Learning How to Say "Robot" in Chinese

Perhaps you were one of the people who were alarmed when Chinese firm DeepSink released its powerful AI R1 a couple months ago, rivaling U.S. AI efforts but supposedly developed much cheaper and much faster. It was a reminder that, when it comes to AI, China is not to be taken lightly; the battle for AI supremacy is far, far from over.

They're coming. Credit: Unitree Robotics

Well, when it comes to robots – especially AI-powered, humanoid ones -- the battle may be closer to being over…and the U.S. is not winning.

China’s robotics version of DeepSink may be Unitree Robotics. Or UBTech. Or maybe Agibot or Pudu Robotics.  You get the point.

Speaking specifically about Unitree Robotics, Kyle Chan, an expert on Chinese industrial policy at Princeton University, told The Washington Post:  “They are almost the symbol of China’s ability to operate at the cutting edge of robotics. They’ve become kind of like the DeepSeek of the robotics world for China.”

WaPo reports that there are almost half a million smart-robot firms registered in China, with a combined market cap of almost a trillion dollars. Morgan Stanley recently noted that China had 5,688 patents containing the word “humanoid” over the past five years; by comparison, the U.S. had 1,483.

Yeah, they take smart robots seriously in China.  

The Morgan Stanley report commented: “Our research suggests China continues to show the most impressive progress in humanoid robotics where startups are benefitting from established supply chains, local adoption opportunities, and strong degrees of national government support.”

China has to take AI and robotics seriously, not only because they are seen as key technologies of the future but also because it is facing a marked labor shortage. Its labor force peaked in the mid-2010’s, and is forecast to shrink by 20% over the next 25 years. China has plenty of automation and even robots in those factories already, but they’re mostly limited to specific tasks. The AI humanoid robots would allow them to do jobs that only humans can do now.

“You won’t have to retrofit your factory, warehouse or home to accommodate a humanoid—that’s the future promise,” Jeff Burnstein, president of the Association for Advancing Automation (A3), a trade group in Ann Arbor, Mich, told The Wall Street Journal.

It won’t stop just at factories. Ming Hsun Lee, head of Greater China automotive and industrials research at BofA Global Research, told CNBC: ““I think in the short-term, three to four years, we will see humanoid robots initially applied in production lines to compare some workers, and in the midterm, we will see them gradually spread into the service industry.”

Unitech CEO Wang Xingxing  told TMTPost: “Within our lifetime, humanoid robots will be able to revolutionize every industry, from industrial and service sectors to agriculture and manufacturing, On an even grander scale, governments could deploy 100,000 humanoid robots to build an entire city.” Mr. Wang is clear about the reason for the progress: “The reason we’ve progressed so quickly is simple: the rapid advancement of AI technology.”

Similarly, Reyk Knuhtsen, analyst at SemiAnalysis, an independent research and analysis company specializing in semiconductors and AI, told CNBC: “China has the potential to replicate its disruptive impact from the EV industry in the humanoid space. However, this time the disruption could extend far beyond a single industry, potentially transforming the labor force itself.”

 AI and robotics leaders in the U.S. are paying attention – and are worried. “They have more companies developing humanoids and more government support than anyone else. So, right now, they may have an edge,” said Mr. Burnstein in WSJ.

A recent “call to action” from SemiAnalysis was blunt:  

Automation and robotics is currently undergoing a revolution that will enable full-scale automation of all manufacturing and mission-critical industries…The only country that is positioned to capture this level of automation is currently China, and should China achieve it without the US following suit, the production expansion will be granted only to China, posing an existential threat to the US as it is outcompeted in all capacities.

SemiAnalysis notes China has already captured the markets for batteries, solar, and EV, and warns that the economies of scale allowed by robotics “will be exponential compared to their last strategic industry captures.”

WaPo notes how Chinese robotics companies are already driving costs down (again, similar to what they’ve done with batteries, solar, and EVs):

Unitree has built its business model on competitive pricing. The company’s cheapest robot dog goes for $1,600, according to its website, while a humanoid robot costs $16,000. A robot dog from Boston Dynamics, by contrast, goes for around $75,000.

 Liu Gang, a professor at Nankai University in Tianjin who researches China’s innovation economy, explained the strategy to WaPo: “We are picking a path where we lower the costs for innovation and industrialization, When many can do things with a comparable quality, whoever makes it more cheaply will have a bigger chance to win.”

That’s going to make it increasingly harder for the U.S. to compete. And that’s a huge problem. When President Trump and others talk about bringing manufacturing back to the U.S., in large part what they want are all those well paying (human) jobs, but, to use the Wayne Gretsky metaphor, they may be skating to where the puck used to be.

