In three of the four general categories of innovation examined in this paper — basic science, diagnostics, and therapeutics — the United States has contributed more than any other country, and in some cases, more than all other countries combined. In the last category, business models, we lack the data to say whether the United States has been more or less innovative than other nations; innovation in this area appears weak across nations.

In general, Americans tend to receive more new treatments and pay more for them — a fact that is usually regarded as a fault of the American system. That interpretation, if not entirely wrong, is at least incomplete. Rapid adoption and extensive use of new treatments and technologies create an incentive to develop those techniques in the first place. When the United States subsidizes medical innovation, the whole world benefits. That is a virtue of the American system that is not reflected in comparative life expectancy and mortality statistics.

Policymakers should consider the impact of reform proposals on innovation. For example, proposals that increase spending on diagnostics and therapeutics could encourage such innovation. Expanding price controls, government health care programs, and health insurance regulation, on the other hand, could hinder America's ability to innovate.

The truth about second-hand smoking is finally out.

Thanks to some unusual candour on the part of the anti-tobacco brigade in New York City, we now have official confirmation that banning smoking in public has absolutely nothing to do with protecting the health of non-smokers from second-hand smoke, but everything to do with stigmatising both smoking and smokers. Closer to home, new evidence from the National Health Service (NHS) shows that the public smoking ban in England has made absolutely no positive difference in smoking rates, despite claims made by its champions that it would.

In September, Dr Thomas Farley, New York City's Health Commissioner, proposed banning smoking at all of the city's parks and beaches (1). Dr Farley's rationale for the ban has nothing to do with the risks that outdoor smoking pose to non-smokers, but rather with preventing people, particularly children, from having to see anyone smoking in public. Farley says, 'We don't think children should have to watch someone smoking'. Farley also defends the extension of the smoking ban to outdoor areas by arguing that it is 'part of a broader strategy to further curb smoking rates'. New York mayor, Michael Bloomberg, confirmed earlier this month that he would implement Farley's proposal, arguing that the public is 'overwhelmingly in favour' (2).

Why have the champions of banning smoking everywhere, even in private accommodation, suddenly come clean about the driving force behind their crusade? The answer is that they have essentially won the war over public smoking. But why is this the case? The answer, sadly, is that for the past 15 to 20 years, the public has been bombarded with a carefully orchestrated government-funded anti-tobacco campaign to convince them — in contradiction of the scientific evidence — that smokers pose a deadly health risk to non-smokers, particularly children.

The scientific evidence has never supported the case against public smoking. The US Environmental Protection Agency's seminal early 1990s report on second-hand smoke was severely flawed. Its critique of second-hand smoke was only sustained through a careful exclusion of non-confirming evidence and a non-traditional application of the statistical test known as confidence limits. The report was subjected to a scathing analysis by a US federal court, which rejected its scientific claims about the dangers of second-hand smoke, a finding that even on appeal was not reversed (3).

Moreover, a scientific study conducted by the World Health Organisation's International Agency for Research on Cancer found that there was no statistically significant association between smoking in the workplace and social settings and lung cancer in non-smokers. Indeed, the majority of studies about second-hand smoke and lung cancer in non-smokers have found non-statistically significant associations both in workplace and domestic settings.

Of course, none of this startling lack of scientific evidence has moved beyond the scientific journals and into the public domain, which means that the debate about public smoking is a non-scientific debate. And this means that it can proceed on virtually any grounds, unchecked by the need for careful and verifiable scientific evidence. The anti-smoking movement has always known that the evidence about the risks of public smoking, or private smoking for that matter, to non-smokers was marginal, at best, and nonexistent, at worst. But this was fundamentally unimportant.

Preventing people from smoking in public was never about real health risks - that is, it was never about protecting non-smokers so much as it was about stigmatising smoking and smokers and making it difficult for them to smoke. So with the science of second-hand smoke now never discussed, the anti-tobacco movement feels confident in moving the argument forward and revealing the starkness of its real agenda.

There is no compelling evidence that second-hand smoke poses a health risk to anyone in open spaces like public parks and beaches, but that is beside the point. The new push seeks, first, to demonise smoking and, second, to exert a brazen paternalism in which it is made virtually impossible for smokers — for their own good, of course — to light up in any public space.

There are profound difficulties with both of these objectives. For one thing, where is the justification for banning unhealthy behaviours from the public square simply on the grounds that someone might see them? Or, indeed, what is the justification for banning unhealthy behaviours from public viewing full stop? This opens up substantial room for prohibiting an enormous range of other behaviours which are neither immoral nor illegal, but simply unhealthy.

For example, by parity of reasoning it could be argued that children should never have to see anyone eating unhealthy foods in public, or indeed see anyone who is fat in public. Surely, there must be some evidence that seeing someone engaged in unhealthy behaviour puts others at risk. But where is this evidence?

For another thing, there is the issue of whether such measures actually work. For example, the NHS recently released a study on the effectiveness of the public smoking ban (4). The fact is that certain groups, such as young males, are smoking more after the smoking ban than before it. So, not only are such bans not supported by science, they are also not supported by the evidence on their practical effect in changing behaviour.

Finally, any policy by which the government engages in stigmatising the legal behaviour of its adult citizens is repugnant in a democratic society. Fundamental to democratic government is the respect that it owes to its adult citizens' choices about legal behaviour and, more fundamentally, how they choose to live their lives. Paternalistic interventions, whether through stigmatising or other means, can only be justified in the rarest of instances.

What the evolution of the debate over public smoking shows is how little science has to do with the anti-tobacco crusade, how disingenuous that crusade is about its real motives and goals, how easily the crusade on tobacco can be extended to other causes (most notably the war on obesity), and how fundamentally dangerous it is to a society both free and democratic.

(1) New York Eyes 'No Smoking' Outdoors, Too, New York Times, 15 September 2009 (2) Mayor Bloomberg vows to snuff out smoking in parks, beaches, New York Daily News, 1 October 2009 (3) For more on the EPA study, see An epidemic of epidemiology, by Rob Lyons (4) See Statistics on smoking, NHS, 29 September 2009 [pdf]

The bottom line of abortion is a dead baby. No amount of obfuscation and euphemism can hide the obvious. And if abortion is a legal right, then motivation is irrelevant. If you have a right to kill all babies, you have a right to kill girl babies.

However, Clinton, a supporter of unrestricted abortion, appears disturbed by the logical outcome of her policy preferences. In commenting on her international agenda for women, she observed that in some nations "girl babies are still being put out to die."

Moreover, she explained, "Obviously, there's work to be done in both India and China, because the infanticide rate of girl babies is still overwhelmingly high, and unfortunately with technology, parents are able to use sonograms to determine the sex of a baby, and to abort girl children simply because they'd rather have a boy. And those are deeply set attitudes."

Clinton's remarks received surprisingly little comment from other advocates of abortion "rights." Pro-lifers suggested that Clinton was a traitor to the abortion cause, but Laurie Carlsson defended the secretary's "nuanced view" on an issue that is "neither simple, nor clean-cut along lines of political beliefs or moral values."

Yet, Clinton challenged two fundamental precepts of the case for legalized abortion. First, she tied the "infanticide rate of girl babies" to sex-selection abortions. If sex-based infanticide and abortion are morally equivalent, then non-discriminatory infanticide and abortion should be morally equivalent as well.

Clinton has raised the core moral challenge of abortion: once we enter the continuum of life, our essential humanity has been established. The moment of birth has no obvious moral distinction. Or else why would Clinton be as upset with those who abort baby girls as with those who put newborn girls out to die?

Second, Clinton undercut the essential argument of abortion activists: there is a right to unrestricted abortion (or abortion "on demand"). That means for any reason. If there is at least one illegitimate reason, might there not be others?

Some people apparently believe that there is no worse offense than to "discriminate," which makes sex-selection abortion so odious to some. National Post writer Barbara Kay says "sex selection is a form of bias — arguably even a form of hatred — against an identifiable group."

But how about abortion of the handicapped, whether physical or mental? Writer George Neumayr warned, "Without much scrutiny or debate, a eugenics designed to weed out the disabled has become commonplace." This is also discrimination.

Nor does discrimination, or even "hatred," necessarily stop there. U.S. Supreme Court Justice Ruth Bader Ginsburg recently discussed Roe v. Wade, which legalized abortion, and noted the "concern about population growth and particularly growth in populations that we don't want to have too many of."

Presumably, she was referring to racial minorities. Cannot abortion be considered a form of society-wide discrimination?

And if we can judge the motives of those who choose abortion, then should we not critically assess other purported justifications? Why is it worse to decide that the baby's sex is "wrong" than to decide that the pregnancy's timing is "wrong."

Clinton's apparent position, that people are free to choose abortion for any reason, except the one reason she finds distasteful, is intellectually unsustainable.

Perhaps the secretary still believes the procedure should be legal. Yet, she coupled infanticide with abortion, and presumably believes that more than persuasion is necessary in the former case. Again, there is no clear line between infanticide and abortion. The females are killed: the only question is when?

In any case, the law is never going to be able to control motives. If other abortions are legal, then anyone desiring one for the purpose of sex selection merely need state anything else — or nothing — and the law would not stand in the way.

Australia, Canada, China and India all formally ban the practice. Some would follow in the United States. However, these measures are wasted efforts so long as abortion is largely unrestricted.

Clinton has grasped an essential truth: It is wrong to kill baby girls. But it also is wrong to kill baby boys.

The problem is not sex-selection abortion. The problem is abortion. Many politicians desperately hope that the issue will go away, but it remains one of today's most profound moral challenges.

Unfortunately, neither of these claims nor policies meets the standards of evidence-based policymaking. Both are, instead, products of advocacy-based 'research' carried out by anti-tobacco lobby groups.

In evidence-based policymaking, as in evidence-based clinical medicine, practices and decisions are based on rigorous, systematic reviews of 'best practice', that is, therapies and interventions that work the best in reducing morbidity and mortality. Evidence, and evidence alone, not theory or tradition, drives practice.

The empirical record about tobacco advertising's affect on young people is decidedly mixed. Large independent studies have failed to find a statistically significant connection between tobacco advertising, consumption, and youth smoking. Indeed, the two major UK government-commissioned studies on tobacco advertising and marketing failed to find a causal link between advertising and young people starting to smoke.

This lack of evidence is confirmed by the fact that countries that have had advertising bans for a quarter century or more have not experienced statistically significant declines in youth smoking. Consumption and prevalence data from 145 countries finds little evidence that the entire range of tobacco control measures, including advertising restrictions and bans, has a statistically significant effect on smoking prevalence in any country.

Yet, the government pushes ahead with increasingly draconian restrictions on tobacco advertising through legislation to ban the display of all tobacco products. Even though the Department of Health claims that there is substantial evidence to show that such bans will reduce youth smoking, this is not the case.

The evidence in support of tobacco display bans, just as for tobacco advertising bans, is embarrassingly thin. Most studies show that tobacco displays have no statistically significant effect on youth smoking.

The most frequently quoted studies actually found that seeing tobacco displays had no effect on youth intentions to smoke. None of the so-called evidence about tobacco displays provides compelling behavioural evidence that any young person started smoking after seeing tobacco displays.

The evidence from the experience of other countries who have tried display bans does not support the claim that they reduce youth smoking. The government has repeatedly claimed that Canada, where several provinces have banned tobacco displays, shows that such bans result in fewer tobacco sales and fewer youth smoking.

The government knew that this claim, and the evidence that it was based on, was not true. Recently released DoH correspondence shows that the government was told in a March 2009 email that removing tobacco displays in Canada 'has not caused a decline in tobacco sales or discourage[ed] kids from smoking'.

Yet, the anti-tobacco lobby continues to push for even more far-reaching tobacco control legislation. This past week, Action on Smoking & Health (Ash) trumpeted a new study about the influence of tobacco packages as proof that putting all tobacco products in plain packages was now required. Ash's Deborah Arnott told the BBC that: "This research shows that the only way of putting an end to this misleading marketing is to require all tobacco products to be sold in plain packaging."

What Arnott did not tell the BBC was that she and Martin Dockrell, Ash's campaign manager, were not only two of the authors of the very study they so fulsomely praised, but Ash, along with the DoH, paid for the study.

Considerable previous research has shown that plain packaging of cigarettes will do nothing to reduce youth smoking. A study from Canada's York University, which asked young people about what effect plain packaging would have on their smoking decisions, found that 90 percent of daily smokers said they would smoke more or the same if cigarettes were in plain packages.

What then of high taxes to discourage or prevent youth smoking?

