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Aug. 12 2009 - 1:27 pm | 335 views | 9 recommendations | 79 comments

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.

via Health Care Rx: Across the Country, Some Systems Are Getting It Right – Newt Gingrich.

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.

Newt Gingrich speaks in Washington on June 8 (Chip Somodevilla/Getty)

Newt Gingrich speaks in Washington on June 8 (Chip Somodevilla/Getty)

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:

On This Week he argued with George Stephanopolous and Howard Dean about the programs. Check it out:

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.


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  1. collapse expand

    Thank you for this one! It seems that Republicans are taking flat out lying to a new level. Its not spin anymore. Its the new political strategy…lie big and by the time someone calls you on it you have hundreds of old people storming town hall meetings because they are afraid someone is going to kill them when they get sick. Herman Cain here in Atlanta on WSB radio is one of them too…disgusting

  2. collapse expand

    Are we headed toward a 21st century version of the French revolution, or will such cheap political rhetoric give way to some fact-based decision making? Our health care system serves too few people well, and costs too much. If we can’t agree in a reasonable timeframe — say within a year — on a synchronized universal care system, and a plan to pay for it, then let’s bite the big bullet and go for a single-payer plan. The trauma of such a change will be nowhere as worse as the individual traumas and agony continuing to be imposed on the population by the current system.

  3. collapse expand

    Brilliant juxtaposition! Thank you.

  4. collapse expand

    What? A right winger lying? Hard to believe, Matt.

  5. collapse expand

    I would call Newt a dumbass dipshit but that would be an insult to dumbass dipshits everywhere so I won’t.

    Why is this man on my teevee? Is this proof there is no God?

  6. collapse expand
    deleted account

    So let’s get this straight. When we talk about cost-controls for non-profit government aided health programs, that’s an eerie omen that couldn’t possibly lead to anything good.

    But when the discussion is about corporations making money when they either don’t have to pay your entire bill or try to get doctors to provide a different treatment plan because it’s less expensive for them, that’s perfectly all right and results in the best and most humanitarian healthcare in the world.

    If the government is so bad, why are there so many people like Newt Gingrich working there, collecting over $130,000 a year, getting a free staff, a free office, reimbursements for almost every expense and free “socialized, single player medical care?” Oh right, that’s why. And I bet being Speaker of the House wasn’t exactly a horrible gig either…

  7. collapse expand

    Well, were his lips moving? Then he was lying.

    We certainly can’t be upset or even surprised, Matt. It’s what they do. Like a dog licking it’s privates, they do it because they can and no one calls them on it. That it feels good because they get to have it both ways is just an additional bonus.

    I’ve often wondered if politicians bet amongst themselves on who can get away with telling the biggest whopper and then how much money they can raise from telling it. Like betting on the point spread.

    Looking forward to the article on the health insurance industry, Matt. Keep up the great work.

  8. collapse expand

    Lying seems to be the only strategy the GOP can rally around; if only the mainstream media would just start calling them out when they do it rather than acting like they just have a different opinion – IT’s Lying, Newt !!

  9. collapse expand

    Politicians like Gingrich are relying on the short memory and general lack of attention of the public so that they can set whatever agenda serves them and their party best. Do the tea-baggers and the like ever stop to remind the men and women in the neo-con camp that they “work for us”?

    In general I think that the progressives need to stay on message, putting the facts out there, and keep the references to the opposition to a minimum – just to keep that rhetoric off the air waves. However, the 2-faced side of politics should be paraded until nobody can honestly say they haven’t seen it. This tactic will keep those for universal health care on board and bring on those who can be swayed by the nay-sayers.

    It’s great that you’ve put this on True/Slant, so I’m hoping that the general media culture will follow suit (Newt’s about-face can’t be the only example). Keep us posted.

  10. collapse expand

    If right-wing of american politics is now referred to as teabaggers, does that make the left-wing the cocksuckers?

  11. collapse expand

    A vampire squid wrapped around the face of politics, isn’t he?

  12. collapse expand

    Matt, I’m wondering if I could get you to speak at Emerson College? I’m pretty sure that there’s an email address in my profile. We’ve had a dearth of guests but it’d be really interesting to get someone in who isn’t the Boston PD’s PR person or city counselmen.

  13. collapse expand

    Matt, I know it’s a lot of fun to put the court jester hat on and yell in the echo chamber, but does even say what you accuse him of? What I read is that he’s addressing people’s mistrust of government, and how this proposed legislation, combined with comparative effectiveness policy in the ARRA, opens up the potential slippery slope for people like Dr. Ezekiel Emanuel to make value judgments such as “should grandma be eligible for that hip replacement given that she’s 85 and has dementia?” But that’s right, I can just keep my own insurance, because President Obama says I can…

    • collapse expand

      First and foremost, craven, career political harlots such as Newt Gingrich are the primary reason people mistrust government so much in the first place, and him blithely going on about it (like he does when ever there’s a camera present) as though the Obama and the Democrats are the problem after the raging clusterfuck almost 28 years of Republican political dominance left us with is a pristine example of why. Jesus H. Christ Newt, could you at least give us a reacharound?