Recently U.S. robotics leaders Agility Robitics, Boston Dynamics, Tesla (think Optimus robots, not Cybertrucks), along with A3, have called for a national strategy for AI-powered robots, much as China has developed (and funded). “The United States is at a critical moment in shaping the future of automation,” said Mr. Burnstein. “While AI is a major focus, we cannot afford to fall behind in robotics.” The strategy includes dedicated federal office to coordinate robotics policy, innovation, and industry collaboration, tax incentives, and funding public-private research partnerships to spur innovation.

According to Jeff Cardenas, co-founder of Austin-based humanoid startup Apptronik: “The next robotics race is powered by AI and is up for grabs.” 

Let’s hope so, anyway. The U.S. is terrible at industrial policy – just ask our steel, shipbuilding, or even chips industries. We still haven’t figured out what we should do about/for AI, other than to hope American ingenuity will save the day.

The U.S. shouldn’t be looking at how to strengthen our oil, gas, or coal industries; we shouldn’t worry so much about gasoline-powered automobiles; we shouldn’t be building multi-million dollar fighters or billion dollar aircraft carriers. Those were all important 20^th century industries/technologies, but, hey, this is the 21st century.

The 21^st century – and the 22^nd – will belong to the countries and industries that best adopt to/innovate in 21^st century technologies. Like AI and robotics.

Home, Alone

News flash: America is not a very happy place these days.

This is too many of us. Credit: Microsoft Designer

No, I’m not talking about the current political divide (which is probably more accurately described as a chasm), at least not directly. I’m referring to the latest results from the World Happiness Report, which found that the U.S. has slid to 24^th place in the world, its lowest position ever. We were 11^th in 2011, the first such report.

Nordic countries scored the highest yet again, taking half of the top ten counties, with Finland repeating for the eighth year in a row as the happiest country. America’s nearest neighbors Mexico (10^th) and Canada (18^th) are happier places, tariffs or not.

The researchers declare: “Belief in the kindness of others is much more closely tied to happiness than previously thought.” They specifically cite the belief that others would return a lost wallet is a strong predictor of a country’s happiness, while noting that such returns are twice as likely as people believe them to be.

John F. Helliwell, an economist at the University of British Columbia, a founding editor of the World Happiness Report, said:

The wallet data are so convincing because they confirm that people are much happier living where they think people care about each other. The wallet dropping experiments confirm the reality of these perceptions, even if they are everywhere too pessimistic.

The U.S., as it turned out, ranked only 52^nd in believing a stranger would return a lost wallet, and even only 25^th that the police would. We were slightly more optimistic (17^th) that our neighbors would.  

Sharing meals with others is also strongly linked to happiness. “The extent to which you share meals is predictive of the social support you have, the pro-social behaviors you exhibit and the trust you have in others,” Jan-Emmanuel De Neve, a University of Oxford professor and an author of the report, told The New York Times.

Unfortunately, the number of people dining alone in the U.S. has increased 53% over the past two decades. According to the Ajinomoto Group, among American adults under 25, it has jumped 80%.

Young Americans are helped drive our dismal results generally. “The decline in the U.S. in 2024 was at least partly attributable to Americans younger than age 30 feeling worse about their lives,” Ilana Ron-Levey, managing director at Gallup, told CNN. “Today’s young people report feeling less supported by friends and family, less free to make life choices and less optimistic about their living standards.”

Eighteen percent (18%) of young U.S. adults (18-29) report not having anyone they feel close to, the highest of all the U.S. age groups, and those same young adults also have lower quality of connections than older U.S. respondents. The report speculates: “Although not definitive, this provides intriguing preliminary evidence that relatively low connection among young people might factor into low wellbeing among young Americans.”

In fact, if the U.S. was measured just by the happiness of our young adults, we wouldn’t even rank in the top 60 countries. “It is really disheartening to see this, and it links perfectly with the fact that it’s the well-being of youth in America that’s off a cliff, which is driving the drop in the rankings to a large extent,” Professor De Neve said.

Researchers also point to inequality as an important factor. “In these Nordic Scandinavian countries, a rising tide lifts all boats, so the levels of economic inequality are much less, and that reflects in well-being as well,” Professor De Neve said. “In Finland, most people will rate [their happiness] as seven or an eight, whereas if you look at the distribution of well-being in the States, there’s a lot of 10s out there, but there’s a lot of ones as well.”

No wonder. According to The Urban Institute:

Wealth inequality is higher in the United States than in almost any other developed country and has risen for much of the past 60 years. Racial wealth inequities have persisted for generations, reflecting the long-standing effects of racist policies, not individual intentions or deficits.

So, no, we’re not all in this together, especially with the bottom 50% having a mere 2.4% of all household wealth, one of the lowest points we’ve seen. Americans also say we’re deeply divided both politically and on values (which, of course, are not unrelated).

