As Europe Presses Google on Antitrust, U.S. Backs Away

BRUSSELS — Google seems on its way to coming through a major antitrust investigation in the United States essentially unscathed. But the outlook is not as bright for Google here, as the European Union’s top antitrust regulator prepares to meet on Tuesday with Eric E. Schmidt, Google’s executive chairman.

In the United States, the Federal Trade Commission appears to be ready to back off what had been the centerpiece of its antitrust pursuit of Google: the complaint that the company’s dominant search engine favors the company’s commerce and other services in search queries, thwarting competition.

Yet in a statement last spring, Joaquín Almunia, the competition commissioner of the European Union, placed the contentions about search bias at the top of his list of concerns about Google. And in a private meeting this month, Mr. Almunia told Jon Leibowitz, chairman of the F.T.C., that European antitrust officials remain focused on that issue, according to two people told of the meeting, who asked not to be identified because they were not authorized to speak about it.

Mr. Almunia’s tougher bargaining stance, antitrust experts say, is not merely a personal preference.

European antitrust doctrine, they say, applies a somewhat different standard than United States law does. In America, dominant companies are given great leeway, if their conduct can be justified in the name of efficiency, thus consumer benefit. Google has consistently maintained that it offers a neutral, best-for-the-customer result.

In Europe, antitrust experts say, the law prohibits the “abuse of a dominant position,” with the victims of the supposed abuse often being competitors. “The Europeans tend to use competition law to level the playing field more than is the case in the United States,” said Herbert Hovenkamp, an antitrust expert and law professor at the University of Iowa. (Mr. Hovenkamp advised Google on one project, but no longer has any financial connection to the company.)

The European rationale, legal experts say, is that shielding competitors to some degree preserves competition and enhances consumer welfare in the long run.

“Europe has a stronger hand to play with Google because of its standards,” said Keith N. Hylton, a professor at the Boston University School of Law.

The European antitrust regulators, like their American counterparts, have been in negotiations with Google for several months. The F.T.C. is expected to announce its decision within days, while the European timetable seems not as tight and is likely to go into next year.

The investigations in the United States and Europe really started with accusations of search bias. Rivals complain that the search giant gives more prominent placement and display for its online shopping and travel services, for example, than to competitors. The potential antitrust concern is that such specialized, or “vertical,” search services — like Yelp or Nextag — are partial substitutes for Google’s search engine because they also allow people to find information.

In his public statement in May, Mr. Almunia identified four areas of concern in Europe’s antitrust investigation of Google. The first concern he cited was search bias.

“Google displays links to its own vertical search services differently than it does for links to competitors,” Mr. Almunia said in a statement then. “We are concerned that this may result in preferential treatment compared to those of competing services, which may be hurt as a consequence.”

His other three concerns are ones that Google is preparing to address with a set of voluntary commitments in the United States, according to two people briefed on Google’s talks with the F.T.C., who declined to give their names because they were not authorized to speak about them.

Google, according to the people, has agreed to refrain from copying summaries of product and restaurant reviews from other Web sites and including them in Google search results, a practice known as screen scraping.

James Kanter reported from Brussels and Steve Lohr from New York. Claire Cain Miller contributed reporting from San Francisco.

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Hospitals Fear They’ll Bear Brunt of Medicare Cuts

Ángel Franco/The New York Times

A hospital technician tends to a patient in the emergency room at Montefiore Medical Center, a large nonprofit hospital system in the Bronx.

WASHINGTON — As President Obama and Congress try to thrash out a budget deal, the question is not whether they will squeeze money out of Medicare, but how much and who will bear the brunt of the cuts.

Angel Franco/The New York Times

Dr. Steven M. Safyer, the chief executive of Montefiore Medical Center, said his hospital has made changes that would result in lower spending in the long run.

Republicans say that some of the savings should come from beneficiaries, and they are pushing proposals like raising the eligibility age or increasing premiums for people with high incomes, who already pay more than the standard premium. Even President Obama has proposed higher premiums, increasing the likelihood that the idea could be adopted. But any significant tinkering with the benefits for older Americans comes with significant political risks, and most Democrats in Congress strenuously oppose raising the age when Medicare coverage begins.

With growing pressure to reach an agreement on deficit reduction by the end of the year, some consensus is building around the idea that the largest Medicare savings should come from hospitals and other institutional providers of care.

“Hospitals will be in the cross hairs for more cuts,” said Lisa Goldstein, an analyst with Moody’s Investors Service, which follows nonprofit hospitals that issue bonds. While hospital executives fiercely defend the payments their own institutions receive, many acknowledge that Medicare is spending too much and growing too fast.

Those executives point out, however, that they have already agreed to $155 billion in cuts over a decade as part of the Affordable Care Act and they face billions more in additional cuts as part of the current negotiations. They argue that such large cuts to hospitals will ultimately affect beneficiaries.

“There is no such thing as a cut to a provider that isn’t a cut to a beneficiary,” said Dr. Steven M. Safyer, the chief executive of Montefiore Medical Center, a large nonprofit hospital system in the Bronx.

Mr. Obama and Speaker John A. Boehner continued trying on Tuesday to reach an overall budget agreement, which would call for significant savings in Medicare and would avert a deep cut in Medicare payments to doctors, scheduled to occur next month.

