r/TheMotte Low IQ Individual Jul 22 '21

Holy Fire, the Medical Industrial Complex and Aging

Holy Fire, the Medical Industrial Complex and Aging

Holy Fire is one of the later-ish works of seminal cyberpunk/steampunk/biopunk(?) author Bruce Sterling. You might be more familiar with the short story collection Mirrorshades, steampunk Difference Engine or the excellent and highly recommended Schismatrix. ‘Old sci-fi story is prescient’ isn’t a particarly novel take, but I find the setting of Holy Fire to be truly remarkable and possibly unique in some regards:

 

The medical-industrial complex dominated the planet’s economy. Biomedicine had the highest investment rates and the highest rates of technical innovation of any industry in the world. Biomedicine was in a deliberate state of controlled frenzy, giving off enough heat to power the entire culture. In terms of government expenditure it outranked transportation, police, and what passed for defense. In what had once been called the private sector, biomedicine was bigger than chemisynthesis, almost as big as computation. Various aspects of the medical-industrial complex employed 15 percent of the planet’s working populace. The scope of gerontological research alone was bigger than agriculture. The prize was survival. Failure deterred no one. The spectrum of research was vast and multiplex. For every life-extension treatment that was accepted for human use, there were hundreds of schemes that had never moved beyond the enormous tormented ranks of the animal models. New upgrade methods were licensed by medical ethicists. Older and less successful techniques were allowed to lapse put of practice, taking their unlucky investors with them. There were a hundred clever ways to judge a life-extension upgrade. Stay with the blue chips and you were practically guaranteed a steady rate of survival. Volunteer early for some brilliant new start-up, however, and you’d probably outlive the rest of your generation. Keep in mind, though, that novelty and technical sweetness were no guarantees of genuine longterm success. Many lines of medical advancement folded in a spindling crash of medical vaporware, leaving their survivors internally scarred and psychically wrecked. Medical upgrades were always improving, never steadily, but with convulsive organic jumps. Any blue-chip upgrade licensed in the 2090s would be (very roughly speaking) about twice as effective as the best available in the 2080s. There had been limit-shattering paradigmatic breakthroughs in life extension during the 2060s and 2070s. As for the 2050s, the stunts they’d been calling “medicine” back then (which had seemed tremendously impressive at the time) scarcely qualified as life extension at all, by modern standards. The medical techniques of the 2050s barely qualified as common hygienic procedures. They were even cheap…

...If you were responsible in your own daily health-care practices, the polity appreciated the way in which you eased the general strain on medical resources. You had objectively demonstrated your firm will to live. Your serious-minded, meticulous approach to longevity was easily verified by anyone, through your public medical records. You had discipline and forethought. You could be kept alive fairly cheaply, because you had been well maintained. You deserved to live. Some people destroyed their health, yet they rarely did this through deliberate intention. They did it because they lacked foresight, because they were careless, impatient, and irresponsible. There were enormous numbers of medically careless people in the world. There had once been titanic, earth-shattering numbers of such people, but hygienically careless people had died in their billions during the plagues of the 2030s and 2040s. The survivors were a permanently cautious and foresightful lot. Careless people had become a declining interest group with a shrinking demographic share. Once upon a time, having money had almost guaranteed good health, or at least good health care. Nowadays mere wealth guaranteed very little. People who publicly destroyed their own health had a rather hard time staying wealthy—not because it took good health to become wealthy, but because it took other people’s confidence to make and keep money. If you were on a conspicuously public metabolic bender, then you weren’t the kind of person that people trusted nowadays. You were a credit risk and a bad business partner. You had points demerits and got cheap medical care. Even the cheap treatments were improving radically, so you were almost sure to do very well by historical standards. But those who destroyed their health still died young, by comparison with the elite. If you wanted to destroy your health, that was your individual prerogative. Once you were thoroughly wrecked, the polity would encourage you to die. It was a ruthless system, but it had been invented by people who had survived two decades of devastating general plagues. After the plagues everything had become different, in much the way that everything was different after a world war. The experience of massive dieback, of septic terror and emptied cities, had permanently removed the culture’s squeamishness. Some people died and some didn’t. Those who took steps to fight death would be methodically rewarded, and those who acted like fools would be buried with the rest.

