The pharmaceutical industry likes to depict itself as a research-based industry, as the source of innovative drugs. Nothing could be further from the truth. This is their incredible PR and their nerve.

Brand-name drugs have no competition, since the government grants them very long, exclusive marketing rights.

In economic terms, health care is a highly successful industry - profitable, growing, and virtually recession-proof - but it's a massive burden on the rest of the economy.

It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.

Alternative medicine plays into this exaggerated notion that you can prevent disease simply by doing the right thing.

Pharmaceutical companies have too much influence over the education of physicians in this country. They have too much control over the evaluation of their own products, and that's a conflict of interest. I think the industry needs to be regulated, but I've never suggested taking it out of the market altogether.

You see that the people who are drawn to alternative medicine are often fairly healthy and they go to alternative medicine for what I call the 'symptoms of life.' Fatigue, joint pains, inability to concentrate, perhaps, the kinds of things that anyone over twenty-five gets at some point.