Professor Jan-Emmanuel De Neve summarized some key takeaways from their report::

This year’s report pushes us to look beyond traditional determinants like health and wealth. It turns out that sharing meals and trusting others are even stronger predictors of wellbeing than expected. In this era of social isolation and political polarisation we need to find ways to bring people around the table again — doing so is critical for our individual and collective wellbeing.

“The fact that we’re increasingly socially isolated means also that we’re not testing our ideas about the world with other people,” Dr. De Neve explained to the NYT. “And the more you sit around the table with other people who might have somewhat different views, the more you start moderating your own views. And the increasing lack of social interaction and social isolation as a result, for a lot of people — amplified by echo chambers — makes people more radical.”

If you’ve read Robert Putman’s classic Bowling Alone (2000) – and, if you haven’t, stop reading this, go buy a copy, and read it – then none of this will be a surprise. Professor Putnam described how, even before the advent of social media, the U.S. went from a society that did a wide variety of things together into one that tended to be more insular, at the cost of much of our social capital.  We could sure use that social capital now.

Sure, there’s a lot to be unhappy about in today’s America. Most Americans don’t think the country is on the right track. We don’t trust our various institutions. We use social media, but we’re very worried about its impact – much moreso than the rest of the world. Eight percent of us have no close friends. 

Look, I can understand being behind Finland, Denmark, even New Zealand in overall happiness, but Slovenia or the U.A.E.? Seriously. We need to put our phones down, stop arguing about politics, go out to eat with friends, and, for goodness’ sake, if you find a wallet, be sure to return it to its owner.

A New Way to Internet

If you live in, say, Ukraine, you probably think about Starlink a lot. Since Russia invaded three years ago, it has been heavily dependent on Starlink for internet connectivity – especially its military. Rural areas around the world that had never developed cable connectivity similarly rely on Starlink. It has been a boon to millions of people.

Taara in action. Credit: Taara

But its CEO/founder Elon Musk has proved, shall we say, unpredictable lately. He’s taken to politics with a passion, supporting President Trump and wielding unknown influence in that Administration. Many worry that Mr. Musk could, on a whim or as a way of strategically applying pressure, simply could turn the service off in selected areas, which would be crippling (he denies that he would). There are not a lot of other great satellite internet options available.  The best of the bunch is OneWeb, which is owned by Eutelsat. It has had a rocky history, is much smaller, and would struggle to scale.

Europe is planning IRIS² as a way to achieve satellite independence, but it is several years away from being a viable option. Similar, there’s Amazon’s Project Kuiper, but let’s put it this way: it’s Jeff Bezos’s Blue Origin versus Mr. Musk’s SpaceX. I.e., some good promise there, but nowhere near delivering at anywhere near the same scale.  

It seems like we’d need a moonshot to catch, much less surpass, Starlink. Fortunately, Alphabet has X, its moonshot factory, and it has just spun off a project that it thinks could rival Starlink and perhaps change how we access the internet.

The company is called Taara, and it uses light to deliver connectivity. Fiber optic uses light as well, but it needs those pesky cables to transmit it. Taara skips the cable. It’s like ditching your landline for mobile phone service.

Mahesh Krishnaswamy, CEO of Taara, says:

Taara Lightbridge brings fast, fiber-like internet access to areas where it’s too difficult or expensive to install traditional fiber, like in dense city neighborhoods, over rivers and seas, or across rugged terrains and national parks. In the same way fiber optic cables in the ground use light to carry data, Taara uses narrow, invisible light beams to transmit information through the air, at speeds as high as 20 gigabits per second and across distances up to 20 kilometers. Taara’s Lightbridge units deliver high speed, high quality internet and require only a few hours to set up, without the time and cost associated with digging trenches or stringing cables.

Taara is an outgrowth of Alphabet’s Loon project, which used ballons (instead of satellite or cable) to establish the connectivity. That effort ran into a number of regulatory and practical problems, and was shut down in 2021. X was still sold on using light – lasers! – as a mechanism, and so continued its work. Earlier efforts were somewhat clunky, involving traffic light-sized devices and a series of mirrors, but two weeks ago X announced a new chip that addressed many of these issues.

Mr. Krishnaswamy said: “…this new chip uses software to steer, track, and correct the beam of light without bulky moving parts. We've taken most of the core functionality of the Taara Lightbridge—which is the size of a traffic light—and shrunken it down to the size of a fingernail.” He told Steven Levy in Wired: “We can offer 10, if not 100 times more bandwidth to an end user than a typical Starlink antenna, and do it for a fraction of the cost.”

