Friday, November 02, 2007

Giuliani The Anglophobe

Universal health insurance is a socialist plot. And it doesn't even work! So says Republican presidential candidate Rudy Giuliani:

Mr Giuliani launched a radio advertising campaign saying that the proposals from Democrats such as Hilary Clinton smacked of European-style socialism that would lower standards in the US.

"I had prostate cancer five, six years ago," the former New York mayor said. "My chance of surviving prostate cancer – and, thank God, I was cured of it – in the United States? 82 per cent. My chance of surviving prostate cancer in England? Only 44 per cent under socialised medicine."

Eek! Hillarycare is going to kill us all! Better leave it all to the health insurance industry.

Well, not quite so fast. There are a couple of small problems with Giuliani's argument if it is supposed to show the superiority of the American system. The Office of National Statistics in the U.K. gives a very different number from that offered by Giuliani: a five-year survival rate of 74.4%. (Note that those five years are calculated from the time of first diagnosis of the disease. If the first diagnosis is earlier in the U.S. the five-year survival rate will be higher here, too, even if early diagnosis makes no difference in the treatment of the disease.)

Why the discrepancy? According to Giuliani's spokeswoman:

Mr Giuliani's campaign did not give an immediate response. But a spokeswoman has previously insisted that he would continue to repeat the statistic and run the advertisement. She said the 44 per cent figure came from an article in a "highly respected intellectual journal" published by the right-wing Manhattan Institute, which he had read because "he is an intellectually engaged human being".

Mmm. Intellectually engaged human beings read only journals written by those who have an axe to grind?

And what is the actual evidence?

Doctors in the two countries have different philosophies for treating the disease, with the US putting more emphasis on early diagnosis and surgery. An analysis of mortality rates suggests that about 25 out of 100,000 men are dying from prostate cancer each year in both Britain and the US.

This doesn't necessarily mean that the two countries are performing equally well in the treatment of prostate cancer, though it could mean just that, too. But neither does it support Giuliani's flawed campaign soundbite.
Added: Paul Krugman takes the media to task for not pointing out Giuliani's use of untruths.