F
Freedom Fighter
Guest
Prostates and Prejudices
By PAUL KRUGMAN Op-Ed Columnist
http://www.nytimes.com/2007/11/02/opinion/02krugman.html?th&emc=th
NY Times
November 2, 2007
"My chance of surviving prostate cancer - and thank God I was cured of
it - in the United States? Eighty-two percent," says Rudy Giuliani in
a new radio ad attacking Democratic plans for universal health care.
"My chances of surviving prostate cancer in England? Only 44 percent,
under socialized medicine."
It would be a stunning comparison if it were true. But it isn't. And
thereby hangs a tale - one of scare tactics, of the character of a man
who would be president and, I'm sorry to say, about what's wrong with
political news coverage.
Let's start with the facts: Mr. Giuliani's claim is wrong on multiple
levels - bogus numbers wrapped in an invalid comparison embedded in a
smear.
Mr. Giuliani got his numbers from a recent article in City Journal, a
publication of the conservative Manhattan Institute. The author gave
no source for his numbers on five-year survival rates - the
probability that someone diagnosed with prostate cancer would still be
alive five years after the diagnosis. And they're just wrong.
You see, the actual survival rate in Britain is 74.4 percent. That
still looks a bit lower than the U.S. rate, but the difference turns
out to be mainly a statistical illusion. The details are technical,
but the bottom line is that a man's chance of dying from prostate
cancer is about the same in Britain as it is in America.
So Mr. Giuliani's supposed killer statistic about the defects of
"socialized medicine" is entirely false. In fact, there's very little
evidence that Americans get better health care than the British, which
is amazing given the fact that Britain spends only 41 percent as much
on health care per person as we do.
Anyway, comparisons with Britain have absolutely nothing to do with
what the Democrats are proposing. In Britain, doctors are government
employees; despite what Mr. Giuliani is suggesting, none of the
Democratic candidates have proposed to make American doctors work for
the government.
As a fact-check in The Washington Post put it: "The Clinton health
care plan" - which is very similar to the Edwards and Obama plans -
"has more in common with the Massachusetts plan signed into law by
Gov. Mitt Romney than the British National Health system." Of course,
this hasn't stopped Mr. Romney from making similar smears.
At one level, what Mr. Giuliani and Mr. Romney are doing here is
engaging in time-honored scare tactics. For generations, conservatives
have denounced every attempt to ensure that Americans receive needed
health care, from Medicare to S-chip, as "socialized medicine."
Part of the strategy has always involved claiming that health reform
is suspect because it's un-American, and exaggerating health care
problems in other countries - usually on the basis of unsubstantiated
anecdotes or fraudulent statistics. Opponents of reform also make a
practice of lumping all forms of government intervention together,
pretending that having the government pay some health care bills is
just the same as having the government take over the whole health care
system.
But here's what I don't understand: Why isn't Mr. Giuliani's behavior
here considered not just a case of bad policy analysis but a character
issue?
For better or (mostly) for worse, political reporting is dominated by
the search for the supposedly revealing incident, in which the
candidate says or does something that reveals his true character. And
this incident surely seems to fit the bill.
Leave aside the fact that Mr. Giuliani is simply lying about what the
Democrats are proposing; after all, Mitt Romney is doing the same
thing.
But health care is the pre-eminent domestic issue for the 2008
election. Surely the American people deserve candidates who do their
homework on the subject.
Yet what we actually have is the front-runner for the Republican
nomination apparently basing his health-care views on something he
read somewhere, which he believed without double-checking because it
confirmed his prejudices.
By rights, then, Mr. Giuliani's false claims about prostate cancer -
which he has, by the way, continued to repeat, along with some fresh
false claims about breast cancer - should be a major political
scandal. As far as I can tell, however, they aren't being treated that
way.
To be fair, there has been some news coverage of the prostate affair.
But it's only a tiny fraction of the coverage received by Hillary's
laugh and John Edwards's haircut.
And much of the coverage seems weirdly diffident. Memo to editors: If
a candidate says something completely false, it's not "in dispute."
It's not the case that "Democrats say" they're not advocating
British-style socialized medicine; they aren't.
The fact is that the prostate affair is part of a pattern: Mr.
Giuliani has a habit of saying things, on issues that range from
health care to national security, that are demonstrably untrue. And
the American people have a right to know that.
----------------------------------------------
http://www.salon.com/opinion/conason/2007/11/02/healthcare_lies/index.html
Rudy's bogus healthcare stats -
Giuliani claims he might not have survived prostate cancer under "socialized
medicine," yet he was covered by a government-provided plan.
