I was talking about 5 year survival rates. They are next to useless as a statistical measure of much of anything other than improved diagnostic capabilities and earlier diagnosis.
There may be other problems with the statistics quoted in the study if the methods used to derived these statistics did not controlling for socio-economic status, as others have noted. We know people who have lower socio-economic status get sicker more frequently, and die younger - whether white or black. The question to answer is, do blacks and whites with similar SES and access to the same level of health care have significantly significantly disease rates or life expectancy.
So you argue that by time Medicare kicks in, lower socio-economic status would lower life expectancy even if health care was identical thereafter? So major disparities in treatment between blacks and whites proved by these studies gets explained in your book by fact that blacks will have shorter life expectancy anyway so why bother to give them access to things like chemotherapy or radiation treatment? Or do you just argue that when blacks receive lower quality medical care, burden should be on them to prove that it doesn't amount to "harmless error"?
You seem to enjoy putting words in my mouth. I am saying that IF you want to do a proper comparison, the only difference between your cohorts should be race. If these studies have other variables which are not controlled for, then there may be other explanations for the data that cannot be scientifically excluded.
What part of
"Whites were 19% more likely than blacks to receive surgical removal of lung cancer tumors, 27% more likely to get chemotherapy after surgery for rectal cancer, 24% more likely to get chemotherapy for colon cancer, 7% more likely to get radiation treatment after breast cancer lumpectomy, and 11% more likely to get surgical or radiation treatment for prostate cancer"
provides improper comparison? You reject five-year survival statistics as meaningless? Fine. But what about these statistics? What additional information do you need after you consider that everyone in this study got their medical care paid for by government, but one group got shafted while another got best care money could buy? You don't believe there might be any correlation between getting best care available and getting inferior care? Would you want to be denied surgery, chemotherapy, or radiotherapy for cancer while patient next to you in line got them, because you happened to belong to wrong ethnic or racial group? Would you want to have to prove that being denied best care posed any special problem before being given level of care other people took for granted? How would you feel if someone explained that there might be other scientific explanations for why you were getting screwed and demanded that you prove otherwise?
Sentence that read "You don't believe there might be any correlation between getting best care available and getting inferior care?" should have read "You don't believe there might be any correlation between getting best care available and surviving your bout with cancer?"
As far as I am aware, I've made no specific claims about this particular research.
As for cancer treatment. I am not aware of any scientific evidence that would lead me to believe that people who are treated for cancer live any longer than those who are not. There are a few types of cancer that are very treatable using surgery, but on average, I think most people will live longer if they are never tested or treated for cancer.
"How would you feel if someone explained that there might be other scientific explanations for why you were getting screwed and demanded that you prove otherwise?"
I wasn't aware that "feelings" should have anything to do with science. But perhaps you'd like to live in a world where researchers regularly fudge their results because they are worried that they might offend a particular group. Oh wait, we already live in that world.
"Specific types of cancer that are very treatable using surgery," like prostate cancer, one of those forms that were part of this study?
Do you claim that this study was "fudged" and that study in 1992 was "fudged"? Do you have any evidence to prove that, or have you invoked "feelings" to arrive at your conclusions?
Your point seems to be that since most cancer treatments accomplish nothing, getting worse treatment may actually be better for black people. Does that also mean that in terms of diseases which you wouldn't doubt were treatable that getting worse treatment might also be better? Or do you claim blacks only get shafted in medical care when it comes to cancer? Oh, I remember, this study was only about cancer, so you can claim blacks probably get medical care just as good as whites when it really matters. No wonder American blacks think so many whites really harbour racist sentiments when disingenuous arguments come so naturally.
Are you aware that a large percentage of men over the age of 80 who died of some cause other than prostate cancer, have prostate cancer? Prostate cancer is one of the least aggressive cancers. If you get it later in life, it's not likely you are going to die of it, it's that slow. Additionally, testing positive on a PSA screening test earlier in life doesn't tell us what kind of prostate cancer you will develop, aggressive or slow, or whether or not you even have prostate cancer.
Counter balance this with the effects of treatment - death (yes, people die in surgery and from infections contracted in the hospital), erectile dysfunction, increased risk of cardiovascular disease on some treatments, and incontinence and you will understand why "watchful waiting" is included in the standard of care for prostate cancer. Basically this a fancy way of saying "do nothing".
Check out the following: http://archinte.ama-assn.org/cgi/content/abstract/167/18/1944
"Ten-year specific survival was 83% (95% confidence interval [CI], 73%-93%), 75% (95% CI, 67%-83%), and 72% (95% CI, 66%-80%) for patients who underwent surgery, radiotherapy, and watchful waiting, respectively (P < .001)."
Note that although surgery appears to have the highest survival rate, it's confidence interval has significant overlap with the confidence interval of "watchful waiting" - doing nothing. So this study failed to find a statistically significant difference between doing nothing and surgery.
Further we have "At 10 years, patients treated with radiotherapy or watchful waiting had a significantly increased risk of death from prostate cancer compared with patients who underwent prostatectomy (multiadjusted hazard ratio, 2.3 [95% CI, 1.2-4.3] and 2.0 [95% CI, 1.1-3.8], respectively). "
Again, notice the confidence interval, it goes down to 1.2 and 1.1 on the low end, this is a weakly significant result. But the important fact here is that they don't quote overall mortality, presumably because there was no statistically significant difference. Yes, if you don't have the cancer cut out, you are more likely to die of prostate cancer, but if you have it cut out, apparently it ups the the risk of your dying of something else. Or maybe people die of so many things other than prostate cancer that those numbers swamp the slight increase in prostate cancer deaths in the untreated.
As for your other statements. It's clear that increased access to health care is not always a positive thing. The UK spends half of what we do in the US, per capita on health care, and their citizens have a very similar life expectancy when socio-economic factors are controlled for. I honestly believe that a clean water supply and effective sewage systems, improved infant/childhood nutrition, antibiotics, and advances in trauma surgery are responsible for almost all the gains in life expectancy in the last 100 years. The rest of our bulging health care apparatus does save lives, but at a significant cost, both in money, and in lives. You risk infection just going in to a modern hospital. You also have a significant risk of death due to mistreatment and misdiagnoses.
Now, would all this justify racial discrimination in the distribution of health care? Clearly not. But if blacks are culturally predisposed to avoiding the doctor, for whatever reasons, I don't think it's doing them much harm.
I'll ask you this though. As the people in the linked studies had similar health care benefits, how do you explain the differences in treatment? Are thousands of white doctors across the US joining together in a massive conspiracy against the black man?
Fascinating final question ("As the people in the linked studies had similar health care benefits, how do you explain the differences in treatment?"). Rather than respond directly, I will quote "Dr. Otis Brawley, chief medical officer of the American Cancer Society, [who] opined, 'This sort of thing has been a problem in the United States for a long, long time. I think individual racism likely accounts for a small amount of it, but not a large amount. What I would refer to as institutional or societal racism accounts for a much larger component of it.'" He thinks "institutional or societal racism" accounts for differences in treatment, since he can't believe that "individual racism" on part of doctors accounts for more than "a small amount of it". What do you think he was trying to say? Do you think him so obviously ignorant that you can safely ignore his opinion?
As for prostate cancer, you might find Rudy Giuliani's rap interesting, since it shows what can be done with statistics. (He claims survival rates for prostate cancer in United Kingdom were 44%, that survival rates were higher in US because of superior health care, which claim you strongly reject.)
But just to make sure we understand one another, your contention has been that increased access to health care doesn't help any and that black people should consider themselves lucky they don't have access as good as white people. You don't practice Christian Science, do you?