The Cold Hard Facts
So, you’ve probably heard about cryonics—the practice of freezing dead bodies in hopes of future revival—whether from sci-fi movies, an episode of Twilight Zone, or news stories about tech billionaires planning for immortality. But is there any legitimate science behind it, or is it all wishful thinking dressed up in lab coats? Let’s dig into this fascinating and controversial field.
Fair warning: this topic gets technical fast. I’ll do my best to keep things accessible, but some science-speak is unavoidable. I won’t pretend to offer an exhaustive examination of every element—that would take a textbook, not a blog post.
First, Let’s Get Our Terms Straight
Before we dive in, there’s an important distinction to make. Cryogenics refers broadly to the science of producing and studying very low temperatures—generally below −150°C (−238°F). This is a legitimate field with real-world applications to everything from rocket fuel to medical equipment to food preservation.
Cryonics, on the other hand, is specifically the practice of preserving a person who has died, with the hope of reviving them sometime in the future. This is where things get speculative—and controversial.
The Scientific Foundations: How Did We Get Here?
The ability to produce extremely cold temperatures emerged from a deepening understanding of thermodynamics—the science of heat, energy, and work. The key theoretical developments happened between 1842 and 1852 when a number of scientists published foundational works on the first and second laws of thermodynamics.
The practical breakthrough came in 1877, when oxygen was first cooled to the point where it became a liquid (−183°C). The term “cryogenics” itself was coined in 1894 by Kamerlingh Onnes of the University of Leiden to describe the science of producing very low temperatures.
There is a theoretical lower limit to how cold anything can get, known as absolute zero: −273.15°C or −459.67°F. At that point, molecular motion essentially stops, though reaching it is physically impossible because the energy required approaches infinity.
The logic behind biological cryopreservation flows naturally from this: if cold temperatures slow and eventually halt chemical processes, then extreme cold could theoretically preserve living tissue indefinitely. At liquid nitrogen temperatures (−196°C), the chemical and biological reactions in cells slow dramatically—and in theory, stop—which is the core premise of cryonics.
A key conceptual pillar of cryonics is that “death” is a process, not a single moment: cells and tissues undergo a continuum of injury after circulation stops, and some damage that is irreversible today might be repairable with future nanotechnology or regenerative medicine. Technically, current procedures emphasize rapid cooling after legal death, cardiopulmonary support to circulate cold fluids, and perfusion of the vasculature with concentrated cryoprotectant solutions that aim to achieve vitrification (a glass‑like solid state with minimal ice).
The Ice Crystal Problem: Why Freezing Destroys Living Tissue
Here’s where things get complicated. While the physics of cold temperatures is well understood, the biology of what happens when you freeze living tissue is where cryonics runs into serious trouble.
Freezing is often catastrophic for cells. On the scale of organs, ice formation can cause mechanical damage through expansion and can literally shatter tissue. When ice forms inside a cell, that cell almost always dies. Wide scale freezing also disrupts capillaries and vessels so that even if the cells were intact, they could not be reperfused.
The brain presents particular challenges on top of all this. Neurons—the cells that form the biological basis of everything you are—are more intricate and vulnerable than any other cell type. They consume roughly a quarter of the body’s available energy just to keep themselves alive. And it’s not just the presence and number of neurons that supports consciousness and memory, but the extraordinarily precise way in which trillions of microscopic connections are arranged between them. Those connections are how your memories and identity are stored, and they are exactly the kind of delicate structures most vulnerable to freezing damage.
Vitrification: The Workaround
To sidestep the ice crystal problem, cryonicists developed a technique called vitrification—essentially turning the body into a glass-like solid without crystallization. The process involves replacing the body’s blood with a special solution of cryoprotectant chemicals. These compounds are believed to prevent ice crystal formation and reduce tissue damage. Bodies are then stored in specialized containers filled with liquid nitrogen at −196°C.
The idea is elegant: instead of freezing, you’re essentially turning biological tissue into an amorphous, glass-like state where nothing moves and nothing degrades. On paper, it sounds like a solution. In practice, it creates a whole new set of problems.
