X-Message-Number: 21
From: Kevin Q. Brown
Subject: who gets life extension
Date: 22 Sep 1988
Carl,
I'll take a crack at answering the first question you recently raised.
- Kevin Q. Brown
...{att|clyde|cuae2}!ho4cad!kqb
< Standard Disclaimer := "these opinions are mine, not my employer's" >
-----
> I would like to have and to hear some discussion regarding the individual and
> mass psychology of life extension and time travel.
I would like to clarify the use of the phrase "time travel"; from the point of
view of someone who is cryonically suspended and then revived, he or she will
have experienced the equivalent of time travel (into the future), since there
will be no memories of the period between suspension and revival.
> 1. How do we decide who get's life extension,
> assuming everyone can't?
Your question has three (implicit) assumptions:
(1) Some person or organization will decide (and presumably enforce)
allocation of life extension,
(2) Some, but not all, people will be able to have this life extension
(presumably because of the expense), and
(3) This results in a widely perceived problem.
I will offer my thoughts on the conditions under which (3) can occur and then
describe some scenarios for alternatives of (1) and (2).
First, under what conditions is there a widely perceived problem? There must
be demand for it and there must be limited availability. When is there demand?
Simple and effective life extension is available now; eat well, exercise,
don't smoke, etc. Yet how many people still take lousy care of themselves?
Thus, if the life extension available requires a lot of trouble, bother, and
discipline, the demand may be small, even if it is cheap and effective.
Furthermore, Mike Darwin's article "A World Gone Wrong" in the July 1986 issue
of Cryonics suggests that many people simply do not have sufficient feelings
of self-worth to want to extend their lives. I suggest that the demand for
a life extension treatment or technology will be high when it is:
(A) fashionable,
(Laetrile was a fashionable treatment for cancer even though it was not
cheap, easy to obtain, or effective.)
(B) perceived as cheap, little bother, and possibly effective, or
(People will pop pills, such as aspirin, which is cheap and little bother,
to get strokes instead of heart attacks. :-()
(C) sexy or fun.
(Skin cream that (allegedly) keeps your skin youthful makes a person feel
more sexy, and selling it is a big business. Humor has reportedly had a
beneficial effect on a person's immune system, but most people (other than
Norman Cousins) don't watch funny movies, etc. for the benefit of their
immune systems; they do it because it is fun.)
Having technical merit is not sufficient to induce a high demand in a
technology. If the technology is not cheap and easy to use and is not sexy or
fun, the only hope for it is that it may become fashionable. I suggest that
what happens is that some technologies with technical merit (and some without)
get good press from opinion leaders and thereby become fashionable. And this
process actually makes some sense. Who has the time and capability to become an
expert in every field? You have to rely on others whose opinion you respect.
I expect a widely perceived problem to occur when a life extension technology
is highly fashionable, yet also not widely available, probably due to the
expense. (As the life extension technology matures, though, it will become
cheaper, better, and more widely available. We are talking about a temporary
problem here.) In this case, (1) what kinds of decisions, if any, will be made
about allocation of life extension and (2) who gets the life extension and who
does not? I have three scenarios:
(i) pure socialist medicine,
(ii) pure free market medicine, and
(iii) a mixture of (i) and (ii).
As you can see, this is quite a political issue, and we could flame about
politics for a long, long time. (So please, just take what you like and leave
the rest.)
The Feb. and March 1988 issues of Cryonics had a two-part series on "The Future
of Medicine" written by Mike Darwin with assistance from Steve Harris, MD.
The second part included a section on the downsides to advanced medicine, the
second of which was the:
"cost of 'middlingly advanced technology' (such as what we'll see in the
next fifty years) in a society which takes a socialistic view of health
care. [ ... ] Nonmolecular technology is EXPENSIVE."
Mike Darwin suggested that the great expense of the nation's health care system
will lead to rationing. In the socialist medicine scenario:
"when people do not pay for their own medical care, no one (not doctors,
family, or the government) has ever been willing to make the decision of
who should benefit from a given technology, and who should not. Therefore,
all systems of rationing to control medical costs ultimately have come down
in the past to rationing technology across the board."
The result, he suggests, is that we will not develop technologies that (in
their initial, expensive stages) are too expensive to be made available to
everyone who (thinks he) needs it. In this scenario, the answer to the question
"who gets life extension" will be "either everybody or nobody". And since it
is a pure socialist scenario, some government organization will do the deciding
of what life extension technologies to support.
The opposite scenario would be a pure, free market where, as long as the life
extension technology is expensive, those who are rich enough and smart enough
to choose the right technologies will have a greatly extended lifespan and
those who are not will suffer and die at a young age. (Of course, some
enterprising people will make money off the poor people by holding lotteries
where the prize is "immortality".) Progress will be rapid because many types
of new technology will have a market. And since the pure, free market is
rather anarchistic, nobody will be deciding what life extension technologies
will be developed. Also, "the market" (and an individual's knowledge about
life extension technology) will decide who will take advantage of existing
life extension technologies and who will not.
What will actually happen will, of course, be much more complex than either of
those two scenarios. For example, the health care market is global, not
national. If people cannot get what they want in the USA, they will look
elsewhere. The pure socialist scenario thus will not happen. And I do not
know of any country (not even Hong Kong) that would model the pure free market
scenario.
An even bigger complicating factor is that life extension is not all or nothing.
Many kinds and degrees of life extension will become available, at a wide
spectrum of prices. In cryonics alone, the price for whole body suspension
ranges from $28,000 to $125,000. Steve Singley has proposed cheap biostasis
alternatives (such as brain freezing) in the July 1988 issue of The Immortalist
and the Winter 1988 and Spring 1988 issues of Venturist Voice. Instead of some
people being able to afford biostasis and others not, the quality of the
biostasis may vary. People with insufficient funds (or insufficient prior
arrangements) may lose more of their memory or may have to wait longer for
reanimation.
My expectation is that we will eventually have large organizations (even
countries) offering cheap, imperfect rejuvenation or biostasis support for
their members (citizens) while more expensive, but presumably more effective,
methods will also be available for those who can afford them. This is
essentially the situation with medical support today. Public clinics are
readily available, but really good care costs money out of your own pocket and
also requires knowledge of (or good advice about) the value of the alternatives.
Thus, the decisions about allocation of life extension and the availability of
life extension technology will be a mixture of the decisions and availability
in the pure socialist and pure free market scenarios. Not surprisingly, it
will still be advantageous to be rich, knowledgeable, and well-connected.
What is new is that, until effective and inexpensive life extension becomes
widely known and widely practiced, money and knowledge may make the difference
between a lifespan of about 70 years and a lifespan that is indefinitely long.
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