#3: Choosing a cryonics provider

post by mingyuan · 2021-01-20T01:47:36.839Z · LW · GW · 21 comments

Contents

      Process
      One more note
  Costs to the consumer
    Alcor
    Cryonics Institute
    When is CI cheaper?
      If you already have life insurance through your employer
      If you're 100% set on whole-body
      If you do not want standby
  Quality of cryopreservation
    Standby services
      What is standby?
      Why does standby matter?
      How does standby work?
      Hospice care
      Mandatory vs optional standby
    Perfusion
      Alcor
      Cryonics Institute
  Organizational longevity
    Alcor
      Company structure
      Long-term financial planning
      Location
    Cryonics Institute
      Can you guarantee success?
      Can you guarantee the safety of patients?
    No but actually??
  Finances
    Responses to inflation
      Cryonics Institute
      Alcor
    Investments & assets
    Expenditures
      Snapshot
      Organization
      2019 expenses
      Liquid assets as of 12/31/2019
      # of patients as of 12/31/2020
      Alcor
      Cryonics Institute
  Other factors
    Professionalism
    Membership
  Summary
    Why choose CI?
      Easier signup
      More financially conservative
      It can be cheaper
    Why choose Alcor?
      Better preservation
      Future planning
      Solid reputation
    Bottom line
  Commenting guidelines
      Whole-body
      price
      Neuro
      price
      Oregon
      Cryo
      Trans
      Time
None
21 comments

This is post 3 of 10 in my sequence [? · GW] on how to sign up for cryonics.

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There are a fair few companies working in or adjacent to the cryonics space, but so far as I can tell*, the most commonly considered ones are: 

• Alcor near Phoenix
• The Cryonics Institute (CI) near Detroit (whole-body only)
• KrioRus in Moscow

I only seriously considered Alcor and CI, which is the case for most people I know, since KrioRus is 6000 miles away from us. 

Edit 9/2022: I've heard good things about Tomorrow Biostasis, based in Germany and serving all of Europe. Given that most Europeans probably currently can't / don't want to deal with Moscow, this seems like a good alternative to look into.

Honestly, I chose Alcor long before I started the signup process – basically because my friends had chosen it, and I figured they'd done so for good reason. But in the interest of information-sharing (which is the whole reason I'm writing this sequence, after all), I decided to dig into the Alcor vs CI question. I came out the other side more confident in my choice of Alcor.

Process

The first thing I did was to look back into ancient history, to this 2012 LessWrong question [LW · GW] about Alcor vs CI. While the comments did raise a lot of important considerations and were a helpful starting point, the primary thing I found out was.... that there's a lot of catfighting in the cryonics community. Here's hoping this post attracts more constructive feedback and fewer diatribes.

Notably, I did not reach out to either Alcor or CI directly, instead working only from publicly available information. While I'm told that people at both organizations are very helpful and happy to answer questions, I think it's illuminating to see what they share publicly. Also, honestly, I just don't like talking to people and didn't want to devote that much time and energy to looking into minutiae, when the broader picture was already pretty clear to me. People who have insider information are welcome to set me straight when I raise questions or reveal gaps in my knowledge.

One more note

While people argue a lot about which organization is better for them at the individual level, I think it’s good to acknowledge that all cryonics organizations are part of the same ecosystem that's pushing research forward and aiming at long-term human flourishing. In this capacity, cryonics organizations all complement one another. People seem to get really caught up in the narcissism of small differences and lose sight of the fact that cryonicists, by and large, all share the same values.

Costs to the consumer

CI is usually cited as the cheaper option, but I became increasingly uncertain about this as I looked into it. If you look just at their preservation prices, then you come away thinking that the cost of whole-body preservation via Alcor is more than 7x what it is via CI. But this is misleading, because Alcor rolls standby and transportation costs into its signup fees, while CI doesn't. 

Ultimately CI does come out cheaper overall, but the cost difference may not be as stark as it first appears. Let's get into it.