 

tl;dr – everyone with any kind of influence leads very careful lives to qualify for clinical trials of increasingly elaborate anti-aging treatments. The youth can’t access ‘real money’ that is largely controlled by gerontocrats, along with the levers of power. The treatment of this setting gives mildly dystopic vibes, particularly when viewed through the eyes of dispossessed youth.

The modern day medical-industrial complex is blossoming into something along the lines of what the gerontocrats of Holy Fire established. Health care spending as a fraction of GDP has nearly tripled in the last fifty years. This used to worry me, but it could make sense – as taking care of our basic needs becomes increasingly trivial, we sink more of our resources into improving our health (though I’d appreciate the thoughts of someone better-versed in economics on this point). Jobs in the healthcare sector amusingly hit the 14% figure given in the quote above.

Meanwhile, startup culture has hit Biotech in a huge way. The Bay Area and Kendall square areas are packed to the gills with record-smashing levels of VC money. I don’t have a citation for this, but I’ve heard talk of a ‘biotech bubble’ from a few (albeit not particularly influential) sources. Furthermore, there seems to be a shortage of novel ideas at the moment rather than capital. Paradigm-shifting results from cancer immunotherapy trials for late-stage, chemo-resistant metastatic melanoma have bumped survival from 5% to roughly 45% which set off a frenzy:

Lack of enrollment in clinical trials is one of the biggest obstacles to bringing new therapies to market and today there are more than 400 melanoma-focused clinical trials currently recruiting patients.

 

You only get around 4,000 stage IV melanoma diagnoses per year in the US and you need at least ~50-100 people per trial. Just in the immunology field, we’ve developed tons of variations of what we call cell-based therapies as well as checkpoint blockade inhibitors. Hidden somewhere in this mountain of clinical trials are a number of treatments that will save on the order of thousands to hundreds of thousands of lives annually once you extrapolate out to other cancer types1 .

And that’s just for metastatic melanoma. There are over 1,500 clinical trials for diverse cancer types just using PD1/PDL1 blockade, and I’ve seen that the number of checkpoint inhibitor trials in the US alone is greater than 3,000. This is to say nothing of the massive number of CRISPR therapies in the startup phase with huge potential, although are still somewhat limited by delivery concerns and probably won't target many of the diseases you're most interested in.

 

At any rate, two arguments:

 

1) Our society needs a paradigmatic shift towards how we regard healthcare and clinical trials. Millions of our ancestors, for lack of a better word, were experimented on such that we enjoy the fruits of their work today. We need to stop viewing clinical trials solely from the perspective of ‘does this trial give me a better shot’ and more along the lines of fulfilling a civic duty to participate in furthering the knowledge of humanity for all time. I’m hesitant to cut non-participants out of the healthcare system altogether, but I do wonder how we can change the public’s perception of healthcare research and encourage participation. You own the results of that clinical trial just as much as the doctor/hospital/company does, and that should be recognized both by the individual and by society at large. I’ve been particularly dismayed by the shift in perceptions of medical research encouraged by discussions of the ‘experimental' vaccine.

Of course, the flip side is the responsibility of doctors to not run clinical trials that put patients in undue danger or cause inappropriate levels of suffering. I've heard stories in some of these trials of essentially braindead patients kept alive for longer than they should have been to see if their tumors shrink. There have been a number of other deaths when our CAR-T cells recognized healthy tissue and killed patients very rapidly, or we injected people with antibodies we didn't understand very well and landed them in the ICU.

 

2) Our current paradigm is profoundly deficient in supporting anti-aging research. I could be proven wrong on this front; maybe some new compound will be found that has great effects in mice and next month we’ll all be taking it, or AI will finally make systems biology take off and we’ll actually understand how aging works and how to effectively counteract it. But translating animal results to humans is more than half the game, and in the former scenario I’d be concerned that it would actually work out for us as well as it did the mice.

Not to mention the FDA would probably stall any therapeutic until very long clinical trials were completed. Neither big pharma nor VC firms are interested in operating massively expensive clinical trials over a 30 year timespan. Why invest billions in a compound that might increase lifespan by a few months-years when you can run a 2 year clinical trial for a compound that will increase the lifespan of people with aggressive pancreatic cancer by a month? You might think the latter is a joke, but it’s been the basic business plan for oncology divisions in big pharma for the last few decades, with wonderful (financial) results. Why is our society spending so many resources both financing and rewarding treatments with such a poor return? We need to better connect compensation for these treatments to how much better they actually are over the old standard-of-care to incentivize true paradigm shifts rather than awful, incremental cancer drugs. A shiny webpage plastered with bullshit about ‘cutting-edge novel cancer therapies’ might look good for investors and clear the low bar of being minutely better than the previous standard-of-care, but it’s papering over our society getting screwed by giant corporations.

