Dr. Cardin’s Misdiagnosis

Maryland congressman Ben Cardin is running for the Democratic nomination for US Senate.  But apparently he has a higher calling in mind.  Cardin promises that if he’s elected, we will find a cure for cancer.  He even released a television commercial in which a cancer survivor credits Cardin, who is not a doctor, with saving his life.  “Thanks to Ben Cardin, others can have their chance. … He’s literally a lifesaver.”  (The ad is an apparent reference to Cardin’s advocacy of early screening under Medicare.)

However, if Cardin truly wants to help cancer patients, perhaps he should reexamine his policy proposals.  The congressman is a supporter of single-payer national health care.  However, the rationing under such national health care systems means more cancer patients die.  For example, even though American men are more likely to be diagnosed with prostate cancer than their counterparts in other countries, we are less likely to die from the disease.  Fewer than one out of five American men with prostate cancer will die from it, but 57 percent of British men and nearly half of French and German men will.  Even in Canada, a quarter of men diagnosed with prostate cancer die from the disease. 

That is in part because in most countries with national health insurance, the preferred treatment for prostate cancer is… to do nothing.  Prostate cancer is a slow-moving disease.  Most patients are older and will live for several years after diagnosis.  Therefore it is not cost-effective in a world of socialized medicine to treat the disease too aggressively.  The approach saves money, but comes at a significant human cost.

Similar results can be found for other forms of cancer.  For instance, just 30 percent of U.S. citizens diagnosed with colon cancer die from it, compared to fully 74 percent in Britain, 62 percent in New Zealand, 58 percent in France, 57 percent in Germany, 53 percent in Australia, and 36 percent in Canada.  Similarly, less than 25 percent of U.S. women die from breast cancer, but 46 percent of British women, 35 percent of French women, 31 percent of German women, 28 percent of Canadian women, 28 percent of Australian women, and 46 percent of women from New Zealand die from it. (For more data on international comparisons, see here and here [.pdf]).

Even when there is a desire to provide treatment, national health care systems often lack the resources to provide it.  In Britain, for example, roughly 40 percent of cancer patients never get to see an oncology specialist.  Delays in receiving treatment under Britain’s national health service are often so long that nearly 20 percent of colon cancer cases considered treatable when first diagnosed are incurable by the time treatment is finally offered.

The Canadian Society of Surgical Oncology recommends that cancer surgery take place within two weeks of preoperative tests.  Yet one study indicates that median waiting time for cancer surgery in Canada ranged from 29 days for colorectal cancer to more than two months for urinary cancers.   Radiation treatment and new therapies, such as brachytherapy, are also far less available than in the United States.  Consider this: seven out of ten Canadian provinces report sending prostate cancer patients to the United States for radiation treatment.

If Ben Cardin is determined to practice medicine, he’s already learned about malpractice.

Gimme That Old Time Sci-ence

Much of America’s soi-pensant intellectual left opposes school choice as a solution to the Intelligent Design vs. Evolution battle. They argue that some things, like science instruction, are too important to be left to the discretion of the drooling masses “unqualified” parents. The state must step in, they believe, to ensure that all children are taught the non-Gospel, God-not-fearing, scientific TRUTH.

A small problem with this “reasoning” is that it fails to consider the possibility that the state might not always be in possession of said TRUTH. Consider, for instance, the recent words of Arkansas’ Democratic gubernatorial candidate, Mike Beebe: “I believe in intelligent design and I don’t think intelligent design and evolution are mutually exclusive.” Beebe went on to tell reporters that intelligent design should be available to students alongside curriculum on evolution theory. The Republican candidate for Lieutenant Governor, Jim Holt, “called evolution a ‘fraud theory’ and said that keeping intelligent design out of the classroom is censorship.”

Thanks to the federal government’s accelerating usurpation of control over the nation’s public schools, it is not difficult to imagine a day when such candidates hold federal office and can shape instruction in classrooms all across America.

