The AI doctor will see you…eventually

"Better diagnoses. Personalised support for patients. Faster drug discovery. Greater efficiency. Artificial intelligence (AI) is generating excitement and hyperbole everywhere, but in the field of health care it has the potential to be transformational. In Europe analysts predict that deploying AI could save hundreds of thousands of lives each year; in America, they say, it could also save money, shaving $200bn-360bn from overall annual medical spending, now $4.5trn a year (or 17% of GDP). From smart stethoscopes and robot surgeons to the analysis of large data sets or the ability to chat to a medical AI with a human face, opportunities abound.

There is already evidence that AI systems can enhance diagnostic accuracy and disease tracking, improve the prediction of patients’ outcomes and suggest better treatments. It can also boost efficiency in hospitals and surgeries by taking on tasks such as medical transcription and monitoring patients, and by streamlining administration. It may already be speeding the time it takes for new drugs to reach clinical trials. New tools, including generative AI, could supercharge these abilities. Yet as our Technology Quarterly this week shows, although AI has been used in health care for many years, integration has been slow and the results have often been mediocre.

There are good and bad reasons for this. The good reasons are that health care demands high evidentiary barriers when introducing new tools, to protect patients’ safety. The bad reasons involve data, regulation and incentives. Overcoming them could hold lessons for AI in other fields.

AI systems learn by processing huge volumes of data, something health-care providers have in abundance. But health data is highly fragmented; strict rules control its use. Governments recognise that patients want their medical privacy protected. But patients also want better and more personalised care. Each year roughly 800,000 Americans suffer from poor medical decision-making.

Improving accuracy and reducing bias in AI tools requires them to be trained on large data sets that reflect patients’ full diversity. Finding secure ways to allow health data to move more freely would help. But it could benefit patients, too: they should be given the right to access their own records in a portable, digital format. Consumer-health firms are already making use of data from wearables, with varying success. Portable patients’ records would let people make fuller use of their data and take more responsibility for their health.

Another problem is managing and regulating these innovations. In many countries the governance of AI in health, as in other areas, is struggling to keep up with the rapid pace of innovation. Regulatory authorities may be slow to approve new AI tools or may lack capacity and expertise. Governments need to equip regulators to assess new AI tools. They also need to fill regulatory gaps in the surveillance of adverse events, and in the continuous monitoring of algorithms to ensure they remain accurate, safe, effective and transparent.

That will be hard. One solution would be for countries to work together, to learn from each other and create minimum global standards. A less complex international regulatory system would also help create a market in which small companies can innovate. Poorer countries, with less developed health infrastructure, have much to gain from introducing new tools, such as an AI-powered portable ultrasound device for obstetrics. 

Because the alternative to an AI tool is often no treatment at all, they may even be able to leapfrog the entrenched health systems of rich countries—though a lack of data, connectivity and computing power will get in the way.

A final problem involves institutions and incentives. AI promises to cut medical costs by assisting or replacing workers, improving productivity, reducing errors and flattening or reducing spending, all while improving care. That is desperately needed. The world could lack 10m health-care workers by 2030, around 15% of today’s workforce. 

And administration accounted for about 30% of America’s excess health-care costs, compared with other countries, in 2022.

Yet saving money using innovation is tricky. Health systems are set up to use it to improve care, not cut costs. New technology may account for as much as half of the annual growth in health spending. Layering on new systems will increase costs and complexity. But redesigning processes to make efficient use of AI is likely to be resisted by patients and medics. Though AI may be able to triage them over the phone or provide routine results, patients may demand to be seen in person.

Worse, many health systems, such as America’s, are set up to reward the volume of work. They have little reason to adopt technologies that cut the number of visits, tests or procedures. And even publicly run health-care systems may lack incentives to adopt technologies that reduce costs rather than improve outcomes, perhaps because saving money may lead to a smaller budget next year. Unless governments can change these incentives, so that AI combines better treatment with new efficiencies, innovation will increase costs. Accordingly, governments and health authorities will need to fund schemes dedicated to testing and deploying new AI technologies. Countries including America, Britain and Canada are pointing the way.

AI, MD

Much of the burden for boosting AI in health care falls on governments and regulators. However, companies have a part to play, too. Insurers have already used AI tools to deny care unfairly; firms have mis-sold or overstated the abilities of health AI; algorithms have made mistakes. Firms have a duty to ensure that their products are safe, reliable and accountable, and that humans, however flawed, remain in control.

