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."


September 2025 was a milestone month for Waymo in California: It reached 1,000,000 paid driverless rides. This represents a year-over-year increase of ~182%, which is a pretty good sign that the technology works and that customers like it.
(Note: The dramatic falloff in rides in June 2025 was because of anti-ICE protests and vandalism taking place in Los Angeles and San Francisco. The company decided to temporarily suspend operations.)
This is still a small fraction of the traditional ride-hailing market, though. According to the California Public Utilities Commission, Uber and Lyft combined complete somewhere around 300-320 million passenger trips per year in the state. That averages out to roughly 25-27 million trips per month for context.
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.
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."


September 2025 was a milestone month for Waymo in California: It reached 1,000,000 paid driverless rides. This represents a year-over-year increase of ~182%, which is a pretty good sign that the technology works and that customers like it.
(Note: The dramatic falloff in rides in June 2025 was because of anti-ICE protests and vandalism taking place in Los Angeles and San Francisco. The company decided to temporarily suspend operations.)
This is still a small fraction of the traditional ride-hailing market, though. According to the California Public Utilities Commission, Uber and Lyft combined complete somewhere around 300-320 million passenger trips per year in the state. That averages out to roughly 25-27 million trips per month for context.
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.
Chart via Charlie Bilello
Chart via Charlie Bilello
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