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)
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.
Post Your Comment
You must be logged in to post a comment
T/S Members
Log in with your True/Slant account.
I wonder how many of you astute liberals have actually heard Gingrich speak on this position. I doubt if any of you have. Liberals tend to get into a feeding frenzy over their favorite “boogey men”. No one is against end of life counseling. It is an essential part of caring for a dying person with the utmost respect and dignity. Newt’s position is that the consultation be between a health professional and the dying person’s doctor with no government intervention. Additionally, Gingrich’s position is that the end of life counseling be at the request of the dying person or members of his/her family. The model that Gingrich espouses was developed by a hospital in MN, not by government bureaucrats.
You can download the text of the health reform bill on the web. The end of life section begins on page 425. You can find Newt’s view on “newt.org”. Researching this issue is not as much fun as having a Newt temper tantrum, but perhaps it will keep you from embarrassing yourselves. Although, I’ve never met a liberal who let facts stand in the way of assailing their “boogey men”.
Gabob,
I’m sitting here right now reading section 1233 of the bill. There is no “government intervention” in the bill at all. The section is wholly and entirely about paying for private consultations on a voluntary basis. The only “government” element in the section is the fact that the patient can bill Medicaid for such a consultation once every five years.
So according to you, this is okay when private insurance pays for it, but “government intervention” when its paid for by the government?
In response to another comment. See in context »I must respectfully disagree. My point is, if the states have to come up with guidelines that then have to be approved by the secretary of HHS, and then these guidelines have to be adhered to by health professionals who must be certified as end-of-life counselors by the government,then there is government intervention. Additionally, madating a meeting every five years with persons over 65 is, again, government intervention.
I do not believe the government has the right to intervene in every phase of my personal life, from the time I am born to the day I die, which is what nationally accessible computerized health records allow.
This isn’t my only disagreement with this bill, it is one of many. For instance, even in the case of small businesses, there is no tax credit for health insurance paid on the behalf of workers who earn $80K per year or more (Title IV SubTitle B). That to me is the typical Democrat/Liberal class warfare and redistribution of wealth philosophy. I don’t know where you live, but in large metropolitan areas in the Northeast, $ 80K is chump change, particularly when you consider that sales tax is 6% – 8%, property taxes run $8K – $10K, etc.
The problem with government is that all issues degenerate into the realm of politics rather than good sense. I have serious reservations trusting my personal and my family’s health and well-being to politicians.
I’ll repeat the mantra: They can’t run the post office, they can’t run social security, they can’t run Medicare, they can’t run medicaid, they pay $70 toilet seats for the military….
But they do great running health care?
In response to another comment. See in context »I’m sorry, but I can’t let this go. There is no “certification” of these programs by the HHS or any other government entity. Private hospitals and privately-employed doctors and counselors will be free to do whatever they want with these programs. The only relation the government has to any of this is payment. They obviously will have to meet some kind of standard in order for Medicaid to agree to pay for them, but that’s true of every single medical procedure. You can’t put a band-aid on your little sister’s arm and bill Medicare for ulnar surgery. But that doesn’t mean you’re prohibited from putting a band-aid on your sister’s arm.
And the five-year period, there is no “mandate” that forces people to make a visit once every five years. They are ALLOWED to receive counseling once every five years, in other words, they are not allowed to do it more often than that and bill Medicare for it. Furthermore, there are provisions in the bill that provide exceptions even for this. If there is a “significant change” in your condition, you are allowed to go more often.
But nobody is forcing anyone to go to any counseling session. Again, the government is not involved in this in any way except that the new bill would make it possible for people to bill Medicare for these programs that already exist and are administered completely by privately-employed persons.