The Toxicity Problem: Cryoprotectants as a Double-Edged Sword
The chemicals that prevent ice formation are toxic to the cells they’re meant to protect, and that toxicity increases with concentration. You need high doses to stop ice from forming, but those same doses cause their own cellular damage.
Dimethyl sulfoxide (DMSO) is the most widely used cryoprotectant, and also the most problematic. It can trigger programmed cell death, induce unwanted cellular changes, create osmotic stress, and may be a potential neurotoxin. At higher concentrations, it may even promote tumor development.
Other cryoprotectants carry their own baggage. Glycerol, long used for preserving blood cells and sperm, simply doesn’t scale up for whole-organ preservation. Ethylene glycol—yes, the same compound found in automotive antifreeze—gets metabolized into glycolic acid, which can cause metabolic acidosis, destabilizes cell membranes and may disrupt protective water layers around critical biological molecules.
Researchers are actively pursuing alternatives, including antifreeze proteins, nanotechnology-based approaches and new cryoprotectants. Each target ice formation or membrane protection through mechanisms designed to reduce the toxicity trade-off that has plagued cryopreservation for decades, though none has yet solved the problem at the scale cryonics requires.
Can We Actually Revive Frozen Bodies?
Short answer: No. Not currently, and possibly not ever.
Dennis Kowalski, president of the Cryonics Institute, has acknowledged that cryonic reanimation is “100 percent not possible today.” Shannon Tessier, a cryobiologist with Harvard University and Massachusetts General Hospital, put it more bluntly: “…the harsh reality is that current cryonic methods give patients only false hope. As they are practiced, they are both unscientific and profoundly destructive, permanently damaging cells, tissues, and organs. For now, the dream of cryonics remains frozen.”
Even setting aside current limitations, revival would require solving an extraordinary stack of problems: repairing damage from oxygen deprivation prior to freezing, neutralizing cryoprotectant toxicity, addressing thermal fracturing that occurs during the cooling process, healing tissues that didn’t vitrify successfully, and then curing whatever originally caused death. In many cases, reversing aging would also be necessary. None of these are close to solvable today.
There’s also a deeply uncomfortable practical question embedded in all of this: even if future medicine could theoretically rebuild and restore neuronal connections, how would anyone know what connections belong where? While the scanning technology is advancing fast enough that reading a well-preserved brain’s connectome at molecular resolution looks plausible within the coming decades, whether that information would be sufficient to reconstruct a person — biologically or digitally — remains genuinely unknown. Unless a complete molecular-level brain scan is performed before freezing—and stored alongside the tissue—trying to reconstruct memories and personality would be like trying to rewrite a burned book by studying the ashes.
Nanotechnology and Recent Progress
Cryonicists often point to future nanotechnology as the solution to the repair problem. The central thesis is that nearly any structure consistent with the laws of chemistry and physics could theoretically be built at the molecular level. The idea is that tiny molecular machines could one day repair cellular damage caused by cryopreservation rapidly enough to make revival possible. This remains highly speculative, but it’s not impossible in theory.
There has been some genuine progress on the warming side of the equation. Scientists have developed methods for safely thawing frozen tissues using nanoparticles—specifically, silica-coated particles containing iron oxide. Tests on human skin cells, pig heart valve segments, and pig artery sections showed no signs of harm from the rewarming process, and the tissues preserved key physical properties like elasticity. Application at the whole organ level has yet to be demonstrated.
What Actually Works Today
It’s worth noting what cryopreservation can accomplish now. Medical laboratories have long used the technique to preserve animal cells, human embryos, and simple tissues—eggs, sperm, bone marrow, stem cells, corneas, and skin—for periods of up to three decades, with successful thawing and transplantation. This is established, working medicine.
The leap from preserving a cell or an embryo to preserving a whole human body, however, is enormous. Large vitrified organs tend to develop fractures during cooling. No one has successfully preserved and revived a large mammal from a fully vitrified state.
What About The Wood Frog?
