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Gratzer later defended the claim: "The mayor is right." Gratzer later defended the claim: "The mayor is right."


<blockquote>Krugman and others have compared statistical ]. My 44% figure, replicated by ] ] and ], looks at a snapshot in time, based on decade-old ] data; Krugman's 74% is a ] from ] ] today.<ref>"Rudy Is Right In Data Duel About Cancer." ''Investor's Business Daily''. </ref></blockquote> Gratzer appears to be referring to a book published in 2004 by Goodman and others '']''. Reporting that 57 percent of men in the UK who were diagnosed with prostate cancer died from it whereas in the United States only 19 percent of those diagnosed with prostate cancer died from it<ref>{{cite book |last=Goodman |first=John C. |coauthors=Gerald L. Musgrave and Devon M. Herrick |title=''Lives at Risk: Single-Payer National Health Insurance Around the World'' |year=2004 |publisher=Rowman & Littlefield Publishers |pages=73 |isbn=0742541525}}</ref> they too had used the data to draw conclusions about the relative effectiveness of medical practice in the U.S. compared to the UK. Gratzer appears to have simpliy followed the lead taken by Goodman et al. but failed to recognize that comparing statistics in this way could be misleading. <blockquote>Krugman and others have compared statistical ]. My 44% figure, replicated by ] ] and ], looks at a snapshot in time, based on decade-old ] data; Krugman's 74% is a ] from ] ] today.<ref>"Rudy Is Right In Data Duel About Cancer." ''Investor's Business Daily''. </ref></blockquote>

The disputed statistic had also appeared in a journal, ] in which Goodman had contributed to.<ref>{{cite journal |last=Himmelstein, M.D. |first=David U. |coauthors=Steffie Woolhandler, M.D., M.P.H; John C. Goodman, Ph.D.; and Robert M. Sade, M.D. |year=2007 |month=November |title="Our Health Care System at the Crossroads: Single Payer or Market Reform?" |journal=The Annals of Thoracic Surgery |volume=84 |issue=5 |pages=1435–1446 |doi=10.1016/j.athoracsur.2007.07.082}}</ref>


FactCheck.org disputed Gratzer's response: FactCheck.org disputed Gratzer's response:

Revision as of 19:36, 14 July 2009

David George Gratzer (born September 5, 1974 in Winnipeg, Manitoba) is a Canadian psychiatrist, conservative columnist, author, and critic of the Canadian health care system. He is a practicing psychiatrist in Toronto and senior fellow at the Manhattan Institute, and as advisor to Rudy Giuliani in his 2008 presidential campaign he was the source for a disputed statistic that led to criticism of Giuliani by a medical statistician, a British politician and by the media in both the United States and Europe.

Background

Gratzer holds a B.Sc. and an M.D. from the University of Manitoba. He was appointed to the University of Manitoba Board of Governors for four successive years from 1994–1998.

Gratzer first book Code Blue: Reviving Canada's Health Care System (1999), which was awarded the Donner Prize, was about problems with the Canadian health care system and his proposed solution--medical savings accounts. .

His book The Cure: How Capitalism Can Save American Health Care (2006), is his view of the problems with the United States health care system and his proposed solutions. The book argues for meaningful choice and competition in health care.

He has been a regular contributor to Conrad Black's National Post, the London Free Press and the Halifax Sunday Herald, and has written wrote columns on health care in several major newspapers and magazines, including the Toronto Star, Conrad Black's Ottawa Citizen and the Calgary Herald

In his youth Gratzer said that he was unapologetically conservative and that minimum wage earners are not underpaid but underproductive. He won first prize in the 1999–2000 Felix Morley Journalism Competition of the libertarian Institute for Humane Studies at George Mason University for his newspaper columns.

