By Ezra
Andrew Sullivan is quite pleased that the US is #1 in cancer survival rates. So am I! Problem is, we don't know what that means. The US has the most aggressive tumor screening in the world. That means we find some tumors earlier, but we also find many tumors that would have been non-lethal, or proven so slow-growing that something else would have killed the individual before the cancer did. In those cases, our treatments are, at best, an enormous waste of money, and at worst, more damaging than the disease. The question is how many otherwise lethal cancers we're curing, not merely how many cancers we're curing (or slowing).
Moreover, simply having the highest survival rates isn't a particularly useful metric of whether we're getting good value for our money. Our 5-year cancer survival rate, according to the study Andrew links, is 62.9%. Italy's is 59%. Italy spends about $2,532 per person. America spends about $6,100. And these numbers, incidentally, are adjusted for purchasing power parity. Then there's the question of who our treatment is best for. Not the poor. Studies show significantly lower mortality rates for the low-income cancer patients in Canada than in the US. Is this all a good deal? Maybe. But Sullivan should explain why we should believe that.
At the end of the day, the question is never American health care: Good or bad. It's whether it can be better. It's whether we get good value for our dollar. It would be absurd if a system that spends twice what anyone else does didn't demonstrate superiority in some areas. The question is why so few, and why by such minor margins (a percent or two, in this case). It baffles me -- genuinely baffles me -- that conservatives seem so intent on defending an obviously bad deal. I don't know if it's a reflexive, for-what-the-left-is-against kind of thing, or whether they're worried about the specter of a single-payer system very few people support, but it leaves them clinging to scraps of evidence, and ignoring vast swaths of the story.
For more on the cancer question, see Jon Cohn's excellent column on the subject.
