thanks so much it’s really a pleasure to
be here and I am thrilled today to get a
chance to talk about something I’m
passionate about and that is the human
services and what I want to try to do
today is to reverse some conventional
wisdom that a lot of us hear about the
nature of the human services and that
conventional wisdom is often conveyed in
a chart like this and this chart sort of
talks about or at least it tells a story
right the chart tells a story about the
rise of health care costs here is a
percentage of GDP and a lot of
economists tend to call this a cost
disease what they mean by that is that
they divide the economy into what they
call productive and stagnant sectors the
hallmark of a productive sector is that
it gradually reduces its share of GDP so
you can think about agriculture or
manufacturing in the 1920s agriculture
was a huge part of the economy it’s
gradually shrunk to about 3%
manufacturing has done the same thing
and a lot of economists when they look
at a chart like this they say if we have
ever increasing health care costs
they’ll be parasitic on our economy
they’ll drag our economy down
they might even impede our ability to
compete on the global stage and by the
way this cost disease narrative has been
around for a long time even in the 1980s
early 1980s when health care was just
about 8% of the economy you can find
articles I’ve done some historical
research here where people are panicking
they’re saying the economy’s gonna
collapse do this 8% of GDP growth you
know and or 80% of GDP a share of the
economy of healthcare and that has just
continued over time now why is this a
problem
the problem here is because what it
leads to is a substitute of approach
versus a complementary approach for
technology okay the substitute of
approach that is really a part of the
cost disease narrative goes like this it
says that if manufacturing is so
productive the way we make human
services like health care more
productive is to make the workers within
those sectors more like machines
we have interchangeable parts that we
can bring in the logic of the assembly
line to healthcare and also it’s been
supercharged recently by talk about
artificial intelligence and robotics and
we see this in particular in a recent
application of AI to stopping
suicidality okay
there was an application developed by an
NGO in England that was designed to
watch people’s Twitter’s feeds and it
would report to individuals if anyone
they knew that they followed on Twitter
seemed suicidal from their tweets okay
and it would send a little message
saying watch how your friends seems
really down now
immediately after this was implemented
people are upset about it sarcasm was
taken as an indicator of suicidality
people got the messages said I don’t
know what to do with this I don’t know
exactly how I’m supposed to deal with
this particular problem and it even
raised privacy concerns under the
European General data protection
regulation and was shut down i contrast’
that with a better internet intervention
called Project Durkheim in project
Durkheim there were major differences
they focused on veterans and people with
particular data epidemiological
potentiality for suicidality they
emphasized opt in they said we’ve got to
have people opt in and they said when we
use AI driven natural language
processing looking at people’s social
media posts we are going to send the
knowledge to their friends we’re going
to inform people who are licensed
healthcare professionals it so far has
been a much better intervention and what
it exemplifies is a complementary
approach where technology complements
human services professionals rather than
replaces them the same thing by the way
the same logic applies to many forms of
social robotics now here we have an
example of a Japanese developed social
robot called the Paro this is a stuffed
animal a little seal and what it does is
that if you pet it it starts to Buell
it’ll bat its eyes at you it might make
some noises that are somewhat sad if you
move away from it for too long and it
has been used in many nursing homes and
other facilities to entertain
elders especially those with dementia
now you could take the Paro and say wow
we’ve now found a way to really cut our
costs in terms of caregiving whatever
time was spent talking with people just
give them a Paro right don’t be the
wrong approach and fortunately this
isn’t just my intuition they’ve actually
been very interesting studies done that
say that if you introduce the Paro in an
environment where you have individuals
that are licensed healthcare
professionals that know how to generate
dialogue about it how to get people
excited about it how to get people
talking about it that leads to a much
better outcome for the elders to which
is exposed than just giving them the
technology giving them the robot now of
course the counter to everything I’ve
just said is we don’t have the money we
don’t have the funds to invest and you
know we heard a similar story back in
the 1930s the 1930s the economy was in
much much tougher straits than it is
today
and even there was at all there was a
Great Depression of the time but what
the government did in response to those
economic straits was it did not sort of
disinvest it didn’t say we’ve got to go
into austerity mode it actually invested
in people it invested in health
well-being work that was done by
entities like the Civilian Conservation
Corps the Works Progress Administration
etc and I think one of our missed
opportunities over the past couple of
decades was that the Affordable Care Act
it’s right there in the name it’s all
about affordability but where’s the
quality Care Act where is the Act that’s
trying to make sure that these
incredible advances in AI and data that
we have on the horizon can complement
existing professionals and that they’re
fairly paid as they’re keeping track of
new data as they’re taking on new roles
as they’re learning things about
computer science and other aspects of
the new healthcare system how do we sort
of develop that attitude toward health
care among our policymakers versus the
austerity narrative I think it is
possible you know I think if we think
about the ways in which the inspiring
examples of investment in human beings
in our environment in our infrastructure
happened in the past
it’s possible for us to do this again
but in order to get there we have to
tell a different story about health care
we have to stop down buying into the
austerity narrative that health care is
taking up too much of the economy that
it’s a parasite that it’s dragging us
down what we instead have to do is we
