A Cult Bike From India Takes On the World

NEW DELHI, India — The Royal Enfield Bullet, often described as the oldest continuously produced motorcycle in the world, is a cult product for enthusiasts who love it for its vintage feel as much as for the thrum of its engine.

Muscular and pliant, the Bullet — an Indian-made avatar of an old British brand — has found renewed popularity over the last few years, as leisure motorcycling in India has blossomed. Its manufacturer, Royal Enfield Motors, sold almost 175,000 motorcycles —Bullets as well as three other brands — in 2013.

Royal Enfield’s newest model, a midsize “cafe racer” called the Continental GT, was introduced at an elaborate event in London in September. “It’s the first bike that we’ve developed keeping the world market in mind,” said Siddhartha Lal, who is credited with turning Royal Enfield around.

Mr. Lal, age 40, is the chief executive of Eicher Motors, a manufacturer of buses, trucks and tractors that owns Royal Enfield. Uncommonly for an Indian executive, he sports sideburns and wears jeans and a bomber jacket to meetings. He was riding a Bullet when he was in university, well before Eicher, under his father’s management, bought Royal Enfield in 1993.

The sale price was “just pennies,” Mr. Lal said. Eicher reported revenue of more than $1 billion in 2012.

The Bullet was first produced by a British firm named Royal Enfield, but after that company shut down in 1971, its Indian manufacturing unit – in the city of Madras (now Chennai) – bought the rights to the name and continued to produce the Bullet.

But through the 1970s and 1980s, Mr. Lal said, Royal Enfield’s management made a series of bad decisions and buried the company in debt. “The motorcycle was still resilient, though. It was probably selling 1,500 or 2,000 pieces a month,” he said. “Eicher bought Royal Enfield because at its core was the Bullet. That was the appeal.”

Mr. Lal set himself to turn Royal Enfield around in 2000, when he was 27, and the company first sputtered and then roared back to life. Dan Holmes, who fell so in love with a Bullet he saw at a trade show that he opened a Royal Enfield dealership in Goshen, Ind., recalled how the quality of the motorcycles improved from the late 1990s through the 2000s.

“Eicher started investing real money into their bikes,” Mr. Holmes said. The electric start grew more reliable while fuel injections and transmissions were revamped.

The Royal Enfield motorcycle, whose basic profile changed very little over the years, appealed to buyers, he said, because one could tinker endlessly with it. Jay Leno owns one, as does Billy Joel. Mr. Holmes himself owns what he calls “the two most modified Royal Enfields in the world,” which he used to set speed records at the Bonneville Salt Flats in 2008.

As one of perhaps seven or eight exclusive Royal Enfield dealers in the United States back in the early 2000s, Mr. Holmes sold his motorcycles for $3,500 to $4,000 each, taking custody of them in dribs and drabs from a national distributor. In 2003, his best year, he sold 35 Royal Enfields.

Exports remain limited, although they are growing, and Mr. Lal is ambitious about scaling up. Last year, Royal Enfield exported 3,500 motorcycles. Six hundred of those went to America, its biggest overseas market.

Back in India, however, Royal Enfield has caught the beginning of a wave in leisure motorcycling. Kumar Kandaswami, a senior director at Deloitte Touche Tohmatsu India, said a split had emerged in the market, between riders who wanted light motorcycles just to commute and those who wanted the thrill of the machine itself.

“Even at a rough estimate, there are easily half a million buyers out there who want to use motorcycles for leisure,” Mr. Kandaswami said. “There are active motorcycle communities now. Our highways have improved. People have more money to spend.”

The vastness of this market attracted manufacturers like the British Triumph, which opened in India in 2013, and Harley-Davidson, which arrived in 2009.

“Before we came, if there was any passion among motorcyclists at all, it was among Royal Enfield owners,” Anoop Prakash, the managing director of Harley-Davidson India, said. “People underestimated the market, thinking that, at our level, sales would be fewer than 800 bikes a year across the country.” Since July 2010, more than 4,000 Harley-Davidsons have been sold in India.

Frequent Flier: A World Traveler Is Harmless, Yet Suspect

As worldwide creative director for the Brand Union, I travel to pitch new clients, make sure all our offices are running smoothly, and meet with existing clients. Work doesn’t stop because I’m on a plane, so I’m not the guy who has a lot of time to chat. I may be missing out on meeting some interesting people, but I want to avoid the nightmare scene of someone talking to me about their children, their pets or their work during an eight-hour flight.

Early in my career I would talk to seatmates, but I’ve learned the hard way that once you start talking, there’s often no good way to stop. The most anyone will get out of me now is a polite nod, which is plenty.

I’m very disciplined about travel. That’s the only way I can get through it. Once I’m done working on international flights, I’ll have a glass of red wine and take some melatonin. I’m out like a light and it’s nothing but sweet dreams for me until we land.

Part of my low-key approach to business travel is the fact that I have been stopped and searched so many times.

Without a doubt, my profile is a mixed bag and must set off all kinds of alarms.

First, I was born in Zambia to Welsh parents. Most people have no idea where Zambia is, including passport officials. Second, I travel on a British passport with a Welsh name, Dyfed Wynn Richards. I live in the United States and have a green card.

Anyone looking through my passport stamps and the frequency of my international travel probably assumes something is up. I can’t blame them. If I was in charge of passport control, I would stop someone with my profile, too.

One of the strangest experiences I have ever had was back when I was a young, broke designer. I was living in London at the time and dating a young woman who lived in France. Back then, the ferry between Dover and Calais was the cheapest option.

I made the trip several times with no problem, but finally customs and immigration officials stopped me when I was returning to Dover.

I was asked to step into a room and I was grilled by three big guys and our conversation was being taped. It was awful. Plus they asked me to remove my clothes and they even took a urine sample. I’m a big guy myself and don’t scare that easy, but I was petrified.

I was let go because I didn’t do anything wrong and when I got home I did tell my father about the situation. He contacted our local parliament member, and we did receive a document detailing the interview. Apparently, the officials thought I was very defensive because of my body language and gestures. They also put in the report that I cried. I remember my dad saying, “Really, you cried?”

Last year I was stopped in Singapore for about six hours. I flew in from Bangkok. Everyone was extremely polite, but I had my baggage searched.

Nothing was out of the ordinary, but I do think the sheer number of stamps on my passport, my real name, and my residency status probably prompted the search.

I take it in stride. Who knows? Maybe they thought I was a bald James Bond. And for the record, I didn’t cry.

By Fred Richards, as told to Joan Raymond. E-mail: joan.raymond

@nytimes.com

Tool Kit: Virtual Currency Gains Ground in Actual World

A type of digital cash, bitcoins were invented in 2009 and can be sent directly to anyone, anywhere in the world. You don’t have to go through a financial institution, which means no fees and no one tracking your spending habits. With a current market capitalization of $1 billion, bitcoins are beginning to be more widely accepted. You can use them to pay for a pizza or make speculative bets that could end up financing your child’s college education.

But bitcoins, and other digital currencies, have also come under scrutiny. Liberty Reserve, an online payment system, was shuttered in the spring by New York authorities, who said the company used its digital currency, known as LRs, to launder up to $6 billion. And law enforcement officials have voiced concerns that bitcoins could also abet illegal transactions. Bart Chilton, a commissioner on the Commodity Futures Trading Commission, suggested that bitcoins might be ripe for regulation.

Moreover, some critics say the bitcoin infrastructure is insecure, as hackable as any other computer-based system.