      Secondly Mr Menlopian, if you think a claims adjuster working for a profit minded Health Insurance company will approve a costly hip replacement for your 85 year old grandma with dementia without having a fight on your hands, I’ve got some Mortgage Backed Securities you might be interested in at a good price.

      In response to another comment. See in context »
  14. collapse expand

    “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.”

    Is this correct, Matt? If there is funding for hospital run, community wide, programs like Gundersen’s in whatever reform we end up with, I’m all for it. But the provision that the idiot masses are screaming their fool heads off about doesn’t seem like the same thing to me. The way I understand it, the provision in question merely allows doctors to be paid by Medicare to have a discussion with a patient about many end of life issues. This is quite a bit less than some organized program, no? Seems like apples and oranges to me.

    My own problems with the current provision, as benign as it is, are twofold:

    First – While the provision encourages doctors and patients to discuss such things as hospice, DNRs and the like, it also mandates that the discussion include things like living wills and powers of attorney. These things are certainly related to healthcare, but they are essentially legal documents. I don’t know that my doctor is qualified to discuss this subject at such a level that he should be paid for it. Hell, a will is related to after death issues, but I wouldn’t go to a mortician to get one.

    Second – I don’t see why a doctor needs additional compensation to discuss these issues with patients. When I go see my doctor, we always spend a couple minutes catching up before we start discussing the reason I made the appointment. It’s not like he can’t, as part of my visit, just take a few minutes to discuss end of life issues with me if I wish. In fact, if my doctor wouldn’t discuss these things with me without additional compensation, I’d get a new doctor.

    I’d be glad to see programs like Gundersen’s. I’d even be glad if there was a provision in the reform that made it mandatory for insurers to provide end of life counseling and documents to all who wanted them. Maybe all the insurance company employees who are currently trained to use their policies and the law to deny care to patients could be retrained to provide this valuable service instead. And maybe doctors shouldn’t be trying to milk health reform money for every minute spent talking to a patient. If reform is to succeed, everyone with a financial stake in the system is going to have to sacrifice a bit. You know – Do more with less – Isn’t that what the rest of us are always told?

    Personally, I’m with chuckebeling – single payer is the way to go!

    Oh yeah, I almost forgot – FUCK Newt Gingrich and the horse that rode in on him!

    • collapse expand

      Mark–

      It is true. The Gunderson program is exactly what’s being referred to in section 1233. The language being used in the bill is “advance care,” but “advance directives” is also used in the industry. And from what I understand it can be as simple as a single consultation with a single person or assistance by a structured program — and you would have the option of doing this once every five years.

      The reason you need something other than a conversation with your doctor is that this is something that goes beyond medical issues, and includes psychiatric counseling, legal counseling, and advice in other areas. It may also include the participation of family members, which does not happen with your doctor.

      In response to another comment. See in context »
  15. collapse expand

    Matt,
    One thing that Newt knows, most in the GOP are not well informed and will believe anything said on TV with conviction.
    This is the same guy who was boinking his own aide while leading the impeachment of Clinton for sex with an intern.
    Ya gotta love it.

  16. collapse expand

    This is pretty ridiculous, but I still feel that his reference to Spanish as a “ghetto language” is the worst yet.

  17. collapse expand

    Matt’s on the money, but the truly sad thing is none of the people in a position to actually shame Newt will do anything. Steph tried to do a little push back, but he still let Newt spread the lie.

    I was no fan of Tim Russert, but some good old “gotcha” journalism wouldn’t be the worst thing at the moment.

  18. collapse expand

    Newt annoys me because he’s obviously very intelligent, he just chooses — as so many politicians do — to spout garbage that he really doesn’t believe. He’s a water carrier, pure and simple. He doesn’t believe in anything, except being against the liberals.

    Matt: Right on with this piece. Keep it up! And also, props for being on the Adam Carolla podcast. Great interview.

  19. collapse expand

    For the sake of precision, he says “people in America who believe in establishing euthanasia”, not “people in the government who believe in establishing euthanasia”. Though it doesn’t significantly alter your argument, it does make his sentence rather more true.

  20. collapse expand

    Matt, I first really got to know you seeing you on Bill Mahr. I appreciated your always interesting, common sense, intelligent journalism. Although I wish to comment on health care, I think part of the problem in this country with any issue is that there are not enough actual facts on the issues reported by other journalists as you do. I follow the news and politics closely so do not beleive anything that hypocrite Newt Gingrich says anyway but many people do hear soundbites from morons like him and beleive them. So what’s behind this idiot’s recent transformation from praising Gundersen Lutheran Health System’s end of life best practices, and rasing hell over the exact same thing proposed in the health care bill? Greed! The fact that he owns The Center for Health Transformation clearly explains the interests he wants to protect. It is truly amazing how little so many people in this country actually know and understand. It’s very simple why so many current and previous politicians are so adamantly opposed to health care reform. When you break down the salaries alone for some of the CEOs of the biggest health insurance companies, they are being paid hundreds of thousands of dollars not a year, but in a day!!. Yes if you divide their annual salaries into days, people like the CEO of United Healthcare make over $800,000 a day. If healthcare is reformed and these CEOs have their salaries reduced, how can they line the pockets of mutts like Newt, upChuck on the grass Grassley, and these other greedy mental midgets? Thanks for your great reporting.

