Governments in much of the world are massive and intrusive. Little of any consequence can be done without considering how government employees will intervene to make matters harder, more costly, or just plain impractical. Therefore there exists an enormous, many-layered industry that works to sway the opinion of politicians and, perhaps more importantly, the many unelected and largely unaccountable career bureaucrats in charge of large budgets or sweeping regulations. In a rational world we'd have none of this, and people would just get on with improving medicine without the need to spend as much money on lobbying as goes to actually building new and better therapies.
It is in this context that I'll point you to an ongoing effort by a lower layer of the lobbying community, one that has some overlap with both the mainstream media and the business of producing data, white papers, and projections on various topics for use by lobbyists. This one concerns the trajectory of the next few decades of human health and longevity, which of course is of great interest to a range of concerns whose agents are pushing for various changes and payouts in the highly regulated healthcare industry. A plague on all their houses from my point of view, as the machinations of politicians and special interests does little but reduce the odds of seeing radical new therapies to extend healthy life. The cost of regulation is very real, and it is measured in lives lost.
So that said, the contents below are of interest as yet another sign that opinions on medicine and longevity are changing. No longer is the status quo of little change in human longevity the only opinion presented by the mainstream. The years of advocacy for longevity science, the scientific results, and the uncertainty over upward bounds on longevity expressed by the actuarial community are starting to be heard. The possibility of radical life extension driven by new directions in medicine, such as the Strategies for Engineered Negligible Senescence and similar repair-based approaches to rejuvenation, is on the table and talked about in public.
Humanity's increase in lifespan may be our greatest achievement. Most of the world's children and their parents and grandparents will live long, productive lives. Even counting the wretched of the Earth, the typical person at birth today worldwide can expect to live to nearly 70, up from her 30s in 1900. But what does the future of longevity hold in the United States? Stagnation? Lift-off? The future is impossible to predict. That's why, to think rationally, systematically and long-term about the future, you need scenarios. These are credible stories, faithful to today's facts, that aim to paint dramatically different futures.
Scenario A: Small Change
Small Change is the official Washington future regarding aging - the one many policymakers expect. In Small Change, the exponential increases in the biological, genetic, neurological, information, nano, and implant technologies have relatively minor impact on current trends in lifespan, healthspan, costs, hospitals, health insurance, Social Security, Medicare, Obamacare, and federal policy. It is a straight-line projection from the present - small but persistent incremental medical change, while costs skyrocket.
Scenario B: Drooling on Their Shoes
In Drooling on Their Shoes, the exponential advances in the GRIN technologies (genetics, robotics, information, and nanotechnology) succeed in increasing lifespan, but largely fail at increasing healthspan. In 2030, octogenarians [are] already in assisted living facilities, where they can expect to spend the next 10 or 20 years. Their long lives, such as they are, will be marked by one major medical intervention after another, at tremendous cost - even greater than in Small Change.
Scenario C: Live Long and Prosper
Live Long and Prosper is based on the assumption that the first human to robustly and even youthfully live to the age of 150 is already alive today. Variations on this scenario are the New Conventional Wisdom among some sober scientists. In Live Long and Prosper, we see marked advances in personalized medicine, tissue engineering, organ regeneration, implants, and memory enhancement, as well as novel means of peering into the body and major interventions in heart disease, diabetes, and cancer. Medicine has become an information technology, and thus follows Moore's Law.
Scenario D: Immortality
Immortality is not as crazy a scenario as it sounds. All it requires is for technology to be advancing faster than you're aging. In principle, all you have to do is turn this line into a curve a little - increase this rate by a factor of four - and you have life expectancy advancing one year for every year you age. And you have something that looks like immortality for some people.
The curve actually has to increase somewhat more than a factor of four to reach actuarial escape velocity. Life expectancy at birth gives that multiple, but life expectancy at birth has no relevance to your future life expectancy as an adult at 20, 40, 60, or 80. Life expectancy at older ages is presently creeping forward at about 1 year with every passing decade. But who cares about trends? Trends reflect what is and what was, not what will be. In eras of rapid progress in enabling technologies old trends can break upward to new heights as radical new advances are introduced, changing the whole picture. In this case the radical new advance is to actually treat the root causes of aging, repairing or slowing them, now that the research community can identify both what to do and how to do it. All progress in the upper end of adult life expectancy in the past has been incidental, fortunate accidents and side-effects of better medical technologies whose goals had nothing to do with aging per se. In contrast the sky is the limit when directed and deliberate efforts are made to extend healthy human life and rejuvenate the old.