One of the irritating things about money is that its value, and the extent to which you can top out your use for it, very much varies according to your passions.
For example, both Charles Stross and I are creatives with a passion for telling stories - but the media we strongly prefer have pretty dramatic effects on the utility of money for both of us.
He mentions having already effectively topped out on the utility of cash for him - as a novelist, there's a limited extent to which more money helps him fulfil his passion.
By contrast, the utility of cash for me tops out around the $300m / yr mark, that being the cost of making and marketing a top-end feature film every year. Below that, there is definitely utility in every dollar as far as Doing What I Like goes - although of course diminishing returns still apply.
And for some people - like Elton Musk, whom he mentions - there is effectively no top end in sight. If your passion is to get to Mars, you really don't hit a point where more money wouldn't be helpful.
Some people don't actually have that money. It's all a money merry-go-round of debt and credit and weird financial instruments and shell companies in tax havens. It doesn't take much for it to all go wrong.
For a small (tiny?) number of people their estimated worth or their position on some 'rich list' is equivalent to HN karma, or reddit karma - meaningless but strangely compelling.
William Gibson[1] has a nice take on the super rich. Those weird families cloning each other and living in space colonies or engaging in high concept 'pranks' against their enemies.
If you meet somebody who literally cannot get enough food, it's pretty easy to recognize that there's something wrong. If their desire to eat wrecks relationships, causes harm to their health, makes it so that all they can talk about is the next meal, you say: that's not right.
But when it's money, it's much harder to recognize that insatiability is a sign of pathology.
That's not to say that all hyper-rich people are pathological. For some it is indeed a favorite game (Buffet) or a tool for big plans (Musk) or the result of doing something they loved (Page and Brin).
But having worked in the financial industry, I have met people for whom the desire to amass incredible wealth is a sign of deep, deep problems.
> Another example: the late Steve Jobs. Doubtless he received the best medical care that money could buy—but it wasn't enough to save him because a cure for his pancreatic cancer didn't exist at any price.
I'm not a Jobsologist, but didn't he eschew traditional treatment in favour of alternative medicine for something like 9 months?
It was actually not quite as bad as it was represented in the press. The cancer was diagnosed in 2003. He avoided surgery for nine months and had surgery in 2004 - when it was still stage 1. That surgery was apparently successful. The cancer had certainly not metastasised in any detectable way at that point.
From stuff his family has said, and from what his biographer said about his interviews with Jobs, the primary driver for the delay was an almost phobic fear of surgery rather than "alternative medicine will cure me". This is surprisingly common from conversations I've had with some cancer treatment folk. I knew a family member who unfortunately had similar feelings :-/
The kind of cancer Jobs had was a rare and slow growing pancreatic cancer. Normally if you get diagnosed with pancreatic cancer you are in surgery later that bleeding day if at all possible. For pNET tumors longer delays of weeks or even months aren't unknown (not recommended either mind - but not insanely stupid).
(as a separate point - I love how all the reporting around Job's cancer was that it was a "rare cancer" presented in the the "ohhh rare and scary sense"... if you have to get pancreatic cancer a pancreatic neuroendocrine tumor like Jobs's is the one you want to get).
The alternative medicine didn't make it worse in of itself.
The delay in surgery may have made it worse - but it's not certain. The five year survival rate for that cancer, when treated by surgery, is still only 61% at stage 1 (see http://www.cancer.org/Cancer/PancreaticCancer/DetailedGuide/...). Steve lasted nearly nine years.
Was the 9 month delay in surgery a sensible thing? Almost certainly not. But the real story was a long way from the "Killed by alternative medicine" line that hit the press. Even if Jobs had had surgery the day he was diagnosed, it would most likely have ended the same way.
He seems to make the implicit assumption that you can only spend money on goods, and not services.
I have all the Stuff I could need or want (save maybe an rMBP instead of my Air, or a new camera or something), but if I had more money I would almost certainly spend it on things like airfare, hotels, seed-stage investments, and the like.
There's a lot more one can do with money than "buy stuff to fill up one's house" or "fund research".
WRT this: "I have three answers." I would add a fourth answer: the stupendously rich have a lot of assets in stock and so on that's not really about the money, per se, but about control. It doesn't seem like Zuckerberg, or Gates before him, deeply cared about having 1x billion + z billion; they cared about having control over Facebook and Microsoft, which happens in the form of stock ownership.
However, I don't see this as the motivating factor for the person Stross mentions in his last paragraph, so, to the extent the post is mostly about that paragraph, I don't have a great answer.
It starts off interesting, but ends a bit abruptly. If possible, I would like a little more at the end about your thinking about all this, some philosophy etc. (Unless it was all a political jab).
PS. Mitt wants what ALL politicians want. A roof over his head, food on the table, running water and unlimited power.
I think it's very unfair to portray all politicians that way. For example, where I live, we have three parties which have been sharing the powers since the transition to democracy (38 years ago), three others which don't go above 7% of the votes, and thirteen others which don't get a single seat in the Parliament.
Do you really think that the leaders of those parties are after unlimited power? Or any power at all - the PM's maid has probably more power than them.
