YouTube Debate

This report, along with other unbiased election analysis, is available at FactCheck.org.

GOP YouTube Debate Flubs

November 29, 2007

Updated: November 30, 2007

Falsehoods, exaggerations and stumbles

Summary

The CNN/YouTube debate among Republicans lacked any talking snowmen, but we did note a few false and misleading statements by the candidates.

• Romney claimed New York called itself a “sanctuary city” for illegal aliens. It didn’t.
• Giuliani denied New York actually was a “sanctuary city.” But the nonpartisan Congressional Research Service has classified it as such, based on immigrant-friendly policies Giuliani still defends.
• Huckabee claimed he would “abolish the IRS.” He failed to mention that he’d replace it with another big tax bureaucracy.
• Huckabee said he had proposed to make children of illegal aliens eligible for Arkansas scholarships if they “had been in our schools their entire school life.” Actually, the proposal required only three years in Arkansas schools.
• Giuliani was correct on two points: While he was mayor, New York snowfall went down and the Yankees won four World Series titles. He was joking, but his gag should remind citizens that it’s a mistake in logic to give mayors, or governors or presidents, all credit or blame for what happens just because they’re in office at the time.
• Romney, claiming to be a “true suffering” fan of the Red Sox, said the team waited 87 years to win a World Series. They actually waited 86.
  

 

 

 

 

 

Analysis

The Nov. 28 debate, which took place in St. Petersburg, Florida, was hosted by CNN and YouTube.com and moderated by CNN’s Anderson Cooper. The candidates participating were former New York Mayor Rudy Giuliani; former Massachusetts Gov. Mitt Romney; former Tennessee Sen. Fred Thompson; former Arkansas Gov. Mike Huckabee; Sen. John McCain of Arizona; and Reps. Duncan Hunter of California, Ron Paul of Texas and Tom Tancredo of Colorado.

“Sanctuary” Semantics

Romney and Giuliani accused each other of willfully providing “sanctuary” to immigrants who are in the U.S. illegally. Both men exaggerated, though we find their denials are more strained than their accusations.

Cooper: Governor Romney, was New York a sanctuary city?
Romney: Absolutely. Called itself a sanctuary city, and as a matter of fact, when the Welfare Reform Act that President Clinton brought forward said that they were going to end the sanctuary policy of New York City, the mayor brought a suit to maintain its sanctuary city status.

Romney is simply wrong on one point: New York never called itself a “sanctuary city.” We find no instance where it did, and the Romney campaign has been unable to provide one.

However, a 2005 report by the nonpartisan Congressional Research Service (updated in 2006) lists NYC under the general heading of “Sanctuary States and Cities” and says it is among those that follow “sanctuary policies.” It lists the city among 32 that “utilized various mechanisms to ensure that unauthorized aliens who may be present in their jurisdiction illegally are not turned in to federal authorities.” But unlike some other cities on the CRS list, New York has never “called itself a sanctuary city,” and Romney was wrong to say that it did.

Giuliani also strained the facts when he flatly stated during the debate that New York “was not a sanctuary city.” Obviously, the CRS disagrees. New York indeed had a policy, which Giuliani defended during the debate, that forbade city employees from giving federal immigration officials the names of illegal aliens unless the immigrant was suspected of other criminal activity or turning the person over was required by law. That protection was granted by a previous mayor through executive order 124 in 1989 and renewed by Giuliani. However the city chooses to characterize its policies, they fit the description of “sanctuary” applied by neutral experts.

Giuliani stretched the facts when he accused Romney of employing illegal aliens at his home, which the mayor called “a sanctuary mansion.” And so did Romney when he said “I did not” have illegals working at his home.

Giuliani: At his own home illegal immigrants were being employed – (laughter, cheers, applause) – not – not – not being turned in to anybody or by anyone. … So I would say he had sanctuary mansion, not just sanctuary city. …

Romney: Mayor, you know better than that. …

Giuliani: You did – you did – you did have illegal immigrants working at your mansion, didn’t you?

Romney: No, I did not.

The fact is, as reported by the Boston Globe in 2006, several illegals worked at Romney’s home in Belmont, Mass., off and on over a period of eight years, sometimes working 11-hour days. They were, however, employed by a contractor, Community Lawn Service with a Heart, and not directly by Romney.

So, Giuliani was technically correct to say that “illegal immigrants were being employed,” since he used the passive voice and didn’t specify who did the employing. Romney could also argue that he was technically correct to say “I did not” have illegals working, since he didn’t employ them directly. The Globe, however, quoted a Guatemalan man as saying that during the years he worked at Romney’s home he occasionally got a “buenos días” from Romney or a drink of water from his wife, Ann.

Overall, the record reflects that both Romney and Giuliani have been more tolerant of illegal immigrants in the past than they now profess to be.

Huckabee’s IRS Sleight-of-Hand

Huckabee again claimed he would get rid of the IRS, a disappearing act that isn’t so easy as he makes it sound.

Huckabee: Anderson, the first thing that I would get rid of would be the Internal Revenue Service. We’d have a complete getting rid of a $10-billion-a-year industry. I’m not being facetious. If we enacted the Fair Tax, one of the most researched ways to revive our economic future. We will get rid of the IRS.

It is true that the Fair Tax would get rid of the agency that we now call the IRS. But, according to the bill Huckabee supports: “There shall be in the Department of the Treasury a Sales Tax Bureau to administer the national sales tax in those States where it is required.” So, Huckabee would “eliminate” the IRS by replacing it with a Sales Tax Bureau.

Furthermore, the new Sales Tax Bureau wouldn’t necessarily be much smaller than the existing IRS. According to the bipartisan Advisory Panel on Tax Reform, which studied the Fair Tax proposal extensively and rejected it: “The federal administrative burden for a retail sales tax may be similar to the burden under the current system” in order to ensure that the various states collected the tax in a systematic way. The panel went on to point out that the Fair Tax, which includes a cash grant to each taxpayer to compensate for its regressive nature, would also  require an entirely new type of bureaucracy to “keep track of the personal information that would be necessary to determine the size of the taxpayer’s cash grant.”

It’s true that the Fair Tax has been heavily researched, as Huckabee said. But most of the research that supports it was paid for by Americans for Fair Taxation – a group that advocates the idea.

Huckabee Scholars

Huckabee ran afoul of the facts when defending his failed proposal to make children of illegal immigrants eligible for state college scholarships:

Huckabee: I supported a bill that would have allowed those children who had been in our schools their entire school life the opportunity to have the same scholarship that their peers had who had also gone to high school with them and sat in the same classrooms. They couldn’t just move in in their senior year and go to college. … [It] said that if you’d sat in our schools from the time you’re 5 or 6 years old and you had become an A-plus student, you completed the core curriculum, you were an exceptional student, and you also had to be drug and alcohol free, and the other provision, you had to be applying for citizenship.

Actually, the bill Huckabee pushed for in his 2005 State of the Union address did not apply only to “those children who had been in our schools their entire school life.” It required only three years in an Arkansas high school to be eligible. And students did not have to be “applying for citizenship,” but rather they had to sign an affidavit stating their intent to do so in the future. All students who apply for state scholarships must “certify that they are drug-free” and “pledge to refrain from alcohol” if they are under 21, just as Huckabee said. But they certainly don’t have to be “an A-plus student.” The state requires a solid “B” average (a 3.0 average on a 4.0 scale). And the state may reduce that to a 2.5 average if sticking with the higher requirement “would unduly reduce the number of low-income or disadvantaged students who would otherwise be eligible for the program.” That’s a C-plus average.

The bill passed the Arkansas House but failed in the Senate. Later, a pared down version that would grant illegals in-state tuition breaks, but not scholarship rights, failed two votes short of passage.

Post Hoc Hooey

The debate included a couple of lighter moments, when Giuliani jokingly claimed credit for reducing annual snowfall “dramatically” and for four World Series victories by the Yankees during his term as mayor of New York.

In a gag video, his campaign joked that King Kong roamed city streets before Giuliani became mayor, adding:

Giuliani Video: Rudy prevailed: crime down by half, taxes cut and annual snowfall dramatically reduced.

Later, Giuliani said:

Giuliani: [When] I was mayor of New York City, the Yankees won four world championships. … I wanted to put this in our reel, but they cut it out, so I’m going to get it in – and since I’ve left being mayor of New York City, the Yankees have won none.

It’s true that snowfall was less than average under Giuliani, though it’s a matter of opinion whether the difference is a dramatic one or not. According to the National Weather Service, between 1869 and 1993, the average snowfall in New York City’s Central Park was 28.2 inches per year. During Giuliani’s term (from January 1994 through December 2001), average snowfall was just 26.7 inches.

And the Yankees did indeed win the World Series in 1996, 1998, 1999 and 2000 – but have failed to do so since.

