#26

I can agree in theory, that “the gap in technology and healthcare available to the plebs and the elites has only reduced over time”, but the key word in that sentence is “available”. It doesn’t seem to be really available. (I guess just like annual full-body MRIs for cancer detection are not truly “available” for everyone). Otherwise the gap in growth of life expectancy would not be getting larger, as it currently is.

The best evidence is that the gap in growth of life expectancy is not “reduced” - it’s large and getting larger. The rate of increase in lifespan for the top 5% is already ~10X faster than that for the lowest 5%. And the gap (in annual growth of life expectancy) is getting larger, not smaller.

So things are currently trending to be more disproportionate (not less) and are diverging rapidly already. The question is what would change these current trajectories? With even better longevity technologies - why would the gap not grow even faster?

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In the United States between 2001 and 2014, higher income was associated with greater longevity, and differences in life expectancy across income groups increased over time.

Source:

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#27

As a general point on the graph… in am exponentially developing world such simple extrapolations are likely to prove naive. For example one exponential curve ball is the impact of AI drug development

In a superintelligent AI world, patent law may become obsolete/superfluous. Medical advance may become so rapid that patents no longer provide meaningful economic value (what’s the point of holding a medical patent for 10 years when the treatment is obsolete with 1 year, or less… would Eli LIlly have developed mounjaro if an equally effective tablet form was only months behind?)
The risk is that capital seeks out a return though secrecy rather than patent protection. In that world cutting edge medicine will take place in one of the few nations outside the current IP framework. Or maybe the whole IP system will collapse.
The proposed curve above could ultimately depend on cyber security. One breach of the secret formula and suddenly everyone’s on it

#28

Straightline projections are the bane of forecasting since time immemorial. The famous anecdote of how it was projected that with increased population and traffic in NY, there will be increased need for horse carriages, but given the space limitations of streets, the city will inevitably drown in horse manure. Of course, they didn’t count on automobiles. But this straighline projection is literally everywhere. Never is any thought given that we live in a dynamic system, and any development is not simply going to go on blithely trees growing to the sky. There is interaction in a dynamic system, so complex, that most of the time forecasting is literally impossible except in very constrained circumstances - the earth will keep revolving tomorrow. Science fiction writers are an example. Jules Verne thought that since a bigger cannon can shoot higher a BIIIIIG cannon can shoot a man into the moon. Not taking the impact on a human body into account. If I put one brick on top of another, I might eventually reach a considerable height, but our straight line projection fans are already talking about the bricks reaching Mars and eventually other galaxies. The equivalent of this straightline projection is a hallmark of all these forecasts, panics and predictions. Just look at the history of what people thought - often the most eminent scientists of the day - the future would look like… it’s straightline projections all the way and of course laughably wrong, never panning out.

Same here. We live in a dynamic system. Straighline projections fundamentally are flawed in principle. Stop. You can only be wrong. This applies abundantly to AGI. The projections bandied about AGI are so laughable, but at the same time depressing, because apparently humanity learns nothing from the march of technology and the past mistakes of straightline projections - and in the case of AGI augmented with almost a complete lack of understanding of the subject matter by the so-called “experts”. Depressing.

Meanwhile, look at reality. Do you really have to be a billionaire to get a full body MRI? What secret super expensive longevity treatment is available to billionaires that is not available to anyone on this site? Provable longevity intervention - CR… only available to billionaires? I’ve been on it for 8 years and never during that time have I managed to accumulate a $billion, not that I’ve tried or cared. And then we have the only other maybe LE, rapamycin - I wonder where my billions are, as I feed rapa to my cat.

Chemical synthesis processes are only getting cheaper - I don’t think you have to be a billionaire to manufacture any molecule. Tools to manipulate genes only getting cheaper. Remember when it took hundreds of millions to get the genome sequenced? The cost of getting your genome data is now affordable to any trailer park resident. Technology is all about dropping costs.

Now we are supposed to imagine how there is this liquid unobtainium mined in the deepest gold mines on a diamond encrusted planet that only billionaires can afford to prolong their lives. What a silly idea. If it’s available to billionaires, it’s available to almost anyone.

