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Artificial intelligence, machine learning, big data, and robotics are central to futuristic visions of fast, optimized medical treatment. This First-Year Seminar examines technology’s promises: who benefits from, and who pays the price for, the automation of care in a profit-driven system? How does the clinical goal of improving health relate to industry demands for cost savings and revenue growth? Automation can entrench inequality, both for patients and for healthcare workers. Authors such as Ruha Benjamin, Frank Pasquale, and S. Scott Graham guide us beyond the “promises and perils” to a critical understanding of how technology can become geared into systems of racial capitalism.