Giuliani is clearly joking here, but he illustrates a serious point that we think voters should keep in mind: Politicians don’t automatically deserve credit or blame for what happens while they are in office. Sometimes it’s just luck. It’s a logical fallacy to conclude a leader’s actions are the cause of what happens afterward. Logicians have named this the “post hoc ergo propter hoc” fallacy (literally, “after the fact, therefore because of the fact.”)

The fallacy is easy enough to see when Giuliani takes credit for a reduction in snowfall during his term. It’s more subtle when he takes credit for halving crime during his term – especially when he fails to mention that crime rates were already falling before he took office and that they dropped nationally as well. And we could say the same thing about, for example, attributing the longest economic boom in U.S. history to the fact that Bill Clinton was in office during most of it.

Curse of the Bambino Prolonged

 

Romney claimed to be a “true suffering Red Sox” fan but got a basic fan statistic wrong:

Romney: Eighty-seven – 87 long years – we waited 87 long years. And true suffering Red Sox fans that my family and I are, we could not have been more happy than to see the Red Sox win the World Series.

Actually, the team won the World Series in 1918, and not again until 2004. That’s 86 years, not 87. Romney has lived much of his adult life in Massachusetts but was born in Michigan and graduated from college in Utah.

– by Brooks Jackson, with Justin Bank, Jess Henig, Joe Miller and Lori Robertson

Clarification, Nov. 30: Our original story may have left some with the impression that New York, and other jurisdictions, prohibited police from turning over the names of illegal immigrants to federal authorities under any circumstances. Rather, New York’s policy prohibited “a city officer or employee” from sharing such information unless disclosure was required by law or the immigrant was suspected of criminal activity, including trying to get public assistance with fraudulent documents. The executive order instructed law enforcement officers to “continue to cooperate with federal authorities in investigating and apprehending aliens suspected of criminal activity. However, such agencies shall not transmit to federal authorities information respecting any alien who is the victim of a crime.”

 

 

 

 

Sources

Congressional Research Service. “Enforcing Immigration Law: The Role of State and Local Law Enforcement.” Updated 14 Aug. 2006.

Saltzman, Jonathan. “Illegal immigrants toiled for governor.” Boston Globe. 1 Dec. 2006.

Linder, John. “H.R. 25 [109th]: Fair Tax Act of 2005.” GovTrack.us. 29 Nov. 2007.

National Weather Service. Monthly & Seasonal Snowfall at Central Park. 1 Nov. 2007. 29 Nov. 2007.

President’s Advisory Panel on Tax Reform. “Final Report Chapter 9: National Retail Sales Tax.” 1 Nov. 2005. TaxReformPanel.gov.

Huckabee, Mike, “State of the State of Arkansas Address, 2005.” 11 Jan. 2005.

Arkansas 85th General Assembly, Session 1. “HB1525: Access to PostSecondary Education Act of 2005.“

Red Sox, Boston. “Postseason Results.”

 

 

 

 

 

Related Articles

The Not-Quite Truth About NYC

Giuliani twists facts about crime and liberalism in the Big Apple.

Huckabee’s Fiscal Record

Under fire from conservatives, the former Arkansas governor misrepresents his tax hikes, and cuts.

Clinton vs. Obama

Who’s right on health care, Social Security?

Tough Guy on Immigration?

Romney puffs up his record.

The Immigration Showdown

Romney’s and Giuliani’s chest-thumping on immigration leaves behind context and, in some cases, the facts.

John McCain’s “‘Outrageous’ Exaggerations”

Read the full article at FactCheck.org

McCain’s ad revisits some oft-mentioned examples of pork, but is he really the one who rooted them out?

Summary

Republican presidential candidate John McCain cites three absurd-sounding examples of pork-barrel spending in a recent ad: a “bridge to nowhere,” a study of the DNA of bears and a Woodstock museum.

McCain is known for fighting against earmarks, the other term lawmakers use for funding of pet projects back home. But he appears to have chosen these three because they’re easy to mock, not because he had significant involvement in removing them from the budget.

• He never specifically went after the “bridge to nowhere,” and he was absent for key votes on its funding.
• While he tried to cut money for several other projects in the same bill, he never proposed cutting the bear study and voted for the final bill containing it.
• He wasn’t present for the most important votes on the Woodstock museum, including one on an amendment he co-sponsored to kill the earmark and divert some of the funds.

Analysis

John McCain’s ad, “Outrageous,” which began running November 12, touts the Arizona senator’s long-standing fight against pork-barrel spending. The ad includes three examples of projects that McCain deems unnecessary and claims that “one man” has “the guts to stand up to wasteful government spending.”

It is indisputable that McCain has been a vocal opponent of earmarks, and indeed of all government spending that he considers wasteful (he has said that Congress spends money “like a drunken sailor”). He has been recognized for his efforts both by the media and by taxpayer advocacy groups.

But the three examples of spending highlighted in the ad – a “bridge to nowhere,” a study of bear DNA and a museum dedicated to Woodstock – seem chosen more for their impact than for any direct involvement McCain had in attacking them. In fact, he voted in favor of the bill that included the bear study funding; he was absent for key votes on the Woodstock museum (including one on an amendment he co-sponsored); and he never specifically tried to eliminate the bridge earmark and missed some crucial votes on that one, as well.

For what it’s worth, we’ll note that the three projects together cost a little under $300 million, which is a tiny fraction of yearly earmark activity. The Office of Management and Budget reports that the fiscal 2005 budget included 13,492 earmarks totaling $18.9 billion dollars. The taxpayer watchdog group Citizens Against Government Waste gives a higher estimate for that year – 13,997 projects for a total of $27.3 billion – and estimates that 2006 earmark activity cost $29 billion. That would make earmarks account for about 0.2 percent of the gross domestic product.

Huckabee’s Fiscal Record

See the whole report at FactCheck.org

Under fire from conservatives, the former Arkansas governor misrepresents his tax hikes, and cuts.

Summary

Republican presidential candidate Mike Huckabee has been hit with criticism over his record on taxes as governor of Arkansas. The faultfinders have been members of his own party, who take issue with tax increases he enacted. In recent interviews on Fox News, Huckabee responded to some of these questions, but we found him to be misleading and incorrect on several points:

• Huckabee claimed that a speech in which he implored the state Legislature to raise taxes was in response to a state Supreme Court order to increase education funding. But he specifically said in that speech that he would address the education matter at a later date.
• He said a tax on beds filled in nursing homes was a “fee” not a tax, despite the fact that he himself has called it the “bed tax.”
• Huckabee claimed a gasoline tax was only passed after 80 percent of voters approved it. Not true. The tax was enacted before a referendum vote on highway repairs.
• He frequently says he cut taxes “almost 94 times” but leaves out the 21 taxes raised during his tenure. In the end, he presided over a net tax increase.

Also, we find that former Tennessee Sen. Fred Thompson stretched the truth in claiming that Arkansas’ spending had doubled under Huckabee. It didn’t increase that much, and Huckabee left a sizable surplus.

Fundraising by Party

At Opensecrets.org, there’s a great interactive map detailing top fundraisers in every state.  In my state, Rudolph Giuliani has raised the most money.  Fascinating.

Biggest Donors Are Digging Deeper

From OpenSecrets.org:

Biggest Donors Are Digging Deeper for ‘08

__________________

Top industries and interest groups have increased their giving over 2004 by 46 percent, Center finds. As money shifts to Democrats, giving from Republican strongholds is mostly flat. 

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WASHINGTON—The industries and interest groups that contribute the most money toward federal elections have substantially increased their giving since the 2004 election, according to an exclusive analysis by the nonpartisan Center for Responsive Politics.

On average, top-giving industries and interests have increased their total contributions to candidates for Congress and president, as well as to national party committees, by 46 percent since the same point in time four years ago. Compared with the first three quarters of the 2006 cycle, when there was no election for president, contributions from the top 50 most active industries are up 54 percent.

“A power shift in Congress and a wide-open race for the White House add up to record-breaking contributions from the nation’s biggest givers,” said Sheila Krumholz, the Center’s executive director. “There is an intensity to the fundraising for 2008 that we’ve never seen before, which means the candidates and parties will be all the more beholden to their biggest donors.”

As interest groups and industries contribute substantially more money, they are also shifting their giving to Democrats, both to members of Congress now that the party is in control and to Democratic presidential candidates. The typical big-giving industry is now giving 57 percent of its contributions to Democrats, a shift of 14 percentage points from both 2006 and 2004, when the party and its candidates collected only 43 percent of the money.

Looking at specific industries and their contributions toward the 2008 election, individuals and PACs associated with the securities and investment industry, which includes hedge funds and private-equity firms, have increased their giving 91 percent since 2004. Lawyers and law firms—the top industry based on total contributions of $76.4 million—are up 52 percent. The real estate industry has increased contributions 51 percent, and the entertainment industry has boosted its giving 68 percent. Health professionals and the insurance industry have both increased their giving 23 percent.

