Newt Gingrich Changes What’s Left of his Mind on End-of-life Care
More than 20 percent of all Medicare spending occurs in the last two months of life. Gundersen Lutheran Health System in La Crosse, Wisconsin has developed a successful end-of-life, best practice that combines: 1) community-wide advance care planning, where 90 percent of patients have advance directives; 2) hospice and palliative care; and 3) coordination of services through an electronic medical record. The Gundersen approach empowers patients and families to control and direct their care. The Dartmouth Health Atlas has documented that Gundersen delivers care at a 30 percent lower rate than the national average ($18,359 versus $25,860). If Gundersen’s approach was used to care for the approximately 4.5 million Medicare beneficiaries who die every year, Medicare could save more than $33 billion a year.
That was Newt Gingrich just a few months ago praising the “Advance Directives” practiced by a hospital in Wisconsin. Advance Directives are another word for the end-of-life consultations that the teabggers have been flipping out over of late. Gingrich loved them a few months ago. This is Gingrich a few months before that, responding to a PBS query:
Let me give you an example that I find fascinating. In LaCrosse, Wisc., the Gundersen Lutheran Hospital system is, according to the Dartmouth [Atlas of Health Care], the least expensive place in America for the last two years of life. They have an advanced directive program, and over 90 percent of their patients have an advanced directive. They have electronic health records, so everybody on the staff knows what the advanced directive is. They have a very strong palliative care program for using drugs to manage pain. They have a hospice program.
The result is today, the last two years of your life in costs are about $13,600. The last two years of your life at UCLA are $58,000. Now, why should Medicare pay $58,000 for the same outcome if it could pay $13,600? You can say, well, Los Angeles is more expensive; they do a couple of more complicated things. So fine. So let’s say it ought to be $20,000 at UCLA. That’s still [$38,000] less than it currently is. …
We don’t think the politicians can ever fix this because the hospital lobby is so powerful, and the doctor lobby is so powerful, and the pharmaceutical lobby is so powerful, and the medical technology lobby is so powerful…
And we also know — this is the great irony — the best places in America are always less expensive than the worst places. Health is not like jewelry and automobiles. In jewelry and automobiles you pay a lot more to get a lot better. In health, because the best places do it right the first time, they do it very efficiently, they pay real attention to quality, they’re actually less expensive than the places that are bad.
He’s pretty unequivocal here. Well, what happens when suddenly the Republican party decides it wants to scare the shit out of a bunch of old people by telling them the new health care bill is going to include a provision in which “death panels” ask them “when they want to die”? Now all of the sudden Gingrich is violently against the same programs he was so windily praising earlier this year.
And make no mistake, this is exactly the same thing. The only thing that’s actually in the health care proposals is a provision that would allow Medicare to pay for exactly the kind of programs Gingrich praised, on a voluntary basis. The programs are not government-administered in any way, there’s just government money now to pay for the private programs. And now Gingrich is suddenly aghast at them:
STEPHANOPOLOUS: The only thing that’s in the bill is that Medicare would pay for what they say is voluntary counseling on end-of-life issues.
GINGRICH: I think people are very concerned when you start talking about cost-controls… you’re asking us to trust the government. Now I’m not talking about the Obama administration, I’m talking about the government. You’re asking us to believe that the government is to be trusted. We know people who’ve said routinely, well, you’re going to have to make decisions. You’re going to have to decide. Communal stadards, historically, is a very dangerous concept.
STEPHANOPOLOUS: It’s not in the bill.
GINGRICH: (stammering) B-but, the bill’s… a thousand pages of setting up mechanisms. It sets up 45 different agencies. It has all sorts of panels. You’re asking us to trust the government when there clearly are people in America who believe in establishing euthanasia, including selective standards.
In other words, there may not be a death panel in the bill, but there are other panels, and while no one has actually ever said such a thing and it is not relevant to this particular discussion, I nonetheless assert that in general it is true that “people in government” believe in euthanasia.
Amazing. I mean, talk about being full of shit. This is as clear a case as you will ever find of a politician just getting up on television and just flat-out dogging it, saying something without even the faintest shred of belief, just as a means to an end. What an asshole!
I know some politicians have kind of a wink-wink nudge-nudge attitude towards lying, and some of them in private will act almost like it’s funny, part of the job description. But there are limits to how much even a politician should be allowed to lie. That’s especially when he’s lying in order to scare a bunch of old people.