The Taara chip. Credit: Taara

Even better, no need to launch a bunch of rockets to put thousands of satellites in orbit or installing new fiber optic cables. “Installation is completed in hours, not days —all without digging, spectrum licensing or right-of-way permitting,” Taara said over its new website.

While Mr. Krishnaswamy acknowledges that currently fiber is high-speed connectivity’s “gold standard,” he sees a different future:

Our team imagines a future where connectivity isn’t bound by cables or constrained by cost. By dramatically reducing the size and complexity of our systems, our aim is to eventually drastically reduce the cost of connectivity, creating a network effect within the industry.

Right now, the company only has a dozen employees, but is trying to rapidly at least double that count. Taara is “delivering commercial service in partnership with Airtel, Liquid Intelligent Technologies and Liberty Networks, as well as pioneering new approaches to wireless optical communications deployments with the likes of T-Mobile and Vodafone.” Taara already claims to operate in 12 countries, such as parts of Africa and India.

The spin-off was intentional to help spur growth. “We’ve realized over time that for a good number of the things we create, there’s a lot of benefit to landing just outside of the Alphabet membrane,” said Eric (Astro) Teller, X’s captain of moonshots. “They’re going to be able to get connected quickly to market capital, bring in strategic investors, and generally be able to scale faster this way.”

Mr. Teller adds: “If you can figure out how to be the first business that starts moving data via light, once the whole world moves to that part of the spectrum, we think Taara is going to be in a really nice place.” I.e., “skating to where the puck is going to be.”

Taara expects the new chip to be more widely available in 2026, but don’t expect a direct-to-consumer approach anytime soon. Think more like serving autonomous vehicles.

Both Mr. Teller and Mr. Krishnaswamy told Mr. Levy that 6G may be the last iteration to be based on radio waves; 7G, they believe, may be based on optics – which would be great for Taara. “We have an enormous worldwide industry that's about to go through a very complex change,” Mr. Teller said. “So to the extent that you buy this, it’s going to be a very big deal.”

Hey, my cable provider still hasn’t upgraded to fiber optics. I had been intrigued by Starlink, but having so much of the world dependent on one company – especially a company run by someone like Elon Musk – makes me very uneasy. I hope OneWeb, Project Kuiper, IRIS² and others are successful. But I’m really rooting for big breakthroughs like Taara promises. 

Health Care in Abundance

A recent report from Moody’s Analytics, by chief economist Mark Zandi, had an eye-opening fact: the top 10% of earners in the U.S. – those who make $250,000 or more – now account for just shy (49.7%) of half of consumer spending. If that strikes you as unusual, you’re right. It is a record since at least 1989. Thirty years ago the comparable percentage was 36%.

This too often describes our healthcare system. Credit: Council on Europe

“The finances of the well-to-do have never been better, their spending never stronger and the economy never more dependent on that group,” wrote Dr. Zandi. He added: "Wealthier households are financially more secure and thus more able and willing to spend their income. That is, they save less than they would otherwise.”

The rest of us are struggling to hold our own against inflation, not always successfully. It’s why companies like Costco and Walmart are trying to target upscale shoppers, while “value” oriented firms like Big Lots, Family Dollar, or Kohl’s are closing stores or even declaring bankruptcy.

This extreme bifurcation, of course, made me think of healthcare, where – as is famously known – half of all spending is attributable to only 5% of patients. In case you’d forgotten, in healthcare, half the population accounts for 97% of all spending, so the other half accounts for a measly 3%.

Now, you might say, neither of those is surprising: rich people spend more, and sicker people cost more. But somehow neither of those seems right to me.

I started thinking more about this after reading a recent New York Times op-ed from Ezra Klein. In it he makes the following assertion:

The answer to a politics of scarcity is a politics of abundance, a politics that asks what it is that people really need and then organizes government to make sure there is enough of it.

Mr. Klein didn’t coin the phrase “politics of abundance,” but he and Derek Thompson did just write a book on the topic (Abundance) that discusses their thoughts at more length. I have not read the book, but I saw a quote from it that I quite liked: “What is scarce that should be abundant? What is hard to build that should be easy?”

And so we’re back to healthcare.

We seem to live in a country where healthcare is too scarce. A new analysis suggests that we have a looming shortage of hospital beds, and if you live in a rural area, it’s already here. If you believe the Association of American Medical Colleges, we have a looming physician shortage, and if you’re looking for primary care, it’s already here. We’re facing nursing storages, pharmacist shortages, nursing home worker shortages, home health worker shortages, to name a few. We even have shortages of many critical prescriptions, including some needed for cancer treatments.         

Despite all these shortages or would-be shortages, of course, we manage to spend way more than other countries on healthcare. One can only imagine how much we might be spending if there were no shortages. I take that back: I’m not sure I can imagine.   