“The way the basic bitcoin system works is both incredibly solid and incredibly clever from a technical standpoint,” said Nicholas Weaver, senior staff researcher at the International Computer Science Institute in Berkeley, which studies and advances a range of emerging technologies. “The system’s security is fragile, however, and the economic model behind bitcoin is, well, crazy stupid.”

Nonetheless, paying with bitcoins can be a weirdly fun way to make transactions. Here is a primer on how to do it.

Like gold, bitcoins, which are both a currency and a commodity, are in limited supply (there is a cap of 21 million total) and have to be “mined” before they are put in circulation. Anyone can mine for bitcoins by downloading software, known as the bitcoin client, which algorithmically crunches a bunch of numbers to legitimize or authenticate a sequence or “block” of past bitcoin transactions. So bitcoins are basically minted as a reward for contributing to the smooth operation of the system. Validating a block yields 25 bitcoins, which are currently worth $2,675.

The fluctuating price of bitcoins, also like gold, is a function of supply and demand, as well as psychology. “Bitcoins have value because people say they have value,” said Andrew White, a former I.T. manager for the Wikipedia Foundation and now a digital currency entrepreneur in San Francisco.

Unlike fiat currencies like the United States dollar and virtual currencies like Facebook credits and the one invented by Liberty Reserve, bitcoins are not created or controlled by a central authority. But with the blistering rate of bitcoin transactions these days, you need a pricey and complex computer rig to effectively run the bitcoin client and procure some bitcoin bounty. An easier way to get bitcoins is to just find someone willing to sell them to you.

Julian Tosh, an I.T. systems administrator in Las Vegas, for example, lets friends and family buy items on his Amazon wish list and pays them back in bitcoins. “This works well as long as I need stuff,” said Mr. Tosh, who also presides over a Wednesday “Bitcoin Lunch Mob” in Las Vegas, which gathers to discuss and trade bitcoins.

But maybe you don’t personally know any bitcoin enthusiasts like Mr. Tosh or the Winklevoss twins, Cameron and Tyler, who own around $11 million worth and have filed papers with the Securities and Exchange Commission to form a bitcoin investment trust. If so, you might try localbitcoins.com, which lists people in your area who are willing to exchange bitcoins for cold hard cash. The market price Tuesday afternoon was $107 for a bitcoin. Be sure to check out sellers’ profiles and reviews to make sure they are reputable. And, of course, it’s always a good idea to meet in a public place to make the transaction.

Bitcoins can be easily transferred and stored using a digital wallet app on your Android mobile device. Popular wallet apps include BitcoinSpinner and Bitcoin Wallet. There are no iOS bitcoin wallet apps and Apple did not respond to e-mails seeking an explanation. But Blockchain has an online wallet service that you can access using any Internet-connected desktop, laptop, tablet or smartphone.

You can also get bitcoins through Mt.Gox, the largest bitcoin exchange and where the currency is traded as a commodity. But it’s a cumbersome and lengthy process, requiring wire transfers and scanning identity documents. The company, which is based in Japan, also charges a 0.6 percent fee for all transactions.

Keep in mind that the United States Department of Homeland Security in May seized Mt.Gox’s United States accounts, saying it misrepresented the full extent of its financial operations. The company did not respond to requests for comment but continues to function as before the seizure.

Another option is Coinbase, a bitcoin transaction platform, which recently announced a $5 million infusion of venture capital. While it’s still a nascent venture (not even a year old), the service hasn’t had any major hiccups yet and is relatively simple to use. You just enter your bank account and routing number, how many bitcoins you want and click “buy.” You can also send bitcoins to others through your Coinbase account. Just know you’ll be charged a 1 percent transaction fee.

Once you have your bitcoins, the fun part is spending them. Bitcoin. travel, BitcoinsInVegas.com, Spendbitcoins.com and Reddit have directories of businesses that accept bitcoins as payment. And Bitpremier.com lists high-priced luxury items (cars, jets, yachts, etc.) you can buy with bitcoins.

To make a purchase, all you have to do is type the receiver’s key code or scan their QR code into your bitcoin wallet and you’re done. Like cash transactions, you can’t cancel payment later, so be sure it’s what you want before you click “send.”

Brewster Kahle, a founder of the Internet Archive in San Francisco, said he routinely used bitcoins to pay for lunch at a local sushi restaurant. He’s interested in the technology and appreciates the libertarian aspect of it. “Bitcoin used to be just in the land of computer geeks, but not anymore,” he said.

More businesses are accepting bitcoins lately thanks to Bitpay, which supplies software for processing bitcoin payments. The merchant pays a 0.99 percent fee per transaction versus the 2 to 4 percent fees charged by credit card companies. Bitpay will also immediately convert bitcoins to dollars if the merchant desires.

“Bitcoin users are pretty enthusiastic, so you get instant loyal customers,” said Adam Penn, owner of Veggie Galaxy, a restaurant in Cambridge, Mass., which began accepting bitcoins through Bitpay in May. “So far, it’s been a no-risk revenue generator.”

Also last month, Bitpay announced a partnership with the mobile gift card app Gyft, which will allow people to use bitcoins to purchase gift cards from hundreds of retailers including Brookstone, Lowe’s, Gap, Sephora, GameStop, American Eagle, Nike, Marriott, Burger King and Fandango.

“It’s a huge development,” said Mr. Tosh in Las Vegas, who predicts Gyft’s embrace of bitcoins will lead to widespread use of the alternative currency. “Pandora’s box has been smashed.”

Or maybe not. The legal trouble at Mt.Gox sent a shiver through the market as did S.E.C. charges last week that the founder and operator of the lesser-known Bitcoin Savings and Trust in McKinney, Tex., was running a bitcoin Ponzi scheme.

Still, bitcoin advocates point out that, despite some bad actors, the actual system has not had a major security breach. Nevertheless, even the most ardent bitcoin boosters urge caution. Bitcoins have appreciated more than 700 percent since this time last year — an increase some have compared to a bubble bound to burst.

“It’s supervolatile, so I’d tell people to go slow,” said Peter Vessenes, chairman and executive director of the Bitcoin Foundation, a nonprofit organization that promotes the currency. “Never hold more bitcoins than you’re prepared to lose.”

Monsanto Executive Is Among World Food Prize Winners

Robert T. Fraley, Monsanto’s executive vice president and chief technology officer, will share the $250,000 World Food Prize with two other scientists who helped devise how to insert foreign genes into plants: Marc Van Montagu of Belgium and Mary-Dell Chilton of the United States.

The announcement was made in Washington on Wednesday, accompanied by a speech from Secretary of State John Kerry.

The prize was started in 1987 by Norman E. Borlaug, who won the Nobel Peace Prize in 1970 for bringing about the Green Revolution, which vastly increased grain output, and who thought there should be a Nobel Prize for agriculture. The award is given to those who improve the “quality, quantity or availability” of food in the world.

The prize has some public relations value for Monsanto, potentially buttressing the case for bioengineered food, which has met with some resistance around the world.

The World Food Prize Foundation said the work of the three scientists led to the development of crops that can resist insects, disease and extremes of climate, and are higher-yielding.

Genetically engineered crops, which for the most part contain genes from bacteria, now account for roughly 90 percent of the corn, soybeans and cotton grown in the United States. Globally, genetically modified crops are grown on 420 million acres by 17.3 million farmers, over 90 percent of them small farmers in developing countries, according to the International Service for the Acquisition of Agri-biotech Applications, an organization that promotes use of biotechnology.

But the crops are shunned in many countries and by many consumers, who say the health and environmental effects of the crops have not been adequately studied. And the role the crops can play in increasing yields and helping farming adapt to climate change is still subject to some debate. One study organized by the World Bank and United Nations concluded in 2008 that genetically modified crops would play only a small role in fighting world hunger.

