Iconic Films

2 for 1 tickets to Singin' In The Rain, this coming Monday. Book now

Navigation - link to other main sections from here

From The Times

November 1, 2007

Rudy Giuliani uses the NHS as ‘political football’ to give Hillary Clinton a kicking

Republican presidential hopeful Rudy Giuliani answers questions following a fundraiserin Milwaukee

Tom Baldwin in Washington

Rudy Giuliani, the front-runner for the 2008 Republican nomination, was accused last night of smearing the NHS to attack Democratic plans for universal healthcare in America.

Mr Giuliani launched a radio advertising campaign saying that the proposals from Democrats such as Hillary Clinton smacked of European-style socialism that would lower standards in the US.

“I had prostate cancer five, six years ago,” the former New York mayor said. “My chance of surviving prostate cancer – and, thank God, I was cured of it – in the United States? 82 per cent. My chance of surviving prostate cancer in England? Only 44 per cent under socialised medicine.”

His advert prompted Alan Johnson, the Health Secretary, to make a rare intervention into US politics as he pleaded with Mr Giuliani to stop kicking the NHS. Mr Johnson told The Times: “The British NHS should not become a political football in American presidential politics. Our rate of prostate cancer survival is actually much higher than has been claimed. The latest data shows a survival rate of over 70 per cent – and increasing.”

The Office for National Statistics says that the five-year survival rate from prostate cancer in Britain is 74.4 per cent.

Mr Giuliani’s campaign did not give an immediate response. But a spokeswoman has previously insisted that he would continue to repeat the statistic and run the advertisement. She said the 44 per cent figure came from an article in a “highly respected intellectual journal” published by the right-wing Manhattan Institute, which he had read because “he is an intellectually engaged human being”.

The article’s author, David Gratzer, who is an adviser to Mr Giuliani’s campaign, has acknowledged to The New York Times that the statistic is seven years old and “crude”.

He said that it came from the Commonwealth Fund, which specialises in health policy issues. But the same organisation has since issued a statement accusing Dr Gratzer of misusing its research.

Mr Johnson himself cited a report this year from the Commonwealth Fund that placed Britain’s health system top of a league table of six nations including Australia, Canada, Germany, New Zealand and the United States.

“While neither health system is perfect, the recent Commonwealth Fund report placed the UK system at the top of its analysis and the US at the bottom,” Mr Johnson said.

US health experts also disputed both the accuracy of Mr Giuliani’s figures and questioned whether it was fair to make a direct comparison.

Doctors in the two countries have different philosophies for treating the disease, with the US putting more emphasis on early diagnosis and surgery. An analysis of mortality rates suggests that about 25 out of 100,000 men are dying from prostate cancer each year in both Britain and the US.

Brantley Thrasher, at the University of Kansas Department of Urology, told The Washington Post that it was “impossible to say” whether a prostate cancer patient has a better chance of surviving under a “capitalistic” or “socialistic” medical system.

Ian Thompson, of the University of Texas, said: “Certainly, if you intensively screen for prostate cancer, you will find early disease. And simply because you find it earlier, you will always have longer survival after the disease is diagnosed.”

The issue of healthcare will be a key battleground in the presidential campaign. Democratic candidates, including Mrs Clinton, have set out plans to extend coverage to the tens of millions of citizens without health insurance.

The Organisation for Economic Cooperation and Development recently issued a report giving warning that the US faces soaring budget deficits unless it does more to control spending on health, which far exceeds that of even the richest European countries, even though 47 million Americans – including nine million children – have no cover.

At the same time Sicko, the latest documentary from the left-wing film-maker Michael Moore has provoked anger from Republicans by painting a flattering portrait of healthcare in Canada, Britain and France, as well as Cuba – which he contrasts with the alleged failures of the US system. Moore said of the NHS: “It doesn’t mean it doesn’t have flaws but it’s a hell of a lot better than what we have.”

Speaking as one who has been treated in both the UK and US health systems I have to say I prefer what we have in the States. Is it perfect? Far from it. But don't believe it when you hear that many millions of US residents have no access to health care. Or that insurance or excellent treatment is beyond the financial reach of the majority of people. That's simply not the case.

We paid for private insurance in the UK as well - thru our employer (just like in the States) - and it wasn't cheap, either. Thank goodness it was available when I needed it. The private service was miles ahead of the NHS. When I went the NHS route I had to queue up in the street to gain access to a shabby, understaffed clinic. And this was in Kensington, too. Goodness knows what goes on elsewhere in the capital.

I've read too many NHS horror stories in these pages to believe that Mr. Guiliani's assertions - while somewhat wide of the mark - aren't grounded in truth.

DJ, West Chester, USA/PA

You also have to remember that when you add up all the costs of the U.S. healthcare system including private health insurance, Medicare, Medicaid, public hospital funding etc., the U.S. pays twice as much as the U.K. The healthcare system in the U.S. is clearly not twice as good as NHS. Put all that money towards even a moderately competent system and the U.S. should have the best healthcare in the world by far.

Mike, Des Moines, IA

The US is only ahead for those patients with top level health insurance. These patients like Mr Guiliani recieve all treatments regardless of cost because the health insurance companies sell the poor substandard policies to subsidise the costs of treating the rich! A ridiculous system which leaves millions of people without even basic medical care. That really is a system gone horribly wrong.

When medications are changed for a cheaper, there will always be a minority who develop side effects. However all these patients will be offered an alternative. I emplore people to remember that there is a wider picture, and that by saving x million pounds on statins, the NHS will have more money to spend on screening for and treatment of cancer. Such a change would perhaps bring our 5-yr prostrate Ca survival rate for our whole population, to the same level as that of the upper classes of America. All that is required is a little less selfishnes when we consider our own health care.

Peter Bamford, Liverpool, England

I believe that Mr Giuliani has made valid point, his statistics may be out of date but his point is still valid.
In many areas of health care, the US is way ahead of of the UK!

I can give you many examples, the use of CHART Radiotherapy increases survival rates in patients with Lung Cancer, its been around for years but we don't use it that much because its labour intensive. Thermal Therapy for breast cancer was done at the Hammersmith, we closed it down!

We are moving backwards. I was on Lipitor for high cholesterol but was switched to a cheaper drug, I immediately got side effects and research has shown that patients have had heart attacks and strokes as a result of being switched to CHEAP statins. If you start to get violent headaches because of a tumour, it can weeks to get an MRI scan on the NHS, in the US it can be done within hours and as a result the American survives but the Brit ends up on a slab!

Let 's get real, something as gone horribly wrong with our system.

Graham Wharton, St. Albans, uk

Seeing a quote from Michael Moore is all that's needed to show the lack of credibility of your assertions. Moore's film has been proven factually innacurate........He doesn't help your point of view at all.

Scott Wilhelm, Des Plaines, Il. 60018, U.S.A.

Of course Mr Giuliani can have a better chance of survival. Because he can afford all the diagnostic tests and the treatment. Has he asked himself what the survual rate is in the large population of his own country who cannot afford either the diagnostic tests or the treatment? The UK and Eurpoean survival rates may not quite match those who can afford the cost of the disease in the US, but at least everyone has a roughly equal chance of being diagnosed and treated. Is Mrs Clinton a rabid left wing soclialist, the 'red Hillary' of America for believing that the poor should be given the same chance of surviving cancer as Mr Giuilani? I think the Republican canidate doth protest too much. After all, cancer is well known for not having any polictal bias so maybe he's on to loser anyway. Taking healthcare out of politics would be a better debating point for him, but then the healtcare insurance business lobby is far more powerful than the 200 million voters, no changee there then.

S Griffin, Bolton, Lancashire, UK

There are many sides to the story. Hundreds of US citizens go oversea for medical care, ie, surgery and cancer treatment, that costs a fraction of what they would pay here. I would consider this for myself.

P Rivera, Greenville, SC

Now that 4000 British junior doctors have been made unemployed, as well as the thousands of nurses and other health care professionals who were also thrown to the skip, I am very eager to see how our Alan Johnson, the Health Secretary, will be "prompted" to say about the effects of this policy of discarding our doctors and health professional to save money when our statistics on the treatment of prostate cancer and other curable diseases suffer and drop to below the 44% level soon as a result! Rude Giuliani was not too far out, watch my lips! ... :-)

Sam, London, UK

The NHS provides free to all service, with no middle men trying to get a cut of the money spent or trying to influence whether you get the best treatment or not.