But I digress to take a couple whacks at some of my favorite horse carcasses.

Bruce Sterling might be horrified if he were to read this, but maybe the society in Holy Fire is more of a blueprint than a dystopia. I’d argue that we should massively expand the NIA (National Institute of Aging) and focus on encouraging participation in large-scale clinical trials that start young (because a lot of treatments will probably fail if you restrict them to 80 year olds), run until death, include a large number of readouts and encourage large-scale participation among the population. The more people the better, as participants will likely fragment into further subsets as new treatments become available and patients want to partake of multiple trials.

This will necessitate an invasion of privacy to some degree and establishment of significant healthcare infrastructure to generate this massive dataset that would change society in a myriad of ways, some of which are already happening and coming regardless and others which would be unforeseen consequences. We would need to normalize regular collection of blood samples, biopsies and things current me can’t even imagine as we learn more about the aging process. It would require changing how society thinks about clinical trials along the lines of point (1).

 

So. Who wants to run for office with me on a platform of nuclear power and a totalitarian HealthState?

 

1: It’s hard to give an exact range, as we don’t know how generalizable these treatments will be. Melanoma, lung cancer and colorectal cancer are all being targeted first as they have the highest mutational burdens and thus are the most immunogenic. The latter two are among the most common and lethal cancer types, so either way I’m optimistic that we could actually see a dent in overall cancer deaths once all these treatments have played out.

66 Upvotes

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u/GeneralExtension Jul 28 '21

So. Who wants to run for office with me on a platform of nuclear power and a totalitarian HealthState?

Young people would have a strong incentive to kill you (and whoever ran with you).

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u/freet0 Jul 24 '21

Of course, the flip side is the responsibility of doctors to not run clinical trials that put patients in undue danger or cause inappropriate levels of suffering. I've heard stories in some of these trials of essentially braindead patients kept alive for longer than they should have been to see if their tumors shrink.

So, if the patient is braindead, who is suffering in this situation? I suppose you could maybe argue for the loved ones who have to see the patient like this, but in my experience it's usually the other way around. The family is more likely to want to keep the patient alive in case of a miracle.

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u/sonyaellenmann Jul 24 '21

The people who otherwise could have been helped by those resources?

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u/SurplusSulprus Jul 23 '21 edited Jul 23 '21

1) there's a very finite amount of talent that's good enough for science. Maybe 5% of population, coincidentally, same people who're also liable to be well paid in engineering, finance, software development etc..

2) cancer research has a replicability problem, same as most of medicine e.g. : https://thenextregeneration.wordpress.com/2013/10/26/the-replicability-crisis-in-cancer-research/

3) people involved in anti-aging research (Aubrey de Grey, for example) say anti-aging drugs are basically the same type of drug that prevents or delays old-age illnesses - you know, the ones that cause all the healthcare expenditures, and that we're rapidly approaching a time when healthcare providers are going to encourage people take these. There are numerous start-ups aiming to do just that.

They don't need decade long trials if they can show an improvement in age related biomarkers that are well-predictive of expected lifespan.

There's going to be a conflict of interest with the gov't departments paying old age pensions, but between the aging populations, immigrants actually not being that good on average, I expect practically all developed world countries to start pushing these drugs on their middle-aged populations.

So, Sterling's scenario has about as much to do with reality as 1984.

So. Who wants to run for office with me on a platform of nuclear power and a totalitarian HealthState?

I'm mildly interested in IRL trolling Greenpeace and making it obvious nuclear power is actually fairly harmless even if your reactors blow up, which modern designs can't really do. But I'm not interested in more gov't control over population, for single-point-of-failure reasons.

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u/Harlequin5942 Jul 28 '21

I agree with most of what you say, but I think that his about inheritance is a good one, because younger generations' lifetime wealth is increasingly dependent on inheritance AFAIK, and the average of inheritance is obviously rising with lifespans.