In the category of things that are scarce that should be abundant, and/or things that are hard to build that should be easy, I’d probably put housing at the top but healthcare as a close second. The trouble is, when we pour more money into healthcare, as we are wont to do, we don’t seem to fill any of our many shortages, much less improve the quality of care or outcomes.

In his article, Mr. Klein recounts the long saga of California’s Prop 1A, which called for a high speed rail line between Los Angeles and San Francisco. Other countries have high speed rail lines, most notably Japan, so certainly the richest state in the richest country should be able to build such a line. But, nope, 15 years later the predicted cost of the line has ballooned 300%, not much of the line is actually complete, and there is no end in sight, much less money available to complete it.

It reminds me of ACA: important goals, lots of money spent towards achieving them, some key accomplishments to show, but oh-so-far from achieving what we actually need.

We can’t keep going on the way we’ve been going on. We need to make scarce health care abundant, and to make things that are hard to build in healthcare easy to build.  Finally, we may be approaching technologies that would allow those.

It starts with A.I., as everything seems to these days. Healthcare, to my surprise, has started to embrace the use of A.I. Whether it is to assist physicians, to handle the too-many administrative tasks, to develop new drugs, it’s clear there will be a role for A.I. in healthcare.

Credit: PwC

My worry is that our healthcare system will absorb A.I. the way it did digital, making use of it but not using it to drive costs lower or to increase access. My worry is that it will be used to make more money for the people already making money in the system. My worry is that it be used to put a shiny new coat on our healthcare system, not to revamp or to reinvent it.

Here’s my plea: let’s use A.I. to make health care abundant – and cheap. Let’s make A.I. make building resources used in healthcare – be they people, devices, drugs, or buildings – easy to build. Simply adding A.I. into our existing system won’t do those. We have to design it towards those ends.

And let’s not stop at A.I. I’ve long been a fan of robots – be they full-sized, nano, or anything in-between – in healthcare. We know we have people shortages, especially for caregiving, and we should be planning for how robots can help fill those. But we need to use them with the abundance mentality: make them cheaply, use them ubiquitously, make them readily available. I think of how Ukraine has reinvented drones for its war efforts, because American drones were too expensive, too few, and too uncertain. We need that mentality for building healthcare robots.

Same for 3D printing. Medical devices, supplies, even prescription drugs: we should be ramping up use of 3D printing to make them – you guessed it – more abundant and easier to build, not to mention much cheaper. The companies currently making them won’t like it, of course, but our healthcare system doesn’t exist to make them money.  Or, at least, it shouldn’t.

The people and companies currently profiting from healthcare thrive on scarcity – perceived or real—and on making things hard to build. We need healthcare leaders that want us to thrive on abundance.  

Next Up: Fiber Computers

I know: you’re pretty proud for being into “wearables” to help monitor your health and other functions. You’ve got some apps on your smartphone. You use a smartwatch. Maybe you’ve tried one of the many iterations of smart glasses, like Google Glass or Meta’s Ray Bans. You were disappointed when Humane’s AI pin bit the dust.

What, you've never seen a fiber computer? Credit: Hamilton Osoy, IFM

Forget all that. With fiber computing, your clothes can be your wearable.

A new paper from MIT researchers discussed the ability to use “single fiber computers” that can be woven directly into clothing. According to the MIT press release:

The fiber computer contains a series of microdevices, including sensors, a microcontroller, digital memory, bluetooth modules, optical communications, and a battery, making up all the necessary components of a computer in a single elastic fiber.

 It also has embedded lithium-ion batteries that power it.

You can see the LEDs. Credit: Yoel Fink/MIT News

MIT has a lab devoted to fiber computing (fibers@mit), led by Professor Yoel Fink, who has been working on it for over ten years. According to its website: “Our research focuses on extending the frontiers of fiber materials from optical transmission to encompass electronic, optoelectronic and even acoustic properties,” with the goal of fibers that can See, Hear, Sense and Communicate.

The lab has had many accomplishments, but the mismatch between the shape of a chip and the shape of a fiber became a problem. Co-lead author Nikhil Gupta, an MIT materials science and engineering graduate student explains the problem:

But we hit a wall in terms of the complexity of the devices we could incorporate into the fiber because of how we were making it. We had to rethink the whole process. At the same time, we wanted to make it elastic and flexible so it would match the properties of traditional fabrics.

The solution: “In this new design, the researchers map the 2D pad alignment of each microdevice to a 3D layout using a flexible circuit board called an interposer, which they wrapped into a cylinder.” Mr. Gupta says: “This advance was crucial for us in terms of being able to incorporate higher functionality computing elements, like the microcontroller and Bluetooth sensor, into the fiber.”

The result is a machine-washable, elastic fiber that can stretch more than 60 percent without failure, Try that with your smartwatch.

