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Patient numbers & stability

bgwowk's Photo bgwowk 19 Jan 2008

This was published today to counter some of the hyperbole going around

http://www.alcornews...gress.html#more

One issue that I do want to speak up on is the issue of patient numbers. It is being repeatedly stated that CI's number of patients is growing faster than Alcor's as if this is a sign of weakness on Alcor's part. CI takes last-minute cases with a far greater frequency than Alcor. This is because Alcor usually declines last-minute cases because of the legal and ethical risks they represent, and especially because of CI's low minimums. Last-minute cases usually pay cash, not life insurance, so they usually pay as little as they can. The result of accepting lots of cases at minimum funding is that long-term patient care funds per patient are diminished. The organization may also become top-heavy with patients compared to living members. I believe that this is not a good situation to be in. Alcor's member-to-patient ratio has been constant at about 10 for the last 20 years. CI's ratio right now is about 4. Also, all of CI's patients are whole body patients, which is a lot of kilograms of patients to be caring for.
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basho's Photo basho 19 Jan 2008

The result of accepting lots of cases at minimum funding is that long-term patient care funds per patient are diminished.
...
Alcor's member-to-patient ratio has been constant at about 10 for the last 20 years. CI's ratio right now is about 4. Also, all of CI's patients are whole body patients, which is a lot of kilograms of patients to be caring for.

Those are some worrying statistics. It implies CI does not have adequate contingency factored into its financials. A failure of CI and the ghoulish media storm that would erupt if the patients were thawed, could have a chilling extremely deleterious impact on the broader cryonics community unless a very wealthy benefactor quickly stepped in to ensure continuity of patient care with a minimum of negative publicity.
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bgwowk's Photo bgwowk 20 Jan 2008

I'm not saying that CI is in difficulty now. The point is that raw patient number is a poor metric of organization success. Membership growth is generally a good thing, but organizations should not be encouraged to accumulate patients for patients' sake. Members are assets, but patients are liabilities because of the long-term obligation they represent. In fact, to my knowledge Alcor is the only cryonics organization that actually records patient care obligations as liabilities on financial statements. An organization that places a patient into biostasis and collects a $150,00 life insurance policy is not suddenly $150,000 richer. It takes on a liability that offsets the asset gain. If little money is collected for a case, the addition of a patient can actually set the organization back.
Edited by bgwowk, 20 January 2008 - 08:59 AM.
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benbest's Photo benbest 21 Jan 2008

One issue that I do want to speak up on is the issue of patient numbers. It is being repeatedly stated that CI's number of patients is growing faster than Alcor's as if this is a sign of weakness on Alcor's part. CI takes last-minute cases with a far greater frequency than Alcor. This is because Alcor usually declines last-minute cases because of the legal and ethical risks they represent, and especially because of CI's low minimums. Last-minute cases usually pay cash, not life insurance, so they usually pay as little as they can. The result of accepting lots of cases at minimum funding is that long-term patient care funds per patient are diminished. The organization may also become top-heavy with patients compared to living members. I believe that this is not a good situation to be in. Alcor's member-to-patient ratio has been constant at about 10 for the last 20 years. CI's ratio right now is about 4. Also, all of CI's patients are whole body patients, which is a lot of kilograms of patients to be caring for.


CI is not in financial difficulty and CI patients are not at risk. I think that a more meaningful ratio
than patients/member would be staff/member. By that metric Alcor is subject to a much greater
financial burden than CI. The marginal costs for liquid nitrogen for a CI patient is now down
to $100 per year. The yearly cost of a staff person is tens of thousands per year. I am NOT
saying that Alcor is in financial difficulty or that Alcor patients are at risk.

-- Ben Best
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bgwowk's Photo bgwowk 21 Jan 2008

Good point, Ben. It's the actual cost of patient care that is most relevant. In Alcor's case, this can't be computed based on the number of staff members because most staff members are not engaged in patient care. Only one Alcor staff member actually draws a salary from the Patient Care Fund.

Operations other than patient care are paid for by dues, donations, and bequests. They tend to scale with availability of funds from these sources. For instance, in recent years two staff positions have been paid for by directed donations. Such donations swell the payroll, making the organization appear inefficient, but I think we agree that all organizations could use more of that kind of apparent inefficiency. If donations and bequests dried up, the organization could and would scale back to a lower level of operational activities.

I do take my hat off to the efficiencies in patient care that CI has achieved, and am glad that by virtue of that efficiency CI is able to help some people that could not afford cryonics otherwise. What all organizations need to do is to convince people of the importance of making cryonics arrangements in advance with good funding so that fewer people need to come in as last-minute cases at funding minimums, which is undesirable regardless of care costs.
Edited by bgwowk, 21 January 2008 - 06:31 AM.
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bgwowk's Photo bgwowk 21 Jan 2008

Even if only 10% of Pizer's claims are true, this should be reason for great concern.

Not concern that the organization is on the verge of failure, which is the jist of his posts.
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benbest's Photo benbest 21 Jan 2008

Good point, Ben. It's the actual cost of patient care that is most relevant. In Alcor's case, this can't be computed based on the number of staff members because most staff members are not engaged in patient care. Only one Alcor staff member actually draws a salary from the Patient Care Fund.


I don't think that patient welfare can be separated from the financial health
of the organization as a operating unit -- even with a patient care fund. It has
always been my contention that economies of scale can make cryonics affordable
for more people. The volume of CI patients has been helpful in that respect,
covering fixed costs as well as the low marginal costs.

I do take my hat off to the efficiencies in patient care that CI has achieved, and am glad that by virtue of that efficiency CI is able to help some people that could not afford cryonics otherwise. What all organizations need to do is to convince people of the importance of making cryonics arrangements in advance with good funding so that fewer people need to come in as last-minute cases at funding minimums, which is undesirable regardless of care costs.


It is an uphill battle to convince people not to associate cryonics with death
and to make arrangements well in advance of impending deanimation.
I do not in any way encourage last minute cases, I make great efforts to discourage
them. The risks associated with last minute cases are worrisome, but it is troubling
to turn people away who are on death's door. There are no easy answers
to this dilemma and there may not be in the foreseeable future.
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Mind's Photo Mind 21 Jan 2008

I just want to publicly thank Brian and Ben for keeping everyone up to date on some of the technical aspects, issues, and differences relating to cryonic suspension, and doing it in a rational and respectful manner.
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Shannon Vyff's Photo Shannon Vyff 22 Jan 2008

This is an excellent thread, illuminating many of the benefits for Alcor and CI. :-D

Here is a link to a nice overview of some differences between all the known cryonics companies (including Russia's!):

http://www.cryonics....omparisons.html
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