The Center examined the 50 industries and interest groups that have contributed the most money toward the 2008 federal elections. Researchers analyzed more than $581 million in individual and political action committee contributions that flowed from those industries and interests in January 2007 through September, and made comparisons to the same periods in 2003 and 2005. (CRP is the only organization that attempts to classify all individual donors to federal politics by industry.) The analysis includes only contributions itemized with the Federal Election Commission, or those exceeding $200.

The sharpest increases since 2004 tend to be in the ideological sector. Democratic/liberal interests have increased their giving 396 percent since 2004, fueled particularly by Internet fundraising organizations such as ActBlue. Candidates have been donating money to each other at a greater rate, too. Contributions from candidate committees are up 164 percent compared with four years ago, and contributions from leadership PACs—political action committees formed by politicians to support other candidates—are up 88 percent over the ‘04 cycle.

The industries with the smallest increases, and even decreases in several cases, tend to have Republican-leaning track records. The automotive industry, which has contributed 75 percent of its money to the GOP since the 1990 cycle, has decreased its contributions by 20 percent since 2004. Food processing and sales, which includes grocery stores and manufacturers of food, is down 10 percent. Contributions from telephone utilities are down 4 percent over ‘04. Single-digit increases have registered among general contractors, defense aerospace and building materials and equipment—all industries that have leaned Republican for years. And the oil and gas industry has increased contributions just 15 percent over the ‘04 cycle, well below the average for big industries.

“Democratic donors seem unusually mobilized for this election,” Krumholz said, “but those industries who’ve traditionally given to Republicans seem to be either nursing their wounds from ‘06 or sitting this election out. That’s a challenge for Republicans—how to mobilize their fundraising base to compete with the momentum on the other side.”

The following chart shows the industries and interest groups that have increased their contributions by the greatest percentage compared to the 2004 cycle. The chart shows how each industry’s 2008-cycle contributions from individuals and PACs are split between Democrats and Republicans.

Largest Increases in Contributions from Top-Giving Industries & Interest Groups, 2008 cycle vs. 2004

Industry or Interest Group

08 Total

Increase vs. 04

08 Dem %

08 Repub %

(Analysis includes contributions greater than $200 to federal candidates and parties from individuals working in the industry and from associated PACs, as reported to the Federal Election Commission. Contributions were generally made during the first nine months of 2007 and 2003.) 

#  #  #

The Center’s website, OpenSecrets.org, tallies contributions from top industries and interest groups in the site’s 2008 Election Overview: http://www.opensecrets.org/overview/industries.asp?cycle=2008.

 

About the Center for Responsive Politics

The Center for Responsive Politics is the nation’s premier research group tracking money in U.S. politics and its effect on elections and public policy. Founded in 1983, the nonpartisan, nonprofit Center aims to create a more educated voter, an involved citizenry and a more responsive government. CRP’s award-winning Web site, OpenSecrets.org, is the most comprehensive resource for campaign contributions, lobbying data and analysis available anywhere. CRP relies on support from a combination of foundation grants and individual contributions. The Center accepts no contributions from businesses, labor unions or trade associations.

Clinton and Obama: Contributions by Gender

From Open Secret:

Contribution Details – Hillary Clinton

	$200-499		$500-999		$1000-2300		$2300+		$4600+
	# Donors	Total	# Donors	Total	# Donors	Total	# Donors	Total	# Donors	Total
Female	3692	$940,462	2425	$1,292,483	4330	$5,390,341	5419	$18,271,950	2173	$10,166,250
Male	2261	$587,017	2210	$1,174,578	4913	$6,207,365	7097	$24,731,626	3140	$14,838,838

Contribution Details – Barack Obama

	$200-499		$500-999		$1000-2300		$2300+		$4600+
	# Donors	Total	# Donors	Total	# Donors	Total	# Donors	Total	# Donors	Total
Female	5466	$1,407,243	3754	$2,005,453	4470	$5,580,109	5097	$13,712,069	608	$3,057,609
Male	5568	$1,440,949	4092	$2,182,696	6204	$7,681,275	7049	$19,154,481	901	$4,608,013

Totals include contributions from individuals whose gender could be determined by the Center, as released electronically by the Federal Election Commission on 10/29/07.

Bogus Cancer Stats, From Factcheck.org

From Factcheck.org:

Giuliani stubbornly repeats a claim about prostate cancer that authorities call “very misleading” and “complete nonsense.”

Summary

Rudy Giuliani insists he was “absolutely accurate” to say that men with prostate cancer have a 44 percent survival rate in England, despite being contradicted by FactCheck.org, major news organizations and several cancer experts.

The Canadian psychiatrist who first came up with the figure, despite his admission to us that the statistic is “technically” not a survival rate at all, is also defending the figure as valid and describing criticism of his figure as a “malignant rumor.” The conservative think tank which published the figure also is defending it.

We find no merit in these rebuttals, nor do the cancer experts we consulted. A professor of biostatistics at Johns Hopkins University calls Giuliani’s figure “very misleading,” and the chief of urology at a leading medical school calls it “complete nonsense.” No less an authority than Britain’s health secretary says Giuliani’s cancer statistic is wrong. We agree.

Giuliani is entitled to his low opinion of what he calls “socialized medicine” in Britain, and to his strongly held belief that patients generally fare better in the U.S. We take no position for or against the British system or the various health-care proposals being advanced in the 2008 presidential campaign. We do object to Giuliani’s continued use of a false statistic to support his argument.

Analysis

Last week, we reported that Rudy Giuliani had used a false statistic in a radio ad in New Hampshire in which he claimed that the chance of surviving prostate cancer was only 44 percent in England and 82 percent in the U.S. We tracked that figure back to its source, Giuliani campaign adviser David Gratzer, who admitted to us that his numbers “technically” weren’t survival rates at all. We reported that Gratzer had calculated his percentages from figures given in a report published in 2000 by two Johns Hopkins University researchers, and that both authors said Gratzer had drawn an erroneous conclusion. One of them told us that Gratzer’s 44 percent figure was wrong, “misleading” and meaningless.

Meanwhile, several mainstream news outlets also disputed Giuliani’s ad, including ABCNews.com, which accused the former mayor of “Fuzzy Health Care Math,” PolitiFact.com, which called his claim “false,” and The Washington Post, which called his statistic “wrong” and awarded him “four Pinocchios,” designating a campaign “whopper.”  By the end of the week, no less an authority than British health secretary Alan Johnson complained that Giuliani was making a “political football” of the British health system, saying: “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.”

But even while creating something of an international incident, Giuliani steadfastly refuses to admit error. Gratzer, meanwhile, now maintains that his calculations are a valid measure of the chances of survival, despite his early admission to us that his figure is not a “survival rate,” as Giuliani claims it is.

“Complete Nonsense”

Gratzer is not a cancer researcher. He has published a handful of articles in peer-reviewed medical journals, but none that we could find regarding cancer or survival rates. He is a Canadian psychiatrist who writes chiefly opinion pieces for conservative U.S. publications that are critical of Canadian-style health care systems.

A day after our original story was published, Gratzer issued a response to the widespread criticism of his 44 percent figure. In that article, he did not mention our article, but cited other news organizations, calling the criticism a “malignant rumor” and maintaining that they were wrong and he and Giuliani were right. He also backtracked: While his original article incorrectly called his statistic a “survival rate” (something he admitted to us was “technically” not true) he now calls his figure a “snapshot.” But he then implies that his figure is just as valid as official government statistics. Gratzer says of the official United Kingdom figures: “Those data look at five-year survival rates – that is, they track cancer patients for five years and report on their survival. Their approach is different from mine. They don’t examine what we might call a ‘snapshot,’ as my data do: that is, examining how many people with a particular disease die during a given interval of time – say, a year.”

What Gratzer dismissively calls “their approach” is actually the one taken and supported by the National Cancer Institute, the Centers for Disease Control and Prevention, the American Cancer Society,and the Mayo Clinic, among other recognized authorities on the subject. We find no other cancer researchers who use a “snapshot” figure, and several who say Gratzer is blowing smoke:

• Marie Diener-West, a professor of biostatistics at Johns Hopkins University Bloomberg School of Public Health, says it’s “inappropriate” and “very misleading” to calculate a survival rate in the way Gratzer attempted.

•  Peter Albertsen, professor and chief of urology at the University of Connecticut Health Center, calls such calculations a “very dangerous thing to do” and “complete nonsense.”