These obstacles are formidable but the potential benefits of using AI in health care are so vast that the case for overcoming them should be obvious. And if AI can be made to work in medicine, it could provide a prescription for the adoption of the technology in other fields." [1]

1.  The AI doctor will see you…eventually. The Economist; London Vol. 450, Iss. 9390,  (Mar 30, 2024): 10.

Kodėl Europa atsidūrė gilioje, smirdančioje, skylėje?

„EUROPA nėra žinoma dėl jos dinamiškumo, tačiau šiandien ji atrodo sustingusi pagal bet kokius standartus. Apimta energetinio šoko, kilusio po sankcijų Rusijai nuo 2022 m., Europos Sąjungos ekonomika šį dešimtmetį išaugo tik 4 proc., palyginti su 8 proc. Amerikoje nuo 2022 m. pabaigos nei ji, nei Didžioji Britanija visiškai neaugo, jei tai nebūtų pakankamai blogai, Europa susiduria su pigaus importo iš Kinijos antplūdžiu, kuris, nors ir naudingas vartotojams, gali pakenkti gamintojams ir padidinti socialinę bei pramoninę nesantaiką.

 

     Ir po metų Donaldas Trumpas gali sugrįžti į Baltuosius rūmus ir įvesti didžiulius muitus Europos eksportui.

 

     Europos nelaimės laikas yra blogas. Žemynui reikia stipraus augimo, kad būtų pasiekti žaliosios energijos tikslai. Jos rinkėjai vis labiau nusivilia ir yra linkę remti tokias dešiniąsias partijas, kaip „Alternatyva Vokietijai“.

 

     Ilgą laiką trukdę augimą stabdantys veiksniai – sparčiai senstanti visuomenė, valdingi reguliuotojai ir nepakankama rinkos integracija – niekur nedingo.

 

     Vyriausybėms bandant reaguoti, Europos sostinėse vyksta audringa veikla. Jos turi rūpintis. Nors Europą patiriantys sukrėtimai kyla užsienyje, pačios Europos politikos formuotojų klaidos gali labai padidinti žalą.

 

     Geros naujienos yra tai, kad energetinis šokas praėjo didžiausio skausmo momentą: dujų kainos nukrito toli nuo jų piko. Deja, kiti tik prasideda. Susidūrusi su defliacijos sulėtėjimu, Kinijos vyriausybė turėtų skatinti menką šalies namų ūkių vartojimą, o tai galėtų pakeisti investicijas į nekilnojamąjį turtą, kaip paklausos šaltinį. Vietoj to prezidentas Xi Jinpingas naudoja subsidijas, kad padidintų Kinijos gamybą, kuri jau sudaro apie trečdalį pasaulinės prekių gamybos. Jis pasitiki užsienio vartotojais, kad paskatintų augimą.

 

     Kinija daugiausia dėmesio skiria ekologiškoms prekėms, ypač elektrinėms transporto priemonėms, kurių pasaulinė rinkos dalis iki 2030 m. gali padvigubėti iki trečdalio. Tai baigtųsi Europos nacionalinių čempionų, tokių kaip „Volkswagen“ ir „Stellantis“, dominavimas. Nuo vėjo turbinų iki geležinkelio įrangos Europos gamintojai nervingai žvelgia į rytus.

 

     Po lapkričio gamintojai taip pat gali pažvelgti į vakarus. Paskutinį kartą eidamas jo pareigas D. Trumpas įvedė muitus plieno ir aliuminio importui, galiausiai įskaitant importą iš Europos, todėl ES ėmėsi atsakomųjų veiksmų prieš motociklus ir viskį, kol 2021 m., dirbant prezidentui Joe Bidenui, buvo sudarytos nelengvos paliaubos. Šiandien D. Trumpas grasina 10 % bendru tarifu visam importui; jo patarėjai kalba apie būtinybę eiti toliau.

 

     Kitas prekybos karo etapas kelia grėsmę Europos eksportuotojams, kurių pardavimai Amerikoje 2023 m. siekė 500 mlrd. eurų perteklius yra natūralus muitų tikslas. Jo komanda taip pat kenčia dėl Europos skaitmeninių mokesčių, anglies dioksido mokesčio ir pridėtinės vertės mokesčių.

 

     Ką turėtų daryti Europa? Kelias priekyje nusėtas spąstais. Viena klaida būtų išlaikyti pernelyg griežtą ekonomikos politiką pažeidžiamumo metu – tokią klaidą Europos centrinis bankas padarė ir anksčiau. Pastaraisiais metais bankas teisingai kovojo su infliacija, didindamas palūkanų normas. Tačiau priešingai, nei, laisvai pinigus išleidžianti, Amerika, Europos vyriausybės subalansuoja jų biudžetus, o tai turėtų atvėsinti ekonomiką, o pigios Kinijos prekės tiesiogiai sumažins infliaciją. Tai suteikia Europos centriniams bankams galimybių mažinti palūkanų normas, kad padėtų augimui. Bus lengviau susidoroti su trukdžiais iš išorės, jei centriniai bankai išlaikys ekonomiką nuo nuosmukio, kuris neleistų perkeltiesiems darbuotojams rasti naujo darbo.

