Rudy 2008: A More Untrue America

The fallout from Rudy G's demonstrably untrue statement about prostate cancer survival rates continues. Ezra Klein:

You'll notice the shot at the Europeans in his ad. His statistics are, as the maligned Brits would say, bollocks. In America, mortality from prostate cancer is 15.8 per 100,000 males. In Britain, it's 17.8 per 100,000. What America does have is a radically more aggressive screening program, which doesn't seem to lower mortality much, but radically increases our diagnostic rate.

As the Journal of the National Cancer Institute wrote [PDF]: "similarity of mortality rates between the two populations supports the hypothesis that risk of fatal prostate cancer among British men does not differ from that among US white men. More intensive screening procedures, such as prostate-specific antigen testing, in the United States is the most likely explanation for the widening gap in incidence." In other words, we diagnose a lot of cancers that aren't lethal or are slow-moving enough to not require treatment. Saying, from that data, that we've got twice the survival rate is like saying we have a lower death rate from car crashes because we record more near-misses in the statistics.

Joe Conason:

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"?

Eugene Robinson:

I see two possibilities. One is that he believed what he wanted to believe -- that this huge supposed disparity in cancer outcomes fits so neatly into his worldview that it just had to be right. Hmmm, isn't cherry-picked data -- about weapons of mass destruction, not cancer survival rates -- the reason we have nearly 160,000 troops bogged down in Iraq?

The other possibility is that Giuliani didn't really care whether the figures made any sense or not. He invokes the specter of "Hillarycare" -- shorthand for any health-care reform that Hillary Clinton might propose -- almost as often as he reminds audiences of Sept. 11. Here was another weapon to use against his nemesis.

Paul Krugman:

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...

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...

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.

About those breast cancer claims - you can read about them here. It's another case of our aggressive screening processes delivering a result pretty much exactly that of Canada, which has also raised public awareness on early screening.

A New Hampshire health care group is now demanding that the ad be taken down because of its falsehoods. The faulty statistics, from a right-wing journal, were taken from a study by the Commonwealth Fund, and they're disputing the stats.

But the Commonwealth Fund said the figures didn’t come from its reports. They can’t accurately be calculated from the seven-year-old report Gratzer references, said Dr. Stephen Schoenbaum, executive vice president for programs at the Commonwealth Fund.

“The figures that they’re working on (are) not correctly derived,” he said. “They’re also old numbers. The numbers are possibly changing.”

This, of course, is par for the course for a candidate who thinks his foreign policy experience as a mayor is greater than the longtime chair of the Senate Foreign Relations Committee.

This has reached a pathological point. Rudy Giuliani is unfit for office simply because he'll decide that Russia is the 51st state, or his new wife is Morgan Fairchild, or he has the power to change the White House into a spaceship with his eyes. This is a disease. I may start a fund for his rehabilitation. Hopefully he still has that public health care so he can afford it.