November 5, 2009
by Diana Furchtgott-Roth
As the Senate and House present their health care reform bills, Al Franken, Minnesota's junior senator, disputes the well-established fact that America has higher cancer survival rates than Europe--even though his state's Mayo Clinic, perhaps the most sophisticated medical center in the world, has developed path-breaking treatments for cancer.
At issue is whether Congress should adopt a public health plan similar to European state-run plans. Some proponents support a public option on the grounds that 62% of personal bankruptcies are due to high medical expenses. They contend that even Americans with health insurance are being bankrupted by health care costs.
This argument for a larger government role ignores data from the Federal Reserve showing that debt from buying goods and services, including medical care, rose from only 5.5% of all debt in 2001 to 5.8% in 2007, and that less than 1% of Americans enter bankruptcy each year.
At a recent Senate Judiciary Committee hearing, where I was a witness, Sen. Franken disagreed with my testimony that pending health care "reform" bills would lead to more bankruptcies, because higher taxes and health insurance premiums would cause more job loss, a major cause of bankruptcy.
Advocating for a government plan, Franken asserted that Switzerland, France and Germany have no medical bankruptcy--implying that their systems of national health care were preferable to ours.
But these countries have practically no personal bankruptcy of any kind, because people who default on debt face tough repayment schedules and have to give up almost all their assets and their homes, unlike in the United States.
When I reminded the committee that the United States has better medical outcomes, as evidenced by higher cancer survival rates than those of Switzerland, France and Germany, Franken was dismissive, saying "That's because we find easily survivable cancers to count as ones that we survive."
In fact, the cancers are survivable precisely because we find them early. Study after study has shown that cancer patients live longer in America than in Europe.
Mark Pearson, head of the health division of the Organisation for Economic Co-operation and Development, testified this fall before the Senate Special Committee on Aging that "the United States stands out as performing very well in the area of cancer care, achieving higher rates of screening and survival from different types of cancer than most other OECD countries."
Pearson presented data that will be published in the OECD Health Quality Indicators in December, showing the five-year survival rate for breast cancer to be 90% in the United States compared with 83% in France and 81% in OECD countries as a whole. American men had a 65% survival rate for colorectal cancer, compared with 57% for the same cancer in France and 57% for the OECD as a whole.
A 2007 paper in The Lancet Oncology compared five-year cancer survival rates in Europe and the United States. The U.S. survival rates for all cancers were 66% for men and 63% for women, compared with European rates of 47% and 56%.
Perhaps Franken's "easily survivable cancers" referred to American high rates of early diagnosis and survival for prostate cancer. But even without prostate cancer, survival rates were 47% for American men and 38% for Europeans--a significant difference, particularly for the American men who survived.
Franken notwithstanding, American health care yields better cancer outcomes than do government-based systems elsewhere.
Why is this? Americans have higher cancer survival rates because the United States has more advanced equipment for early diagnosis and more routine screenings. We have the newest technology and we spend more than other countries on diagnostic tests.
Once diagnosed, we use more advanced medications for treatment than they do Europe. Many new drugs are available earlier in the United States than in Europe, because European governments negotiate prices from pharmaceutical companies before a drug may be given to patients. This results in higher survival rates in America.
Evidence shows that more advanced technology and drugs result in longer life even across different states in the United States. Columbia Business School professor Frank Lichtenberg has examined the effects on life expectancy in the 50 states of diagnostic imaging procedures, drugs and physician quality. Not surprisingly, he found that "our indicators of the quality of diagnostic imaging procedures, drugs and physicians almost always had positive and statistically significant effects on life expectancy."
As we consider moving toward a public plan, we should remember that European health care may be less costly, but it is also less effective at keeping cancer patients alive. When Sen. Franken was playing comedy, he never had to worry about the truth. Now that he's playing with people's lives in the Senate, he needs to get his facts straight.
Diana Furchtgott-Roth, former chief economist of the U.S. Department of Labor, was a Senior Fellow at Hudson Institute from 2005 to 2011.
Home | Learn About Hudson | Hudson Scholars | Find an Expert | Support Hudson | Contact Information | Site Map
Policy Centers | Research Areas | Publications & Op-Eds | Hudson Bookstore
Hudson Institute, Inc. 1015 15th Street, N.W. 6th Floor Washington, DC 20005
Phone: 202.974.2400 Fax: 202.974.2410 Email the Webmaster
© Copyright 2013 Hudson Institute, Inc.