Invariably, in the discussion of cryonics someone will bring up the wood frog. In northern climates, the wood frog can seemingly freeze solid in the winter and then be hopping around with no obvious injuries in the spring. But there are several reasons why this isn’t applicable to the human science of cryonics.
First, and most obvious, the wood frog is cold-blooded, and we are not. The wood frog survives freezing at -3°C to -16°C, while cryonics stores bodies at -196°C—temperatures no frog could survive. Crucially, wood frogs, thanks to eons of evolutionary adaptation, prepare biologically before freezing—their liver actively flooding tissues with glucose cryoprotectant through a functioning circulatory system. While most metabolic activity ceases, the frog’s cells remain alive throughout; cryonics begins with legally dead patients. Even Ken Storey, the leading wood frog researcher, is a prominent cryonics skeptic. The frog demonstrates cold-blooded animals can evolve freeze tolerance—not that dead mammals can be revived from liquid nitrogen temperatures.
The Bottom Line
Cryogenics as a branch of physics is legitimate, well-established science. Cryopreservation of cells, embryos, and simple tissues works and has real medical applications. Cryonics—preserving entire human bodies or brains for future revival—is built on legitimate scientific principles but requires technological capabilities that don’t exist and may never exist. The damage from freezing is extensive, cryoprotectants are toxic, and no proven method exists for repairing the accumulated harm, let alone reversing death itself.
One cryonicist summed it up honestly: “Most people do not think it’s going to work and they might be right.”
That said, given the remarkable arc of scientific progress over the past few centuries, it’s difficult to dismiss cryonics entirely. If the next few centuries bring comparable advances, arguing that tissue repair is inherently and forever impossible becomes harder to sustain.
For those who choose cryopreservation, it’s essentially a bet—a wager that future science will solve problems we can’t currently solve, using technologies we can’t currently imagine. Whether that’s a reasonable gamble or an expensive expression of unfounded technological faith is something each person has to decide for themselves.
There’s one practical question nobody seems to have a good answer for: if the technology to reanimate frozen bodies is ever developed, who pays for it? None of the current cryonics companies appear to have a clear idea of what future revival costs might look like, or what happens if the cost of maintaining storage outlives the payments made upfront. As it stands, collecting rent from the frozen is not a well-developed business model.
One last thought, more philosophical than technical. Just because science may one day be able to reanimate a cryonically preserved human, should we?
Illustration generated by author using ChatGPT
Sources:
NIST Cryogenics: https://trc.nist.gov/cryogenics/aboutCryogenics.html
Britannica on Cryogenics: https://www.britannica.com/science/cryogenics
Britannica on Cryonics: https://www.britannica.com/science/cryonics
National Library of Medicine-PMC – Scientific Justification of Cryonics: https://pmc.ncbi.nlm.nih.gov/articles/PMC4733321/
National Library of Medicine-PMC – Spending Eternity in Liquid Nitrogen: https://pmc.ncbi.nlm.nih.gov/articles/PMC3328517/
National Library of Medicine-PMC – Ice Inhibition for Cryopreservation: https://pmc.ncbi.nlm.nih.gov/articles/PMC7967093/
National Library of Medicine-PMC – Cryoprotectant Toxicity: https://pmc.ncbi.nlm.nih.gov/articles/PMC4620521/
National Library of Medicine-PMC – Cryopreservation Overview: https://pmc.ncbi.nlm.nih.gov/articles/PMC7995302/
National Library of Medicine-PMC – Cryopreservation of Animals and Cryonics: https://pmc.ncbi.nlm.nih.gov/articles/PMC9219731/
BMC Biology – Winter is Coming: https://link.springer.com/article/10.1186/s12915-021-00976-8
Live Science on Nanowarming: https://www.livescience.com/58098-nanotech-may-revive-frozen-organs.html
MIT Technology Review on Cryonics: https://www.technologyreview.com/2022/10/14/1060951/cryonics-sci-fi-freezing-bodies/
The Conversation on Cryonics: https://theconversation.com/will-we-ever-be-able-to-bring-cryogenically-frozen-corpses-back-to-life-a-cryobiologist-explains-69500
Discover Magazine on Cryonics: https://www.discovermagazine.com/technology/will-cryonically-frozen-bodies-ever-be-brought-back-to-life
BBC Science Focus: https://www.sciencefocus.com/the-human-body/freezing-brain-back-to-life
PMC: “Cryoprotectants and Extreme Freeze Tolerance in a Subarctic Population of the Wood Frog”: https://pmc.ncbi.nlm.nih.gov/articles/PMC4331536/
ScienceDirect – Ice Crystal Formation: https://www.sciencedirect.com/science/article/abs/pii/S0011224010000222
Wood frog freeze tolerance research: https://www.nature.com/articles/s41598-021-98073-4
The Price Tag Mystery: Why Nobody Really Knows What Healthcare Costs in America
By John Turley
On January 29, 2026
In Commentary, Medicine, Politics
Imagine walking into a store where nothing has a price tag. When you get to the register, the cashier scans your items and tells you the total—but that total is different for every customer. Your neighbor might pay $50 for the same items that cost you $200. The store won’t tell you why, and you won’t find out until after you’ve already “bought” everything.