Gratzer was the editor of Better Medicine: Reforming Canadian Health Care, a book of essays which concluded with an essay by Gratzer titled The ABCs of HSAs. He has supported the concept of Medical Savings Accounts. with: a commentary by Gratzer in favor of MSAs as a counterpoint to a commentary opposing MSAs, a peer-reviewed research article opposing MSAs, a peer-reviewed review article opposing MSAs, and a book review by a University of Toronto medical student of Gratzer's Better Medicine: Reforming Canadian Health Care.

In September 2002, Gratzer was one of 25 Canadians under age 30 featured in a Maclean's "Leaders of Tomorrow" cover story.

In May 2006, Gratzer became board-certified in psychiatry.

Allegations regarding the misuse of statistics

On several occasions, critics have accused Gratzer of misusing medical statistics.

As a student, Gratzer became involved in a minor public dispute about the use of statistics, this time by another writer. Responding to an article he had read in in the Canadian Medical Association Journal (CMAJ), Gratzer claimed that the article had misused statistics to justify the large reserves held by the Canadian Medical Protective Association (CMPA). The author disputed that his use of statistics was "deceptive" or "provide skewed data" or "distort the presentation" as Gratzer had claimed..

Gratzer's work as an adviser to Rudolph Giuliani came to national and international media attention when the politician released a radio ad in New Hampshire that claimed, "My chance of surviving prostate cancer—and thank God I was cured of it—in the United States? 82%. My chances of surviving prostate cancer in England? Only 44%, under socialized medicine."

A City Journal article by Gratzer was the source for the claim. In that piece Gratzer said, "...if we measure a health care system by how well it serves its sick citizens, American medicine excels. Five-year cancer survival rates bear this out.... The survival rate for prostate cancer is 81.2% here, yet 61.7% in France and down to 44.3% in England — a striking variation."

This claim was contested by the UK Health Secretary. Several American news outlets investigated the matter after the advertisement was released. According to articles published by the Annenberg Public Policy Center's FactCheck.org, PolitiFact.com (a service of the St. Petersburg Times and Congressional Quarterly), The New York Times, The Washington Post, and The Times, Giuliani's statistics were "false" and "innumerate." PolitiFact.com said, "Rudy Giuliani used cancer statistics from a conservative journal to compare the U.S. and the U.K. but the stats are wrong and the underlying comparison is faulty at best."

"I find it personally distasteful to have Mr. Giuliani exploiting cancer patients to make a political statement," said Andrew Vickers, associate attending research methodologist at New York’s Memorial Sloan-Kettering Cancer Center. "As a prominent individual who is a cancer survivor, I would think it’s more incumbent on him to be accurate in the way he uses cancer statistics," he said.

After the advertisement aired, the group which Gratzer cited as his source in the City Journal article, The Commonwealth Fund, issued a statement stating that the five-year survival data cited in the City Journal article could not be calculated from the statistics in that report.

The Washington Post said: "The former New York mayor has had personal experience battling prostate cancer, but he's confused about the stats, according to several experts we consulted."

"When you introduce screening and early detection into the equation, the survival statistics become meaningless," said Howard Parnes, chief of the Prostate Cancer Research Group at the National Cancer Institute. You are identifying many people who would not otherwise be diagnosed." "You can't say that it's better to have prostate cancer here or in some other country," with a developed health care system, said Brantley Thrasher, chairman of the Department of Urology at the University of Kansas, who also serves as a spokesman for the American Urological Association.

New York Times columnist Paul Krugman said that Giuliani's statistics were "just wrong" and "scare tactics."

Gratzer later defended the claim: "The mayor is right."

Krugman and others have compared statistical apples to oranges. My 44% figure, replicated by economist John Goodman and others, looks at a snapshot in time, based on decade-old OECD data; Krugman's 74% is a five-year relative survival rate from government sources today.

FactCheck.org disputed Gratzer's response:

Marie Diener-West, professor of biostatistics at Johns Hopkins Bloomberg School of Public Health, said Gratzer's attempts to calculate cancer survival rates were "inappropriate" and "very misleading." ...Peter Albertsen, professor and chief of urology at the University of Connecticut Health Center, called Gratzer's calculations a "very dangerous thing to do" and "complete nonsense."

