Comment author: tylermjohn 20 April 2018 08:43:29PM 0 points [-]

thanks, gregory. it's valuable to have numbers on this but i have some concerns about this argument and the spirit in which it is made:

1) most arguments for x-risk reduction make the controversial assumption that the future is very positive in expectation. this argument makes the (to my mind even more) controversial assumption that an arbitrary life-year added to a presently-existing person is very positive, on average. while it might be that many relatively wealthy euro-american EAs have life-years that are very positive, on average, it's highly questionable whether the average human has life-years that are on average positive at all, let alone very positive.

2) many global catastrophic risks and extinction risks would affect not only humans but also many other sentient beings. insofar as these x-risks are risks of the extinction of not only humans but also nonhuman animals, to make a determination of the person-affecting value of deterring x-risks we must sum the value of preventing human death with the value of preventing nonhuman death. on the widely held assumption that farmed animals and wild animals have bad lives on average, and given the population of tens of billions of presently existing farmed animals and 10^13-10^22 presently existing wild animals, the value of the extinction of presently living nonhuman beings would likely swamp the (supposedly) negative value of the extinction of presently existing human beings. many of these animals would live a short period of time, sure, but their total life-years still vastly outnumber the remaining life-years of presently existing humans. moreover, most people who accept a largely person-affecting axiology also think that it is bad when we cause people with miserable lives to exist. so on most person-affecting axiologies, we would also need to sum the disvalue of the existence of future farmed and wild animals with the person-affecting value of human extinction. this may make the person-affecting value of preventing extinction extremely negative in expectation.

3) i'm concerned about this result being touted as a finding of a "highly effective" cause. $9,600/life-year is vanishingly small in comparison to many poverty interventions, let alone animal welfare interventions (where ACE estimates that this much money could save 100k+ animals from factory farming). why does $9,600/life-year suddenly make for a highly effective when we're talking about x-risk reduction, when it isn't highly effective when we're talking about other domains?

Comment author: Alex_Barry 20 April 2018 09:28:26PM *  1 point [-]

I'm surprised by your last point, since the article says:

Although it seems unlikely x-risk reduction is the best buy from the lights of the total view (we should be suspicious if it were), given $13000 per life year compares unfavourably to best global health interventions, it is still a good buy: it compares favourably to marginal cost effectiveness for rich country healthcare spending, for example.

This seems a far cry from the impression you seem to have gotten from the article. In fact your quote of "highly effective" is only used once, in the introduction, as a hypothetical motivation for crunching the numbers. (Since, a-priori, it could have turned out the cost effectiveness was 100 times higher, which would have been very cost effective).

On your first two points, my (admittedly not very justified) impression is the 'default' opinons people typically have is that almost all human lives are positive, and that animal lives are extremely unimportant compared to humans. Whilst one can question the truth of these claims, writing an article aimed at the majority seems reasonable.

It might be that actually within EA the average opinion is closer to yours, and in any case I agree the assumptions should have been clearly stated somewhere, along with the fact he is taking the symmetric as opposed to asymmetric view etc.

Comment author: turchin 18 April 2018 05:13:13PM 0 points [-]

How could it explain that diabetics lived longer than healthy people?

Anyway, we need a direct test on healthy people to know if it works or not.

Comment author: Alex_Barry 20 April 2018 04:08:11PM 0 points [-]

How could it explain that diabetics lived longer than healthy people?

If all of the sickest diabetics are switched to other drugs, then the only people taking metformin are the 'healthy diabetics', and it is possible that the average healthy diabetic lives longer than the average person (who may be healthy or unhealthy).

This would give the observed effective without metformin having any effect on longevity.

Comment author: turchin 19 April 2018 07:00:42PM 0 points [-]

In the next version of the article, I will present general equation in which will try to answer all these concerns. It will be (price of the experiment)(probability of success) + indirect benefits of experiment - (fixed price of metformin pills for life)(number of people)(share of adopters)(probability of success of the experiment) - unexpected side effects - growth of food consumption because of higher population. Anything lost?

Comment author: Alex_Barry 20 April 2018 10:33:55AM 1 point [-]

I'm not quite sure what this equation is meant to be calculating. If it is meant to be $ per life saved it should be something like:

Direct effects: (price of the experiment)/((probability of success)*(lives saved assuming e.g. 10% adoption))

(Note the division is very important here! You missed it in your comment, but it is not clear at all what you would be estimating without it.)

