Incoherent Fears of Unequal Access to Longevity Science

There is something about the prospect of treating the causes of aging and greatly extending healthy life spans that makes otherwise sensible people throw common sense out of the window. If I had a dime for every time I saw incoherent predictions and conspiracy theories suggesting that rejuvenation therapies would be developed in secret and restricted to the wealthy elite, I'd have a lot of dimes. There is something ugly and irrational in human nature when it comes to this sort of topic.

In reality it is impossible to build new medical science in secret. It is impossible to build anything in secret that requires a community of tens of thousands, an entire supporting industry, global collaboration in research and development, and the active participation of the scientific community, relentlessly focused on papers and publication. The rejuvenation treatments that will result from from SENS-style repair approaches will be mass-produced infusions akin to biopharmaceutical medicines that today cost a few thousand dollars for a course of treatment, administered by a bored clinician once every few years. After a couple of decades of market action they will be far less costly, like the older drugs produced today that are so cheap even the third world has access.

In short we all win together or we all lose together. This is a cooperative game, not a competitive one. This is all obvious and right in front of our noses; there are scores of examples in medicine today, demonstrating exactly how development and price works out over the years. Yet people are still willing to believe strange things about the future of treatments for aging, building castles of fearful fancy in the clouds.

Concerns about the advance of life extension science research and development frightens many people. Particularly, the level of private investment pouring into the industry. The most extreme of prophecies argue that there will be an absolute divide between the handful of super rich who can afford life extension treatments, and those who can't. The fear is that this divide will permit a world in which a new social order is established planted in financial wealth, but rooting from access to life-prolonging medicine.

Life extension science is at the forefront of this debate, with critics arguing that scientific research should be led by a social contract, rather than a fiscal objective. However, supporters believe that commercial input, especially in life extension, is accelerating the overall momentum of scientific research.

Ultimately though, life extension science is suffering from a complete lack of federal funding, and so if an anti-aging community is to be created, whether the result will benefit us all or just the richest in society, it must first be born out of big business and philanthropy. So then, if this is the case, how much truth and evidence are there in the claims from either side of the debate, and should we be afraid of private entities taking hold of the anti-aging industry?



Perhaps a pithy name for this is the Ferryman (Charon) error, with the Charon story you need two coins to pay the ferryman to cross the river Styx to reach the afterlife, here people assume that only those with money will reach the beneficial treatments. This is like the Tithonus error where people assume life extension equals decrepitude extension.

Posted by: Jim at October 1st, 2015 6:38 AM

English: Unfortunately there is an irrational fear of death that paralyzes the ability to think in people. Hence his strange behavior and denials in medicine and in general, everything that threatens with a change.

Lamentablemente hay un temor irracional a la muerte que paraliza la capacidad de pensar en la gente. De ahi sus extrañas conductas y negaciones en la medicina y en general, en todo lo que amenace con un cambio.

Posted by: eduardo at October 1st, 2015 7:22 AM

I think a situation where treatments are available in the more affluent countries in the world first is more likely than secret treatments for the wealthy elite. At least initially, before its common worldwide, like much of the current medical technology today. That being said, look at Glybera which got released in Europe and is being sold for 1.1 million euros... So who knows. I'd like to think something for aging would be cheaper because it has a vastly larger target audience than Glybera but you never know, at least until it comes to fruition.

Posted by: Ham at October 1st, 2015 7:33 AM

Apathy kills the imagination, and Americans today are especially apathetic about their chances of living a good life. As Aubrey de Grey said in a reddit AMA, even the super-rich don't wish to get their hopes up about longevity-therapies. If it is so easy for even the super-rich to be afraid of failure, it goes without saying the less fortunate feel the same way.

