Even as I've tracked every twist and turn in the technology for autonomous vehicles for going on 15 years now, the key development I've been waiting for occurred, not in the lab or on the road, but in a recent op-ed in the New York Times. In it, a neurosurgeon made the case for AVs as a "public health breakthrough."
He said he was horrified by the more than 39,000 deaths from motor vehicles just in the U.S. last year, "more than homicide, plane crashes and natural disasters combined.... 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."
Then he made the sort of case technologists have been making for years about the potential for AVs to drastically reduce death, injuries and property damage... but this time it came from a doctor.
And he framed his case as a public health issue, the sort of effort government gets behind and citizens appreciate, even if they may discount the claims they hear from those they see as techno-optimists and rapacious capitalists.
Based on other favorable press in recent weeks and on the relentless rollouts of robotaxis planned for this year, I think we're seeing a sea change. Arthur C. Clarke famously wrote that "any sufficiently advanced technology is indistinguishable from magic," but, over time, the magic wears off, and wildly advanced technologies begin to seem almost normal.
AVs are now being normalized to the point where I think the clock has started ticking on what will be a fundamental rewiring of the auto--and auto insurance--landscape.
While I've long been an enthusiast about driverless technology, I've always been worried about winning over public sentiment. The techies initially argued that they just needed to be demonstrably better than human drivers and felt that was a fairly low bar, given that more than 100 people a day die in car crashes just in the U.S. But that's not how people look at technology.
When a driver causes a crash, we may be understanding. We've all done careless things and had near-misses. But if software causes a crash, it wasn't making a mistake in the heat of the moment. Someone designed that software, and they screwed up. The huge company employing that coder somehow missed that mistake, too.
Machines aren't supposed to make mistakes. Ever. So the bar for AVs' safety is actually higher than it is for human drivers.
Uber stopped its efforts to develop autonomous vehicles after a single fatal accident in 2018 caused a PR disaster. GM's Cruise halted its robotaxi development after one of its cars hit a pedestrian in 2023. The collision was a freak accident, in which another car hit a jaywalking pedestrian and flipped her in front of the robotaxi. But Cruise's AV, programmed to get out of the way after an accident, pulled off to the side of the road--not understanding that the pedestrian was caught underneath the car. The multibillion-dollar AV program couldn't survive the bad PR and scrutiny that followed.
The Cruise debacle left a bad taste. Subsequent press played up resentment of AVs, such as by people who learned they could paralyze a driverless car by putting an orange traffic cone on the hood.
But the press has gradually been shifting. Recently, for instance, Tesla got some nice publicity because one of its cars drove the famous Cannonball Run route between Los Angeles and New York entirely in self-driving mode. (CEO Elon Musk had promised one of his cars would do so by the end of 2017, but still....) Tesla got more attention when Lemonade said it would offer steep discounts to Tesla drivers for miles they traveled while in so-called Full Self-Driving mode, based on the belief that Tesla's AI is much safer than human drivers are, at least in certain circumstances.
Public opinion has seemed to shift, too, both based on the press and on the growing familiarity with the cars. Yahoo! Finance reports that a survey "conducted in San Francisco this past July found that 67% of San Francisco residents now support the operation of driverless robotaxis, up from 44% in 2023, with 'net favorability' of robotaxis swinging from -7% in late 2023 to +38% in mid-2025."
The New York Times piece by the neurosurgeon pulls all those threads together for me and suggests that the public is ready to accept whatever the technologists can deliver.
Yes, there is always a danger that a car will do something catastrophic. And we'll still see the occasional story about an embarrassing glitch, such as the recent one where a power outage in San Francisco knocked out all the traffic lights, and Waymo's cars just stopped, citywide, because they didn't know what to do.
But, barring a disaster, people are certainly going to see a lot more robotaxis on the road this year. Google's Waymo is already up to about 250,000 paid, fully autonomous rides a week and aims to quadruple that by the end of the year. Waymo already has fleets in San Francisco, Phoenix, Los Angeles, Austin, and Atlanta and plans to add 20 markets this year--including Miami, Dallas, Houston, San Antonio, Orlando, Las Vegas, San Diego, Detroit, Washington, D.C., Baltimore, Philadelphia, Pittsburgh, and St. Louis. Waymo is testing in New York and plans to test in London soon, too.
Waymo is doubling its production of AVs and expects to build more than 2,000 this year.
And that's just Waymo. Tesla has big plans to expand this year--though any prediction from Musk must be viewed with skepticism, given that he's been consistently overpromising about AVs for more than a decade. Amazon says it will build 10,000 robotaxis a year starting in 2027. Some smaller companies say they're testing robotaxis in Tokyo and Southeast Asia. A host of Chinese companies have pursued autonomous driving aggressively, though generally at the driver-assist level, and the government recently became more cautious after a gruesome accident. Baidu says it will test in London this year, and Europe is shaping up as a battleground. Most of the players there figure to be Chinese and American companies, but Mercedes just announced an autonomous venture with Nvidia, and Nvidia hopes to provide the technology, including simulators, in similar ventures with other manufacturers.
Insurance won't feel the effect right away, by any means. The tectonic shift won't happen until individuals start buying driverless cars, and when that happens is anybody's guess. But even robust adoption of robotaxis, which should happen over the next couple of years, could be material. If Waymo is really doing 1 million paid rides a week by the end of this year, that's maybe $1 billion of revenue, if annualized. That revenue would have gone to gig drivers and taxi drivers, who buy traditional insurance, but instead will go to a corporate behemoth that self-insures.
That shift in revenue will mean maybe the loss of just $100 million of premium for auto insurers (based on my back-of-the-envelope calculation). That's a drop in the bucket in a U.S. market measured in the hundreds of billions of dollars of premiums. But exponentials are crazy things. If Waymo quadruples its size this year, what will it do next year? The year after that? And after that? It's pretty easy to imagine Waymo having 20X its current presence within a few years. And if Tesla, Amazon, Baidu and other Chinese behemoths can deliver, too....
It's worth watching, especially if the public health argument really gains traction.
Cheers,
Paul