#1
Percentage of men and women who survived a cancer five years after diagnosis:
U.S. 65%
England 46%
Canada 42%
We begin our journey into the world of unverified cancer statistics with the claim that the US has higher cancer survival rates 5 years after diagnosis which is a wonderful set of numbers. However, there are no sources (providing evidence for ones claims is quite annoying, right?) and what these numbers fail to consider are important issues such as the percentage of the population who receive an accurate received diagnosis, whether 5 years after diagnosis the patient was living cancer free or still subject to chemo-therapy treatment or the total number of incidents. Wouldn’t a reasonable person much rather live in England or Canada if the incidence incidences of cancer in these countries were one tenth of what they are in the USA?
http://www.statistics.gov.uk/pdfdir/can0410.pdf (notice the “.GOV” in the URL, that **** is official!!!)
Counting 109,747 incidents per year and tracking them for 5 years their average survival rate came out to be around 58% (63,585 patients still alive after 5 years). Notice how that rate is a full 12% higher than the rate quoted by the author of the prior email? That’s so far beyond any measurement error as to defy credulity.
But maybe they made the same mistake with 5 year survival rates for US cancer patients. Let’s have a look!
http://seer.cancer.gov/statfacts/html/all.html#survival ) “the overall 5-year relative survival for 1999-2006 from 17 SEER geographic areas was 66.0%. Five-year relative survival by race and sex was: 66.8% for white men; 67.0% for white women; 60.6% for black men; 54.9% for black women”. It needs to be noted here that the 17 SEER geographic areas only cover about 40% of the US population, but we’ll just let that stand since Joe, the author of the email, understated the SEER rate by a full percent.
http://www.cancer.ca/Canada-wide/Abo...spx?sc_lang=en ) “62% of people are expected to survive for 5 years after their cancer diagnosis”.
So let’s compare our unverified sources to the verified sources:
Country 5 year survival (without sources) 5 year survival (with sources provided)
United States of America 65% 66%
United Kingdom 46% 58%
Canada 42% 62%
On average, our un-sourced claims were off by only about 11% from official statistics. Clearly that’s an acceptable margin of error for people who try to form a political opinion. Joseph Goebbels would approve.
Lastly, before moving on to the next point let’s take a look at this “5 year survival” rate and examine what it really tells us and what it’s limitations are. Generally, 5 year survival statistics are more useful as a tool to determine the standard of care for aggressive diseases that have a shorter life expectancy following diagnosis (lung cancer for example) than diseases with a longer life expectancy following diagnosis (colon cancer).
So, the above statistics, in order to paint a fair picture, really should be broken down into sub-types of cancer since if lung cancer rates in the UK for some reason are disproportionately higher than in Canada and the USA that might well account for the difference in 5 year survival rates.
#2
Percentage of patients diagnosed with diabetes who received treatment within six months:
U.S. 93%
England 15%
Canada 43%
Now, let’s move onto the next claim. The numbers above would like the reader to believe that it is far better to be a diabetes patient in the USA than in Canada or England. Sadly, it is impossible to verify the claims regarding the percentages of patients receiving treatment within 6 months as these statistics are nowhere to be found.
However, accepting these numbers at face value, the question the reader should ask is why we ought to care if the patient receives treatment within such a timeframe. Diabetes is not an aggressive disease like malaria so we are left to wonder why a six month treatment window is of such relevance.
Looking for some authorities on the subject, the Diabetes Quality Improvement Project of the International Diabetes Federation, when discussing factors on the quality of care for diabetics, does not reference any such time frames being of vital importance. In fact, they suggest measuring standards of care for diabetics as follows:
- Process of Care;
o Annual HbA1c testing
o Annual LDL cholesterol testing
o Annual screening for nephropathy
o Annual eye examination
- Proximal outcomes:
o HbA1c control
o LDL cholesterol control
- Distal outcomes:
o Lower-extremity amputation rates
o Kidney disease in persons with diabetes
o Cardiovascular mortality in people with diabetes.
http://www.diabetesatlas.org/content...l-quality-care )
Notice how in that list there is not one mention to treatment being received within 6 months. So how vital of a statistic can a six month treatment time-frame really be if the IDF doesn’t consider it worth including in their list of Healthcare quality indicators for diabetes?