The claim that high tobacco taxes will reduce smoking is an odd one since we have been taught that smoking is addictive. If smoking is addictive, logic dictates that smokers will be insensitive to price increases.

But the claim also runs counter to what most experts say about how young people smoke. Most young smokers are experimental smokers who do not buy their cigarettes, but instead get them from friends or family, which makes them much less sensitive to high tobacco prices.

Data from the US National Household Survey on Drug Abuse recently showed that over 85 percent of 12-18 year old smokers consume the three most expensive brands of cigarettes, a fact that is also difficult to square with the claim that young people are price sensitive.

A series of American longitudinal studies has found tax increases have a statistically insignificant effect on preventing young people smoking. Last year, in a study of tobacco control policies in 27 European countries, it was found that, for adolescents, price was unrelated to smoking prevalence.

Tax increases do succeed, however, in increasing the risk of smoking. Jerome Adda and Francesca of University College London found that a one percent increase in tobacco taxes increases smoking intensity by 0.4 percent, which leads the smoker to inhale more dangerous chemicals and causes cancer deeper in the lung.

The result of public health policymaking absent of evidence is tobacco policy that repeatedly fails to address youth smoking. While the government is entitled to its own opinion about the most effective ways to reduce smoking, it is not entitled to its own evidence.

President Barack Obama's nomination this month of Dr. Regina Benjamin as U.S. surgeon general brought down upon the White House a barrage of criticism from medical "experts" who claim Dr. Benjamin is setting a bad example because of her weight. For example, Dr. Sarah Reed, who religiously keeps her own Body Mass Index in the "underweight" category, was quoted in The Daily Telegraph saying: "Although her credentials speak for themselves, her weight cannot be overlooked. Shame on her!".

Is Dr. Benjamin too fat to handle the nation's health? There are three evidence-based public health reasons why worries about her weight are unwarranted.

First, there is little credible scientific evidence that supports the claims that having an overweight or obese BMI leads to an early death. For example, Katherine Flegal of the Centers for Disease Control and Prevention found that in the U.S. population there were more premature deaths among those with BMIs of less than 25 — the so-called normal weight — than those with BMIs in excess of 25.

In fact, the lowest death rates were in the "overweight" category — that is, those with BMIs from 25 to 29.9. Indeed, in this study, Americans who were overweight were those most likely to live the longest.

In the American Journal of Public Health, Professor Jerome Gronniger looked at weight and mortality for each BMI point, rather than simply comparing, as is usually done, mortality across broad categories, such as underweight, normal, overweight and obese. He found that men in the "normal" weight category exhibited a mortality rate as high as that of men in the moderately obese category (BMIs of 30 to 35); men in the "overweight" category clearly had the lowest mortality risk.

Moreover, a new study published in the American Journal of Clinical Nutrition that looked at alternative measures of obesity, such as percentage of body fat, skin fold thickness, waist circumference, and waist-hip ratio, found even less scientific support for the alleged fat-equals-early-death thesis. The authors report that for the intermediate level of each of the alternative measures of obesity, there was a negative link with mortality. In other words, those with a higher waist circumference or a higher percentage of body fat had lower mortality rates.

A second reason why Dr. Benjamin's weight is a non-issue is because in those studies that have found statistically significant associations between overweight/obesity and premature mortality, the risks are so modest as to be essentially negligible. For example, whereas the reported lung cancer risks for smokers are typically 10 to 20 times higher than for nonsmokers, the death risks for those who are overweight and obese are often closer to only 0.5 above those of normal weight.

Third, contrary to conventional wisdom, the association of overweight and obesity with higher risks for a variety of diseases, such as cancer, diabetes and heart disease is unproven. In part, this is because these diseases have multiple causes.

More strikingly, increases in overweight and obesity have been paralleled by falls in total cardiovascular mortality and mortality from coronary heart disease and stroke, as well as in the prevalence of hypertension and hypercholesterolemia, undermining claims that overweight and obesity lead to higher rates of morbidity.

The case against Dr. Benjamin's suitability as surgeon general is constructed out of an anti-obesity crusade that has been splashed across so many front pages for so long that no one asks whether it is based on evidence. The questionable science underpinning the criticism of Dr. Benjamin is a smoke screen for an artfully choreographed anti-fat prejudice that, according to the eating disorder statistics, has already taken white women, girls, boys and ethnic minorities as its victims.

The last demographic holdout against "fatism" is the African-American female, who on average is disproportionately heavy. And she is disproportionately comfortable with her weight. The fat police view this fact as simply unacceptable.

Hence, their attack on Dr. Benjamin, which they perceive as an opportunity to lance this particular demographic boil once and for all. Shame on them.

Fat celebrities are the latest victims of the UK public health establishment's attempt to socially engineer our cultural and political environment so that the public becomes less tolerant of obesity and those the government categorises as obese. Through such nanny-state paternalism, the government seeks to ensure that people behave in "appropriate" ways, as defined by itself and a coterie of public health bureaucrats and academics.

Professor Michael McMahon, author of this week's Nuffield Health report on the influence of fat celebrities on obese people's attitudes to weight, says fat stars are seen as role models, helping to make being overweight acceptable. Professor McMahon's anti-fat stance epitomises the public health establishment's increasing use of a "denormalization" campaign against fat people.

As employed by the government and the anti-obesity industry, denormalization is a made-up word that functions as both a noun and as a verb to describe both a state in which the obese are perceived to be abnormal, aberrant, even deviant, and a series of activities designed to achieve this end.

In practice, denormalization means that the government attempts to shame adults into changing their behaviour. For the government's denormalization campaign to succeed these adults must be stigmatised; that is, they will be placed apart from the rest of civilised society until and unless they learn to behave in the approved manner.

Denormalization pushes the obese from being a health hazard to being a moral hazard, nothing less than blots on the nation's moral landscape. The environmental approach to obesity epitomized by denormalization is spelled out by Dr Kawshi De Silva of the Problem Gambling Foundation of New Zealand, who states: "The perceptions and beliefs in society about obesity can profoundly influence behaviour change and resistance to it."

The prominent American journalist, Morton Kondracke, recently called for being fat, let alone obese, to be made as socially unacceptable as smoking. Earlier this year, a London Evening Standard columnist advocated the public ridicule of fat people eating chocolate. In some quarters, it is predicted that the language of denormalization will soon be the main ingredient in the obesity debate.

The anti-obesity movement has accepted the argument of those, such as Australian nutritionist Dr. Rosemary Stanton, who have argued that: "We need to learn from the successes in tobacco control in tackling the obesity epidemic." Clearly, the anti-obesity campaign has modelled its denormalization campaign on the politically, if not empirically, successful tobacco denormalization campaign. Hence, the anti-obesity lobby employs public policy tactics to denormalize the use of the food industry's products.

There are significant downsides to the obesity denormalization campaign. In a recent article, published in Health Promotion International, L MacLean et al express a well-founded concern regarding the stigmatization of obese people, particularly of children. While there is much written about stigma and how it is exacerbated, these researchers point out that few, if any, guidelines exist for public health managers and practitioners who may attempt to design and implement obesity prevention programmes that minimize stigma. They examine the stigmatization of obese people and the deeply negative consequences of this social process, and discuss how stigma is manifest in the provision of public health services.

Recently published research by CD Elliott published in the Journal of Canadian Studies is particularly insightful in demonstrating the obesity denormalization campaign's dangerous ambitions. Elliott is unequivocal in concluding that the obesity denormalization campaign is central to the connection between obesity and citizenship in contemporary Western society.

This particular piece of research examines how denormalization has connected one's physical body to that of one's citizenry. In tracing the evolving narrative, Elliott explains why denormalization campaigners believe that the ideal citizen is, literally and figuratively, a "fit" citizen.

The person with the larger body is quite simply categorised as a lesser citizen than his or her smaller countrymen. Elliott outlines the ways in which the fat body or "failed body project" is equally positioned to that of the "failed citizen." Elliott points out that the figurative concept of citizen fitness is often mistakenly conflated with the visible look of leanness.

Given that public health reports such as this week's from Nuffield Health officially classify the majority of adults as overweight or obese, the framing of the fat body as the failed citizen is, to put it mildly, of considerable significance to both policymakers and non-policymakers alike.

We may draw several general conclusions from the denormalization experience to date. First, the obesity denormalization campaign represents yet another failure to address particular social problems, such as eating disorders.

Second, the fact that the denormalization campaign has failed to work in the tobacco arena apparently means nothing to the public health establishment, which has confidently prescribed comparable denormalization campaigns for the food, gambling and drinks industries.

Third, these campaigns dehumanize whole categories of people, which is arguably the most damning conclusion possible. Whatever one may or may not think of smoking and of smokers themselves, one unavoidable truth is that the smoker's social status (or lack thereof) in the modern era foreshadowed the current, lowly social status of the fat person.

Fourth, the obesity denormalization campaign is also worrisome because it wastes large sums of taxpayer money to satisfy the new Puritanism's anti-obesity agenda.

A potentially greater worry, however, stems from the reality that this denormalization campaign represents a new and dangerous assault on our core democratic traditions of choice about risk and lifestyle. Like so much in the "war on obesity," denormalization is a very bad prescription for supposedly good public health.

Exhibit A is today's World Cancer Research Fund (WCRF) report, Policy and Action for Cancer Prevention - Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective, which warns of a global catastrophe from obesity-induced cancer.

As the Observer's David Smith breathlessly previewed the WCRF report last weekend, 'Cancer cases are now rising at such a rate in Britain and the rest of the world that the disease poses a threat to humanity comparable to climate change'. Not to be outdone, the Mail on Sunday's David Derbyshire wrote that the 'obesity epidemic will double the number of cancer deaths within 40 years... At least 13,000 cases of cancer are caused by obesity in Britain each year'.

The new WCRF report is largely based on a report published two years ago by the same group that claimed that a third of cancers were caused by diet and lack of exercise. That controversial report advised people to be as thin as possible, and to avoid red and preserved meat and alcohol. The problem with this latest effort from the WCRF is that it is as blatantly and foolishly wrong as its 2007 version. This is especially evident in four areas.

Are cancer and obesity linked?

The report's headline-grabbing claim about the link between obesity and cancer is not supported by the majority of the WCRF's own data from the 2007 study, or by other, more recent British and American studies. Once you dig beyond the bold claim, you find that what is being claimed is that overweight and obesity can increase your risk for six cancers (cancers of the oesophagus, pancreas, colon-rectum, breast, endometrium and kidney). But even this more limited claim has little scientific support.

Take pancreatic cancer, for example. The 2007 report cites 20 case control studies, but only three show a statistically significant association between obesity and pancreatic cancer. Similarly, of 42 cohort studies on colorectal cancer, only 13 show a link with obesity. Again, with breast cancer and obesity, of 16 studies only three are statistically significant, while eight show a decreased risk between breast cancer and obesity.

Even for oesophageal cancer, the increased risk was generally found in the morbidly obese (ie, those with a body mass index, or BMI, of at least 40 - a very small percentage of the population). And with endometrial and kidney cancers the relative risks were below two. According to the National Cancer Institute, relative risks below two (that is, two times the risk compared to a control group) are so small that they may be due to 'chance, statistical bias or the effects of confounding factors'.

These claims about a link between obesity and cancer are further called into question by the UK's recent Million Women Study, which examined the link between 17 of the most common cancers and BMI. In that study, the incidence of 10 of the cancers does not show a statistically significant association with either higher levels of overweight or obesity. Of the remaining seven cancers, the association between overweight and cancer is non-significant in four, and where the results are significant the relative risks (except for endometrial and oesophageal cancer) are never stronger than two, except in the obese.

The supposed link between cancer and overweight and obesity is again called into question by a study from the US National Cancer Institute and the Centers for Disease Control published in 2007 in the Journal of the American Medical Association. This study found that being overweight was not associated with increase mortality from cancers considered obesity-related, and further noted that 'little or no association with excess all-cancer mortality with any of the BMI categories'. In other words, the overall risk of dying from cancer was not related to body weight.

Indeed, the study suggested that being overweight might be protective against cancer. For example, in individuals aged 25-59, obesity appeared to be protective against death from cancer. Even for those individuals aged 70 and over, BMIs in excess of 35 were not significantly linked with a higher risk of dying from cancer.

Will 'five a day' keep cancer away?

The WCRF report claims that there is a link between a certain kind of diet, obesity and cancer, and that fruits and vegetables, which fat people tend to eat less of, can protect against cancer. Once again, the scientific evidence contradicts such claims.

For example, of the 17 cancers discussed in the report, virtually all have statistically non-significant associations with every type of food, which means that they provide no evidence of a link between a particular food and a particular cancer. For example, of the 17 studies cited that looked at a link between colon cancer and processed meat, 13 are not statistically significant.