Mr. Boehner said that an increase in the eligibility age for Medicare, favored by many Republicans, could wait until next year.

“I don’t believe it’s an issue that has to be dealt with between now and the end of the year,” Mr. Boehner said Tuesday when asked about a possible change in the Medicare eligibility age. “It is an issue, I think, if Congress were to do entitlement reform next year and tax reform, as we envision, if there is an agreement, that issue will certainly be open to debate in that context.”

The starting point for the current negotiations is President Obama’s most recent budget request, which proposed legislation that would save $300 billion, or 4 percent of projected Medicare spending, over 10 years.

By contrast, Republicans in Congress are seeking savings of $400 billion to $600 billion, at least some of which should come from beneficiaries, they say.

Members of the Medicare Payment Advisory Commission, an influential panel that advises Congress, see many opportunities to rein in costs, and they say that financial pressure on providers could make them more efficient without harming the quality of care. At a meeting of the panel earlier this month, one commission member, Scott Armstrong, president of Group Health Cooperative, a nonprofit health system in Seattle, said Medicare spent “too much” on inpatient hospital care — $117 billion last year. “In an efficient system,” he said, “we wouldn’t be spending that kind of money on hospital services.”

Although Congress may leave the details of Medicare savings to be worked out next year, there is already discussion of cutting special payments to teaching hospitals and small rural hospitals. Lawmakers are also considering reducing payments to hospitals for certain outpatient services that can be performed at lower cost in doctors’ offices. Medicare pays substantially higher rates for the same services when they are provided in a hospital outpatient department rather than a doctor’s office. The differential added $1.5 billion to Medicare costs last year, and as hospitals buy physician practices around the country, the costs are likely to grow, the Medicare commission says.

The savings contemplated by Mr. Obama and Mr. Boehner are substantially larger than the Medicare savings that would be produced by automatic across-the-board cutbacks scheduled to start next month if Congress does not intervene. Those Medicare savings have been estimated at $123 billion from 2013 to 2021. Some hospital executives favor the automatic cuts as more equitable — and less painful — than some of the specific reductions being contemplated.

Hospital administrators and others warn of potential hospital closings, shutting down of unprofitable services like hospitalization for psychiatric care and less access to medical care for the most vulnerable if the cuts are too deep. Nancy M. Schlichting, the chief executive of the Henry Ford Health System in Detroit, says severe cuts might make it harder for hospitals like hers to treat patients without insurance. “It’s a big question whether we can continue to do that,” she said. “We would have to make tough decisions.”

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Ancient Bones That Tell a Story of Compassion

Lorna Tilley

DISABLED Almost all the other skeletons at the Man Bac site, south of Hanoi, are straight. But the man now called Burial 9 was laid to rest curled in a fetal position that suggests lifelong paralysis.

While it is a painful truism that brutality and violence are at least as old as humanity, so, it seems, is caring for the sick and disabled.

And some archaeologists are suggesting a closer, more systematic look at how prehistoric people — who may have left only their bones — treated illness, injury and incapacitation. Call it the archaeology of health care.

The case that led Lorna Tilley and Marc Oxenham of Australian National University in Canberra to this idea is that of a profoundly ill young man who lived 4,000 years ago in what is now northern Vietnam and was buried, as were others in his culture, at a site known as Man Bac.

Almost all the other skeletons at the site, south of Hanoi and about 15 miles from the coast, lie straight. Burial 9, as both the remains and the once living person are known, was laid to rest curled in the fetal position. When Ms. Tilley, a graduate student in archaeology, and Dr. Oxenham, a professor, excavated and examined the skeleton in 2007 it became clear why. His fused vertebrae, weak bones and other evidence suggested that he lies in death as he did in life, bent and crippled by disease.

They gathered that he became paralyzed from the waist down before adolescence, the result of a congenital disease known as Klippel-Feil syndrome. He had little, if any, use of his arms and could not have fed himself or kept himself clean. But he lived another 10 years or so.

They concluded that the people around him who had no metal and lived by fishing, hunting and raising barely domesticated pigs, took the time and care to tend to his every need.

“There’s an emotional experience in excavating any human being, a feeling of awe,” Ms. Tilley said, and a responsibility “to tell the story with as much accuracy and humanity as we can.”

This case, and other similar, if less extreme examples of illness and disability, have prompted Ms. Tilley and Dr. Oxenham to ask what the dimensions of such a story are, what care for the sick and injured says about the culture that provided it.

The archaeologists described the extent of Burial 9’s disability in a paper in Anthropological Science in 2009. Two years later, they returned to the case to address the issue of health care head on. “The provision and receipt of health care may therefore reflect some of the most fundamental aspects of a culture,” the two archaeologists wrote in The International Journal of Paleopathology.

And earlier this year, in proposing what she calls a “bioarchaeology of care,” Ms. Tilley wrote that this field of study “has the potential to provide important — and possibly unique — insights into the lives of those under study.” In the case of Burial 9, she says, not only does his care indicate tolerance and cooperation in his culture, but suggests that he himself had a sense of his own worth and a strong will to live. Without that, she says, he could not have stayed alive.

“I’m obviously not the first archaeologist” to notice evidence of people who needed help to survive in stone age or other early cultures, she said. Nor does her method “come out of the blue.” It is based on and extends previous work.