Further, the reader is also left to wonder what time-frame the diabetics in the UK and Canada will receive their treatments in? Is it 9 months or 2 years? If the former were the case then that would hardly be something worth a raised eyebrow over. If the latter were the case that could be disastrous. Lastly, we are also not told what the rate of diagnosis is. Are only 10% of diabetics diagnosed in a timely manner in the USA compared to Canada and England? Then these statistics make the USA look much better than it actually is while if the rate of diagnosis is equivalent a different picture emerges.
So rather than oracle about further, let’s compare a statistic for which verifiable data is available to measure the quality of care for diabetics in these countries. Let’s look at mortality rates by country for diabetics. Because what better measure to determine quality of care than to see if the care can keep patients from dying!
http://www.phac-aspc.gc.ca/ccdpc-cpc..._DM_RR_Age.csv ).
Next, let’s get an idea of how many diabetics there are in each of these countries. Based on 2000 data and 2030 projections we can get the following numbers:
- USA: 20,644,333
- UK: 2,005,800
- Canada: 2,313,400
http://www.who.int/diabetes/facts/wo.../en/index.html extrapolated based on 2000-2030 projections)
These numbers together with the countries respective populations give us:
- a mortality rate of 1.37% for diabetics in Canada and a diabetes rate of 5.87% among Canadians;
- a mortality rate of 0.28% for diabetics in the UK and a diabetes rate of 2.84% among the Brits, Scotts and Welsh;
- a mortality rate of 0.35% for diabetics in the USA and a diabetes rate of 5.71% among Americans.
This provides quite a strong contrast to the numbers above which would have us believe that being a diabetic in the UK is tantamount to a death sentence on account of treatment not being available in a timely manner.
As a kicker, let’s also take a look at amputation rates among diabetics for these three countries, because short of dying that sounds like the next best thing to want to prevent as a diabetic. For this issue we find:
- Canada 0.51% amputation rate per year for diabetics.
- USA 0.41% amputation rate per year for diabetics.
- United Kingdom 0.26% amputation rate per year for diabetics.
http://www3.interscience.wiley.com/j...16430/abstract )
So let’s recapitulate. The UK is about as good as the US as preventing diabetics from dying and better than the US at preventing diabetics from having their limbs chopped off in spite of the egregious delay in getting diabetics their treatment. Canada still sucks, but not as badly as we would’ve otherwise been led to believe.
#3
Percentage of seniors needing hip replacement who received it within six months:
U.S. 90%
England 15%
Canada 43%
http://answers.google.com/answers/th...id/775660.html )
How we are supposed to verify that patients receive an elective surgery within 6 months of needing it I am not sure. My uncle needs a hip replacement badly for 10 years now but he hasn’t elected to go in for the procedure so is he counted and dragging down the average?
Next, let’s take a look at the number of actual replacement surgeries these countries engage in on a year to year basis. Looking at this data we get:
- Canada: 23,000 surgeries per year or one for every 1,487 people per year.
- UK: 43,500 surgeries per year or one for every 1,426 people per year.
- USA: 120,000 surgeries per year or one for every 2,583 people per year.
http://www.cbc.ca/health/story/2010/...lacements.html )
What the above implies is that per capita the US rate of hip replacement surgeries is actually much lower, possibly due to the fact that many people who need it simply can’t afford it on account of the cost being 3-4 times what they are in Canada or the UK. Now if we assume that the rate of osteoarthritis per capita is equivalent for these three countries then we’d be left to conclude that hip replacement surgery is actually less readily available to patients who need it in the USA than in Canada or the UK. So let’s look for the data:
http://www.cdc.gov/arthritis/data_st...ated_stats.htm )
http://www.cks.nhs.uk/osteoarthritis...ion/prevalence )
http://www.statcan.gc.ca/pub/82-619-...053549-eng.htm ) – 3,419,800 extrapolated patient population
So using these numbers we can now determine the number of hip replacement surgeries per osteoarthritis patient. Of course it needs to be noted at this point that osteoarthritis can also necessitate knee joint replacement surgery, but for the purpose of this review we will focus only on hip replacement.