Despite the advice to avoid red meat, the report itself concludes that 'there is limited evidence...suggesting that red meat is a cause of oesophageal cancer'. Or, again, 'there is limited, inconsistent evidence...that grilled or barbecued animal foods are causes of stomach cancer'.

If the evidence is so limited and inconsistent, how can the advice to entire populations to reduce red meat consumption or avoid it entirely be so dogmatic?

What of the extraordinary claim that, since fat people tend to eat less fruit and vegetables, they are more likely to get certain cancers? This claim is contradicted by the largest and most expensive randomised controlled studies of the effect of eating certain foods and weight on the risk of getting breast cancer, colon cancer, heart disease, and stroke, that is, the Women's Health Initiative Dietary Modification Trial.

Almost 49,000 American women were followed over an eight-year period in terms of eating, weight, and disease. The women in the intervention group ate 'healthy' diets that were low fat and high fibre. The results? There were no statistically significant differences between the intervention and the control group in the incidence of breast cancer, colon cancer, strokes, or heart attacks.

In fact, the women following the healthy diet didn't even weigh less than they did at the beginning of the study, or less than the group that continued to eat as they always had. So much for the claim that there is a link between eating certain foods and avoiding cancer.

Are fat children more likely to get cancer in later life?

The WCRF's Martin Wiseman told the Mail on Sunday that 'the increase in the number of overweight children is deeply troubling because the more overweight a child is, the more likely they are to be overweight as an adult. And the more overweight the population becomes, the more cases of cancer we are storing up for the future.'

But if Wiseman had simply looked at the official figures on childhood overweight and obesity in the most recent Health Survey for England, he would have found that since the previous survey in 2006, there was a decrease in obese girls aged 2-15, from 18 per cent to 15 per cent. Among boys aged 2-10, the prevalence of overweight declined from 16 per cent to 12 per cent. Indeed, according to the Health Survey, amongst boys and girls aged between 2 and 15, overweight and obesity has been declining since 2004.

Nor is Wiseman's claim about fat kids becoming overweight adults true. Only morbidly obese children - that is, a very small minority of all children - are at risk for adult obesity. As Charlotte Wright in her Thousand Families Study in Newcastle found, there is 'little tracking from childhood overweight to adulthood obesity'.

Does exercise protect against cancer?

The final problem with the WCRF report is its assumption that there is a scientifically established link between physical activity, obesity, and cancer prevention. To put it charitably, this assumption is open to significant question.

Most of the summaries of the relevant scientific literature on this supposed connection are either non-committal or highly skeptical, despite the common sense claim that exercise is good for one. As one reviewer wrote, 'It is important to emphasis at the outset that most of what can be written on this topic remains speculative. No study exists which has recorded adequate birth-to-death information relating physical activity to health'.

Moreover, the evidence of a specific cancer-physical activity link is difficult to establish. Commenting on the supposed association between breast cancer and physical activity, Rissanen and Fogelholm wrote that due to the lack of evidence one could not make a public health recommendation for women to exercise to reduce their risk of breast cancer.

A recently published meta-analysis on 52 studies that looked at the association between colon cancer and physical activity reported that 44 were not statistically significant. So the supposed, obvious link between physical activity and preventing cancer dissolves upon closer examination.

Once you get beyond the scary headlines, the WCRF's claims about diet, weight, and cancer turn out to be, at best, dubious and, at worst, simply untrue.

Remember that acronym, CCSP. If its latest "Synthesis Report" on climate change sees the light of day, we may one day thank CCSP for policies that drive America into the poor house.

The problem is that our professional selfishness has a price: We have to agree the problem is so bad that it becomes, in Al Gore's words, "the central organizing principal for civilization." So we climate scientists wind up espousing policies are so drastic they will paralyze any economy.

Having been a climate scientist for about as long as these documents have been around, I have had the opportunity to review and comment on many documents that do this - not that my comments are listened to very much. I found two changes in the thousands of pages of the last (2007) IPCC report - after I sent in a 30,000-word point-by-point review.

I'll be lucky to get even that much attention after my equally long critique of a new CCSP report, Global Climate Change Impacts in the United States. The sum of my analysis: This is the worst document in this genre I have ever seen. By comparison, it makes the 1962 Mets (or, for that matter, 2008's Washington Nationals) paragons of professional excellence.

Virtually every sentence can be contested or simply ignores published science that disagrees with CCSP's preconceived message. In its own words: "Aggressive near-term actions would be required to alter the future path of human-induced warming... future generations will inherit the legacy of our decisions."

If "future generations" and "legacy of our decisions" sound more to you like politics rather than science, you're correct. The CCSP report isn't a science document at all. Not unless global warming science is a virtually one-sided world where almost everything is bad and getting worse, and where a moderate response dishonors our progenitors.

Of course, this can't be. Global warming lengthens growing seasons. Carbon dioxide, the cause of (part of the) warming (dormant for 11 years now) clearly improves crop yields in a world where stupid global warming policies (like burning our food supply in cars) are increasing food scarcity. If they have the money, by and large, Americans move to a warmer climate. And so on - which is why the CCSP document and the delete key should become intimate friends.

How did such a remarkable distortion see the light day? The "product lead" is Tom Karl, who heads the Commerce Department's National Climatic Data Center in Asheville, N.C. He is perhaps the most political and politically savvy climate scientist in U.S. history. When Al Gore was vice president, he would issue monthly briefings on the horrors of climate change. When Mr. Gore exaggerated some local flood, or claimed Florida would burn because of global warming, Mr. Karl stood by and remained mute. But now, with the prospect of an increasingly Democratic Senate, and a president who will go along with the madness of climatically futile policies (Barack Obama or John McCain on global warming? Pick em!), Mr. Karl and CCSP have picked up the scent.

From a policy viewpoint, it's even worse. The current administration has punted to the next president the question of what rules EPA should make about global warming. All the levers of political power - the presidency, Congress and the relevant agencies - are therefore all pointed in the same direction. All will cite the CCSP as their bible, and anyone who voices a more factual opinion will in fact be marginalized as insane.

Want more evidence as to the perfidy of the CCSP process? The senior editor is no climate scientist; it's Susan J. Hassol, who wrote the HBO global warming "documentary," "Too Hot Not to Handle." Laurie David, the force behind Al Gore's "An Inconvenient Truth," was the executive producer. This isn't science, it's science fiction.

The first illustration inside the front cover gives away the spin. It's a picture of people of as many races and sexes as possible holding hands. What that has to do with climate change science is a mystery, but it certainly reflects a political view.

The draft CCSP report knowingly uses Photoshopped imagery of a flood, uncritically publishes a misleading temperature history, which splices together two completely different sets of climate data, and generally assumes people are stupid.

There's a wonderful picture on Page 55 of two senior citizens, captioned: "The elderly are especially vulnerable to extreme heat." If that's true, then there must be massive and increasing numbers of heat-related fatalities in hot cities with old populations. In fact, Tampa and Phoenix have a disproportionately elderly population and very few heat-related deaths; statistically, Tampa has the fewest of any major U.S. city.

It may shock the CCSP, but when heat waves become more frequent, people change their habits and localities adapt their infrastructure to better deal with the heat.

Trash the entire report. It's neither scientific nor logical. It's a political document. Send the product lead back to Asheville and the senior editor back to Hollywood.

But of course, that won't happen. Instead, the CCSP report and its production team will be lionized. It will serve as the basis for the most onerous environmental legislation and regulations in U.S. history. And when historians look back at a nation made poorer by foolish policies (which themselves will have no effect on warming), they will wonder how climate science could have gone so far into the wilderness of politics.

First, a new Harvard study came out alleging that the tobacco industry manipulated menthol levels in cigarettes to hook young smokers in violation of the 1998 Master Settlement Agreement, which bans tobacco companies from targeting youths. And second, billionaires Michael R. Bloomberg and Bill Gates last week threw their support behind a new $500 million worldwide effort to stop smoking.

Whatever the tobacco companies may have done with menthol levels, the bigger scandal is how states have misspent the billions paid to them by the tobacco industry. And however well-intentioned, the Gates-Bloomberg effort, which involves the Johns Hopkins Bloomberg School of Public Health, is likely to fail because the tobacco control programs that it will fund - featuring such things as higher taxes, smoking bans and advertising restrictions - have failed before. These multiple shortcomings point to the need for a new, more effective approach to handling, and funding, tobacco prevention.

The Master Settlement Agreement resulted in a payment of $206 billion by the tobacco industry to 46 states over 25 years for smoking prevention. The states also receive annual payments in perpetuity based on inflation and cigarette sales.

When the agreement was signed, the state attorneys general pledged that this massive windfall would go toward funding smoking prevention programs. However, from the moment the states got their hands on the tobacco settlement money, this has not been the case. Instead of being spent on smoking prevention, the billions have gone to such things as expanded broadband cable networks, museum development, sewer upgrades, new schools and parks, economic development and general tax rebates.

Maryland's share of the settlement is $4.4 billion over 25 years. Yet the state falls short of the minimum amount recommended by the U.S. Centers for Disease Control and Prevention for state tobacco prevention spending: $30.3 million per year. According to the Campaign for Tobacco-Free Kids, in fiscal year 2007, Maryland spent only $18.7 million from tobacco settlement and tax revenues to prevent and reduce tobacco use.

The CDC recommends that the states invest 20 percent to 25 percent of the money they receive in tobacco control. Only three states ( Maine, Delaware and Colorado) are funding their smoking prevention efforts at the CDC-recommended level. According to the Campaign for Tobacco-Free Kids, the states will receive $24.9 billion this year from the settlement and tobacco taxes, of which they will spend approximately 3 percent on tobacco control.

Yet the tobacco settlement scandal is greater than the states' refusal to spend money for tobacco control on tobacco control. That's because even the meager efforts they do undertake bear little fruit.

For example, an enormous smoking prevention program in 11 communities called COMMIT (Community Intervention Trial for Smoking Cessation) was designed to help smokers, particularly heavy smokers, quit. It was a huge failure. Similarly, the largest attempt to put smoking prevention theory into practice was the American Stop Smoking Intervention Study (ASSIST), an eight-year project involving 17 states and run by the National Cancer Institute. This project possessed all of the bells and whistles of traditional smoking prevention: limiting tobacco advertising, restricting public smoking and making it harder for kids to access tobacco. Nevertheless, the project failed to produce a statistically significant reduction in smoking prevalence and consumption.

True, the U.S. smoking rate has declined sharply, but this trend began before the onset of significant government regulation and has continued, in large measure, because our society has continued to grow wealthier. Higher incomes stimulate public interest in, and concern about, matters of personal and public health.

A big part of the problem is that most anti-tobacco groups spent the last 25 years operating on the erroneous assumption that if you could prevent the tobacco industry from marketing, you could stop people from smoking. Most tobacco control efforts have failed because they have not been linked to the right predictors of becoming a smoker. These include socioeconomic status, connection and success at school, self-esteem, family structure and relations with parents.

Likewise, the $500 million in the Gates-Bloomberg plan would be far better spent on advocating for educational, economic and trade policies that would raise living standards and, consequently, dampen public interest in smoking - without the heavy hand of government intervention.

Ten years and $53 billion after the tobacco settlement windfall, there is precious little to show in terms of credible smoking prevention. It's time for Congress - and perhaps the president - to step in and demand that the states live up to their promise to use the settlement money for effective tobacco prevention. To ensure the settlement money has an impact, it needs to be diverted from projects unrelated to smoking and then placed into interventions that are based on what the best evidence shows are the real reasons kids start using cigarettes.

Until that happens, anti-tobacco efforts - whether funded by the states or by well-intentioned billionaires - will continue to amount to little more than blowing smoke.

The law requires everyone between 40 and 74 years of age to have their waist measured. The requirement, which will cover almost half of the country's population, stipulates that people whose waists exceed the allowable limit — 33.5 inches for men and 35.4 inches for women — will be given three months to get in to shape. Failing that, they will be given another six months of health re-education to reduce their waist measurements. Companies with large-waisted employees will be financially penalized.

The Japanese government argues that such draconian measures are necessary to prevent significant increases in diabetes and cardiovascular diseases (CVDs), as well as to rein in health-care costs. According to the Health Ministry, the underlying problem is metabolic syndrome (MS), which the Japanese call "metabo," a collection of supposed risk factors, such as waist circumference, along with blood sugar blood pressure and cholesterol levels, which increase the likelihood of cardiovascular disease.