Alcor

As of this writing, Alcor charges a minimum of $80,000 for neuropreservation and $200,000 for whole-body. Here's a breakdown of the full costs:

• One-time application fee: $300
• Standby fees: $180/year (waived if you overfund your life insurance policy by $20,000, which you should do anyway [? · GW]) = $0/month
• Membership dues: $15 x (age at time of sign up) / year = $22–$75/month (median ~$44/month)
• Life insurance premiums (neuro): $15–$300/month (median ~$100/month)
• Life insurance premiums (whole-body): $30–$600/month (median ~$200/month)

So, if you are healthy and under ~35, your monthly fees are likely to come out to about $150 for neuro or $250 for whole-body. Note that you get significantly discounted application fees and membership dues if someone else in your immediate family is already signed up for Alcor. If this applies to you, your monthly fees will be $23 lower!

(You may be wondering why there's such a wide range of life insurance premium costs. I will talk a whole lot more about life insurance in later posts, but in brief, your premiums depend heavily on the type of insurance you decide to buy, and also increase steeply with your age.)

Cryonics Institute

First let's do the same calculation we just did for Alcor. CI's minimum whole-body suspension fee is $28,000, but if you're an Annual Member rather than a Lifetime Member, it's actually $35,000. But I don't think it actually matters that much, since as far as I can tell, it's hard to take out a life insurance policy for less than $50,000. So your life insurance premiums end up being pretty much the same either way.

Annual Membership:

• One-time initiation fee: $75
• Membership dues: $120/year = $10/month
• Life insurance premiums: $8–$300/month (median ~$100/month)

Lifetime Membership:

• One-time initiation fee: $0
• Membership dues: $1250 once, amortized over ~50 years = ~$2/month
• Life insurance premiums: $8–$300/month (median ~$100/month)

So your fees come out to about $100/month if you're an Annual Member, or $110/month if you're a Lifetime Member. 

But wait! Unlike for Alcor, it doesn't end there! Behold:

  

You can see that if you want standby and transportation, you'll end up needing to pay an extra $60,000, for a total of about $90,000 – on par with signing up for Alcor neuro. 

When is CI cheaper?

If you already have life insurance through your employer

CI accepts funding via employer-sponsored group life insurance, while Alcor doesn't. If you can get your employer to pay for your life insurance you'll have a much cheaper out-of-pocket cost. (Note that Suspended Animation does not accept group insurance, so you'll still have to figure out standby costs.)

If you're 100% set on whole-body 

If you're signing up for whole-body preservation regardless of provider, then preservation via Alcor still costs twice as much as preservation via CI, even taking into account the extra standby and transportation fees that CI members pay to Suspended Animation.

If you do not want standby  

All of CI's 'hidden costs' are for standby and transportation. If you are making your own arrangements in this domain, then it doesn't make sense to pay Alcor's mandatory standby fees. There are three main reasons you might not want standby:

• You live in the Detroit area, so you're likely to already be very close to CI when you die.
• You're contracting with a local standby team and/or funeral director – especially likely if you're outside of North America, since Alcor and Suspended Animation are primarily set up to operate in the US and Canada.
• You think [LW · GW] centralized [LW(p) · GW(p)] standby [LW(p) · GW(p)] doesn't [LW(p) · GW(p)] work [LW(p) · GW(p)].

Quality of cryopreservation

There are two main factors that determine the quality of your cryopreservation:

1. How quickly preservation happens after your clinical death
2. What preservation methods are used

I'll go into both of these below. For a sense of how things actually go down in real-world, non-idealized situations, you can see CI's cryopreservation case reports here or Alcor's here.

Standby services

What is standby?

When you're close to death, you (or your loved ones) may call for a team of trained individuals to wait at your bedside, ready to stabilize you and get you ready for cryopreservation and (if needed) transportation, as soon as you're pronounced legally dead.

Why does standby matter?

Standby exists so that you can get cooled down and cryopreserved as quickly as possible. Speed is important because your organs degrade quickly after you stop breathing and your heart stops beating. 

You'll hear the word "ischemia" used in this context. Ischemia refers to deficient blood flow to part of the body – in this case the whole body, but we primarily care about the brain – and the resulting oxygen shortage. Organs without oxygen are quickly damaged (see Wikipedia if you're interested in the mechanism), and importantly, this interferes with the cryopreservation process:

One of the most robust findings in our studies, and scientific papers of others researchers going back to the 1960s, is that cerebral ischemia produces perfusion impairment in the brain in a time- and temperature dependent manner. In cryonics such perfusion impairment translates itself into ice formation. The real difference is not between Alcor and CI but between people who do not receive rapid stabilization and cooling and those who do. (source [LW(p) · GW(p)])

Cryonicists often talk about "ischemic time", which refers (roughly) to the duration of time between your legal death and your cryopreservation. In cryonics, you can incur either warm ischemia (at room temperature) or cold ischemia (cooled down). Cold ischemia is less bad than warm ischemia, because being colder slows down the degradation process, but it's still ischemia. The shorter your ischemic time, the better.