These advances allow them to build these fiber computers into clothing. Each fiber computer incorporates LEDs and light sensors that enable multiple fibers in one garment to communicate, creating a textile network that can perform computation. They also have a Bluetooth communication system that can stream information wirelessly to other devices, such as a smartphone.

Why clothing? Professor Fink points out:

Our bodies broadcast gigabytes of data through the skin every second in the form of heat, sound, biochemicals, electrical potentials, and light, all of which carry information about our activities, emotions, and health. Unfortunately, most — if not all — of it gets absorbed and then lost in the clothes we wear. Wouldn’t it be great if we could teach clothes to capture, analyze, store, and communicate this important information in the form of valuable health and activity insights?

Well, they did. They added four fiber computers to a top and a pair of leggings, and had the wearer perform various exercises, such as squats, planks, arm circles, and lunges. Using a machine-learning model, each such fiber computer recognized the exercises with an average accuracy of about 70%; when the four fibers were allowed to communicate, the accuracy went up to 95%.

Professor Fink says that this demonstrates “the importance of residing on multiple body areas and forming a network between autonomous fiber computers that does not need wires and interconnects.” He predicts: “In the not-too-distant future, fiber computers will allow us to run apps and get valuable health care and safety services from simple everyday apparel.”

We’ll soon find out. The team is working with DARPA, the Army, and the Navy to conduct tests in the Artic. Service members will wear shirts with fiber computers in a monthlong winter study, tracking their health and activity over 1000 kilometers and an average temperature of – 40F.

Again, try that with your smartwatch.  

They're wearing fiber computers. Credit: US Army Cold Regions Research and Engineering Lab

“As a leader with more than a decade of Arctic operational experience, one of my main concerns is how to keep my team safe from debilitating cold weather injuries — a primary threat to operators in the extreme cold,” says U.S. Army Major Mathew Hefner, the commander of the project. “Conventional systems just don’t provide me with a complete picture. We will be wearing the base layer computing fabrics on us 24/7 to help us better understand the body’s response to extreme cold and ultimately predict and prevent injury.”

Karl Friedl, U.S. Army Research Institute of Environmental Medicine senior research scientist of performance physiology, says the technology may become a “gamechanger for everyday lives.” He goes on to add:

Imagine near-term fiber computers in fabrics and apparel that sense and respond to the environment and to the physiological status of the individual, increasing comfort and performance, providing real-time health monitoring and providing protection against external threats. Soldiers will be the early adopters and beneficiaries of this new technology, integrated with AI systems using predictive physiological models and mission-relevant tools to enhance survivability in austere environments.

Professor Finks is excited: “We are excited to see glimpses of this future in the upcoming Arctic mission through our partners in the U.S. Army, Navy, and DARPA. Helping to keep our service members safe in the harshest environments is a honor and privilege.”

We’re not quite in this future yet. The fiber computers don’t have much memory or computing power, and it’s not clear how they would be recharged. There are going to be real-world setbacks. Mass production and cost haven’t yet been considerations. But, Professor Finks believes: “The convergence of classical fibers and fabrics with computation and machine learning has only begun.”

Let it begin.

Goodbye, American Science

Many people don’t realize it, but a hundred years ago America was something of a scientific backwater. Oh, sure, we had the occasional Nobel laureate, but the center of science was in Europe, particularly Germany. Then in the early 1930’s the Nazis decided that “purity” – of political ideas, of blood – was more important than truth, making life uncomfortable at best and deadly at worst for their scientists. So hundreds of them fled, many of them ending up in the U.S. And – voila! – American science came of age and hasn’t looked back.

If we're not careful, scientists are going to pack up & leave the U.S. Credit: Microsoft Designer

Until now. Now, I fear we’re going to suffer what Germany did, a brain drain that will bode well for some other country’s scientific fortunes.

Once of the first chilling announcements from the Trump Administration was that it was freezing NIH grants in order to ensure they were in compliance with Trump’s executive order banning DEI-related efforts. That froze some $1.5b in grant funding.

Piling on, the Administration announced that NIH grants would limit indirect costs to 15%. Sounds reasonable, you might say, but the vast machinery of U.S. biomedical research uses these “indirect” costs to fund the infrastructure that makes the research possible. Numerous state Attorney Generals immediately filed a lawsuit to block the cuts, claiming:

This research funding covers expenses that facilitate critical components of biomedical research, such as lab, faculty, infrastructure and utility costs. Without it, lifesaving and life-extending research, including clinical trials, would be significantly compromised. These cuts would have a devastating impact on universities around the country, many of which are at the forefront of groundbreaking research efforts – while also training future generations of researchers and innovators.