- USA: 120,000 / 27,000,000 = 0.44 surgeries / patient per year
- UK: 43,500 / 8,500,000 = 0.51 surgeries / patient per year
- Canada: 23,000 / 0.67 surgeries / patient per year
This suggests that patients in Canada and the UK are actually more likely to get a hip replacement in a given year that patients in the US, which is quite contradictory to the suggestion that 90% of US hip replacement requiring patients receive one within 6 months.
#4
Percentage referred to a medical specialist who see one within one month:
U.S. 77%
England 40%
Canada 43%
http://www.nationmaster.com/graph/he...r-1-000-people referencing the World Bank’s World Development indicator database):
- United States: 2.3 physicians per 1,000 people.
- United Kingdom: 2.2 per 1,000 people.
- Canada: 2.1 per 1,000 people.
Please note that there is only a marginal difference in the per capita number of physicians comparing these three countries (Germany & France, two other bastions of “socialized medicine” by contrast have around 3.4 physicians per 1,000 people). So, we should ask: “How it is that the number of physicians per 1,000 people is almost equivalent amongst these three countries and yet supposedly specialists are “harder” to come by in Canada and England?”
Also, do we as patients really care if we see a specialist right away if our regular physician can see us at once? Let’s assume for a moment that in the U.S. we have a hypothetical 2 month waiting list to see a physician but only 3 week waiting list to see a specialist while in the UK and Canada a physician can be seen in 2 weeks and a specialist in 6 weeks. Then the US patient would be in front of a specialist after 11 weeks and the British / Canadian patient would be in front a specialist after 8 weeks.
The bottom line – don’t let misleading statistics fool you!
#5
Number of MRI scanners (a prime diagnostic tool) per million people:
U.S. 71
England 14
Canada 18
MRI scanners are great. But the data given above is just flat out wrong. Based on OECD data (Source:http://www.irdes.fr/EcoSante/DownLoa...uestedData.xls) the number of machines per million people actually breaks down as follows:
- USA: 25.9
- UK: 5.6
- Canada: 6.7
The above numbers are based on 2007 data but it is unlikely that in the last 3 years either the UK or Canada purchased enough machines to bridge the gap. What is really sad about this particular issue is that whoever falsified these statistics in this email could not even be bothered to get accurate statistics to support his claims regarding the notion of supremacy of the US medical system.
#6
Percentage of seniors (65+), with low income, who say they are in "excellent health":
U.S. 12%
England 2%
Canada 6%
Where is this survey? What’s the sample size that was used? And could it be that the discrepancy exists maybe because seniors in the UK and Canada have more regular check-ups or access to a better diagnostic medicine infrastructure alerting them to problems sooner? I’m not sure what exactly this is supposed to tell us. Using self-identification in lieu of actual hard facts seems like a bad idea to determine quality of a nation’s health care system.
So in keeping with the pattern of this rebuttal let’s get some actual facts in here about the health of seniors for these three countries. Life expectancy for people 65+ seems like a great way to measure that and the good old OECD was kind enough to provide this data for the three referenced countries.
- USA: Males; 17.1 years / Females: 19.8 years
- UK: Males; 17.6 years / Females: 20.2 years
- Canada: Males; 18.1 years / Females: 21.3 years
In other words, while seniors in the USA may self-identify as in “excellent health” the actual OECD data (Source:http://www.irdes.fr/EcoSante/DownLoa...uestedData.xls) suggests that citizens 65+ in the UK and Canada are in fact in better health as measured by their life expectancy