have to think about Human Services as
the backbone of the economy as something
that’s inspiring as something that’s as
inspiring as say the moon a moonshot the
literal moonshot well now we have the
precision minute medicine moonshot right
we have to think about metaphors that
exemplify the value of our health
infrastructure and our health personnel
and I’ll close today just by thinking
about you know different periods of
historical time and when we did this in
the 1930s we did have a really great
investment in human labor and in trying
to ensure that technology complemented
rather than replaced human labor
similarly in the 1960s we had great
expansions in Social Security for
example with disability insurance and
other initiatives and I think now is the
time to really renew that and we even
heard it from President Obama himself
Obama himself when he described the
Affordable Care Act he didn’t say this
is the final word in health policy he
said this is like a starter home we’re
gonna build on it and I think of it more
as like a foundation right I think this
is a foundation for great advances that
we can make in health care but to make
those advances we have to look back on
some inspiring economists of the past
and I think particularly the ideas of
John Maynard Keynes and Keynes is famous
for this idea of the paradox of thrift
the idea was there was he was writing in
the 1930s and he observed that a lot of
people were so desperate and worried
about the decline in the economy but
they started saving more and more money
they just wanted to hoard money to
themselves just in case things got worse
in the future but the problem there was
that say you know you have someone
that’s hair dress for the decides I’m
not going to take taxis anymore well
that person may find out that yes
they’ve saved some money on taxis but
then if all hairdressers in the economy
decide to do the same thing then taxi
drivers have no money to get their hair
done right so similar types of problems
occur
what one person is saving ends up taking
away income from others and Keynes by
identifying that said you can reverse
this narrative the paradox of thrift by
saying if we emphasize the ability of
individuals to consume that can create a
virtuous cycle of consumption so this
brings us back to the original problem
of the talk the cost disease my bottom
line here is that rather than seeing the
cost of various human services as a
disease on the economy we instead can
see it as a cure to the problem of mass
joblessness and all via automation right
we hear the robots are taking all the
jobs we hear all these narratives about
people being knocked out of positions of
work I think the answer to that has to
be trying to create and invest in
sectors that can employ and indeed are
doing caring work important work that’s
often neglected and I’ll close by saying
that we can invest in humans of
expertise rather than simply replacing
it that’s within our ability we can have
that as our goal but the key is seeing
human services as a boon to the economy
as it cure to the potential problem of
mass joblessness rather than as
something that’s dragging the economy
down so with that thank you very much
and I hope we can all work together to
work on this cost cure and this
investment in human expertise thank you [Applause]
be here and I am thrilled today to get a
chance to talk about something I’m
passionate about and that is the human
services and what I want to try to do
today is to reverse some conventional
wisdom that a lot of us hear about the
nature of the human services and that
conventional wisdom is often conveyed in
a chart like this and this chart sort of
talks about or at least it tells a story
right the chart tells a story about the
rise of health care costs here is a
percentage of GDP and a lot of
economists tend to call this a cost
disease what they mean by that is that
they divide the economy into what they
call productive and stagnant sectors the
hallmark of a productive sector is that
it gradually reduces its share of GDP so
you can think about agriculture or
manufacturing in the 1920s agriculture
was a huge part of the economy it’s
gradually shrunk to about 3%
manufacturing has done the same thing
and a lot of economists when they look
at a chart like this they say if we have
ever increasing health care costs
they’ll be parasitic on our economy
they’ll drag our economy down
they might even impede our ability to
compete on the global stage and by the
way this cost disease narrative has been
around for a long time even in the 1980s
early 1980s when health care was just
about 8% of the economy you can find
articles I’ve done some historical
research here where people are panicking
they’re saying the economy’s gonna
collapse do this 8% of GDP growth you
know and or 80% of GDP a share of the
economy of healthcare and that has just
continued over time now why is this a
problem
the problem here is because what it
leads to is a substitute of approach
versus a complementary approach for
technology okay the substitute of
approach that is really a part of the
cost disease narrative goes like this it
says that if manufacturing is so
productive the way we make human
services like health care more
productive is to make the workers within
those sectors more like machines
we have interchangeable parts that we
can bring in the logic of the assembly
line to healthcare and also it’s been
supercharged recently by talk about
artificial intelligence and robotics and
we see this in particular in a recent
application of AI to stopping
suicidality okay
there was an application developed by an
NGO in England that was designed to
watch people’s Twitter’s feeds and it
would report to individuals if anyone
they knew that they followed on Twitter
seemed suicidal from their tweets okay
and it would send a little message
saying watch how your friends seems
really down now
immediately after this was implemented
people are upset about it sarcasm was
taken as an indicator of suicidality
people got the messages said I don’t
know what to do with this I don’t know
exactly how I’m supposed to deal with
this particular problem and it even
raised privacy concerns under the
European General data protection
regulation and was shut down i contrast’
that with a better internet intervention
called Project Durkheim in project
Durkheim there were major differences
they focused on veterans and people with
particular data epidemiological
potentiality for suicidality they
emphasized opt in they said we’ve got to
have people opt in and they said when we
use AI driven natural language
processing looking at people’s social
