My Davao economist friend Dr. Antong Victorio told me recently of how he decided one day to begin monitoring his own blood pressure. His BP had been elevated for some time, requiring regular visits to his doctor. But COVID-19 stopped all that. So he looked for other ways, and found that he could buy his own BP monitor at an online retail site for P500. As it cost the same as one visit to his doctor, he decided to order one. With his new device, he found that his BP was high in the morning, higher in the afternoon, but low after dinner. He texted his doctor to interpret these findings, but no reply came. So he checked the internet, and found plausible answers there.His story highlights how the pandemic had disrupted access to medical care not only for my friend, but surely millions of others around the country with non-COVID ailments. But he was also led to wonder: Did his doctor no longer care to see him because, knowing he now has his own BP monitor, he would have discovered that he was not seriously hypertensive after all, and did not really need a doctor anyway? And all this was due to a cheap gadget that allowed him to diagnose himself. The device had empowered him to replace his doctor’s services for the same amount it would cost to make one visit.
I’ve written before of how technology has promoted “jobless growth,” with its undesired effect of taking jobs away (“Does technology worsen poverty?”, 10/13/17). That it takes away jobs of poorer, unskilled workers has been obvious for some time (think of farm workers losing out to farm machines), but my friend’s anecdote shows a higher-level problem that has been unfolding.
Artificial intelligence, big data, and data analytics now make possible products like IBM’s Watson, described as being able to diagnose cancer better than the best doctors, and provide legal advice faster and better than the best lawyers can. Even the fictional Tricorder in the 1960s futuristic TV series “Star Trek,” a handheld device that could diagnose and prescribe cures for various ailments, is now close to a reality, after a technology company mounted a global competition to develop such gadget. With the onset of the so-called Fourth Industrial Revolution (aka Industry 4.0), it has been estimated that about one-fifth (likely an underestimate) of all jobs today, spanning blue and white collar jobs alike, would be lost to the rapid advance of technology. COVID-19 may have been a major disruption to all of us, but Industry 4.0 could well be a more serious long-term disruption that calls for serious planning now.
So how do we deal with the looming challenge? For some, banning the wide sale of “income-undermining” gadgets like personal BP monitors may sound like an appealing prospect. But fighting technological change like the 19th-century Luddites in England did cannot be a solution. After all, any such ban can be circumvented through underhanded tactics, and yes, by applying technology to beat the system. History tells us that bans tend to turn out counterproductive. Or some might conceive of a law, purportedly to protect doctors’ incomes, imposing a minimum charge for their medical services. But just like the ill-advised price ceiling on the price of pork in the face of a supply crisis, it would only do more harm than good. Not only will it hurt the poor, it would also drive patients all the more to seek the technological alternatives that have led to the problem to begin with.
The economist in my friend Doctor Antong leads him to argue that the way to go is to embrace technology that raises productivity, hence incomes—but manage it to ensure win-win outcomes. We can even urge doctors to sell these erstwhile competitor devices in their own clinics, while focusing on (and charging more for) professional services no machine or gadget could replace—and there will remain many. That way, his doctor could work less and possibly earn more—a true instance of increased productivity and, ultimately, a stronger economy.
But it’s also crucial to ensure that productive technology is made widely accessible to all, and that we manage it to be an equalizer rather than a gap widener in society.
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