For the advocates of MS, risk factors such as waist size provide a much better indication of cardiovascular risks than Body Mass Index, the height-to-weight ratio that is the conventional obesity measurement. The argument is that fat is the real cause of MS, which puts the large-waisted at an increased risk of heart disease and sudden death.

Is this really so? Does MS actually increase the risk of heart disease? The answer from two studies published last month in the British medical journal, the Lancet, suggests it does not.

The studies, led by Professor Naveed Sattar from the University of Glasgow's Faculty of Medicine, looked at the link between MS and CVD and diabetes in the elderly. Dr. Sattar and his colleagues focused on the elderly as the association between MS and CVD and diabetes in younger populations remains, as they note, "contentious." As they observe, the lack of supporting evidence for a link between MS and, with it, waist sizes, and heart disease and diabetes, has led to significant questions as to whether MS can usefully predict the onset of these diseases.

To test the MS/waist-size-heart disease/diabetes link, Dr. Sattar used two prospective studies — the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) and the British Regional Heart Study (BRHS) involving more than 7,000 patients aged 60-82 who were followed for three years.

The results are astonishing: They completely discredit the assertion that MS, with its claims about waist size and heart disease risk, provides a reliable predictor of CVD. In both PROSPER and BRHS, there were no statistically significant differences in waist measurements, BMI, or blood sugar levels between subjects who had heart disease and those who did not develop it.

Metabolic syndrome, with its regime of measuring waist circumference, was not useful in predicting risk for heart disease in the elderly. As the authors note, "Our findings concur with data in middle-aged populations for whom criteria for MS are inferior to, and do not enhance conventional methods for, risk prediction of coronary heart disease."

Lest these results be dismissed as a British quirk, the findings of the Cardiovascular Health Study, involving older Americans followed from 1989 to 2004 and published last month, refute the hysteria surrounding MS. The American study found that, after controlling for confounding factors such as smoking, drinking and physical activity, there were no statistically significant associations between heart disease mortality and the components of MS (waist measurements, cholesterol levels, etc.).

In fact, men and women with large waist sizes had lower risks for CVD mortality than the thinner-waisted. Moreover, these were Americans, who generally have larger waists than the Japanese.

The assertion that those with MS (particularly large waists) are likely to develop heart disease and run a higher risk of dying from a heart attack is unproven hysteria on the part of the obesity-obsessed public health establishment comparable to the discredited claims that those with BMIs in the overweight or obese category are likely to live shorter lives.

Let us hope this reassuring message reaches the Japanese before 50 million people are ordered to get their waists measured, let alone sent for obesity re-education, in the phony belief that there is a connection between a small waist and avoiding a heart attack.

That's too bad, because I support the idea that climate change is an object worthy of public scrutiny, and, as a scientist, the only way I can scrutinize is with numbers.

Citizens may or may not believe climate change is all it's cracked up to be, and this might bother them, but I have to say it. The commission's climate-change goal is to cut greenhouse gas emissions by 30 percent by 2025. It's high time people see what they'll get for their money.

This is a 30 percent reduction from the total that would accrue if we did nothing -- that is, stayed on the same emissions trajectory we've been on for decades.

A 30-percent target sets Virginia's emissions back to the level they were at in the year 2000. Let's be charitable and say that people around the country think so highly of Virginia's ambitions that every state in the nation decides to mandate the same cuts. Let's be even more charitable and say that every nation on Earth that has obligations to reduce emissions under the 1997 Kyoto Protocol on global warming follows Virginia's lead. The protocol was an appendage to a 1992 United Nations' "framework" treaty of climate change.

Remember Kyoto? It would have reduced global emissions to about 5 percent below 1990 levels for the years 2008-2012. Instead, they rose at double-digit levels, and only two significant nations actually met their obligations: Germany and the United Kingdom. (Each for reasons that had much more to do with local economics than environmental stewardship.) According to figures from the U.S. Energy Information Administration, in 2000, the U.S. (which never ratified Kyoto) emitted roughly 10 percent more CO2 than its 1990 total.

That's a pretty standard figure across all Kyoto signatories with growing economies. So applying the Virginia plan to this group of nations actually does less than Kyoto because it takes the developed world also back to 2000, rather than to somewhere around 1985 (when emissions were about 5 percent below 1990 levels).

As early as 1998, scientists at the U.S. National Center for Atmospheric Research in Boulder, Colo., calculated how much global warming would be saved by full compliance with Kyoto. As a study published in the scientific journal Geophysical Research Letters found, that works out to 0.07 degrees C per half-century. That's right: not 7 degrees or even seven-tenths of a degree, but seven hundredths of a degree.

Adopting the Virginia plan across all Kyoto nations would result in about 72 percent of the emissions reductions of Kyoto itself by 2050, again according to data from the Energy Information Agency. That means a savings of five hundredths of a degree of warming by then, and 0.13 degrees by 2100 (which is 72 percent of the warming projected for Kyoto). The 2050 figure is about 20 times less than the mean annual temperature difference between downtown Richmond and suburban Short Pump.

No one will be able to identify the changes Virginia's policy makes in either state or global temperature histories, because temperatures vary naturally from year to year -- thanks to changes in the sun, El Nino oscillations in the tropics, and random volcanoes -- about as much as the Virginia plan would affect temperatures 100 years from now.

Incidentally, these figures assume that if atmospheric carbon dioxide is doubled, surface temperature will increase by 2.5 degrees C. The lack of any net global warming in the last decade, and recent projections published in Nature magazine indicating that there will be little, if any, through the middle of the next decade, argue that this number itself is probably too high. If that's true, the Virginia Commission goal will prevent even less warming.

It's hard to believe that any member of Virginia's commission really thinks he's doing much about global warming. And it's equally hard to believe that the members haven't made these numbers public.

They are now. People need to know that the proposed goal of the Governor's Commission on Climate Change will simply have no detectable effect on global warming. So what's the point?

The Loss of Sadness: How Psychiatry Transformed Normal Sorrow Into Depressive Disorder, by Allan V. Horwitz and Jerome C. Wakefield, New York: Oxford University Press, 287 pages, $29.95

Is Tony Soprano really depressed?

That is one of many questions sure to hound readers of The Loss of Sadness: How Psychiatry Transformed Normal Sorrow Into Depressive Disorder, a tightly reasoned, paradigm-shaking new book. Written by Allan Horwitz, a specialist in the sociological aspects of mental health at Rutgers University, and Jerome Wakefield, a professor in the School of Social Work at New York University, The Loss of Sadness could alter the official definition of depression, change the way we get mood-enhancing drugs, and clarify how effectively our culture delivers well-being.

In the late, lamented HBO series The Sopranos, mafia boss Tony Soprano's confessions to his psychiatrist opened a window on the fragile psyche of an extralegal executive. We discovered that Tony — a man who has killed with his bare hands — once dreamed a bird had absconded with his penis. More importantly, we learned that no man, no matter how tough, is impervious to depression.

There's no second-guessing his sadness, but does Tony really suffer from a genuine depressive illness, a breakdown of normal psychological functioning? And what about the rest of the Prozac-popping multitudes? Are they truly sick?

If the numbers are to be believed, serious depression is the dark lining in the silver cloud of capitalist abundance. "There is more purchasing power, more music, more education, more books, worldwide instant communication, and more entertainment than ever before," the psychologists Ed Diener and Martin Seligman wrote in 2004. "But contrary to the economic statistics," they continue, "all the statistics on depression and demoralization are getting worse." As Horwitz and Wakefield show, this claim is not clearly true.

According to epidemiological estimates, major depressive disorder afflicts 1 in 10 adult Americans each year. Outpatient treatment of depression in the United States increased 300 percent between 1987 and 1997, the last year for which comprehensive statistics are available. By 2020, according to the World Health Organization, depression will trail only heart disease as the leading cause of disability worldwide. As Seligman, a professor at the University of Pennsylvania, has written, "We are in the midst of an epidemic of depression, one with consequences that, through suicide, takes as many lives as the AIDS epidemic and is more widespread." What accounts for this deadly, rapidly spreading malaise?

Nothing.

According to Horwitz and Wakefield, "There are no obvious circumstances that would explain a recent upsurge in depressive disorder." The ranks of the depressed are bulging, they argue, because the clinical category fails to make the elementary distinction between normal, functional sadness and true mental disorder. The depression data are littered with false positives — jilted lovers, white-collar workers who missed out on a promotion, and kids nobody asked to the prom. People who are suffering but aren't sick.

The Loss of Sadness argues that Darwinian natural selection has equipped us with a "loss response" system. We are built to be saddened by loss, just as we are built to be enlivened by success. A genuine depressive illness requires the "harmful dysfunction" of the loss system. Even bouts of quite profound sadness — say, a month-long funk following a devastating romantic reversal — can be perfectly consistent with the proper function of our mental machinery. A response to loss of a duration or intensity out of proportion with the precipitating event often signals the breakdown of proper function; so do symptoms without an intelligible cause. Similarly, the failure of the fog to lift after well-motivated sadness has run its course could signal dysfunction, like a heart that hammers too long after a race. If you mourn your dead schnauzer for two weeks, you're probably normal. If you're still blue after two years, you have a problem.

Since its third edition was published in 1980, the Diagnostic and Statistical Manual (DSM), the standard handbook used by clinicians to classify mental problems, has defined major depressive disorder with a complex checklist of symptoms. In order to meet the exigencies of 15-minute doctor's visits and the needs of public health surveys, the few diagnostic qualifications calling for expert judgment were stripped away to produce a simple rule of categorization that family doctors, mental health epidemiologists, and even — or especially — computers can apply. To simplify only slightly, if you meet five of nine mundane requirements over the course of two weeks, you qualify as suffering from major depression. The checklist: a persistently low mood, a diminished interest or pleasure in almost everything, an increase or decrease in appetite leading to a gain or loss in weight, too much or too little sleep, fatigue or low energy, fidgetiness or listlessness, feelings of worthlessness or guilt, difficulty concentrating or indecisiveness, and thoughts of death, suicide, or an attempt of suicide.

The DSM admits a single exception: If the symptoms are precipitated by the death of a loved one, they represent normal grief and there is no disorder. But as Wakefield and his team showed in a 2007 study, one in four people diagnosed with major depressive disorder exhibited symptoms only negligibly different than that of the bereaved. They too were responding to major losses; it's just that the precipitating events were not deaths. In both sets of cases, the sadness came on the heels of a genuine loss, was similarly deep, and was similarly long-lasting. For Horwitz and Wakefield, it is the context within which symptoms present themselves, not just the fact that they exist, that divides sickness from health. A woman who awakes one day to find herself bereft of hope and a woman who has lost her job may have identical symptoms, but that does not mean they are both ill.

According to Horwitz and Wakefield, the definition of depression in the DSM is an embarrassing overreaction to some prior embarrassments in the psychiatric profession. A widely-touted 1972 study, for example, exposed a scandalous degree of disagreement between British and American shrinks in the diagnosis of depression in the same patients. The third edition of the DSM was a comprehensive revamp, headed by the prominent psychiatrist Robert L. Spitzer, aimed at improving the reliability of diagnosis across clinicians by laying out clear, symptom-based diagnostic rules that take no sides in psychiatry's contentious debates about the root causes of pathologies. On that level Spitzer succeeded, vastly increasing the chances two doctors given the same clinical information would agree on a depression diagnosis. But it came at the cost of gutting the validity of the diagnostic rule; that is, its ability to sort the truly sick from the merely beleaguered.

Spitzer, who contributes a preface to The Loss of Sadness, reflects prevailing psychiatric opinion when he registers skepticism about the clinical utility of the context-sensitive diagnostic approach Horwitz and Wakefield defend. Spitzer implies that hordes of false positives are better than a few false negatives. It is true, as Spitzer worries, that a more scientifically valid diagnostic category could allow a few truly depressed people to slip undetected through the diagnostic net. But such an outcome does not vindicate bad science. Instead, it should draw our attention to the careless, checklist-centered diagnostic practice encouraged by the over-wide definition of depression.

Patients seeking help from a doctor deserve an accurate diagnosis, appropriate treatment, and a prognosis they can count on. A new self-image as "mentally disordered" and a vial of antidepressants (beware sexual side effects!) might not always work wonders for those feeling temporarily bleak. Then again, mood-enhancing drugs may well help many of those struggling through normal loss. But couldn't a tighter diagnostic rule put drugs out of reach for many people who want them? If we need to revise our definition of depression, don't we also need to accept the right of everyone, sick or not, to feel the way they want?

