We've been talking a lot about autonomous vehicles, and in particular Waymo, on this blog. In my opinion, the safety records — which Waymo has published after driving more than 100 million driverless miles — already suggest that none of us should be driving cars anymore. Some or many of you will disagree with this statement, but there's a reason why car crashes are the number two cause of death for children and young adults in the US.

So not only is this a tech breakthrough and a profound city-building shift, but it's also a public health breakthrough. Here's a recent opinion piece published in the New York Times by Dr. Jonathan Slotkin, the vice chair of neurosurgery at the Geisinger Health System in Pennsylvania. I found this statement particularly interesting:

In medical research, there’s a practice of ending a study early when the results are too striking to ignore. We stop when there is unexpected harm. We also stop for overwhelming benefit, when a treatment is working so well that it would be unethical to continue giving anyone a placebo. When an intervention works this clearly, you change what you do.

Now the imperative:

There’s a public health imperative to quickly expand the adoption of autonomous vehicles. More than 39,000 Americans died in motor vehicle crashes last year, more than homicide, plane crashes and natural disasters combined. Crashes are the No. 2 cause of death for children and young adults. But death is only part of the story. These crashes are also the leading cause of spinal cord injury. We surgeons see the aftermath of the 10,000 crash victims who come to emergency rooms every day. The combined economic and quality-of-life toll exceeds $1 trillion annually, more than the entire U.S. military or Medicare budget.

Dr. Slotkin goes on to talk about some of the cities that are pushing back against AV adoption, or simply erecting barriers, namely Washington, D.C. and Boston. That's too bad. This is a decision that can be easily guided by data: Which is the safest option for the greatest number of people? Just do that. Dr. Slotkin gets it right: "policymakers need to stop fighting this transformation and start planning for it."

Fred Wilson chose the perfect quote by William Gibson, here, to describe the current status of self-driving cars: "The future is already here — it's just not very evenly distributed." That's how it feels right now.

Waymo isn't in Toronto yet, but they are expanding rapidly throughout the US and elsewhere. Last week they announced fully autonomous driving in five new cities: Miami, Dallas, Houston, San Antonio, and Orlando. Autonomy is here, as we have talked about many times. There's no longer a question.

But what's interesting is that we're at the point in the hype cycle where expectations are not as inflated as they were a number of years ago (at least that's the way it appears to me). Years ago, everyone in real estate was talking about how it would disrupt parking requirements and reshape the landscape of our cities.

So when does this happen?

Fred ended his post by saying that "the downstream effects of this technology and behavior change are going to be profound." But he doesn't get into what these changes might be. Let's do a reminder of that now. Some of the most commonly believed consequences are as follows:

• Cars consume a vast amount of real estate and also spend the vast majority of their lives just sitting around idle. Switching to a "mobility-as-a-service" model will require dramatically less parking. This is going to force landlords to repurpose the parking they already have and it's going to encourage developers to build new buildings with reduced parking, or no parking at all. That will be good for housing affordability.

• However, the autonomous vehicles will need to park and corral somewhere at some point. My guess is that we will see something akin to rail yards today. This would be a good use for some of our excess parking, though this use won't require nearly as much. I would also imagine that many of the cars will leave the most valuable and dense parts of a city during off-peak periods.

• At the same time, it's not clear what the winning business model for AVs will be. Will it be a Waymo-like model where the ride-hailing company owns and operates all of the cars? Will it be a Tesla Robotaxi model where individuals own the cars and put them out to work? In this case, maybe the Robotaxis just go back to people's individual garages. Or will Uber remain the dominant platform? Meaning, an asset-light model that aggregates customer demand remains the highest-value component of the stack. Personally, I can't see Tesla's Robotaxi model being very lucrative for individual owners, so I'm inclined to look toward Waymo and Uber.

• Street parking will be replaced by a proliferation of pick-up/drop-off zones. This urban design problem will need to be solved as we dramatically increase the number of people getting in and out of AVs on busy urban streets.

• In the mid-1990s, Italian physicist Cesare Marchetti remarked that, all throughout history, humans have tended to cap their commute times at about 60 minutes per day. Something like a half hour each way. This became known as Marchetti's Constant. What this has meant is that as new technologies (streetcars, cars, and so on) allowed us to move faster within that 60 minutes, humans have tended to sprawl further outward. Will AVs do the same, and could they actually break Marchetti's Constant?

• As we all know, the key difference with AVs is that we will no longer need to pay attention to our commute. We could sit in an AV and sleep, work, watch a movie, or do whatever else we'd like. One can think of it like a mobile office or mobile living room. This should, in theory, make commuting long distances a lot more enjoyable and encourage even greater "super sprawl."

• The counterforce to this phenomenon is that if more people are willing to commute long distances in an AV, we will see demand greatly outstrip supply on our roads. In other words, traffic congestion in large cities will get even worse. I think this will force more/most cities to adopt congestion pricing. Politically, it will finally become acceptable, because now we'll be able to use "the machines" as our scapegoat. They're overrunning our cities! Ironically, this means that we won't adopt the thing that makes driving a lot better until we all stop driving.

So where do these opposing forces ultimately net out? Well, my view (and bias) is that human-scaled walkable communities will always have value. We are social animals. I also think that the experience within our cities will improve dramatically. Pedestrian safety will increase (the data already supports this) and far less space will be dedicated to cars. Good.

At the same time, I think that reducing commute friction will encourage an exurban explosion. Like the technologies that came before AVs, it's going to empower humans to further decentralize. What this will do is exacerbate the divide between our urban cores and our suburban and exurban fringes.

Of course, this is just me surmising. I don't really know. But AVs are here, and I think it's time we get back to discussing and planning for the second and third-order effects of this technology.

Last week, Uber announced something called "digital tasks." These are simple, quick tasks that drivers can do when they are not driving — things like recording a voice note in a person's mother tongue, submitting a document in a different language, or uploading images of everyday items (such as a menu or storefront).

This is Uber expanding its data-labeling and AI-training business, and they are positioning it as a "new way to earn" for drivers. But another way to think about this move is that it's a way for Uber to start to repurpose its workforce in preparation for a world where human drivers are far less essential to the business. That feels like the case to me.

On a related note, Waymo also announced last week that it will start operating its autonomous ride-hailing service in London, beginning in 2026. This is another first for the company: the first commercial operation outside of the US. Though they are also driving vehicles around Tokyo in preparation for eventually launching there.

Things continue to happen. As a casual observer of this market, Waymo feels like it is out front, which often makes me wonder about Tesla's sky-high valuation. Does the market really believe their Robotaxis have more potential?

In theory, this could be true. Their decentralized model — where individuals own the vehicles and plug them into their ride-hailing network — could allow them to scale quickly. But this is less proven — they're still in the pilot/validation phase. They also seem to chronically overpromise.

Regardless, I would really like to see Waymo launch in Toronto in the near future. As I understand it, regulatory barriers are the problem. I hope whoever is in charge is working on fixing this.