Hello everyone
I hope you had an enjoyable festive period and that 2024 is treating you well.
In 2023 there was a lot of talk about dystopian futures, in particular the scenario where AI (artificial intelligence) enslaves humanity…or something like that.
I’ve never quite believed that AI is going to replace humanity. That’s not to say that I don’t think AI will have consequences…I just tend to believe that (at least in the short- to medium-term) it will make us more efficient when it comes to Excel spreadsheets. Also, I’ve (already) found that I’m bored with fictional portrayals of the end of times inspired by AI.
So instead, let me offer you a different dystopian vision. This one inspired by improved health.
Caveat
Before we go any further, I must emphasize that this is not a prediction. This is a bit of speculation and there are many, many variables underlying this notion, and many of these variables would need occur in combination for this situation to arise.
I must also point out that I’m not offering financial or medical advice. You should never seek advice from a novelists on either of these matters.
What Could Happen?
In the next decade or two, we could see a situation where:
- people live longer, and
- those extra years are lived in excellent health.
As a species, we have been incrementally living longer and in better health for centuries, but we have now reached a moment where these changes may progress at a much faster rate.
And if people are living to a much greater age and living in better health, then there may be significant societal changes. Changes which may be more significant than the changes that flow from AI.
The question you are likely asking is: what could lead to this?
In short: drugs. And, let me remind you that I am not a doctor.
Semaglutide
Semaglutide is a medication originally developed for the treatment of type 2 diabetes. The medication was subsequently found to have effect as an anti-obesity and weight management tool and has recently been licensed for this purpose. The medication is sold under the brand names Ozempic (injectable), Rybelsus (pill), and Wegovy (for weight loss).
It’s the application of this drug for anti-obesity and weight management that I find interesting. Being able to take a pill to “fix” obesity potentially has immense consequences. Think about the most prevalent obesity-related diseases:
- type 2 diabetes
- heart disease
- strokes
- osteoarthritis
- chronic back pain
- Alzheimer’s and vascular dementia
- many cancers (including prostate, bowel, and breast)
These conditions are all life changing. Typically, they reduce life expectancy (usually significantly) and the quality of life before death is greatly reduced.
In the UK, current typical life expectancy is 80 years (as a rough average). Obesity (depending on the severity) can reduce life expectancy by 10 years (and typically, in these circumstances, the quality of life before that earlier death would not be great).
So having a pill which can prevent obesity and so prevent obesity-related illnesses, thereby increasing life expectancy greatly while improving the quality of life must be a good thing, right?
And it is.
But there may be consequences.
Longevity
Increased longevity has many potential consequences. To give a few examples:
Population Increase
If people aren’t dying, then the population will increase. This could (among other matters) lead to:
- increases in climate change (or at least a slowing of the effectiveness of actions to combat climate change), and
- a reduction in available housing (and therefore increases in house prices)
Resources
For people who had expected to retire at 65 and die at 70, but who may now expect to live until 80, their pensions/savings would need to be stretched over fifteen years rather than five years—in other words, three times as long.
This could lead to elder poverty and as a consequence, a hoarding of resources. It may equally lead to people staying in work for longer (which they may also choose to do in order to maintain a meaningful purpose to their lives).
Leisure Activities
But for those who can afford to retire, retirement will be longer and healthier. This may lead to greater emphasis on leisure activities, such as travel. It may also lead to many choosing to live in more desirable locations for periods of the year (for instance, moving to warmer areas during the cold season).
Politics
Older voters issues are often given greater weight by politicians because older voters are far more likely to vote. Increasing the size of this demographic could significantly increase the influence of this group.
For the Younger Generation
I’ve focused on what may happen to the older generation. However, there is a consequence for the younger generation and this is where I see the societal changes which could mean that semaglutide is more consequential than AI (at least in the short- to medium-term).
And again I should stress, I’m speculating about a second order changes and the interaction between generations will be different in individual cases.
Financial
The most obvious difference may be financial.
If there is a significant increase in the older population, then this will lead to an increase in the cost of providing age-related benefits (such as pensions provided from the state). That increased cost will put a burden on taxpayers (both younger and older). This additional cost is likely to be unsustainable leading governments to cut old age benefits—historically, cuts to old age pensions have disproportionately affected younger people.
A cut in tax may benefit the younger generation, but any change to pensions will also likely lead to the older generation wanting to keep hold of what money they have, meaning that there is less money to pass to younger generations. And of course, the older generation may choose retain more of their money to enjoy their extended life (for instance, spending the money traveling).
Childcare
Grandparents often take an active part in raising grandchildren. However, if grandparents now have a more active life—working longer, enjoying their own pursuits, traveling more—then they may not be as involved in their grandchildren’s lives. And if they are less involved in their grandchildren’s lives, then they may also be less inclined to help financially with these children.
And, if the younger generation are more financially squeezed (because the older generation won’t/can’t help), then the date at which would be parents decide to start a family may be pushed back. A declining birth rate may then lead to an even greater proportion of the population being older, giving this cohort yet more political influence.
Housing
An increasing population will lead to housing shortages and increased house prices.
There is already a house shortage in many countries. This will only get worse, and the trends we are seeing today with younger people—giving up on the dream of ever owning a house and so spending their money on leisure; worrying less about careers (and thereby giving up on planning for retirement); pushing starting a family until later in life—will be exacerbated.
Tearing Apart
If these trends continue with younger and older generations both becoming more selfish and with widely different aspirations, this could lead to further destruction of the inter-generational settlement.
Worse, it could lead to destruction of the notion of society. Many countries have stepped back from their international obligations/international agreements—it’s a small step to then see countries fracturing into smaller enclaves dedicated to groups looking to their own self-interest.
Does this constitute a dystopia? Maybe…maybe not. It certainly could lead to a far more fractured and atomized society with many unintended and unexpected consequences.
Will This Happen?
Will semaglutide become widely available? And if so, will the consequence be that our societies are torn apart?
At a guess (and this is the nearest I’m going to come to a prediction), semaglutide will become widely available, particularly in countries with publicly funded health systems. If it’s cheaper to prescribe pills to combat obesity than to fund the consequences of obesity—particularly when the cost of a healthcare system is already becoming unsustainable and there’s a benefit of a more healthy life for patients—then the case seems obvious.
Obvious, even if the societal consequences could be alarming and there’s little understanding of the long-term consequences of these drugs.
Will the societal consequences flow from wide-scale adoption of this drug? I don’t know. I doubt it. However, I suspect that the consequences from future medical developments will be more consequential than the changes introduced by AI. Essentially, we’re at the point of being able to reengineer human beings with pills.
At the very least, the changes from medical developments will make much more interesting novels than dystopian tomes where our robot overlords have taken up residence.
Until February
That’s me for this month. I’ll be back in February.
Until then.
All the best
Simon