Horwitz and Wakefield don't want anyone to lose access to their pills, but they are weak on this score, arguing that if a patient who is not ill really is helped by drugs, doctors will nevertheless write prescriptions and fool the insurance companies. In the meantime, they can only hope that their proposed diagnostic reforms will help "facilitate a discussion" about allowing those who are not certifiably ill to receive drugs anyway. That discussion may not conclude as they wish, given that so many Americans believe drugs should be reserved for those officially designated "sick."

Nevertheless, we've come a long way in dissociating sadness, whether normal or disordered, from a lack of inner fortitude. The overbroad definition of major depressive disorder in the DSM, together with the 1987 appearance of Prozac, seems to have done much of that work. Thanks in large part to pharmaceutical companies trying to sell us (and our insurers) on the idea that every bout of the blahs is a treatable medical disorder, more Americans than ever attribute depressive symptoms to a "chemical imbalance," seek treatment, and approach their pharmacists with prescription slips signed by insurance-reimbursed physicians.

But we should not expect a swift correction in the way depressive disorder is diagnosed, no matter how strong Horwitz and Wakefield's case is. As they make clear, thousands of mental health studies, thousands of careers, and tens of millions in research funding are wrapped up in the very diagnostic category they claim is fundamentally broken. Doctors who are paid by insurance companies have an interest in keeping the category permissive. So do pharmaceutical companies wanting to boost sales of mood enhancers. And so do the ordinary people who feel better on Prozac, Wellbutrin, or Effexor, whether or not they genuinely qualify as disordered.

The evidence suggests that anti-depressants work just as well as, and are cheaper and less time intensive than, cognitive behavioral therapy. Drug marketing seems to work as well: Advertising can increase demand when people were previously unaware a product was available. So the hugely increased diagnosis of depression and the correspondingly huge increase in the use of mood-enhancing drugs may be a sign of improvement in the way we feel. As the health economists David M. Cutler and Elizabeth Richardson Vigdor write in a paper published by the Brookings Institution, "Only measuring the prevalence of reported depression over time leads to the conclusion that the prevalence of debilitating mental illness has increased, when in fact the opposite may have occurred." If anti-depressants generally do make people feel better, an increase in usage should mean a decrease in sadness. Promiscuous diagnosis may be a boon for the national mood.

Interestingly, the evidence for an increase in normal sadness is also scarce. Data on "happiness" or "life satisfaction" from the huge General Social Survey flatly contradict the depression data. The percentage of Americans reporting themselves in the lowest category of life satisfaction dropped slightly over the past 30 years, just as rates of diagnosed depression were exploding. We should expect an epic epidemic of sadness, not to say depressive illness, to at least register in the life satisfaction numbers.

And if depression is booming, why do the suicide trends look so rosy? According to data from the U.S. National Center for Health Care Statistics, the overall suicide rate in 2003, the last year recorded in the U.S. Statistical Abstract, was barely higher than the rate in 2000 — which was lower than that of any of the previous 50 years. Suicide among teen boys did hit a record high in 1990, but rates have declined sharply since then, perhaps because of the increased availability of antidepressants.

Indeed, last year a group of UCLA medical researchers found a strong statistical association between the decline in the suicide rate and the growth in the number of people taking fluoxetine (generic Prozac) during the 1990s. (A team at Stanford has proposed an alternate cause for the decline: "the sustained economic recovery of the 1990s.")

The alleged epidemic of depression simply doesn't exist. Horwitz and Wakefield are right: Millions who have been diagnosed with major depression never had it in the first place, even if their lives were nonetheless improved by the drugs they were prescribed. We risk our very real and very satisfying prosperity if the self-assigned stewards of public health insist on "treating" our illusory unease. That would be depressing.

Before we condemn red meat, alcohol, sodas, shakes, chips, and other such "bad" foods to the realm of the inedible, it's worth looking at the scientific evidence to see whether it really supports the claims.

The report's authors tell us that they looked at over half a million studies, and then concentrated on the 7,000 that were most relevant. That is not quite true — actually they refer to slightly fewer than 2,500 studies on diet and disease. More importantly, they conveniently omit many major studies that don't support their three truths theory.

Crucially, they almost exclusively refer to epidemiological studies, which inherently cannot establish that being fat or that eating red meat gives you cancer, as that's not what this type of study does. Indeed, the very nature of epidemiological studies means that the margin of error arising from the nature of the data exceeds the supposed relationships that the study has found.

What about the headline-grabbing claim that being fat gives one cancer? The report actually claims that being overweight or obese increases your risk for six cancers — cancers of the oesophagus, pancreas, colon/rectum, breast, endometrium, and kidney. However, when you look at the report's support for this conclusion, the evidence is extremely thin.

Take pancreatic cancer, for example. The report cites 20 case control studies, but only three show a statistically significant association between obesity and pancreatic cancer. Similarly, of 42 cohort studies on colorectal cancer, only 13 show a link with obesity.

Of the 16 studies that the report documents on the relationship between breast cancer and obesity, only three are statistically significant, while eight actually show a decreased risk of breast cancer for those who are obese. Even for oesophageal cancer, the increased risk was largely confined to the morbidly, as opposed to the moderately, obese.

With endometrial and kidney cancers, the relative risks were below two. According to the U.S. National Cancer Institute, such risks are so small that they may be due to "chance, statistical bias or the effects of confounding factors."

The just-published Million Women Study from the U.K., which examined the evidence for a link between 17 of the most common cancers and Body Mass Index (the conventional yardstick for measuring overweight and obesity), found a similar pattern of results.

In this study, ten of the cancers do not show a statistically significant association with either higher levels of overweight or obesity. Of the remaining seven cancers, the association between overweight and the cancer is nonsignificant in four, and where the results are significant, the risks (except for endometrial and oesophagal cancer) are never stronger than two, except among the obese.

A new study from the National Cancer Institute and the Centers for Disease Control also contradicts the obesity-cancer link. This study found that being overweight was not associated with those cancers previously considered obesity-related.

The study found "little or no association of excess all-cancer mortality with any of the BMI categories." Indeed, the study suggests that overweight might in fact be protective against cancer.

It also concludes that eating certain foods increases our risk for cancer. Of the 17 cancers discussed in the report, however, virtually all have statistically non-significant associations with every type of food, which means that they provide no evidence of a link between a particular food and a particular cancer.

For example, of the 17 studies cited which assessed the link between colon cancer and processed meat, 13 are not statistically significant. Despite the scary headlines about red meat, the report concludes that "there is limited evidence… suggesting that red meat is a cause of oesophageal cancer."

Again, "there is limited, inconsistent evidence… that grilled… or barbecued animal foods are causes of stomach cancer." Given the limited nature of this evidence, it is difficult to see how the report justified its advice to avoid red meat.

Are these anomalous findings? On the contrary. Consider, for example, the American Cancer Society's 2001 study of diet and stomach cancer, which looked at 436,000 men and women, and found no increased risk of stomach cancer associated with eating processed meats. What that study did find, by contrast, was an increased risk of stomach cancer in women who consumed more vegetables!

Finally, the report claims that cancer is "mostly preventable." This is perhaps the most curious claim of all — since there is massive evidence of the best kind that suggests precisely the opposite.

The Women's Health Initiative Dietary Modification Trial is the most recent, and one of the largest, and most expensive, randomized, controlled studies of the effect of diet and weight on breast cancer, colon cancer, heart disease, and stroke. It studied 49,000 American women over an eight-year period. The women in the intervention group ate diets that were low in fat and high in fiber, with six servings of grains and five of vegetables and fruits per day.

There were no statistically significant differences between the intervention group and the control group in the incidence of breast cancer, colon cancer, strokes, or heart attacks. Ironically, the women following the 'healthy' diet designed to reduce cancer and heart disease didn't even weigh less than they did at the beginning of the study, or even weigh less than the women in the control group who continued to eat as they always had.

Unlike the epidemiological studies cited in the World Cancer Research Fund report, this gold standard, randomized, controlled intervention, found no evidence to support the claim that there is a connection between eating certain foods, being a certain weight, and preventing cancer.

This study is not unique. A new study published in the Journal of the National Cancer Institute analyzed data from 14 studies involving 756,000 men and women who were followed from six to 20 years. The study found that fruit and vegetable intake was not associated with a reduced colon cancer risk. Some cancer prevention, indeed.

Contrary to recent media headlines, the World Cancer Research Fund report does not prove there is a causal connection between cancer and being fat, or cancer and eating certain foods, or diet and cancer prevention. Rather, the report merely demonstrates that, as epidemiologist Petr Shrabanek observed, "People who eat, die."

Aubrey de Grey is so deep into geek biogerontology that using "almost everyone thinks of" in the sentence quoted above does not strike him as rather generous. In reality, most of us are thinking "amyloid...amyloid...you're talking about the singer, right? No, no...what am I saying...Wasn't she the actress in that movie...?"

Four years ago, I reported that de Grey foresees a not-too-distant future in which humans can reverse the effects of aging, raising the possibility of living healthy lives for hundreds of years. He has not backed away from that position, and this book, written by de Grey and his research associate Michael Rae, represents an update from his perspective. In brief, he says that

1. The latest scientific research indicates no flaws in the theory that aging can be eradicated.
2. However, getting the required techniques developed will require institutional changes relative to our current system for conducting medical research.

As an economist, I am most interested--and most qualified to form an opinion about--the second point.

Accessible Metaphors

De Grey makes state-of-the-art scientific issues accessible to an intelligent layman. He uses metaphors, as when he describes the role of mitichondria in terms of a power plant analogy (p. 53).

But while hydroelectric dams are (for the most part) environmentally benign, mitochondria are in one key aspect more like conventional power sources [in that they] create toxic wastes during the conversion of energy from one form to another...oxygen is also the sink for the electrons that are not fumbled--that are properly processed by the mitochondria--but that process loads four electrons onto each oxygen molecule...Adding one electron, by contrast, transforms benevolent oxygen into a particularly important free radical, superoxide. With your mitochondria generating ATP day and night continually, the ongoing formation of superoxide is like having a constant stream of low-grade nuclear waste leaking out of your local reactor.

De Grey's overarching metaphor is that the body is like a machine that, if properly maintained, can be kept running forever (p. 21).

we have hundred-year-old cars and (in Europe anyway!) thousand-year-old buildings still functioning as well as when they were built--despite the fact that they were not designed to last even a fraction of that length of time...the precedent of cars and houses gives cause for cautious optimism that aging can be postponed indefinitely by sufficiently thorough and frequent maintenance.

However, maintenance of a car or a building often consists of replacement of components at a macro level. You replace whole tires and lightbulbs. You rip out a transmission or a kitchen and put in a new one.

What de Grey is talking about for humans is not macro replacement--giving you new organs or giving your cardiovascular system the equivalent of a transmission overhaul. Instead, he is talking about maintenance at a molecular level. For a car, it would be like having nanobots that repair corroded parts by reversing rust molecule by molecule. For a house, it would be like having shingles that when damaged by wind or wear are able to grow back to their original shape.

Internal Evolution at Work

De Grey sees aging as a byproduct of an evolutionary process that takes place within the body. Mutations occur over time within your cells, sometimes randomly and sometimes stimulated by external events. This evolutionary process changes the balance between what I might call "good stuff" and "bad stuff" (here I am taking the technical caliber of the scientific exposition down several levels). Sometimes, the "good stuff" gets stronger, as when we develop an immunity to a disease. More often, however, the "good stuff" gets weaker and the "bad stuff" (like arterial plaque or pre-cancerous cells) gets stronger. It is this shift in the balance that leads to the symptoms of aging, including susceptibility to disease, which ultimately proves fatal.

Because aging is a natural outcome of the body's internal evolutionary processes, de Grey argues that the standard paradigm for fighting the diseases of aging one by one is flawed. Prevention of one disease, in the form of slowing the processes that cause it, is a doomed strategy.

First, there is the fact that the processes that cause disease are the very processes that make life possible and enjoyable. The prevention paradigm amounts to lengthening the life of a car by keeping it in a dry, climate-controlled garage forever without ever driving it.

Second, there is the fact that if one age-related disease does not get you, then another one will. In my research into the causes of rising health care spending, I learned the sad truth that as we have achieved success in the battle against heart disease, we are increasing the chances that people will die of diseases like Parkinson's or Alzheimer's, with the result that expenditures on institutional care and full-time home care are soaring.

Only Seven Types of Damage

De Grey argues that there are only about seven generic forms of damage, in which our body's evolutionary processes cause it to lose "good stuff" or produce more "bad stuff" (again, those are my dumbed-down expressions). De Grey's approach to reversing aging is to stimulate the body to throw out the bad stuff and grow more good stuff, maintaining a youthful balance.