By Joe Conason
Nov. 02, 2007 | To a politician pandering to his party's right wing, a role
that Rudolph Giuliani plays every day now, citing his own recovery from
prostate cancer as an argument against "socialized medicine" must have
seemed like pure genius. The that went up this week in New Hampshire
suggests that Giuliani not only faced down the 9/11 terrorists -- or
something like that -- but triumphed over a terrifying disease as well,
without the help of any government bureaucrats.
Or as Giuliani himself says in the controversial ad: "I had prostate cancer
five, six years ago. My chance of surviving cancer -- and thank God I was
cured of it -- in the United States: 82 percent. My chances of surviving
prostate cancer in England: only 44 percent under socialized medicine."
Yes, it's another inspiring and instructive story -- or would be, perhaps,
if only it were true.
The former New York mayor did survive prostate cancer, but otherwise his
statistical claims were not difficult to debunk, as reporters for the New
York Times, the Washington Post, MSNBC and other news outlets quickly
discovered. Giuliani had picked up his numbers from an article in City
Journal, a publication of the right-wing Manhattan Institute, and simply
repeated them in public without bothering to check their validity.
Unfortunately, they were essentially fraudulent figures, extrapolated
inaccurately from old data (by a doctor who also advises the Giuliani
campaign on healthcare).
Accurate and current data, easily available from public health agencies and
medical authorities, shows that the survival rate from prostate cancer in
England is better than 74 percent and in the United States is better than 98
percent. Even that difference, as experts explained, probably has nothing to
do with the British National Health Service and much to do with the
aggressive screening programs employed in this country. (And for the moment,
let's merely mention another highly pertinent issue, namely that the great
majority of prostate cancers occur in men over 65, which indicates that many
if not most are treated successfully under Medicare -- our version of
national health insurance for the elderly -- or by the Department of
Veterans Affairs, which comes as close to truly socialist healthcare as any
system in the world.)
The Giuliani ad's problems go well beyond a pair of phony numbers. Among the
blogging wonks scrutinizing the relevant health data is Ezra Klein, who
asked a separate but penetrating question: "Wouldn't it be interesting to
find out if the gold-standard care Giuliani got during his prostate cancer
came while he was on government-provided health insurance?"
As Klein surmised, Giuliani was serving as mayor and participating in a city
of New York health plan when his doctor informed him that his prostate
biopsy had come up positive. The coverage he enjoyed -- which resembles the
Federal Employees Health Benefits Plan -- permits all city employees, from
trash haulers and subway clerks up to the mayor himself, to select from a
variety of insurance providers, and it is not much different from the reform
proposals adopted by his nemesis Hillary Clinton.
In the spring of 2000, when Giuliani learned that he had cancer and abruptly
dropped out of the Senate race against Sen. Clinton, he was enrolled as a
member of GHI, one of the two gigantic HMO groups that provide care for most
city workers (the other is known as HIP). He underwent surgery and radiation
at Mount Sinai Hospital, a prestigious institution that participates in the
GHI plan, which means that his costs were largely underwritten by city
taxpayers.
So does that qualify as "socialized medicine"?
At GHI and HIP, the city government pays the premiums for its hundreds of
thousands of enrolled members, of course. On the board of directors of GHI,
a nonprofit corporation, sit half a dozen officials from the city's largest
unions, including Harry Nespoli, president of the Sanitationmen's
Association Local 831, and Roger Toussaint, president of the Transport
Workers Union Local 100 (who led a tough, illegal strike against the subway
system last year). Among the many state and federal regulations and programs
that support the operations of these major insurers is a New York state
"risk allocation pool" that cushions the financial impacts of certain kinds
of mandated coverage.
If that isn't socialism, it hardly sounds like pure private enterprise,
either. While that may startle a boob who accepted the premise of Giuliani's
silly commercial, it is hardly surprising to anyone familiar with the
pedigree of GHI and HIP, which were among the earliest examples of prepaid
healthcare in the United States. Both were originally cooperative
enterprises, founded by idealistic progressives whose hope was to make care
more affordable for working-class families. (And their earliest supporters
notably included Fiorello LaGuardia, a liberal Republican mayor of New York
who happened to be of Italian descent.)
Naturally such hopeful initiatives outraged the reactionary ideologues and
political mountebanks of that era. Back in 1937, the appearance of
Washington's first group health plan for federal employees was denounced in
Time magazine as a "blood-curdling new excursion into the practice of
medicine" by the government, which surely meant the end of professionalism,
declining standards, ruinous expenses and nothing less than the advent of
"Soviet medicine."
We've heard it all before, Rudy. And 70 years later, it isn't exactly fresh.