“I’m sure there will be some controversy about it,” Kenneth M. Quinn, the president of the World Food Prize Foundation, said in an interview before the winners were announced. “At the same time the view of our organization and our committee is that in the face of controversy, you shouldn’t back away from your precepts. If you do so, you are diminishing the prize.'’

Mr. Quinn, a former United States ambassador to Cambodia, said crop biotechnology had “met the test of demonstrating it would impact millions of people and enhance their lives.'’

Mr. Quinn is not a member of the committee that selects the prize winners. That committee is led by M.?S. Swaminathan, an Indian geneticist and the winner of the first World Food Prize in 1987. The names of the other committee members are kept secret to shield them from lobbying.

The winners of the 2013 prize were part of teams that independently developed methods three decades ago for putting foreign genes into the DNA of plants.

The key was a soil microbe called Agrobacterium tumefaciens, which can inject its own DNA into plants, causing a tumorlike growth called crown gall disease. The researchers disabled the tumor-causing part of the bacterium and inserted the gene that they wanted to be carried into the plant’s DNA.

Scientists from the three teams, which were fiercely competing with one another, presented their results at a conference in Miami in January 1983. That essentially marked the birth of the crop biotechnology business, though it took more than a decade for the first genetically modified crops to come to market.

Dr. Van Montagu, who did his research at Ghent University, founded two biotechnology companies, Plant Genetic Systems and Crop Design.

Dr. Chilton, who did much of her research at the University of Washington and Washington University in St. Louis, became the core of the biotechnology team at Syngenta, where she still works.

Monsanto started later than the other two teams, but it helped finance their work and was therefore able to learn from them and catch up, eventually dominating the crop biotechnology business, according to “Lords of the Harvest,” a book about Monsanto by Daniel Charles.

A big reason was Dr. Fraley, who was hired by Monsanto as a molecular biologist in 1981 but soon moved beyond tinkering with plant cells as he rose up the ranks at the company.

He harbored “oversized ambitions and visions of a business empire in the making,” Mr. Charles wrote. The book described Dr. Fraley as “preternaturally self-confident” and driven, a Midwest farm boy who did not want to go back to the tractor and instead preferred the perks of corporate life, like fancy clothes and sports cars.

Monsanto’s biggest successes have been soybeans and other crops that can tolerate its herbicide Roundup, allowing farmers to kill weeds without harming the crop.

Dr. Borlaug, the founder of the food prize, who died in 2009, was a big supporter of the technology. Past winners have included scientists, politicians and leaders of advocacy and charity groups.

The prize was endowed by John Ruan, an Iowa trucking magnate and philanthropist who died in 2010. But the prize foundation also receives contributions.

Of the roughly $8 million in contributions received in 2011, Monsanto gave $40,000, Syngenta nearly $50,000 and DuPont Pioneer, a seed company, $280,000, according to the foundation’s report to the Internal Revenue Service. Far bigger contributions were received from the state of Iowa, where the prize foundation is based, and from some nonprofit organizations like the Rockefeller Foundation.

On the Road: Travel Security Companies Watch a Volatile World

A few days ago, Alex Puig, a regional security director for the travel emergency company International SOS, was in his office in suburban Philadelphia watching reports on a volcano erupting in western Alaska. At the same time, he was monitoring events in Turkey, where street violence sharply escalated over the weekend.

Those were just two hot spots on a long list. Troubles, mayhem, disease, natural disasters and other disruptions hit like lightning strikes all over the world, and are monitored around the clock by companies like International SOS, which claims to have 70 percent of the Fortune Global 500 companies as clients, and competitors in the travel alert and response business like iJet.

That pesky volcano, named Pavlof, in the western Aleutian archipelago, began erupting again in mid-May. On some days it was belching ash 20,000 feet into the skies, forcing cancellation of some regional flights. The question was whether the eruptions at the volcano, one of Alaska’s most active, might worsen and spew a higher and wider ash cloud that could potentially disrupt hundreds of flights a day on the ever-more-important travel and cargo routes between North America and Asia.

“The concern now is primarily over the effect that volcanic ash has had, and potentially again could have, on air traffic,” said Mr. Puig, a former travel and cargo security executive with Target and a former agent in the clandestine services of the Central Intelligence Agency. “At the end of the day, let’s assume that more ash clouds get spewed into the atmosphere, and now airlines are having to reroute and greatly reduce — or completely cancel — flights.” That, as we saw in Europe three years ago, can mean big trouble.

In its update on Sunday, the Alaska Volcano Observatory, a joint federal, state and university program, reported that seismic tremors on Pavlof had weakened. But it added that given the volatile nature of Pavlof, “eruptive activity could increase again with little warning.”

While there was no immediate cause for alarm about air travel in the region, there was plenty of precedent for paying attention — for travelers and for those in corporate offices who send business travelers around the world. Those corporate officials are charged with so-called duty-of-care responsibilities, not only to respond properly to emergencies, but also to anticipate them.

Lessons were learned from the calamitous effects on travel caused by the ash cloud that covered much of Western Europe when a volcano in Iceland erupted in spring 2010. At one time, Mr. Puig said, such an event might not have seemed as disruptive or dangerous as, say, an earthquake, and might have been taken for granted.

“People said, ‘O.K., we’ll just fly over it or around it,’ ” he said. “But in Europe we found out that this wasn’t feasible, and a lot of people got stranded.”

Over an eight-day period in April 2010, 104,000 commercial flights in Europe, half of the total scheduled, were canceled. Five million travelers all over the world were left stranded, as the effects of those cancellations rippled through the global commercial aviation networks. It was a slow-moving travel disruption with huge logistical effects — hotel rooms were hard to get, ground transportation was uncertain, work communications were going haywire as travelers found themselves stuck all over the world. But most business travelers at least had support systems in place back home.

“If you’re a business traveler and you get stranded in say, Hong Kong, and you can’t leave because of flight disruptions, it probably means you get to stay an extra week in Hong Kong on the company dime,” while trying to manage work and personal schedules thrown into turmoil, he said. “But as we saw in Europe, a lot of leisure travelers were caught” and were scrambling for options.

“If you’re on your own, you can easily end up sleeping at the airport,” he said.

As the volcano in Alaska quieted down, at least temporarily, the violence in Turkey was becoming worse. Many travel managers with employees on the road in Istanbul and elsewhere had assumed that the situation would be controllable, given the long stability of Turkey. But then concerns were raised at home offices by reports that the riot police and government supporters were singling out foreigners in Istanbul and that police even fired tear gas inside a hotel favored by international business travelers.

“Right now, we’re telling people you can travel to Turkey — not a problem — but make sure your travel arrangements are in order, check that the airports are still working, make sure of your ground transportation, check to see that the hotel where you’re staying isn’t affected,” Mr. Puig said.

“It’s a very tricky thing,” he said of the emergency response in the “be informed” stage, as it was regarding Turkey.

“You don’t want to underreact,” Mr. Puig said. “We actually prefer to land on the overreact side, if we feel it’s moving fast in a certain direction and we need to put our teams on the ground and start to organize logistics.”

Violence on the ground is a lot more dangerous than a volcano that disrupts international air travel, of course. But in these kinds of situations, it pays to be prepared. You just never know. Things could settle down in Turkey, as far as the potential effects on travelers. That volcano in Alaska could go back to sleep. “It’s too early to tell,” Mr. Puig said.

But it’s a good idea to pay close attention.