How, exactly, would that protect the scientific truth so ostensibly dear to the anti-choice left?

This is why the latent totalitarianism of so many American intellectuals is remarkably short sighted. It might not always be a friendly face waiving from the back seat of the flag-adorned staff-car….

More here.

Fomenting Hysteria

Scotland Yard should rein in Deputy Police Commissioner Paul Stephenson.

Last week, discussing the foiled attack on passenger air transportation, Stephenson stood before cameras, flash-bulbs popping, and read the following from a prepared statement:

We cannot stress too highly the severity that this plot represented. Put simply, this was intended to be mass murder on an unimaginable scale.

Stephenson quite badly over-stressed the severity of the plot. It is easy to comprehend in terms of both execution and anticipated result. The planned attack would have killed many people in a very dramatic way - everyone should be glad that it was defeated - but it wasn’t anything near “unimaginable.”

Is this a quibble about semantics? No. Stephenson’s overwrought statement is a form of incompetence.

As I wrote last week (citing national security expert John Mueller), it is the reaction to terrorist attacks that inflict the most damage. Controlling the reaction through even-handed public communications is the best thing officialdom can do when an attack has succeeded - to say nothing of the opportunity for confidence-building when an attack has been thwarted.

The fact that this embarrassing public display was part of a statement written in advance is reason for Scotland Yard to fully review its communications strategy. Stephenson’s overreaction splashed across America’s television screens numerous times over the weekend.

Fortunately,the public doesn’t appear to be falling for it. A poll appearing in this morning’s Washington Post Express found that 72% of people feel safe flying. USA Today reports that air travelers are adapting quickly to measures that foreclose the threat of a liquid bomb attack. Let’s hope that the measures are quickly minimized to reach what attacks are actually possible, rather than those that are only speculative.

My colleague Gene Healy’s post here last week (preceding news of the foiled terror plot) and his citation to James Fallows’ article ” Declaring Victory ” are even more solid and relevant now than they were before. We do not face an existential threat from terrorism. The “War on Terror” is effectively won. All that’s left is for someone to declare it so.

Where Are the Conservatives?

When the Education Department was created in 1979, many critics warned that a secretary of education would turn into a national minister of education. Rep. John Erlenborn (R-Ill.), for instance, wrote,

There would be interference in textbook choices, curricula, staffing, salaries, the make-up of student bodies, building designs, and all other irritants that the government has invented to harass the population. These decisions which are now made in the local school or school district will slowly but surely be transferred to Washington.

Dissenting from the committee report that recommended establishing the department, Erlenborn and seven other Republicans wrote, “The Department of Education will end up being the Nation’s super schoolboard. That is something we can all do without.”

That’s why Ronald Reagan promised to abolish Jimmy Carter’s Department of Education in his 1980 campaign. And why House Budget Committee chairman John Kasich put abolition of the department in his budget proposal after the 1994 GOP takeover of Congress.

But things changed. Instead of eliminating or at least reducing federal intervention in local schools, Republicans in 2001 decided to dramatically escalate it with the No Child Left Behind Act. And now Jeb Bush, whom some conservatives call the best governor in the country, writes in the Washington Post (along with Michael Bloomberg) that we should strengthen NCLB. Make it tougher, they write, with real standards and real enforcement. Create data systems to “track” every student. Create federal standards for teachers.

If there’s an earthquake this week, it may be caused by Madison, Taft, Goldwater, and Reagan turning over in their graves. Imagine it: the leading conservative governor in America, considered a pioneer in education reform, wants the distant federal government to come into his state’s schools and impose tougher rules and regulations. And even the Wall Street Journal’s redoubtable editorial page deplores “rampant noncompliance” with federal mandates and “lax enforcement” by Big Brother in Washington.

In its new issue, American Conservative magazines asks two dozen leading intellectuals “What is left? What is right? Does it matter?” Not if leading conservatives have made their peace with federal control of local schools–and are demanding that the feds crack down on the locals.

Another Fiscal Conservative Sighted?

