Making Epistemological Sense Out of Existential Madness

Alan Milner

Alan Milner
Florida, USA
October 12
Senior Mortgage Analyst
Brooklyn-born, graduate of Brooklyn Technical High School and City College of New York. Background includes advertising, public relations, journalism, marketing, organizational development and fund raising and, for the past 15 years, mortgage banking. You can still find my poetry at sagemerlin.

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JULY 14, 2011 1:51AM

Longevity Nonsense

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In recent weeks, a spate of new stories have appeared purportedly citing longevity scientists predicting that children being born right now might never die. Others have predicted that people who are now alive might very well live to 150.

 I won't.  I can't.

In 2008, Barabara Walters posted an article on the ABC website touting her upcoming ABC “Live to Be 100....Can You Do It?”

Well, actually, no, you can't, and telling people they can is the worst kind of intellectual arrogance.

Some people may very well live to be 150 or more, but they belong to a very different segment of the population from the rest of us.

They are the Super-Rich.

Today, in order to get first class medical care, you need to be under the care of a “concierge physician,” a very expensive medical specialist who promises to give you and your family his or her undivided attention ….for $150,000 a year.

Concierge physicians don't take Medicare, Medicaid, or private insurance because, if you have Medicare, Medicaid or private insurance, you can't afford their services.

The average primary care physician follows anywhere from 200 to 500 patients per year. The average concierge physician sees 50 to 100.

That $150,000 a year doesn't cover medication, emergency medical care, acute treatment, surgical procedures, palliative care, hospitalization and everything else that patient needs to achieve and maintain good health.

Scientists are telling us that they soon will be able to “customize” children by enhancing their mental abilities, their physical attributes, and their longevity, through genetic manipulation. Other scientists have been reporting progress toward combating the diseases of old age, while others are announcing success at curing many of ancillary side-effects of old age.

These "customized" children will have pre-selected facial features, skin tones, hair and eye color, and even a specified height and weight range - but the cost of these services will probably be upwards of $250,000.  

 A simple artificial insemination costsup to $500 per attempt for intrauterine insemination and, with a 15% average success rate, up to seven attempts may be needed, at a cost of just $3,500....but the cost for in vitro insemination runs around $12,000 per cycle....and sometimes it takes ten or more attempts to create a viable embyrio, bringing the cost for the harvesting and implantation of the eggs up to $120,000 PER YEAR and that's before you integrate the cost of customizing the genetic characteristics of the embyrio, which can easily double the cost.

 At $250,000 per pregnancy, the only people who will be able to obtain these super-smart, super-talented children will, of course, be the Super Rich because no insurance covers these procedures. 

 Taking this as merely one example of the discrepancy between the availability of a procedure and the accessibility of that procedure, we can extropolate that other life extension therapies will only be available to the Super Rich, to the point where they will not only live better but will also live longer than the rest of us.

So, while excited scientists proclaim this new era in human longevity, perplexed philosophers are wondering what will happen to a human race that diverges into two sub-races, a small patrician race of the super-engineered super rich who have been bred to their positions of wealth and power,  and a huge plebian race of underlings and servants.  

There are, in fact, corrective measures for almost all of the things that kill us....if only we could afford them.

The cost of a single bout of cancer treatment is now inching up over $500,00 per instance.  In an era where cutbacks in Medicare and Medicaid appear inevitable, who is going to pick up those bills for the increasing number of retiring seniors who can no longer afford their health insurance costs?  (I was treated for two different cancers in 2003.  The total cost of the treatments were well over $500,000.  My cost was $50.00.  Fifty bucks.  Today, with my present health plan, the same treatments would now cost almost $1 million, but I couldn't even afford the 25% co-pay.)

The  bitter fact is that most people simply can't afford this kind of high quality medical care right now, and the ratio of those who can afford this high quality of care is decreasing precipitously.