Among archaeological finds, she said, she knows “about 30 cases in which the disease or pathology was so severe, they must have had care in order to survive.” And she said there are certainly more such cases to be described. “I am totally confident that there are almost any number of case studies where direct support or accommodation was necessary.”

Such cases include at least one Neanderthal, Shanidar 1, from a site in Iraq, dating to 45,000 years ago, who died around age 50 with one arm amputated, loss of vision in one eye and other injuries. Another is Windover boy from about 7,500 years ago, found in Florida, who had a severe congenital spinal malformation known as spina bifida, and lived to around age 15. D. N. Dickel and G. H. Doran, from Florida State University wrote the original paper on the case in 1989, and they concluded that contrary to popular stereotypes of prehistoric people, “under some conditions life 7,500 years ago included an ability and willingness to help and sustain the chronically ill and handicapped.”

In another well-known case, the skeleton of a teenage boy, Romito 2, found at a site in Italy in the 1980s, and dating to 10,000 years ago, showed a form of severe dwarfism that left the boy with very short arms. His people were nomadic and they lived by hunting and gathering. He didn’t need nursing care, but the group would have had to accept that he couldn’t run at the same pace or participate in hunting in the same way others did.

Ms. Tilley gained her undergraduate degree in psychology in 1982 and worked in the health care industry studying treatment outcomes before coming to the study of archaeology. She said her experience influenced her interest in ancient health care.

What she proposes, in papers with Dr. Oxenham and in a dissertation in progress, is a standard four-stage method for studying ancient remains of disabled or ill individuals with an eye to understanding their societies. She sets up several stages of investigation: first, establishing what was wrong with a person; second, describing the impact of the illness or disability given the way of life followed in that culture; and third, concluding what level of care would have needed.

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Hospitals Fear They’ll Bear Brunt of Medicare Cuts

Ángel Franco/The New York Times

A hospital technician tends to a patient in the emergency room at Montefiore Medical Center, a large nonprofit hospital system in the Bronx.

WASHINGTON — As President Obama and Congress try to thrash out a budget deal, the question is not whether they will squeeze money out of Medicare, but how much and who will bear the brunt of the cuts.

Angel Franco/The New York Times

Dr. Steven M. Safyer, the chief executive of Montefiore Medical Center, said his hospital has made changes that would result in lower spending in the long run.

Republicans say that some of the savings should come from beneficiaries, and they are pushing proposals like raising the eligibility age or increasing premiums for people with high incomes, who already pay more than the standard premium. Even President Obama has proposed higher premiums, increasing the likelihood that the idea could be adopted. But any significant tinkering with the benefits for older Americans comes with significant political risks, and most Democrats in Congress strenuously oppose raising the age when Medicare coverage begins.

With growing pressure to reach an agreement on deficit reduction by the end of the year, some consensus is building around the idea that the largest Medicare savings should come from hospitals and other institutional providers of care.

“Hospitals will be in the cross hairs for more cuts,” said Lisa Goldstein, an analyst with Moody’s Investors Service, which follows nonprofit hospitals that issue bonds. While hospital executives fiercely defend the payments their own institutions receive, many acknowledge that Medicare is spending too much and growing too fast.

Those executives point out, however, that they have already agreed to $155 billion in cuts over a decade as part of the Affordable Care Act and they face billions more in additional cuts as part of the current negotiations. They argue that such large cuts to hospitals will ultimately affect beneficiaries.

“There is no such thing as a cut to a provider that isn’t a cut to a beneficiary,” said Dr. Steven M. Safyer, the chief executive of Montefiore Medical Center, a large nonprofit hospital system in the Bronx.

Mr. Obama and Speaker John A. Boehner continued trying on Tuesday to reach an overall budget agreement, which would call for significant savings in Medicare and would avert a deep cut in Medicare payments to doctors, scheduled to occur next month.

Mr. Boehner said that an increase in the eligibility age for Medicare, favored by many Republicans, could wait until next year.

“I don’t believe it’s an issue that has to be dealt with between now and the end of the year,” Mr. Boehner said Tuesday when asked about a possible change in the Medicare eligibility age. “It is an issue, I think, if Congress were to do entitlement reform next year and tax reform, as we envision, if there is an agreement, that issue will certainly be open to debate in that context.”

The starting point for the current negotiations is President Obama’s most recent budget request, which proposed legislation that would save $300 billion, or 4 percent of projected Medicare spending, over 10 years.

By contrast, Republicans in Congress are seeking savings of $400 billion to $600 billion, at least some of which should come from beneficiaries, they say.

Members of the Medicare Payment Advisory Commission, an influential panel that advises Congress, see many opportunities to rein in costs, and they say that financial pressure on providers could make them more efficient without harming the quality of care. At a meeting of the panel earlier this month, one commission member, Scott Armstrong, president of Group Health Cooperative, a nonprofit health system in Seattle, said Medicare spent “too much” on inpatient hospital care — $117 billion last year. “In an efficient system,” he said, “we wouldn’t be spending that kind of money on hospital services.”

