When Rudy Giuliani said the survival rate for prostate cancer is 82 percent in the U.S. but only 44 percent in Britain, which has socialized medicine, you'd think a typical American response would be sympathy for the Britons, and the logical British response, outrage at its government.
You'd think wrong. The U.S. press corps devoted considerable energy -- and in some quarters, heated emotion -- to knocking down Giuliani's statistic, even when it had to twist logic like pretzels to do so. Meanwhile, the only outrage detected in Britain was against Giuliani -- for mentioning it.
Yet Giuliani's point, which is that socialized medicine systems fare badly compared to our own, remains valid.
Among those springing to the defense of Britain's National Health Service: the Boston Globe, the Washington Post, the Associated Press, the New York Times, the St. Petersburg Times, Reuters, and, predictably, lefty columnists Paul Krugman of the New York Times and Eugene Robinson of the Washington Post.
Take the AP story, which sought to take down Giuliani's statistics this way:
The American Cancer Society says that survival rates are actually higher and that it's misleading to compare the two countries.
The group cautions that screening for prostate cancer is much more widespread in this country — meaning that in the U.S., higher survival rates include many whose lives probably weren't in danger and whose cancers might have gone unnoticed in the U.K.
Five-year survival rates were 95 percent in the U.S. and 60 percent in the United Kingdom, which includes Britain, in 1993-1995, the most recent time period with data to compare, the group said.
Today, rates are higher — 99 percent in the U.S. and an estimated 74 percent in the U.K.
Doctors in the two countries have different approaches. That's because while aggressive prostate cancer can kill, it often grows so slowly, and is found when it's so small, that men die of something else before it ever threatens their lives or even causes symptoms.
So there is disagreement — and studies conflict — over whether the chances of survival for men with low-risk tumors really improve with aggressive treatment, or if they can be closely monitored and treated only if their tumors grow, thereby avoiding side effects such as impotence and incontinence.
When you read that carefully you realize the thrust of the argument is that the U.S. system is not better than Britain's at handling prostate cancer because the U.S. system screens more aggressively for this cancer and catches it earlier.
But isn't catching cancer early a good thing?
You'd think so, but apparently not when it makes socialized medicine look bad. "Doctors in the two countries," says the AP, "have different approaches. That's because while aggressive prostate cancer can kill, it often grows so slowly, and is found when it's so small, that men die of something else before it ever threatens their lives or even causes symptoms."
So if you are a British man using the National Health Service your taxes pay for, the NHS has decided that you don't need to know if you have prostate cancer early. After all, it "often" grows slowly, so why should you have the option of early treatment that could save your life? The British government will make this intensely personal decision for you.
Meanwhile, your brothers in the United States will find out early that they have it, and will decide for themselves if they want to risk side effects by treating it early.
The AP story failed to tell readers that the American Cancer Society is not a neutral party to the debate over the merits of competing health systems. The American Cancer Society is devoting its entire $15 million advertising budget in the coming year to advocating universal health insurance in the United States. It's advocacy arm, the American Cancer Society Cancer Action Network, shills for an expansion of publicly-funded health care in the U.S., as in this statement by its president excoriating President Bush for wanting to expand SCHIP by $5 billion instead of $35 billion over the next five years:
The President today sided with the tobacco industry instead of America’s children with his veto of the bipartisan bill to expand the State Children’s Health Insurance Program (SCHIP). The President's action strikes a blow against efforts to provide health insurance to low-income children and to save lives through an increase in the federal cigarette tax.
The SCHIP bill passed both houses of Congress last week with strong bipartisan majorities. We strongly urge lawmakers to do what's right for public health — not what’s most advantageous for the tobacco industry — by overriding this veto.
The American Cancer Society is pushing a petition to all presidential candidates saying, "imagine a world where every man, woman and child has access to the proven screening exams that can detect cancer early and even prevent it," yet when the U.S. does better than Britain at screening for prostate cancer, it calls the early screening a "misleading" factor in comparing the quality of the two countries' systems.