Posted by: Eric at October 1st, 2015 11:19 AM

This article addresses a concern of mine. I have read Reason's explanation that SENS therapies will be mostly in the form of infusions and medications that will be non-invasive and therefore hopefully cheap. However, I believe that he has also written that the super-rich will be gouged for the first treatments. The million-dollar question (pardon the pun) is how soon will effective treatments decrease in price to be accessible to the common man? AdG has said that in 10 years SENS will achieve the robust mouse rejuvenation. Hopefully, at that point research will explode due to a mass conversion to a pro-longevity stance. If we have effective but non-FDA approved therapies for humans in 20 years, the gouging will begin. I imagine a scenario 30 years from now when I myself will be elderly and needing rejuvenation. I believe that Reason has also estimated that treatments may cost somewhere in the neighborhood of a current major procedure for $100-200K. If this is the case and repeated treatments are required as I continue to age, I may go broke paying for rejuvenation. I place a high priority on health and longevity so I will fork it over, but if treatments are needed every 5-10 years in addition to the cost of living - bankruptcy will loom. Medical tourism is a given for access so I will have to balance penny-pinching versus the quality of care via Consumer Report-type reviews. I support SENS but I must anxiously financially plan my future in order to afford it. Ultimately, I may end up living on Social Security (or whatever replaces it as a basic income guarantee) but enjoying a healthy mind and body. My standard of living will depend on not only cheaper health care but also cheaper energy, robotics, food, etc. so that I will not live in squalor. Additionally, increasing automation will likely mean fewer opportunities to work or return to work to prevent this scenario. Has anyone else worried about this situation?

Posted by: Morpheus at October 1st, 2015 2:12 PM

Calling others' fears incoherent does not strike me as an efficacious method of persuasion.

In any case I think you've read the linked piece uncharitably.

First, it says that life extension "is not the problem", rather "The problem is with healthcare, in the lack of government action toward alleviating inequality and taking steps toward advancing access to medicine" implying those who have a problem with unequal access to medicine should work on that, not on opposing life extension. The piece is apologia for life extension!

Second, its concerns about access to medicine are global:

This inequality in the research approach would coincide with the economic and access to healthcare trends within these areas of the world. In terms of medicinal and biological scientific advancements, in the majority of low income nations, it is only the minority of their populations who can afford treatment that receive it. The UNHDI reveals the very low levels of adult health, health expenditures, population in or near severe poverty within the bottom 40-50 nations classified with the ‘Low Human Development category’. If following this trend, it is thus clear that life extension advances would more than likely not reach the majority of people within these countries.

Eventually life extension therapies might be cheap enough to reach the poorest people in the world, but in the meantime billions will die early and be severely disadvantaged, just as they are now with respect to non-regenerative therapies.

This seems to me a legitimate concern, and again one that should be met with work on cheap access to medicine, not opposition to research.

I suspect people's fears about life extension increasing inequality would be better addressed by life extension advocates also advocating for access to cheap medicine rather than telling people that their fears are incoherent.

Relatedly, a new Open Source Pharma Foundation has received funding from the Tata Trusts. It'll focus on TB and other diseases of poverty at first, but to the extent its methods prove workable, they'd remove barriers (at least those in the form of patents) from cheap access to other medicines developed through those methods. Life extensionists should do so, or choose to complain about ever-increasing fears about unequal access to life extension therapies.

Posted by: Mike Linksvayer at October 1st, 2015 3:23 PM

I know Maria Konovolenko has said that initial treatments will likely be very expensive. I believe Aubrey has said something similar, mostly because once the groundwork is laid, it's the pharmaceutical companies that will bring it to fruition, not SENS. It's a lot of money, but if it was only 1-200k Initially I'd be relatively happy. People on places like reddit always say it'll be millions or a billion dollars, which is outrageous... But something the company marketing it COULD do. If it comes out before I really need it (29 now) and is cheaper when I do need it, that would be great. But I definitely am prepared and willing to have to take out loans if needed.

Posted by: Ham at October 1st, 2015 3:56 PM

Morpheus: The question of price is not much a medical/technological question as a political question. Being aged is hugely expensive (now, medical expenses in the last year of life of a person equal medical expenses in the rest of his/her life). Also, pensions are expensive. And it's a huge cost for a country to have a large part of his population that can't work. Also, there is an colossal political pressure when all your voters are sick of the same disease and treatments are expensive. For these political reasons, antiaging therapies' prices will decrease very fast. It would be a political suicide not to do so (suicide for the party in the government and suicide for the country with respect to competing countries).

Posted by: Antonio at October 1st, 2015 4:26 PM

I hope you're right Antonio, I just have my doubts. We have a majority of one party here that is very conservative and religious, so I don't think it would be out of the realm of possibilities for them to be against it on religious or "moral" grounds, like they were initially with stems cells, despite the benefits for people. You would think it would be political suicide but who knows... There are plenty of people who are seemingly willing to tell you that aging is fine, natural, and we shouldn't be messing with it. These are usually the same people that support research on cancer, Alzheimer's, and everything else that kills you. Hopefully it isn't something that has to be debated over and voted on.