Despite what these and other recognized authorities are saying, no correction is forthcoming from the Manhattan Institute, where Gratzer is a senior fellow and whose magazine published the opinion piece from which Giuliani first plucked the 44 percent figure.  Instead, the group has mounted a vigorous defense of his work. The conservative think tank’s home page now includes a prominent box that says “Gratzer’s statistics are correct” and lists several articles by him along with links to a number of Republican and conservative commentators who have come to Giuliani’s defense (often by merely repeating Gratzer’s erroneous method). The Manhattan Institute, incidentally, is not ideologically neutral. It is a conservative, free-market think tank that favors a health care system of private (not government-run) insurance. Its Web site advocates “opening Medicare and Medicaid to private insurance markets and putting consumers, not bureaucrats, in control of their own health care spending through health savings accounts and targeted vouchers.”

Wrong Again

Bill Pugliano/Getty Images

As for Giuliani, he also continues to insist that the 44 percent figure is “absolutely accurate” and implies that critics are merely confused about dates:

Giuliani (press conference, Nov. 2): I made my decision about what to do about prostate cancer in 2000. The report is from the year 2000. The report indicates that in the United States, back in the year 2000, there was an 82 percent chance of my surviving prostate cancer if it was detected, whereas in England, there would have been a 43 percent chance.

Actually, the inaccuracy is, I think I say 44 percent—it’s actually 43 percent in England… But the statistics, as of the time I made the decision, [were] absolutely accurate and I stand by them.

Actually, the 44 percent figure isn’t correct now and wasn’t correct in 2000 either, despite what Giuliani claims. As we mention above, the statistics Giuliani cites never constituted a ”survival rate” in the first place. And it’s true that survival rates for prostate cancer in England were lower in 2000 than they are now, but they weren’t even close to 44 percent. According to the U.K.’s Office of National Statistics, the five-year relative survival rate for patients diagnosed with prostate cancer between 1993 and 1995 (and thus followed up to 1998 or 2000) was 59.8 percent, well above the 44 or 43 percent that Giuliani cites for the year 2000. The National Cancer Institute’s Surveillance Epidemiology and End Results database puts concurrent U.S. rates at 95.4 percent. As with the more recent figures, there is indeed a significant difference, but the numbers bear no relation to Giuliani’s claims.

Wrong on Breast Cancer, Too

In an October 30 interview with Fox News’ Neil Cavuto, Giuliani not only stood by his figures, but expanded his claims to other forms of cancer – and strained yet another cancer statistic:

Giuliani: And the same thing is true, by the way — my wife will explain this to you in better, more detail than I can, because she has all these statistics — the same thing is true with women with breast cancer. The chance of surviving in the United States for a woman much greater than in France or in England or in Canada or in Cuba where Michael Moore would like us all to go for health care.

Giuliani is continuing to make this claim, most recently at a campaign event in Iowa, according to the Quad-City Times. Actually, the United States’ five-year relative survival rate for breast cancer is about 89 percent, according to the National Cancer Institute. By contrast, the most recent available five-year survival rates in France, England and Canada were 85 percent, 81 percent and 86 percent, respectively. Even taking into account the difficulties with international comparisons, this is at most a spread of 8 percentage points. Describing 89 percent as “much greater” than 81 percent is a stretch, in our judgment.

Giuliani has a point about Cuba, a poor country where cancer mortality is indeed high, and survival less likely than in the U.S. According to a 1997 report from the American Association for World Health, Cuba saw an increase in breast cancer mortality after mammography began to be severely restricted due to the difficulty of importing spare parts and x-ray film. In any case, none of the leading Democratic candidates are embracing a health care system like Cuba’s, or Britain’s, for that matter.

– by Lori Robertson and Jess Henig

Sources

Gratzer, David. “Malignant Rumor.” City Journal. 31 Oct. 2007.

Surveillance Epidemiology and End Results, National Cancer Institute, U.S. National Institutes of Health. “Fast Stats: Prostate Cancer.” 8 Nov. 2007.

Surveillance Epidemiology and End Results, National Cancer Institute, U.S. National Institutes of Health. “Table XXIII-5: Prostate Cancer.” SEER Cancer Statistics Review, 1975-2004.  8 Nov. 2007.

Surveillance Epidemiology and End Results, National Cancer Institute, U.S. National Institutes of Health. “Cancer of the Breast.” 8 Nov. 2007.

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. “Health, United States, 2006.” Nov. 2006.

“Prostate Cancer Survival Rates.” American Cancer Society. 27 June 2007.

Mayo Clinic staff. “Cancer survival rate: A tool to understand your prognosis.” MayoClinic.com. 6 April 2007.

Baldwin, Tom. “Rudy Giuliani uses the NHS as ‘political football’ to give Hilary Clinton a kicking.” TimesOnline (London). 1 Nov. 2007.

Arveux, P., et al. “Breast cancer survival in France: A relative survival analysis based on 68,449 cases treated in the 20 French comprehensive cancer centers between 1980 and 1999.” Proceedings of the American Society of Clinical Oncology 22: 2003.

American Association for World Health.  “The Impact of the US Embargo on Health and Nutrition in Cuba.”  March 1997.

United Kingdom.  “Cancer Survival: One- and five-year survival of patients diagnosed in 1992-94 and 1993-95: major cancers, sex and age, England.”  Office of National Statistics. 8 Nov. 2007.

United Kingdom. “Cancer Survival,” rates for adults diagnosed during 1999 – 2003, England. Office of National Statistics. 21 Aug. 2007.

National Cancer Institute of Canada.  “Breast Cancer.”  13 Apr. 2007.

Hillary’s High-Stepping

Another great report from Factcheck.org

The Democratic front-runner bobs and weaves at a candidate debate in Philadelphia.

Summary

At a Democratic debate in Philadelphia, Sen. Hillary Clinton ducked some questions and gave misleading answers to others.

• She falsely implied that the reason White House documents about her communications with her husband haven’t been released is due to bureaucratic delays, and she avoided saying whether she would ask Bill Clinton to clear their release from the National Archives.
• She avoided a yes-or-no answer to whether she supports giving New York driver’s licenses to illegal immigrants and at one point denied saying the idea made sense, when in fact she said less than two weeks earlier that it “makes a lot of sense.”
  
• She avoided saying what, if anything, she would do about Social Security taxes or benefits, saying a commission should study the system “if” it has problems, and saying that acting as though the troubled system is in “crisis” is “a Republican trap.”

 

Analysis

 

 

The most recent debate among Democratic candidates took place Oct. 30 at Drexel University in Philadelphia. Absent this time was former Sen. Mike Gravel, who was too low in opinion polls and had raised too little money to be invited by  MSNBC. The front-runner, Sen. Hillary Clinton, faced tough questioning from moderators Tim Russert and Brian Williams of NBC News, and from rival candidates. Her responses were often uninformative and sometimes misleading.

Release of White House Documents

Clinton avoided saying whether she’d urge her husband to tell the National Archives to release documents related to her communications with him while he was president.

Clinton: Well, actually, Tim, the Archives is moving as rapidly as the Archives moves. There’s about 20 million pieces of paper there and they are moving, and they are releasing as they do their process. And I am fully in favor of that.

Russert pressed:

Russert: But there was a letter written by President Clinton specifically asking that any communication between you and the president not be made available to the public until 2012. Would you lift that ban?

Clinton: Well, that’s not my decision to make. And I don’t believe that any president or first lady has. But certainly we’ll move as quickly as our circumstances and the processes of the National Archives permits.

We find her response doubly misleading.

First, the primary reason that no documents related to correspondence between the two of them have been made public is, just as Russert said, that Bill Clinton asked the Archives not to release them until 2012. The Presidential Records Act allows a president, while still in office, to bar disclosure of six categories of documents for 12 years following the end of his or her tenure. One of those categories is “confidential communications requesting or submitting advice, between the President and his advisers.” Communications between a president and his wife are considered to fall in that category. He claimed the exemptions broadly (without mentioning Hillary) in 1994. In 2002, he amended his claims to loosen the restrictions – but specifically identified communications between himself and the First Lady (among others) as items that should remain sealed until 2012.

Secondly, while Hillary is correct in a legal sense when she says it is “not my decision to make,” we have little doubt that her husband would do as she asked should she want the documents made public.

Sen. Clinton is correct on one front: Things are moving slowly at the Clinton Library. According to a declaration filed by the Clinton Presidential Library’s then-acting director, Emily Robison, in August 2007, there are just six archivists to sort through what the library’s Web site says are 76.8 million pages and 1.85 million photos. Even if she wanted her correspondence with Bill Clinton released, it’s not clear that the documents would be processed before the election.

But while she may also be correct that other presidents haven’t allowed access to communications between themselves and their wives before the 12 years were up, none of those wives were running for president themselves – and holding out their experience in the White House as a qualification for election.

Driver’s Licenses for Illegal Immigrants

Clinton bobbed and weaved on whether illegal immigrants should be granted driver’s licenses, avoiding a yes-or-no answer but denying her own words in the process.

Russert asked her about an interview she had given to an editorial board in Nashua, New Hampshire, in which she was asked about New York Gov. Eliot Spitzer’s proposal to grant state driver’s licenses to immigrants who are in the U.S. without legal permission.