In December 2007, The New York Times public editor wrote, "Fact-checking the candidates has long been an important part of campaign coverage," but that:

To be most useful, fact-checking needs to be timely. In October, Giuliani incorrectly claimed that the prostate cancer survival rate in England, under the "socialized medicine" he falsely implied Democrats favor, was only 44 percent, compared with 82 percent in the United States. The Times initially said the number for England was "in dispute," though it provided all the necessary information for a reader to conclude it was wrong. It wasn’t until Friday that the newspaper declared the statistic a 'false statement.'

The Washington Post awarded Giuliani its "Four Pinocchios" rating (reserved for "whoppers") for his radio advertisement's claims and named it one of "the top ten fibs of the year."

"You would get an F in epidemiology at Johns Hopkins if you did that calculation," said Johns Hopkins professor Gerard Anderson, whose 2000 study "Multinational Comparisons of Health Systems Data" has been cited by Gratzer as a source for his statistics.... Five-year prostate cancer survival rates are higher in the United States than in Britain but, according to Howard Parnes of the National Cancer Institute, this is largely a statistical illusion.... Both Anderson and Parnes say that it is impossible, on the basis of the available data, to conclude that Americans have a significantly better chance of surviving prostate cancer than Britons.

More recently, in a U.S. Congressional hearing on the issue of single-payer health care, Dr. Gratzer and Congressman Dennis Kucinich clashed over statistics:

Kucinich: “Fifty million Americans can’t get any healthcare at all. Now, Dr. Gratzer, you’ve tried to make the case for rationing in Canada worse than it is in the U.S. Do you know what Statistics Canada, the analogue to the U.S. census, says the median wait time is across Canada for elective surgery?” Gratzer: “Why don’t you inform us, sir?” Kucinich: “It’s four weeks. And what does Statistics Canada say the median wait time for diagnostic imaging like MRIs is?” Gratzer: “I can tell you the Ontario government recently looked at that for . . .” Kucinich interrupts: “It’s three weeks.” Gratzer: “. . . certain cancers. It was six months.” Kucinich: “It’s three weeks.” Kucinich: “How many medical bankruptcies are there in Canada?” Gratzer: “It depends how you define a medical bankruptcy.” Kucinich, supplying the answer: “None or very few.”

At one point, Gratzer stopped answering questions, petulantly slouched back in his chair, and said he was being led up a garden path by the questioning. Kucinich told him, "There is another side to the picture that you don't seem to be aware of even though you claim to be an expert on Canada".