For example, his approach to eradicate cancer is particularly radical. Cancer consists of "bad stuff" that has won the evolutionary battle and is now reproducing like gangbusters. He wants to make it impossible for any type of cell to take over the internal ecosystem, so his proposal amounts to programming all cells to self-destruct after they reach an expiration date. Obviously, this creates a problem in that we need some of our cells to be able to last longer, or we will run out of "good stuff." His solution is to use periodic stem cell implants to replenish our inventory of "good stuff." Along the way, he makes a clear and compelling case that we need embryonic stem cell research.

(As an aside, I did not find his argument against the conventional cancer-fighting paradigm fully convincing. I find it more appealing to hope that there is a way to give every cell a "suicide pill" that it takes only if it recognizes that it is about to be captured by the cancer-enemy. Instead, killing off every cell, good or bad, and then trying to add new good cells strikes me as inelegant.

De Grey expresses the concern that when a conventional therapy goes after cancer (and the approach that appeals to me is more conventional), the laws of evolution suggest that a few cancer cells are likely to mutate and survive. Those that survive will be drug-resistant and therefore much more dangerous. However, I think that this is not like the mutation of germs, where a drug-resistant bacteria or virus can get started in one person's body and continue to evolve somewhere else. The fact that a cancer cell evolves in my body to evade a particular drug does not make that drug any less effective in your body. If your body is going to develop a drug-resistant form of that cancer, it is going to have to start from scratch. As a result, there may be a limited number of such mutations, and therefore we may need only a finite set of anti-cancer drugs. Of course, I have absolutely no expertise in this area. It is more likely that I misunderstand de Grey's argument than that he is wrong.)

A Crash Course

Too often, academics use their credentials to spit out biased polemics dressed up as science. Ending Aging is the opposite. It is a crash course in state-of-the-art science dressed up as a polemic. De Grey wears his passion for undertaking a war on aging on his sleeve, yet most of the book consists of scientific analysis that, although simplified to enable a layman to follow, is conscientious in reporting doubts and objections to the author's point of view.

I would recommend giving Ending Aging to any scientifically-inclined youngster. It gives a sense of the possibilities, drama, and frustration of scientific inquiry. Also, it might inspire some young geniuses to undertake the sort of investigations and experiments that de Grey thinks will help win the war against aging.

New Institutions

The polemical component of de Grey's book is aimed primarily at the institutions and incentives that currently govern the medical research process. Some of the changes that he proposes are radical, and some are subtle.

The first institutional problem, from de Grey's perspective, is that the incentives lead researchers to focus on specific diseases rather than on general-purpose technologies to fix cell damage. In scientific research, the usual distinction is between "basic" research and "applied" research. Almost everything that De Grey is talking about is in the "applied" arena. We can always use more basic research, but I think he would regard the basic research that we have today as sufficient in many respects.

The distinction between disease-specific and general-purpose fits under applied research. Within the category of applied medical research, there are discoveries that attempt to treat specific diseases, such as prostate cancer or Parkinson's. However, the technologies that de Grey advocates developing might reverse the processes that are implicated in many diseases.

Today, the incentives to experiment with general-purpose anti-aging technologies are limited. Only if a technique can be demonstrated as helping to treat a specific disease can its development be funded and its efficacy tested in humans. Of course, many of the techniques necessary to achieve de Grey's vision can be shoehorned into a disease-fighting agenda somewhere, which is why he can report results that justify his belief in the potential to conquer aging. However, there remains the fact that the current system gives too much incentive to find stopgap solutions to specific diseases and too little incentive to develop general-purpose anti-aging technologies.

The second institutional barrier is risk aversion, which is hard-coded into regulations pertaining to research and to clinical trials. De Grey writes (p. 323-324),

Regulation of experimental drugs and therapies...is based on one abiding principle above all others: the minimization of risk that the therapy might make the patient worse...

I take the view, quite simply, that Hippocrates has had his day...the psychological effect of possibly causing harm...skews the objective cost-benefit analysis of a given treatment...I believe that the 10:1 (at least) ratio of lives lost through slow approval of safe drugs to lives lost through hasty approval of unsafe drugs is no longer acceptable.

...[Laws and regulations will change.] People will die as a result; the 10:1 ratio mentioned above will probably be reduced to 2:1. And people will be happy about this change, because they'll know it's wartime, and the first priority--even justifying considerable loss of life in the short term--is to end the slaughter as soon as humanly possible.

What de Grey is saying is that today's cautious approach to experimental medical testing significantly slows the rate of progress, which means that many people will suffer and die unnecessarily. However, those people are unseen and unknown, whereas those who suffer and die as a result of medical experiments are identifiable and visible. I think that trying to sell people on the idea of taking more risks in order to advance medical progress is not as straightforward as de Grey makes it sound.

As an economist, I immediately think in terms of paying people to undergo risky therapies. For better or worse, this might appeal more to people who are very poor--perhaps even people living in other countries. However, those citizens who are squeamish about de Grey's proposal to expose more people to harm now in order to reduce harm to others in the near future probably would not feel any less squeamish just because those who undergo the experiments are well paid.

At a more subtle level, de Grey wants institutional changes that wrest control of the research agenda from the medical establishment, which is vested in the existing paradigm. Here, the fact that so much medical research is under government auspices makes the outlook discouraging, in my view. If there is one thing that you can count on government to do, it is to protect incumbents and move with great reluctance to support upstarts and innovators.

My guess is that de Grey will have better luck if he tries to mobilize wealthy philanthropists. If instead of donating buildings to universities our billionaires would donate money for prizes that reward general-purpose medical technologies, we might not have to wait for government research to adopt a paradigm shift, which is almost surely not going to happen. Wealthy (and not-so-wealthy) philanthropists who are reading this should check out de Grey's organization SENS and look for ways to contribute both to his institute and to a prize fund.

Let me give de Grey the last word (p.328-329):

Just as people were wrong for centuries about how hard it was to fly but eventually cracked it, we've been wrong since time immemorial about how hard aging is to combat, but we'll eventually crack it, too. But just as people have been pretty reliably correct about how to make better and better aircraft once they had the first one, we can expect to be pretty reliably correct about how to repair the damage of aging more and more comprehensively once we can do it a little.

Opening the Washington concert leg, Mr. Gore denounced climate change skeptics "who don't understand what is now at stake." Strong words from a public figure flaunting an Oscar comprised of junk science.

Sadly, the IPCC encouraged deeply disturbing departures from sound scientific research that significantly undermine Live Earth's alarmist message. Yet, the problems with the IPCC report go much further than politicized science. They extend to the core of the climate change debate, namely the degree of scientific certainty about the causes and consequences of global warming.

Scientific uncertainty: What level of scientific certainty do IPCC's global warming claims really have?

The gold standard level of scientific certainty is the 95 percent confidence level. This allows a researcher to attest that he or she is 95 percent confident his or her findings are genuine and not due to chance. Claims that fail to meet this standard carry little scientific weight.

Applying this scientific concept to the IPCC report reveals how uncertain are the alarmists' claims. For example, not a single IPCC conclusion about the human sources of global warming meets a 95 percent confidence level standard.

There are, however, 26 claims termed "likely," meaning their chance of being true is greater than 66 percent. To put this into context, you might ask yourself how comfortable you would feel driving a car whose brakes worked only 14 times out of 20.

This has importance for understanding how much genuine scientific knowledge, as opposed to mere political posturing, the IPCC report offers. For example, the key claim — that there has been significant human-caused warming over the last 50 years — is merely "likely," according to the IPCC.

Not one of the IPCC's seven projected man-made weather trends reaches a 95 percent confidence level. This fact makes implausible the claim that human activity is the driver of climate change.

Politicized science: The IPCC's Rules of Procedure mandate not the normal scholarly peer review process but "review by governments." Furthermore, the IPCC states that, "In taking decisions and approving, adopting and accepting reports, the Panel, its Working Groups and any Task Force shall use all best endeavors to reach consensus."

Both rules suggest something other than a process committed to sound science. Science does not proceed by consensus or government review but by reliably replicable, public results always open to doubt and falsification.

Injecting government review into the scientific process corrupts the process by switching from one in which science drives policy to one in which policy drives science. In truth, these rules reveal the IPCC process for what it really is: politicized science in the service of government, rather than science in the service of the truth.

Some commentators say casting doubt on the science of climate change is the equivalent of Holocaust denial. Such thinking can only come from those who either fail to understand or choose to disown the scientific enterprise.

At the heart of the scientific enterprise is a curious and always difficult tension between certainty and the possibility that certainty can suddenly dissolve. Respectful of that tension, the climate change skeptic asks for two things: first, to bring the normal standards of scientific evidence to the climate debate; and, second, to make certain there is not some politically driven and premature closure of what is a scientific controversy.

Live Earth's inconvenient truth is that Al Gore and his friends are wrong about the strength of the climate change evidence. Using normal scientific standards, there is no proof we are causing the Earth to warm, let alone that such warming will cause an environmental catastrophe. To claim otherwise is to be untrue to the skepticism at the heart of science.

The drug in question is Gardasil, a vaccine for four types of human papillomavirus, two of which are responsible for 70 percent of cervical cancer cases. The Food and Drug Administration approved Gardasil last year for use against HPV in females aged 9 to 26. Texas, New Mexico and Virginia have all recently mandated HPV vaccination, and Michigan may be next.

The Senate Health Policy Committee held hearings last month on two bills introduced earlier this year by Sen. Tony Stamas, a Republican, and Sen. Deborah Cherry, a Democrat, that would require all Michigan girls to be vaccinated against HPV before entering the sixth grade. There is an option not to participate. Similar bills were introduced in the House by Rep. Brenda Clack, a Democrat, and Mark Meadows, a Democrat. Amended and/or combined committee versions of these bills could come before the Legislature before the end of this session.

With a price tag of $360 for a series of three shots, mandatory vaccination would be quite a boon for Merck. If all sixth-grade girls were vaccinated, the company could reap over $29 million a year in Michigan alone.

Gardasil is not all it's cracked up to be. A recent study in the Journal of the American Medical Association finds that among women ages 14 to 24, the rate of all 37 types of sexually transmitted HPV combined is 33.8 percent -- much lower than the 50 percent figure cited on Merck's Web site. More important, the rates for HPV 16 and 18 -- the two types responsible for 70 percent of all cervical cancers -- are astronomically lower: only 1.5 percent and 0.8 percent, respectively.

And even among those cases, last month's American Cancer Association guidelines report that most HPV infections, even carcinogenic ones, resolve without treatment. Approximately 75 percent of infections in adults and 90 percent of those in adolescents disappear on their own.

It's worth noting that the American Cancer Society sees its fight against cervical cancer as a success story even without Gardasil. When detected early through Pap testing, the survival rate for the disease is over 90 percent.

In short, even without the vaccine, when early detection methods are used, the number of girls who are actually at risk of dying of cervical cancer from HPV is extremely low. Most of the time, the body takes care of the virus without any help whatsoever.

Under these circumstances, are we really prepared to spend untold millions administering this vaccine? In truth, it may very well cause more harm than good.

What if the vaccine lulls young women into a false sense of security? Gardasil only protects against the viruses responsible for 70 percent of cervical cancers, and women may not realize the necessity of regular Pap tests even when they've been vaccinated. As a result, many pre-cancerous conditions may go undetected before it's too late.

Merck's drug trials followed women who received Gardasil for an average of less than three years, so we know little of how long the immunity lasts or the long term risks that may be associated with it. Children vaccinated in the sixth grade could potentially lose their immunity by the time they were seniors in high school.

The New England Journal of Medicine recently reported similar problems with the chickenpox vaccine. Not only did the incidence of illness among those vaccinated increase over time, so did the severity of the illness itself.

And what if some horrible side effect were to materialize later? The possibility isn't as far fetched as you might think. In 1976, swine flu caused only one documented death in the United States, but the vaccine administered by government mandate seriously injured or killed hundreds. It turned out that the vaccine caused Guillain-Barri Syndrome, a rare paralytic disease similar to polio, with a 5 percent fatality rate and a 10 percent rate of permanent paralysis.

Mandatory Gardasil vaccinations certainly brighten Merck's future, but it's not so clear that they're in the best interest of the people of Michigan. In all but the clearest cases, health risk assessments should be left up to individual families, not only because making such determinations rightly rests with families, but because it's simply not sensible policy to experiment on such a large portion of our population all at once.

Mandating HPV vaccinations would bring Merck huge profits, but they might well come at the expense of Michigan's citizens -- or at least at the expense of Michigan's little girls.