Clinton: I did not say that it should be done, but I certainly recognize why Governor Spitzer is trying to do it. And we have failed –

Sen. Chris Dodd: Wait a minute. No, no, no. You said yes, you thought it made sense to do it.

Clinton: No, I didn’t, Chris. But the point is, what are we going to do with all these illegal immigrants who are (driving ?) – (inaudible)?

Actually, we checked the video, and Clinton did tell the Nashua Telegraph interviewers on Oct. 17 that Spitzer’s plan “makes a lot of sense,” despite her denial to Dodd.

Clinton (Nashua, N.H.): I know exactly what Governor Spitzer’s trying to do and it makes a lot of sense. He’s trying to get people out of the shadows.

During the debate, Clinton repeatedly said immigration should be dealt with nationally, not on a state-by-state basis. But after a long exchange she still hadn’t answered the question to Russert’s satisfaction:

Russert: Do you support [Spitzer's] plan?

Clinton: You know, Tim, this is where everybody plays gotcha. It makes a lot of sense. What is the governor supposed to do? He is dealing with a serious problem. … Do I think this is the best thing for any governor to do? No. But do I understand the sense of real desperation, trying to get a handle on this? Remember, in New York we want to know who’s in New York. We want people to come out of the shadows. He’s making an honest effort to do it. We should have passed immigration reform.

We don’t agree that asking a candidate for a specific stand on an issue is a “gotcha” question. In any event, Clinton avoided a direct answer.

Social Security

Throughout the debate Clinton resolutely avoided saying specifically what, if anything, she would do to shore up the finances of the Social Security system. She repeatedly called for “fiscal responsibility” and said she would appoint a bipartisan commission to study the system. And she made clear she was in no hurry to act:

Clinton: I think for us to act like Social Security is in crisis is a Republican trap.

In fact, the system is headed for nearly certain collapse unless some action is taken to increase taxes or at least slow down the projected rise of future benefits. And delay will only make the eventual corrections more painful, experts say.

The system’s trustees state that the program is financially adequate for the short term, but fails the test of financial adequacy by a “wide margin” in the long term. Within 10 years, under the most likely projection, payroll taxes will no longer be adequate to pay for current benefits and the system will begin cashing in the IOUs that make up its trust fund. That means it will be paying for a portion of benefits out of other federal taxes, and that portion will increase year to year. At that rate the trust fund will be exhausted in 2041, at which point the payroll tax could finance only 75 percent of promised benefits, and less in each succeeding year. At that point benefits would necessarily be cut 25 percent, or taxes would be increased.

To bring the system into balance for the next 75 years would require “an immediate increase of 16 percent in payroll tax revenues or an immediate reduction in benefits of 13 percent or some combination of the two,” the trustees stated. That’s  assuming the action is “immediate.” Delaying action beyond this year will only make the needed changes more painful for future generations. The trustees said:

Social Security and Medicare Trustees (April 2007): To the extent that changes are delayed or phased in gradually, larger adjustments in scheduled benefits and revenues would be required that would be spread over fewer generations.

Nevertheless, at one point during the debate, Sen. Clinton seemed to imply that it was possible no action was needed at all, saying that “if” there are problems a commission should address them.

Clinton: If there are some of the long-term challenges that we need to address, let’s do it in the context of having fiscal responsibility, and then let’s put together a bipartisan commission and look at how we’re going to deal with these long-term challenges.

Clinton Flip-Flops?

Sen. Barack Obama and former Sen. John Edwards accused Clinton of multiple flip-flops on trade, torture and Social Security:

Obama: And Senator Clinton in her campaign, I think, has been for NAFTA previously, now she’s against it. She has taken one position on torture several months ago and then most recently has taken a different position.

Edwards: And then finally she said in our last debate that she was against any changes on Social Security – benefits, retirement age or raising the cap on the Social Security tax.

• NAFTA: Obama is partly right concerning the North American Free Trade Agreement. Clinton’s views on NAFTA have shifted, but they shifted prior to her official run for the White House. Back in 1998, in a keynote speech given at the Davos Economic Summit, Clinton praised business leaders for mounting “a very effective business effort in the U.S. on behalf of NAFTA,” adding later that “it is certainly clear that we have not by any means finished the job that has begun.” But by 2005 she was expressing reservations about free trade agreements, voting that year against the Central America Free Trade Agreement (CAFTA). And she told Bloomberg News in March 2007 that, while she still believes in free trade, she supports a freeze on new trade agreements – something she calls “a little time-out.”

• Torture: Obama is right. In an interview with the New York Daily News in October 2006, Clinton condoned torture in what she called “improbable” ticking time bomb scenarios:
  

Clinton: In the event we were ever confronted with having to interrogate a detainee with knowledge of an imminent threat to millions of Americans, then the decision to depart from standard international practices must be made by the President, and the President must be held accountable. That very, very narrow exception within very, very limited circumstances is better than blasting a big hole in our entire law.

But in a debate in New Hampshire last month, Sen. Clinton shifted her position when moderator Tim Russert offered her just such a ticking time bomb case:

Russert: Senator Clinton, this is the number three man in al Qaeda. We know there’s a bomb about to go off, and we have three days, and we know this guy knows where it is. Should there be a presidential exception to allow torture in that kind of situation?

Clinton: As a matter of policy it cannot be American policy, period.

To our ears, that sounds like a reversal.

• Social Security: But in accusing Clinton of reversing course, Edwards mischaracterizes what she actually said during the September 26 debate at Dartmouth College. Moderator Tim Russert pressed Sen. Clinton on what, specifically, she was willing to “put on the table” to ensure the solvency of Social Security. Her reply:
  

Clinton: I’m not putting anything on the proverbial table until we move toward fiscal responsibility. I think it’s a mistake to do that.

That’s not being “against any changes on Social Security” as Edwards claimed. Rather, Clinton simply refused to specify what changes she might be willing to accept.

Obama’s Revised Remarks

Obama attempted to soften a previous accusation that Clinton was being less than truthful about a variety of issues.

Russert: But when asked by The New York Times whether Senator Clinton has been truthful, you said no.

Obama: What I said is that she has not been truthful and clear about this point that I just made [about Social Security], which is, we can talk about fiscal responsibility, and all of us agree with it. All of us oppose privatization. But even after we deal with those issues, we are still going to have an actuarial gap that has to be dealt with. It is not going to vanish.

Actually, the Times paraphrased Obama on October 28 as saying Clinton was being somewhat untruthful about “what she would do as president” generally, not just on Social Security:

New York Times: Asked if Mrs. Clinton had been fully truthful with voters about what she would do as president, Mr. Obama replied, “No.”

“I don’t think people know what her agenda exactly is,” Mr. Obama added, citing Social Security, Iraq and Iran as issues on which she had not been entirely forthcoming. “Now it’s been very deft politically,” he said. “But one of the things that I firmly believe is that we’ve got to be clear with the
American people right now about the important choices that we’re going to need to make in order to get a mandate for change, not to try to obfuscate and avoid being a target in the general election.”

Russert’s characterization of Obama’s quote, as featured in the Times, was accurate. Obama, however, attempts to narrow the claim down to her position on Social Security when he really referred to her statements overall regarding what she would do as president.

Presidential Qualifications

Finally, we wondered about the accuracy of this statement from Sen. Joe Biden:

Biden: Rudy Giuliani [is] probably the most underqualified man since George
Bush to seek the presidency.

Biden is certainly entitled to state his opinion, and his line did get a lot of laughs and some applause. But a twice-elected former mayor of New York City is hardly without executive qualification. And does Biden really think Giuliani is less qualified than, say, cable TV comic Stephen Colbert, who is seeking signatures to qualify for the ballot in South Carolina?

Just asking.

– by Brooks Jackson, with Viveca Novak, Justin Bank, Jess Henig, Emi Kolawole, Joe Miller and Lori Robertson

 

Sources

Office of William Jefferson Clinton. Letter to the National Archives. Presidential Libraries. 6 Nov. 2002.

Landrigan, Kevin. Clinton says gender has been advantage. Video. 17 Oct. 2007. NHPrimary.com. 31 Oct. 2007.

Jensen, Kristin and Mark Drajem. “Clinton Breaks With Husband’s Legacy on Nafta Pact, China Trade.” Bloomberg News. 30 Mar. 2007. 31 Oct. 2007.

Smith, Ben. “McCain Team Mocks Hil Torture Loophole.” New York Daily News. 16 Oct. 2006.

Nagourney, Adam and Jeff Zeleny. “Obama Promises a forceful stand against Clinton.” The New York Times. 28 Oct. 2007: A1.

“Status of the Social Security and Medicare Program, A summary of the 2007 Annual Reports.” Social Security and Medicare Boards of Trustees 23 Apr. 2007.