How does standby work?

Standby teams aim to intervene as soon as possible after the pronouncement of legal death, to minimize ischemic time. Once death is pronounced, they stabilize the patient by lowering body temperature and restoring circulation. They also administer medications intended to improve the quality of cryopreservation (e.g. heparin to avert blood clots). 

Perfusion can be done near the location of legal death ('field perfusion') but is usually done at the preservation facilities. This means that, for anyone who undergoes clinical death while not located right near their cryonics provider, there are hours and often even days between clinical death and the beginning of perfusion.

See this case report from Suspended Animation for a complete picture of the standby process.

Hospice care

A friend who recently helped cryopreserve a family member told me "The best quality preservations by far occur in hospice death near the perfusion team." This is because being near the perfusion team and preservation facility allows for the quickest preservation following clinical death, and the least ischemic time. 

Alcor strongly encourages members who are terminally ill to relocate to a care facility near Alcor; if you choose to do so, their standby program entitles you to relocation assistance of up to $10,000. 

A cooperative care center is important, because some hospices will refuse to allow the standby team into the room or try to block them from acting. Alcor has a relationship with a hospice in Scottsdale, Arizona. CI does not have a relationship with a hospice. For my friend, this meant he wasn't able to relocate his family member to Michigan in their final days. He did contract with Suspended Animation, but his family member still incurred significant cold ischemia while being flown to Michigan.

Mandatory vs optional standby

As mentioned in the previous section, on costs, CI does not make standby mandatory for its members, while Alcor does. Alcor "attempts to provide bedside standby service to all members in the U.S. and Canada [subject to a 180 day waiting period after signup]" (source), and paying into its standby program is mandatory for Alcor members.

CI members can get standby and transport services from Suspended Animation by paying a fee, but in practice, only about 30% of CI members choose this option.^[1]

CI makes a good point that "Spending large sums of money for remote standby services… does not guarantee a successful suspension." However, I think a major hole in their standby philosophy is that, while personalized, decentralized local standby is likely better than the 'one-size-fits-all' centralized standby provided by Suspended Animation (at least in terms of average response times), almost no one is going to go to the trouble to set up their own standby solution. So the default for a CI member is to have no standby at all, which seems obviously worse than centralized standby.

Perfusion

Alcor and CI both aim to vitrify their patients rather than just straight freezing them, a process that significantly reduces damage to the organs. However, the two organizations perfuse their patients with different vitrification solutions, and that's what I'll be looking into here.

Alcor

Alcor pitches itself as performing state-of-the-art cryopreservation. I'll just quote from their FAQ:

The cryoprotectant used by Alcor, M22, was developed for purposes of medical organ banking and transplantation. It was the first solution to ever permit the cryopreservation and subsequent long-term survival of a vital mammalian organ (kidney). M22 is a “6th generation” vitrification solution, incorporating ice blockers, chilling injury protection, and numerous other insights...

[M22] is able to vitrify at slower cooling rates, and larger volumes, than any other vitrification solution in published scientific literature...

Alcor also uses demanding “closed circuit” perfusion, the same method of circulating fluids through the body used in heart surgery and organ cryopreservation research. This permits cryoprotectant to be introduced more gently, with better temperature control, without requiring cryoprotectant concentration in blood vessels to be far above target tissue concentration.

Cryonics Institute

CI pitches itself as performing affordable cryopreservation. They use a vitrification agent that they developed in-house, called VM-1. While there are no scientific journal publications about VM-1, this LessWrong comment [LW(p) · GW(p)] goes into M22 vs VM-1 a bit (linked page available here). CI also discusses their perfusion process here (scroll to the bottom). Most relevant paragraph:

[VM-1 inventor] Dr. Pichugin believes that the combination of his vitrification solution and carrier solution are well optimized for both low viscosity and minimal expense, while providing powerful vitrification capability. He does not believe in the value of high molecular mass agents such as proteins, dextrans, HES, PVP, etc, to support oncotic pressure in brain perfusion in CI's protocol because he believes these agents increase viscosity and are not necessary due to the dehydrating effect of cryoprotectants. In practice the Cryonics Institute has not seen much brain edema or the need for oncotic support in perfusions of brains with CI−VM−1 and [the carrier solution] m−RPS−2.