The problem is, as always, information. Billionaires have to be able to know what they’re getting. It doesn’t look like Bryan Johnson has a clue. Through history, there have always been kings and magnates and quacks who promised them health and longevity. How would the king know a quack is a quack? And no king or magnate got to cash in on their quack investment. The billionaire is in no better position than you or me when it comes to judgment and information.

I don’t fear billionair “health gaps”, seeing as billionaire after billionaire croaks at a disgracefully early age. The limit and deciding factor is not money, but information, and that is available to all.

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#29

Yes, you know what they say… :wink:

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But really, we’re talking past each other. I’m not saying any single drug or therapeutic will be unaffordable to all but the billionaires. I’m saying that in totality, the billionaires (as a category of consumers) will have the ability to adopt therapies earlier, repeat them more frequently, and mitigate risks through intensive monitoring, with better and more medical professionals to help… and this will likely drive a significant and growing gap in annual growth in lifespan between them and the rest of society.

So far I’ve seen no good argument against this hypothesis. These are not so much “forecasts” as statements on human nature.

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#30

You make an interesting case. Underpinning this is the assumption that the new therapies are increasingly effective and/or increasingly rapidly developed. That does seem likely, thanks to AI and the wave of capital hitting the sector. But the consequences of exponential AI advance will complicate things enormously and unpredictability. Your logic may be sound, but the effect may still be overwhelmed by other factors.

I mentioned the collapse of the medical patent system above. that alone could lead to a much more rapid rollout to a mass market than is currently the case.
Also cheaper AI drug development may democratize medicine development in unpredictable ways.
Also Early adoption is inherently riskier than later adoption, which may disadvantage billionaires. And/or advantage poor risk takers with less to lose.
Also efficacy of treatments may develop incredibly rapidly for a few years and then plateau for some unpredictable reason. By the time we have super AI the above chart might collapse into a couple of weeks rather than 100 years.
Or it may be that we develop preventative ‘miracles’ before treatments. And so being under 40 may be a much better predictor of lifespan than wealth.

On balance though I think having a $2m dollars spare would be a sensible hedge against the effect you describe. And maybe $2bn would be better.

I recently spoke with a researcher in t cell therapies at a local UK firm. they are opening their first clinic in Saudi, to tap the super HNW market defined as able to pay $1-$2m for a treatment. The real money though, is to be made scaling this to target the global 1%. (the 80 million people with total wealth above $1m) That’s where they aim to make the most total profit at the nexus of pop size and wealth. By then any given t-cell therapy will be vastly cheaper but only after a “3 to 5 year” wait.
Time to start saving…

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#31

I am pretty sceptical that you can significantly benefit from a treatment that is so new, it costs $2mil. Odds are you’re a guinea pig. And once the “treatment” is well established and the bugs worked out, it no longer costs $2mil, and the middle class can afford it. Even “expensive” treatments that work, the critical point they provably work, and costs as much as therapeutic blood transfusions (which we have no definitive proof work!) so say, anywhere from $10K - $30K, almost anyone on this site could likely afford. If there was a treatment that provably added 5 years of lifespan, who here would not be able or willing to pull together, say $100K? That’s not even millionaire money. For extra class credit: please name a therapy TODAY that has a high chance of adding even a year to your lifespan, and costs $100K? Exactly none, today, and I bet for the foreseeable future.

The “gap” scenario just sounds stupid. So you are telling me that there will be a rash of $2mil treatments that most wealthy are going to get and most middle class can’t afford and so a “gap” of 5 year lifespan will pop up? It will have to involve huge numbers of people on a population level to observe a statistically significant “gap”. So most wealthy people are flocking to clinics all over the place for $2mil treatments, while the middle class stands outside the glass door enviously looking in? Yeah, I don’t think this scenario is plausible outside a feverish screenwriter’s imagination.

I think this whole “gap” thing opposing billionaires(!) who live a long gap while the rest - even mere millionaires - weep, is just plain bunk, with zero plausibility. The title of this thread is already disqualifying. There are no likely longevity treatments that only billionaires could afford or a resulting “gap” or “escape velocity”. That’s laughable.