A Bogus Cancer Statistic

See Factcheck.org for this and other bias-free reports.

Giuliani falsely claims that only 44 percent of prostate cancer patients survive under “socialized medicine” in England.

Summary

In a new radio ad, Rudy Giuliani falsely claims that under England’s “socialized medicine” system only 44 percent of men with prostate cancer survive.

We tracked down the source of that number, which turns out to be the result of bad math by a Giuliani campaign adviser, who admits to us that his figure isn’t “technically” a survival rate at all. Furthermore, the co-author of the study on which Giuliani’s man based his calculations tells us his work is being misused, and that the 44 percent figure is both wrong and “misleading.” A spokesperson for the lead author also calls the figures “incorrect survival statistics.”

It’s true that official survival rates for prostate cancer are higher in the U.S. than in England, but the difference is not nearly as high as Giuliani claims. And even so, the higher survival rates in the U.S. may simply reflect more aggressive diagnosing of non-lethal cancers, according to the American Cancer Society.

Actually, men with prostate cancer are more likely to die sooner if they don’t have health insurance, according to a recent study published in one of the American Medical Association’s journals. Giuliani doesn’t mention that.

 

Analysis

Rudy Giuliani’s latest radio ad, which began airing in New Hampshire this week, draws a stark picture for anyone diagnosed with prostate cancer in England. “I had prostate cancer, five, six years ago,” the Republican presidential candidate says in the ad. “My chance of surviving prostate cancer, and thank God I was cured of it, in the United States, 82 percent. My chances of surviving prostate cancer in England, only 44 percent under socialized medicine.”

Giuliani Radio Ad:
“Chances”
Giuliani: I had prostate cancer, five, six years ago. 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.
You and I should be making the decisions about what kind of health care we get with our doctors, not with a government bureaucrat. What we need to do is to give people a $15,000 deduction for a family, a $7500 deduction for an individual so they can go out and by their own health insurance.
If we do that, and we end up with a market of 50, 60 million Americans buying their own health insurance, without a mandate, the cost of health insurance will come down and the quality will come up.
Government has never been able to reduce costs. Government never increases quality.
We have the best health care system in the world. We just have to make it better.
Announcer: Rudy Giuliani. Leadership. Principle. Results.
Giuliani:  I’m Rudy Giuliani and I approved this message.
Announcer: Paid for by Rudy Giuliani Presidential Committee Incorporated. Visit joinrudy2008.com

Giuliani is wrong about that. Fortunately for the English, their chances of surviving prostate cancer are far better than Giuliani claims: The actual five-year survival rate is 74.4 percent, according to the United Kingdom’s Office of National Statistics. Even those in the U.S. have a better chance than what Giuliani states: The five-year survival rate is 98.4 percent in this country, according to the National Cancer Institute. (Furthermore, Milton Eisner, a statistician with the SEER program of NCI, which compiles these numbers, warns that the two countries’ statistics are “probably not comparable because they’re not done on the same scale.”)

Giuliani got his figures from a campaign adviser whose methods would make scientists and statistics professors cringe. Indeed, one of the authors of the report cited by the adviser says the figures in the ad are “misleading” and the math employed is “absolutely not” a legitimate way to calculate survival rates.

A Tale of Bad Math

Giuliani pulled these stats on prostate cancer from an opinion piece in this summer’s issue of City Journal, a publication of the conservative Manhattan Institute think tank. Giuliani spokeswoman Maria Comella says the former mayor saw the statistics himself and first cited them in a campaign stop. The article, titled “The Ugly Truth About Canadian Health Care,” was written by Dr. David Gratzer, a physician, senior fellow at the institute and a health care adviser to Giuliani. Gratzer states, without attribution: “The survival rate for prostate cancer is 81.2 percent here, yet 61.7 percent in France and down to 44.3 percent in England—a striking variation.”

What we find truly striking is Gratzer’s lack of thoroughness in checking his facts. His source, he says, is a 2000 report for the Commonwealth Fund by Gerard F. Anderson and Peter S. Hussey, of Johns Hopkins. When we checked with Hussey, now with the RAND Corp., he said Gratzer made inappropriate use of his report and was simply wrong.

SCOTT OLSON/Getty Images

The report, titled “Multinational Comparisons of Health Systems Data,” used data from the Organization for Economic Co-operation and Development (OECD)  to compare health care indicators in several countries. It included a chart showing that for every 100,000 men in the United Kingdom (not just England) during the single year 1997, 49 were diagnosed with prostate cancer and 28 died. Gratzer says he looked at the number who died over the people who were diagnosed. Specifically, he calculated, incorrectly, that 21 had survived, and calculated that number as a percentage of those diagnosed. His math was off; that equation actually produces a “rate” of 43 percent, not 44. (He also took figures that applied to the U.K. and said they were only about England.) But either way, such back-of-the-envelope calculations don’t produce anything that public health officials recognize as a “survival rate,” which is usually given as the portion of patients who are still living five years after they are diagnosed.

“In fact, the five-year survival data cited in the City Journal article do not come from The Commonwealth Fund report, and cannot be calculated from that report,” reads a statement by the Commonwealth Fund sent to us at lead author Anderson’s request. “Five-year survival rates cannot be calculated from incidence and mortality rates, as any good epidemiologist knows.”

Hussey says of Giuliani’s figure: “It’s misleading, because to calculate a survival rate you need to track a population who get the disease.” He adds, “What you’re looking at here [in his report] is two different populations. One who is being diagnosed with the disease, and another who has died from the disease.” To calculate a valid five-year survival rate, those who were diagnosed with prostate cancer in 1997 would need to be followed to figure how many would live until 2002.

Gratzer, when we confronted him with this, conceded that his 44 percent figure  “technically wasn’t a survival rate” – even though that’s what he called it in his article. He now calls his figure “a very crude indicator” and claims it “does give you an indication of what’s going on.” We disagree, as do other public health experts we consulted. The 44 percent figure is better described as a miscalculation based on decade-old data.

Hussey says the math that was performed on data in his report produces a number that is meaningless. “As somebody who’s trying to present facts I’m just disappointed that they were used in that way,” he says.

We can relate.

A “Misleading” Comparison

Official figures do show a discrepancy between survival rates for prostate cancer in the U.S. and England. The U.S. five-year survival rate is actually 98.4 percent, according to the National Cancer Institute. The rate in England is 74.4 percent, as we noted earlier. But do these figures support Giuliani’s argument that “socialized medicine” can be lethal? Even using these figures, that’s not so clear.

For one thing, according to the American Cancer Society, many more men are screened for prostate cancer in the U.S. than in Britain. This leads to more cases being diagnosed. And many who have prostate cancer live for years, without treatment, whether they are diagnosed or not. Thus, a higher number of diagnoses leads to a higher official survival rate. But this tells us nothing about the quality of treatment available to those who have the disease. A spokesman for the ACS told us that comparing rates in the two countries is “misleading.”

On top of that, Eisner, with the National Cancer Institute, told us we would need to find numbers that are standardized to a world standard, not just compare rates given by the two countries’ government agencies. He referred us to Cancer Mondial, a Web site of the International Agency for Research on Cancer, which maintains databases of such standardized numbers. We were not able to find prostate cancer survival rates for all of the U.S. and all of England (the data is broken down into smaller regions). The best figures we could find were comparable mortality rates in an IARC/World Health Organization database. For 2002, those rates (per 100,000 men) were 15.6 and 12.0, in the U.K. and the U.S., respectively.

Getting it Backward

Besides using a false statistic, Giuliani implies the health plans put forth by the Democratic candidates are the same as the government-run, “socialized medicine” system in England. That’s simply false.

British health care is universal, overwhelmingly provided through the publicly funded National Health Service; only 12 percent of the population has private insurance, according to Gerard Anderson’s 2006 report on multinational health systems. The leading Democratic candidates’ plans include expanding government-offered insurance but they also allow people to keep whatever insurance they have now. Barack Obama’s plan mandates coverage for children, but not adults. The only Democratic candidates advocating complete government-run care are Ohio Rep. Dennis Kucinich, who calls for an end to private insurance and “Medicare for all,” and former Sen. Mike Gravel, who calls for equal medical care provided through health care vouchers.

Giuliani’s central argument is that if the Democrats have their way, the public’s health is in danger. As we’ve noted, that’s simply not supported by the bogus statistic he gives as evidence. There is, however, ample evidence that lack of health insurance is hazardous to an individual’s health, and that those who do have coverage (as Giuliani did as mayor) live longer.

When it comes to prostate cancer specifically, a 2003 study of cancer patients in Kentucky, published by the American Medical Association’s Archives of Internal Medicine found: “Among patients with prostate cancer, 3-year relative survival proportion was 98% for the privately insured and 83% for the uninsured.”

