Ideology, science, and public policy.

I deologies—strong beliefs based on untestable assumptions—are the antithesis of science. Whether economic (the ‘‘invisible hand of the market’’ will solve social inequities ‘‘in the long run’’), religious (‘‘we’’ hold the sole truth of a divine entity), or political (our way is the best governance for assuring liberty and justice), these kinds of widespread beliefs are acceptable in individuals, indeed their right to espouse. Ideologies are weak, even counterproductive, as guides to government policy. Science, basic or applied, does not claim to be ‘‘truth’’, only to reveal plausible, testable hypotheses, methodologically acceptable, transparent, and replicable. It is an essential ingredient to responsible and responsive policymaking, not the sole criterion. It can help develop, implement, evaluate, and uncover potential consequences of policies, thereby clarifying the moral and economic choices facing decision makers. Ideologies preclude the input of new information or compromise with non-believers. Americans are experiencing the results of ideologically driven policies. The Bush Administration’s 2006 Budget Plan is a statement of its beliefs, allocating over $2.5 trillion accordingly, with sharp impacts on the health and welfare of Americans, the environment, and much of the world. One theme is promotion of mainly a fundamentalist brand of Christianity. The administration believes ‘‘faith based’’ programmes—now receiving $2 billion yearly—are cheaper, because they rely in part on church volunteers, and are more effective, because of their religious commitment. Yet, no federal effectiveness studies have been done to test these beliefs. The Budget Plan favours the agenda of ‘‘faith based’’ groups that worked for and voted most for the president in the 2004 election. For example, health care providers now have the right not to provide information, referral, or service to women who want an abortion— without risk of losing their federal funds as previously. The administration has also increased funds—to $170 million— for abstinence only sex education for youth. The Centers for Disease Control were told not to monitor the birth rates of girls in abstinence only programmes, but only their attendance and attitudes, and to emphasise the failure rates of condoms in its educational material. More of these funds are now going to faith based groups than to traditional health education groups. Conservative religious groups are also a large part of advisory committees that review and recommend these grants, displacing health and research organisations that have widely respected track records in sex education. ‘‘Faith based’’ funds are administered by numerous government departments, including Agriculture, Housing, Health, Justice, and the Veteran’s Administration—which now allows its health practitioners and counsellors to exert ‘‘religious influence’’ on troubled vets. These faith groups are also having growing influence on US international aid programmes, especially regarding birth control, HIV/AIDS prevention, and drug misuse control. This new federal bureaucratic infrastructure is led by a White House Office and called a ‘‘parallel government’’ in a study by the Rockefeller Institute of Government. It is aimed to help faith based groups ‘‘penetrate agency operations’’, to enlist, equip, enable, empower, and expand their role in federal health and social services. A second budget theme is market oriented privatisation of government. The government’s stated policy is to privatise as many public functions as possible, ranging from 250 000 defence jobs, redirecting primary school funds to private and religious schools, to diverting social security funds to Wall Street brokers. The government will spend $100 billion on outside service contracts next year, more than it spends on Federal employee salaries. As studies revealed in recent years, privatisation brings less transparency and accountability for tax spending because contracting organisations can claim their operations are ‘‘proprietary’’ information that would compromise their competitiveness if made public. This secrecy makes external evaluation difficult or impossible. It also permits a weakening of civil rights guarantees, partly because monitoring is rare. Religious groups who receive government funds are granted special privileges to discriminate against hiring persons whose beliefs are not compatible with their precepts. Commercial and religious programme outsourcing also results in poorer quality jobs, as unionised government jobs are shifted to ones without union representation, fewer benefits, lower or uncertain pay rates, and less possibility for worker grievance appeals. By definition industry must first satisfy investors—in contrast with the client service priority of non-profit and public services. When profits are not high enough, any provider can end any service programme, with little warning. Commercial health maintenance organisations recently dropped over a million federally financed elderly beneficiaries when profits from them were too lean. Companies also factor in marketing costs and top salaries for their executive pyramids, increasing federal, tax based expenditures. Combined with continued growth of military spending (at least $500 billion for 2006), the Administration’s Plan will cut further into an already frayed social safety net for mothers and children, elders, workers, and the disabled in health and nutrition programmes, education, employment, and housing. The Plan hollows out parts of the public and private health and science infrastructure and backs away from workplace and environmental protection—25% is to be cut from environmental and land conservation programmes over five years. Budget plans no longer favour science. Hundreds of top US scientists recently protested against huge increases in funding for biodefence, antiterrorist research while research on larger public health threats, such as syphilis and tuberculosis, were cut by 27% since 2001. They objected to the manipulation of knowledge, especially about abstinence only sex education; the effects of abortions; drinking water and food safety, global warming, workplace safety, and the endangerment of the world class status of US research agencies. There is now a scientist shortage: the US increasingly relies on foreign born scientists, who account for 38% of science personnel, drawn mainly from Asia. Other countries now spend more of their gross domestic product on research and development than the US. Last year saw a drop in Asians coming to 814 EDITORIAL