Or for another example, take the current leaders of Communist Party USA, and all the power they have.
Any of those would have a much greater chance at power if they joined the bigger parties.
I'm wondering who in his right mind can like this particular politician. Mormonism (as recently said in Sam Harris' last post) is as crazy a religion as you get; and it all goes downhill from there. Geez, even Clint Eastwood admitted in cover words that he wasn't taking his party's candidate seriously.
(I'm European BTW; as you know, something like 80 or 90% of Europe would vote Obama without thinking twice about it according to the polls).
Harris is really not the best source for information on the craziness of Mormonism, both he and Dawkins can't get their facts straight on several key issues.
I'm a 'Mormon' and it's obvious everytime they open their mouths on the subject that they are as unaware on the nuances of the theme as creationists are with the nuance of Natural Selection.
"Mormonism (as recently said in Sam Harris' last post) is as crazy a religion as you get;"
Come on, what religion isn't crazy in reality? Grading each religion on their value based on their "crazy factor" shows most of the world's religions would get a failing grade.
I'm an atheist, thus of course I thik all religions to be crazy; however many have for them at least the fake lustre of ancient venerability, and the excuse of originating from simpler times where the relation to magic and miracles were different.
Steven Randy Waldman of the blog Interfluidity has a great post which makes the case that "Wealth is about insurance much more than it is about consumption."
It's a great insight, and the thought experiment to "[c]onsider a libertarian Titanic" is illustrative.
(Though, it's a unfair slur to label the scenario 'libertarian', as that word does not mean 'everything is reduced to dollar purchases' except in a caricature promoted by critics. Just calling the scenario a 'pay-to-play Titanic' would be descriptive without extra partisanship.)
This makes me think actual insurance would work better:
"If there is drought terrible so terrible that there simply isn’t enough for everyone, the right to live at all may be rationed by price, survival of the wealthiest."
Sustenance insurance ought to be much easier to get than staggering wealth.
The examples he give seem to be more about "money can't buy everything" instead of diminishing marginal returns.
Under diminishing marginal returns of Stuff, I would have expected something akin to "Gadget A generation n+1 is only an incremental improvement over Gadget A generation n, we should aim to build Gadget B instead".
This is one of the major reason for mandatory wealth redistribution (= taxes etc.). It makes poor people significantly better at the expense of making rich people slightly worse off. The society as a whole benefits from this.
Expanding on the part about wanting to buy therapies but not being able to - a place where rich and poor are in a similar boat, but it isn't the same boat, as suitable wealth means you can start to do something about the environment of research, not just live in its shadow:
[Of] the world's high net worth individuals, most [do] very little in the way of funding research into aging or the conditions of aging. [Or any other medical technology for that matter]. It is their inaction that is opposed to their own self-interest: they are all aging to death at the same pace as the rest of us, after all. When it comes to access to medical technology the world is remarkably flat: the poor struggle in this as in everything else, but the wealthy have no more ability to buy a way out of aging (or heart disease, or cancer, or any of the other conditions that attend aging) right this instant than does anyone else. What they do have is a far greater ability to create a near future in which rejuvenation biotechnologies exist and are just as widely available as any present day clinical procedure.
It is in the self-interest of everyone who can significantly speed up the development of ways to reverse aging to set forth and do exactly that - but very few are making the effort. [Consider Ellison's medical foundation, or Thiel's funding of SENS as some of the few, lone examples]. At some point it will become evident to the public and the world at large that aging to death whilst surrounding by wealth is insanity in an age in which those resources could be used for the development of age-reversing medicine: ways to repair mitochondrial DNA, break down accumulated metabolic byproducts that clog up cells, clear out senescent cells, restore declining stem cell activity, and so forth. But as yet this is not obvious enough to those people who matter.
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Expanding on the part about vision versus the drive to gain greater amounts of money: it's a challenge and a rare thing to be both a zealot and very wealthy. The roads to being these things are both long and quite different; either is a process more than a thing you are:
My suspicion is that it is not just longevity science that looks in vain for wealthy zealots, but that in general any grand cause that people can feel very strongly about also lacks wealthy zealots. It seems to me that there is in fact little overlap between the small population of zealots for a cause, people willing to devote their working life and significant resources to a grand project, and the small population of very wealthy people, those with a net worth of $100 million and up.
We can speculate as to why this might be. For example, I might try to argue that the sort of person who can successfully run the long and unlikely process of becoming very wealthy is the sort of person who doesn't think about what they can do with money. They are not doing what they do for money, and the process is their passion. Someone who was a zealot for a cause would have stepped off that process long before reaching the possibility of attaining a very high net worth. Having a mere seven figure net worth for most people enters the territory of being able to prioritize volunteering over working, or funding a small mission in their favored charity. The temptation to break off and work on doing good rather than continually doubling down and doubling down on the process is ever there.
Or to put it another way, the passion for the process that will make a person wealthy takes up the much the same mental space as the passion for a cause: there are only so many hours in the day, and only so much attention that a person can give to any one set of information. So you are unlikely to see a person who has (a) accomplished the necessary devotion to work and process for a shot at becoming very wealthy, but also (b) put in the necessary work and process to become a zealot.