The study found similar disparities for breast cancer, lung cancer and colorectal cancers. For each type of cancer, those without insurance were more likely to die sooner. The study looked at 35,855 cancer patients in the state, including 6,959 men with prostate cancer.

The authors noted that earlier studies established that cancer patients who lack health insurance tend to be diagnosed later in the course of their disease, and also to receive different treatment, than those who have coverage. Similarly, a 2002 report by the National Academies’ Institute of Medicine examined 130 research studies and found that “working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital.”

Conclusion

With the wealth of research available, Giuliani may well find other evidence to support his opposition to expanded federal health insurance programs. Indeed, when we challenged his bogus prostate-cancer figures, his campaign sent us links to a study by Lancet Oncology that found better cancer survival rates in the U.S. compared to Europe overall. But that’s no excuse for feeding a false statistic to the public.

– by Lori Robertson, with Jess Henig

 

Sources

United Kingdom. Cancer Survival, rates for adults diagnosed during 1999 – 2003, England. Office of National Statistics. 21 Aug. 2007.

United States. Cancer Stat Fact Sheets: Cancer of the Prostate. Survival rates for 1996-2003. National Cancer Institute. 2007.

Gratzer, David. “The Ugly Truth About Canadian Health Care.” City Journal. Summer 2007.

Anderson, Gerard F. and Peter S. Hussey. “Multinational Comparisons of Health Systems Data, 2000.” The Commonwealth Fund. 1 Oct. 2000

Cylus, Jonathan and Gerard F. Anderson. “Multinational Comparisons of Health Systems Data, 2006.” The Commonwealth Fund. May 2007.

McDavid, Kathleen, PhD, MPH; Thomas C. Tucker, PhD; Andrew Sloggett, MSc; Michel P. Coleman, MD, MSc, MFPHM. “Cancer Survival in Kentucky and Health Insurance Coverage.” Archives of Internal Medicine. 13 Oct. 2003: 2135-2144.

Institute of Medicine of the National Academies. “Care Without Coverage, Too Little, Too Late.” Washington, DC, 2002: 161-65.

Verdecchia, Arduino, et al. “Recent cancer survival in Europe: a 2000–02 period analysis of EUROCARE-4 data.” Lancet Oncology. Sept. 2007.

 

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Republicans tangle with each other and the facts on torts, taxes and health care, and refuse to shed some old myths.

Summary

Tongues were sharpened before Sunday night’s GOP presidential debate in Orlando, with the candidates drawing blood right out of the gate. We found them factually challenged in several areas:

• Giuliani stretched till he broke, in calling Thompson “the single biggest obstacle to tort reform” in the Senate.
• Romney boasted of his Massachusetts health care plan and criticized Hillary Clinton’s, although her plan is strikingly similar to Romney’s Massachusetts program. He also falsely accused her of favoring “all-government insurance.”
• Giuliani claimed the price of health insurance would drop more than 50 percent if millions more people purchased it directly, a statement unsupported by any evidence he’s offered so far.
• Thompson said the most affluent 40 percent of Americans pay “about 99 percent of the taxes.” Actually, they pay less than 85 percent, and also have nearly 74 percent of all the income.
  
• Giuliani made an inflated boast about bringing down crime in New York “more than anyone in this country – maybe in the history of this country.” But the decline started before he took office, continued after he left, and even the FBI itself warns against attributing crime statistics to any specific cause.

 

 

 

Analysis

With Sen. Sam Brownback out of the race, the number of contestants on the stage Sunday night was down to eight: Former New York Mayor Rudy Giuliani, former Massachusetts Gov. Mitt Romney, Sen. John McCain of Arizona, former Sen. Fred Thompson of Tennessee, former Arkansas Gov. Mike Huckabee, and Reps. Ron Paul, Tom Tancredo and Duncan Hunter. The debate, sponsored by the Florida Republican Party, was televised on Fox News Channel, with Fox anchor Brit Hume as moderator.

Thompson and Torts

Giuliani and Thompson seemed to contradict each other about a pet Republican cause, changes to the civil legal system. Giuliani accused Thompson of being “the single biggest obstacle to tort reform” in the Senate, while Thompson said, “I supported tort reform” as it applied to securities and product liability lawsuits.

Giuliani: I mean, Fred was the single biggest obstacle to tort reform in the United States Senate. He stood with Democrats over and over again. He voted against $250,000 caps on damages, which they have in Texas. He voted against almost anything that would make our legal system fairer: loser pays rules, things that would prevent lawsuits like that $54 million lawsuit by that guy who lost his pants – you know? That cost that family $100,000 in legal fees. I think the man should have to pay the family for the $100,000 that he took from them in the abusive lawsuit….

Thompson: As far as tort reform is concerned, I supported tort reform with regard to securities legislation. I supported tort reform with regard to product liability legislation, things that have to do with interstate commerce. I think it appropriately passed. I supported and worked for those things. Local issues belong at the state level. Most states have passed tort reform.

When Republicans use the term tort reform, they’re generally talking about making it more difficult for individuals to file lawsuits against, say, doctors, toy manufacturers or dry cleaners for alleged wrongs, or in some cases capping the monetary damages that plaintiffs are awarded. We’ll leave aside for now our objection to the use of the word “reform” in situations like this; according to Webster’s, to “reform” means to “improve,” and the merits of the tort proposals are hotly debated.

First, it’s hard to see how anyone could think that Thompson was the “single biggest obstacle” to these changes in the legal system when he was in the Senate. Thompson voted with a majority of his fellow Republicans on some measures, with a large bloc of Democrats on others, but he was no crusader, nor did his vote ever prove decisive (none of the votes were that close).

More substantively, the innocent bystander should be excused for thinking that Giuliani and Thompson couldn’t both be right about the latter’s position on various tort measures. Actually, though, they mostly can. In 1995, Thompson voted against an amendment to a medical malpractice bill that would have capped punitive damages at $250,000 (Giuliani should have used the word “punitive”; those awards are distinct from the economic damages that compensate victims for their actual losses).

But Thompson is dead on, as well. He supported the Common Sense Product Liability Legal Reform Act of 1996 as well as the Private Securities Litigation Reform Act of 1995, which were designed to curb certain kinds of lawsuits against securities firms and manufacturers.

He also voted, in 1995, to make punishment more severe for lawyers who filed “frivolous” lawsuits. But Thompson opposed an amendment that same year to raise the standard of proof for plaintiffs to be awarded punitive damages in lawsuits involving interstate commerce.

Thompson is also correct that “most states” have passed some measures of the broad array that advocates refer to as “tort reform.”

It’s not clear whether “loser pays rules” would stop lawsuits like the recent infamous case in Washington, D.C., where a man sued a dry cleaner for $54 million over a lost pair of pants. There already are rules in local jurisdictions that allow defendants who win their cases to petition the court for reimbursement of their legal expenses, as the dry cleaner did in the case above. (The dry cleaner withdrew the claim, however, having raised more than enough funds to cover the $83,000 – not $100,000 – in legal bills; the case is on appeal.) The claims are decided on a case-by-case basis.

RomneyCare vs. HillaryCare

Romney attacked Hillary Clinton’s health care proposal while boasting of health care success in Massachusetts. But the plan he enacted in his state is quite similar to Clinton’s.

Romney: But Hillary says the federal government’s going to tell you what kind of insurance, and it’s all government insurance. And I say no, let the states create their own plans, and instead of government insurance, private, market-based insurance.…

The price of the premium for an individual, 42 years old, in Boston, used to $350 a month. Now, it’s $180. We basically cut it in half by deregulating…. This is the first state in America that is on track to have everybody insured. Half of my uninsured are now insured, and I am proud of what we’ve done.

Actually, the plan Romney brags about in Massachusetts shares a number of key characteristics with Clinton’s:

• They both require that individuals obtain insurance and also require employers provide it.
  
• They both provide government subsidies for those with low incomes.
  
• Both expand the number of people covered under Medicaid.
  

However, Romney now says he wouldn’t propose a Massachusetts-style plan for the nation, so the track record of the Massachusetts plan is a poor indicator of what Romney’s current proposals might accomplish nationally. And while his claim that his state plan lowered premiums is correct according to the Commonwealth Connector, a state agency created to implement the plan, the group says that resulted from a legally required merging of small group and non-group markets, which is something states would be allowed to do – but not required – under Romney’s current proposal.

It’s also unclear how many of the previously uninsured have gained coverage under the Massachusetts plan. While the program has successfully enrolled 200,000 people (and the Connector calls those “newly insured individuals” on its Web site), some of those may have switched from less desirable policies. “Certainly there are people who didn’t have insurance and people who did,” says Dick Powers, a spokesman for the Connector. A more apples-to-apples measure comes from an annual survey of the uninsured taken by the Massachusetts Division of Health Care Finance Policy, which found that 395,000 people didn’t have insurance in the state in 2006. The survey shows only a 10 percent decrease in the uninsured between January through July 2006 and the same time period in 2007. That agency does not have more up-to-date numbers.

