personalized pharmaceuticals, remote surgery, implanted medical devices, highly specialized treatment techniques, and various other technical developments. These advances seem to be effective, as improvements in life expectancy attest.
But the scale, importance, and especially the cost of medical service is also a major incentive for labour-saving innovation. The most technologically optimistic specialists imagine a near future where smartphones and embedded technologies replace substantial portions of current evaluations and monitoring by medical professionals. High-technology solutions—contact lenses that alert patients via text messages of changes in blood sugar, digital tablets that provide remote and personalized assessments of various chronic diseases, embedded monitoring systems that alert both patients and their medical caregivers to changes in health indicators, nanotechnologies that attack diseases at the cellular level, sophisticated precision operating tools that allow complex surgeries at vast distances, and super-high -efficiency radiation systems that use synchrotron science to target radiation treatment at the smallest and least intrusive level possible—have already revolutionized medical care in first-world countries. Helped by high-tech and corporate philanthropists such as Bill and Melinda Gates and Warren Buffett, companies have turned their attention to the developing world, looking for innovations that could address the health care needs of the “bottom billion,” a global effort that has the potential to use new technologies to bring about major improvements in the life prospects for the world’s poorest citizens.
All of this makes medical care one of the most dynamic and promising fields of technological innovation—but it less clear what this means for the physicians, nurses, and paraprofessionals in the field, particularly in the industrialized world. Of course, there are many reasons for caution. Massive investments in e-health, particularly focused on the management of health records, have produced mixed results, at best, and several spectacular failures. Far from saving money, these efforts produced huge contracts for consultants and failed to deliver on the promise of massive labour and wage savings. If the technology works, however—and the passage of time suggests that it will, although perhaps not as currently anticipated—there could be a sharp reduction in the number of physicians, nurses, and other health care providers—although not, at least in the United States, an improvement in the staggeringly inefficient management of the nation’s health insurance system.
The point of these examples is that an intense transformation is underway in the adult labour force in the present, and it will continue into the future. Researchers suggest that half of all of the jobs in the North American economy could be eliminated through technological change in less than twenty-five years. Half! Even if the figure is just futurist-babble, and the number is smaller, some changes are certainly coming, and even a 20- or 30-percent reduction will be catastrophic. Some of the remaining work will require high-end, science and technology-driven employees. These people will usually require advanced STEM (science, technology, engineering, and mathematical) skills, precisely the areas of study where North American students are at their worst and where the college and university system produces fewer graduates than the market requires. Some scenarios about future economic profiles foreshadow a world dominated even more dramatically by billionaires, with a small and wealthy tech-elite buttressed by global demand for their expertise, a large service sector that caters to the well-to -do, and alarmingly large groups of the unemployed and underemployed. While techno-enthusiasts claim that the technology-driven economy will both redefine work and create many new opportunities, the current trajectory of the “new economy” is far from promising for the majority of people who lack high-end skills. The American Bureau of Labor Statistics has made some interesting predictions on the future growth of STEM, as opposed to non-STEM, employment. Between 2000 and 2010, STEM growth increased 7.9 percent and non-STEM 2.6 percent. Between 2008 and 2018, these figures are projected to be 17 percent and 9.8 percent.
The creation of vast wealth in the digital sector has not been matched with a large and expanding workforce. The oft-cited example of Instagram—sold to Facebook for $1 billion at a time when it employed only twelve people—is emblematic of a fundamental disconnect between the prosperity of the elites and the reduced opportunities for the many. Even more dramatic is the case of Markus Frind, founder and for years the only employee of PlentyofFish (POF.com), an algorithm-based dating site. Frind sold his company in 2015 for $575 million, a pretty price for a firm with millions of dollars in annual revenue but only a tiny number of employees. The leading high-technology companies are small in terms of the total number of people who work for them. Some of the more dynamic sectors, such as animation, rely on a small, fluid workforce that struggles to cope with routine turnover and industry-wide instability. For those with the key technical skills—computer programmers, software engineers, software managers, and the like—the job market looks spectacular. Jobs are readily available. Salaries are high. And prospects, for now, look impressive. The field is not for everyone and certainly not for those with a generic college degree.
Companies compete for talent and offer handsome incentives to those with highly specialized skills, such as young professionals with knowledge of the semantic web (the “thinking” Internet). North American companies routinely cite labour shortages as a justification for hiring foreign workers to fill highly paid jobs. Indeed, international students are overrepresented in the STEM disciplines in colleges, particularly at the graduate level, and many use their expertise to move quickly into full-time employment and even permanent resident status in the USA or Canada. This creates some unique and creative solutions. The USA has been more reticent about allowing foreign workers into the country than Canada, frustrating American high-technology firms. Microsoft, eager to attract hundreds of workers for urgent projects, was blocked by American immigration rules. The company set up a satellite office in Vancouver, capitalized on Canada’s more liberal immigration regulations, and got the workforce it wanted, operating only a hundred and fifty miles from the Microsoft headquarters in Redmond, Washington.
Outsourcing Work and Forecasting the Future
But even in the IT sector, the present and the future of work are far from secure. For many American companies, it has been easier to move the work offshore. Starting in the late 1990s and following on the profitable lead established by outsourcing call-centre work, North American firms began shifting a lot of their high-technology work to Asia. Sun Computer Systems, once a leading American research powerhouse, currently has more than 90 percent of its high-technology workforce in Asia, with most of it in China. The Chinese firm Huawei, little known in North America, has a massive high-technology force—over a hundred and fifty thousand strong—and is a world leader in wireless technologies. Foxconn Technology in Taiwan, with over 1.5 million employees, is the world’s largest high-technology firm, a title that for much of the postwar period belonged to American firms.
This new reality highlights the need for a highly specialized workforce, but it also suggests that the Western economy will require many fewer workers than at present. With China, India, the Middle East, Turkey, and other countries churning out hundreds of thousands of highly motivated, well-trained, and eager young STEM professionals, it is by no means certain that the current demand for workers in these fields will hold. This is where things get really unnerving. The economy is shifting—and certain highly skilled workers will have the best opportunities in the workforce of the twenty-first century. Logic clearly suggests that young adults should head to the STEM disciplines where assured employment awaits. But will it? It is equally possible that competitor countries will emerge to displace leading North American firms. To the degree that there are more jobs, they may well be in Taiwan, China, and South Korea (where most of the digital economy is based) or in emerging economies in India, Turkey, or Brazil. Or not. The reality is that no one knows for sure. And it is upon precisely these uncertainties and ambiguities that young people are expected to chart their educational paths and career aspirations.
Here is the dilemma that faces governments, parents, and young people when it comes to making sense of the evolving work environment. Everyone has no doubt heard—many times—about all of the new jobs, professions, and opportunities that will be available for young people in the future. It is easy to recall these optimistic and even enticing views. Futurist gurus predict that young people
