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Car Crashes Are a Public Health Crisis, and Autonomous Vehicles May Be the Cure
Self-driving technology will drastically decrease the number of motor vehicle accidents and will lower costs for ride-hailing services
By Jordan McGillis
Over the otherwise sunny postwar period loomed the dark cloud of polio, with case numbers rising from 4,000 in 1942 to 57,000 in 1952. That year, the virus killed 3,000 American children and left 20,000 more paralyzed. By 1962, however, an innovative public health solution—Jonas Salk’s vaccine—had all but eliminated polio in the United States. Beginning in 1955, children across the country took a jab in the arm, and polio soon became a disease of the past. Decades removed from the horrors of its death and disfigurement, we now look at the polio era as a grim aberration.
And yet, another public health horror—one of much graver annual and cumulative impact—exists today in our collective blind spot. Since 2020, motor vehicle collisions have killed more than 120,000 people in the U.S. and sent an estimated 10 million more to emergency rooms. Mercifully, a solution of a profundity comparable to Salk’s vaccine—autonomous vehicles—could significantly lower these terrible figures if strategically adopted.
The Human Element
By taking humans out of the driver’s seat, autonomous vehicles remove the proximate cause of the vast majority of crashes. According to the National Highway Traffic Safety Administration’s (NHTSA) “Critical Reasons for Crashes Investigated in the National Motor Vehicle Crash Causation Survey” released in 2015, in 94% of collisions the “immediate reason for the critical pre-crash event” was the vehicle’s human driver. This finding corroborates a 1977 NHTSA-commissioned study, which found that human errors “were probably causes in about 90–93% of accidents” and “were possibly a cause in up to 97.9% of accidents.”
Autonomous vehicles (AVs) are already proving safer than the catastrophic human-driving baseline. As humans behind the wheel, we doze, we check our phones, we reach into the backseat to separate fighting children. With disturbing frequency, we recognize danger too late, inflicting grievous bodily harm upon ourselves and others. The autonomous systems that control AVs continuously scan their surroundings with comprehensive and overlapping sensor arrays, immune to human distraction.
Trained on data collected across entire networks of vehicles, AVs can be said to have more on-road experience than most individual human drivers already. Waymo and Cruise, two AV companies that offer customers autonomous ride-hailing services in designated areas of select U.S. cities, have logged millions of driverless miles in the past three years. Their safety performance is strong, as both their own extensive self-reporting and California Department of Motor Vehicles records show.
Autonomous ride-hailing is the perfect on-ramp for AVs to enter the U.S. transportation mix. Ride-hailing companies such as Uber and Lyft have proven to have a public health value over the past decade by offering a low-friction alternative to driving one’s own car, particularly when intoxicated. Autonomous ride-hailing will build upon this success while providing the public a measure of assurance by confining the technology to fleet vehicles that are strictly monitored.
An ugly October incident in San Francisco that left a person trapped beneath a Cruise vehicle has put that company’s driverless operations on hold. But it is worth recalling that the incident began when the human driver of another vehicle struck the person and propelled her into the path of the Cruise car—and that the human driver who caused the accident fled the scene. Video evidence from the Cruise vehicle itself is what ultimately gave the California state government the justification for putting the brakes on Cruise’s rollout.
What will set autonomous ride-hailing services apart from existing services such as Uber and Lyft is cost. According to a McKinsey analysis, by eliminating labor costs, autonomous driving will be able to cut ride-hailing fares in half by the end of this decade. But not only will the AV rides be cheaper, they will also be safer. Self-reporting indicates that Cruise and Waymo are involved in 50% fewer collisions than their human-driven ride-hailing counterparts in similar conditions.
Swiss Re, an insurance company, has now corroborated that conclusion regarding Waymo: “[I]n over 3.8 million miles driven without a human being behind the steering wheel,” Swiss Re said in an October 2023 release, “[Waymo vehicles] incurred zero bodily injury claims in comparison with the human driver baseline of 1.11 claims per million miles … [and] significantly reduced property damage claims to 0.78 claims per million miles in comparison with the human driver baseline of 3.26 claims per million miles.”
The favorable economics of this new technology can reduce roadway risk without forcing any drivers out of their cars. Rather, autonomous ride-hailing services will invite people to choose a more affordable option. While public transit can serve some of the same purposes, such as reducing collisions and lowering negative environmental impacts, it is less flexible than ride-hailing and demands large public investment. Autonomous ride-hailing provides a public health improvement without costly public expenditures. Moreover, autonomous driving systems are not limited to cars for single-rider trips; buses and small shuttles—whether public or private—are also prime candidates for automation.
Yet, contrary to the jubilant reception of the polio vaccine in the 1950s, 21st-century techno-pessimists are attempting to sabotage the emergence of today’s life-saving innovation. On the streets of San Francisco, anti-AV activists have intentionally disabled AVs by placing traffic cones on their hoods, covering their sensors. Ironically calling itself “Safe Street Rebel,” the group rallies to the cry of “We do not consent to this,” and videos of its vandalism rack up thousands of views on TikTok. In the halls of the state Capitol in Sacramento, meanwhile, the Teamsters built a political coalition around a bill (AB 316) to ban autonomous trucks (which Gov. Gavin Newsom thankfully vetoed). Today’s AV backlash is as if Salk’s vaccine had been met with parents smashing vials and iron lung manufacturers petitioning governments to entrench the tried and true.
What perhaps explains the different attitudes observed in the 1950s and the 2020s is that while the polio epidemic mushroomed quickly before postwar Americans’ eyes, the vehicular carnage we see today has been widely accepted as a fact of life for 100 years. Anti-AV activists have succumbed to the status quo bias and tacitly endorse the tens of thousands of annual roadway fatalities America endures in perpetuity.
My recent Manhattan Institute report, “Autonomous Now: Why We Need Self-Driving Technology and How We Can Get It Faster,” explains the public health and economic benefits of both autonomous ride-hailing and autonomous freight trucking—the use of AVs to move goods between regions. By taking the human driver out of the equation, AVs will reduce the risks we face each day on the road and, once scalable, cut transportation costs, thereby boosting economic performance.
To address our unacceptable roadway fatality statistics, cities, states and the federal government should establish policy norms that facilitate the proliferation of autonomous ride-hailing and freight trucking. These AV applications serve clear purposes in defined environments, so they are a good first step toward more widespread adoption of AVs. Governments can pave the way for AVs with subtle road use changes at the local level, licensing changes at the state level and manufacturing regulation changes at the federal level.
Motor vehicle collisions are a public health threat that far eclipses the polio epidemic even at its peak. Autonomous vehicles, like Jonas Salk’s vaccine in the 1950s, can help to eliminate great suffering. They deserve the same laudatory reception.