Paying Till It Hurts: Colonoscopies Explain Why U.S. Leads the World in Health Expenditures

MERRICK, N.Y. — Deirdre Yapalater’s recent colonoscopy at a surgical center near her home here on Long Island went smoothly: she was whisked from pre-op to an operating room where a gastroenterologist, assisted by an anesthesiologist and a nurse, performed the routine cancer screening procedure in less than an hour. The test, which found nothing worrisome, racked up what is likely her most expensive medical bill of the year: $6,385.

That is fairly typical: in Keene, N.H., Matt Meyer’s colonoscopy was billed at $7,563.56. Maggie Christ of Chappaqua, N.Y., received $9,142.84 in bills for the procedure. In Durham, N.C., the charges for Curtiss Devereux came to $19,438, which included a polyp removal. While their insurers negotiated down the price, the final tab for each test was more than $3,500.

“Could that be right?” said Ms. Yapalater, stunned by charges on the statement on her dining room table. Although her insurer covered the procedure and she paid nothing, her health care costs still bite: Her premium payments jumped 10 percent last year, and rising co-payments and deductibles are straining the finances of her middle-class family, with its mission-style house in the suburbs and two S.U.V.’s parked outside. “You keep thinking it’s free,” she said. “We call it free, but of course it’s not.”

In many other developed countries, a basic colonoscopy costs just a few hundred dollars and certainly well under $1,000. That chasm in price helps explain why the United States is far and away the world leader in medical spending, even though numerous studies have concluded that Americans do not get better care.

Whether directly from their wallets or through insurance policies, Americans pay more for almost every interaction with the medical system. They are typically prescribed more expensive procedures and tests than people in other countries, no matter if those nations operate a private or national health system. A list of drug, scan and procedure prices compiled by the International Federation of Health Plans, a global network of health insurers, found that the United States came out the most costly in all 21 categories — and often by a huge margin.

Americans pay, on average, about four times as much for a hip replacement as patients in Switzerland or France and more than three times as much for a Caesarean section as those in New Zealand or Britain. The average price for Nasonex, a common nasal spray for allergies, is $108 in the United States compared with $21 in Spain. The costs of hospital stays here are about triple those in other developed countries, even though they last no longer, according to a recent report by the Commonwealth Fund, a foundation that studies health policy.

While the United States medical system is famous for drugs costing hundreds of thousands of dollars and heroic care at the end of life, it turns out that a more significant factor in the nation’s $2.7 trillion annual health care bill may not be the use of extraordinary services, but the high price tag of ordinary ones. “The U.S. just pays providers of health care much more for everything,” said Tom Sackville, chief executive of the health plans federation and a former British health minister.

Colonoscopies offer a compelling case study. They are the most expensive screening test that healthy Americans routinely undergo — and often cost more than childbirth or an appendectomy in most other developed countries. Their numbers have increased manyfold over the last 15 years, with data from the Centers for Disease Control and Prevention suggesting that more than 10 million people get them each year, adding up to more than $10 billion in annual costs.

Largely an office procedure when widespread screening was first recommended, colonoscopies have moved into surgery centers — which were created as a step down from costly hospital care but are now often a lucrative step up from doctors’ examining rooms — where they are billed like a quasi operation. They are often prescribed and performed more frequently than medical guidelines recommend.

The high price paid for colonoscopies mostly results not from top-notch patient care, according to interviews with health care experts and economists, but from business plans seeking to maximize revenue; haggling between hospitals and insurers that have no relation to the actual costs of performing the procedure; and lobbying, marketing and turf battles among specialists that increase patient fees.

While several cheaper and less invasive tests to screen for colon cancer are recommended as equally effective by the federal government’s expert panel on preventive care — and are commonly used in other countries — colonoscopy has become the go-to procedure in the United States. “We’ve defaulted to by far the most expensive option, without much if any data to support it,” said Dr. H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice.

In coming months, The New York Times will look at common procedures, drugs and medical encounters to examine how the economic incentives underlying the fragmented health care market in the United States have driven up costs, putting deep economic strains on consumers and the country.

Hospitals, drug companies, device makers, physicians and other providers can benefit by charging inflated prices, favoring the most costly treatment options and curbing competition that could give patients more, and cheaper, choices. And almost every interaction can be an opportunity to send multiple, often opaque bills with long lists of charges: $100 for the ice pack applied for 10 minutes after a physical therapy session, or $30,000 for the artificial joint implanted in surgery.

The United States spends about 18 percent of its gross domestic product on health care, nearly twice as much as most other developed countries. The Congressional Budget Office has said that if medical costs continue to grow unabated, “total spending on health care would eventually account for all of the country’s economic output.” And it identified federal spending on government health programs as a primary cause of long-term budget deficits.

While the rise in health care spending in the United States has slowed in the past four years — to about 4 percent annually from about 8 percent — it is still expected to rise faster than the gross domestic product. Aging baby boomers and tens of millions of patients newly insured under the Affordable Care Act are likely to add to the burden.

With health insurance premiums eating up ever more of her flat paycheck, Ms. Yapalater, a customer relations specialist for a small Long Island company, recently decided to forgo physical therapy for an injury sustained during Hurricane Sandy because of high out-of-pocket expenses. She refused a dermatology medication prescribed for her daughter when the pharmacist said the co-payment was $130. “I said, ‘That’s impossible, I have insurance,’ ” Ms. Yapalater recalled. “I called the dermatologist and asked for something cheaper, even if it’s not as good.”

The more than $35,000 annually that Ms. Yapalater and her employer collectively pay in premiums — her share is $15,000 — for her family’s Oxford Freedom Plan would be more than sufficient to cover their medical needs in most other countries. She and her husband, Jeff, 63, a sales and marketing consultant, have three children in their 20s with good jobs. Everyone in the family exercises, and none has had a serious illness.

Like the Yapalaters, many other Americans have habits or traits that arguably could put the nation at the low end of the medical cost spectrum. Patients in the United States make fewer doctors’ visits and have fewer hospital stays than citizens of many other developed countries, according to the Commonwealth Fund report. People in Japan get more CT scans. People in Germany, Switzerland and Britain have more frequent hip replacements. The American population is younger and has fewer smokers than those in most other developed countries. Pushing costs in the other direction, though, is that the United States has relatively high rates of obesity and limited access to routine care for the poor.

A major factor behind the high costs is that the United States, unique among industrialized nations, does not generally regulate or intervene in medical pricing, aside from setting payment rates for Medicare and Medicaid, the government programs for older people and the poor. Many other countries deliver health care on a private fee-for-service basis, as does much of the American health care system, but they set rates as if health care were a public utility or negotiate fees with providers and insurers nationwide, for example.

“In the U.S., we like to consider health care a free market,” said Dr. David Blumenthal, president of the Commonwealth Fund and a former adviser to President Obama. ”But it is a very weird market, riddled with market failures.”

Consider this:

Consumers, the patients, do not see prices until after a service is provided, if they see them at all. And there is little quality data on hospitals and doctors to help determine good value, aside from surveys conducted by popular Web sites and magazines. Patients with insurance pay a tiny fraction of the bill, providing scant disincentive for spending.

Even doctors often do not know the costs of the tests and procedures they prescribe. When Dr. Michael Collins, an internist in East Hartford, Conn., called the hospital that he is affiliated with to price lab tests and a colonoscopy, he could not get an answer. “It’s impossible for me to think about cost,” he said. “If you go to the supermarket and there are no prices, how can you make intelligent decisions?”

Instead, payments are often determined in countless negotiations between a doctor, hospital or pharmacy, and an insurer, with the result often depending on their relative negotiating power. Insurers have limited incentive to bargain forcefully, since they can raise premiums to cover costs.

