mikedarwin comments on The cost of universal cryonics - Less Wrong

37 Post author: handoflixue 26 May 2011 02:33AM

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Comment author: mikedarwin 29 July 2011 07:38:30AM 14 points [-]

I found this a fascinating and amusing exercise. The 1990 Alcor article, "The Cost of Cryonics" and the accompanying tabular breakdown of the actual marginal costs that was used, in part, to generate the scenario above, were done by me in 1989-1990. [And you will note they have not been repeated since ;-0] If you look closely at that article you’ll also note that there is a disclaimer at the start which says, “these opinions are mine and do not represent those of Alcor…” That was there because the management was not happy with my projections, and instead backed those of Ralph Whelan http://www.alcor.org/cryonics/cryonics9310.pdf. If you go to page 10 of Ralph’s article you’ll see the projected growth rate for Alcor. The article also contains projections for “post-start-up” economies of scale. If you actually take the trouble to look at where Alcor is today, versus the “anticipated” numbers in that article, you’ll see that just about every assumption made was wrong. A short while ago, Brian Wowk tersely informed me during a phone call that my projections, if adjusted for inflation, constitute the actual current rate at which Alcor charges for cryopreservation services. I’m not sure if this is true, or not, because I haven’t bothered to re-run those numbers.

What is interesting in looking over the discussion here on Less Wrong is that all these various cost estimates don’t take into account the social and political context in which they are supposed to operate. Cryonics is very expensive if it is practiced as a high technology endeavor aimed at minimizing the extent to which it is (reasonably) technologically practical, damage from ischemia and from cryopreservation. And that was in the absence of skilled professionals who are vulnerable to malpractice judgments doing the procedures. When my estimates were done in the late 1980s, reasonably skilled, but non-professional people, were available to minister to cryonics patients. Any global scale-up of cryonics would have to factor in not only professionals’ fees and associated costs (licensing, regulation, litigation, etc.), but also the complex infrastructure required to implement such a technology on a widespread basis.

If you do that by, for instance, looking at the cost to provide EMS services to people in the US or the UK, you will find it is staggeringly expensive, and that far from there being economies of scale, the costs rise, dramatically. If you posit making Universal Cryonics a reality at a high level of technology, then you can easily bound the cost by simply using the existing medical system as your model. How much does it cost to respond to and to and transport a patient in cardiac arrest to a hospital ED? Add to that say, ~ $5,000 for ischemia-reperfusion medications and for en-route cooling. Then, figure out how much a typical Coronary Artery Bypass Graft (CABG) costs today and add to that ~ $25,000 for cryoprotectants, associated IP licensing, and for extended use of the OR for CPA perfusion. From there, you can try to figure cool-down costs. If you like, you can just plug in existing numbers for cool-down. What you’ll find if you do this is that cryonics will cost about $170,000 to $250,000 for the up-front part of the procedure. And that is being very, very conservative and assuming that automation can be used to pinch hit for expensive human labor.

The only place where there is a reasonable possibility for economies of scale is in storage. Mostly, those economies of scale have already been reached by Alcor and CI for the type of storage they are using. In other words, if you want further economies of scale you have to build BIG, because the only way you get more efficient is by exploiting the reduction in heat leak that is to be had by decreasing the surface to volume ratio of your cryogenic storage system. That can most efficiently be done by building very large spherical storage vessels. Of course, practical considerations will kick in at some point and, unless you want to build gigantic storage vessels that you just pitch patients into like cord wood, you’ll need a way to access individual patients at will. This requirement greatly constrains the simplicity of the engineering it is possible to use, and thus increases the costs. Still, I would guess that you might halve existing neuro storage costs.

Finally, once you have a society that takes cryonics seriously, not only are they going to start suing for bad care, they are going to want protections to be present against sudden, undetected cardiac arrest and against myriad other contingencies that could frustrate cryopreservation andthat will also increase cost. Finally, they are going to want protection against existential risks to cryopreserved patients. Consider the situation today with nuclear power plants. These energy generating pieces of infrastructure are very dangerous if mishandled, sabotaged or subjected to fire, earthquake, flooding, or any of a number of other man-made or natural calamities. As a consequence, these plants are subject to very costly uber-engineering AND REGULATION. And even with such costly precautions, they are still sadly vulnerable, as recent experience attests.

Completely leaving aside the issue of how securely people will want to store their cryopreserved relatives, there can be little doubt about how securely they will want to store themselves once they are in a vulnerable and indeed completely helpless state. That means a level of engineering that is at least comparable to, or better than that currently employed in nuclear power installations. And there will be pragmatic limits on economies of scale because few sane people would buy off on the idea of 4 or 5 mega-regional storage facilities for the whole planet, or even for the whole of the US.

The take home message is simple. Barring absolutely “Singularity-style” improvements in technology and wealth, cryonics is going to not only remain an expensive proposition; it is going to get a lot more expensive. For a mature “universal cryonics procedure” in the framework of existing/foreseeable technology, my guess would be that the cost would be between $500,000 and $750,000 per person in the West, and perhaps half of that in the Developing World – but with a lot more risk (no hardened storage facilities, more risk of unattended death, and so on).