 

     Kiti spąstai būtų kopijuoti Amerikos ir Kinijos protekcionizmą, išlaisvinant didžiules subsidijas politikams palankioms pramonės šakoms. Subsidijų karai yra nulinės sumos ir iššvaistomi riboti ištekliai – Europoje šalys jau pradėjo žemynines lenktynes dėl dugno. Pastarojo meto Kinijos ekonominės bėdos rodo per didelio vyriausybės planavimo trūkumus, o ne dorybes; Amerikos pramonės politika nesužavėjo rinkėjų taip, kaip tikėjosi prezidentas Bidenas, o tarifai kainavo daugiau darbo vietų, nei jie sukūrė.

 

     Priešingai, prekyba daro ekonomiką turtingesnę, net jei jų prekybos partneriai yra protekcionistai. Gamybos bumas Amerikoje yra galimybė Europos gamintojams tiekti dalis (apkrautas didžiuliais Amerikos muitais? (K.)); pigus importas iš Kinijos palengvins perėjimą prie žaliosios energijos (ir sunaikins Europos pramonę? (K.)) bei suteiks pagalbą vartotojams, nukentėjusiems per energetikos krizę. Atrankinis ir proporcingas atsakas prieš protekcionizmą gali būti pateisinamas, siekiant atkalbėti Ameriką ir Kiniją nuo tolesnio pasaulinių prekybos srautų trikdymo. Tačiau tai kainuotų Europos ekonomikai ir pakenktų jos numatytiems tikslams.

 

     Vietoj to Europa turėtų sukurti savo ekonominę politiką, tinkančią šiuo metu. Kai Amerika apipila pramone viešaisiais pinigais, Europa turėtų išleisti pinigus infrastruktūros, švietimo, mokslinių tyrimų ir plėtros srityse. 

 

Užuot mėgdžiojusi Kinijos intervenciją, Europa turėtų atkreipti dėmesį į naudą, kurią Kinijos įmonės gauna iš didžiulės vidaus rinkos.

 

     Europos paslaugų rinkos, kurioje prekyba tebėra sudėtinga, integravimas padėtų įmonėms augti, atlygintų naujovėms ir pakeistų kai kurias prarastas darbo vietas gamyboje (? (K.)). ES turėtų reformuoti jos sudėtingą ir susiskaidžiusį reguliavimą, kuris taip pat stabdo paslaugų pramonę. Kapitalo rinkų suvienijimas turėtų tą patį poveikį. Europos diplomatai turėtų pasirašyti prekybos susitarimus, kad ir kur jie vis dar būtų siūlomi, o ne leisti ūkininkams juos sulaikyti, kaip per keletą pastarųjų derybų. Sujungus elektros tinklus, ekonomika taptų atsparesnė energijos sukrėtimams ir būtų sklandus perėjimas prie ekologiško.

 

     Nepadvigubinkite

 

     Tokia atvira darbotvarkė protekcionizmo amžiuje gali atrodyti naivia. Tačiau būtent gilios, atviros rinkos gali paskatinti Europos augimą, keičiantis aplinkiniam pasauliui. Kai ištinka sukrėtimai, politikos formuotojai turi išlikti šioje realybėje.“ [1] 

 

Šiuo straipsniu Jungtinės Karalystės specialistai siūlo Europai gulti ant dugno ir tyliai numirti. Realybėje mums teks į muitus atsiliepti muitais, į subsidijas - subsidijomis. Tik tokiais metodais pajėgsime išlaikyti Europos pramonę ir žemės ūkį.  Aišku, naivu būtų gulti ant bėgių prieš Kinijos vystymosi traukinį - jo jau niekas nesustabdys.

 

1.  Triple shock. The Economist; London Vol. 450, Iss. 9390,  (Mar 30, 2024): 9.

Why Europe is in deep doodoo?

"EUROPE IS not known for its dynamism, but today it looks stagnant by any standard. Frazzled by the energy shock that followed sanctions on Russia, starting from 2022, the European Union’s economy has grown by only 4% this decade, compared with 8% in America; since the end of 2022, neither it nor Britain has grown at all. If that were not bad enough, Europe faces a surge of cheap imports from China which, while benefiting consumers, could harm manufacturers and increase social and industrial strife. 

And within a year Donald Trump could be back in the White House, slapping huge tariffs on Europe’s exports.

