Progress in the World

Sunday's NYT had an article about the effects of innovation by Neil Irwin: http://www.nytimes.com/2016/05/15/upshot/what-was-the-greatest-era-for-american-innovation-a-brief-guided-tour.html?em_pos=small&emc=edit_up_20160516&nl=upshot&nl_art=2&nlid=47043350&ref=headline&te=1.

His contention, which I have seen before in a current economics book, is that recent technological innovations have had less effect on society than did innovations of a century and a century and a half ago. While this argument has some initial appeal, I believe that it is essentially fallacious. He mentions advances such as indoor plumbing, railroads, cars and highways, elements of society that we can't imagine doing without. Yes, these are now essential to us, and there is a huge difference between having enough (toilets), and having more than enough (fancy showers,) but I think the trap Irwin falls into is that of thinking too narrowly.

But first, a little bit on how he is right. Advances in a field often meet the Law of Diminishing Marginal Returns. As an analogy, if you buy a stock at 3, arriving at 6 is a 100% advance, but then a similar gain of 3 points up from 6 is only a 50% advance, and so on. The further you go the less the impact of an equivalent gain. When the United States was a developing economy, we went from horse to train to car, moving from a 3 or 5 mile life experience perimeter to 200 miles – huge – to maybe 1,000 miles to 2,000 – huge, but less so – to intercontinental – still huge, but even less life-altering. From less than enough, to enough, to more than enough. True.

Here is my rebuttal. One, there are other fields of advance to look to in society, so while it might be true for households and transportation, it isn't true for society as a whole. And two, the Law itself is not always true. Readers will not be surprised as I cite, once again, my profession of medicine.

First, society as a whole. Our society is composed of many different sectors. Each one will advance with different start dates and different end dates. It is analogous to the business cycle of leading and lagging sectors of the economy. Transportation and manufacturing started when Irwin says they did. The 19^th and 20^th centuries had huge advances. Their impact is now slowing down. OK. But medicine started later and is now proceeding faster than ever before. Where the leading sectors faltered in their effects, the lagging sectors have taken over.

Look how impactful medicine has been and will be. In 2011 I had a pituitary adenoma operated on without cutting open my head. Instead, my surgeon used fiber-optics to go in through my nose and sinuses and cut out a tumor the size of a small tomato and I was out of the hospital completely cured in two days. My hormones are easily supplemented by a pill and application of a gel every day. Unlike transportation or home improvements, everyone doesn't see and experience this every day, but to me and thousands like me, it's a pretty big difference in what would have happened just a few decades ago.

Likewise for my friend Bob, who without modern cardiology would be dead as a nail. And what about the millions with hypertension who now go through life normally instead of dying from cerebral hemorrhages the way FDR did, or from heart attacks the way two of our neighbors did when I was a young teenager. And what would Mickey Mantle's knees have looked like with today's orthopedics? Light years differences here, everybody.

Moreover, and here's the second point, it is not at all clear that we are reaching medical nirvana asymptotically. It is not clear that we are going from enough to more than enough. Medicine and other technologies seem not to experience linear advances, but geometric advances, building cumulatively as knowledge expands. In fact, we are on track now to see Star Trek medicine sooner rather than later.

At some point, of course, we will reach an asymptote. Maybe when we conquer aging we will be faced with the dilemma of not enough room for everyone, even more than we are finding that now in the world. Maybe medicine will outrace reaching for satellite civilizations on the Moon and on Mars. Maybe the contradictions will appear at that point. Or, maybe they are appearing already, as medical advances lead to overpopulation right now, as in places like Syria where modern survival statistics and traditional large families combine with drought to produce wars and exodus. Maybe the killer will be the introduction of genetically altered mosquitoes that abolish malaria as the scourge it is, leading to overpopulation and untold hardship and suffering. That will be a horrible asymptote. Who knows where the asymptote will be?

But as of now, I think Irwin is premature in his assessment that progress has found its asymptote. He's right about households and transportation, but wrong about medicine and other technologies. He's probably also wrong about education, which could do a lot better than it has done. He's certainly wrong about the science of the mind. Eventually he will be right, just not now. And then if we last that long, eventually he will be wrong again with the next wave of advancement.

He needs to read some science fiction, probably.

Budd Shenkin