Although Congress may leave the details of Medicare savings to be worked out next year, there is already discussion of cutting special payments to teaching hospitals and small rural hospitals. Lawmakers are also considering reducing payments to hospitals for certain outpatient services that can be performed at lower cost in doctors’ offices. Medicare pays substantially higher rates for the same services when they are provided in a hospital outpatient department rather than a doctor’s office. The differential added $1.5 billion to Medicare costs last year, and as hospitals buy physician practices around the country, the costs are likely to grow, the Medicare commission says.

The savings contemplated by Mr. Obama and Mr. Boehner are substantially larger than the Medicare savings that would be produced by automatic across-the-board cutbacks scheduled to start next month if Congress does not intervene. Those Medicare savings have been estimated at $123 billion from 2013 to 2021. Some hospital executives favor the automatic cuts as more equitable — and less painful — than some of the specific reductions being contemplated.

Hospital administrators and others warn of potential hospital closings, shutting down of unprofitable services like hospitalization for psychiatric care and less access to medical care for the most vulnerable if the cuts are too deep. Nancy M. Schlichting, the chief executive of the Henry Ford Health System in Detroit, says severe cuts might make it harder for hospitals like hers to treat patients without insurance. “It’s a big question whether we can continue to do that,” she said. “We would have to make tough decisions.”

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Syria Warns Palestinians Not to Aid Rebels as Camp Residents Flee

BEIRUT, Lebanon — Syria warned its Palestinian refugee population on Monday not to aid the insurgency that is fighting President Bashar al-Assad, as hundreds of Palestinians fled the Yarmouk neighborhood of Damascus, with many heading for relative safety in Lebanon, a day after Syrian forces attacked that neighborhood for the first time in the civil war.

The New York Times

For many Yarmouk residents — refugees from conflict with Israel and their descendants — the attacks shattered what was left of the Syrian government’s claim to be a champion and protector of Palestinians.

The Syrian warning appeared to reflect the sensitivity Mr. Assad attaches to the loyalty of the country’s Palestinians, an important element of what remains of his political legitimacy. It came as new clashes were reported in and around the Yarmouk neighborhood between government forces and rebel fighters.

Hundreds of thousands of Palestinians live in Syria, displaced by the Arab-Israeli struggle. Historically, they have considered Mr. Assad a benefactor and ally. Yarmouk was originally a refugee camp, and has developed into a mixed Damascus neighborhood where many Palestinians live — but increasing numbers of them have been siding with the insurgents.

The warning aimed at these Palestinians was conveyed in a news dispatch by the official Syrian Arab News Agency, SANA, about a telephone conversation between the country’s foreign minister, Walid al-Moallem, and United Nations Secretary General Ban Ki-moon concerning the general situation in Syria and specifically the Yarmouk neighborhood.

Mr. Moallem was quoted as telling Mr. Ban that mayhem had been convulsing Yarmouk for days, caused by infiltrations from terrorist groups, the government’s blanket description for insurgents.

“The minister also stressed that Palestinians should not shelter or help terrorist groups who are outsiders to the camp, and should work on kicking them out,” Mr. Moallem was quoted as saying.

The SANA account said Syrian ground forces had refrained from entering Yarmouk, but said nothing about the Syrian air and artillery strikes that first hit Yarmouk on Sunday, which were reported by witnesses, rebels and Palestinian defectors to the rebel side. By some accounts, as many as 20 people were killed and dozens hurt, and families could be seen hastily fleeing the area with packed bags.

Martin Nesirky, a spokesman for Mr. Ban at the United Nations, confirmed that the secretary general had spoken with the Syrian foreign minister to express concern “about the escalation of violence in recent days, and very specifically the incident yesterday in which a Palestinian refugee camp, Yarmouk, right near Damascus, came under attack.”

The United States also expressed concern. Victoria Nuland, a State Department spokeswoman, said the aerial bombardment of Yarmouk constituted “a significant and alarming escalation of the conflict in Syria.”

In the aftermath of the bombardment, Syrian government tanks and dozens of troops could be seen taking positions at the northern entrance to Yarmouk on Monday as hundreds of people fled on foot, searching for taxis or buses to take them to safety in Lebanon and elsewhere. Some residents headed to schools where classes were abruptly stopped so that they could accommodate fleeing families. Luckier refugees went to relatives living outside the neighborhood.

During a predawn announcement, Yarmouk mosques told residents to take advantage of a brief window of time, from 6 to 8 a.m., to flee the area, according to Yussef, a 40-year old Palestinian refugee who hurried out of the camp with his family, carrying a large black bag in one hand and his six-month-old-baby in the other. “I couldn’t sleep the whole night,” he said. “I heard a lot of shooting, but I don’t know from where.”

He said he was shocked on Sunday at the speed of the government assault, in which fighter planes and artillery were used to attack the area just hours after rebel fighters entered Yarmouk. One fighter said that the rebel’s goal was not to control the neighborhood but to use it as a valuable staging ground for an eventual attack on central Damascus.

On Monday, groups of rebel fighters patrolled Yarmouk’s main street as the government forces shelled parts of the neighborhood. Yussef said he was moving his family to his brother’s house outside the camp.

“I want to save my family’s life,” he said. “I will never, ever return.”

Hania Mourtada reported from Beirut, Lebanon, and Rick Gladstone from New York. Reporting was contributed by an employee of The New York Times from Damascus, Hwaida Saad from Beirut and Ellen Barry from Moscow.

