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I was just this weekend reflecting on the extent to which we already live in this future. Specifically, I was purchasing over-the-counter medicine for a family member's lingering cough, and thinking about the mass produced medicinal miracles of modern chemistry. With the cost of open-market health insurance premiums set to rise next year, there is a lot of public discourse on the state of modern medicine (and how it gets funded). But for the vast, overwhelming majority of health concerns we have today, we live in an age of remarkable abundance and shocking affordability. Furthermore, we live in an age where there is very little difference in the treatments and medicines available to the rich versus the poor.
Now, don't misunderstand--I am absolutely aware of the eye-watering costs of some treatments, particularly experimental or end-of-life treatments, and the relatively better care available to people with money. But the kind of care that costs serious "rich person" cash is also the kind of care very few people would benefit from receiving. The vast majority of medical maladies you will face in your life are treatable by a nurse practitioner with medicine you can buy for less than an hour's wages, and a billionaire in your place would receive the very same prescription at the very same price.
Furthermore, though not everyone benefits in the same way or at the same level, most Americans do have some kind of health insurance that genuinely protects them from bankruptcy while providing them with treatments they could otherwise not possibly afford. Countries with socialized health care are arguably more efficient in how they structure the financing of all this, but either way the risk pooling that modern industrialized nations do with health care costs seems to work pretty well to everyone's absolute benefit, despite the persistence of individual disparities in particular cases.
Your mention of "if everyone went to college" is particularly noteworthy given that anyone who genuinely wants to learn something, today, is far better situated to make that happen than they would have been even twenty years ago. The existence of online college and satellite internet means you never even have to leave your house to get an education, often of a quality much higher than you could get at a top tier university a century ago. We have more knowledge, we disseminate it more smoothly, the costs are minimal and almost always subsidized. I have more books stored in my cell phone than I could physically fit in my house and office--combined. Someone with a loose attitude toward copyright infringement could very easily download several PhD's worth of knowledge for actual pennies (or, at their local library, possibly gratis).
Of course, credentials are a different story, but that's evidence of a society with so much abundance that it actively works to rate limit expertise. America's physician shortage (which is much less than the physician shortage in many other places) is driven in substantial measure by the profession's reluctance to increase the availability of training. This has resulted in a proliferation of paraprofessionals (who often think they are professionals)--but I digress. The point is that we have so much abundance, actually, many of our current sociocultural systems are kind of choking on it.
I sometimes wonder if this is why we are seeing a rise in political movements that, on my view, promise to function by ending abundance. On my view, trade is the lifeblood of prosperity; interfering with trade reduces abundance. On my view, free discourse generates a bounty of ideas; restricting discourse reduces abundance. Asceticism is often a kind of allergic reaction to abundance. Probably someone reading this comment is thinking of Universe 25 and wondering how it relates! Yes: possibly we are poorly evolved to thrive in an environment of abundance.
But I feel like the alternative is strictly worse. Better to wrangle with (and perhaps evolve beyond) our pyschological hangups in an environment of peace and plenty, I think, than to RETVRN to 50% infant mortality rates on grounds that this better reflects the ancestral environment. To answer the question directly, I think things could still get better in a variety of cool ways (I would like to live much, much longer then 100 years, for example!) but I do think we already live in an age of remarkable abundance, for which many, maybe most people are shamefully ungrateful, because they insist on thinking about wealth comparatively rather than in absolute terms.
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