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Times Online – Comment Central – Why Rudy Giuliani was right about the NHS, by Daniel Finkelstein

Rudy Giuliani has been in a spot of hot water with his claims about prostate cancer survival being better in the US than in the UK

Even over here. The Health Secretary has been defending the record of the NHS, arguing that Rudy’s attack on “socialized” healthcare is wrong and the NHS record on prostate cancer is good.

Now David Gratzer, the man whose article gave Rudy Giuliani his cancer survival data, has waded into the controversy on the Mayor’s side. And I’d say his points were pretty strong:

Let me be very clear about why the Giuliani campaign is correct: the percentage of people diagnosed with prostate cancer who die from it is much higher in Britain than in the United States. The Organisation for Economic Co-operation and Development reports on both the incidence of prostate cancer in member nations and the number of resultant deaths.

According to OECD data published in 2000, 49 Britons per 100,000 were diagnosed with prostate cancer, and 28 per 100,000 died of it. This means that 57 percent of Britons diagnosed with prostate cancer died of it; and, consequently, that just 43 percent survived. Economist John Goodman, in Lives at Risk, arrives at precisely the same conclusion: “In the United States, slightly less than one in five people diagnosed with prostate cancer dies of the disease. In the United Kingdom, 57 percent die.”

None of this is surprising: in the UK, only about 40 percent of cancer patients see an oncologist, and historically, the government has been reluctant to fund new (and often better) cancer drugs.

Here is Gratzer’s explanation of the error made by the critics:

So why do the critics think that Britain’s survival rates are as high as America’s? The main reason is that they are citing overall mortality rates, which are indeed, as Ezra Klein writes, similar across various countries.

That is, the percentage of all Americans who die from prostate cancer is similar to the percentage of all Britons who do. But this misses the point, since a much higher percentage of Americans than Britons are diagnosed with prostate cancer in the first place. If you are a patient already diagnosed with prostate cancer, like Rudy Giuliani, your chances of survival—as Giuliani correctly said—are far higher in the United States.

So Gratzer is arguing that people in the UK are dying of undiagnosed prostate cancer and are not counted at all. Perfectly possible.

Yeah, that’s something to be proud of. “If people trusted the NHS enough to come in for a check-up, our mortality rates wouldn’t be nearly as bad!”

(Or, of course it could mean “If the NHS was competent enough to spot it in more cases, our mortality rates wouldn’t be nearly as bad!”)