  21. collapse expand

    Newt Gingrich has held the well-deserved position of has-been for a decade now, so why is he suddenly the Great Guru of all the corporate network pundits in ‘09?

    I can’t help but remember, from about the time we saw Gingrich fall into oblivion, when a wave of unearned fawning attention for some reason was lavished on an obscure Texas governor – what was his name again?

  22. collapse expand

    I’m not surprised US wingnuts are inventing “death panels” to discredit Obama’s plan for a more public system but it’s certainly ironic considering private insurers already have what you could probably reliably call death panels in place, i.e. you pay them thousands every year and if you suddenly get a disease requiring expensive or extensive treatment to save your life, they may or may not cover you. Some people are already dying because private insurers decide not supporting you is the more “practical” option FOR THEM. I’m surprised no one has raised this at the Clown Halls. Panelists should include ordinary Americans who’ve been screwed by private insurers. They wouldn’t be hard to find. Doctors employed by insurers receive bonuses (like those Wall Street fucks) every time they say no to a patient and save the company money. That’s what I’d call a death panel.

  23. collapse expand

    Why are the only two places who seem to dig into archives to expose politicians and pundits shamelessly contradicting themselves, Matt here at TS and The Daily Show? Wouldn’t it be normal for a journalist, next time someone has Newt on their show, to show him his own words, confront him? I’ve only been a journalist myself for a short while now, but that seems to be a fairly simple assignment any novice ought to be able to perform…

  24. collapse expand

    I recall reading comments by, I think, David Gregory a while back that perfectly exemplify what’s wrong with the majority of America’s MSM journalists. I think it was about the Iraq war, and the run up to it. He actually said that he didn’t feel it was his job to contest the administration’s assertions about Iraq and Saddam’s links to 9/11. It wasn’t his job!?!?

    There’s the fucking problem right there. The most elementary task of a journalist, informing it’s readers/viewers/listeners of the simple facts, was not in Gregory’s damn job description. When did this shift happen? That journalists somehow feel they need to let both sides to a discussion talk equally, as if both opinions are equally valid and truthful. Sometimes they aren’t!

    “Next week on Meet the Press: a fascinating disccussion between two opponents. The Earth: round or flat?”…

    *sigh*

  25. collapse expand

    The question is, why doesn’t anyone in the media call these guys on their bullshit? I mean, I know it might hurt his tiny little brain, but George COULD have done a little bit of research beforehand and discover the passages that you’ve cited and slap Newt upside the head when he tried to pull that crap. That’s supposed to be the job of the media.

    Rocks are hard, water’s wet, and politicians lie. That’s why we need journalists who have some brain cells and some integrity.

  26. collapse expand

    By the way Matt, any indication on when we can expect your health care story for RS?

    And on a sidenote, I wish RS would be distributed in a more timely manner outside the States. Or at least where I am, the Netherlands. I wanted to buy the issue with your Goldman story, but it takes so long for an issue to arrive in stores here (I think it was four or five weeks eventually) that it was up on the website in its entirety before the issue hit the stores.

  27. collapse expand

    Shirley you jest Matt.
    This can’t be the same Newt Gingrich that dumped his first wife while she was fighting cancer. According to the Wiki he even produced a hand-written agreement for her to sign during one of his compassionate visits. Too bad she was just returning to consciousness from her recent cancer-related surgery to fully enjoy the visit. Classy!
    Is this kinda behavior business as usual for all the grownups?
    It reminded me of the bedside visit Gonzo paid Ashcroft.

  28. collapse expand

    My parents honestly believe that Obama wants to euthanize them someday. Seems to me that if anyone started euthanizing the elderly that a revolution would start in this country. I tried to explain to them that this is America, not the Netherlands. People like Newt and that bimbo Sarah Palin make me sick. Almost as sick as the Americans who depend on Fox news as their primary source of misinformation and believe every word they here, without researching elsewhere.

    Don’t get me wrong though. While I find is alarming and sad that there are Americans with teeth rotting out of their heads because they can’t afford to go to the dentist, I do not want the federal government running health care in this country. There is not a group of people on this planet who lacks more financial responsibility and general awareness of how normal Americans live than our federal government.

  29. collapse expand

    Newt has been ringing the douchebag-quotient bell so hard for so long it seems almost ridiculous to ridicule his hate-mongering and fear-brokering. But his high profile media campaign, and that of all his full of shit hate posse, is inflaming, albeit lowering, the national debate on healthcare reform to a dangerous level of mob mentality; no facts allowed.
    While it is quite certain that the final legislation will be written largely by self-interested lobbyists, and the American people will become well acquainted with fist shaped rectal thermometers, this anti Obama (ostensibly anti HC reform) furor at town halls is unsettling.

  30. collapse expand

    Meanwhile…”Bubble #6″ goes undiscussed…Matt, don’t let Bubble #6 fade away.

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