By PAUL KRUGMAN Op-Ed Columnist
http://www.nytimes.com/2007/11/02/opinion/02krugman.html?th&emc=th
NY Times
November 2, 2007
"My chance of surviving prostate cancer - and thank God I was cured of
it - in the United States? Eighty-two percent," says Rudy Giuliani in
a new radio ad attacking Democratic plans for universal health care.
"My chances of surviving prostate cancer in England? Only 44 percent,
under socialized medicine."
It would be a stunning comparison if it were true. But it isn't. And
thereby hangs a tale - one of scare tactics, of the character of a man
who would be president and, I'm sorry to say, about what's wrong with
political news coverage.
Let's start with the facts: Mr. Giuliani's claim is wrong on multiple
levels - bogus numbers wrapped in an invalid comparison embedded in a
smear.
Mr. Giuliani got his numbers from a recent article in City Journal, a
publication of the conservative Manhattan Institute. The author gave
no source for his numbers on five-year survival rates - the
probability that someone diagnosed with prostate cancer would still be
alive five years after the diagnosis. And they're just wrong.
You see, the actual survival rate in Britain is 74.4 percent. That
still looks a bit lower than the U.S. rate, but the difference turns
out to be mainly a statistical illusion. The details are technical,
but the bottom line is that a man's chance of dying from prostate
cancer is about the same in Britain as it is in America.
So Mr. Giuliani's supposed killer statistic about the defects of
"socialized medicine" is entirely false. In fact, there's very little
evidence that Americans get better health care than the British, which
is amazing given the fact that Britain spends only 41 percent as much
on health care per person as we do.
Anyway, comparisons with Britain have absolutely nothing to do with
what the Democrats are proposing. In Britain, doctors are government
employees; despite what Mr. Giuliani is suggesting, none of the
Democratic candidates have proposed to make American doctors work for
the government.
As a fact-check in The Washington Post put it: "The Clinton health
care plan" - which is very similar to the Edwards and Obama plans -
"has more in common with the Massachusetts plan signed into law by
Gov. Mitt Romney than the British National Health system." Of course,
this hasn't stopped Mr. Romney from making similar smears.
At one level, what Mr. Giuliani and Mr. Romney are doing here is
engaging in time-honored scare tactics. For generations, conservatives
have denounced every attempt to ensure that Americans receive needed
health care, from Medicare to S-chip, as "socialized medicine."
Part of the strategy has always involved claiming that health reform
is suspect because it's un-American, and exaggerating health care
problems in other countries - usually on the basis of unsubstantiated
anecdotes or fraudulent statistics. Opponents of reform also make a
practice of lumping all forms of government intervention together,
pretending that having the government pay some health care bills is
just the same as having the government take over the whole health care
system.
But here's what I don't understand: Why isn't Mr. Giuliani's behavior
here considered not just a case of bad policy analysis but a character
issue?
For better or (mostly) for worse, political reporting is dominated by
the search for the supposedly revealing incident, in which the
candidate says or does something that reveals his true character. And
this incident surely seems to fit the bill.
Leave aside the fact that Mr. Giuliani is simply lying about what the
Democrats are proposing; after all, Mitt Romney is doing the same
thing.
But health care is the pre-eminent domestic issue for the 2008
election. Surely the American people deserve candidates who do their
homework on the subject.
Yet what we actually have is the front-runner for the Republican
nomination apparently basing his health-care views on something he
read somewhere, which he believed without double-checking because it
confirmed his prejudices.
By rights, then, Mr. Giuliani's false claims about prostate cancer -
which he has, by the way, continued to repeat, along with some fresh
false claims about breast cancer - should be a major political
scandal. As far as I can tell, however, they aren't being treated that
way.
To be fair, there has been some news coverage of the prostate affair.
But it's only a tiny fraction of the coverage received by Hillary's
laugh and John Edwards's haircut.
And much of the coverage seems weirdly diffident. Memo to editors: If
a candidate says something completely false, it's not "in dispute."
It's not the case that "Democrats say" they're not advocating
British-style socialized medicine; they aren't.
The fact is that the prostate affair is part of a pattern: Mr.
Giuliani has a habit of saying things, on issues that range from
health care to national security, that are demonstrably untrue. And
the American people have a right to know that.
----------------------------------------------
http://www.salon.com/opinion/conason/2007/11/02/healthcare_lies/index.html
Rudy's bogus healthcare stats -
Giuliani claims he might not have survived prostate cancer under "socialized
medicine," yet he was covered by a government-provided plan.
