Seriously though it pisses me off immensely that most leftist’s response to the possibility of immortality only for the rich is to oppose immortality rather than to try and make it available for everyone.
Like, what the actual fuck, you’re the left, that is supposed to be your thing, saying you’d rather just ban transhumanism is basically just ceding ground to capitalism.
Immortality for all.
basically just ceding ground to capitalism.
That’s a good point, actually. If you offer people to be Capitalist and have a chance of not dying, or be Communist and have a 100% chance of dying, they’re probably going to pick the former.
Anyhow, the good news is that life extension is probably worth a lot of money for any government that has to pay for healthcare, simply because aging is so ludicrously expensive. If costs $100,000 to delay aging-related care for 10 years, then to a government like that of France’s, it’s worth it to just subsidize it en masse.
The other thing is that it’s not that probable that whatever procedure is needed will be necessarily expensive because of physics, the way rocket launches are. It will probably be able to see large cost-reductions long-term through automation.
You most likely would not be eliminating old age and end-of-life costs but only delaying their onset by X years. And during much of that X-year period the person is very probably going to be retired and drawing a Social Security or equivalent payment. In this case, it’s a net absolutely massive *rise* in costs.
(Also, trust me, the procedure will be expensive. Look at immunotherapy and biologic cancer drugs and get back to me.)
And during much of that X-year period the person is very probably going to be retired and drawing a Social Security or equivalent payment. In this case, it’s a net absolutely massive *rise* in costs.
That’s assuming the life extension effect doesn’t kick in until the person is already quite old. That probably is not the case, or the life extension mechanism is not likely to be effective at its goal of extending life. It won’t stretch out puberty, either (probably), so that leaves an effect on early and particularly middle adulthood, which are prime earning years.
If you can extend the amount of time that someone is effectively 40 by about a decade, or even just five years, then sure it isn’t as fun as being in one’s 20s, but it still adds plenty of earning potential.
(Also, trust me, the procedure will be expensive. Look at immunotherapy and biologic cancer drugs and get back to me.)
At first, sure. And the willingness of wealthy tech executives to pay almost any cost for it will fund a lot of the research necessary to make it cheap enough to be more widely available. But while we are on the side of the medical cost curve where medical costs come down from infinity, and therefore costs go up since we start actually paying them rather than dying, there should be a far side of the curve where the costs start going back down again.
We’re growing new organs on laboratory animals, printing new (and functional) organs with 3D printers, and we just got CRISPR. Apparently this year the NHS will be testing some kind of gene therapy on a subset of blind patients. Surgical robots, while not autonomous, are becoming more common. (That’s leaving aside the prosthetic robot arms since those aren’t relevant to aging right now.) Even those immunotherapy drugs are a step up.
On the far side of that curve, the sorts of chronic conditions that cost us so much money are prevented through gene therapy and selective IVF, while tissue engineering replaces organs damaged by disease with natural ones that require no immunosuppressant drugs. Robots decrease the cost of surgery, either by automating part of it or allowing more labor to enter the field from elsewhere in the economy. Critically damaged limbs can be replaced by nervous-system-linked prosthetics (which already exist) produced by highly-automated factories and custom-fit to the patient (factories are getting massive reductions in staff even in places like China), without drastically impacting patient mobility.
Much of the cost is in the research. One can gene mod bacteria to synthesize the desired chemicals, build big heavily-automated factories, that sort of thing.
Many very expensive drugs cater to an illness that is not common in the population. However, the market for life extension is probably at least one quarter of the population in all developed nations, if not much more, and they would be willing to pay an enormous amount of money to have it. That’s a very large number of people to amortize the research cost over.
Now, reading all this, you might say I’m being naive and that it will require personalized interventions for each person, not a nice mass-manufactured one-size-fits-all solution.
But that’s what we have computers and big data for. The market is enormous, and computer power is still increasing, so even if the genes have to be tailored to each specific person, the genetic tailoring can still probably be done by machines.
Now, it’s possible that I’m wrong about this, and it will remain unreachably expensive forever. However, I think that sort of pessimism on this matter is driven in large part by how unattainable life extension has been for humanity, and all the Deathist myths in our culture that tell us that old age and mortality are really better for us, and that the immortality we crave but cannot have would be terrible. In our myths, it is often associated with vampires and other undead, the temptation that drives sorcerers and other villains to do evil and corrupts their hearts.