“It all comes down to market share, and very rarely is anyone looking out for the patient,” said Dr. Jeffrey Rice, the chief executive of Healthcare Blue Book, which tracks commercial insurance payments. “People think it’s like other purchases: that if you pay more you get a better car. But in medicine, it’s not like that.”

A Market Is Born

As the cases of bottled water and energy drinks stacked in the corner of the Yapalaters’ dining room attest, the family is cost conscious — especially since a photography business long owned by the family succumbed eight years ago in the shift to digital imaging. They moved out of Manhattan. They rent out their summer home on Fire Island. They have put off restoring the wallpaper in their dining room.

And yet, Ms. Yapalater recalled, she did not ask her doctors about the cost of her colonoscopy because it was covered by insurance and because “if a doctor says you need it, you don’t ask.” In many other countries, price lists of common procedures are publicly available in every clinic and office. Here, it can be nearly impossible to find out.

Until the last decade or so, colonoscopies were mostly performed in doctors’ office suites and only on patients at high risk for colon cancer, or to seek a diagnosis for intestinal bleeding. But several highly publicized studies by gastroenterologists in 2000 and 2001 found that a colonoscopy detected early cancers and precancerous growths in healthy people.

They did not directly compare screening colonoscopies with far less invasive and cheaper screening methods, including annual tests for blood in the stool or a sigmoidoscopy, which looks at the lower colon where most cancers occur, every five years.

“The idea wasn’t to say these growths would have been missed by the other methods, but people extrapolated to that,” said Dr. Douglas Robertson, of the Department of Veterans Affairs, which is beginning a large trial to compare the tests.

Experts agree that screening for colon cancer is crucial, and a colonoscopy is intuitively appealing because it looks directly at the entire colon and doctors can remove potentially precancerous lesions that might not yet be prone to bleeding. But studies have not clearly shown that a colonoscopy prevents colon cancer or death better than the other screening methods. Indeed, some recent papers suggest that it does not, in part because early lesions may be hard to see in some parts of the colon.

But in 2000, the American College of Gastroenterology anointed colonoscopy as “the preferred strategy” for colon cancer prevention — and America followed.

Katie Couric, who lost her husband to colorectal cancer, had a colonoscopy on television that year, giving rise to what medical journals called the “Katie Couric effect”: prompting patients to demand the test. Gastroenterology groups successfully lobbied Congress to have the procedure covered by Medicare for cancer screening every 10 years, effectively meaning that commercial insurance plans would also have to provide coverage.

Though Medicare negotiates for what are considered frugal prices, its database shows that it paid an average of $531 to gastroenterologists for a colonoscopy in 2011. But that does not include the payments for associated facility fees and to anesthesiologists, which could double the cost or more. “As long as it’s deemed medically necessary,” said Jonathan Blum, the deputy administrator at the Centers for Medicare and Medicaid Services, “we have to pay for it.”

If the American health care system were a true market, the increased volume of colonoscopies — numbers rose 50 percent from 2003 to 2009 for those with commercial insurance — might have brought down the costs because of economies of scale and more competition. Instead, it became a new business opportunity.

Profits Climb

Just as with real estate, location matters in medicine. Although many procedures can be performed in either a doctor’s office or a separate surgery center, prices generally skyrocket at the special centers, as do profits. That is because insurers will pay an additional “facility fee” to ambulatory surgery centers and hospitals that is intended to cover their higher costs. And anesthesia, more monitoring, a wristband and sometimes preoperative testing, along with their extra costs, are more likely to be added on.

In Mount Kisco, N.Y., Maggie Christ had two colonoscopies two months apart, after her doctor decided it was best to remove a growth that had been discovered during the first procedure. They were performed by the same doctor, with the same sedation. The first, in an outpatient surgery department, was billed at $9,142.84 (insurance paid $5,742.67). The second, in the doctor’s office, was billed at $5,322.76 (insurance eventually paid $2,922.63) because there was no facility fee. “The location was about accommodating the doctor’s schedule,” Ms. Christ said. “Why would an insurance company approve this?”

Ms. Yapalater, a trim woman who looks far younger than her 64 years, had two prior colonoscopies in doctor’s offices (one turned up a polyp that required a five-year follow-up instead of the usual 10 years). But for her routine colonoscopy this January, Ms. Yapalater was referred to Dr. Felice Mirsky of Gastroenterology Associates, a group practice in Garden City, N.Y., that performs the procedures at an ambulatory surgery center called the Long Island Center for Digestive Health. The doctors in the gastroenterology practice, which is just down the hall, are owners of the center.

“It was very fancy, with nurses and ORs,” Ms. Yapalater said. “It felt like you were in a hospital.”

That explains the fees. “If you work as a ‘facility,’ you can charge a lot more for the same procedure,” said Dr. Soeren Mattke, a senior scientist at the RAND Corporation. The bills to Ms. Yapalater’s insurer reflected these charges: $1,075 for the gastroenterologist, $2,400 for the anesthesia — and $2,910 for the facility fee.

When popularized in the 1980s, outpatient surgical centers were hailed as a cost-saving innovation because they cut down on expensive hospital stays for minor operations like knee arthroscopy. But the cost savings have been offset as procedures once done in a doctor's office have filled up the centers, and bills have multiplied.

It is a lucrative migration. The Long Island center was set up with the help of a company based in Pennsylvania called Physicians Endoscopy. On its Web site, the business tells prospective physician partners that they can look forward to “distributions averaging over $1.4 million a year to all owners,” “typically 100 percent return on capital investment within 18 months” and “a return on investment of 500 percent to 2,000 percent over the initial seven years.”

Dr. Leonard Stein, the senior partner in Gastroenterology Associates and medical director of the surgery center, declined to discuss patient fees or the center’s profits, citing privacy issues. But he said the center contracted with insurance companies in the area to minimize patients' out-of-pocket costs.

In 2009, the last year for which such statistics are available, gastroenterologists performed more procedures in ambulatory surgery centers than specialists in any other field. Once they bought into a center, studies show, the number of procedures they performed rose 27 percent. The specialists earn an average of $433,000 a year, among the highest paid doctors, according to Merritt Hawkins & Associates, a medical staffing firm.

Hospitals and doctors say that critics should not take the high “rack rates” in bills as reflective of the cost of health care because insurers usually pay less. But those rates are the starting point for negotiations with Medicare and private insurers. Those without insurance or with high-deductible plans have little weight to reduce the charges and often face the highest bills. Nassau Anesthesia Associates — the group practice that handled Ms. Yapalater’s sedation — has sued dozens of patients for nonpayment, including Larry Chin, a businessman from Hicksville, N.Y., who said in court that he was then unemployed and uninsured. He was billed $8,675 for anesthesia during cardiac surgery.

For the same service, the anesthesia group accepted $6,970 from United Healthcare, $5,208.01 from Blue Cross and Blue Shield, $1,605.29 from Medicare and $797.50 from Medicaid. A judge ruled that Mr. Chin should pay $4,252.11.

Ms. Yapalater’s insurer paid $1,568 of the $2,400 anesthesiologist’s charge for her colonoscopy, but many medical experts question why anesthesiologists are involved at all. Colonoscopies do not require general anesthesia — a deep sleep that suppresses breathing and often requires a breathing tube. Instead, they require only “moderate sedation,” generally with a Valium-like drug or a low dose of propofol, an intravenous medicine that takes effect quickly and wears off within minutes. In other countries, such sedative mixes are administered in offices and hospitals by a wide range of doctors and nurses for countless minor procedures, including colonoscopies.

