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.