Andrew Yang has a gift for naming things. In February, writing with what he described as sadness, he labelled the coming wave of AI-driven white-collar job displacement “the Fuckening.” The term is deliberately graceless. It is meant to be. When the social contract of study hard, work hard, keep your head down and you’ll be fine gets vaporised to smithereens — his words — you don’t reach for the reassuring language of economic transition. You reach for something that sounds like how it feels.
Yang’s forecast is blunt: somewhere between 20 and 50 per cent of America’s 70 million white-collar workers displaced in the next several years. Not eventually. Now. A CEO he spoke to described three tranches of redundancies — 15 per cent now, another 20 per cent in two years, another 20 after that — as if he were announcing a building refurbishment. Sell anything that consists of people sitting at a desk looking at a computer, one investor told him. The stock market will reward headcount cuts and punish the companies that don’t follow suit.
His advice, in the end, is practical to the point of being bleak: cut your expenses, build your savings, make a plan, because a lot of people are about to lose their jobs and you could easily be one of them.
I can already hear the health communications response to this. We’re different. We’re regulated. You can’t just run AI output through MLR and call it a medical claim. Regulatory agencies have views. HCPs can tell when the science has been garbled. The structural constraints of this industry are real, and they will slow things down.
This is true. It is not sufficient.
I made a version of this argument in the first essay I published here, which was about the framework knitters who called themselves Luddites. They, too, had quality controls: guild structures, expert buyers who understood the craft, customers who had complained about inferior product before. None of it was enough, because the economics changed who was making purchasing decisions and what they were optimising for. The market for hand-finished hosiery didn’t disappear — it shrank, and the people serving it had to accept that the volume work had moved permanently somewhere else.
The regulatory apparatus of health communications is a more robust quality control than the hosiery guild. MLR is a forcing function that doesn’t yield to market pressure in the way that consumer goods can. But watch what’s happening at the client side. Large pharma companies are signing enterprise AI agreements — Bristol-Myers Squibb’s deal with Anthropic being the most visible recent example — and framing them as infrastructure investments. When AI becomes infrastructure, it changes the procurement question. Not “is this the best possible output?” but “given what we can now produce internally, what exactly are we paying agencies for?”
That’s not a regulatory question. It’s an organisational one. And organisations tend to answer it with headcount reduction.
The specific character of the Fuckening in health communications is that it will arrive on delay, and then arrive all at once.
The regulatory layer means you won’t get a letter this quarter. You’ll get two or three years of enterprise AI getting embedded in client workflows, junior roles quietly not being backfilled, scope creep in what “AI-assisted” means on a deliverable, and then a procurement conversation that has already concluded before you were invited to it. Yang’s CEO describes three tranches of cuts because the maths only becomes undeniable in stages. The regulated nature of pharma communications means the stages will be longer. It does not mean there won’t be stages.
The Luddites didn’t see the end coming because the early machines were genuinely inferior — and the early objections were genuinely valid. By the time the machines were good enough, the infrastructure to deploy them was already in place, and the economic logic was irreversible.
So what would Yang advise, adapted to this specific professional context?
He would say: cut your expenses and build your savings now, while you still have income and while the role still exists in its current form. Not because you’ll definitely lose your job, but because the people who survive disruptions of this scale are the ones who had optionality — who could take a risk, turn down a bad deal, wait for the right thing — rather than the ones who needed next month’s salary the moment it was threatened.
He would say: make yourself genuinely useful in the parts of the work that AI cannot replicate. Not “AI can’t replace expertise” as a general reassurance — that’s the quality argument the framework knitters made, and it’s true and insufficient in equal measure. Specifically useful: you know what a medical director is actually worried about; you know how an MHRA reviewer reads a data table; you know what the trial results actually imply as opposed to what they appear to imply. That’s the supervisory and judgment layer. It’s where the premium will concentrate.
And he would say — and this is the part that the reassuring voices in health communications tend to skip — that being right about the quality argument will not protect you from the market’s eventual indifference to it. The weavers were right. It didn’t save Nottinghamshire.
The Fuckening will come for health communications. It will take a little longer than it takes for tech and finance and marketing. Use the time.
— Ned
Sources
[1] Andrew Yang — “The End of the Office”, February 2026
[2] The Irreplaceables — “The Weavers Were Right”
[3] Bristol-Myers Squibb press release — BMS Announces Strategic Agreement with Anthropic