It has long been assumed that the service sector—that part of the economy devoted to producing intangible commodities—will continue to grow and become the major employer and generator of wealth in developed societies. Such writers as the American sociologist Daniel Bell assume that countries of the first world will advance naturally to become “postindustrial” (i.e., postmanufacturing) societies.

“Service workers” already constitute over half the work force in most developed countries, and take comfort from a view which seems to guarantee their future livelihoods. But, their comfort may be unfounded. I shall outline a contrary, less cozy, alternative view, and suggest its implications for the medical sector.