Everything I Need to Know About Cryonics I Learned in Kindergarten

Local cryonics groups have a checkered history of fits and starts, of
good intentions gone awry, of high hopes cruelly dashed.  It's not
just that there isn't enough money.  Not enough people are cooperating
or playing fair.

The Service Gap in the Hinterlands.

Because cryonics in the United States is an infant industry with a
market of 400 or so suspension members nation-wide, it suffers from
terrible diseconomies of scale.  400 widely scattered cryonicists can
support only so much investment in cryonics technology and expertise.

The compromise adopted by the national cryonics organizations offering
cryonic suspension services is to perform the first phase of a
suspension -- on-site stabilization -- with a mobile team, and the
second phase -- cooldown, perfusion, and storage -- at a home base.

To minimize warm ischemia and maximize the patient's chances for
recovery to life and health, a stabilization kit and trained personnel
are needed on-site when the patient deanimates.  For a patient
deaminating far from the home base, sufficient notice of the impending
deanimation is needed; otherwise the mobile team and its kit won't get
there in time.

Should the national organizations invest in on-site stabilization
technology and expertise to ensure reliable, rapid-response
stabilization service?  The initial costs of stabilization equipment,
supplies, medication, perfusate (organ preservation solution), and
training can reach $20,000.  Recurring costs (including replacing
expired perfusate and medications) are on the order of $4,000 or
$5,000 per year.  However, if perfusate and medications are financed
from suspension fees rather than expiring, annual unfunded costs are
reduced to $1,000 or so per year.

With a local kit and expertise in place, a national organization can
save thousands of dollars, primarily in equipment air freight and the
mobile team's air fares.  For example, a national organization in the
West saves about $4,000 per cryonic suspension in the East if two
mobile team members and all stabilization equipment and materials stay
home.  The national organization can save additional dollars if there
is a "false alarm."

The national organization has no financial incentive to acquire
and maintain a local presence until the deanimation rate among
its suspension members in the locale is so high that the annual
savings outweigh the initial and recurring costs.  In the East, the
deanimation rate would have to be one and one-half or two persons per
year.  In other locales closer to the home bases, the savings are
less, and an even higher deanimation rate is required.  The service
gap is widened where competing national organizations have split the
local suspension membership.

Bridging the Service Gap.

To bridge this gap, local cryonics organizations in the hinterlands
have to provide local stabilization technology and expertise
themselves.  They have to drive down initial and recurring costs, find
ways to finance those costs, and recruit additional suspension members.

The local organizations need not provide full stabilization services.
For instance, a local organization could acquire and maintain all
necessary equipment and supplies, train all personnel needed for
standby and "initial stabilization," and rely on the national
organization's perfusionist to fly in and lead the local team in
"total body washout," which follows initial stabilization.

Cost reduction, service improvement, and membership growth are
mutually reinforcing, and should be pursued concurrently.  Cost
reduction creates the opportunity for additional investment in service
improvements.  Effectively advertising service improvements attracts
new suspension members.  Membership growth leads to economies of
scale: as the number of suspension members in an area increases, the
cost of providing given technology and expertise also increases, but
not as quickly, and costs that are indivisible do not change at all.

Economies of Scale from Regional Cooperation.

Two forms of cooperation create economies of scale that accelerate the
cycle of cost reduction, service improvement, and membership growth.

The first form of cooperation is among cryonicists in a region.
Certain services can be regionalized through inter-local agreements,
the expansion of an existing organization, or the creation of a new
organization.

Tapping a regional membership base in this manner creates two
economies of scale.  The first type of economy is more effective use
of, and greater continuity in, leadership, talent, and stabilization
expertise.  A larger group would be less vulnerable to fits and starts
brought about by deanimations and changes in personal status.

The second type of economy is a decline in the cost of service per
suspension member.  The Northeast offers an example.  Cryonics groups
in New York, Boston, and Washington, D.C. have operated independently
up to now.  Without regional cooperation, each group needs a complete
kit, which includes a package for initial stabilization and a
package for total body washout, including perfusate.  With regional
cooperation, three initial stabilization packages might still be
needed, but the entire region could get by with a single total body
washout package and pagers or some other emergency notification
system.  The Life Extension Society has suggested the creation of a
company, the Cryonic Rescue Service, as a means to institutionalize
regional cooperation in the Northeast.

Economies of Scale from Perfusate Rotation.

The second form of cooperation is rotating perfusate among national
and local cryonics organizations.  The purpose of perfusate rotation
is to ensure that all supplies held by cryonics organizations are
used, thereby reducing perfusate cost and increasing perfusate
availability.  At a cost of $2,500 and with a shelf life of only
one year, a perfusate supply is too precious to waste.

Let's use an example.  Each of two national organizations performs two
suspensions per year, for a total of four suspensions per year.  The
shelf life of new, improved perfusate is two years.  Using the equation

INVENTORY = DEANIMATION RATE x SHELF LIFE

the maximum inventory of perfusate supplies is eight.  Each national
organization could keep a supply for its mobile team to use, and up to
six local organizations could keep supplies on hand as part of their
service.

An independent organization would operate the rotation network.  The
perfusate supplied would meet the specifications of both national
organizations.  The supplies closest to expiration would be rotated
to the most frequent users.  Immediately after a stabilization by a
frequent user, an infrequent user would overnight mail its supply to
the frequent user on dry ice, at a cost of about $150.  The network
operator would replace the infrequent user's supply within a few days.