Right now, there are people dying all over the world for the lack of clean water, basic sanitation, adequate nutrition, crop failures, natural disasters, and war. People in these situations will never have access to life extension treatments, nor will most of the rest of us because the cost of these procedures, while relatively modest compared to the cost of sending men into space, is simply prohibitive when extended across an entire society.

More importantly, most of the rest of us will never be able to afford this kind of care because the exponentially increasing cost of regular medical care will make it impossible for any government to distribute these kinds of life extension therapies for the most basic political consideration:

There are two people in adjacent hospital beds. In one bed, there's a 12 year old prodigy who urgently needs a kidney transplant. In the next bed, there's an 80 year-old Nobel laureate in exactly the same situation.

Who do you think should get the kidney, if there's only one available on the day both the young person's kidney and the old person's kidney collapse?

The answer is self-evident. The younger patient should get the kidney, and usually does, and, if he doesn't, he certainly should.

Now, put yourself into the picture. The Nobel laureate is your father. The 12 year old prodigy is your son. The doctors come to you with one kidney and ask you what they should do.

This is the position into which life extension experiments put every single one of us.

As a society, over the next few years, we are going to be forced to make numerous decisions like this one, and we're not going to like it.

Wouldn't you want to live to 150, 200 or longer, if you were assured that you would be able to maintain the same level of mental and physical health you enjoy right now.

Or would you?

As we continue to age, the accumulation of new experiences demands our attention in a very specific manner. In order to manage out lives, we have to our attention into the present moment, while remembering the things we need to remember from our recent past. As we accumulate more and more memories, the newer memories always force the older memories out of consciousness.  But the fact of the matter is that we are nothing but our memories and without our memories we are nothing at all.

If you're comfortable with living in the constant present tense, you might embrace this additional span of life with open arms, but most people can't live in the present for more than a few seconds at a time. Instead,  you will associate past events with current activities, and project future events on the basis the conditions of the present moment.

As we age, we forget the past because we have to in order to continue accumulating memories and, while it is possible, with varying degrees of effort, to remember every single past moment of our lives, the effort of doing so would drive us into a severely dissociated autistic state that can evolve into actual catatonia.

When we age out of our responsibilities for caring for parents and our children, we become increasingly self-centered and less engaged with other people because the people you grew up with are spread all over the world, and the ones who remain close are as old and as self-centered as you are.

For every Gandhi or Dali Llama, there are millions of elderly people who contribute nothing of significance to the world, which steals from them their desire to live.

Right now, in America, we are seeing the effects of over-population. Whenever you see high levels of unemployment for significant periods of time, what you are seeing is nothing less than an accurate articulation of our population dilemma.

We have millions of Americans of working age for whom we have no jobs....and never will again...while we import workers from other countries to do jobs that Americans can't or won't do, and allow millions more to enter the country illegally, precisely to drive down the cost of cheap labor even further.

Given the high rates of unemployment, increasing medical costs, and decreased underwriting of medical care through the almost inevitable reductions in Medicare and Medicaid, and you have a situation in which all the high end research into life extension will be at the cost of regular medical care for the working classes.

And this is the rub that the budget cutters simply can't seem to understand:

Without Medicare and Medicaid underwriting the wherewithall to meet the cost of maintaining our vast medical establishment, the hospitals, clinics and laboratories these longevity researchers need simply will not exist.

Far from being a drain on the economy, Medicare and Medicaid, along with Social Security and, alas, military spending, are all that is propping up this economy and preventing an even Greater Depression.

There's a special relationship between Medicare, in particular, and private insurance companies that no one ever talks about. Medicare off-loads patients from the private insurers to a government-sponsored insurance system at precisely the age – 65 – that medical problems begin to accumulate for most patients. Without an effective public insurance program, private insurers would find themselves carrying those patients well past that age, bankrupting them.

Without these contributions to our economy, our medical economy will collapse. Hospitals will close, bankrupted. Clinics will collapse from the overload. Doctors will flee their practices because, without Medicare and Medicaid, perhaps half of the practices in the United States would be underwater in a matter of months, putting ever increasing pressure on the remaining physicians who have not given up their practice.