Nonetheless, between 2003 and 2009, the use of an anesthesiologist for colonoscopies in the United States doubled, according to a RAND Corporation study published last year. Payments to anesthesiologists for colonoscopies per patient quadrupled during that period, the researchers found, estimating that ending the practice for healthy patients could save $1.1 billion a year because “studies have shown no benefit” for them, Dr. Mattke said.

But turf battles and lobbying have helped keep anesthesiologists in the room. When propofol won the approval of the Food and Drug Administration in 1989 as an anesthesia drug, it carried a label advising that it “should be administered only by those who are trained in the administration of general anesthesia” because of concerns that too high a dose could depress breathing and blood pressure to a point requiring resuscitation.

Since 2005, the American College of Gastroenterology has repeatedly pressed the F.D.A. to remove or amend the restriction, arguing that gastroenterologists and their nurses are able to safely administer the drug in lower doses as a sedative. But the American Society of Anesthesiologists has aggressively lobbied for keeping the advisory, which so far the F.D.A. has done.

A Food and Drug Administration spokeswoman said that the label did not necessarily require an anesthesiologist and that it was safe for the others to administer propofol if they had appropriate training. But many gastroenterologists fear lawsuits if something goes wrong. If anything, that concern has grown since Michael Jackson died in 2010 after being given propofol, along with at least two other sedatives, without close monitoring.

‘Too Much for Too Little’

The Department of Veterans Affairs, which performs about a quarter-million colonoscopies annually, does not routinely use an anesthesiologist for screening colonoscopies. In Austria, where colonoscopies are also used widely for cancer screening, the procedure is performed, with sedation, in the office by a doctor and a nurse and “is very safe that way,” said Dr. Monika Ferlitsch, a gastroenterologist and professor at the Medical University of Vienna, who directs the national program on quality assurance.

But she noted that gastroenterologists in Austria do have their financial concerns. They are complaining to the government and insurers that they cannot afford to do the 30-minute procedure, with prep time, maintenance of equipment and anesthesia, for the current approved rate — between $200 and $300, all included. “I think the cheapest colonoscopy in the U.S. is about $950,” Dr. Ferlitsch said. “We’d love to get half of that.”

Dr. Cesare Hassan, an Italian gastroenterologist who is the chairman of the Guidelines Committee of the European Society of Gastrointestinal Endoscopy, noted that studies in Europe had estimated that the procedure cost about $400 to $800 to perform, including biopsies and sedation. “The U.S. is paying way too much for too little — it leads to opportunistic colonoscopies,” done for profit rather than health, he said.

Some doctors in the United States are campaigning against the overuse of the procedure, like Dr. James Goodwin, a geriatrician at the University of Texas. He estimates that about a quarter of Medicare patients undergo the screening test more often than recommended, even though the risks of complications, like long recovery times and poor tolerance of sedation, increase for older people. Routine screening is not recommended for all people over 75.

And some large employers have begun fighting back on costs. Three years ago, Safeway realized that it was paying between $848 and $5,984 for a colonoscopy in California and could find no link to the quality of service at those extremes. So the company established an all-inclusive “reference price” it was willing to pay, which it said was set at a level high enough to give employees access to a range of high-quality options. Above that price, employees would have to pay the difference. Safeway chose $1,250, one-third the amount paid for Ms. Yapalater’s procedure — and found plenty of doctors willing to accept the price.

Still, the United States health care industry is nimble at protecting profits. When Aetna tried in 2007 to disallow payment for anesthesiologists delivering propofol during colonoscopies, the insurer backed down after a barrage of attacks from anesthesiologists and endoscopy groups. With Medicare contemplating lowering facility fees for ambulatory surgery centers, experts worry that physician-owners will sell the centers to hospitals, where fees remain higher.

And then there is aggressive marketing. People who do not have insurance or who are covered by Medicaid typically get far less colon cancer screening than they need. But those with insurance are appealing targets.

Nineteen months after Matt Meyer, who owns a saddle-fitting company near Keene, N.H., had his first colonoscopy, he received a certified letter from his gastroenterologist. It began, “Our records show that you are due for a repeat colonoscopy,” and it advised him to schedule an appointment or “allow us to note your reason for not scheduling.” Although his prior test had found a polyp, medical guidelines do not recommend such frequent screening.

“I have great doctors, but the economics is daunting,” Mr. Meyer said in an interview. “A computer-generated letter telling me to come in for a procedure that costs more than $5,000? It was the weirdest thing.”

Jo Craven McGinty contributed reporting.

Frequent Flier: M.J. Day Shepherds Swimsuit Models Around World

I NEVER stepped foot on a plane until I was a freshman in college. But once I took a trip to Chicago on a plane, I never wanted to stop flying. I’ve worked on the last 14 issues of the Sports Illustrated swimsuit issue, and I’ve been very fortunate to see most of the world. I generally fly in business class, but occasionally coach. In my life outside of work, I seem to always fly coach. Nothing much bothers me, and that’s really helpful because flying with a crew and models can be an adventure.

Q. How often do you travel for business?

A. On average, four times a month, domestic and international, but mostly international.

Q. What’s your least favorite airport?

A. Miami International. Plow it over and start new. It’s difficult to navigate, flights are always messed up, and it just has bad juju.

Q. Of all the places you’ve been, what’s the best?

A. I often say home because I’m never there. But now, after recently seeing Antarctica, I have to say that’s my favorite place. I would go there every year for the rest of my life and stay for a month if I could.

Q. What’s your secret airport vice?

A. Manicures, pedicures and shopping for sunglasses. I can’t tell you how many sunglasses I own. I can’t tell you how many I’ve lost, either.

I swear when we go out on shoots, we look like a traveling band of Gypsies. There’s me, my assistant, hair stylists, a model or two, our photographer, two photo assistants and sometimes our own TV crew. It can be up to 12 or 15 people, and part of my job is to herd everyone and make sure we get where we’re going, which can include one location per trip, or sometimes two.

This year, we shot on all seven continents, and it was crazy. Obviously, we don’t just take carry-ons. We have a lot of luggage. I have the cell numbers of all of the skycaps at Kennedy Airport and La Guardia, and I’ll call ahead and they meet us outside. I can’t tell you the number of times people in airports have asked if we were in a band or something. It’s kind of funny.

But what’s really amusing is watching reactions to the models. One of my favorite airport pastimes is people-watching, and watching people watch the models walk through the airport is hysterical. The models are obviously tall and gorgeous, in a preternaturally perfect kind of way. People try to be cool and not stare at them, but they can’t help themselves. Men stare. Women stare. Children stare. Even babies stare.

If I have a problem traveling, it’s usually at customs. Even in English-speaking countries, it’s sometimes very difficult to convince an agent that we don’t plan on selling the hundreds of bathing suits and matching accessories we’re bringing in. If it’s tough in an English-speaking country, it’s even tougher if there is a language barrier. It’s not that people want a bribe or just want to be difficult, it’s just that agents have a hard time fathoming why we need all this stuff.

The longest trip I’ve taken was to a shoot in the Philippines. I took three flights, two car rides, two buses and a boat to the location. It took a total of 36 hours, door to door. With all of the luggage and crew, it was insane. I wanted to die by the time we got there. The crew and I were dragging. The models looked just fine, which doesn’t seem fair.

The scariest trip I’ve ever taken was on a helicopter. I had never been on one until about two years ago. We were shooting on the San Blas Islands of Panama and a helicopter was the only way to get there. I was in the helicopter with a model and we were talking a lot, and the pilot actually changed channels to get away from our chatter. All of a sudden, we started banking and the helicopter doors flew open. The model and I were screaming like crazy. The pilot turned around, and his eyes were bugging out because of our screams.

