A radio ad aired by Rudy Giuliani in New Hampshire has unleashed a firestorm of protest by the media. In it, Giuliani, a prostate cancer survivor, thanks God that he was treated in the United State's (semi-socialized) medical system where survival rates for this type of cancer are 82 percent â€“ as opposed to the (fully) socialized medical system in Britain where survival rates are allegedly only 44 percent.
But a number of reporters and pundits have pounced on the stat like a jackal on a bunny (actually, make that an ant). Rick Klein of ABC News accuses Rudy of "fuzzy healthcare math." Ezra Klein of CBS denounces the stat as a "straight lie resulting from a basic mathematical error." Washington Post's Eugene Robinson intones that this is precisely the kind of "cherry-picking" of data that has caused 160,000 US soldiers to be bogged down in Iraq.
My, my! So what exactly is the truth, according to these oracles?
Well, WaPo's Michael Dobbs claims that mortality rates for prostate cancer in the United States and UK are the same: About 25 men out of 100,000 die of prostate cancer each year in the two countries. But that comparison hides more than it reveals.
Rudy's claim was taken from an article in a 2007 issue of the City Journal by Dr. David Gratzer of the Manhattan Institute â€“ and a contributor to Reason Roundtable â€“ that were based on 2000 OECD data. Gratzer admits the figures are now outdated -- although it is curious as to why he used 2000 figures in a 2007 article (he does provide an answer of sorts in a New York Post article linked below.) But Gratzer points out that Dobb's comparison is based on overall mortality rates. That is, the percentage of all Americans who die of prostate cancer is similar to the percentage of all Britons.
However, Gratzer, who is also Rudy's health care policy adviser, notes, that this comparison misses the point given that a much higher percentage of Americans are diagnosed with prostate cancer than Britons. And the latest figures from Lancet Oncology, a respected journal, show that the five-year survival rate of people diagnosed with prostate cancer is much higher in the U.S. (99 percent) than in Europe (78 percent) and Scotland and Wales (71 percent). Britain's latest figures are not yet available.
Gratzer's detractors such as Eugene Robinson of WaPo, however, counter that the higher prostate cancer diagnosis in the U.S. is not the result of higher incidence of cancer -- but of early screening and detection. And that discredits Rudy and Gratzer how? Because very often this type of cancer is non-lethal and its detection bumps up U.S. survival rates among patients diagnosed with prostate cancer even when they are not treated or treated inadequately. Get it?
But even if these pundits were right that the higher diagnosis of non-lethal prostate cancer does artificially boost the survival rate of U.S. patients, can it account for the entire 22-27 percent differential between U.S. and European survival rate that the Lancet study found? Highly unlikely.
The bottom-line is that Rudy's accusers have no fool-proof evidence of willful mendacity on his part. Rudy might have over-stated his case (Isn't that shocking: a politician overstating!). But they have certainly engaged in over-kill.
All of which raises this interesting question: Where were these pundits when Al Gore was going around making movies claiming that global warming would cause sea levels to rise by 20 feet, when, in reality, the UN's Intergovernmental Panel on Climate Change put the figure at no more than two feet: a ten-fold exaggeration?
How do you spell d-o-u-b-l-e s-t-a-n-d-a-r-d?
David Gratzer's column in the New York Post taking on his critics here:
WaPo's Eugene Robinson's commentary here: