X-Message-Number: 13600
Date: Wed, 19 Apr 2000 16:01:38 -0400
From: mgdarwin <>
Subject: Risks and Life Insurance

Someone brought to my attention that John Grigg had asked for my experience
(and Fred Chamberlain's) on delaying buying life insurance. I have a
reputation for always looking at the "worst pssible side of things." As one
of my dialysis patients once said of me: "Mike's the kind of guy that, if
you show him a beautiful rose, he'll immediately tell you about a guy who
got pricked by a thorn from the rose his girlfriend gave him on tyheir
wedding day, got a horrible infection, had his arm amputated, lingered in
the ICU for weeks, and finally died leaving his whole family impoverished."

This not withstanding I would make the following points based on a REAL but
SKEWED experience in this area:

1) Mike Perry notes the odds:

>>>How slim? Have you checked it out? I looked on the Web just now and
found a
1997 mortality table (or "life table" as it's called. If you're interested,
the URL was <http://www.cd.gov/nds/data/lewk3_97.pdf>; I believe it
pertains
to the US only--a good enough start however). Starting with 100,000 people
at birth (age 0), there were 96,330 surviving to age 39, and 93,712
surviving to age 40. The fraction dying thus is (96,330-93,712)/96,330 or
2.72% or about one in 37. "Small" maybe, but not what I'd call "very, very
small." If I had to attend a lecture that 36 others were attending, and
knew
a terrorist would shoot one of us but only one, at random, I think I'd wear
a bulletproof vest. There are other reasons for signing up too.
Strengthening the organization of your choice, strengthening the cryonics
movement overall, setting an example for others, putting yourself mentally
in a firmer state of opposition to death, contributing to a very worthy
cause--all are reasons enough, and others could be found.>>>>

These are the odds for DEATH for a 39 year old cohort. These are not
numbers I'd be happy with: not 1 in 36!

2) These are NOT the odds for people who become uninsurable at or before
age 39. The number of people who are, for all PRACTICAL ($$) purposes
uninsurable by age 39 has to be much higher. In fact, I know it is and the
College of life Insurance in NYC can probably give you the precise numbers.


Leaving really obvious cases of uninsurability aside, there are all sorts
of things that can really make it very unpleasant and costly to get
insurance: a history of depression (depression has about the same mortality
as heart disease over a 5-year time course). Prozac isn't the big negative
in getting insurance that it used to be, but if you innocently tell them
(or they find out in checking your medical records) that you have been on 3
or 4 different antidepressants you are in deep shit with a lot of the best
companies. Incidentally, FYI, it is not at all uncommon for people to have
to try half a dozen or more antidepressants or combinations before they
find one that works for them. I know people who Prozac works miracles for,
but others it turns into "zombies." By contrast, the same class of
medications (SSRIs) like Paxil or Zoloft may be perfect for some, and
useless or even deterimental for others as individual drugs. If you look at
the number of depressed people in the US, it is staggering. This will cause
many companies to decline you coverage (especially if something weird like
cryonics is in the equation) or to "rate you" (charge more).

3) There are LOTS of diseases like diabetes, arthritis, in fact, too many
to mention here, that are disasters in terms of coverage and costs. These
can hit at any time, but the older you get the greater your risk. By the
time you are 40, judging from my chart of % of initial function left in
various organ systems versus age (From the work of Benjamin Shock) hanging
on the wall next to my desk, your risk of having a serious pathology that
could interfere with purchase of insurance is probably rising very fast:
maybe exponentially.

4) Life insurance as we know it is doomed IMHO. The development of "gene
chips" and soon to come CD-ROMS with THOUSANDS of possible antigens, genes,
biomarkers, serum enzymes, metabolites, gene products, etc. on each CD-ROM.
This latter technology will allow a physician to test for literally several
thousand things with a VERY small sample of blood using a standard CD
reader at a ver low cost. Even as it is, insurance companies are using
increasingly sophisticated assays to asess risk. People buying life
insurance in the past, and to a great extent today, are either overpayig or
underpaying for their risk. This averaging is "fair" as long as as you
can't quantify risk very well. But that is about to change. And, already,
people with bad HDL/LDL ratios, high homocysteine levels, certain drugs in
their blood, etc,. are going to find they are quietly declined coverage or
quoted a very high rate.

Now, having done lifespan studies with "gentetically identical" animals I
can speak from experience that they do not die all at once, or even in a
tight "squared-curve" cluster. They die all over the place and from an
amazing array of things. It *is* certainly true that they die more
"clustered" and of more of the same pathologies (say a largre number of
lymphomas for one strain versus renal failure for another) than do
genetically heterogenous animals. But, the stunning fact is that only about
50% of their mortality is obviously gene-linked. The other 50% is chance
and "that which is not seen:" extragenetic environmental influences.

Examples of chance are getting hit with a cosmc ray at JUST THE RIGHT SPOT
on your DNA to cause cancer, or eating a peanut with an alflatoxin molcule
that just happens to kinetically react with your DNA at just the right time
and place and cause a primary hepatoma (liver cancer). Extragenetic
influences are things like womb conditions (access to placental nutrition,
etc.), competetion for food after birth, whether you are on the top of the
cage rack close to the flourescent lights in the ceiling and the UV they
emit, or lower down and farther away frm the UV. Mice and rats at the top
of the rack get cataracts and skin cancers (ears, nose) at a far higher
rate than animals at the bottomof the rack. Thus, a GOOD lifespan
researcher rotates cage positions on a tight schedule to avoid these
effects.

I bring this up to point out that genes are NOT everything, and that
foolish people who *do known* they are doing self-damaging things like
smoke or drink excessively will often say things like: "Both my parents
smoked 3 packs a day since they were kids and they are still alive and well
at age 75." This used to be my colleague Jerry Leaf's standard line to me:
Jerry is now pushing up bubbles in LN2 in Phoenix, AZ, having had an MI at
age 50 which resulted in sudden cardiac death (no standby and transport and
lots of ischemia). It's OK to smoke if you want to, but be realistic about
the risks and above all realize mom and and dad ain't you!  And neither are
your cousins or your uncles or you aunts..."

So, I guess, on purely calculable bases, the odds of becoming "uninsurable"
are REALLY bad compared to dying at a given age.

5) First hand-experiences: lots in the cryonics business. It's hard to say
if this a skewed population or not since people who decide to sign up may
have a clue "something isn't right." Or, more directly, they may have had
next of kin who died unusually early, sensitizing them to their own
mortality; this again might well be a marker for increased risk of death
for THEM, thus skewing the numbers. I can tell you that if I were to guess,
about 1 person in 15 who tried to sign up (age ~30) were either uninsurable
or had MAJOR problems finding insurance or paying for it.

6) Insurance sucks as any kind of reasonable invesment. You'd do lots
better with the NYSE listing of stocks and a dartboard to make your
investment selections. However, insurance DOES have these unique
advantages:

a) It is almost NEVER successfully contested (Steve Bridge is incorrect, it
can be contested, but rarely is because the odds of success are terrible,
at least now, and in the historical past).

b) It is immune from asset seizure for debts and is not patrt of your
estate, with ONE IMPORTANT EXCEPTION: the IRS or federal government can
take your life insurance for tax liabilities or for certain drug-related
penalties (i.e., they can argue you used money made from selling illegal
drugs to pay the premiums and take your insurance under the seizure laws).

c) It isa  quick and complication free ( in the US) way of conveying assets
after death, and since it was created to PROTECT FAMILY VALUES (money for
the widow and the semi-orphans) it enjoys specially status in this regard.

7) There is another tremendous advantage to life insurance which is sadly
overlooked by all to many people. Let's say you "win" and the life
insurance company stands to lose. Bad news, right? Well, yes, generally.
But, with viatical settlements you now have options. Unless you are Jim
Neighbors or Larry Hagman and you get end-stage liver disease it is going
to cost you $250K for a liver transplant and follow up care. You will note
that BOTH these guys had liver transplants years ago and both are alive and
doing well. They HAD the $250K. Most of us don't. Life insurance companies
will cash in your policy or others will buy it for a good fraction of its
face value IF you are terminal (usually up to 80% of face value). I know a
LOT of guys who were on death's door from AIDS, cashed out $500K of term
and whole life (work and private coverage), traveled all over, bought gobs
of "toys" (cars, luxury condo, etc.) and then along came HART therapy. They
are now pumping iron (literally), have normal T cell counts, undetectable
viral loads, money left to pay for the meds (which are not cheap), and in a
few cases, money enough to invest so that they don't even have to work
anymore.

In any event, the ability to use life insurance for viatical purposes means
exapanded treatment options, money to pay for up-end cryonics services like
remote standby, relocate to a good hospice facility, or get better
end-of-life medical care. Skilled registry nurses who can pronounce death
cost $30.00 an hour on the cheap-side. If you don't die on schedule you
could rack up $5, $10, or evemn $15K in nursing bills in a few days! The
alternative is to wait till the hospice nurse drives out (after you are
dead) and pronounces you: I've had this range from 30 minutes to over an
hour. In the meantime you sit there with no ice, no meds, no nothing.

Finally, you don't have to cash out the whole policy, and life MATTERS NOW,
at least to most people. You may want to cash out $5K to take that dream
trip to Sri Lanka, Hawaii, or wherever. Both Mary Naples (NY Life Ins.
agent) and I have see friends fulfill one of their greatest dreams, like
that dream trip they got around to taking. 

I was lucky; I've always wanted to go to Egypt, preferably in style and for
awhile! In other words, really see it all and do it all, and *not* from a
tourist bus. I took the time and money to do it while I still had my
health. For many people that is not an option. I'm grateful that for me it
was! It was a life-transforming experience that was worth every penny of my
hard come by savings. I spent the first morning of the "second millenium
CE" floating in a hot air balloon over the Ramasseum and the Valley of the
Kings in Luxox as the sun came up across the Nile. I landed to a sumptuous
breakfast, crossed the Nile by felucca from the West (the side of death) to
the East the side of life and the rising sun, and spent the rest of that
wonderful day listening to the soundtrack from 2001: A Space Odyssey on an
in-ear CD-player (immersed in the sound) and viewing some of the most
magnificent Egyptian sculpture still in existence which is housed in the
seemingly modest Luxor Museum and darkened, windowless Luxor Museum.

Cryonics aside, these are some of the other options that help make life
insurance a reasonable buy despite its lousy capital return rate. There's
more to life (and death) than price to earnings ratios....

Mike Darwin

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