Now, overload this fragile system with the intense care required to keep people healthy in their later years...and you see the depths of the conundrum. Systemic breakdown.

Enough said?

The people who promote this silliness do so to get publicity for themselves, which they then turn into contributions to support their work in the arena of life extension....but the only lives they are extending are their own.

There will always be some people who beat the reaper and live far longer than the curve suggests they should. Some are rich. Others, frankly, are experimental subjects. A  very few are very, very lucky, if you think living to a decrepit old age is happiness.

The rest of us obviously aren't. We are shit out of luck when it comes to living forever because we can't afford to live right now, let alone forever.



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Don't generalize. At 85 I have clear memories of the time I was 2 or 3. I see a doctor once or twice a year for about 15 minutes for basic medical checkups. Beyond rent and utilities I live on less than $100 per week which is, of course, a good deal more than the people in the average third world countries and I am not complaining. I am reasonably sure the world would not miss me when I kick off. I doubt I will survive more than a few more years but I delight i remaining alive. I doubt I am unique in anyway. The idiotic things the country does spend billions on might well do better going to life extension. The medical industries are raping the country and the average individual deserves better.
At 85, Jan, you are the exception that proves the rule. I have watched people younger than you die in extreme discomfort after many years of living a shadowy existence between life and death, during which it was my responsibility to help them along. When my turn comes, I won't get that quality of care.

Unfortunately, in political discussions, generalizations are essential because we cannot take up every single case individually. My job, as a pseudo-philosopher, is to reflect upon the implications of trends.

You would be missed here. I would certainly miss you after our various conversations. Your presence adds flavor to the soup, and that's simply a fact, just as Art James contributions help to make OS different from anyplace else on the web.

My main theme here was to point out the economic incongruities of life extension. The political ones remain for another post. Can we afford to become a civilization of elders? Who will foot the bills?

Obviously, the current younger generation doesn't feel compelled to honor the pledges made to our generations, nor is it reasonable to expect that trend will change.
By the way, if you can live on $100 a week, I want to move in next door. I have friends in Norway.
Sage/Alan: I have an entirely different problem. I don't want to have medical care. My body takes care of itself that is until it won't. I've gone through so many early deaths in my family and among friends, that I want to live well and die well.

There is a great film that speaks to (and against) your thesis, and I highly recommend finding it. Called "Barbarians at the Gate" from Canada by Denis Arcand.

IMO You can't beat most diseases no matter what kind of money or quality of care you get. I would not want to live with that kind of anxiety so I do not. I see one doctor only for my diabetes and he's a cardiologist. He finally understood my position: I want to die of death, not of those early diagnoses that often lead to death and horrible death anyway.

I surely value life but not the way Jan does or most do. I value living well while I can and dying of death when it's about to be over. I probably should not write this since I don't have a suicidal bone in ny body but I wrote out a living will that is actually hilarious, do not ressurect me if I'm bleeding a lot. Do not ever take me to a hospital, I'd like to die in a hospice where they give heroin not morphine because it is said that that is a thousand times more effective in going out nicely.

I don't know why no one thinks as I do but no one seems to. Live fully, and die of whatever when it becomes stage 4 or stroke 5 or whatever. I wouldn't do chemo at all. So I'm actually the wrong person to answer this post great as it was.

Jan, however, I wish you will live to 120 and be well the whole time. R
Lately the ratings here do not stick. So I re-rated but do not look at ratings as a true indictor because at least on my computer, and I have two now, they do not often stick!
Wendy, thanks for the comment and the head's up about the rating system. OS was running quite well for a few days, but it seems to have bogged down again. One of the problems with OS is that we have a lot of people using older computers on slower connections. I have a very fast connection and a very, very fast computer so I often don't see the wait times that other people do. Now, I am again.