Selected works

  • The Audacity of Distortion, City Journal, 10-15-08
  • McCain Is the Real Health-Care Reformer. Wall Street Journal, 10-07-08
  • American Cancer Care Beats the Rest. Wall Street Journal, 07-22-08
  • A GOP Prescription. National Review Online, 06-19-08
  • Bad Medicine. National Review Online. 06-17-08
  • Don't believe the health hype; Enemies of Canadian health reform endlessly fret over the 'Americanization' of our medical system. National Post, 04-30-08
  • Time to Rechristen SCHIP, City Journal, 02-08
  • UK's Bad Medicine: Why US Has Better Odds vs. Cancer. New York Post, 11-05-07
  • Malignant Rumor, City Journal, 10-31-07
  • The Ugly Truth About Canadian Health Care, City Journal, 07-30-07
  • Simplisticko, City Journal, 07-30-07
  • A Prescription for SiCKO. National Review Online, 07-10-07
  • Who's Really 'Sicko'? Wall Street Journal, 06-28-07
  • Unhealthy Policies. Weekly Standard, 06-18-07
  • Mandates Are Not the Answer, City Journal, 03-31-08
  • A Health-Care Bargain. Wall Street Journal. 01-31-07
  • First, Do No Harm. Forbes Magazine, 02-12-07
  • Health and Taxes. Weekly Standard, 02-05-07 (This article also appears on RealClearPolitics.com, 1-29-07)
  • A Tale of Two Anniversaries: The Discovery of Alzheimer's and the Founding of the FDA. Medical Progress Today, 7-5-06
  • Putting Patients First. The Weekly Standard, 2-6-06
  • Health of the Union. Wall Street Journal, 1-26-06
  • Congress Got Something Right! The Wall Street Journal, 12-7-05
  • The "Choo Choo Man" Party On the Outs. National Review, 11-28-05
  • Socialized Medicine on Life Support. The Weekly Standard, 6-27-05
  • The Return of HillaryCare. The Weekly Standard, 5-23-05
  • What ails health care. The Public Interest, Spring 2005
  • Medicaid needs Surgery. The Weekly Standard, 2-14-05
  • Simple, but Effective. Wall Street Journal, 1-25-05
  • HSA Man Vs. Healthzilla. Wall Street Journal, 10-12-04
  • From HillaryCare to KerryCare. The Weekly Standard, 5-24-04
  • Vermont's Badly Managed Care Dean's health care record as governor is nothing to brag about. The Weekly Standard, 1-12-04
  • How Not to Handle Health Care. Wall Street Journal, 10-1-03
  • Miller’s Centrist Tale. National Review, 9-29-03

Books

  • Gratzer, David (1999). Code Blue: Reviving Canada's Health Care System. Toronto: ECW Press. ISBN 1550223933. {{cite book}}: Unknown parameter |month= ignored (help)
  • Gratzer, David (ed.) (2002). Better Medicine: Reforming Canadian Health Care. Toronto: ECW Press. ISBN 1550225057. {{cite book}}: |author= has generic name (help); Unknown parameter |month= ignored (help)
  • Gratzer, David (2006). The Cure: How Capitalism Can Save American Health Care. New York: Encounter Books. ISBN 1594031533. {{cite book}}: Unknown parameter |month= ignored (help) Paperback edition (May 2008) ISBN 159403219X, ISBN 978-1594032196.