Two stem cell funding bills passed the Senate last week and are now being considered in the House: one, sponsored by Democrats, that would fund research on any embryo destined to be discarded, and another, introduced by Republicans, that does little to further research because it only allows funding for research that won't harm embryos.

It's better to allow private interests to fund the most promising research than to allow the party in power to make medical and scientific decisions for all. In 2005, California passed Proposition 71, committing $3 billion in state funding to stem cell research, and since then, not a cent of that money has been spent. Private donations and loans -- including some from the state's general fund -- are making moderate progress on stem cells, but the money authorized by Prop. 71 remains tied up in lawsuits filed by those who oppose the research on moral grounds.

It'll be at least another year before California can issue the bonds to raise the funding, let alone distribute it. And these being bonds, they'll saddle California taxpayers with an additional $3 billion in interest payments over the next 30 years.

By contrast, in Missouri, voters last November passed a constitutional amendment protecting the right to pursue all forms of stem cell research allowed under federal law -- but not funding it. This ensured that the state kept the door open for private laboratories like the Stowers Institute for Medical Research, which employs an international team of researchers and $2 billion in private endowments. For years, Stowers has been doing extraordinary research on adult stem cells, and the amendment will see to it that the progress continues as the lab expands into embryonic stem cell research in the future. And since it's privately funded, there'll be no bond issues, no debts, no interest to pay, and no taxpayer liability.

Stowers has shown tremendous success in adult stem cell research. Earlier this year, they documented the development of cancer stem cells. And just last month, they discovered the mechanism by which certain stem cells regenerate themselves -- a process essential to therapies that may one day heal damaged organ tissue. They are working now to expand current research programs to include embryonic stem cell research.

Medical research has never ground to a halt when government has declined to support it. The Journal of the American Medical Association reported last September that between 1994 and 2003, the U.S. nearly tripled spending on biomedical research, and in any year where federal funding decreased, private funding increased to make up for the difference. The private sector can easily compensate for fluctuations in government spending, and more importantly, can move forward without any federal funding at all.

The great advantage of private funding is that it allows research to proceed even -- especially -- when it is politically touchy. When the federal government refused to fund in-vitro fertilization research in the mid-1970s, critics cried that the U.S. would fall behind, that there would be a brain drain, and that infertile couples would suffer. None of these dire predictions came true. Instead, the research proceeded privately and today reproductive technologies -- IVF and related technologies for humans and animals -- represent a $16 billion a year industry in the U.S. alone.

So not surprisingly, when President Bush exercised the first and only veto of his presidency to stop federal funding for embryonic stem cell research in 2006, private interests donated millions upon millions of dollars to continue embryonic stem cell research without federal assistance.

Now, when private laboratories are already in motion, the Senate is sending over to the House a ham-handed bill that would threaten everything our scientists are already accomplishing. The lure of federal funding would pervert existing incentives, prompting laboratories to abandon productive but politically sensitive research for politically safe but less promising work.

Even Michael J. Fox's own Foundation for Parkinson's Research seems to have given up on government action. Just last month, Fox's foundation made a significant contribution to ReNeuron, a private stem cell research laboratory. The actual dollar amount of the donation remains undisclosed, but ReNeuron officials claim that it is large enough to cover their operating costs and accelerate their research efforts for at least the next year.

No doubt it's hard for Senators to accept that progress can happen without them, but if they'd really like to see stem cells do wonders, they should leave the funding to the private sector, and the research decisions to the researchers. Let the labs get on with their work: discovering the cures for what ails us.

However, actually "doing something" about warming is a daunting endeavor. The journal Geophysical Research Letters estimated in 1997 that if every nation on Earth lived up to the United Nations' Kyoto Protocol on global warming, it would prevent no more than 0.126 degrees F of warming every 50 years. Global temperature varies by more than that from year to year, so that's not even enough to measure. Climatically, Kyoto would do nothing.

In the past four years, the Senate has voted twice against "cap-and-trade" legislation — sponsored by New Mexico senators Jeff Bingaman, a Democrat, and Pete Domenici, a Republican — that would set quotas on carbon emissions and let companies buy and sell them. If adopted, their cap-and-trade law would reduce emissions by less than the Kyoto Protocol specifies. In other words, the Senate has been loath to even adopt something that does less than nothing.

The stark reality is that if we really want to alter the warming trajectory of the planet significantly, we have to cut emissions by an extremely large amount, and — a truth that everyone must know — we simply do not have the technology to do so. We would fritter away billions in precious investment capital in a futile attempt to curtail warming.

Consequently, the best policy is to live with some modest climate change now and encourage economic development, which will generate the capital necessary for investment in the more efficient technologies of the future.

Fortunately, we have more time than the alarmists suggest. The warming path of the planet falls at the lowest end of today's U.N. projections. In aggregate, our computer models tell us that once warming is established, it tends to take place at a constant, not an increasing, rate. Reassuringly, the rate has been remarkably constant, at 0.324 degrees F per decade, since warming began around 1975. The notion that we must do "something in 10 years," repeated by a small but vocal band of extremists, enjoys virtually no support in the truly peer reviewed scientific literature.

Rather than burning our capital now for no environmental gain (did someone say "ethanol?"), let's encourage economic development so people can invest and profit in our more efficient future.

People who invested in automobile companies that developed hybrid technology have been rewarded handsomely in the past few years, and there's no reason to think environmental speculators won't be rewarded in the future, too.

It is hoped that the "Summary for Policymakers" will be an accurate distillation. Hundreds of scientists have been involved in the review process, and it is safe to say that means hundreds of bored scientists, because there is very little in it that is scientifically new. For example, it will report with increasing certitude that humans are responsible for most of the surface warming that began in the mid-1970s. That's been pretty obvious for years.

Graphs in today's summary will show that the rate of global warming has been remarkably constant -- about 0.18 degrees Centigrade per decade -- since 1975. So, any news report that "U.N. panel says the planet is warming at an increasing rate" (and there will be many) will be dead wrong.

For more than a century, it has been known that increasing the atmospheric concentration of carbon dioxide will eventually lead to a warming of surface temperatures, concentrated more in winter than summer, and more in mid and high-latitudes over land. That's exactly what's been observed for years, as is a global cooling of the stratosphere, another prediction of greenhouse theory.

More interesting, and, again, less newsy, is that the communal behavior of the dozens of computer models for future climate also predicts a constant (rather than an increasing) rate of warming.

That means that unless the collective conclusions of all of the models is wrong, we can confidently estimate a warming of about 1.8 degrees Centigrade from 2000 to 2100. That's very near the low end of the range of projections released today. The fact that the most logical distillation of observed and predicted warming yields such a modest heating should be reassuring, rather than alarming.

The new estimate for maximum rise in sea level, assuming a middle-of-the-road estimate for carbon dioxide changes, is going to be lower than in previous IPCC reports. The last figure I saw was around 17 inches by 2100, down 40 percent from their previously estimated maximum.

A small, but very vocal, band of extremists have been hawking a doomsday scenario, in which Greenland suddenly melts, raising sea levels 12 feet or more by 2100. While this forecast enjoys no real support in the traditionally refereed scientific literature, it is repeated everywhere, and its supporters are already claiming that the IPCC -- the self-proclaimed "consensus of scientists" -- is now wrong because it has toned down its projections of doom and gloom.

But the integrated warming of southern Greenland (the region that sheds ice) was much greater for several decades in the early and mid-20th century than in the last decade. In fact, with the exception of one year (2003), Greenland's recent temperatures aren't particularly unusual, nor is its rate of ice loss.

As measured recently by satellite, and published in Science magazine, Greenland is losing .0004 percent of its ice per year, or 0.4 percent per century. All modern computer models require nearly 1,000 years of carbon concentrations three times what they are today to melt the majority of Greenland's ice. Does anyone seriously believe we will be a fossil-fuel powered society in, say, the year 2500?

In summary, what's not new in today's IPCC report -- that humans are warming the planet -- will be treated as big news, while what is new -- that sea levels are not likely to rise as much as previously predicted -- will be ignored, at least by everyone except the extremist fringe.

"Economic forecasting over just a few years is a difficult and imprecise task," the review cautions, so forecasting technology a hundred years from now "requires caution and humility." Unfortunately, there is little caution or humility in this report.

The 27-page summary begins by saying, "The current level of greenhouse gases in the atmosphere is equivalent to around 430 parts per million (ppm) CO2, compared with only 280 ppm before the Industrial Revolution. These concentrations have already caused the world to warm by more than half a degree Celsius."

More specifically, that 54 percent increase of greenhouse gases was apparently associated with a warming of only 0.6 degrees Celsius, give or take two-tenths. Citing a 2001 survey of "high projections" for global warming, however, the report claims that a much smaller, 28 percent increase in greenhouse gases by the year 2050 could result in a "global average temperature rise" exceeding 2 degrees.

Yet if we use the same rule-of-thumb now used to predict 2 to 3 degrees more global warming by 2050, the much larger increase in greenhouse gases ever since 1750-1850 should already have increased the average global temperature by at least 2 degrees. But it didn't.

Suppose this theory works this time, and the Earth actually warms by 2 to 3 degrees Celsius, putting aside what it means to average Chicago's winters with Key West's summers. The Stern report reluctantly concedes that places like Canada, Russia and Scandinavia would likely experience "higher agricultural yields, lower winter mortality, lower heating requirements and a possible boost to tourism."

Plants thrive in greenhouses, particularly fruits and vegetables. The report claims biodiversity would be at risk, as though no threatened species could possibly benefit from milder winters.

And the report thinks malaria would increase, as though mosquitoes are picky about the climate. My great-grandfather J. Mason Reynolds died of malaria in Grand Rapids, Mich., in 1891.

Naturally, The Washington Post seized this opportunity to complain that "Bush has declined to sign the 1997 Kyoto Protocol." Yet the United Nations just reported that from 2000 to 2004 greenhouse gas emissions increased 4.6 percent in Canada, 2.4 percent in Europe and 1.3 percent in the United States. Besides, as the Stern report notes, "most future emissions growth will come from today's developing countries, because of their more rapid population and GDP growth and their increasing share of energy-intensive industries."

As I have often noted, passenger cars are not nearly as large a share of greenhouse emissions as people think. In fact, this report's first graph shows transportation accounting for less than 14 percent of greenhouse gas emissions -- the same share as agriculture or industry. Trucks, buses and cars account for less than 10 percent of global greenhouse gas emissions. Electricity is a much bigger offender, which must be why Hollywood lefties are infatuated with electric cars.

Two contradictory dogmas of the anti-auto cult are that consumption of fossil fuels will continue to increase just as rapidly as it has in the past and that fossil fuels will become increasingly expensive because we have passed the peak of oil.

If the second prediction were correct, people would find ways to use less oil. Because some of Mr. Stern's conclusions are "based on simple extrapolations," however, he must and does argue that the world has "an abundant supply of fossil fuels." Otherwise, we wouldn't need thousands of international bureaucrats being bribed to decide which uses of fossil fuels are more meritorious than others, and which "alternative" fuels merit the biggest subsidies.

Mr. Stern's view of "sensible policies" involves a truly global system of high carbon taxes, tough regulations and generous subsidies "across both developed and developing nations." Because "low-carbon technologies are currently more expensive than fossil-fuel alternatives," he would heavily tax cheaper fuels and subsidize expensive ones. A high and "broadly similar price of carbon" throughout the world is apparently to be enforced in some way by the notoriously ineffectual United Nations and World Bank.

The Washington Post described the Stern Review as proof that "failing to curb the impact of climate change could damage the global economy on the scale of the Great Depression or the world wars by spawning environmental devastation." But such sensational comments about "worst-case scenarios" use strong words to conceal weak logic and nonexistent facts.

For one thing, the disaster scenarios largely depend on unconvincing assertions pretending to link "extreme weather events" -- such as "heat waves like that experienced in 2003 in Europe" -- to extremely gradual and highly variable changes in the average temperature of many nations. The report says, "The risk of outcomes much worse than expected are very real and they could be catastrophic." But any outcomes that are "very real" must to some extent be expected in a report claiming to deal in probabilities. And why is there no comparable assessment of outcomes much better than expected (such as the past 200 years)?

There is repeated abuse of the old trick of switching from talking about things that could conceivably happen to things that would happen. Mr. Stern writes that "the temperatures that may result from unabated climate change would take the world outside the range of human experience."

The most widely reported conclusion of the Stern Review is that keeping a lid on greenhouse gases would cost "only" about 1 percent of world GDP (about $607 billion last year). Yet the fine print says the actual estimates "are clustered in the range of 2 percent to 5 percent of GDP," with some estimating costs as high as 15 percent of GDP.