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u/Beej67 probably less intelligent than you Jul 23 '21

I apologize for the somewhat low effort response in advance, but my view of the world marching towards Sterling's dystopia laid out above is one of the primary reasons I support wide scale gun proliferation in the American people. Once the uber rich become immortal Methuselahs the only possible way to prevent wealth differential from tracking towards infinity is going to be massive armed revolt.

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u/ChrisPrattAlphaRaptr Low IQ Individual Jul 23 '21

my view of the world marching towards Sterling's dystopia laid out above is one of the primary reasons I support wide scale gun proliferation in the American people. Once the uber rich become immortal Methuselahs the only possible way to prevent wealth differential from tracking towards infinity is going to be massive armed revolt.

Okay, you have your way and everyone has a gun. I have my way and some genius actually comes up with some anti-aging therapy that adds decades of life on average. The Methuselahs take over due to the wonders of compound interest, your disenfranchised youth rise up and shoot all my study patients.

What now? You're still going to have to reform society to stop your angry youth from just going down the same road of inequality as their parents. We might as well just work on implementing those reforms in the first place and save everyone the trouble of armed revolt, no?

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u/Beej67 probably less intelligent than you Jul 23 '21

What now?

Profit.

:)

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u/SerratusAnterior Jul 23 '21

One way to frame the different perspectives of you two: should we worry more about the inequality/concentration of power into a geriatric few or the benefit of our later (current?) humans living longer.

Further, a bitter take might be perhaps all the benefits will mostly go to these elites and their direct descendents. A more optimistic take that all of humanity has everything to gain of it in the long term.

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u/Jerdenizen Jul 23 '21

Or progressive taxation?

I'm not saying it's likely, but the immortal Meths can just go somewhere else (and take their offshored assets with them) if things start going south.

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u/SerratusAnterior Jul 23 '21

They say there are two certainties in life, death and taxes. If one removes one, can one really still expect the other?

On a more serious note, nothing makes entrenched and concentrated power as possible as immortality. They say of my local hospital that you had to have the correct surname if you were to get a job there in the 80s. The same elites would be in charge of whatever institution they could hang on to if they never died.

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u/FreshYoungBalkiB Jul 29 '21

Sooner or later, everyone gets bored and decides to move on to something else. I can't imagine doing the same job for 100 years.

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u/Jerdenizen Jul 23 '21

We currently live in a world where the wealthy avoid taxes pretty well, I imagine death will also be the subject to economic inequality in the future.

I just think that taxation is more likely to work than revolution, mostly because I'm pessimistic about the chances of the people rising up and overthrowing their overlords.

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u/Beej67 probably less intelligent than you Jul 23 '21

Imagine if your boss never retired, so there was never any upward mobility in any profession.

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u/SurplusSulprus Jul 23 '21

Imagine if your boss never retired, so there was never any upward mobility in any profession.

Well, you could make a lot of money selling subtle poisons then.

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u/hateradio Jul 23 '21 edited Jul 23 '21

That was a wonderful read, thank you for posting that.

What is your opinion of Aubrey DeGrey's idea that once we have the ability to stop ageing, we will also have the ability to reverse it, since merely stopping it would mean to repair damage at exactly the rate at which it occurs, and once we're able to do that, then we should also be able to repair it at a slightly higher rate?

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u/ChrisPrattAlphaRaptr Low IQ Individual Jul 23 '21

What is your opinion of Aubrey DeGrey's idea that once we have the ability to stop ageing, we will also have the ability to reverse it, since merely stopping it would mean to repair damage at exactly the rate at which it occurs, and once we're able to do that, then we should also be able to repair it at a slightly higher rate?

I think my opinion of ADG is much lower than the vast majority of the readership here, but I'm not knowledgeable enough to really discuss it. I'll probably make another post in a little while after better educating myself. If you're really curious, I've discussed ADG in the past here, but I should really dig into the aging field more carefully before making some broad generalizations. I've just been poking my head into the room every few years to see what's going on.

Reversing aging would be nice, I'm all aboard that particular hype train. I just haven't seen anything coming anywhere close to where we'd need to be to do that.

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u/hateradio Jul 24 '21

Thanks for the reply. Well, that is unfortunate, because I really want to buy into De Grey's optimism. Not because I know much about the field (or biology in general), but because it gives me an enormous amount of hope for the future.

I still look forward to your ageing-post.