Many of the news stories cited above noted that Giuliani got his statistic from Dr. David Gratzer of the conservative Manhattan Institute, an exceedingly reputable source, but they often went on to deride the reliability of Gratzer's work. None of them fairly represented Gratzer's compelling defense of the accuracy of Giuiliani's remarks. An excerpt:
Let me be very clear about why the Giuliani campaign is correct: the percentage of people diagnosed with prostate cancer who die from it is much higher in Britain than in the United States. The Organisation for Economic Co-operation and Development reports on both the incidence of prostate cancer in member nations and the number of resultant deaths. According to OECD data published in 2000, 49 Britons per 100,000 were diagnosed with prostate cancer, and 28 per 100,000 died of it. This means that 57 percent of Britons diagnosed with prostate cancer died of it; and, consequently, that just 43 percent survived. Economist John Goodman, in Lives at Risk, arrives at precisely the same conclusion: “In the United States, slightly less than one in five people diagnosed with prostate cancer dies of the disease. In the United Kingdom, 57 percent die.” None of this is surprising: in the UK, only about 40 percent of cancer patients see an oncologist, and historically, the government has been reluctant to fund new (and often better) cancer drugs.
The press corps is willing to defend socialized medicine, even if it kills them.
















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I'm reminded of the joke (I
November 4, 2007 - 02:00 ET by riff_raffI'm reminded of the joke (I forget where I saw it):
"If the US adopts socialized medicine, where will the Canadians go for their health care?"
riff... ROFL...
November 4, 2007 - 02:05 ET by bigtimerriff...
ROFL...
P.J. O'Rourke said it
November 4, 2007 - 02:29 ET by fitzfongP.J. O'Rourke said it best..."If you think health care is expensive now, wait until you see what it costs when its free".
As a cancer survivor myself, I owe my life to the treatment I received under the American Health Care system. I shudder to think what my life would be like if the cancer had been discovered in some kind of socialized medical bureaucracy.
Canada's great health care system
November 4, 2007 - 04:49 ET by UnsaneIndeed.
Canada couldn't even take care of a Vietnamese orphan sent there by a charity. He has a growth on his face which looks like a tumor or a cyst. It was supposed to be removed, but the hospital said "No, it's just a birthmark, its harmless, send him back to Vietnam". (Source: CBC's The National from 1 November 2007)
I'm thinking that if that poor kid was just sent 80 miles down the lakeshore to Buffalo, he would have been well taken care of...
Res tantum valet quantum vendi potest.
And even the Canadian
November 4, 2007 - 10:02 ET by HypocriteHaterAnd even the Canadian "free" health care isn't so free when it comes to cancer treatment.
And speaking of socialized healthcare, I'll bet Gerald Ford would have been glad he didn't have Hillarycare right before he died. These people are scary!!
Doctors in the two
November 4, 2007 - 08:17 ET by motherbeltDoctors in the two countries have different approaches. That's because
while aggressive prostate cancer can kill, it often grows so slowly,
and is found when it's so small, that men die of something else before
it ever threatens their lives or even causes symptoms.
That may have been a good plan years ago. I was a nurse in the 80's and that was the thinking in the US at that time, too. But that was also when prostate cancer was showing up in men in their 70's and 80's, so it often was true that they would die of something else first.
It's a whole different ballgame when a man in stricken in his 50's. Then the chances of his dying of something else first are significantly reduced.
I think the difference in survival rates for the US and the UK prove that.
The group cautions that
November 5, 2007 - 12:42 ET by pbanks7The group cautions that screening for prostate cancer is much more widespread in this country — meaning that in the U.S., higher survival rates include many whose lives probably weren't in danger and whose cancers might have gone unnoticed in the U.K.
Nothing like rationalizing the incentives of a "free" system. We might as well not screen for PSA because it's not cost-effective. "Weren't in danger" = early detection, duh. "Unnoticed" = didn't screen for it.
Ignorance is bliss. It's easier to repeat a mindless slogan than to do some actual research.
Cheaper to let 'em die?
November 4, 2007 - 10:09 ET by nkviking75What's even more amazing about it is, you'd think a government run system would want to catch a disease like prostate cancer early, so that treatment would be cheaper. But then, the more people who live, the more people they have to spend money on for health care. So maybe it does make a perverse kind of sense.
When you put the clowns in charge, don't be surprised when a circus breaks out.
Amy. Super. Robert Reich - lower life expectancy. Check this out
November 4, 2007 - 14:08 ET by Gary HallAmy. Super analysis. Check this out. On one point, and then I'll tie comments from former Clinton Labor Sec. Robert Reich. You quoted:
My understanding here is that, generally speaking, when prostate cancer is first diagnosed in elderly men, indeed it is often very slow growing. Often, at advanced ages, the treatment is hormonal only. Slow the growth down a bit, and the patient will outlive the cancer.