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European Mobile Stocks Fall After Costly Spectrum Auction

BERLIN — Shares of four big European cellphone operators fell Monday after they paid more than twice what investors had been expecting in a spectrum auction in the Netherlands, raising concern that a damaging bidding war could sap the industry.

The Dutch auction began Oct. 31 and ended Friday, raising €3.8 billion, or $4.9 billion, for spectrum that the companies plan to use for high-speed service using Long Term Evolution, or LTE, technology. But analysts warned that the sale, to be followed next year by a much larger spectrum auction in Britain, could herald a new round of expensive infrastructure levies that might hamstring operators at a time when their sales have been stagnating.

The winners were KPN, the former Dutch monopoly; Vodafone, the British mobile group; the German company T-Mobile; and the Swedish operator Tele2.

LTE supports all of the typical high-speed applications, including audio and video streaming and Internet surfing, but is much faster, cutting download times and significantly expanding the capacity of existing networks to handle increases in data traffic.

After the bidding, KPN, which is partly owned by the Mexican communications mogul Carlos Slim Helú, canceled its dividend for 2012 and lowered its projected investor payout for 2013 to cover the $1.35 billion the company spent in the auction.

On Monday, the first day of stock trading after the completion of the auction, shares of KPN fell nearly 15 percent in Amsterdam, the steepest drop in more than a decade. Shares of Vodafone were down 1.7 percent by the close of the day in London. Shares of Deutsche Telekom, the parent company of T-Mobile, fell 0.3 percent in Frankfurt, and shares of Tele2 declined 1 percent in Stockholm.

“The money raised in the Dutch auction was a lot more than investors were expecting,” said Phil Kendall, an analyst at Strategy Analytics in Milton Keynes, England. “The concern now is that the sums will now be so great the technology will be unprofitable.”

Mr. Kendall said mobile operators were eager to obtain additional spectrum because extensive bandwidth had become increasingly critical amid the explosion of mobile Internet data, which is testing the capacity of some carriers’ grids and causing overloading.

“Really, for many operators, the only way they will be able to differentiate themselves from other operators is by having enough spectrum to manage the demand on their services,” Mr. Kendall said. “That is why there is such intense interest in buying more frequency.”

More radio spectrum, or wireless network capacity, is crucial to delivering the high speeds advertised for LTE, which theoretically can produce download rates of up to 300 megabits per second on a wireless connection. Such speeds and the expanded capacity of the networks are considered essential to support the rapid expansion of the wireless Internet, as well as the increasing use of mobile grids for robotic communication between devices.

Speeds on the first generation of LTE networks activated in Germany, South Korea, Sweden and the United States have averaged much less, generally 10 to 25 megabits per second, in part because operators do not have enough spectrum to exploit the technology’s full potential.

The Dutch auction also raised the specter of another costly round of infrastructure fees on the cellphone industry similar to those in 1999 and 2000, when operators paid billions for the first European 3G mobile licenses.

Investors were concerned that the Dutch prices could set a precedent for auctions planned in Britain and perhaps Poland next year, as well as others that will be held across Europe over the next five years, as bandwidth is freed up and sold by national governments to wireless carriers. Germany, which held its latest spectrum auction in 2010, has indicated that it may hold another in 2016.

Those license sales in 1999 and 2000, engineered in most cases by cash-strapped governments to extract the maximum from mobile operators, led to large profit write-downs by operators including Vodafone and Telefónica, which owns the carrier O2.

With completion of the Dutch auction, the focus will now shift to Britain, where the sector’s regulator is planning to begin its spectrum auction in January.

All four British mobile network operators are expected to bid: Everything Everywhere, the venture of Deutsche Telekom and France Telecom; Vodafone; O2 U.K.; and 3, a unit of Hutchison Whampoa. The former landline monopoly, BT, has not ruled out a potential bid, which could further raise the stakes.

Matthew Howett, an analyst at Ovum, a research firm in London, said the British auction could raise £2 billion to £4 billion, or $3.2 billion to $6.5 billion.

“The £2 billion to £4 billion range that is widely touted is based on similar auctions elsewhere in Europe,” he said. “There is nothing to suggest that the U.K. should be any different. It’s possibly the most competitive market in Europe and all existing operators will want to make sure they walk away with spectrum to feed the almost insatiable appetite we in the U.K. now have for data.”

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Well: A Running Bias Against Really Dedicated Runners

From the moment it appeared online last month, an editorial in the journal Heart became a Rorschach test for opinions about runners.

Do you roll your eyes when they start talking about their races and times? Do you snigger when you see bumper stickers that simply say “26.2,” the number of miles in a marathon, or “13.1,” the half-marathon distance? Do you lose patience with family members who have to go for a run — even if it means waking up at 4 a.m. before leaving on a vacation?

Then perhaps the editorial will appeal to you. It was titled “Run for your life… at a comfortable speed and not too far.” The authors, Dr. James H. O’Keefe Jr. of Saint Luke’s Mid America Heart Institute Hospital in Kansas City, Mo., and Dr. Carl J. Lavie of the Ochsner Health System in New Orleans, wrote that those who run slowly and keep their mileage down gain health benefits. But those who run for more than about 40 minutes a day and those who run faster than eight minutes a mile actually increase their risk of death.

Too much or too intense running, the two cardiologists said, “appears to cause excessive ‘wear and tear’ on the heart.”