I’m not even going to address your other points because this is a way you talk-radio conservatives like to argue: you say something that is obviously untrue, and when you are corrected, you move on to some other issue. I think we should stay on your original point until you admit that you’re wrong. Unless you’re willing to say that you consider the government paying for an already-existing private program an unwelcome intrusion of government — in which case we would merely have a philosophical difference — then you’re simply mistaken. I advise you to go to the bill and actually read it. If you don’t understand it, do what journalists do and call the relevant committees in congress and ask for clarification. They will tell you exactly what I’m telling you; that this provision has nothing to do with anything except monetary compensation for existing services.
Moreover, this provision is the brainchild of Georgia Senator Johnny Iskason, a Republican conservative who tried two years ago to introduce a bill along exactly the same lines (I think it was called the End-of-Life Care Planning Act). It is very curious that people like yourself were not against it then.
In response to another comment. See in context »“It is very curious that people like yourself were not against it then.”
Nor did we hear much of a fuss from these people when Gov. G.W. Bush signed the Advance Directives Act into law.
As much as we get suckered into refuting the series of unfounded factual claims made by these talk-radio conservative types, I think we need to wake up to the reality that all this “birther”, “deather” and other nonsense is just the latest round of the culture war that began with the Southern Strategy. White men will stop at nothing to defend what they perceive as a threat to undermine their privileged position in this society. The Southern Strategy begat the Christian fundamentalist movement of the 1980s begat the “market populists” (so well examined by Thomas Frank). So it’s no surprise that man who lead market populism’s “rise to orthodoxy” in the ’90s, is once again rearing his ugly head. For Gingrich and his ilk, our institutions of exchange (markets = one dollar, one vote) are seen as more legitimate than our institutions of consent (government = one man, one vote). They focus myopically on the evils of corruption in government and in unions, never recognizing the ways in which much more harmful wrongdoing by corporations is encouraged by the logic of the market, wrongdoing which is obscured by lack of transparency and which typically goes unpunished. (For example, you never hear these patriotic conservatives pointing to the fact that our health care industry makes its profits by killing tens of thousands of Americans every year.) So now with a black president advocating a moderately liberal (but still very much corporatist) agenda, the right-wing reactionary machine has gone into overdrive. Facts are not their friends.
In response to another comment. See in context »gabob1,
In response to another comment. See in context »I won’t paint all “conservatives” with one brush because they are all humans, too. Look at what E.D. Kain has written on health care, and you will find that conservatives can have thoughtful disagreements with liberal plans without resorting to wild-eyed yelling and outright lies. Your accusations against “liberals” are probably part of the latter, but if not, please cite references.
Oh the irony of a conservative saying liberals have a negative relationship with the truth. Do you clowns have any actual level of comprehension?
This whole moronic topic is a lie dreamed up by idiot conservative politicians.
We wouldn’t even be having this foolish debate if not for conservatives lying their pathetic asses off.
There is nothing more sickening than the current conservative mindset. Truly people without conscience.
In response to another comment. See in context »What one may nebulously call ‘a liberal feeding frenzy over a favorite boogeyman’ (what does that mean anyway?) a rational human being would describe as “Calling out and demonstrating Lies as Lies with factual proof, and not rolling over to a Neo-Con bully that is using a canard of debating inane details of end of life care to blow smoke over the fact that insurance companies are making sure that a large part of the nation has No health insurance, another large part will get DENIED when they get sick and yet another is stuck in a job just because it’s the only way he can keep his health insurance”.
Conservatives should stop worrying so much about government intervention anyway. You guys love private enterprise so much; if you really opened your eyes to capitol hill you would see that it’s owned by Corporations these days. Can’t be that bad then right?
[...] reporterMatt Taibbi points out, Mr. Gingrich has long been a vociferous proponent of advance planning for end-of-life [...]
[...] only conservative leader completely flip-flopping on this issue. Merely months ago, Gingrich too endorsed end of life counseling. At a conference in April of this year, Gingrich said advance directives can “save money” while [...]
[...] and read our e-mails, but not to pay for our doctors to discuss end-of-life issues. Of course, Newt used to think advance directives were a great idea. By the way, Newt, while you had the first Mrs. Gingrich sign the divorce papers in her hospital [...]