If you pull cryonics out of the context of a “universal, mainstream operation,” then costs could be very different. – Mike Darwin

Comment author: lsparrish 01 August 2011 06:47:36AM *  6 points [-]

I am skeptical of this analysis for several reasons:

  1. For better or worse, skilled personnel providing the service would be protected from malpractice to some degree by the very nature of the procedure. It's simply too hard to prove that harm occurred by all possible future standards. Even if malpractice is a possibility, the penalties would tend to be lower.
  2. The $25,000 for cryoprotectant sounds unrealistic unless there are no competing firms producing comparable cryoprotectants. That Alcor pays this at present seems to be a result of the fact that M22 is produced and consumed on a very small scale. Nonetheless, an insanely high profit margin for companies developing less toxic cryoprotectants could be a very good thing for cryonics quality. Cryoprotectant toxicity is an incredibly important area to develop for the purpose of not only cryonics but also for organ preservation and the advent of true suspended animation.
  3. Responding rapidly to cardiac arrest is something we pay for already with the existing health care system in developed countries that have EMS. If cryonics provides motive to extend EMS infrastructure to undeveloped countries, that is useful for other reasons -- it would save lives in the ordinary sense of the term. It should not be considered an additional expense of cryonics except in situations where EMS would not be deployed.
  4. A society that takes cryonics seriously would feel very differently regarding assisted "suicide". It would be something encouraged (and voluntarily pre-arranged) for situations when the brain and personality is seriously threatened. This would result in extraordinary savings not only by eliminating the need for emergency response and standby for cryonics, but coincidentally by reducing the burden (which is intense both financially and psychologically) in terms of caretaking. Not to mention that the patient would actually possibly survive.
  5. Monolithic domes are cheap to construct, and well suited for cold storage warehouses. This is not the same thing as cryogenic warehouses; the engineering requirements are more stringent, but their use as a cold storage room at -135C does not seem implausible. The first of such cryogenic warehouses to be constructed would be more expensive than the last due to development requirements for a robust cryogenic storage system. I do agree it would realistically be kept to a smaller scale than national or continental -- municipal seems reasonable. The warehouses would need to have an automated pack-and-place mechanism for easy storage and retrieval, which could be maintained externally. Patients would be stored in crates which can be added in through the top and moved into place by an automated crane. Retrieval of specific patients would require that all crates stored on top or in front of them would need to be moved, but should be feasible if necessary. Other kinds of cryogenic goods could be stored in the same warehouse temporarily in similar crates until enough patients are accumulated for it to pay for itself.
  6. Large scale facilities would cost less because they do not need to be kept at liquid nitrogen boiling temperature, only at the glass transition temperature. The heat sink effect of the large amount of thermal mass comprising the structure and other patients would prevent it from fluctuating without the necessity of LN2 boiloff. Patients would also benefit from this in terms of reduced or eliminated cracking effects.
  7. The only energy (heat) source in the plant would be the crane. There could however be explosive potential depending on how the building was kept cool. If there is an LN2 pipeline or tank involved, that would be something that needs to be engineered very carefully. This is potentially an argument in favor of (multiple redundant) electric coolers. On the plus side, cryogenic engineering is a fairly mature field and LN2 storage is commonplace at hospitals. I don't think the required level of precautionary spending would be nuclear plant levels.
  8. Monolithic domes are extremely stable against tornados, hurricanes, and earthquakes. Additional earthquake proofing could be added below ground to help ensure that patients are not jostled too much, as is done for hospitals, but my guess is we're talking a few million dollars for tens of thousands of patients if not better.
  9. You mention halving the neuro storage cost. But logically you are either saying that storage costs would go to half across the board, or that full-body costs go to half that of a neuro. If neuro is 1/7th of full body, this implies that the cost is 1/14th, which is pretty significant.
  10. Whether we like it or not, the wealthy, to maintain their place in the status hierarchy, would tend to spend dramatically more than the publicly-funded or middle class, just as is the case with medicine today. Spending several million on a cryopreservation with a tiny chance of working better is not a big deal for a billionaire, any more than buying a private jet would be. To some degree this subsidizes the infrastructure and research for the less privileged classes.

Finally, it bears emphasis that even if you're right and the costs do tend to rise dramatically from the causes you are suggesting, most of them imply much better cryonics. The worst cryonics then would be better than the best cryonics today. Furthermore they would naturally evolve into a suspended animation style cryonics as soon as reversible suspension is developed, ensuring that hardly anyone "dies" of aging, cancer, etc. once that milestone is achieved. As it stands, if true suspended animation were discovered tomorrow, cultural (and financial/organizational) inertia would keep most people who could benefit from signing up for it for decades to come. Thus in terms of cost per unit value delivered, I would still maintain that universal cryonics scales very well.

Comment author: handoflixue 08 August 2011 07:02:36PM 4 points [-]

Thank you for the very insightful response!

The main trade off, I think, is whether we view cryonics as a medical procedure or a universal human right. Your numbers seem spot-on if we're trying to prevent every single death, and pessimistically assuming that cryopreservation must be done immediately after death.

If instead this is simply a medical procedure for those that can be saved (such as current treatments for heart attacks - rushed to a hospital, but without any special standby), or something that people routinely volunteer for when their health is failing, then you'll be eliminating a large chunk of those costs.

Equally, if vitrification is shown to be effective even a few hours after death, then much of the expense from urgency disappears.

It's also worth noting, as Isparrish pointed out, cryonics can simply move money around that's already being spent - a heart attack patient is going to be rushed to a hospital regardless of whether or not cryonics is an option. Maybe people will be less blase about death thanks to the prospect of immortality, but right now people risk death due to heart attack, smoking, and a myriad of other ostensibly preventable causes. On the other hand, if they're less blase, they're probably also willing to spend more on it :)

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