The editorial got extensive news attention, often tinged with schadenfreude. “What do you get if you finish a marathon? A finisher’s medal and a risk of death! ” said MSN-Now. The Wall Street Journal’s article was headlined “One Running Shoe in the Grave.”

On the other side, of course, were aggrieved runners. Runner’s World instantly published a rejoinder titled “The Too-Much-Running Myth Rises Again.” The Heart editorial, it said, was “twisting the data.”

Meanwhile, some runners panicked. “I got 650 e-mails in four hours,” said Dr. Aaron Baggish, associate director of the cardiovascular performance program at the Massachusetts General Hospital. (Dr. Baggish cycles, he runs — more than 30 marathons so far — and he competes in triathlons. “I certainly exceed any dose of exercise that has been said to be bad for you,” he noted.)

By now the evidence has been thoroughly dissected. Suffice it to say that leading exercise researchers agree with Runner’s World and have stacks of journal articles to bolster their arguments.

Dr. Benjamin Levine, a competitive tennis player and director of the Institute for Exercise and Environmental Medicine at Texas Health Resources and the University of Texas Southwestern Medical School, said: “You can always find one or two papers and studies that, if you spin the right way, can seem to reflect your argument.”

But, he added, while health benefits rise most sharply as people go from sedentary to moderately active, there is no good evidence that they decline, or even level off, for distance runners. “Our data and other data are quite convincing,” Dr. Levine said.

Dr. O’Keefe is not swayed. In an as yet unpublished editorial, he recommends running just two or three miles at a relaxed pace a few times a week, interspersed with days of swimming, a couple of sessions of weight lifting and some yoga. In an interview, he said that was his own exercise regimen.

The real question, though, is why does running arouse such passions? You don’t hear gleeful chortling about the health hazards to master swimmers or cross-country skiers or cyclists who do 100-mile “century” rides.

Dr. Paul Thompson, a cardiologist and exercise researcher at Hartford Hospital who is also an endurance athlete, cites two factors. First, he said, among runners “a lot of people use their athleticism in an attempt to show they are a superior human being.”

Paula Broadwell said she ran in the mountains of Afghanistan with Gen. David H. Petraeus, maintaining a pace of six or seven minutes a mile while interviewing him. The Wall Street Journal published her available race times, in an article that gushed over her speed.

But it was clear to runners that she could not possibly have run that fast, even at sea level. Her best time in a race was 7:21 minutes a mile, and most people race faster than they normally run. Even that pace barely put her in the 70th percentile for her age.

When runners use their prowess, real or exaggerated, to suggest superiority, they generate resentment, Dr. Thompson noted. As a result, he said, “people love to find studies that support the bias that too much exercise is bad.”

Why is this not an issue in other sports? Runners, Dr. Thompson and others say, are just so much more plentiful than other athletes; if you find yourself resenting an athlete who fancies himself superior, odds are that athlete will be a runner. And running appears so easy — anyone can run, it seems. Anyone can finish a marathon, even Oprah Winfrey did it. So those who do not run can feel a little defensive.

Added to that is all the running talk by devotees who may not realize how annoying and boring their monologues can be. Dr. Baggish said his patients often bring in huge folders full of decades worth of data — heart rates on various runs, finishing times in races.

“They can talk about it until the cows come home,” he said.

So it might behoove runners to keep their running talk and braggadocio to their running friends. There may be something more than health concerns behind those cracks from friends and family about failing knees and backs and heart attacks among runners.

“When I see runners in my office, I always encourage them to bring their spouses,” Dr. Baggish said. Often a wife, for example, will start to complain: her husband “can’t enjoy Christmas Day with the family because he has to run.” A husband might say he just can’t understand why his wife has to be out there all the time running.

“That sort of inconvenience translates into concerns about health,” Dr. Baggish said.

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Well: A Running Bias Against Really Dedicated Runners

From the moment it appeared online last month, an editorial in the journal Heart became a Rorschach test for opinions about runners.

Do you roll your eyes when they start talking about their races and times? Do you snigger when you see bumper stickers that simply say “26.2,” the number of miles in a marathon, or “13.1,” the half-marathon distance? Do you lose patience with family members who have to go for a run — even if it means waking up at 4 a.m. before leaving on a vacation?

Then perhaps the editorial will appeal to you. It was titled “Run for your life… at a comfortable speed and not too far.” The authors, Dr. James H. O’Keefe Jr. of Saint Luke’s Mid America Heart Institute Hospital in Kansas City, Mo., and Dr. Carl J. Lavie of the Ochsner Health System in New Orleans, wrote that those who run slowly and keep their mileage down gain health benefits. But those who run for more than about 40 minutes a day and those who run faster than eight minutes a mile actually increase their risk of death.

Too much or too intense running, the two cardiologists said, “appears to cause excessive ‘wear and tear’ on the heart.”

The editorial got extensive news attention, often tinged with schadenfreude. “What do you get if you finish a marathon? A finisher’s medal and a risk of death! ” said MSN-Now. The Wall Street Journal’s article was headlined “One Running Shoe in the Grave.”

On the other side, of course, were aggrieved runners. Runner’s World instantly published a rejoinder titled “The Too-Much-Running Myth Rises Again.” The Heart editorial, it said, was “twisting the data.”