Or to put it yet another way, neither becoming exceedingly wealthy nor becoming a zealot are things that just happen one day out of the blue. They are each a fair way down their own different paths of effort, realization, and specialization.
> When it comes to access to medical technology the world is remarkably flat: the poor struggle in this as in everything else, but the wealthy have no more ability to buy a way out of aging (or heart disease, or cancer, or any of the other conditions that attend aging) right this instant than does anyone else. What they do have is a far greater ability to create a near future in which rejuvenation biotechnologies exist and are just as widely available as any present day clinical procedure.
This is a surprising paragraph. I'm not sure how you're defining "poor".
Illnesses of old age are a "luxury" that poor people don't have, because poverty related illnesses kill them before they get chance to be old.
Access to chemotherapy or radiotherapy or surgery is much easier for wealthy people than it is for poor people. (Although variations in cancer survival rates across wealthy countries shows that it's not just cash that makes a difference).
And rich people may not fund research into illnesses that affect them, but pharma knows where the money is. Compare the amount of money spent researching erectile dysfunction versus malaria.
> Compare the amount of money spent researching erectile dysfunction versus malaria.
I don't think much money goes into researching ED. The father of one of my med school classmates discovered the principle of action behind sildenafil and the other nitric oxide pathway interventions. They were working on preserving blood flow to the heart during a heart attack.
Compared to the vast toolbox of medical devices, the reebok-pump style penile implants are pretty simple implant system, probably one the way out as the old smokers die off (Leriche syndrome is primarily a vascular problem of smokers).
If you have some data, I'd love to see it, but I suspect there's a lot more time and money spent on malaria than ED at the research level. At the consumer level, the reverse is probably true.
I've never understood why ED is always the example of trivial medicine. Maybe I'm the only one who wouldn't go on living with no sex ever again. They weren't even working on it until they found a promising treatment by accident.
I agree. It's not trivial, and although very few people die from erectile dysfunction it was a bad example to use. My last paragraph talks about cough medicine.
Here's some information about medication costs in the NHS for 2011.
A search for viagra shows the page for ED meds. Sildenafil totals are 1,279,500 prescribed, at a cost of £40,872,800 (Check my decimal places!) and the total for all ED meds is £84,033,500.
That might not sound like much - the UK wants to spend something like £500m per year just on malaria.
But spending on ED targets a small number of mostly old people. The QALY cost is about $11,000. Spending on malaria targets a very large number of people, many young, but people of all ages.
If you want an actual trivial medication let's look at cough medicine; mostly sugary syrup with strong flavorings, sometimes with paracetamol and sometimes with other stuff. Most doctors say it's pointless and expensive and that people do just as well with hot lemon and honey and correctly taken paracetamol. We spend about £500m in the UK on cough mixtures. Americans spend about $2Billion. (That B isn't a typo.)
But by the same argument, cough medicine spending is by virtually everyone for their own direct benefit: that 500m targets a vastly greater number of people in the UK than malaria spending.
> Access to chemotherapy or radiotherapy or surgery is much easier for wealthy people than it is for poor people.
Is it? When I underwent chemotherapy, I did not pay for anything (to be honest, I paid gas to get to the hospital, but did not pay for medics, hospital bed, tests, blood analysis nor lost my salary for the days I could not work). Even though the price of some of the medics that were injected in me twice a month was greater than my monthly salary. Cancer is a disease for which poors are very well treated in France (So yes, in some wealthy country, cash makes no difference).
I have relatives who died due to a lack of health care. They felt sick for a long time, but only got treatment once the chronic problem became acute. Unfortunately, when a chronic undiagnosed cancer condition becomes acute, it means that it has metastasized and the survival rates drops precipitously. Lack of health care meant that the sick person died in pain instead of getting better early on and living for many more years. (Nota bene: this is a USA story - I am under the impression that this would not happen in basically any other western democracy)
I think it says something that one of the most critically acclaimed TV series in the US right now is premised on a middle-class high school teacher who turns to a life of crime when his state-provided health insurance is insufficient to cover his cancer treatment.
Not at all. Why, I expect a thousand dollar check to each household in the US -- not even per person, just per mailable address -- would do perfectly well. Enclose a nice form letter: "This check is a sample of what my leadership as President can do for you."
Finding the optimal value of the check to get a 51% popular share is left as an exercise for the student.
For example, both Charles Stross and I are creatives with a passion for telling stories - but the media we strongly prefer have pretty dramatic effects on the utility of money for both of us.
He mentions having already effectively topped out on the utility of cash for him - as a novelist, there's a limited extent to which more money helps him fulfil his passion.
By contrast, the utility of cash for me tops out around the $300m / yr mark, that being the cost of making and marketing a top-end feature film every year. Below that, there is definitely utility in every dollar as far as Doing What I Like goes - although of course diminishing returns still apply.
And for some people - like Elton Musk, whom he mentions - there is effectively no top end in sight. If your passion is to get to Mars, you really don't hit a point where more money wouldn't be helpful.