The Associated Press states as fact that Sen. Lincoln “Chafee is a fiscal conservative.” OK, let’s go to the tape.

According to the National Taxpayers Union, Chafee voted to restrain taxes and spending only 33 percent of the time in 2005. He introduced 43 bills to raise spending and only two to cut spending. He voted against Medicaid cuts. He voted not to allow a cap on spending increases. He voted to increase spending on community development block grants, low-income heating assistance, education, and a package of welfare programs.

What is the AP’s definition of a fiscal conservative?

New at Cato Unbound: Mexicans in America

Be sure to check out today’s fresh August issue of Cato Unbound, kicking off with celebrated essayist Richard Rodriguez’s provocative meditation on the place of Mexico and Mexicans in the U.S. economy and consciousness. Here’s a taste:

It is as though America, having benefited from illegal labor, pretends that the transaction was one of middle-class benevolence. Mexicans should be thankful for a month of cheerless eight-hour shifts, standing there waiting for the old lady to get off the commode. The odd thing is that they are thankful!

Read the whole thing, and stay tuned: Mexifornia author Victor Davis Hanson will reply on Wednesday, and it’s not going to be a lovefest.

Another Year Older and Deeper in Debt

Social Security turns 71 today. One can argue about whether or not the program was a good idea in 1935, but there should be no question about its inadequacies today. And its flaws just get worse with each passing year.

Social Security will begin running a deficit in just 11 years. Of course, in theory, the Social Security Trust Fund will pay benefits until 2040. That’s not much comfort to today’s 33-year-olds, who will face an automatic 26 percent cut in benefits unless the program is reformed before they retire. But even that is misleading, because the Trust Fund contains no actual assets. The government bonds it holds are simply a form of IOU, a measure of how much money the government owes the system. It says nothing about where the government will get the money to pay back those IOUs.

Overall, the system’s unfunded liabilities—the amount it has promised more than it can actually pay—now totals $15.3 trillion. Yes, that’s trillion with a “T.” Setting aside some technical changes in how future obligations are calculated, that’s $550 billion worse than last year. In other words, because Congress failed to act last year, our children and grandchildren were handed a bill for another $550 billion.

Moreover, Social Security taxes are already so high, relative to benefits, that Social Security has quite simply become a bad deal for younger workers, providing a low, below-market rate-of-return. In fact, many young workers will end up paying more in taxes than they receive in benefits. They will actually lose money under the program.

But the single most important problem with the current Social Security system is that workers have no ownership of their benefits. The U.S. Supreme Court has ruled, in the case of Flemming v. Nestor, that workers have no legally binding contractual or property right to their Social Security benefits, and those benefits can be changed, cut, or even taken away at any time. This means that workers completely dependent on the goodwill of 535 politicians when it comes to what they’ll receive in retirement. And because workers don’t own their benefits, those benefits are not inheritable. This particularly disadvantages those groups in our society with shorter life expectancies, such as African-Americans.

Social Security reform was once a bipartisan issue. Democrats like Senators Bob Kerrey and Daniel Patrick Moynihan were outspoken in warning about the program’s looming insolvency, and in calling for innovative approaches to fixing it. The Democratic Leadership Council and its think tank arm, the Progressive Policy Institute, explored many approaches to reform, including personal accounts. Congressmen like Charlie Stenholm reached across the aisle in search of compromise. Even President Clinton led a national debate to “Save Social Security First.”

But since President Bush called for reforming the nation’s troubled retirement program, congressional Democrats have had only one answer: “No.” No to personal accounts. “No” to changes in benefits. “No” to offering a real reform plan of their own. “No” to any discussion or negotiation.

At the same time, Republicans—apparently terrified of offending AARP and other special interests—have scurried for cover, running from positions they should know are correct. Republicans seem to believe that if the just stick their heads far enough in the sand for long enough, Democrats won’t attack them. The result is a choice between Democratic obstructionism and Republican cowardice.

And we wonder why so many young people are turned off to politics?