#32

Whatever the outcome, it’s better to have extra $2 mlns than not to have it. Even a piece of mind when there’s no financial burden would contribute tremendously to better sleep and better life overall.

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#33

You make some good points. As an example of expensive treatments with decent evidence… In the UK various Car-T immunotherapy treatments are offered for cancers but the funding is on a cost benefit basis.

Due to his age, Rupert Murdoch might not qualify. But I think he’d be able to find the $400k treatment privately.

A wave of immunotherapy treatments are coming for everything from autoimmune disease to Parkinson’s. And the cost will initially be potentially a lot higher. Sooner or later there will be regenerative treatments too.

In terms of ‘the gap’. If I were a billionaire with Parkinson’s I’d be tempted to be an early adopter and spend $1 to 2m. For a regenerative treatment? Even as a billionaire, I’d probably eat some sardines, take some rapamycin and wait for more safety data. And then get the same treatment for $400k 2 years later.

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#34

Actually, going whole foods plant based is much cheaper AND can add years to your life! I used to have polyps at every colonoscopy until I gave up animal products and started eating real foods- veggies, beans, fruits, nuts and seeds…Haven’t had a polyp now for several years! Cholesterol and blood pressure low, and sometimes I force myself to eat more so I don’t get too thin…Who needs GLP-1!

-Fawn

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#35

That’s the point, isn’t it? Whatever intervention that exists today which has some reasonable evidence for it wrt. longevity, well, it is readilly available to most middle class people, certainly you don’t have to be a billionaire. And there isn’t some out of reach $100K therapy that has good longevity evidence for it.

Of course, there’s always the question of what is provably a longevity intervention. There will be those who will claim that no diet is going to have such an effect. That view says that diet can only shorten your life, but not lengthen it. If your body is builty for 85 years, at best with a brilliant diet and everything else going fine, you will last 85 and not a day longer. Meanwhile, you can have a very poor diet and last only 75.

The distinction between reaching full biological potential and extending that potential is what’s at stake. A mouse is built for 900-1000 day lifespan. If you feed it poorly, with poor husbandry, you can have it last only 650 days (the bane of many labs, which have terrible mouse husbandry and the resulting research is poor to say the least). But with optimal husbandry it’ll last its full potential of 1000 days. To get more now you’re talking true life extension treatments, be it CR or rapamycin and now you got a mouse that lasts 1400 days. That’s true life extension. Where is the therapy that gives us the equivalent of a 1400 day human LE and costs $100K? There is none. No matter how much money a billionaire throws at it - at least curently, and I suspect for a long time yet. In fact we get back to the original thesis - I don’t believe that there is a “health and longevity gap” between what’s available to a billionaire and a well informed middle class person, nor will there ever be such, certainly not sustainable for any consequential period of time.

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#36

I’m on plant based food as well and have never had a polyp.

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#37

I believe polyps are more likely a result of genetic factors. No matter what I do that supposedly reduces polyps, I still have the same number of polyps every 3 years when I have a colonoscopy done.

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#38

While you can argue about the evidence (heterochronic parabiosis research is only in rats and mice, for the most part)… I bet that “young blood plasma” is one therapy that meets your criteria… Do it frequently (say weekly, 5 liters) and the cost would be well over $100K per year.

While the data is still early, and you aren’t ever going to see lifespan data generated in humans due to cost and practicality, it seems like a “reasonable bet”.

Of course, any therapeutic that has a not insignificant cost (e.g. over $1,000 per month) is going to start to add up over time, especially when you consider a full stack of interventions and ongoing regular testing to track progress.

From ChatGPT:

in mice, **heterochronic parabiosis (HPB) has shown a small but real survival benefit for the old partner in at least one rigorous study—on the order of ~6–10% median life-extension. Details below.