Of course, I found out that helicopters are made to fly with their doors open and we were never in any danger. I had to take about 25 helicopter rides on that particular shoot, and fortunately I didn’t scream on any except that one. I think the pilots were very happy about that.

By M. J. Day, as told to Joan Raymond. E-mail: joan.raymond@nytimes.com.

U.N. Presents Grim Prognosis on the World Economy

The main author of the report, Robert Vos, director of the Development Policy and Analysis Division of the United Nations Department of Economic and Social Affairs, said it could take until at least 2017 just to recoup the jobs lost in the United States and Europe since the 2008-9 global recession.

He forecast world growth for 2013 at 2.4 percent, “a significant downgrade” from the United Nations midyear forecast of 3.1 percent. He said the 2012 growth rate was 2.2 percent, vs. the midyear forecast of 2.5 percent.

“I’m afraid this time around we’re not very optimistic about how things are moving,” Mr. Vos said at a news conference at United Nations headquarters.

“A worsening of the euro area crisis, the ‘fiscal cliff’ in the United States and a hard landing in China could cause a new global recession,” Mr. Vos said in the report, “World Economic Situation and Prospects 2013.” He said the forecast growth was “far from sufficient to overcome the continued jobs crisis that many countries are still facing.”

The report’s proposals to avoid that outcome — more government programs that focus on job growth, fiscal coordination and aid to developing countries — are not likely to be widely embraced by policy makers in the United States and Europe, where the preoccupation is on budget cuts and spending discipline. Still, the report provides one of the most complete assessments of the world’s economic trends and reflects what United Nations experts view as the most pressing areas of concern.

Shamshad Akhtar, assistant secretary general for economic development, who introduced Mr. Vos’s report, began by reciting a litany of maladies, including record unemployment in Europe, a decline in global trade, volatility in the flows of capital and low food stocks in many poorer countries that have made prices in those countries unpredictable.

While she and Mr. Vos acknowledged the news reports on progress in the debt-reduction negotiations between the White House and Congressional Republicans to avoid dire automatic year-end spending cuts, what has been called the fiscal cliff, they erred on the side of assuming the worst. Both said the shock of such spending cuts would further weaken economies elsewhere.

“Even if we don’t get to the fiscal cliff, what’s on the table now is not too far from what would happen if the United States goes over the cliff,” Mr. Vos said. “That is reason for some concern.”

He criticized the focus in developed countries on austerity, calling it “detrimental to their own economic recovery,” and said cuts “should not come at the expense of the development efforts of the poorest nations.”

Unlike the economic crisis four years ago, when China helped to cushion the impact with enormous doses of stimulus spending, there is no single savior this time. If China’s growth rate of 7.5 percent this year slows to 5 percent or less, Mr. Vos said, “that would have major global ramifications.”

He said growth rates in 2012 fell sharply almost everywhere except Africa, where economies grew in the 5 percent to 6 percent range, helped by strength in oil-exporting countries, spending on basic infrastructure improvements and expanding ties with Asian economies.

Nonetheless, he said, Africa remains plagued by armed conflicts and other “numerous challenges,” and the strong growth rates will not hasten the end of the continent’s poverty.

News Analysis: Message, if Murky, From U.S. to the World

At the global treaty conference on telecommunications here, the United States got most of what it wanted. But then it refused to sign the document and left in a huff.

What was that all about? And what does it say about the future of the Internet — which was virtually invented by the United States but now has many more users in the rest of the world?

It may mean little about how the Internet will operate in the coming years. But it might mean everything about the United States’ refusal to acknowledge even symbolic global oversight of the network.

The American delegation, joined by a handful of Western allies, derided the treaty as a threat to Internet freedom. But most other nations signed it. And other participants in the two weeks of talks here were left wondering on Friday whether the Americans had been negotiating in good faith or had planned all along to engage in a public debate only to make a dramatic exit, as they did near midnight on Thursday as the signing deadline approached.

The head of the American delegation, Terry Kramer, announced that it was “with a heavy heart” that he could not “sign the agreement in its current form.” United States delegates said the pact could encourage censorship and undermine the existing, hands-off approach to Internet oversight and replace it with government control.

Anyone reading the treaty, though, might be puzzled by these assertions. “Internet” does not appear anywhere in the 10-page text, which deals mostly with matters like the fees that telecommunications networks should charge one another for connecting calls across borders. After being excised from the pact at United States insistence, the I-word was consigned to a soft-pedaled resolution that is attached to the treaty.

The first paragraph of the treaty states: “These regulations do not address the content-related aspects of telecommunications.” That convoluted phrasing was understood by all parties to refer to the Internet, delegates said, but without referring to it by name so no one could call it an Internet treaty.

A preamble to the treaty commits the signers to adopt the regulations “in a manner that respects and upholds their human rights obligations.”

Both of these provisions were added during the final days of haggling in Dubai, with the support of the United States. If anything, the new treaty appears to make it more intellectually challenging for governments like China and Iran to justify their current censorship of the Internet.

What’s more, two other proposals that raised objections from the United States were removed. One of those stated that treaty signers should share control over the Internet address-assignment system — a function now handled by an international group based in the United States. The other, also removed at the Americans’ behest, called for Internet companies like Google and Facebook to pay telecommunications networks for delivering material to users.

Given that the United States achieved many of its stated goals in the negotiations, why did it reject the treaty in an 11th-hour intervention that had clearly been coordinated with allies like Britain and Canada?

In a Dubai conference call with reporters early on Friday, Mr. Kramer cited a few remaining objections, like references to countering spam and to ensuring “the security and robustness of international telecommunications networks.” This wording, he argued, could be used by nefarious governments to justify crackdowns on free speech.

But even Mr. Kramer acknowledged that his real concerns were less tangible, saying it was the “normative” tone of the debate that had mattered most. The United States and its allies, in other words, saw a chance to use the treaty conference to make a strong statement about the importance of Internet freedom. But by refusing to sign the treaty and boycotting the closing ceremony, they made clear that even to talk about the appearance of global rules for cyberspace was a nonstarter.

It may have been grandstanding, but some United States allies in Europe were happy to go along, saying the strong American stand would underline the importance of keeping the Internet open.

News Analysis: Message, if Murky, From U.S. to the World

At the global treaty conference on telecommunications here, the United States got most of what it wanted. But then it refused to sign the document and left in a huff.

What was that all about? And what does it say about the future of the Internet — which was virtually invented by the United States but now has many more users in the rest of the world?

It may mean little about how the Internet will operate in the coming years. But it might mean everything about the United States’ refusal to acknowledge even symbolic global oversight of the network.

The American delegation, joined by a handful of Western allies, derided the treaty as a threat to Internet freedom. But most other nations signed it. And other participants in the two weeks of talks here were left wondering on Friday whether the Americans had been negotiating in good faith or had planned all along to engage in a public debate only to make a dramatic exit, as they did near midnight on Thursday as the signing deadline approached.

The head of the American delegation, Terry Kramer, announced that it was “with a heavy heart” that he could not “sign the agreement in its current form.” United States delegates said the pact could encourage censorship and undermine the existing, hands-off approach to Internet oversight and replace it with government control.

Anyone reading the treaty, though, might be puzzled by these assertions. “Internet” does not appear anywhere in the 10-page text, which deals mostly with matters like the fees that telecommunications networks should charge one another for connecting calls across borders. After being excised from the pact at United States insistence, the I-word was consigned to a soft-pedaled resolution that is attached to the treaty.

The first paragraph of the treaty states: “These regulations do not address the content-related aspects of telecommunications.” That convoluted phrasing was understood by all parties to refer to the Internet, delegates said, but without referring to it by name so no one could call it an Internet treaty.