Welcome to American healthcare, where the simple question “how much does this cost?” has no simple answer.
You might think I’m exaggerating, but the evidence suggests otherwise. Research published in late 2023 by PatientRightsAdvocate.org found that prices for the same medical procedure can vary by more than 10 times within a single hospital depending on which insurance plan you have, and by as much as 33 times across different hospitals. A knee replacement that costs around $23,170 in Baltimore might run $58,193 in New York. An emergency department visit that one facility charges $486 for might cost $3,549 at another hospital for the identical service.
The fundamental problem is that hospitals and doctors don’t have one price for their services. They have dozens, sometimes hundreds, of different prices for the exact same procedure depending on who’s paying. This bizarre system evolved because most healthcare in America isn’t a simple transaction between patient and provider—there’s a third party in the middle called an insurance company, and that changes everything.
The Fiction of Chargemaster Prices
A hospital chargemaster is essentially the hospital’s internal price list—a massive catalog that assigns a dollar amount to every service, supply, test, medication, and procedure the hospital can bill for, from an aspirin to a complex surgery. These listed prices are usually very high and are not what most patients actually pay; instead, the chargemaster functions as a starting point for negotiations with insurers and government programs like Medicare and Medicaid, which typically pay much lower, pre-set rates. What an individual patient ultimately pays depends on several factors layered on top of the chargemaster price. Think of them like the manufacturer’s suggested retail price on a car: technically real, but nobody pays them.
A hospital might list an MRI at $3,000 or a blood test at $500. But then insurance companies come in. They represent thousands or millions of potential patients, which gives them serious bargaining power. They negotiate with hospitals along these lines: “We’ll send you lots of patients, but only if you give us a discount.” So, the hospital agrees to accept much less—maybe they’ll take $1,200 for that $3,000 MRI or $150 for the blood test. This discounted amount is called the “negotiated rate,” and it’s what the insurance company will really pay.
Here’s where it gets messy: every insurance company negotiates its own rates with every hospital. Blue Cross might negotiate one price, Aetna a different price, UnitedHealthcare yet another. The same exact MRI at the same hospital might be $1,200 for one insurer’s customers and $1,800 for another’s. And these negotiated rates have traditionally been kept secret—treated like confidential business information that gives each party a competitive advantage.
The Write-Off Game
What happens to that difference between the chargemaster price and the negotiated rate? The hospital “writes it off.” That’s accounting language for “we accept that we’re not getting paid this money, and we’re taking it off the books.” If the hospital charged $3,000 but agreed to accept $1,200, they write off $1,800. This isn’t lost money in the normal sense—they never expected to collect it in the first place. The chargemaster prices are inflated specifically because everyone knows discounts are coming. Some hospitals now post “discounted cash prices” that are often far below chargemaster and sometimes even below some negotiated rates. These are sometimes, though not always, offered to uninsured patients, generally referred to as self-pay. There can be a catch—some hospitals require lump-sum payment of the total bill to qualify for the lower price.
