Free Markets, Free People

prostate cancer

Dodd, Cancer and Health Care “Reform” – Be Careful What You Wish For

First let me wish Sen. Chris Dodd a full recovery from the prostate surgery he will undergo soon to remove the cancer he’s been found to have.

But with all things personal, politicians try to turn them into “teachable moments” that support what they’re trying to do. And Dodd is no exception.

“I wanted to let you know that I’ve been diagnosed with an early stage of prostate cancer,” Dodd wrote. “Luckily, a routine test allowed my doctor to catch it at a very early stage, and my prognosis is excellent – we expect a full and speedy recovery. I want to assure you that I am feeling fine.”

“After the Senate adjourns at the end of next week, I’ll have surgery to remove the cancer,” Dodd wrote. “After a week or two of recuperation, I expect to be right back to work. After all, as a member of Congress, I have great health insurance. I was able to get screened, seek the opinions of highly skilled doctors, consider all the available options, and choose the treatment that was right for me.”

He added, in a reference to his current work to pass healthcare legislation, “I know you’ll agree that every American deserves the same ability. We have healthcare legislation to pass – and an election to win. And I can’t thank you enough for your support.”

The implication, of course, is that without universal health care or universal health insurance, detection and survival rates must be lower than they could be.

But a quick check of systems with universal care and insurance doesn’t at all back up the implication:

Survival was significantly higher in the United States for all solid tumors, except testicular, stomach, and soft-tissue cancer, the authors report. The greatest differences were seen in the major cancer sites: colon and rectum (56.2% in Europe vs 65.5% in the United States), breast (79.0% vs 90.1%), and prostate cancer (77.5% vs 99.3%), and this “probably represents differences in the timeliness of diagnosis,” they comment. That in turn stems from the more intensive screening for cancer carried out in the United States, where a reported 70% of women aged 50 to 70 years have undergone a mammogram in the past 2 years, one-third of people have had sigmoidoscopy or colonoscopy in the past 5 years, and more than 80% of men aged 65 years or more have had a prostate-specific antigen (PSA) test. In fact, it is this PSA testing that probably accounts for the very high survival from prostate cancer seen in the United States, the authors comment.

99.3% survival rate on prostate cancer in the US vs. 77.5% among the “universals”. How can that be, given Dodd’s indication that he’s just among the lucky ones? How in the world can the US, with such a badly broken system manage to save all but 0.7% of the prostate cancer patients, while the exemplar of universal care – Europe – loses 22.5% of theirs?

The PSA? It is a blood test. It is a test routinely run in the US when people have bloodwork done. And look at the testing for breast and colon cancer – isn’t that “preventive medicine”? So why aren’t the Europeans running all of these tests?

Good question. My guess would be cost. Here’s the result:

The age-adjusted 5-year survival rates for all cancers combined [Europe] was 47.3% for men and 55.8% for women, which is significantly lower than the estimates of 66.3% for men and 62.9% for women from the US Surveillance, Epidemiology, and End Results (SEER) program ( P < .001).

The point? Don’t buy into this “the system is broken” rhetoric in which politicians claim to have a better way of providing health care. My guess is a significant portion of Europeans diagnosed with various cancers would much rather be treated here than there.


[HT: Carly B.]