Testimonies

References

  1. ^ Lumley, Elizabeth (ed.) (2007). Canadian who's who (2007 ed., v. 42 ed.). Toronto: University of Toronto Press. p. 514. ISSN 0068-9963. {{cite book}}: |author= has generic name (help)
  2. Tertius (2000). "Jumping the Donner Foundation's gun". The Globe and Mail: R2. {{cite journal}}: Unknown parameter |month= ignored (help)
  3. Square D (2000). "Fourth-year medical student takes Donner Prize" (PDF). CMAJ. 162: 1863. {{cite journal}}: Unknown parameter |issues= ignored (help); Unknown parameter |month= ignored (help)
  4. Gratzer, David (1997). "Being a young conservative is nothing to apologize for". The Gazette: A9. {{cite journal}}: Unknown parameter |month= ignored (help)
  5. Gratzer, David (1999). "Raising the minimum wage hurts the poor it hopes to help: Cheap compassion comes with a significant cost". National Post: D08. {{cite journal}}: Unknown parameter |month= ignored (help)
  6. "Highlights of this issue : Medical Savings Accounts". CMAJ. 167 (2): 117. 2002. {{cite journal}}: Unknown parameter |day= ignored (help); Unknown parameter |issues= ignored (help); Unknown parameter |month= ignored (help)
  7. Gratzer D (2002). "It's time to consider Medical Savings Accounts" (PDF). CMAJ. 167: 151–2. PMID 12160121. {{cite journal}}: Unknown parameter |issues= ignored (help); Unknown parameter |month= ignored (help)
  8. Hurley J (2002). "Medical Savings Accounts will not advance Canadian health care objectives" (PDF). CMAJ. 167: 152–3. PMID 12160122. {{cite journal}}: Unknown parameter |issues= ignored (help); Unknown parameter |month= ignored (help)
  9. Forget EL, Deber R, Roos LL (2002). "Medical Savings Accounts: will they reduce costs?" (PDF). CMAJ. 167: 143–7. PMID 12160120. {{cite journal}}: Unknown parameter |issues= ignored (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  10. Shortt SE (2002). "Medical Savings Accounts in publicly funded health care systems: enthusiasm versus evidence" (PDF). CMAJ. 167: 159–62. PMID 12160125. {{cite journal}}: Unknown parameter |issues= ignored (help); Unknown parameter |month= ignored (help)
  11. Dhalla IA (2002). "On policy and cherries" (PDF). CMAJ. 167 (2): 173–4. {{cite journal}}: Unknown parameter |month= ignored (help)
  12. Aubin B; et al. (2002). "Leaders of tomorrow: 25 Canadians under age 30". Maclean's. 115 (36): 20–30. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)
  13. "ABPN Congratulations" (PDF). American Board of Psychiatry and Neurology. May 14, 2006.
  14. Korcok M (1996). "CMPA not alone in pursuing huge reserves, CMAJ survey of US firms reveals". CMAJ. 154: 1891–4. PMID 8653650. {{cite journal}}: Unknown parameter |issues= ignored (help); Unknown parameter |month= ignored (help)
  15. Gratzer D (1996). "Drawing comparisons and conclusions between Canadian and US malpractice insurance". CMAJ. 155: 1389–90. PMID 8943923. {{cite journal}}: Unknown parameter |issues= ignored (help); Unknown parameter |month= ignored (help)
  16. "Chances". Rudy Giuliani Radio Advertisement. 2007-10-29.
  17. IBDeditorials.com: Editorials, Political Cartoons, and Polls from Investor's Business Daily - A Canadian Doctor Describes How Socialized Medicine Doesn't Work
  18. Rudy Giuliani uses the NHS as ‘political football’ to give Hillary Clinton a kicking - Times Online
  19. "A Bogus Cancer Statistic". FactCheck.org. 2007-10-30.
  20. ^ "Bogus Cancer Stats, Again". FactCheck.org. 2007-11-08.
  21. "Giuliani's dose of fear". St. Petersburg Times. 2007-11-03. {{cite web}}: Italic or bold markup not allowed in: |publisher= (help)
  22. ^ "A cancer ad gone wrong for Rudy". PolitiFact.com. 2007-10-31.
  23. ^ "The Public Editor. Fact and Fiction on the Campaign Trail". The New York Times. 2007-12-02. {{cite web}}: Italic or bold markup not allowed in: |publisher= (help)
  24. ^ "The 2007 Pinocchio Awards. The top ten fibs of the past year". The Washington Post. 2007-12-31. {{cite web}}: Italic or bold markup not allowed in: |publisher= (help)
  25. "The worst junk stats of 2007". The Times. 2007-12-22. {{cite web}}: Italic or bold markup not allowed in: |publisher= (help)
  27. "Statement by The Commonwealth Fund on Use of Prostate Cancer Statistics". The Commonwealth Fund. 2007-10-30.
  28. "Rudy Wrong On Cancer Survival Chances". The Washington Post. 2007-10-30.
  29. Krugman, Paul (2007). "Prostates and Prejudices". The New York Times: A.27. {{cite journal}}: Unknown parameter |month= ignored (help)
  30. "Rudy Is Right In Data Duel About Cancer." Investor's Business Daily.
  31. "The Pinocchio Test". The Washington Post. 2007-09-01.
  32. Anderson, Gerard F.; Hussey, Peter S. (2000). "Multinational camparisons of health systems data, 2000" (PDF). The Commonwealth Fund. {{cite web}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  33. "Four Pinocchios for Recidivist Rudy". The Washington Post. 2007-11-07.
  34. http://www.youtube.com/watch?v=DII7v8yeRjs Dennis Kucinich and David Gratzer clash during a congressional hearing

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