There may be something truly informative and original concealed within the 700 pages of the Stern Review, but it does not appear as easy to find as the rough edges.

Congress has already authorized some $62 billion in hurricane-related aid to the affected states. That money could be used for health care costs if necessary. Yet the Grassley/Baucus bill would expand federal largess to some 29 states, including $78 million for Alaska, which seems a long way from the hurricane zone.

Many states are undoubtedly salivating at the prospect of more federal money. But, as with most federal money, there’s a catch. The new money would last for only about 5 months, after which states would be left holding the bag for thousands of new Medicaid recipients--that is, unless they convince Washington to keep the money flowing.

The real purpose of the Grassley/Baucus bill is not just to help states pay for health care, but to expand the Medicaid program dramatically. Indeed, many of the bill’s cheerleaders outside Congress, from former Clinton Health and Human Services Secretary Donna Shalala to New York Times columnist Paul Krugman, see this as a step toward national health insurance. The Left is still focused on that goal despite overwhelming evidence from other nations--and from within Medicaid itself--that government involvement leads to poor-quality medical care.

Medicaid is the last, best hope for these advocates of socialized medicine. Indeed, the program is designed to ensure that it will cover more and more of the American people over time. The federal government matches every dollar a state spends on Medicaid with as many as five additional dollars. That has encouraged state officials to keep expanding eligibility, because those officials only bear a small portion of the cost.

As Medicaid grows, it makes private medical care more expensive and even "crowds out" private health insurance. Employers of low-income workers often drop their coverage and push those workers onto the backs of taxpayers. Low-income workers frequently decline private insurance, opting instead for essentially free Medicaid coverage. Medicaid eligibility has expanded so much that there are many enrollees who could obtain private coverage on their own, but who now receive lower-quality care than they would have received with private coverage. Moreover, Medicaid creates a serious disincentive to work, save, and escape poverty.

Yet Grassley/Baucus would force states to expand eligibility even further. The new enrollees would be entitled to the full Medicaid benefits package, including services now considered optional, as well as additional new benefits such as broad mental health benefits. Under the bill, states would have to ask whether a would-be recipient has private coverage, but would not be required to do anything to help that worker retain it. Moreover, having private coverage would not disqualify a person from enrolling in Medicaid. In fact, Medicaid would become the default option for low-income workers.

In the type of back-room deal typical of Congress these days, the bill was drafted in secret without committee hearings and brought to the floor under procedures that would have prevented debate. Fortunately, this underhanded move was blocked by a small group of senators, including John McCain (R-AZ), John Ensign (R-NV), Tom Coburn (R-OK), and John Sununu (R-NH). The bill will now have to proceed through regular debate, but its sponsors--the chairman and ranking member of the powerful Senate Finance Committee--remain determined.

When it comes to high-quality, affordable medical care, Medicaid is the problem, not the solution. Republicans understood this 10 years ago when they tried to reform Medicaid the same way they (successfully) reformed welfare.

The picture is different today. Before Hurricane Katrina, Congress had planned to debate minor restraints on Medicaid's spending growth. Now even those feeble attempts at fiscal responsibility have been abandoned.

Republicans are supposedly the party of limited government. If so, they need to rediscover their roots.]]> Fri, 21 Oct 2005 00:00:00 EDT http://www.cato.org/pub_display.php?pub_id=5144 http://www.cato.org/pub_display.php?pub_id=5132

For anyone who cooks but doesn't like scrubbing, Teflon is a wonder product. Before Teflon, washing a pan or pot was among the most disagreeable of tasks. Cleaning up is a very different task in today's post-Teflon world.

There are even some unintended health and safety benefits from Teflon kichenware. You can cook using less fat, grease, or oil.

Doing so is better for your heart. There's also less chance of fire. It's a wonderful example of how a profit-minded company, in this case DuPont, came up with something that makes life easier, healthier, and safer -- all at once.

But no good deed goes unpunished, at least in today's legal system. In July attorneys filed a $5 billion class action lawsuit against DuPont over the alleged health effects of perfluorooctanoic acid, or PFOA.

There are 14 plaintiffs, though that's just the start. "The class of potential plaintiffs could well contain almost every American that has purchased a pot or pan coated with DuPont's nonstick coating," explained attorney Alan Kluger.

The remedies demanded include replacement cooking utensils, "medical monitoring" of plaintiffs, research funding, and the ubiquitous warning label. There also would be ample fees for the two law firms involved.

Observes Kluger: "I don't have to prove that it causes cancer. I only have to prove that DuPont lied in a massive attempt to continue selling their products."

Actually, to collect he needs to prove that Teflon skillets harm people. And that is unlikely.

Many companies use PFOA to produce a wide variety of products, including auto fuel systems, clothes, computer chips, firefighting foam, phone cables, as well as Teflon. Despite such wide use for decades, there are no known cases of consumers suffering long-term harm. If using PFOA posed a danger, that many people using that many products for that many years should have yielded at least one victim.

Better grounded, though still uncertain, are concerns about the impact of PFOA's release in the air or water. An Environmental Protection Agency advisory panel issued a draft report classifying PFOA as a likely carcinogen.

DuPont, however, disputes such a connection; a recent University of Pennsylvania study found no link between PFOA and several other diseases.

The health issue understandably concerns people who might have been exposed to high levels of PFOA, in one case in drinking water near a DuPont plant. But the chemical has no impact on consumers because studies have found no PFOA release when people cook.

Which is why the EPA, though concerned about the presence of PFOA in the environment, officially announced that it "does not believe there is any reason for consumers to stop using any consumer or industrial related products" because of PFOA. If cooking doesn't cause the harmful PFOA escape of Teflon of pots or pans, there is no health risk.

That's the conclusion of a peer-reviewed study earlier this year in the Environmental Science & Technology journal. Ten researchers looked at the use of PFOA in cookware, as well as carpets, cleaners, clothes, paints, and other products. They concluded that PFOA exposure "during consumer use of the articles evaluated in this study are not expected to cause adverse human health effects in infants, children, adolescents, adult residents or professionals, nor result in quantifiable levels" of the chemical in people's blood.

There's no harmful PFOA emission for Teflon products even if they are heated at a very high temperature or used after being scratched, the study found. Indeed, it's more accurate to term PFOA a "processing aid" than an ingredient.

Scare-mongering has replaced rational thinking when it comes to many environmental issues. So it is with PFOA.

If inadvertently discharged into the air or water, it might pose a problem. But when used in making products, it is perfectly safe.

Hopefully, the courts will be able to tell the difference. Ultimately consumers will pay if junk science again runs amok in the courtroom.]]> Mon, 26 Sep 2005 00:00:00 EDT http://www.cato.org/pub_display.php?pub_id=5132 http://www.cato.org/pub_display.php?pub_id=2905 The Centers for Disease Control announced recently that the often-mentioned figure of 400,000 American deaths each year due to obesity is based on a study that's plagued by methodological errors. The CDC estimates that the number may be off by 20 percent, but longtime critics of the figure say it may be closer to four times the number of early deaths attributable to obesity.

The CDC's announcement represents a tidy anecdote for what's wrong with the fat debate. The problem, put simply, is that hysteria sells. It sells research to grant writers, it sells executive summaries to media outlets, and it sells newspapers to the public.

Anyone who took a close look at the 400,000 number could see obvious flaws in its computation. In the New York Times, the University of Chicago's Dr. Eric Oliver pointed out that there are only 2 million deaths each year in the United States, total. Since obesity has little effect on the mortality rates of people over 65, and since 70 percent of annual deaths are among people over 65, in order for the 400,000 figure to be correct virtually every single death among people under 65 would have to have been caused by obesity.

There were other obvious problems. The Journal of the American Medical Association study that came up with the number was a meta-study, which examined other studies dating back as early as the 1940s and then extrapolated the data to today's population. Obviously, several ailments that killed us 60 years ago are treatable and preventable today. Most remarkably, the study's researchers admitted that their calculations "assume that all excess mortality in obese people is due to their adiposity."

That's an astounding concession. It means that every person in the study's data who was obese and died early was assumed to have died because of obesity. There are thousands of things that could cause an obese person to die early -- getting hit by a car or succumbing to cancer, for instance -- that aren't related to weight at all.

Despite these obvious flaws, the 400,000 figure was recited ad nauseum by government officials, nutrition activists, and the media. Researchers such as the University of Virginia's Glen Gaesser and Dr. Katherine Flegal had been criticizing the figure since it was published, yet they were rarely consulted or quoted in press accounts.

A Lexis search finds over 1,500 mentions of "obesity" and "400,000" in the last two years. And that does not include mentions of "obesity will soon overtake smoking as America's number-one killer," a statement widely perpetuated in the obesity debate that was also based on those alleged 400,000 deaths.

Dig a little more into America's health statistics and you'll find that despite our expanding waistlines, we've never been healthier. Heart disease, stroke, and cardiovascular disease are all down dramatically in the last 20 years. Mortality rates in nine of the ten types of cancer most associated with obesity have dropped in the last 15 years. Overall cancer rates and deaths from cancer have dropped every year for the last ten years.

We're living longer, too. In fact, while black men and black women have seen greater increases in obesity rates than their white counterparts over the last 15 years, they've also seen greater increases in life expectancy. The only ailment that is more common in the last 20 years is diabetes, and that can be at least partly attributed to an aging population or changes in the definition and collection methods of diabetes statistics.

If all the obesity hype is true, we should at least be seeing the front end of this pending health care disaster by now. It simply isn't happening.

The troubling thing about the 400,000 fiasco is the way nutrition activists and politicians relied on such a flimsy number to call for drastic new laws and regulations, and that the media reported it with barely an ounce of skepticism.

SpaceShipOne's triumph teaches us four lessons:

First, it reminds us of the power of competition. Entrepreneurs who compete with one another generate the dynamism of free enterprise. They cannot simply offer adequate goods and services when competitors might offer the excellent. Competition pushes entrepreneurs to strive to satisfy and thus keep their customers. Whether it's automobiles, personal computers, the Internet, consumer electronics or airline flights, only entrepreneurs can commercialize goods and services, making them available to all. The X Prize stimulated competition in spaceflight, which has for too long been dominated by government. The result is SpaceShipOne's triumph.

Second, it shows us the power of pride. Rutan's team, as well as the other two dozen competitors for the X Prize, struggled with limited resources to develop new, innovative and ingenious ways to travel 100 kilometer above the Earth, into space. They called upon the best within themselves and gave themselves something no one else could give them: the knowledge of a job superlatively done in the face of great challenges and a manifestation of their creativity and rationality, which made the achievement possible.

Third, it demonstrates the motivational power of profit. Private cash prizes were heavily used in the development of civil aviation; Charles Lindbergh won by $25,000 Orteig prize in 1927 when be became the first individual to fly nonstop across the Atlantic. In the wake of the X Prize success, Robert Bigelow, the founder of Bigelow Aerospace, which plans to place a private station in space, has offered a $50 million prize for the development of a vehicle capable of carrying as many as seven individuals to an orbital outpost - hopefully, one of Bigelow's.

Rutan used some $20 million invested by Allen to win $10 million. That doesn't sound very profitable, but Rutan's efforts aim at long-term profit - he plans a business carrying passengers on sub-orbital trips and eventually orbital flights into space. In fact, billionaire Richard Branson, founder of Virgin Atlantic airline, is partnering with Rutan and Allen in hopes of carrying 3,000 private astronauts into space in the next five years. Prosperity is a good thing and, in the process of pursuing their own economic and spiritual well-being, these space entrepreneurs will create a commercial revolution as Allen did with Microsoft and Branson did with Virgin.

And fourth, SpaceShipOne marks a paradigm shift. For nearly five decades, most people thought of space as a government program and believed that travel beyond the atmosphere simply was too costly for the private sector to provide. Of course, it was because the government was providing the service that the cost stayed high, and government regulations helped to discourage private entrepreneurs from trying to create their own space businesses. But Peter Diamandis, president of the X Prize Foundation, sought to create a revolution not only by sparking entrepreneurial competition but by changing the way people think about space - it can be a place to which private providers can take you to private facilities for your own private edification.

Rutan was the man who designed the Voyager, the first plane to fly around the world without stopping or refueling. That craft now hangs in the Smithsonian Air and Space Museum in Washington, along with Lindbergh's Spirit of St. Louis, the Wright Brothers' 1903 flyer, Chuck Yeager's X-1, and the Apollo 11 craft that carried the first men to the Moon.

SpaceShipOne should one day hang beside those pioneering craft, in tribute to the private entrepreneurs who opened space to all of mankind.