Your estimate of the indirect costs seems right to me, although in the case of:

growth of food consumption because of higher population

I would probably not include this level of secondary effect, since these people are also economically productive etc. so it being very hard to estimate.

Comment author: turchin 19 April 2018 02:22:03PM -1 points [-]

Ok. I just have two ideas in different moments of time, that is why there are two comments.

I think that again the problem of expensive pills is not a problem of antiaging therapies, but a more general problem of expensive medicine and poverty. I should not try to solve all possible problems in one article as it will immediately grow to the size of the book.

Most drugs we now consume are overpriced compared with bulk prices; also food is much more expensive in retail. I think it is important problem, but it is another problem.

Comment author: Alex_Barry 19 April 2018 03:23:44PM 1 point [-]

I'm not saying you need to solve the problem, I'm saying you should take the problem into account in your cost calculations, instead of assuming it will be solved.

Comment author: turchin 18 April 2018 04:02:34PM 0 points [-]

It probably should be analysed how the bulk price of metformin could be lowered. For example, global supply of vitamin C costs around 1 billion USD a year with 150 kt of bulk powder.

I also not suggesting buying metformin for people. In case of food fortification, the price is probably included into the total price of food and the manufacturers pay lowerest bulk price.

Comment author: Alex_Barry 18 April 2018 11:35:43PM 1 point [-]

It probably should be analysed how the bulk price of metformin could be lowered. For example, global supply of vitamin C costs around 1 billion USD a year with 150 kt of bulk powder.

Yes but as I discuss above it needs to be turned into pills and distributed to people, for which a 2 cents per pill cost seems pretty low. If you are arguing for fortification of foods with metformin then presumably we would need to show extraordinary levels of safety, since we would be dosing the entire population at very variable levels.

In general I would find it helpful if you could try and keep your replies in the same comment - this basically seems to be an extension of your other comment about buying metformin in bulk and having it split in two makes it harder to keep track.

Comment author: turchin 18 April 2018 04:33:51PM 0 points [-]

Also, Alibaba suggests metformin for 5 USD for kg, which implies lifelong supply could be bought for something like 50 USD.

https://www.alibaba.com/product-detail/HOT-SALE--99-High-Purity_50033115776.html?spm=a2700.7724857.main07.53.2c7f20b6ktwrdq

Comment author: Alex_Barry 18 April 2018 11:28:15PM *  1 point [-]

Yes, but 10kg of pure Metformin powder is not much good since it needs to be packaged into pills for easy consumption (since its needs to be taken in sub gram doses). Since you are not able to find pills for less than 2 cents (and even those only in India) I think you should not assume a lower price than that without good reason.

Presumably we run into some fundamental price to form, package and ship all the pills? I would be surprised if that could be gotten much below 1p per pill in developed countries. (although around 1p per pill is clearly possible since some painkillers are sold around that level)

Comment author: turchin 18 April 2018 03:03:24PM 0 points [-]

It was in fact discussed in section 7.1 there we wrote:

The price of a lifetime supply of metformin, 500 USD, will pay for an additional 1-3 years of life expectancy and a proportional delay of age-related diseases.

However, the actual price of the therapy for a person could be negative, because medical insurance companies will be interested that people will start taking age-slowing drugs, as it will delay payments on medical bills. Insurance companies could gain interest on this money. For example, if 100K of medical bills is delayed by three years, and the interest rate is two percent, the insurance company will earn 6 000 USD on later billing. Thus, insurance companies could provide incentives such as discounts or free aging treatments to those who use antiaging therapies.

Comment author: Alex_Barry 18 April 2018 03:28:34PM *  1 point [-]

I more meant it should be mentioned by the $0.24 figure e.g. something like:

"Under our model the direct cost effectiveness is $0.24 per life saved, but there is also an indirect cost of ~$12,000 per life saved from the cost of the metformin (as we will need to supply everyone with it for $3 trillion, but it will only save 250 million lives)."

Noticeably the indirect figure is actually more expensive than current global poverty charities, so under your model buying people metformin would not be an attractive intervention for EAs. This does not mean it would necessarily not be cost effective to fund the trial to 'unlock' the ability for others to buy the drugs, since it might be more efficient than e.g. other developed government use of money, but it does hammer home that the costs of the drugs is very non-negligible.

Comment author: turchin 18 April 2018 01:59:57PM 0 points [-]

For example, here https://www.medindia.net/drug-price/metformin/diamet.htm one table of 500mg costs 1 rupee, which is 0.0015 USD.

The model was deliberately oversimplified, as actually these 5 billions will be born the whole duration of the 21 century and will start to take the drug in different ages.