CI later mentions keeping costs low by using industrial-grade cryoprotectants. Their focus on costs and their description of VM-1 make me inclined to believe Alcor when they say, "VM1 was developed as a solution of simple composition for economical cryonics, not preservation of organs for transplantation." I haven't seen positive evidence that VM-1 will allow for revival.

A comment from the 2012 thread says that CI "cryoprotects only the head, allowing the rest of the body to be straight frozen with massive damage", but I think this is no longer true. While head-only perfusion is still the default, CI members can now choose to have their body perfused as well – although CI recommends against it because "body perfusion with glycerol after having perfused the brain results in longer brain exposure to cryoprotectant toxicity and ischemic damage."

Organizational longevity

Organizational failure is the number two reason I expect cryonics not to work, with number one being existential catastrophe that wipes out all of humanity. I'm far from confident that any cryonics company is prepared to weather a couple hundred years, black swan events and all.

The actions Alcor has taken – choosing a low-risk location, planning their finances for the long term, and structuring their organization so that it's not in imminent danger of falling apart – do show that they've seriously considered the problem of organizational longevity, but I'm not convinced that they're prepared for the future to be... weird. 

Relevant 2012 comment [LW(p) · GW(p)] from LessWrong user shminux [LW · GW]:

To quote Peter Lynch, "I want to buy a company any fool can run, because eventually one will". Making a company fool-proof is essential when the main purpose of the company is to survive several hundred years (maybe even thousands), an exceedingly rare occurrence. None of the current cryo shops seem anywhere close to having the necessary structure in place.

Alcor

For an overview of measures Alcor has taken in pursuit of institutional longevity, see pages 4-8 here.

Company structure

Alcor has a self-perpetuating board (which means that the board votes on who will be on the board) that's made up solely of Alcor members, which makes it pretty hard for any hostile outsiders to take over the organization.

Financially, Alcor has made sure not to put all of its eggs in one basket. It has its main operating funds, some reserve funds, an endowment, and the Alcor Care Trust (formerly the Patient Care Trust), and there are set rules for when and how each of those funds is touched. For example, the Alcor Care Trust has separate assets and a separate board of directors, and is supported by a 501(c)(3) distinct from Alcor. This makes it so that Alcor can't dip into patient care funds in order to cover other costs, such as legal fees. 

These precautions seem pretty good overall, but it doesn't necessarily seem like Alcor is prepared for extreme events like the collapse of the US dollar, or widespread and enduring violent unrest in the United States.    

Long-term financial planning

We'll go into finances more in the next section, but it's worth taking a look at how Alcor responds to point-blank questions (in its own FAQ). In answer to the question "How will Alcor sustain itself for the duration of my cryopreservation?"

Alcor’s long-term planning is conservative. Minimum funding requirements budget $115,000 to be set aside to fund long-term care of whole body patients, and $25,000 for neuropatients. Any excess funding also goes toward long-term care unless the member specifies otherwise. As a result, Alcor has more funding set aside per volume of patients under care than any other organization by a wide margin.

Alcor also segregates long-term care funds in the Patient Care Trust (PCT), which has a separate board of directors that oversees investments and ensures PCT funds are only used for long-term patient care… The Trust holds the mortgage of the building housing Alcor patients as well as majority interest in the ownership of the building.  The rest of the Trust investments are held at the investment firm of Morgan Stanley...

...Using a conservative estimate, the funds should generate more than enough money to cover patient maintenance indefinitely.

Location

Alcor intentionally chose a location with very low natural disaster risk, a low crime rate, good weather (to avoid transportation delays), and access to a major airport (the facilities are a 20-30 minute drive from Phoenix's international airport). In addition, Alcor's facilities have good security, and police response times in the area are quick. 

Cryonics Institute

CI is pretty open about the fact that they have no plans whatsoever. From their FAQ:

Can you guarantee success? 