According to the American Hospital Association, U.S. hospitals collectively plan to write off approximately $760 billion in billed charges in 2025 across all categories of write-offs. That’s not a typo—$760 billion. These write-offs happen in several different situations. The most common are contractual write-offs, where the provider has agreed to accept less than their list price from insurance companies.
Hospitals have far more write-offs than just contractual. They also write off money for charity care—treating patients who can’t afford to pay anything, and they write off bad debt when patients could pay but don’t. They write off small balances that aren’t worth the administrative cost of collection, and they write off amounts related to various billing errors, denied claims, and coverage disputes. Healthcare providers typically adjust about 10 to 12 percent of their gross revenue due to these various write-offs and claim adjustments.
Why Such Wild Variation?
Even with all these negotiated discounts built into the system, the prices still vary enormously. A 2024 study from the Baker Institute found that for emergency department visits, the price charged by hospitals in the top 10% can be three to seven times higher than the hospitals in the bottom 10% for the identical procedure. Research published in Health Affairs Scholar in early 2025 found that even after adjusting for differences between insurers and procedures, the top 25% of prices across all states is 48 percent higher than the bottom 25% of prices for inpatient services.
Several factors drive this variation. Hospitals in areas with less competition can charge more because insurers have fewer alternatives for negotiation. Prestigious hospitals can demand higher rates because insurers want them in their networks to attract customers. Some insurance companies have more bargaining power than others based on their market share. There’s no central authority setting prices—it’s all private negotiations, hospital by hospital, insurer by insurer, procedure by procedure.
For patients, this creates a nightmare scenario. Even if you have insurance, you usually have no idea what you’ll pay until after you’ve received care. Your out-of-pocket costs depend on your deductible (the amount you pay before insurance kicks in), your copay or coinsurance (your share after insurance starts paying), and whether the negotiated rate between your specific insurance and that specific hospital is high or low. Two people with different insurance plans getting the same procedure at the same hospital on the same day can end up with drastically different bills.
Research using new transparency data confirms this isn’t just anecdotal. A study from early 2025 found that for something as routine as a common office visit, mean prices ranged from $82 with Aetna to $115 with UnitedHealth. Within individual insurance companies, the price of the top 25% of office visits was 20 to 50 percent higher than the bottom 25%, meaning even within one insurer’s network, where you go or where you live makes a huge difference.
The Government Steps In
The federal government finally said “enough” and started requiring transparency. Since 2021, hospitals must post their prices online, including what they’ve negotiated with each insurance company. The Centers for Medicare and Medicaid Services (CMS) strengthened these requirements in 2024, mandating standardized formats and increasing enforcement. Health insurance plans face similar requirements to disclose their negotiated rates.
The theory was straightforward: if patients could see prices ahead of time, they could shop around, which would force prices down through competition. CMS estimated this could save as much as $80 billion by 2025. The idea seemed sound—transparency works in other markets, so why not healthcare?
In practice, it’s been messy. A Government Accountability Office (GAO) report from October 2024 found that while hospitals are posting data, stakeholders like health plans and employers have raised serious concerns about data quality. They’ve encountered inconsistent file formats, extremely complex pricing structures, and data that appears to be incomplete or possibly inaccurate. Even when hospitals post the required information, it’s often so convoluted that comparing prices across facilities becomes nearly impossible for average consumers.
An Office of Inspector General report from November 2024 found that not all selected hospitals were complying with the transparency requirements in the first place. And CMS still doesn’t have robust mechanisms to verify whether the data being posted is accurate and complete. The GAO recommended that CMS assess whether hospital pricing data are sufficiently complete and accurate to be usable, and to assess if additional enforcement if needed.
Imagine trying to comparison shop when one store lists prices in dollars, another in euros, and a third uses a proprietary currency they invented. That’s roughly where we are with healthcare price data—technically available, but practically unusable for most people trying to make informed decisions.