What’s been demonstrated (old mice)

  • ~6–10% longer median lifespan after 3 months of HPB followed by detachment.
    • The primary paper reports a +6 weeks shift in median survival (and +2 weeks in maximum survival) relative to old isochronic controls; press materials from the authors translate this to ≈6–9% (some say “~10%”). Smithsonian Magazine+3Gwern+3Harvard Gazette+3How to read that: In the study, old mice (20 → 23 mo during pairing) detached and then lived ~6 weeks longer at the median than controls; authors also show improved healthspan and multi-omic “rejuvenation.” Gwern

Practical range to cite today

  • Old partner (HPB): roughly 0% to ~10% median life extension across published studies to date, with the best outcome (long-term HPB + detachment) in the ~6–10% band and others showing 0%. Maximum lifespan effects are small (~1–2%) in the positive study and nil in others. Gwern+1

Note: These figures are mouse data and protocol-dependent (pairing duration, ages, surgery/aftercare). Harms to the young partner are a recurring finding in negative/neutral studies.

PCSK9 Gene Therapy

How about this one:

Emerging PCSK9 Gene Therapy Costs

  • Novel Approach:

A new form of gene therapy called a PCSK9 base editor is being developed to provide a one-time treatment to permanently reduce levels of PCSK9.

  • Projected Price:

Ark Invest’s analysis in 2025 estimates that a one-time gene-editing therapy for cardiovascular disease could cost around $165,000 per patient.

  • Potential for Broader Use:

While expensive, this cost is a single-treatment expense, potentially offering a different economic model compared to the ongoing annual costs of PCSK9 inhibitors.

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#39

From today’s Financial Times of London:

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Why 94 is the new 54 for moguls

The careers of moguls are growing to unprecedented lengths

Rupert Murdoch’s media empire will pass to his eldest son Lachlan when (or if) the 94-year-old mogul dies. Rupert’s mother lived to 103, but that was before modern medical advances. Warren Buffett, who will step down from Berkshire Hathaway by the end of this year, aged 95, remarked recently: “I didn’t really start getting old, for some strange reason, until I was about 90.” Giorgio Armani told the FT, days before he died at the age of 91, “My greatest weakness is that I am in control of everything,” right down to micromanaging a museum exhibition.

These men seem to be trying to make reality of the old Woody Allen joke about immortality: “I don’t want to live on in the hearts of my countrymen; I want to live on in my apartment.”

Moguls’ careers have grown to unprecedented lengths, thanks partly to innovations like stem-cell therapy and blood washing. This is helping to create a near-permanent power class of businesspeople who accompany us through our lives the way only a few royals did in the past. Murdoch, for instance, inherited his first Australian newspapers from his father in 1953, and has been influencing British politics since he bought the News of the World in 1969. These men tower over most elected politicians in the west, whose life expectancy in office might be four years or less.

Longevity is its own kind of power. When a newly elected head of government enters the global engine room, admitted on their temporary pass, they encounter a few dozen life members who have been there for decades, are planning ahead for decades more, and know exactly how each lever of power works. These men own the websites where most voters spend their waking hours and have the networks and capital to buy control of each new technological trend. Note that two of the leading moneymakers from AI so far are Larry Ellison (aged 81) and Les Wexner (88).

“Sit down,” the life member will tell the nervous newbie, whose membership of the engine room he may well have sponsored. “Don’t step on my blood-washing tubes. Now, what can you do for me?”

Read the full story: Why 94 is the new 54 for moguls (FT.com)

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"Why 94 is the new 54 for moguls"
#40

Peter Thiel has been one of the most prominent tech billionaires backing the longevity space with serious investments. This is an interesting and contradictory article about his most recent interview (Antichrist, Third World War, stagnation, etc.)

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#41

Have you had a vegan / @drfawn typenog diet for 4-5 year period?

Totally agree that genetics is a big part, just wonder how much we can modulate around that

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#42

I’ve been vegan for about a decade. As Dr Michael Greger says, “Genetics loads the gun, but diet and lifestyle pull the trigger…”

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#43

Or lifestyle loads the gun but genetics pulls the trigger at the end. How about that?

#44

Frequent HBOT seems to be one of BJ’s most successful interventions. At $100k for a device that can be used with the frequency he uses it - that is for the rich

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#45

If it works well, and you use it with high frequency, it is actually not that expensive.