I just remembered that you used to be The Death Pornographer back in the day. LOL.
[...] only conservative leader completely flip-flopping on this issue. Merely months ago, Gingrich too endorsed end of life counseling. At a conference in April of this year, Gingrich said advance directives can “save money” while [...]
Hi Matt; great article as usual.
I’ve been following the current healthcare debacle from up here in Canada, and one thing that always boggles me is that people don’t seem to be aware that the current system of healthcare by insurance companies is no less a form of government than state apparatuses. I think the debate might benefit if this point were made and insisted upon. It seems difficult in our society to maintain the distinction between “governmental” and “non-governmental” by restricting the former to “the State”. There was a time when the Church was the predominant form of government; there was also a time when parliamentary democracy or republicanism (in the broad sense) and so on could at least have been called the predominant form of government; but today, how can we say that corporations or “the market” haven’t achieved that status? Like, you see a lot of complaints about the state meddling in the free market, but it’s hard to see how the state hasn’t already been utterly permeated by business for a long time now.
Maybe that’s too much of an abstraction for such an urgent and present problem, but it seems like giving up too much to Gingrich and company to let them get away with framing the dispute along the lines of an increasingly obsolete distinction, especially for such destructive purposes.
Keep up the great writing!
[...] And Matt Taibbi, a first-class journo, unclosets Gingrich similarly – Taibbi – Uhhh, Newt? [...]
This is a total reversal from the conclusions of his book on healthcare “Saving Lives, Saving Money.” His conclusion? There had to be nationalized, government insurance, ala Medicare, for people of all ages with catastrophic illness and injury. That private, for profit insurance just couldn’t do it. The book was written right after he had resigned from Congress, and was embarking on his new life as a consultant. So he had to be logical.
Now, Ol’ Newt is obviously fixin’ to run for President in 2012, he has to be “relevant,” not logical. . . So yes, what’s left of his mind has to be judged in that context . . .
[...] a government program that determines if you’re going to pull the plug on grandma’”) and Newt Gingrich “‘[. . . T]here clearly are people in America who believe in establishing euthanasia’”), [...]
[...] Additionally, Gingrich aslo publicly supported endorsed end of life counseling. [...]
Matthew, Matthew: Good post. But… Gingrich would disagree with you and I think he’d have a point. I’ve been following the blogs on the right (one is retire doc), and with their tortured logic they put it “if the GOVERNMENT initiates it, specifies it, qualifies it, determines it then then it’s BAD”. Government is the problem, remember? It’s Zeke Emanuel bed. And politically, it might have the reform package might have been more sale-able if instead of seeming to micro-manage in advance by specifying everything, they would have put in mechanisms for incentivizing institutions such as the ones in Gingrich’s piece to come up with plans to provide advance directive policies.
[...] to think about living wills and end of life decisions, if they haven’t already. As Matt Taibi reports, Newt Gingrich was not only for living wills and end of life counseling — what he and other [...]
About 20 minutes ago, I heard Newt Gingrich on Greta Van Susteren talking about *his* health plan for America. He had 4 or 5 main proposals – including one where end of life care would be based on the Gundersen model! What’s up with this guy? What happened to all of his concerns about “death panels”? Obviously he has no worries about being called out on it. I’m not sure what I find more chilling – his manipulative shamelessness or his confidence that his audience will neither notice and/or care.
[...] website, it shows that Palin’s current fear-mongering is purely political. Palin is not the only conservative leader completely flip-flopping on this issue. URL before it was deleted from her website: [...]
[...] [...]
[...] course, Grassley isn’t the only two-faced pol in this arena. Former House Speaker Newt Gingrich has recently done a similar flip-flop on end-of-life care. And the hypocrisy exists on the “local” level as well; anti-reform lobbyist Sarah [...]
[...] System in La Crosse, Wisconsin has developed a successful end-of-life, best practice…” Matt Taibbi hit him hard on it at the [...]