The Trump administration in 2025 signed a new executive order aimed at strengthening enforcement of price transparency rules and directing agencies to standardize and make hospital and insurer pricing information more accessible; this action built on rather than reduced the earlier requirements. Hopefully this will improve the ability of patients to access real costs, but it is my opinion that the industry will continue to resist full and open compliance.
The Limits of Shopping for Healthcare
There’s also a deeper philosophical problem: for healthcare to work like a normal market where price transparency drives competition, patients would need to be able to shop around based on price. That could work for scheduled procedures like knee replacements, colonoscopies, or elective surgeries. You have time to research, compare, and choose.
But it doesn’t work at all when you’re having a heart attack, or your child breaks their arm. You go to the nearest hospital, period. You’re not calling around asking about prices while someone’s having a medical emergency. Even for non-emergencies, choosing based on price assumes equal quality across providers, which isn’t always true and is even harder to assess than price itself.
A study on price transparency tools found mixed results on whether they truly reduce spending. Some research shows modest savings when people use price comparison tools for shoppable services like imaging and lab work. But utilization of these tools remains low, and for many healthcare encounters, price shopping simply isn’t practical or appropriate.
Who Really Knows?
So, who truly understands what things cost in this system? Hospital administrators know what different insurers pay them for specific procedures, but that knowledge is limited to their facility. They don’t necessarily know what other hospitals charge. Insurance company executives know what they’ve negotiated with various hospitals in their network, but they haven’t historically shared meaningful price information with their customers in advance. And they don’t know what their competitors have negotiated.
Patients, caught in the middle, often find out their costs only when they receive a bill weeks after treatment. By that point, the care has been delivered, and the financial damage is done. Recent surveys suggest that surprise medical bills remain a significant problem, with many patients receiving unexpected charges from out-of-network providers they didn’t choose or even know were involved in their care.
The people who are starting to get a comprehensive view are researchers and policymakers analyzing the newly available transparency data. Studies published in 2024 and 2025 using these data have given us unprecedented visibility into pricing patterns and variation. But this is aggregate, statistical knowledge—it helps us understand the system but doesn’t necessarily help individual patients figure out what they’ll pay for a specific procedure.
Where We Stand
The transparency regulations represent a genuine attempt to inject some market discipline into healthcare pricing. Making negotiated rates public breaks down the information asymmetry that has allowed prices to vary so wildly. In theory, if patients and employers can see that Hospital A charges twice what Hospital B does for the same procedure, competitive pressure should push prices toward the lower end.
There’s some early evidence this might be working. A study of children’s hospitals found that price variation for common imaging procedures decreased by about 19 percent between 2023 and 2024, though overall prices continued rising. Whether this trend will continue and expand to other types of facilities remains to be seen. I am concerned that rather than lowering overall prices it may cause hospitals at the lower end to raise their prices closer to those at the higher end.
Significant obstacles remain. The data quality issues need resolution before the information becomes truly usable. Many patients lack either the time, expertise, or practical ability to shop based on price. And the fundamental structure of American healthcare—with its complex interplay of providers, insurers, pharmacy benefit managers, and government programs—means that even perfect price transparency won’t create a simple, straightforward market.
So, to return to the original question: does anyone truly know the cost of medical care in the United States? In an aggregate sense, researchers and policymakers are starting to understand the patterns thanks to transparency requirements. The data are revealing just how variable and opaque pricing has been. But as a practical matter for individual patients trying to figure out what they’ll pay for needed care, not really. The information is becoming available but remains largely inaccessible or incomprehensible for ordinary people trying to make informed healthcare decisions.
The $760 billion in annual write-offs tells you everything you need to know: the posted prices are largely fictional, the negotiated prices vary wildly, and the system has evolved to be so complex that even the people operating within it struggle to understand the full picture. We’re making progress toward transparency, but we’re a long way from a healthcare system where patients can confidently get the answer to the simple question: “How much will this cost?”
A closing thought: All of this could be solved by development of a single-payer healthcare system such as I proposed in my previous post America’s Healthcare Paradox: Why We Pay Double and Get Less.