The Anti-Social Bent of Modern Medicine – The Health Care Blog

BY MIKE MAGEE

In George Packer’s classic 2013 New Yorker article titled “Change the World: Silicon Valley transfers its slogans – and its money – to the realm of politics,” there is a passage worth a careful reread now a decade latter.

Packer shares an encounter with a 20-something techie critiquing his young colleagues who said, “Many see their social responsibility fulfilled by their businesses, not by social or political action. It’s remarkably convenient that they can achieve all their goals just by doing their start-up. They actually think that Facebook is going to be the panacea for many of the world’s problems. It isn’t cynicism—it’s arrogance and ignorance.”

Packer’s assessment at the time was “When financiers say that they’re doing God’s work by providing cheap credit, and oilmen claim to be patriots who are making the country energy-independent, no one takes them too seriously—it’s a given that their motivation is profit. But when technology entrepreneurs describe their lofty goals there’s no smirk or wink.”

Or, as others might say, “They believe their own bull shit.” Where many of us are currently focused on issues of values, fairness and justice, those in the shadows of Silicon Valley see the challenge to be inefficiency and incompetence, and the solution amenable to technologic engineering.

Back in 2013, a Belarusian immigrant student at Stanford named Evgeny Morozov coined the term “solutionism” for those with unshakeable confidence in hi-tech solutions.  A decade latter, Evgeny is now Visiting Scholar in Liberation Technology at Stanford, and a colleague of Larry Diamond (director of Stanford’s Center on Democracy) who coined the term, “liberation technology.” 

Stanford describes their focus this way: “The Internet, mobile phones, and other forms of ‘liberation technology’ enable citizens to express opinions, mobilize protests, and expand the horizons of freedom. Autocratic governments are also learning to master these technologies, however. Ultimately, the contest between democrats and autocrats will depend not just on technology, but on political organization and strategy.”

Evgeny naturally bridges this world of individual entrepreneurship and public policy.  His current focus is on AGI (artificial general intelligence) and its interface with his original concept of neo-liberal “solutionism.” He believes we have all been sold a bill of goods that technology is inevitable and beneficial, and that it will expand our intelligence and fix our inhumanity.

Evgeny says that it is already clear that the rise of entrepreneurial capitalism and destructive profiteering (let alone massive income inequality and segregation of tech gazillionaires) is altering representative democracy and replacing it with libertarians on steroids.

It is useful to remind ourselves that we’ve been down this road before. For example, it was none other than Margaret Thatcher who said, “There is no such thing as society.” How has that worked out in the post-Brexit period for the UK? 

Were she alive today, she would likely agree with AGI fans that private beats public, efficiency solves social troubles, and adjusting to change is a great deal quicker and easier that addressing core weaknesses in human or societal behavior.

Health tech’s recent “boom and bust” cycle laid truth to the lie that “really smart people” versus venture capitalist corporations are driving the information technology revolution. In the vast majority of cases, in health care and beyond, the “charm offensive of heavily subsidized services” is followed by “ugly retrenchment, with overdependent users and agencies shouldering the costs…”

In 2021, Health Tech managed to break all the records. The digital health market gained 43% more investors than in 2020, with $30.7 billion – a 107% rise – in venture capital. By 2022, the 85 corporations devoted to the field had collective valuations that had tripled to $73 million. 

Were these ideas category-defining? Were they sustainable? Were the investors a source of expertise or wise guidance? Were any of these products driving impactful change that would equitably change the life trajectory of the humans served? Did they lessen the populations fear and anxiety? Did they expand hopefulness and community engagement. Did they make America and Americans healthy?

Not according to Evgeny. He says, “The open agenda is, in many ways, the opposite of equality and justice. They think anything that helps you to bypass institutions is, by default, empowering or liberating. You might not be able to pay for health care or your insurance, but if you have an app on your phone that alerts you to the fact that you need to exercise more, or you aren’t eating healthily enough, they think they are solving the problem.”

Mike Magee MD is a Medical Historian and regular contributor to THCB. He is the author of CODE BLUE: Inside the Medical-Industrial Complex.