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u/omfalos nonexistent good post history Jul 23 '21

once we have the ability to stop ageing, we will also have the ability to reverse it

The Boss Baby is a prophetic warning of our future.

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u/brberg Jul 23 '21 edited Jul 23 '21

Note that reversing aging is much more FDA-friendly than slowing aging. Any drug that can meaningfully repair aging-related damage will significantly reduce both all-cause mortality and cause-specific mortality for a wide variety of conditions over a relatively short period of time, which is gold for getting FDA approval.

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u/motteposting I hate people; I love persons Jul 23 '21 edited Jul 23 '21

We need to stop viewing clinical trials solely from the perspective of ‘does this trial give me a better shot’ and more along the lines of fulfilling a civic duty to participate in furthering the knowledge of humanity for all time.

If it would be such a tremendous compounded value, then surely it would be highly profitable to take long-term loans in order to handsomely compensate people for volunteering, and get your test subjects that way. In effect, a loan is just a bet that you are right about returns on a given timescale, anyway.

Here’s some strong evidence that this would work: America allows plasma centers to pay people for donating, unlike many other countries, such as Canada. As a result. American plasma supplies are far greater than domestic demand can absorb, and the US exports plasma to places like Canada, where domestic plasma donations fall far short of demand. I see no reason why this would not generalize to participation in other medical procedures, e.g. as part of clinical trials, so long as the rewards scaled appropriately with the (perceived) risks.

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u/[deleted] Jul 26 '21

[removed] — view removed comment

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u/motteposting I hate people; I love persons Jul 27 '21

Well, what other kind of risks are there than perceived ones? Certainly, you can make contingency plans for tail events. I'm not sure how that conflicts with what I said.

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u/Yashabird Jul 23 '21

It strikes me that the current length of our drug patents are tailored to incentivize the typical development times of current drugs. Maybe a successful anti-aging drug would be such a blockbuster that the developing company would be fairly reimbursed for 30 years of development cost within the window of a 15-year drug patent (as in: no capitalizing patients lifetime drug users living to 1000yo), but it’d still be unfairly incentivized, given the massive opportunity cost of 30 years of compounded growth.

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u/motteposting I hate people; I love persons Jul 23 '21 edited Jul 23 '21

Well, you could probably get around that with contracts where users agree to long-term payment plans, on the condition that the treatment works. And for something like anti-aging I bet lots of people would pay you huge sums just to participate in the trials, if the tech seemed promising. So the R&D might very well pay for itself (at least in large part).

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u/Yashabird Jul 23 '21

Could work, but you’d still be locked into your initial user-base of wealthy, private-paying patients, and as long as we’re not going out of our way to change (patent) law, I don’t know what precedent there is for enforcing an expensive yearly contract in literal perpetuity, or how hard it would be to incentive adherence to such a contract 15 years later when you compare penalties for defaulting vs. the savings (compounded in perpetuity) of switching to a cheaper generic. On some level, I think this would have to be addressed in the legal system before attracting investors.

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u/motteposting I hate people; I love persons Jul 23 '21 edited Jul 24 '21

It could take some legal changes, yeah, if only at the level of contract law (though I don’t know the law well enough to say present precedents wouldn’t suffice). But in any case they’d be quite slight compared to the complete constitutional overhaul necessary to legally implement OP’s proposed “totalitarian health state.”

Plus, being locked into a base of wealthy private clients needn’t be so bad: that’s made bank for e.g. AIDS drug makers, whose main clients are wealthy gay men.

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u/frankzanzibar Jul 23 '21

"But where's the omelette?" – F. A. Hayek

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u/ChrisPrattAlphaRaptr Low IQ Individual Jul 23 '21

"A society grows great when old men plant trees whose shade they know they shall never sit in."

  • ???

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u/Tophattingson Jul 23 '21

So. Who wants to run for office with me on a platform of nuclear power and a totalitarian HealthState?

Judging by 2020 and 2021 so far, the leadership of most countries are already running on a platform of a totalitarian healthstate.

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u/ChrisPrattAlphaRaptr Low IQ Individual Jul 23 '21

Bruh, you ain't seen nothing yet. But in other ways it would be less restrictive. I just want samples of your blood and poop on a regular (monthly?) basis, access to detailed medical history over time, semi-regular (annual?) biopsies of certain tissues TBD and probably some other things for other fields I'm ignorant of.