In this example, perfusate rotation prevents three supplies per year
from being wasted.  Total cost, including the cost of overnight
delivery, is cut by one-third or more, depending on perfusate cost,
and a new supply is just an overnight package away.

Savings and the availability of perfusate would increase with an
increase in the deanimation rate nation-wide.  Perfusate rotation will
continue to make sense unless the cost of perfusate drops dramatically.

Fairness in Financing Initial Costs.

Cryonicists far from the national organizations' home bases have an
incentive to invest in stabilization technology and expertise long
before a national organization would find it feasible to do so.
On the other hand, national cryonics organizations save when local
organizations provide stabilization services.  A way must be found to
equitably share the initial and recurring costs of local stabilization
services.

To finance initial costs, a local organization must rely largely on
living suspension members.  One problem is that some members seek to
obtain a "free ride," that is, to benefit from others' investment of
time and money.  However, with so much at stake, a local group is
loath to withhold service from the free riders, so free ridership
persists.  By maximizing the participation rate among living
cryonicists, a local organization can reduce the cost per participant,
contain the free rider problem, and maximize investment.

The key to widespread participation is to give investors something for
their money and/or enable investors to liquidate their investments.
One mechanism for obtaining widespread participation is the sale
of shares in a stock corporation owned and controlled by local
cryonicists.  Purchase of shares brings ownership and voting rights.
An investor may liquidate the investment by selling his shares.  The
local organization may desire to limit shares per person in order to
maximize participation and minimize inequities.  The Life Extension
Society has suggested the creation of one such company, the Cryonic
Rescue Service, to finance and provide stabilization services in the
Northeast.

Fairness in Financing Stabilization Readiness.

Where a local organization has developed rapid-response stabilization
services, a national cryonics organization will agree readily to pay
for the replacement of supplies, medications, and perfusate consumed
during a stabilization.  (It also will contract with individuals for
their services during standby and stabilization.)

Simply replacing consumed materials is not enough, for two reasons.
First, the fixed, recurring costs of local stabilization services are
ignored.  These costs include the costs of replacing obsolete durable
equipment, replacing expired perfusate and medications, retraining,
and administration.  Without a stable funding source for recurring
costs, a local organization will suffer a financial hemorrhage and die.

Second, a national organization's savings in suspension costs (air
freight, air fare, patient shipment, etc.) that are created by the
availability of local stabilization services are ignored.  At the
expense of local cryonicists, the savings accrue as a windfall to the
national organization, the suspended patients, suspension members in
the area, or suspension members nationwide, depending on whether and
how the savings are reflected in the national organization's fees.

Most revenue sources that a local organization might explore are
unreliable or unfair.  For instance, contributions are unreliable.  If
suspension members are charged annual local readiness fees or patients
are charged one-time local stabilization fees, the members or patients
simply are sharing the pain (or seeking a free ride) while the
national organizations retain their windfalls.

The fair thing to do in this circumstance is to pass the savings
through to the local organization, not to keep the savings or pass the
savings through to patients or suspension members.  The pass-through
could be in the form of an equipment rental fee.  Presumably the
national organizations would rather pay after stabilizations take
place (since that is when the savings are realized) than pay an annual
readiness fee.

With a contract or contracts in-hand for savings pass-through, the
local organization can assure prospective local investors that it
will be able to stanch the financial hemorrhage over time, thereby
triggering the cycle of service improvement, membership growth, and
cost reduction.

Savings pass-through seems to be a "wash" at best for each national
organization.  However, each national organization is under
competitive pressure to provide the best service possible, and a
national organization that fails to contract with a local organization
to offer rapid-response stabilization service may lose market share in
that locale.

Fairness in Pricing of Suspension Services.

As things currently stand, each national organization charges uniform
prices across the Nation for cryonics suspension services.  Since
far-off services cost more in air freight, air fares, and patient
shipment, among other things, this practice creates cross-subsidies
between nearby locales and far-off locales, with the national
organization making money in nearby locales and losing money in
far-off locales.  In locales where one is losing money, it is tempting
to cut corners or take risks that adversely affect the quality of
service.

If cost differences were reflected in suspension fees, the fees
for far-off suspension members would rise and the fees for nearby
suspension members would fall.  Cost-based pricing eliminates
cross-subsidies and the temptation to cut the quality of service
in far-off locales.  All other things being equal, a national
organization that adopts cost-based pricing plus pass-through of
savings is able to enhance its competitive position by reducing the
price of suspensions in nearby locales and by improving the quality of
stabilizations in far-off locales, where quality of service is a key
consideration.

A New Model for Local Stabilization Services.

Local cryonicists have an incentive to invest in acquiring and
maintaining stabilization technology and expertise long before a
national organization would find it feasible to do so.  They can drive
costs down and maximize investment and membership growth through the
economies of regional cooperation and cooperative perfusate rotation.
They can distribute initial costs equitably through the sale of shares
in a local, cryonicist-owned company.  They can reach agreements
with national organizations to repay the costs of materials used in
stabilizations.  However, their efforts be wasted if they cannot
stanch the financial hemorrhage of recurring costs.  For this, they
need to capture the savings that the national organizations, their
clients, or deanimated patients otherwise would obtain as a windfall
from the local investment.  For its part, each national organization
can enhance its market share and competitive position by pricing its
service fairly and passing through cost savings to the local
organizations that create the savings.

It all seems so clear now.  To succeed in saving lives, we need to
cooperate with each other and to play fair.  Everything I need to know
about cryonics I learned in kindergarten.