media posts we are going to send the
knowledge to their friends we’re going
to inform people who are licensed
healthcare professionals it so far has
been a much better intervention and what
it exemplifies is a complementary
approach where technology complements
human services professionals rather than
replaces them the same thing by the way
the same logic applies to many forms of
social robotics now here we have an
example of a Japanese developed social
robot called the Paro this is a stuffed
animal a little seal and what it does is
that if you pet it it starts to Buell
it’ll bat its eyes at you it might make
some noises that are somewhat sad if you
move away from it for too long and it
has been used in many nursing homes and
other facilities to entertain
elders especially those with dementia
now you could take the Paro and say wow
we’ve now found a way to really cut our
costs in terms of caregiving whatever
time was spent talking with people just
give them a Paro right don’t be the
wrong approach and fortunately this
isn’t just my intuition they’ve actually
been very interesting studies done that
say that if you introduce the Paro in an
environment where you have individuals
that are licensed healthcare
professionals that know how to generate
dialogue about it how to get people
excited about it how to get people
talking about it that leads to a much
better outcome for the elders to which
is exposed than just giving them the
technology giving them the robot now of
course the counter to everything I’ve
just said is we don’t have the money we
don’t have the funds to invest and you
know we heard a similar story back in
the 1930s the 1930s the economy was in
much much tougher straits than it is
today
and even there was at all there was a
Great Depression of the time but what
the government did in response to those
economic straits was it did not sort of
disinvest it didn’t say we’ve got to go
into austerity mode it actually invested
in people it invested in health
well-being work that was done by
entities like the Civilian Conservation
Corps the Works Progress Administration
etc and I think one of our missed
opportunities over the past couple of
decades was that the Affordable Care Act
it’s right there in the name it’s all
about affordability but where’s the
quality Care Act where is the Act that’s
trying to make sure that these
incredible advances in AI and data that
we have on the horizon can complement
existing professionals and that they’re
fairly paid as they’re keeping track of
new data as they’re taking on new roles
as they’re learning things about
computer science and other aspects of
the new healthcare system how do we sort
of develop that attitude toward health
care among our policymakers versus the
austerity narrative I think it is
possible you know I think if we think
about the ways in which the inspiring
examples of investment in human beings
in our environment in our infrastructure
happened in the past
it’s possible for us to do this again
but in order to get there we have to
tell a different story about health care
we have to stop down buying into the
austerity narrative that health care is
taking up too much of the economy that
it’s a parasite that it’s dragging us
down what we instead have to do is we
have to think about Human Services as
the backbone of the economy as something
that’s inspiring as something that’s as
inspiring as say the moon a moonshot the
literal moonshot well now we have the
precision minute medicine moonshot right
we have to think about metaphors that
exemplify the value of our health
infrastructure and our health personnel
and I’ll close today just by thinking
about you know different periods of
historical time and when we did this in
the 1930s we did have a really great
investment in human labor and in trying
to ensure that technology complemented
rather than replaced human labor
similarly in the 1960s we had great
expansions in Social Security for
example with disability insurance and
other initiatives and I think now is the
time to really renew that and we even
heard it from President Obama himself
Obama himself when he described the
Affordable Care Act he didn’t say this
is the final word in health policy he
said this is like a starter home we’re
gonna build on it and I think of it more
as like a foundation right I think this
is a foundation for great advances that
we can make in health care but to make
those advances we have to look back on
some inspiring economists of the past
and I think particularly the ideas of
John Maynard Keynes and Keynes is famous
for this idea of the paradox of thrift
the idea was there was he was writing in
the 1930s and he observed that a lot of
people were so desperate and worried
about the decline in the economy but
they started saving more and more money
they just wanted to hoard money to
themselves just in case things got worse
in the future but the problem there was
that say you know you have someone
that’s hair dress for the decides I’m
not going to take taxis anymore well
that person may find out that yes
they’ve saved some money on taxis but
then if all hairdressers in the economy
decide to do the same thing then taxi
drivers have no money to get their hair
done right so similar types of problems
occur
what one person is saving ends up taking
away income from others and Keynes by
identifying that said you can reverse
this narrative the paradox of thrift by
saying if we emphasize the ability of
individuals to consume that can create a
virtuous cycle of consumption so this
brings us back to the original problem
of the talk the cost disease my bottom
line here is that rather than seeing the
cost of various human services as a
disease on the economy we instead can
see it as a cure to the problem of mass
joblessness and all via automation right
we hear the robots are taking all the
jobs we hear all these narratives about
people being knocked out of positions of
work I think the answer to that has to
be trying to create and invest in
sectors that can employ and indeed are
doing caring work important work that’s
often neglected and I’ll close by saying
that we can invest in humans of
expertise rather than simply replacing
it that’s within our ability we can have
that as our goal but the key is seeing
human services as a boon to the economy
as it cure to the potential problem of
mass joblessness rather than as
something that’s dragging the economy
down so with that thank you very much
and I hope we can all work together to
work on this cost cure and this
investment in human expertise thank you [Applause]
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