Oh, and on top of all this, as many as 1,500 NIH employees are in line to be laid-off.  

Credit: M. Scott Brauer for The Chronicle of Higher Education

Katie Witkiewitz, a professor at the University of New Mexico, lamented to The New York Times: “The N.I.H. just seems to be frozen. The people on the ground doing the work of the science are going to be the first to go, and that devastation may happen with just a delay of funding.”

Universities are similarly frozen, not sure when or how much money they can expect. The University of Pittsburgh has paused all Ph.D. admission, until it can better understand its funding future. One has to suspect it won’t be the only such program to do so, and we may never know how many would-be Ph.D. students will simply decide a future in U.S. science is too bleak to risk.

The effects of all this will be long lasting. Bita Moghaddam, a behavioral scientist at Oregon Health & Science University, warned The Washington Post: “Things aren’t going to get slowed down for six months — they may get slowed down for years.”

“The discoveries that aren’t made — you can’t point to them, because they will never be made,” Jeremy Berg, a former director of the National Institute of General Medical Sciences, told WaPo. “The hard part is you don’t know what you missed until years later, when something doesn’t happen.”

It’s not just NIH and not just biomedical research at risk. The National Science Foundation laid off some 10% of its workforce. "These arbitrary firings and failure of leadership directly impact the agency's ability to evaluate and fund good science," Mary Feeney, a public policy researcher at Arizona State University, said to NPR. "[It] is demoralizing for those who remain at the NSF, and will negatively affect the government's ability to attract talent to public service in the future."

NSF research funding could also be cut by half or more, as well as more staff cuts.  The cuts disproportionately impact young scientists, the future of our science. “There’s going to be a missing age class of researchers that will reverberate for years,” one federal scientist fears, reports Katie Langin in Science.

Don’t even get me started on RFK Jr. and his advocacy of junk science.  Don’t get me started on how federal agencies are purging datasets in order to meet vague DEI demands either; short-sighted and stupid.. Don’t get me started on climate change denialism, with the Trump Administration doing its best to kill participation by U.S. researchers on the next major report from the Intergovernmental Panel on Climate Change (IPCC).

Science is under attack. “Everyone is in a panic right now,” Mati Hlatshwayo Davis, the director of health for St. Louis, told Katherine Wu in The Atlantic. “And when researchers don't know what they’re allowed to do, science is not going to get done.”

“If you believe that innovation is important to economic development, then throwing a wrench in one of the most sophisticated and productive innovation machines in world history is not a good idea,” Deborah Seligsohn, an assistant professor of political science at Villanova University, told Karen Ho in MIT Technology Review. “They’re setting us up for economic decline.”

Ms. Ho predicts:

For starters, the purging of tens of thousands—and perhaps soon hundreds of thousands—of federal workers is removing scientists and technologists from the government and paralyzing the ability of critical agencies to function. Across multiple agencies, science and technology fellowship programs, designed to bring in talented early-career staff with advanced STEM degrees, have shuttered. Many other federal scientists were among the thousands who were terminated as probationary employees, a status they held because of the way scientific roles are often contractually structured.

She believes that talent will flow elsewhere – such as to China, to Canada, and even, ironically, to Germany. According to a report from the Center for Security and Emerging Technology (CSET), over the past decade or so, Chinese universities have made “significant gains” in listing of world universities, driven largely by research productivity. U.S. universities remain among the best in the world, but number in the top 500 has dropped.   

One can only imagine what such a listing will look like in a few years.

Things aren’t frozen everywhere. Ms. Ho points out: “China has made a remarkable ascent to become a global peer in scientific discoveries. By some metrics, it has even surpassed the US; it started accounting for more of the top 1% of most-cited papers globally, often called the Nobel Prize tier, back in 2019 and has continued to improve the quality of the rest of its research.” 

If you’re not worried, read Ms. Hao’s The foundations of America’s prosperity are being dismantled. Read Ms. Wu’s The Erasing of American Science. Read Ms. Langin’s U.S. early-career researchers struggling amid chaos. Then tell me you’re not worried.

Science will go on. Scientists will continue to invent the future. But it doesn’t have to be here, and, if we’re not careful, it won’t be.

Patients are NPCs

I found a new way to think about patients in an opinion piece by Ezra Klein: they’re NPCs. For those of you unfamiliar with gaming, NPCs are those characters in video games that aren’t controlled by live players; they’re part of the game, serving as background for the actions the actual players take.

When it comes to healthcare, we are, alas, just NPCs

Not a very flattering metaphor.