I will add more links on previous studies of metformin, as it probably seems unclear from the article that it is already tested drug for other conditions.

If we speak about fortification of food with useful microelements like iodine, fluoride, and some vitamines it probably has very high reach in developed countries. For some life extending drugs was shown that they could be taken in courses and could have effect on life expectancy.

The problem of constant taking a medical drug is not related to metformin, but to any drug which a person has to take constantly, like hypertension drugs, antidepressant, vitamins etc. This is a different important problem which should be solved to improve public health. There is one possible solution in the form of app (already exist) which records what one has taken and remind to take the drug.

Comment author: Alex_Barry 18 April 2018 02:54:40PM *  1 point [-]

Even if the cost of Metformin is only 2 cents a day, giving to to 5 billion people every day for 80 years would cost about $3 trillion (0.02*365*80*5*10^9). Whilst the cost would (at least potentially) be distributed across the population, it also seems like something that should be mentioned as a cost of the policy.

Comment author: Jeffhe  (EA Profile) 13 April 2018 11:43:01PM *  0 points [-]

Thanks for the exposition. I see the argument now.

You're saying that, if we determined "total pain" by my preferred approach, then all possible actions will certainly result in states of affairs in which the total pains are uniformly high with the only difference between the states of affairs being the identity of those who suffers it.

I've since made clear to you that who suffers matters to me too, so if the above is right, then according to my moral theory, what we ought to do is assign an equal chance to any possible action we could take, since each possible action gives rise to the same total pain, just suffered by different individuals.

Your argument would continue: Any moral theory that gave this absurd recommendation cannot be correct. Since the root of the absurdity is my preferred approach to determining total pain, that approach to determining total pain must be problematic too.

My response:

JanBrauner, if I remember correctly was talking about extreme unpredictability, but your argument doesn't seem to be based on unpredictability. If A1 and A2 are true, then each possible action more-or-less seems to inevitably result in a different person suffering maximal pain.

Anyways, if literally each possible action I could take would inevitably result in a different person suffering maximal pain (i.e. if A1 and A2 are true), I think I ought to assign an equal chance to each possible action (even though physically speaking I cannot).

I think there is no more absurdity to assigning each possible action an equal chance (assuming A1 and A2 are true) than there is in, say, flipping a coin between saving a million people on one island from being burned alive and saving one other person on another island from being burned alive. Since I don't find the latter absurd at all (keeping in mind that none of the million will suffer anything worse than the one, i.e. that the one would suffer no less than any one of the million), I would not find the former absurd either. Indeed, giving each person an equal chance of being saved from being burned alive seems to me like the right thing to do given that each person has the same amount to suffer. So I would feel similarly about assigning each possible action an equal chance (assuming A1 and A2 are true).

Comment author: Alex_Barry 17 April 2018 01:38:57PM *  0 points [-]

I was trying to keep the discussions of 'which kind of pain is morally relevant' and of your proposed system of giving people a chance to be helped in proportion to their suffering sperate. It might be that they are so intertwined as for this to be unproductive, but I think I would like you to response to my comment about the latter before we discuss it further.

You're saying that, if we determined "total pain" by my preferred approach, then all possible actions will certainly result in states of affairs in which the total pains are uniformly high with the only difference between the states of affairs being the identity of those who suffers it.

Given that you were initially arguing (with kblog etc.) for this definition of total pain, independent of any other identity considerations, this seems very relevant to that discussion.

Anyways, if literally each possible action I could take would inevitably result in a different person suffering maximal pain (i.e. if A1 and A2 are true), I think I ought to assign an equal chance to each possible action (even though physically speaking I cannot).

But this seems extremely far removed from any day to day intuitions we would have about morality, no? If you flipped a coin to decide whether you should murder each person you met, (a very implementable approximation of this result) I doubt many would find this justified on the basis that someone in the future is going to be suffering much more than them.

I think there is no more absurdity to assigning each possible action an equal chance (assuming A1 and A2 are true) than there is in, say, flipping a coin between saving a million people on one island from being burned alive and saving one other person on another island from being burned alive.

The issue is this also applied to the case of deciding whether to set the island on fire at all

Comment author: turchin 17 April 2018 10:52:41AM 0 points [-]

May I share with you the next version when all that changes will be done? I expect that the next revision will appear in 2 months.

Comment author: Alex_Barry 17 April 2018 01:06:12PM 1 point [-]

Sure, although I'm not sure how much time I will have to look it over. My email is alexbarry40@gmail.com.

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