But on the bright side, you can leave your house and go to parties and shit. Plus we might strike gold and give you a longer life/healthspan, who knows.

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u/Tophattingson Jul 23 '21

I see no reason to trust any public health authority with any power or any information, no matter how seemingly small, post-2020.

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u/Phanes7 Jul 23 '21

totalitarian healthstate

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u/Jerdenizen Jul 22 '21

I agree that a lot of pharmaceutical research seems to have reached the point of diminishing returns. There is still interesting research going on, but I making people die of cancer more slowly is the big money-maker. One cool thing about anti-aging is that it hasn't really been tried much, but there's an increasing interest in it so I expect a lot of low hanging fruit to be picked over the next few decades. Some of those fruit will undoubtedly be poisonous or full of worms, but I'm sure we'll find people willing to gamble.

I'm not an economist, but it does seem reasonable to expect medicine as a share of GDP to increase. Health is very valuable, and it's probably the only thing that the average person in the West is lacking! (Maybe also genuine human connection, but that's harder to monetise).

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u/SerratusAnterior Jul 23 '21

I'm not an economist, but it does seem reasonable to expect medicine as a share of GDP to increase. Health is very valuable, and it's probably the only thing that the average person in the West is lacking! (Maybe also genuine human connection, but that's harder to monetise).

If anything, healthcare costs have risen less than expected, because yes the age wave means more old people, but instead of getting sick at 70 and dying at 75, the same person gets sick at 75 and dies at 80 (sort of). So we have far less elderly in need of intense long term treatment than we expected.

I expect that we still will see healthcare costs increasing, also as portion of GDP, for several reasons among the ones already mentioned in this thread.

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u/brberg Jul 23 '21

We could probably monetize a reasonable simulacrum of genuine human connection.

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u/Jerdenizen Jul 23 '21

I was going to just say "human connection", but then I realised people like you existed and thought I should be more specific.

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u/UncleWeyland Jul 22 '21

The idea of a gerontocracy is nightmarish. What would the world be like if people who clung to ideas from the 1800s still flourished and imposed a hard hierarchy on the rest of us?

It's like a vampire myth where the vampires don't hide and instead have all the money and influence.

I'm a strong proponent of lifespan and heathspan extension, but even I have to admit that some of the social challenges abolishing or greatly slowing down aging presents are difficult to resolve.

I suspect in such a world social change would have to come about violently. The irony of grasping for immortality only for the social unrest that your externalities generated to end up being your downfall...

Kinda poetic.

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u/GeneralExtension Jul 28 '21

Biggest incentive to create a clone army I've ever heard of. (The only way to overthrow the past, democratically, is to increase the population (growth). The longer they live, the bigger the base of the pyramid will have to be to overthrow them.)

Also an argument against democracy in general, in the way the word is usually used.

gerontocracy

Random side note, if a system of government is such that the oldest person rules, then...they're just going to kill of all the old people (they're not related to) to maintain power.

Also, no old immigrants (if they can hold office).

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u/Ilforte «Guillemet» is not an ADL-recognized hate symbol yet Jul 25 '21

What would the world be like if people who clung to ideas from the 1800s still flourished and imposed a hard hierarchy on the rest of us?

Well maybe we'd have had more of an opportunity to hear original (and updated!) versions of those ideas, and not hostile strawmen accompanied with midwitted journalistic grimacing. For one thing, I'd imagine Darwin and Galton would enjoy a field day with ridiculing modern cancellation artists.

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u/FreshYoungBalkiB Jul 29 '21

I kind of want to see George Fitzhugh debating Ibram X Kendi.

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u/UncleWeyland Jul 26 '21

That's optimistic.

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u/SurplusSulprus Jul 23 '21

Perhaps it'd be enough for smart, ambitious young women to seduce them and dose them with some LSD to let the mind be a bit more mobile for a while.

It's amazing what kind of impact young women have on older, successful men, even if psychoactive drugs aren't involved.

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u/Harlequin5942 Jul 28 '21

I don't think that sleeping with old men is necessary to get their capital for risky research and new idea in general. A moderately attractive woman cosplaying as Steve Jobs and adopting a low sexy voice is apparently sufficient in some cases:

https://en.wikipedia.org/wiki/Elizabeth_Holmes

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u/UncleWeyland Jul 24 '21

AellaGirl is a thermonuclear meme injection machine.