Furthermore, Romney’s claim that Clinton espouses “all government insurance” is false. Under her proposals, people could keep their current insurance and employer-offered health insurance could continue as it does now. It is true that Clinton’s plan would require much more government involvement than Romney’s nationwide proposal, which doesn’t call for any mandates and relies on tax incentives, such as allowing individuals to deduct insurance and medical expenses from their taxes.

Fred’s Tax Flub

Thompson exaggerated when he claimed the most affluent bear almost the entire federal tax burden.

Thompson: Hillary basically says that, you know, 40 percent of the people pay about 99 percent of the taxes. Why not 30 percent of the people? Why not 20 percent of the people?

We’ve never heard Sen. Clinton say any such thing, and it would be false if she did. It’s true that the U.S. taxes the affluent more than those who earn little, and also true that Sen. Clinton and other Democrats propose to ask upper-income earners to pay a somewhat greater share. However, Thompson’s “about 99 percent” figure would get him an “F” in 6th grade math. The actual figure is considerably lower. According to the nonpartisan Congressional Budget Office, the share of all federal taxes (including federal income taxes, excise taxes and payroll taxes) borne by the most affluent 40 percent of Americans in 2004 was actually 84.7 percent. (These affluent earners also had close to 73.9 percent of all pre-tax income, something Thompson neglected to mention.)

Thompson was probably referring only to the federal individual income tax, and omitting payroll taxes, which fall more heavily on lower-income workers, as well as excise taxes and corporate income taxes. CBO figures show 99.1 percent of the federal individual income tax was paid by the most affluent 40 percent in 2004.

Welcome, Aliens

Giuliani glossed over his own record in denying that he made New York a “sanctuary” for illegal aliens.

Giuliani: Oh, the simple fact is that New York City had a policy of allowing people who are illegal immigrants to report crime and to put their children in school. Otherwise, we reported every single illegal immigrant that committed a crime.

In fact, Giuliani’s policy as mayor was not so simple as he now claims. As we’ve noted before, New York didn’t describe itself as a “sanctuary city” for aliens. However, Giuliani told the New York Times early in his first term that a hard-working but undocumented alien is “somebody that we want in this city.”

Giuliani, 1994: Some of the hardest-working and most productive people in this city are undocumented aliens…. If you come here and you work hard and you happen to be in an undocumented status, you’re one of the people who we want in this city. You’re somebody that we want to protect, and we want you to get out from under what is often a life of being like a fugitive, which is really unfair.

The Times said back then that the mayor was “virtually urging [illegal immigrants] to settle in New York City.”

Anti-Crime Capital
Giuliani made a grandiose boast that he “brought down crime more than anyone in this country – maybe in the history of this country – while I was mayor of New York City.” Crime certainly dropped dramatically during Giuliani’s tenure from 1993 to 2002. In fact, the city is still in the midst of a record-setting trend for consecutive years of declining violent crimes. However, it is a trend that actually started under Giuliani’s predecessor, David Dinkins, in 1990, when a high of 174,542 violent crimes were reported, according to the FBI, and has continued under his successor, Michael Bloomberg. In 2006, a new low of 52,086 such crimes were reported.

Plus, the FBI itself warns against drawing broad conclusions (one might even say claiming undue credit) based on these statistics. Click on its most recent Uniform Crime Report and you’ll see a pop-up window that advises:

FBI: Some entities use reported figures to compile rankings … these rough rankings provide no insight into the numerous variables that mold crime in a particular town, city, county, state or region. Consequently they lead to simplistic and/or incomplete analyses that often create misleading perceptions.

We couldn’t have said it better ourselves.

Health Insurance Fire Sale

Giuliani made a claim, unsupported by any evidence we can find, that health insurance rates would drop by half if more citizens bought their own health insurance.

Giuliani: We only have 17 million people in America who buy their own health insurance. If we have 50 million or 60 million people who bought their own health insurance, the price of health insurance would be cut in more than half.

We asked the campaign if there was any research supporting that statement, and they had no comment. The only backup we could find is Giuliani’s own faith in the virtue of free markets. He told The New York Times and other news organizations that as people buy private health insurance instead of getting it from their employers, the competition for customers would cause companies to lower their prices. In a town hall meeting in Concord, New Hampshire, in July, he equated the change in the price tag on plasma TVs to what could happen to health insurance. Televisions became cheaper, he said, “because there are lots of empowered consumers and the more you reduce the price the owners and operators realize the more consumers you get.” In health care, “[m]ost people are covered by their — by the government, Medicare and Medicaid, or by their employer,” Giuliani continued. “What we need is individual consumers in health care.”

We ran that logic by Kenneth Thorpe, professor of health policy at Emory University, who once worked in the Clinton administration and who has evaluated a number of presidential candidates’ health plans. Thorpe says he’s not exactly sure what Giuliani means, but he questions how such a price drop could happen. Administrative costs, he says, would not be lower if more people bought health insurance. “The only possible way it would reduce premiums is if the underlying claims expenses … were a third to a half lower.”

War over Peace

Romney falsely blamed Bill Clinton for the entire post-Cold War reduction in U.S. military forces.

Romney: During the Clinton years, the president said we’re going to take a peace dividend. We got the dividend. We didn’t get the peace. He reduced the scale of our military dramatically, took 500,000 troops out, cut back our Navy by 80 ships, knocked our Air Force down 25 percent. Our aircraft fleet today are 28 years old.

Romney has tried this bit before. In fact, we’ve called him on it once already. We pointed out in that earlier article that in inflation-adjusted dollars, defense spending dropped nearly 15 percent between Reagan’s last budget and the final budget of George H.W. Bush four years later – compared with just under 13 percent between Bush’s last budget and Clinton’s, a span of eight years. Bush’s defense secretary, a guy named Dick Cheney, told the Senate Armed Services Committee in 1992 that “overall, since I’ve been secretary, we will have taken the five-year defense program down by well over $300 billion. That’s the peace dividend.… And now we’re adding to that another $50 billion.”

Alien Benefits

Tancredo dusted off an old piece of misinformation from the 2006 campaign trail when he said there “is a plan to give Social Security benefits to illegal aliens who have worked in this country. That is ridiculous.” What’s more ridiculous is that this outdated scare tactic is still being used. There is no such plan. Rather, current law says that a formerly illegal alien who eventually becomes a legal citizen can get credit for any payments he or she made into the Social Security system while illegal. A Republican amendment to end the practice was defeated as part of an immigration bill that the Senate passed in May 2006 (which subsequently stalled). You can read more about the wrangling over this measure in our original report.

Not Again!

Romney, yet again, claimed to have closed a “$3 billion budget gap,” saying, “We solved it without raising taxes, without adding debt.” This is the fourth time we’ve pointed out that the actual budget gap was closer to $1.2 billion. And while he didn’t raise anything he called a “tax,” Romney increased fees and closed corporate tax “loopholes” to the tune of about $500 million during his four years as governor.

Giuliani, meanwhile, continued to claim credit for bringing about 23 tax cuts in New York City during his eight years as mayor. As we and others have pointed out repeatedly, a more accurate number would be 14. He also claimed to have “balanced the budget” and replaced deficits with surpluses, which was true for a time. But as we’ve pointed out before, he left his successor with a projected deficit of nearly $2.8 billion, even before the terrorist attacks of Sept. 11, 2001, worsened the city’s financial picture.

– by Viveca Novak, with Brooks Jackson, Justin Bank, Jess Henig, Emi Kolawole, Joe Miller and Lori Robertson

 

 

 

Sources

Massachusetts Commonwealth Connector. “About the Connector: Overview.” www.MAHealthConnector.org Oct. 2007. 22 Oct. 2007.

Massachusetts Executive Office of Health and Human Services. “HCFP Survey Finds 40,000 Decrease in State’s Uninsured.” 27 Aug. 2007

Romney, Mitt. “The Romney Vision for Health Care Reform. “ www.mittromney.com 24 Aug. 2007. 22 Oct. 2007.

Clinton, Hillary. “American Health Choices Plan.” www.hillaryclinton.com 2007. 22 Oct. 2007.

Santora, Marc. “Giuliani Seeks to Transform U.S. Health Care Coverage.” The New York Times 1 Aug. 2007.

Romney, Mitt. “Expanding Access to Affordable Health Care.” Press release 24 Aug. 2007.

Langan, Patrick A. and Durose, Matthew R., “The Remarkable Drop in Crime in New York City.” Bureau of Justice Statistics, U. S. Department of Justice 21 Oct. 2004

Congressional Budget Office. “Historic Effective Federal Tax Rates: 1979 to 2004.” December 2006.

Sontag, Deborah “New York Officials Welcome Immigrants, Legal Or Illegal,” New York Times 10 June 1994: A1