Meanwhile, some runners panicked. “I got 650 e-mails in four hours,” said Dr. Aaron Baggish, associate director of the cardiovascular performance program at the Massachusetts General Hospital. (Dr. Baggish cycles, he runs — more than 30 marathons so far — and he competes in triathlons. “I certainly exceed any dose of exercise that has been said to be bad for you,” he noted.)

By now the evidence has been thoroughly dissected. Suffice it to say that leading exercise researchers agree with Runner’s World and have stacks of journal articles to bolster their arguments.

Dr. Benjamin Levine, a competitive tennis player and director of the Institute for Exercise and Environmental Medicine at Texas Health Resources and the University of Texas Southwestern Medical School, said: “You can always find one or two papers and studies that, if you spin the right way, can seem to reflect your argument.”

But, he added, while health benefits rise most sharply as people go from sedentary to moderately active, there is no good evidence that they decline, or even level off, for distance runners. “Our data and other data are quite convincing,” Dr. Levine said.

Dr. O’Keefe is not swayed. In an as yet unpublished editorial, he recommends running just two or three miles at a relaxed pace a few times a week, interspersed with days of swimming, a couple of sessions of weight lifting and some yoga. In an interview, he said that was his own exercise regimen.

The real question, though, is why does running arouse such passions? You don’t hear gleeful chortling about the health hazards to master swimmers or cross-country skiers or cyclists who do 100-mile “century” rides.

Dr. Paul Thompson, a cardiologist and exercise researcher at Hartford Hospital who is also an endurance athlete, cites two factors. First, he said, among runners “a lot of people use their athleticism in an attempt to show they are a superior human being.”

Paula Broadwell said she ran in the mountains of Afghanistan with Gen. David H. Petraeus, maintaining a pace of six or seven minutes a mile while interviewing him. The Wall Street Journal published her available race times, in an article that gushed over her speed.

But it was clear to runners that she could not possibly have run that fast, even at sea level. Her best time in a race was 7:21 minutes a mile, and most people race faster than they normally run. Even that pace barely put her in the 70th percentile for her age.

When runners use their prowess, real or exaggerated, to suggest superiority, they generate resentment, Dr. Thompson noted. As a result, he said, “people love to find studies that support the bias that too much exercise is bad.”

Why is this not an issue in other sports? Runners, Dr. Thompson and others say, are just so much more plentiful than other athletes; if you find yourself resenting an athlete who fancies himself superior, odds are that athlete will be a runner. And running appears so easy — anyone can run, it seems. Anyone can finish a marathon, even Oprah Winfrey did it. So those who do not run can feel a little defensive.

Added to that is all the running talk by devotees who may not realize how annoying and boring their monologues can be. Dr. Baggish said his patients often bring in huge folders full of decades worth of data — heart rates on various runs, finishing times in races.

“They can talk about it until the cows come home,” he said.

So it might behoove runners to keep their running talk and braggadocio to their running friends. There may be something more than health concerns behind those cracks from friends and family about failing knees and backs and heart attacks among runners.

“When I see runners in my office, I always encourage them to bring their spouses,” Dr. Baggish said. Often a wife, for example, will start to complain: her husband “can’t enjoy Christmas Day with the family because he has to run.” A husband might say he just can’t understand why his wife has to be out there all the time running.

“That sort of inconvenience translates into concerns about health,” Dr. Baggish said.

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E.U. and Google to Discuss Antitrust Issues

BRUSSELS — The European Union’s top antitrust regulator is expected to meet with Google executives early this week as settlement talks between the search giant and the U.S. authorities gain momentum.

The Europeans have been seeking a settlement with Google since May, and Joaquín Almunia, the Union’s competition commissioner, and Eric E. Schmidt, the executive chairman of Google, have met on previous occasions trying to reach an accord.

But the Europeans have been pressing Google harder than their U.S counterparts to address accusations that the company biases its search results to favor its own services like mapping and online shopping. That makes the expected talks between Mr. Schmidt and Mr. Almunia particularly delicate.

The two men could meet as soon as Tuesday, according to a person with knowledge of the talks who spoke on condition of anonymity as the meeting was to be private.

While Google is the dominant search engine in the United States, it holds even greater sway in Europe, accounting for more than 90 percent of searches in a number of major markets. That could leave rivals like Microsoft scope to try to set some rules — at least in the European Union, where regulators often rely more on complaints by competitors than in the United States — for how Google ranks competing services.

After a two-year inquiry, Mr. Almunia said in May that Google might have abused its dominance in Internet search and advertising, giving its own products an advantage over those of rivals.

“Google displays links to its own vertical search services differently than it does for links to competitors,” Mr. Almunia said in a statement then. “We are concerned that this may result in preferential treatment compared to those of competing services, which may be hurt as a consequence.”

The accusation that Google biases its search results to favor its own services, which originally was a main issue in the U.S. talks, has been taken off the table there, two people who have been briefed on those discussions said Sunday. They spoke on the condition of anonymity because the negotiations were continuing.

Google has consistently maintained that it offers a neutral, best-for-the-customer result.

Mr. Almunia said in May that Google would need to propose a plan within weeks for changes to various practices, including how it links to competitors’ services. Google made its first formal settlement proposal in July, but the talks have dragged on since.