In younger men - the chance of the cancer being more agressive is far more common, and immediate aggressive intervention is indicated. I've just had two friends, in their 50's - and another a few years back - had their prostate removed. Scary, but both are fine, because of the early catch. Otherwise, most probably, both would have died from the disease.
Now, to confirm the British socialist approach to bad medicine, we have none other than Robert Reich spelling out for students what our media should be vetting for all of us. Of course Reich is pushing for socialized medicine, but at least he understands the cost -- nevermind, we must kill off our parents in the process and pay more for it.
Robert Reich (audio) at UC Berkeley on a number of issues. Reich begins by saying that he is going to tell the students things that candidates and policians will not tell us - not if they want to achieve their agenda, that is:
http://webcast.berkeley.edu/course_details.php?seriesid=1906978463
Choose the "A Sept 26 Q & A with students at UC Berekely.. by Reich -- theme seems to be on "can a politician be honest and be elected."
I found his comments at about the 9 minute mark on his health care ideas
.. paraphrasing... "you young people are going to have to pay more." applause (always amazes me why liberals clap when the news is either bad and bad and not humorous). " And we're not going to have to decide not to take care of old people... and you kids are not going to live to be any older (live as long?) as your parents." i.e., socialized medicine in America will lower life expectancy.
I've been saying that was a no brainer for years.
Of course other interesting bits are on the recording, as well. (none of the Q's are audible -- doesn't matter):
Prostate Ca
November 5, 2007 - 01:04 ET by stratmanSocialized medicine requires greater constraints on costs, meaning certain testing and/or treatments are less likely to be offered if the cost to benefit ratio cannot be justified. American health insurance use similar methodology but their ceiling for denial of tests/treatments is much higher overall. Hence, American medical care will be more comprehensive and readily available compared to Britain's or Canada's system. Capitalism once again triumphs over Socialism.
Facts concerning prostate cancer:
Prostate cancer is the most common noncutaneous cancer among males. Lung cancer and bronchial cancer account for 37% of male cancer deaths, and prostate cancer and colon cancer account for another 10% each.
Forty-seven percent of patients with prostate cancer are asymptomatic. This is one reason why digital rectal exams and PSA blood tests are important for screening.
According to recent figures from the American Cancer Society, 220,900 new cases were diagnosed in 2003 and 28,900 men will die of prostate cancer. Prostate cancer is rarely diagnosed in men younger than 40 years, and it is uncommon in men younger than 50 years.
Prevalence rates: Blacks > Whites and Hispanics. Hormonal, dietary (high fat) and genetic factors have been implicated as explanations for differences within and outside of racial identifiers.
Prostate cancer incidence rates and deaths have been declining since a peak in the early 1990's.
Data suggests that although most prostate cancers diagnosed at an early stage have an indolent course, local tumor progression and aggressive metastatic disease may develop in the long term. In addition, these findings would support early radical treatment, notably among patients with an estimated life expectancy exceeding 15 years.
Advocates of screening believe that early detection is crucial in order to find organ-confined disease and, thereby, impact mortality. If patients wait for symptoms or even positive DRE results, less than half have organ-confined disease.
Men who choose to undergo screening should begin at age 50 years. Men in high-risk groups, such as those with a strong familial predisposition (2 or more first-degree relatives are affected) and those of African American race, should begin screening at a younger age (40-45 y). These men are less likely to have the latent form of the disease and benefit from treatment. More data on the precise age to start prostate cancer screening are needed for men at high risk.
Recent data from Canadian and Austrian studies suggest that mortality rates are lower as a result of PSA screening. Currently, US data have shown a decrease in mortality of 1% per year since 1990, which coincides with the advent of PSA screening.
Fun fact: Sexual activity/orgasm is not believed to cause prostate cancer. (True) There is no scientific literature available concerning the existence of "hairy palm" either. A collective sigh of relief from 49% of the world's population is heard. (Obvious joke)
Fun fact II: If men live long enough they will all get prostate cancer. Most men, though, do not live long enough, or, if they already have prostate cancer, will die of something else (eg stroke, heart attack). The second statement seems particularly true if you live in America!
For more layperson/patient oriented information see here.
Killing them with kindness isn't working. Time to get scrappy with the Donkeys.