The timing of Europe’s misfortune is bad. The continent needs strong growth in order  to meet its green-energy goals. Its voters are increasingly disillusioned and liable to back hard-right parties such as the Alternative for Germany. 

And long-standing drags on growth—a fast-ageing population, overbearing regulators and inadequate market integration—have not gone away.

There is a frenzy of activity in European capitals as governments try to respond. They must take care. Although the shocks facing Europe originate abroad, errors from Europe’s own policymakers could greatly aggravate the damage.

The good news is that the energy shock is past the moment of maximum pain: gas prices have fallen far from their peak. Unfortunately the others are just beginning. Faced with a deflationary slowdown, China’s government should be stimulating the country’s paltry household consumption, which could replace property investment as a source of demand. Instead President Xi Jinping is using subsidies to supercharge Chinese manufacturing, which already accounts for about a third of global goods production. He is relying on foreign consumers to prop up growth.

China’s focus is on green goods, most significantly electric vehicles, for which its global market share could double, to a third, by 2030. That would end the dominance of Europe’s national champions like Volkswagen and Stellantis (whose largest shareholder, Exor, part-owns The Economist’s parent company). From wind turbines to railway equipment, Europe’s manufacturers are nervously looking eastward.

After November manufacturers might look westward, too. Last time he was in office Mr Trump imposed tariffs on steel and aluminium imports, eventually including those from Europe, leading the EU to retaliate against motorbikes and whiskey until an uneasy truce was struck under President Joe Biden in 2021. Today Mr Trump threatens a 10% blanket tariff on all imports; his advisers talk of going further.

Another round of the trade war threatens Europe’s exporters, which had €500bn ($540bn) of sales in America in 2023. Mr Trump is obsessed with bilateral trade balances, meaning that the 20 (of 27) EU member states with a goods-trade surplus are natural targets. His team is also aggrieved by Europe’s digital levies, its carbon border tax and its value-added taxes.

What should Europe do? The path ahead is littered with traps. One error would be to keep economic policy too tight at a moment of vulnerability—a mistake the European Central Bank has made before. In recent years the bank has rightly fought inflation with interest-rate increases. But in contrast to free-spending America, Europe’s governments are bringing their budgets into better balance, which should cool the economy, while cheap Chinese goods will bring down inflation directly. That gives Europe’s central banks room to cut interest rates to support growth. It will be easier to cope with disruption from outside if central banks keep the economy out of a slump that would stop displaced workers finding new jobs.

Another trap would be to copy America’s and China’s protectionism by unleashing vast subsidies on favoured industries. Subsidy wars are zero-sum and squander scarce resources—within Europe, countries have already started an intra-continental race to the bottom. China’s recent economic woes demonstrate the flaws, not the virtues, of excessive government planning; America’s industrial policy has not wowed voters in the way President Biden had hoped, and tariffs have cost more jobs than they have produced.

By contrast, trade makes economies richer even when their trading partners are protectionist. A manufacturing boom in America is a chance for European producers to supply parts; cheap imports from China will make the green-energy transition easier and provide relief to consumers who suffered during the energy crisis. Selective and proportional retaliation against protectionism may be justified in an attempt to dissuade America and China from further disrupting global trade flows. But it would come at a cost to Europe’s economy, as well as hurting its intended targets.

Instead Europe should forge its own economic policy fit for the moment. As America showers industry with public money, Europe should spend on infrastructure, education, and research and development. Instead of emulating China’s interventionism, Europe should note the benefit Chinese firms derive from a vast domestic market. 

Integrating Europe’s market for services, where trade remains difficult, would help firms grow, reward innovation and replace some lost manufacturing jobs. The eu should reform its burdensome and fragmented regulation, which also holds back service industries. Unifying capital markets would have the same effect. European diplomats should sign trade deals wherever they are still on offer, rather than letting farmers hold them up, as in several recent negotiations. Linking electricity grids would make the economy more resilient to energy shocks and smooth the green transition.

Don’t double down

Such an open agenda in a protectionist age may seem naive. But it is deep, open markets that have the potential to boost Europe’s growth as the world changes around it. As the shocks strike, policymakers must stay grounded in that reality." [1]

With this article, specialists from the United Kingdom suggest that European Union lie on the bottom and quietly die. In reality, we will have to respond to tariffs with tariffs, to subsidies - with subsidies. Only with such methods will we be able to maintain European industry and agriculture. Of course, it would be naive to lie on the tracks in front of China's development train - nothing will stop it now.

1.  Triple shock. The Economist; London Vol. 450, Iss. 9390,  (Mar 30, 2024): 9.