Posted by: Ham at October 1st, 2015 4:53 PM

I hope you're right Antonio, I just have my doubts. We have a majority of one party here that is very conservative and religious, so I don't think it would be out of the realm of possibilities for them to be against it on religious or "moral" grounds, like they were initially with stems cells, despite the benefits for people. You would think it would be political suicide but who knows... There are plenty of people who are seemingly willing to tell you that aging is fine, natural, and we shouldn't be messing with it. These are usually the same people that support research on cancer, Alzheimer's, and everything else that kills you. Hopefully it isn't something that has to be debated over and voted on.

Posted by: Ham at October 1st, 2015 6:21 PM

Antonio, to be clear, that post applied to citizens of liberal democracies, not the undeveloped world that lacks a medical infrastructure or the people to staff it. Western countries will (be forced to, though social and economic pressures) make it available to their own citizens. Sub-Saharan Africa, not so much.

I won't go as far as Reason did and say that the fears here are incoherent, but they're silly and a bit misguided. Focusing on "inequality" is exactly the wrong approach. Person A using his wealth and resources to make his lifespan indefinite does not affect impoverished Person B! "Inequality" may have increased, but Person B's situation has not changed. The only way Person B is ever going to get his life extended (whether it's given to him or he finds a way to take it) is after Person A has already developed and gotten it. So the only way to benefit Person B's situation is to (temporarily, at least) increase inequality!

If you don't want to keep this situation unequal in the future, Doctors Without Borders and the Red Cross are right there, but worrying about this stuff at this point is pointless because nobody has it right now- not even the rich.

And eventually, maybe we can start turning Person B into Person A, but that requires transhumanization that goes well beyond life extension.

Posted by: Slicer at October 1st, 2015 8:50 PM

Call me a worrywart, but I am still concerned and I still support SENS. Antonio's and Slicer's arguments largely hinge on scenarios such as governments and health insurers who are burdened with excess costs agreeing to pay for SENS therapies that will be fresh out of the laboratory. These will not be FDA approved or indeed 100% safe in humans. This would open these payers up for class action lawsuits if many patients are treated and even a few percent suffer ill effects. More importantly, a U.S. based insurer or U.S Medicare may not pay for medical tourism in Third-World countries. The same may be true for other Western governments/insurers. As for the cost of healthcare bankrupting society, we can see from such examples as the the Greek economic bailout and the threat of insolvency in U.S. Social Security and Medicare that financial crises such as healthcare costs are ignored or provided Band-Aid treatments until the last possible minute. We can hope for radical changes to the FDA, governments, insurers, etc. but we all know that these institutions change at a glacial pace. As I will be elderly in 30 years, I think that today's determined SENS followers must also be concerned. They all need to live healthy lifestyles to minimize damage and to plan on expending large sums for treatment - possibly to the point of bankruptcy.

Posted by: Morpheus at October 1st, 2015 10:03 PM

Nobody on the front end pays for therapies fresh out of the lab, Morpheus. In fact (and this is a good thing), it's illegal to sell them to consumers in the United States until they've been through clinical trials that prove that they work! The expense of these trials means that someone with money has to make an investment, and quite a few people have to be guinea pigs. (I'll volunteer.)

Posted by: Slicer at October 1st, 2015 11:27 PM

Morpheus, how old are you? I'm 29 now and my plan is pretty much the same if it comes down to it. I figure I have 36 years before I'm considered elderly and about 45-50 before I need to get my hands on a therapy, or accept that there isn't one available yet.

Posted by: Ham at October 2nd, 2015 4:37 AM

Ironic that most of the people who voice these fears are westerners, westerners who wouldn't hesitate to get a current-day expensive western cancer treatment that is out of reach of billions of poor people on the planet today.

Posted by: KC at October 6th, 2015 12:20 PM

IMO anyone interested in healthy life extension should have two bank accounts, one that distributes funds regularly to SENS (which will hopefully make therapies happen earlier through research and publicity and advocacy), and another that invests in stock market index funds to pay for their own person therapies down the road. Make as much money as you can and put it into these two accounts now and otherwise live modestly.

Posted by: KC at October 6th, 2015 12:40 PM
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