Mr. Klein’s article is neither about healthcare nor gaming, but about politics: The Republican Party’s NPC Problem — and Ours. Conservatives, Mr. Klein explains, accused liberals of being NPCs -- passive, conformists, deferential – whereas they were the live players, willing to take chances and make things happen. He goes on to explain why this is not at all accurate, especially in the Congress, but this paragraph is what really struck me:

It’s a genuine failure of Democrats that they didn’t put more energy into making the government faster and better when they were in charge. How did the Biden administration pass $42 billion for broadband in 2021 and have basically nothing to show for it by November of 2024? How did it get $7.5 billion for electric vehicle chargers but build only a few hundred chargers by the end of the term?

I.e., Democrats had some good ideas, took action to try to make them happen, but failed in the delivery. Good intentions matter, but are necessary, not sufficient.

Marc J. Dunkelman makes a similar argument in The Atlantic: How Progressives Broke the Government (an adoption of his new book Why Nothing Works: Who Killed Progress--And How to Bring It Back). Here are a couple of the relevant passages, aimed at the Progressive movement:

Progressives are so fearful of establishment abuse that reformers tend to prefer to tighten rather than loosen their grip on authority. The movement discounts whatever good the government might do in service of ensuring that it won’t do bad. And that’s driven well-intentioned reformers to insert so many checks into the system that government has been rendered incompetent.

At present, progressives are too inclined to cut public authority off at the knees. And that’s why they so often feel like they can’t win for losing. Their cultural aversion to power renders government incompetent, and incompetent government undermines progressivism’s political appeal.

America can’t build housing. We can’t deploy high-speed rail. We’re struggling to harness the promise of clean energy. And because government has failed in all these realms—because confidence in public authority has waned through the years—progressives have found it difficult to make a case for themselves.

What does any of this have to do with healthcare, much less NPCs? It’s this: we talk a good game about health care, especially Democrats, but we consistently fail to deliver. Pick your poll: Americans are critical of the healthcare system in general, of the quality of care, and especially its costs.  Americans hate Big Pharma, we hate health insurers, and our trust in doctors and hospitals has plummeted, especially since COVID.

U.S. researchers develop innovative, life-saving treatments, but we often can’t get them to the people who need them most. U.S. produces miraculous prescription drugs, but we pay far more for them than anywhere in the world. Healthcare professionals and institutions urge us to get preventive care, to seek care when needed, and to go to the ER in a crisis, but put us in a queue when we try to do any of those. “Complicated” is perhaps the kindest description one could use for our healthcare system.

Every healthcare organization claims to “put patients first.”  It’s all about the patients. Except, of course, it isn’t. Healthcare has been invaded by private equity, which offers no pretenses about its priorities. If your health care or health insurance is delivered by a publicly traded company, it can say all it wants about patients but its mission is to deliver for its shareholders. Even supposed non-profit healthcare institutions are increasingly acting like for profits, and if you don’t believe that, ask your local hospital how many patients it has sued for nonpayment.

Democrats tout Obamacare as evidence of improving the healthcare system, and it is a great improvement over what it was before, but no one believes it “fixed” anything. Tell that to the residents of the ten states that have still not expanded Medicaid, or to the twenty million who would lose Medicaid coverage under proposed House Medicaid cuts. Tell that to the millions of Americans whose bankruptcy is directly tied to their medical debt.

Who would put up with all this? NPCs, of course.

The “live” players in the healthcare system are the ones making money; patients are the means to that end. We may be the ones suffering, but that suffering makes other parties’ money. The game isn’t about our health; the game is about returns on investment. If you don’t believe that, you probably still believe Facebook is all about connecting the world and Google is all about making the world’s information accessible. We’re the product; we’re in NPCs in their game.

We need a healthcare system that works for patients, one that treats us like individuals with unique challenges, not like nameless NPCs.

Our healthcare system is not sustainable as is. Credit: Harvard Health

Our government – at the state, local, and federal level – is not delivering. Our major institutions are not delivering. And our healthcare system is most definitely not delivering. I have to modify all that; if you are in the 1%, things are pretty good. Otherwise, though, you’re just an NPC in their world.

We need leaders who won’t just talk a good game but play it well. Last year Democrats campaigned as though health care meant abortion access, transgender care, and capping prescription costs (e.g., transferring them to the insurer, and into premiums). Not bad goals, but not getting at root problems either.

Mr. Dunkleman argues:

Populism takes hold not when democracy works well, but rather when it doesn’t deliver. No amount of righteous sanctimony can substitute for the political benefits of making public authority serve the public interest. That should be the progressive movement’s north star.

Similarly, conservative Bret Stevens, in the most recent The Conversation with liberal Gail Collins, asserts: “A better motto for Democrats, I think, is “Effective government,” which is primarily about delivering the services people need or expect and not just about saving money, which seems to be the central criterion of “efficiency.””

That needs to be more than a motto, and not just for Democrats.  Healthcare would be a great place to start.