In fact, weren’t people joking about Peter Thiel wanting to look into the qualities of young blood? But we can just grow cell cultures, and if it’s something that’s common to all young blood, then that sort of thing would only last for about ten years before they crack the secret of how to do semi-artificially it on an industrial scale.
It seems likely to me that either the rich will have life extension treatment and it will become cheaper over a couple of decades, or that no one will have effective life extension treatment worth more than a few years, and not a stable in-between state where we go for a century with only the wealthy having life extension.
Clearly the interventions won’t be priced in the mid-six-figures on the rare-disease model, but that doesn’t mean that an intervention with everyone as its target market will necessarily be cheap, nor that there’ll be the fundamental willingness to pay for it on a large scale. Right now there are mortality-extending drugs for patient populations in the millions, pricing in the $4K-$6K a year range – that’s rack rate, obviously, much higher than the various sorts of actual rates – and the payor landscape has been extremely resistant, despite not only rigorous clinical evidence and strong medical guidelines recommendations but also great pharmacoeconomics models and strong value propositions across health-systems, hospital, and patient levels. It’s not going to be as simple as demonstrating impressive clinical benefits and rigorously proving cost-effectiveness.
(And I mean I’d really, really like the answer here to be as simple as “well, fucking well charge a bit less and just roll around in a zillion tons of moneys instead of a jillion,” cf: literally everyone. I get that. I spent fifteen years in oncology. I’ve seen some shit. Suffice it to say structural incentives across biopharma and the entire US access landscape are pervasively and fundamentally fucked in that way where you can’t do much more than tinker with any one bit without catastrophic repercussions due to the whole contextual gestalt of it and solving for pricing strategy is a killer of a hard problem.)
As per the rest of your response, of course, there’s always the possibility (necessity) of a lateral and sharply innovative solution.
I actually like your optimism and find it less implausible that outsider/cross-industry thinking could in fact end up generating the way to break the back of what look like intractable problems from here than that the healthcare industry will manage to painfully stepping-stone its own way out of the mess. I’ve been in the industry for a long time (mostly in biopharma rather than devices, which your post is kind of suggesting to me might be part of the problem) and I’m tired and maybe jaded. And personally I might be a little bitter about transhumanism. I’m over forty and feel like even if all of this really truly comes to pass it’s going to be too late for me to benefit, certainly while in my prime, on which I haven’t yet lost my goddamn death-grip [so to speak] thank you very much but the writing would seem to be on the wall even if I’m not yet forced to look that way. It’s hateful tbh.
And personally I might be a little bitter about transhumanism. I’m over forty and feel like even if all of this really truly comes to pass it’s going to be too late for me to benefit, certainly while in my prime, on which I haven’t yet lost my goddamn death-grip [so to speak] thank you very much but the writing would seem to be on the wall even if I’m not yet forced to look that way. It’s hateful tbh.
I’m younger than you are, enough that I may benefit from at least replacement organ technology (probably only 10-20 years out now), if not reach at least the early tiers of life extension or cryo that actually works.
But my parents aren’t. I’m fortunate enough that they’ve made it this far, but I need to start thinking about how they may not be here in 20 years. And that hurts, because I have not yet showed them me being successful. I want them to at least see that, before it’s too late. I’m trying to record some more things, too.
They had me late. On the one hand, that put me perhaps ten years farther into the future, which gives me more of a fighting chance, and allowed me to meet the people and have the experiences that are important to me. On the other hand, I won’t be able to know them as long, and they are good people.
I know you may feel bitter about Transhumanism, because younger generations will benefit more than you will, and younger generations still would benefit more than me.
…but isn’t it better to be one of the last generations than any generation before? Isn’t it better than to be born earlier than this, in the 1700s or the 1800s, or the early 1900s, where the people were recognizable to us, but the only hope was some vague abstract notion that progress would overcome it? Clashing against a seemingly-indestructible monolith of despair.
It’s like knowing a war will end soon, and that even though you won’t make it through to the end, your children will, and after this, they may never have to experience a total war again, not the way you have.
Please, keep fighting, though. At this point, even a few years could make a difference, for both you and for others. Those tech billionaire money spigots are starting to turn. If we can just manage to keep the economy going for another 20 to 30 years, I think we may just make it through to the other side as a species.