This book consists of nine chapters and three appendices. The standard configuration for nonfiction titles is ten chapters. Why is this one short one chapter? The book wasn't started as a book per se. It's really a research white paper put into book form. I got that impression within the first few pages. Comments in the acknowledgements and other areas support this conclusion.

It's also fairly apparent when you see endnotes after each chapter; I associate that style with research paper projects instead of book projects. This is neither good nor bad; it just is my explanation for the size of the book.

And this book is on the thin side. Thud factor, while important to those who buy their literature by the inch or pound, doesn't tell you much about what's actually in a book. I've read 20-page white papers that say far more than 350-page books on the same subject. This book runs a little under 200 pages (that count includes the endnotes, appendices, and glossary).

The basic premise of this book is that we can look at current trends and developments in several converging (and some nonconverging) areas to formulate a fairly reliable picture of life extension in the near future. The year 2025 serves as a sort of capstone year for how far the authors look into the future.

While predictions of the future often fall flat, that isn't always the case. Predictions based on trend extrapolations give us a pretty good idea of what the future holds.

For example, an issue today is the "surprise" that Medicare will be overwhelmed in the next few years due to demographics. But it's a simple fact that, in 1954, we knew how many babies were born in 1953 and so an extrapolation of the demographics more than half a century ago would clearly have shown the number of retirees 60 years hence in 2013 and allow for suitable planning to accommodate that. What has CONgress been doing for half a century other than spending us into a $60+ trillion hole to please the corporate lobbyists who make them millionaires?

The authors stuck to what's real, as they did their projections and predictions. Other authors tackling this kind of topic have ventured out into the fantastical, I guess because they thought that would sell their books. But the Schoemakers didn't give in to that temptation.

The first chapter looks at the current longevity projections and the basis for those. Chapter 2 provides a short history of biomedicine, while Chapter 3 provides a short history of the biosciences, and Chapter 4 looks at how these two areas (and some others) converge.

Chapters 5 and 6 discuss the business factors in the medical care, pharma, and related industries. The authors take care here to avoid demonizing companies for making money, which is good. But I think they soft-pedal this a bit too much. Big pharma has more than two lobbyists for each member of CONgress. That's a lot of influence on our misrepresentatives and senators.

This "buy a CONgressman" problem could explain why we have drugs for osteoporosis, but don't have legislation protecting the public from the psychopaths who produce and sell osteoporosis in a can--in fact, the typical grocery store has an entire aisle devoted to selling this poison. It would be much cheaper to fix the problem at the source, but then you can't sell a drug to treat a problem that no longer exists.

Chapters 7 looks at variables that can skew any and all projections of the future. Chapter 8 build then makes those projections. Chapter 9 ties it all together to discuss both positive and negative ramifications of the projections.

Appendix A provides background information on DNA, RNA, and protein. Appendix B discusses gene cloning. Appendix C discusses the complexity of the genome. Following the appendices is an 8-page glossary of biomedical terms; I found the definitions to be clear and concise.

Something that kept irritating me in this book was the misuse of the word "impact." The cliché of "nails on a chalkboard" comes to mind. If the authors can excise every instance of that word in a future revision, they will have a better book.

The authors took a daring leap by tying the concept of "health care" to the concept of "medical care." This logical connection is missing from the hackneyed "debates" currently raging about the medical care system in America. That system, for reasons that defy logic, is mis-referred to as the "health care system."

Treating a disease is disease care, not health care. By definition, health care is preventive. Medical care can treat only the disease, while health care treats the person to prevent the disease in the first place or to cure it at its source by removing its cause. Absent a reasonable level of health care, our society is incurring outsized medical care costs.

You just have to look into 99 out of 100 grocery shopping carts and to see why our disease culture is producing so much disease. For example, look at the amount of hydrogenated oil, high fructose corn syrup, and soft drinks people put into their bodies. All of these substances cause disease and eliminating them entirely is a common sense first step in health care. Yet, it does not happen.

Trying to control medical care costs without addressing health care is like trying to control the costs of window replacement without addressing the problem of the guy who is habitually throwing rocks at his windows. If he would stop doing that, window replacement costs would drop dramatically. Arguing over who pays for window replacements is not going to reduce the cost of replacing the windows.

So, the authors make the logical connection but do so in a way that isn't advocating any particular group's agenda. I commend the authors for wading into a subject area fraught with political opinions, yet not using the book to proselytize any particular opinions. When authors tackle a subject that is as ripe for abuse as this one but don't abuse it, that's quite a testimony to the integrity of the authors. They presented a balanced view of the social and political factors relevant to the subject and constrained that discussion to reality-based commentary. Kudos!

The authors even explore the question of whether it's desirable for people to live much longer than they do now. The answer isn't an automatic yes. The authors' take on this is truly thought-provoking. As much as we hate to see people die, our culture is built around certain things happening at certain ages, and if you extend the lifespan there will be consequences that aren't always pleasant. I'm tempted to photocopy those pages, pass them around to a few friends, and then invite those friends over for coffee and a lively discussion of the issues raised. It would be interesting, to say the least.

The topics raised in this book don't have immediate practical value. But many worthy topics don't. I think it's a great read, and it does get away from the non-topics that dominate the news these days. The issues discussed in this book will become increasingly important, and looking at the central question of how far the biosciences will take us can help us make more intelligent decisions today.