Topic: Government and Politics

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.

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?

Sore Loserman

NPR reporter Luke Burbank, guest-hosting “Wait Wait … Don’t Tell Me,” mocked Sen. Joe Lieberman’s decision to run for re-election as an independent after losing the Democratic primary. Burbank ridiculed Lieberman, saying that “nothing, not poor poll numbers, not scorn from his party, not losing the damn primary, could stop him from running for Senate … selflessly ignoring the will of the people… . If [the independent campaign] doesn’t work, he’s planning a bloodless coup of the Bridgeport High School PTA.”

OK, that’s a fair point. But I was trying to think of how NPR might have treated other candidates who lost an election and wouldn’t take “no” for an answer. One example was Rep. John B. Anderson (R-Ill.), who ran for the Republican presidential nomination. After losing every primary, he filed to run as an Independent. Nexis doesn’t include any NPR transcripts from 1980, but the general reaction of the mainstream media was to celebrate Anderson’s courage and independence in standing up to the extreme conservative Republican primary voters who gave the nomination to Ronald Reagan. That same year, liberal Republican Sen. Jacob Javits (R-N.Y.) lost his primary to Alfonse D’Amato and went on to run as the Liberal Party nominee. Again, the media reaction was sympathetic.

But then I remembered a more recent example of a political candidate who wouldn’t give up, even after winning the election: Joe Lieberman in 2000, along with running mate Al Gore. So Lieberman may be the first candidate in American history to refuse to accept losing an election twice.

Do they still sell those “Sore Loserman” shirts?

Jefferson-Jackson Day: Laissez Les Bons Temps Rouler

Here’s an idea for the cash-strapped Louisiana Democratic Party: for next year’s Jefferson-Jackson Day dinner, instead of paying big bucks for first-class air travel and hotel rooms for some national party poohbah, why not have the dinner feature Rep. William Jefferson, currently the target of an FBI investigation, and businessman Vernon L. Jackson, who has pleaded guilty to bribing Jefferson?

Fiscal Conservatives, Again

The often astute Washington Post columnist Steven Pearlstein writes that Rep. Benjamin Cardin (D-MD), a candidate for the Senate, is “a budget-balancing fiscal conservative.”

Well. According to the National Taxpayers Union, Cardin voted 13 percent of the time to restrain taxes and spending in 2005, making him slightly more spendthrift than the average Democratic House member. He has introduced 42 bills in this Congress to raise spending, and one bill that would cut spending. It’s true that he has supported some IRS and budget process reforms, but he has not supported a Balanced Budget Amendment to the Constitution.

As I wrote last week, the search for a fiscally conservative Democrat continues.

Meanwhile, a headline in the Post reads:

“President Remains Eager to Cut Entitlement Spending”

Honestly, it’s like reporters are Charlie Brown and Bush is Lucy, pulling the football away time after time. Bush promises to control spending, then increases spending by 48 percent. Bush promises to control spending, then passes a multi-trillion-dollar expansion of Medicare. Bush says, “We need to cut entitlement spending,” and he gets a six-column headline in the Post.

Importing Ideas

In the new Afghanistan, which seems uncomfortably like the old Afghanistan, the cabinet has revived the Department for the Promotion of Virtue and the Discouragement of Vice. The government will once again be able to keep an eye out for short beards, chess playing, slipping veils, alcohol, and other vices.

An official tells the Washington Post that he’s “swamped with job applicants” for the department.

Perhaps if they lose in the fall, Sens. Rick Santorum and Joe Lieberman could team up to lobby for such a department in the United States. And future president Hillary Clinton just might endorse the effort.