You have almost taken my point about this longevity nonsense. I agree with you that trying to extend life when life is a burden is simply stupid. I watched my parents go through that and I have absolutely no intention to go out that way. I wrote a very well received column once about my experiences running dealing with suicidal people on a telephone hotline, but I fully expect to pull the pin someday...but not yet.

The point of this article is that we don't really have a choice, but the very rich do, and that's the worst kind of inequality.
really well reasoned piece here, sage (sorry--Alan)...i appreciate your insight...rated
Actually, since I do my own cooking and baking and eat better and healthier than anything I can get at a restaurant, do not have a car, am bored by sports, find TV useless, do not drink, am past the age when my sexual prowess could make a woman happy, find that thinking, observing, discovering new things and resources every day on the internet is great fun, am more creative with graphics and poetry than I can ever find time or skill to execute properly, I find that $100 per week is far more than I personally need. I run into money trouble in trying to help out about 60 seagulls and an equal number of wild ducks who expect bread and peanuts from me each day. They are far more responsive and interesting and inherently genuine than most of the people I encounter and I am seriously considering becoming an honorary seagull but flying seems to be a problem I have yet to overcome. As a starter I am considering practicing shitting on car windshields but the agility of correct placement still evades me.
Two, somewhat disconnected thoughts came to mind as I read your intriguing piece. Do you remember the movie in which Don Ameche repeatedly used the phrase "Things Change"? With this phrase in mind, I envisioned a lone researcher who discovers a way to cheaply alter DNA and thereby slow the aging process. Like Dr. Jonas Salk, he makes it freely available to the world. Who knows? Things change.

The second thought is more somber. While our politicians empower the rich, and throw money at pork barrel projects, our sick and elderly waste away in nursing homes that are severely lacking in humanitarian care. Our focus should be on bringing these up a few notches.
Human stupidity may be entertaining in the political sector where the US Congress is filled with incompetents, crooks, and downright imbeciles and the executive and judicial sectors are not far behind, but the medical sector is far too important to relegate to the control of human baboons and financial thugs.
That almost 100,000 people die each year from medical errors alone (about twice as many people as died in the US military in the entire Vietnam farce), that the pharma industry is bamboozling the country outrageously in the price of vital medicines, that patient information is not universally available instantaneously from a common data base throughout the country, that many other things which are not only possible but vitally necessary for the health of the nation and very clear to someone not an expert such as myself is a national crime. The expensive diddlysquat crap going on in Iraq and Afghanistan to entertain the meat-heads in control of that sector throwing national wealth to the wind is far less important to national security than the basic health of the nation. If the USA does not know enough to basically save the lives of its citizens and the citizens don't have the sense to riot every day in every city and rural area just to remain alive and healthy then the country deserves to go over the cliff as it rapidly seems to be doing.
Jan, I hope you aren't feeding the ducks with bread. They can't digest bread and it does bad things to them, or so I have been told. Ranger, I have to say this planet is already over-populated by an order of magnitude, and the exponential growth of the population is straining all of our systems to the breaking point. If anyone does cure death, massive chaos would result.
The world is already in massive chaos. The financial sector is misbehaving so radically as to destroy whatever humanitarian advances many governments have made throughout the last century and the whittling away of social security and medicare and unemployment compensation in favor of the extremely wealthy playing gambling games on the stock market is either a move towards world totalitarianism or the final decay of current commercial systems or most probably both.
That massive sectors of humanity are denied basic health necessities for attaining even the medical fundamentals now available is a clear indication that any major advance in life prolongation will be denied them in any case. The move to demand retirement age be moved even further to higher numbers is in direct conflict with the extreme difficulty of older people finding any work that pays a decent basic wage is a further indication of the incapacity of social systems to deal with reality. When older people now have to debate themselves over whether to buy food or medicine whatever advances science makes in life prolongation becomes a sick joke.
The rest of us obviously aren't. We are shit out of luck when it comes to living forever because we can't afford to live right now, let alone forever.