Sadly, we can't. No one can guarantee success, because no one can guarantee the future. No one can predict scientific progress with certainty. We believe that a very strong case can be made for the probable success of cryonics. But that doesn't mean that social disruptions aren't possible. Nuclear war, economic collapse, political strife and terrorism, are all possible, and they could end the lives of cryopreserved patients just as easily as they can end the lives of any of us.

and

Can you guarantee the safety of patients?

The oldest patient currently still being held in cryopreservation is Dr. James Bedford, who was cryopreserved in 1967. He has survived the Cold War, the Vietnam War, the Gulf War, Watergate, the collapse of the Soviet Union and the 9/11 attacks — which is more than many of his contemporaries can say. The world is (relatively) stable at the moment, global world war doesn't seem likely, and the economy is relatively stable.

We can't guarantee the future. But we can and do guarantee this: that at CI we will give our very best efforts to see our member patients are restored to life and good health. The life of every director and officer and member of CI depends on those same efforts.

It's also worth noting that I didn't find anything about long-term financial planning on their website, and that their location is not optimized along the lines of Alcor's – while CI is very near a major airport (again, a 20-30 minute drive), it's also just outside the infamously high-crime Detroit, and Michigan is subject to a fair number of natural disasters. (Michigan might not get many earthquakes, but it does regularly get thunderstorms and blizzards, which frequently cause delays both at airports and on roads.)

No but actually??

shminux [LW · GW] made an excellent point back in 2012 that I have yet to see addressed anywhere. I think it's [LW(p) · GW(p)] worth quoting in full:

[M]y biggest concern is the continuous operation of a cryoshop over the potential centuries or even millennia until the revival is attempted, as nearly no entities have ever survived that long. I have been unsuccessful in my search for an Alcor executive explicitly responsible for existential risk analysis and mitigation.

By existential risk to the company I mean an event that would result in the company failing to the degree that the stored patients are discarded, even though the outside world merrily hums along, and not an event that wipes out a large chunk of humanity.

The FAQ does not seem to answer the obvious hard questions like "what if Morgan Stanley goes under?", "what if the US dollar collapses?", "what other existential risks exist, and what are their probability estimates and error bars?", "what is the estimated lifetime of Alcor until it suffers a complete failure from one of the existential risks to it coming to pass?" etc. By the way, if you think that the answer to the last question is "infinite", I recommend a basic probability and statistics course.

In other words, the risk management appears to be at the level no better than that of a regular insurance company, which is completely inadequate for an organization whose long-term survival is the most critical issue. Is this perception wrong?

Seems right to me.

Finances

(Please help make this section better! Finances are not my forte^[2])

The fundamental financial need of a cryonics organization is to be able to pay for the preservation and indefinite storage of its members. To do this, they have to balance [charging high enough prices that they get enough money per person to cover costs] and [charging low enough prices that they can attract new members and retain old ones]. They should also be conservative in their planning, and wise in their spending and investment.

Responses to inflation

Cryonics Institute

CI has not raised its prices since it was founded in 1976.^[3] This makes me extremely nervous. CI themselves point out^[4] that not charging enough can bankrupt a cryoshop, and I don't see why they're not more worried about that for themselves. 

Sure, CI's expenses have stayed constant and quite low over the past ~15 years, but it still seems like bad financial planning to keep costs the same over a period that's seen 363% inflation! More than anything, eating continuously decreasing real costs for 45 years indicates to me that CI isn't taking long-term planning seriously.

This is what it looks like to keep costs at $28,000 starting in 1976:

Alcor

Alcor has raised its prices multiple times since its founding, and even they are struggling to keep up with inflation. Here's a history of Alcor's cost increases that Mati Roy and I pieced together from this essay and the Wayback Machine:

	Neuro minimum	Whole-body minimum	Inflation rate since then
1976	$25,000	$60,000	254%
1982	$35,000	$100,000	127%
1991	$45,000	$120,000	68%
1994	$50,000	$120,000	57%
2005	$80,000	$150,000	27%
2011	$80,000	$200,000	12%

And here's what that looks like inflation-adjusted:

You can see that Alcor has kept real costs fairly steady over time – and that it's due for another increase soon. Dues and application fees have followed a similar pattern of periodically adjusting upwards for inflation, though those adjustments are smaller and more frequent.