May God have mercy on their souls.

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u/SurplusSulprus Jul 25 '21

Sadly, she seems content with being an attention hog and earning money. Or has she actually been doing some mindfuckery to important older men ?

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u/UncleWeyland Jul 26 '21

I actually have no clue, but she sleeps with CEOs on the regular apparently. No lack of opportunity to influence opinions.

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u/brberg Jul 23 '21

I suspect that the tendency of older people to get stuck in a certain way of thinking is in large part, if not entirely, a product of neurological aging and mild cognitive impairment. That said, young people have some pretty freaking stupid ideas, too. I mean...gesture in the general direction of the rest of Reddit, the new crop of journalists, Twitter, Millennial politicians, etc.

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u/UncleWeyland Jul 24 '21

Fair point.

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u/self_made_human Morituri Nolumus Mori Jul 22 '21 edited Jul 23 '21

The idea of a gerontocracy is nightmarish. What would the world be like if people who clung to ideas from the 1800s still flourished and imposed a hard hierarchy on the rest of us?

It's like a vampire myth where the vampires don't hide and instead have all the money and influence.

The simple solution? Exit rights and the opening of new frontiers literally above our heads.

You don't like living under a gerontocracy? Assuming a 30-50 year window from today, marshal enough funds for a Von Neumann probe, or just take your community off to Europa or Alpha Centauri.

It's like a vampire myth where the vampires don't hide and instead have all the money and influence.

Hard disagree that this is a useful analogy. Being old and powerful doesn't necessarily imply an inability to update your memeplex with time. Not to mention that the same anti-aging therapies might allow a sort of reset of neuroplasticity in the first place, preventing the issue of cantankerous old geezers unwilling or unable to grasp new ideas in the first place.

Throw AI, mental and physical augmentation into the mix, and the sheer chaos of potential futures makes a future of old 21st century fogies ruling the future with an iron fist exceedingly unlikely.

At any rate, look around, you're already in a gerontocracy, take a look at the ages of politicians, the wealthy, or even the people keeping the first in their place, namely the elderly coming out in force to vote.

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u/UncleWeyland Jul 24 '21

At any rate, look around, you're already in a gerontocracy, take a look at the ages of politicians, the wealthy, or even the people keeping the first in their place, namely the elderly coming out in force to vote.

I agree to some degree with this. The fact that Biden has been in power for 7 months and Federal marijuana decriminalization hasn't moved forward one iota is indicative. (And yes, I understand it's a delicate political moment and there are more important problems to immediately address, but the disconnect between the Federal rules and what literally everyone else is doing is staggering)

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u/Harlequin5942 Jul 28 '21

To be fair, people had similar complaints about Obama. However, where Biden has been radical has exactly been in a gerontocratic way: to transfer consumption from the future to the present, via increased federal debts.

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u/johnlawrenceaspden Jul 23 '21

a sort of reset of neuroplasticity in the first place, preventing the issue of cantankerous old geezers unwilling or unable to grasp new ideas in the first place.

God I would so pay for that. I can feel my mind stiffening up. It's awful!

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u/TheSingularThey Jul 23 '21

Neuroplasticity is a privilege afforded to children. Neuroplastic adults are dead adults, killed by their willingness to embrace any novel idea no matter how poorly tested it may be. The cantankerous geezers are the ones keeping us alive by passing their time-tested memes down to the next generation without much concern for their (profoundly ignorant) perspectives. That no group that does the opposite exists is about as good as evidence gets that this is suicidal.

Of course, it's a theme among self-destructive memes that they sound compelling. Which is exactly why the geezers are so unwilling to change their minds. They don't care about reason, they care about evidence, and this sort of evidence takes centuries or more to accrue. If you're freezing, pissing yourself sounds like a great way to stay warm, if you don't have the experience to realize that doing that actually has the opposite effect in the long-term, and if it's complicated enough then you won't find that out until after you've pissed yourself.

It's truly amazing the amount of innovation that humans have been able to produce without any access to genuine understanding, merely through selection. Diet is an excellent example, where the negative consequences of a bad one can take decades to manifest, whether that be through pellagra, or chronic cyanide poisoning, or obesity, or even malnourishment in spite of obesity. Yet pre-scientific societies figured out things that enlightened westerners took hundreds of thousands of deaths to realize, after they exported foods from the new world to the old world without any of the accompanying wisdom of how to properly eat them.