By Joe Conason
Nov. 02, 2007 | To a politician pandering to his party's right wing, a role
that Rudolph Giuliani plays every day now, citing his own recovery from
prostate cancer as an argument against "socialized medicine" must have
seemed like pure genius. The that went up this week in New Hampshire
suggests that Giuliani not only faced down the 9/11 terrorists -- or
something like that -- but triumphed over a terrifying disease as well,
without the help of any government bureaucrats.
Or as Giuliani himself says in the controversial ad: "I had prostate cancer
five, six years ago. My chance of surviving cancer -- and thank God I was
cured of it -- in the United States: 82 percent. My chances of surviving
prostate cancer in England: only 44 percent under socialized medicine."
Yes, it's another inspiring and instructive story -- or would be, perhaps,
if only it were true.
The former New York mayor did survive prostate cancer, but otherwise his
statistical claims were not difficult to debunk, as reporters for the New
York Times, the Washington Post, MSNBC and other news outlets quickly
discovered. Giuliani had picked up his numbers from an article in City
Journal, a publication of the right-wing Manhattan Institute, and simply
repeated them in public without bothering to check their validity.
Unfortunately, they were essentially fraudulent figures, extrapolated
inaccurately from old data (by a doctor who also advises the Giuliani
campaign on healthcare).
Accurate and current data, easily available from public health agencies and
medical authorities, shows that the survival rate from prostate cancer in
England is better than 74 percent and in the United States is better than 98
percent. Even that difference, as experts explained, probably has nothing to
do with the British National Health Service and much to do with the
aggressive screening programs employed in this country. (And for the moment,
let's merely mention another highly pertinent issue, namely that the great
majority of prostate cancers occur in men over 65, which indicates that many
if not most are treated successfully under Medicare -- our version of
national health insurance for the elderly -- or by the Department of
Veterans Affairs, which comes as close to truly socialist healthcare as any
system in the world.)
The Giuliani ad's problems go well beyond a pair of phony numbers. Among the
blogging wonks scrutinizing the relevant health data is Ezra Klein, who
asked a separate but penetrating question: "Wouldn't it be interesting to
find out if the gold-standard care Giuliani got during his prostate cancer
came while he was on government-provided health insurance?"
As Klein surmised, Giuliani was serving as mayor and participating in a city
of New York health plan when his doctor informed him that his prostate
biopsy had come up positive. The coverage he enjoyed -- which resembles the
Federal Employees Health Benefits Plan -- permits all city employees, from
trash haulers and subway clerks up to the mayor himself, to select from a
variety of insurance providers, and it is not much different from the reform
proposals adopted by his nemesis Hillary Clinton.
In the spring of 2000, when Giuliani learned that he had cancer and abruptly
dropped out of the Senate race against Sen. Clinton, he was enrolled as a
member of GHI, one of the two gigantic HMO groups that provide care for most
city workers (the other is known as HIP). He underwent surgery and radiation
at Mount Sinai Hospital, a prestigious institution that participates in the
GHI plan, which means that his costs were largely underwritten by city
taxpayers.
So does that qualify as "socialized medicine"?
At GHI and HIP, the city government pays the premiums for its hundreds of
thousands of enrolled members, of course. On the board of directors of GHI,
a nonprofit corporation, sit half a dozen officials from the city's largest
unions, including Harry Nespoli, president of the Sanitationmen's
Association Local 831, and Roger Toussaint, president of the Transport
Workers Union Local 100 (who led a tough, illegal strike against the subway
system last year). Among the many state and federal regulations and programs
that support the operations of these major insurers is a New York state
"risk allocation pool" that cushions the financial impacts of certain kinds
of mandated coverage.
If that isn't socialism, it hardly sounds like pure private enterprise,
either. While that may startle a boob who accepted the premise of Giuliani's
silly commercial, it is hardly surprising to anyone familiar with the
pedigree of GHI and HIP, which were among the earliest examples of prepaid
healthcare in the United States. Both were originally cooperative
enterprises, founded by idealistic progressives whose hope was to make care
more affordable for working-class families. (And their earliest supporters
notably included Fiorello LaGuardia, a liberal Republican mayor of New York
who happened to be of Italian descent.)
Naturally such hopeful initiatives outraged the reactionary ideologues and
political mountebanks of that era. Back in 1937, the appearance of
Washington's first group health plan for federal employees was denounced in
Time magazine as a "blood-curdling new excursion into the practice of
medicine" by the government, which surely meant the end of professionalism,
declining standards, ruinous expenses and nothing less than the advent of
"Soviet medicine."
We've heard it all before, Rudy. And 70 years later, it isn't exactly fresh.