads because in most places mobility is impossible without driving. Self driving regulations should take heed to the mistakes of generations past to encourage more pro-social outcomes.
I don’t think the analogy between vaccines and self-driving cars is apt, for a couple of reasons.
What people don’t understand about autonomy is how strong the Pareto Principle is here. It seems like driverless cars are “almost there”, but the cases they can’t handle are really, REALLY hard. I’m a believer that artificial general intelligence is possible in principle, but I don’t think we’re anywhere near autonomous driving technology that can make a car go anywhere a human can drive it.
Additionally, some companies (Tesla is one, Waymo isn’t) are submitting innocent bystanders to their experimentation with unconscionably little concern for safety protocols. If this were a vaccine, would you be okay with the drug company inoculating random people without their knowledge or consent? I’m fine with cities banning driverless cars from companies that don’t meet a very high standard of caution in how they verify and roll out new updates.
Last, autonomous cars are vastly more expensive than vaccines. Even if the perfect driverless car existed, it would take probably 1,000 to 10,000 times more money to replace the human-driven fleet than it would to vaccinate everybody. The number of lives saved might be the same, but the cost matters. At that price, you have to seriously consider whether you could save even more lives with different spending priorities.
Why wouldn't AI driven cars be safer than Ape driven cars?
Couple of thoughts on your provocations: the risk of going first, the vulnerability needed for common ground and the role or behavior of reputation. It takes a long time to earn and shape but can be wiped out or destroyed instantly. With all the accidents, deaths and scenes of self-inflicted traffic jams or honk fest reputation of Cruise, and in general autonomous vehicles was swiftly torn down. Doesnt help that SF and other cities can feel like living laboratories. If you dont know what is the product you’re the product could be, if you dont know who are the mice, in the experiment, you are? Similar pattern for vaccines. Which makes pulling dull edged policy levers that alter the flow of the above a scary proposition. Many orgs and elected officials struggle to successfully co-create w communities, in general, which undermines how to establish, communicate any ‘living in beta’ change, renovation, alteration etc. 2cents. Thx for the work you do to put these together.