Alcor previously had a policy of grandfathering members in at the prices at their time of signup, but this policy is no longer in force, which I think is a wise financial decision on their part.

Investments & assets

I'll continue to disclaim that I'm not very financially savvy, but it seems to me, just as a basic sanity check, that if an organization is being smart about its investments, its assets should grow over time.

I graphed the assets of both companies for the most recent 13 years, excluding restricted assets as well as property and equipment (it's really bad if they liquidate their property and equipment). Data is taken from public financial statements (Alcor, CI).

As you can see, both organizations passed my sanity check. Both have seen their assets grow at an average of 12.4% per year since 2011 (I excluded the years before that because of the recession), suggesting they are following similar investment strategies. This roughly tracks the S&P 500 over the same time period.

Note that Alcor has decided to keep more assets in cash lately; I don't know why.

Expenditures

Snapshot

I skimmed the financial statements of both organizations for the past couple years, and this is what I think I see:

Organization	2019 expenses	Liquid assets as of 12/31/2019	# of patients as of 12/31/2020
Alcor	$4.4M	$27.9M	181
Cryonics Institute	$350K	$7.9M	198

In brief: The two have similar numbers of patients, Alcor has significantly more assets than CI, but CI spends a significantly smaller percentage of its assets each year than Alcor (4.4% vs 15.8% in 2019).

Alcor

I think the most obvious question is: Why are Alcor's expenses so high?? Not only are they high, but they've been increasing over the past few years – they hovered between $1.5M and $2M from 2007 to 2017, then shot up to $3M in 2018 and $4.4M in 2019. 

In both cases (2017-18 and 2018-19) the bulk of the increase was due to 'professional fees', which increased by more than a million dollars each year – a 550% year-over-year increase from 2017-18 and an additional 100% increase from 2018-19. 

I didn't see any explanation for this, either in the financial reports or in any of Alcor's updates since late 2017 – admittedly I didn't look that hard, but the increase is so large that you'd hope it'd be mentioned prominently. I'd hazard a guess that it points to either a major shift in strategy, or some really thorny legal cases (Mati pointed me to this 2019 lawsuit), but that's just speculation. I did check whether there'd been a large spike in the number of preservations done in those years, but there wasn't anything outside of the normal range.

Another concern I have is that the 2017 numbers as reported at the end of 2017 are substantively different from the 2017 numbers as reported (and used for comparison) at the end of 2018. Not different enough to affect the trends, but definitely different, and I don't know why. Note that, as mentioned above, I did not reach out to Alcor directly to ask.

Cryonics Institute

(Note: 2017 is omitted because as far as I can tell they only have half-year data for that year? Spending for that year does appear to fall somewhere within the expected range – I'm just not sure exactly where.)

As you can see, CI's expenses have remained remarkably stable over the past decade, basically always falling between $300K and $400K per year – and note that this is before adjusting for inflation.

Other factors

Professionalism

CI does a way worse job than Alcor of projecting professionalism. For example, compare Alcor's annual financial report's vs CI's. Alcor has long, standardized, well-formatted documents full of legalese, while CI has PDFs of spreadsheets that look different from year to year and don't even have font consistency within individual documents. Its website is difficult to navigate and riddled with spelling errors. As we saw above, it doesn't even pretend to be planning for long-term stability.

Also, CI members regularly receive phishing emails like this one:

On the other hand, there's the argument that CI is what it is, and it isn't trying to deceive you with a veneer of professionalism. It's not like Alcor's consistent font usage changes the fact that it's underprepared for global disasters or that many of its patients incur lots of ischemic time.

Membership

If we take their reported membership numbers at face value, CI has more members than Alcor. However, I'm told that CI has stopped reporting how many of its members are actually signed up for cryopreservation (you can be a CI Member without signing up, whereas you're only a full Alcor Member if you sign up; otherwise you're only an Associate Member), so just comparing the numbers to one another doesn't tell you much.^[1] In any case, they're in the same general ballpark, with around 1000 people signed up for cryonics through each organization.

Summary

Why choose CI?

Easier signup

Signing up with CI is easier because they don't need to be the owner of your life insurance policy (just the beneficiary), which broadens your options considerably. You can even use a group insurance policy obtained through your employer.