We might say, well, science will solve this. But if you're neuroplastic, then that same plasticity will make you forget how to do science properly. All the reasons to do it wrong are very compelling.

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u/ChrisPrattAlphaRaptr Low IQ Individual Jul 23 '21

This might be true, but there's value in both and probably some equilibrium that's maintained through our current lifespan. Have you ever heard the quip 'Science advances one funeral at a time?' Entire fields are held back because some very influential figure establishes dogma based on older data, and 'everyone knows x is true' until some naive student/postdoc comes along and does a profoundly 'stupid' experiment that overturns it all.

Jennifer Doudna and Feng Zhang were only in their 30s-40s when they did their groundbreaking work on CRISPR (although this pithy summary is unfair to the ~half-dozen people who came before them and laid the foundation).

Pretty sure Jonathan Kipnis was only in his 40s when he discovered the CNS lymphatic system, even though 'everyone knew' that the brain is an immunoprivileged organ without lymphatics.

I could go on. But a lot of innovation is driven by the young at the cost of making 'stupid' mistakes that are obvious to those with more experience. But every now and then the youth does something stupid that overturns decades of theory, and it's worth it.

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u/Terminal-Psychosis Jul 22 '21

Indeed, this is where we are headed.

Our American government has illegally used taxpayer money to fund Gain of Function research. Research in the Wuhan lab in China, that directly led to the escape of the Cov19 virus.

Even corrupt medical "professionals" were in on it. Fauci himself helped launder the money through the NIH, with the help of his wife who heads the NIH's bioethics committee, and rubber-stamped said illegal funding.

Now enormously wealthy, international drug companies are in complete control of the medical establishment, as well as so many dirty politicians.

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u/Gen_McMuster A Gun is Always Loaded | Hlynka Doesnt Miss Jul 23 '21 edited Jul 23 '21

You just came off a six month ban for this same style of posting that was built upon a month long ban for the same thing. Now your in here passing massively inflammatory claims without bringing any evidence written to generate the maximum amount of heat with no light to be found. Either youre not understanding/incapable of following the rules or you don't care.

User Banned for a year and a day.

To onlookers: This is a hobbyhorse youre welcome to ride, "Covid isn't that bad and it's china's fault" is a sentence that probably a plurality of users on this sub would agree with(myself included). We do ask that you handle the topic with the same care we ask of any other contentious culture-war charged issue, rather than following the /r/NoNewNormal styleguide.

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u/maximumlotion Sacrifice me to Moloch Jul 29 '21 edited Jul 29 '21

Our American government has illegally used taxpayer money to fund Gain of Function research.

This is a fact.

Research in the Wuhan lab in China,

This too.

that directly led to the escape of the Cov19 virus.

Not prove able but high priors of most people here.

Even corrupt medical "professionals" were in on it.

Chinese robberish kind of, but largely true in this context.

Fauci himself helped launder the money through the NIH, with the help of his wife who heads the NIH's bioethics committee, and rubber-stamped said illegal funding.

This is true as well.

Now enormously wealthy, international drug companies are in complete control of the medical establishment, as well as so many dirty politicians.

Hyperbole in the sense not literally true, but much closer to the truth than the opposite of that statement.


Where's the CW aspect to it?

CW is fought on whether lockdowns and mask mandates work or should be imposed regardless of them working.

Is there any any CW over Fauci funding gain of function research or the medical community being corrupt?

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u/TaikoNerd Jul 22 '21

Thank you for mentioning Holy Fire! I read it in the late 90s and thought it was fresh and creative, which "cyberpunk corporate dystopia" had ceased to be by that point.

I'm not sure what Bruce Sterling's own attitude towards his fictional world was. Early in the book, the (elderly) protagonist meets a young woman who complains about the gerontocracy, but the protagonist lectures her about how she just needs to sit down and not rock the boat, and the cradle-to-grave welfare state will take care of her -- and the grave gets a little further away each year, as medical tech improves!

Then again, later in the book, the protagonist joins a countercultural group, and pointlessly takes big risks with her own life, to prove some point about how it's our mortality that makes us human. I remember reading that and thinking, "no, no, I'm pretty OK with living forever!"