In the USA they have some wonderful hospitals with truly cutting-edge procedures available - if, like Rudy Giuliani, you can afford it. But if you can't, or if your insurance company finds some flaw in the small print of your policy and refuses to pay - you are completely abandoned by the American Health 'Service'. The irony is that the average American spends more on health than the average Brit or European, yet has less access to it. Giuliani is doing what he's told by his campaign contributors.

There are similar top class hospitals in the UK that are privately run, again, if you can afford it. But there are also many that are free to all.

The NHS is far from perfect but because it is government run there are no insurance companies or health companies able to get their hands on NHS money, though God knows they are trying.

Adrian Mc Elholm, Belfast, N Ireland

I'll say it again the health care in the US is appalling. Yes if I was Gulliani with untold amounts of money then I would be OK but I have not. I am now approaching medicare age and the ruthless way the insurance companies are piling my mail with rubish is frightening. They want me to pay at least $350 per month just for paying the 20% medicare doesn't pay and that is just for me if I add my wife then it is another $350 per month. I say get the drug and insurance companies out of my life.

Mike Brannigan, Avon Lake, OH USA

It is now clear Giuliani's statistics are wrong.

But what I'd like to know is this:

What is the survival rate for those US citizens that are denied healthcare due to being too poor? Still 82%?

Do his figures include everyone in the US? Even those that are denied health care?

In the UK everyone gets healthcare so our figures include absolutely everyone in the country - so about 75% of all people that get prostate cancer survive after 5 years.

If so then it is clear how to make statistics look better - remove the poor from the figures!

Lies, Damn Lies and Statistics?

Andrew Saxon, Sheffield, South Yorkshire

I will repeat what I've said before, when Giuliani has misused his numbers on the subject of NHS (and he did it to Gordon Brown's face, as I remember hearing, which is no way to treat your host) - it's sick to begin with to try to make money off of human illness. I see a lot of criticism on this page of government healthcare that is coming from Americans. Interesting. I know you believe in your "freedom" of healthcare choice just for the sake of believing in freedom, but have some common sense for God's sake. What purpose does the health insurance company "middleman" have in our current arrangement, but to try to pocket as much money as possible (especially by not paying out claims), money that could better be used on medical equipment and treatment...? We seem to confuse ideology in this debate with efficiency and a few glaring economic truths.

Sarah Law, New York,, US

I find it interesting that a Labour politician is complaining about Americanâ€™s slurring the NHS. For years Labour and the unions have used the lie that healthcare in the US is means tested to the extent that people who donâ€™t have insurance donâ€™t get treated, as a reason not to reform the currently dysfunctional NHS. A system where over 100 people are allowed to be killed by a callous, inefficient and lazy work force who tell them to wallow in their own faeces is broken, not fit for purpose. Who cares if it is indeed free at the point of service if you donâ€™t emerge from the other side and are unable to enjoy the economic benefits.

The waiting list numbers are soviet farm tractor mathematics and have no basis in reality. People are dying while we as a nation have our heads firmly planted in the sand. If I become ill, please send me to France.

Robert Anderson, Oxford, UK

Rudy's right. The 5-year survival rate for prostate cancer is better in the United States. His figures are simply outdated. Lancet Oncology magazine reported last month a 99.3% 5-year survival rate for prostate cancer in the United States. Your man's 74.4% survival rate means he would have a 1-in-4 chance of dying under the NHS. Early detection. You might try that

Don Surber, Poca, WV, USA

Look, here's the deal: if one chooses to go down the road of government health care then the result will always and everywhere be that the cost is going to be too high for those who pay it and the provision of service will be inadequate to those who demand it.

The rub is that the ones who pay for it and demand it are the same people....

The government doesn't tell one where to live, what kind of a car to drive, what kind of a TV to watch or anything else (yet) so what business do they have thinking they can do any better at providing quality health care than they do at providing quality education?

It's a pig in a poke and I don't want any part of it.

The siren song is that health care will be "free."

Well, it won't be free. Nothing in life is free....

Jim, Milwaukee, USA

The NHS has proved itself incapable of provide excellent healthcare in the 21st century. Just how have we got to a point where people are left to soil themselves in their hostpital beds and then die from deadly infections? It deserves nothing but contempt. The French, Dutch and Germans would not stand for such low standards.

Jason Dack, Woking, Surrey