Rudy’s Fuzzy Healthcare Math

Oct 29, 2007 3:36pm

ABC News’ Rick Klein Reports: To hear Rudy Giuliani describe it in his new radio ad, the British medical system is a scary place.

"My chance of surviving prostate cancer — and thank God I was cured of it — in the United States: 82 percent," Giuliani says in a new radio spot airing in New Hampshire. "My chances of surviving prostate cancer in England: Only 44 percent, under socialized medicine."

But the data Giuliani cites comes from a single study published eight years ago by a not-for-profit group, and is contradicted by official data from the British government.

According to the United Kingdom’s Office for National Statistics, for men diagnosed with prostate cancer between 1999 and 2003, the "five-year survival rate" — a common measurement in cancer statistics — was 74.4 percent.

The statistics show that the five-year survival rate for prostate cancer victims in the UK has been steadily rising to approach the survival rate Giuliani cited for the United States.

The 74.4 percent survival rate "was 3.6 percentage points higher than the rate of 70.8 per cent for men diagnosed during 1998-2001," according to a British government report published in August.

In releasing the ad, the Giuliani campaign cited statistics published in an article in the Summer 2007 issue of City Journal, an urban-policy magazine that Giuliani has pronounced himself a fan of. The article, "The Ugly Truth About Canadian Health Care," was written by David Gratzer, a physician who is a senior fellow at the Manhattan Institute and is a healthcare adviser to the Giuliani campaign.

"And if we measure a health-care system by how well it serves its sick citizens, American medicine excels. Five-year cancer survival rates bear this out," Gratzer writes. "The survival rate for prostate cancer is 81.2 percent here, yet 61.7 percent in France and down to 44.3 percent in England — a striking variation."

The article did not name a source for those statistics. Through a spokeswoman, Gratzer said he was relying on data compiled for a 2000 study by the Commonwealth Fund, a not-for-profit foundation that supports health research.

Maria Comella, a Giuliani campaign spokesman, said the former New York City mayor is an avid reader of City Journal and found the passage in the article himself. He cited the statistics at a campaign stop, and the campaign used a recording from that appearance in the radio advertisement.

The campaign did not attempt to independently verify the statistics, Comella said.

"The citation is an article in a highly respected intellectual journal written by an expert at a highly respected think tank which the mayor read because he is an intellectually engaged human being," she said.

Don McCanne, a senior health policy fellow at Physicians for a National Health Program, conceded that the five-year survival rate for cancer diagnoses is higher in the United States than in many countries that have single-payer systems, though the disparity is not as great as Giuliani claims in his ad.

But he said that any such comparison is flawed, since it fails to take into account the additional investment in cancer education and screening in the United States. Much of the gap would be closed if other countries invested similar sums in catching cancer early.

If all Americans had access to preventive care, screenings, and treatment — through a single-payer system or another universal healthcare plan — the five-year survival rate would almost certainly be increased, since cancers would be caught sooner.

"It’s not a result of the healthcare-financing issue. That’s not what this is about at all," McCanne said. "Under a universal system, we would increase access to preventive screening."

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