X-Message-Number: 4362
From:  (David Stodolsky)
Subject: Socialized medical system
Date: Sat, 6 May 95 20:55:06 +0200 (CET DST)

 (MR RONALD SELKOVITCH) writes
in #4347: neural nets (really, no subject):
> Sad to say it didn't materialize and has confirmed my fears that politics
> is only unwelcome here if it doesn't contain  either Libertarian views or
> the usual Clinton bashing.
> 
> I guess its a good thing that I have already made a firm commitment to
> Cryonics because I am beginning to believe there is not much room for
> anyone who is not ultra Conservative.(Let alone left of center).
> Am I the only one who feels this way?.

No. But this is only to be expected. The cryonics movement as it exists
today can only cater to individuals. While there is talk of "saving
loved ones", most cryonicists have assumed that cryonics
is about saving their *own* lives. This leads to two phenomenon. One
is that the movement attracts extreme individualists, for the most
part. Any messages not compatible with that view may be seen as threatening
and draw a negative response. The other is that any suggestion that 
survival of the "mind" requires the survival of a social environment 
(beyond that needed to maintain suspension) is met with a negative reaction. 

Every social movement, if it succeeds, goes through at least two stages:
First, there is separatist stage, during which the adherents isolate
themselves from the dominant society and formulate their most
often highly discordant viewpoint. This period leads to consolidation
of the discordant viewpoint, an analysis of how it relates to the
dominant view, formal organization, etc. 

The second stage is the turning away from isolationism and toward the
larger society. In this process, viewpoints are moderated so that the
movement can be transformed into a mass movement, with the objective
of achieving political power. It looks like we are at the very beginning
of this second stage. This means that political discussion (not the
internal politics of the past) will be a continuing feature here and
in other media. This can not and must not be avoided, if the movement
is to mature. What should be avoided is irrelevant political discussion
which gives the message "only those with politics of type X are candidates
for cryonics." These two types of political discussion are difficult
to distinguish, and there is probably no way to have one without the
other. So, let's stop wasting bandwidth trying to regulate what other
people are permitted to say. This is an unmoderated list, and as long
as it stays that way, there is no way to exercise any kind of topic
control. This probably for the best, but a separate list for "politics"
type discussion might be created, as it was for the internal politics
in the past. Otherwise, the best we can expect is that people will
realize that political discussion *unrelated* to cryonics is not appropriate
for posting on Cryonet. It should be clear by now that interest in
cryonics is not equivalent to interest in Libertarianism or any other
political view. In any case, complaints about off-topic messages should
not go to the List, but directly to the sender.



> Has any one dared to consider that a Socialized medical system may be more
> sympathetic to Cryonics than the private system we have now. Isn't it

The argument that probably has to be made to convince legislators,
is of the cost-benefit type. However, the actually decision would
probably be based upon "moral" (i. e., political) grounds. Let's assume
that the individual would then have a choice between continuing hospitalization
and suspension.

There is a well know rumor (and I have tried to trace it to a valid
source without success) that 1/3 of all medical expenses are incurred
in the last year of life. If this is true, then there are grounds for hope.

A pure economic analysis would look at the relative cost of maintaining
life and of cryonic suspension. That is, how many days in the hospital
equals the least expensive suspension option (This would be substantially
cheaper than today's lowest price, since we would have tremendous economies
of scale even in a small country). Also, quality of life in the last
year of life is often poor, though it is not obvious how to quantify
this.

If we assume that a day in the hospital costs US$1,000 and the lowest
cryonics option is US$14,000 (half of today's lowest price), then two
weeks in the hospital pays for suspension. The costs of hospitalization,
especially of the intensive care type, are likely to increase substantially
as the technology of life support improves. Low end suspension costs
are likely to stay constant. Actually, since suspension would be guaranteed
by the state, only the immediate costs - perfusion and cool down - 
would need to be paid "up front". These could be substantially lower,
if we take the lowest price option. What is the actually cost, including
capital expenditure, for this option?

[The more speculative side is the probability of revitalization and value 
of life after revitalization. The probability can be set at 50 per cent, 
if we assume social risks are minimized (Perry, _Cryonics_, May 1989), and 
if a *country* adopted cryonic suspension as a standard option, the social 
risks certainly would be minimized. Value of life after revitalization
is even more problematic, especially if future years are discounted
(Quaife, _The Trans Times_, April 1995).]

Fortunately, the political decision to offer suspension could be made on
the basis of the prior to suspension economic analysis. Individuals could 
decide whether to forego life support on the basis of the more 
speculative revitalization figures. However, if the state offered suspension 
as an option, this would probably convince many that it was worthy of
serious consideration. The question of whether persons could "trade"
continuing life support for suspension is moral mine field, that is
beyond the scope of this discussion, as is the question of "limits" 
on "free" medical care.

If we assume that:
:we have the tools to predict remaining days of life and quality of
life, before massive medical expenditures are incurred,
:the legal climate supports substituting suspension for continuing life
support, and
:most persons will choose the suspension option,
then, can this substitution be economically justified for at least a
fraction of the population at large?

If true, then a state supported health system might be more favorable
toward cryonic suspension, because it must pay for either the medical
care or the suspension. In a private system, this trade-off might not
be easily arranged, because the payer for medical care and for suspension
services would be different. To be fair, in a completely private system,
where all assets were under direct control of the individual, the trade-off
would also be available. While this option seems to be more in line
with the individualist view, it has not become available even in this
movement dominated by individualists. 

dss


David S. Stodolsky, PhD,  Euromath Center,  University of Copenhagen
Universitetsparken 5, DK-2100 Copenhagen, Denmark. 
 Tel.: +45 38 33 03 30. Fax: +45 38 33 88 80. (C)


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