More financially conservative

You might decide to bet on CI long-term based on the fact that its spending is much lower and much more consistent than Alcor's.

It can be cheaper

If you're really strapped for cash and want to get signed up right now, CI is more likely to be affordable. See "When is CI cheaper?" [LW · GW] above. 

Why choose Alcor?

Better preservation

It seems like by far the most important thing is being near a perfusion team when you die, if at all possible. Alcor makes that easier with its relocation assistance and its relationship with a hospice. It also removes the cognitive burden of standby arrangements by making centralized standby mandatory for all members. 

Perfusion is a murkier area, but I feel that I've seen more reason to be confident in Alcor's perfusion technology than CI's.

Future planning

While it's still far from as good as it needs to be to last 1000 years, Alcor at least outperforms CI on having done basic future planning, like choosing a low-risk location for its facilities and raising its prices to keep pace with inflation.

Solid reputation

While the reputation itself is screened off by the other considerations presented in this post, it appears to me that – due to its claims to professionalism – Alcor is held to higher standards than CI by people in the cryonics community. This kind of scrutiny may or may not lead to actual better performance, but it at least incentivizes it. 

Bottom line

If you're in the Americas, I recommend Alcor. If you're in Eurasia, I probably still recommend Alcor, but I'd also be interested in someone looking further into Tomorrow Biostasis.

Commenting guidelines

I approached this question in good faith and had no pre-existing ties to either Alcor or CI. No cryonics organization fills me with confidence, but given that these are the options I have to choose among, I've chosen Alcor. If your calculus comes out different, feel free to express why in the comments. I'd also be interested to hear if you think I've made any factual errors. However, if I judge your comments to be unnecessarily partisan (in any direction), hostile, or otherwise unproductive, I will delete them. 

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*Besides Alcor and CI, there are at least four other US-based cryonics organizations:  American Cryonics Society (ACS), Oregon Cryonics, Osiris, and Trans Time.

• If you sign up for cryopreservation through American Cryonics Society, your storage will ultimately be handled by CI. ACS's value-add is that they offer additional options, like different preservation procedures and establishment of a research and reanimation fund. You can read more about these on their website.
• Oregon Cryonics has a decent reputation from what I can tell, but they only accept members who live very near their facilities in Salem, so they're not worth looking into for the vast majority of people.
• Osiris is very new and not very well regarded.
• Trans Time appears to have its own cryo storage facility with a nonzero number of patients in cryostasis, but their website is so intensely awful that I can't figure out what they do or how one might go about signing up with them.

	Whole-body price	Neuro price	Founded	Standby	Patients	Members*
Alcor	$200,000	$80,000	1974	Mandatory	181	1317
ACS	$155,000	N/A	1969	Optional	19	?
CI	$28,000	N/A	1976	Optional	200	1725
KrioRus	$36,000	$18,000	2005	Optional	51	200
Oregon Cryo	N/A	$48,000	2005	Mandatory	8	?
Osiris	$28,500	N/A	2016	?	?	?
Trans Time	$150,000	?	1972	?	3	?

*Remember that members are not necessarily signed up for cryonics.

There are also some additional international cryonics organizations:

• Shandong Yinfeng Life Science Research Institute (or Yinfeng for short), in China, has been operating since 2015.
• Cryonics Germany is a small operation that provides neuro storage only.
• Southern Cryonics is slated to open soon and will be the first cryonics provider in the southern hemisphere.

1. ^{^}

   The last time CI shared the fraction of their members that were signed up for cryonics was in 2014, and it was 578/1010 = ~57%. If we assume the same ratio today, we find that 983 people are signed up for cryonics with CI. As of October 2020, 285 CI members were signed up with Suspended Animation; 285/983 = ~29%. 

2. ^{^}

   This section would benefit immensely from someone more financially savvy looking into it for even just an hour. For example, I'd love for someone to look into this claim from the 2012 thread:

   Unlike CI, Alcor has created robust practices and mechanisms for long-term maintenance and growth of the Patient Care Trust Fund and the Endowment Fund. Go take a look at CI’s financial reports. See how little money is available for the indefinite care and eventual revival of each patient. Also look at the returns on investment of those funds.

3. ^{^}

   See "What about inflation?"

4. ^{^}

   See "But what if I don't have anything?"

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