A preamble to the treaty commits the signers to adopt the regulations “in a manner that respects and upholds their human rights obligations.”

Both of these provisions were added during the final days of haggling in Dubai, with the support of the United States. If anything, the new treaty appears to make it more intellectually challenging for governments like China and Iran to justify their current censorship of the Internet.

What’s more, two other proposals that raised objections from the United States were removed. One of those stated that treaty signers should share control over the Internet address-assignment system — a function now handled by an international group based in the United States. The other, also removed at the Americans’ behest, called for Internet companies like Google and Facebook to pay telecommunications networks for delivering material to users.

Given that the United States achieved many of its stated goals in the negotiations, why did it reject the treaty in an 11th-hour intervention that had clearly been coordinated with allies like Britain and Canada?

In a Dubai conference call with reporters early on Friday, Mr. Kramer cited a few remaining objections, like references to countering spam and to ensuring “the security and robustness of international telecommunications networks.” This wording, he argued, could be used by nefarious governments to justify crackdowns on free speech.

But even Mr. Kramer acknowledged that his real concerns were less tangible, saying it was the “normative” tone of the debate that had mattered most. The United States and its allies, in other words, saw a chance to use the treaty conference to make a strong statement about the importance of Internet freedom. But by refusing to sign the treaty and boycotting the closing ceremony, they made clear that even to talk about the appearance of global rules for cyberspace was a nonstarter.

It may have been grandstanding, but some United States allies in Europe were happy to go along, saying the strong American stand would underline the importance of keeping the Internet open.

French Music Streaming Service Takes on the World, Sans America

The company, Deezer, is one of the biggest players in digital music streaming, trailing only the market leader, Spotify, in the number of paying customers it has attracted globally. Like Spotify, which is based in London, Deezer, with headquarters in Paris, offers subscribers unlimited access to millions of songs on demand, via PCs, mobile phones and other devices.

Deezer just got a big endorsement for its approach. Access Industries, the owner of Warner Music Group, pumped 100 million euros, or about $130 million, into Deezer this month, in what analysts described as one of the biggest investments ever in a French start-up.

“This shows that they think the music market is beginning to turn around,” Axel Dauchez, chief executive of Deezer, said in an interview.

Deezer, which started in 2007, has just moved into a slick new headquarters, where employees conduct business meetings on lawn chairs and on sofas disguised as musical keyboards. “Paint it black,” reads a neon sign on the somber-toned wall behind Mr. Dauchez. Like the Rolling Stones, Deezer is on a mission to blot out the color red — in this case, from the ailing music industry’s ledgers.

After a battle with piracy that has cut its sales in half in just over a decade, the music industry has high hopes for streaming, which is growing faster than digital purchases, as many listeners decide that ownership makes less sense than in the days of plastic and vinyl.

While Deezer and Spotify are still losing money, their sales are growing rapidly. Deezer generated about 50 million euros in revenue last year, and Mr. Dauchez has set a goal of 1 billion euros in sales in 2016.

With more than two million paying customers, Deezer trails Spotify, which has more than four million. Spotify introduced an American version last year, and it has been growing quickly. But Deezer has turned its back on the United States and plans to use its new money to finance an expansion into more than 160 other countries.

“Like a canny general who decides to march around a heavily fortified stronghold and thus effectively leave it stranded behind enemy lines, so Deezer expects the streaming war to be waged on different shores,” Mark Mulligan, a music industry analyst, wrote on his Web site. “They are both right and wrong.”

Analysts say Deezer is right to worry about competition in the United States, where Spotify competes with services like Rhapsody, Pandora and Rdio, even though their business models all vary slightly.

Mr. Mulligan says there is room for growth in the United States, because premium streaming services remain too expensive for most consumers. But the field is less crowded outside the United States, where Spotify is the clear leader in streaming in many of the markets it has entered — except France, where Deezer reigns.

Spotify, too, is planning for the battles ahead. Several people briefed on the company’s plans said it had begun a new round of fund-raising, seeking to secure several hundred million dollars in new investment.

New financing is essential for Deezer and Spotify because they are burning through significant amounts of cash. To attract new listeners, both companies offer free versions of their services, subject to certain restrictions. Yet both companies must pay a royalty to a recording company every time someone listens to one of their tracks.

While streaming services sell advertising to cover some of the costs of free listening, Mr. Dauchez said raising revenue in this way had proved to be more challenging than expected. So Deezer now sees its free service primarily as a way to entice listeners into paying for its premium offerings, which include things like unlimited streaming and special content and recommendations, along with no ads.

This makes expanding into new markets expensive. While Deezer says it was profitable last year, it expects to lose money until 2014 as it enters new markets. The company set up sites in several other European countries in 2011 and accelerated its global expansion this month.

Off the Charts: Working Longer in the Developed World

The Organization for Economic Cooperation and Development this week released its latest figures on the proportion of people in older age groups working, showing that some European countries, whose social welfare systems had made possible early retirements, have begun to keep more people on the job.

In 2003, less than a third of German men age 60 to 64, and less than a sixth of German woman of the same age, were working. In the numbers for 2011 released this week, more than half of the men and a third of the women had jobs.

But as can be seen in the accompanying charts, it is still relatively rare for Germans over 65 to continue working.

Italy is one country that seems to have avoided change. In 2001, about 30 percent of men in their early 60s had jobs, as did 11 percent of women. A decade later, the figures were virtually identical.

Older workers in the United States have long been more likely to have jobs than their European counterparts. But since 2008, the proportion of American men in their early 60s who are working has fallen by three percentage points, to 54.7 percent, as a weak economy limited hiring. But the proportion of men with jobs in the 65 to 69 age bracket has continued to rise as men who could do so delayed retirement.

The proportion of men in their early 60s with jobs also fell in Iceland, Portugal and Turkey. In Greece, the proportion of men in their early 60s with jobs fell to 37.5 percent in 2011 from 44 percent in 2008.

In many countries, said Anne Sonnet, a senior economist at the O.E.C.D. and team leader of its older workers review, “the main problem for older workers is to be hired” for new jobs, not to keep jobs they already have. “There is almost no job mobility for older workers.”

The figures were released for the 34 countries in the O.E.C.D., which includes all the major developed countries and some countries that have developed since the organization was established half a century ago. But the group still does not include such rapidly growing countries as Brazil, India and China.

Ms. Sonnet said the recession that enveloped the world in 2008, and that seems to have returned in some European countries, was different from earlier downturns in the 1970s and 1980s in that countries did not encourage early retirements of older workers to make jobs available to younger people.

She sees longer working years as a good thing in a world where life expectancies have risen. “For the society, it is very important to work longer to avoid higher social costs from having to pay retirees for many, many years,” she said in a telephone interview.

There remains a large diversity in employment patterns, a diversity that is growing in Europe. While Germans are more likely to keep working into their 60s, their French neighbors still generally quit before they reach their 60th birthdays. In 2011, just one in five Frenchmen age 60 to 64 still held jobs, as did one in six women.

Of the 34 O.E.C.D. countries, only Hungary, with 17.9 percent of men in their early 60s holding jobs, had lower employment among men in that age range. At the other extreme, more than 70 percent of men 60 to 64 were working in Iceland, New Zealand, Chile and Japan.

In five countries — Slovakia, Belgium, Spain, France and Hungary — fewer than 10 percent of men in their late 60s had jobs, In four others — Mexico, Iceland, Chile and South Korea — more than half of those men were employed.

Floyd Norris comments on finance and the economy at nytimes.com/economix.