In September, Mr. Almunia signaled that there were limits to how much longer his office would try to negotiate. But early this month, Mr. Almunia appeared to take a softer tone, saying that time was needed to conclude “conversations” with Google that were going on “quite intensively.”

If Mr. Almunia ultimately accepts a settlement offer, Google would avoid a possible fine of as much as 10 percent of its annual global revenue, about $37.9 billion last year. It would also avoid a guilty finding that could restrict its business activities in Europe.

A settlement would offer advantages for Mr. Almunia, too. He has sought to speed up resolution of antitrust cases to prevent them from dragging out, particularly in the fast-changing technology marketplace, where proposed remedies often rapidly lose their relevance.

As negotiations stand in the U.S. case, Google would make a set of voluntary commitments, the two people briefed on those discussions said.

Google, according to the people, has agreed to refrain from copying summaries of product and restaurant reviews from other Web sites and including them in Google search results, a practice known as screen scraping.

The company would also agree to make it easier for advertisers to transfer data on products, pricing and bidding to Google’s competitors, including Bing from Microsoft, the two people said. Google, they said, would also refrain from striking exclusive deals with Web sites to use Google’s search service.

In addition, Google would sign a consent decree, agreeing to license patents deemed essential for wireless communications on reasonable terms, the two people said. The patent issue is a late entrant to the case. Subpoenas that the U.S. Federal Trade Commission started sending to Internet companies last year laid out a wide-ranging investigation focusing on Google’s conduct in the search business. The Web site Politico reported Saturday that the talks had moved away from search, adding details to reports that Google was resisting a consent decree in that area.

Steve Lohr reported from New York.

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Syrian Airstrike Kills Palestinian Refugees

DAMASCUS, Syria — Syrian government forces for the first time hit the country’s largest Palestinian refugee neighborhood with airstrikes on Sunday, killing at least eight people in the Yarmouk district of Damascus and reportedly driving dozens of formerly pro-government Palestinian fighters to defect to the rebels.

New signs emerged on Sunday of political pressure on President Bashar al-Assad. Mr. Assad’s vice president was quoted as saying neither side could win the war and calling for “new partners” in a unity government, a possible sign that at least some in the government were exploring new ways out of the crisis. The comments came as two close allies, the government of Iran and the leader of the Lebanese Shiite group Hezbollah, appeared to slightly temper their support.

In Yarmouk, flesh stuck to the walls and burned body parts littered the ground at the Sheik Abdul Qader mosque, which had offered shelter to Palestinians and others displaced by fighting in other areas. Minutes before, a reporter saw a Syrian fighter jet fire rockets at the camp. Women, crying children and white-bearded men thronged the streets with hurriedly packed bags, not sure where to look for safety.

For many Yarmouk residents — refugees from conflict with Israel and their descendants — the attacks shattered what was left of the Syrian government’s claim to be a champion and protector of Palestinians, a position that the Assad family relied upon as a source of domestic and international legitimacy during more than 40 years of iron-fisted rule.

“For decades the Assad regime was talking about the Palestinians’ rights,” said a Palestinian refugee who gave his name as Abu Ammar as he debated whether to flee with his wife and five children from the camp, on the southern edge of Damascus. “But Bashar al-Assad has killed more of us today than Israel did in its latest war on Gaza.”

He added: “What does Bashar expect from us after today? All of us will be Free Syrian Army fighters.”

The Palestinian militant group and political party Hamas has broken with Mr. Assad over his crackdown on what began as a peaceful protest movement, and while most Palestinian parties still profess neutrality, a growing number of Palestinians support — and have even joined — the rebels.

The Syrian government long held the loyalty of hundreds of thousands of Palestinian refugees, giving them health care, education, and access to professional careers, among other rights denied by other Arab host countries. But those policies also gave Palestinians a stake and sense of belonging in Syria that has led many to join the uprising.

Several of Mr. Assad’s allies signaled a new push for a peaceful solution. Iran’s Foreign Ministry called for an end to military action, the release of political prisoners and a broad-based dialogue to form a transitional government that would hold free elections, Iran’s state news agency reported.

Mr. Assad’s vice president, Farouk al-Shara, said that neither the government nor the rebels could end the conflict militarily, the pro-Syrian Lebanese newspaper Al Akhbar reported. And he called for a solution involving a cease-fire and brokered by international leaders that would establish a “national unity government with wide powers.”

He added that the battle was for the country’s very existence, not “the survival of an individual or a regime,” and that Syria’s leaders “cannot achieve change without new partners.”

The impact of the statements was unclear. Mr. Shara, a Sunni Muslim like most of the rebels, has been floated by the Arab League as a possible successor, but many of Mr. Assad’s opponents reject any dealings with leaders of the current government.

In neighboring Lebanon, Hassan Nasrallah, the leader of Hezbollah, appeared to acknowledge for the first time that the Syrian uprising is at least in part driven by popular sentiment.

“Today, in Syria,” he said in a videotaped address at a graduation ceremony, “there is a big part of the population with the Syrian regime and a part against it, and the latter armed themselves to fight the regime.”

An employee of The New York Times reported from Damascus, and Anne Barnard from Beirut. Hani Mourtada contributed reporting from Beirut, and Hala Droubi from Dubai.

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