Newt Gingrich on (Nearly) Everything

January 23, 2007 | Newt Gingrich waited patiently for attendees to be seated and was, perhaps, forgetful of the large internet audience already listening in. He turned to a session organizer and said, "I think I want to do a totally different talk. They already get the big picture and vision stuff."

Moments later the former Speaker of the U.S. House of Representatives and now healthcare reformer painted pictures large and small: better axles couldn't have saved the horse buggy industry; President Bush missed too many of Katrina's lessons; the new Congress will make health-IT progress despite posturing; and HHS Secretary Mike Leavitt deserves praise for his adroit handling of Congress ("They bite you harder if you ignore them").

It was vintage post-speakership Gingrich gliding easily (and genially) from topic to topic. He has emerged as a forceful champion for healthcare reform and health-IT adoption. The webcast, entitled Saving Lives and Saving Money: Transforming Health and Healthcare in the 21st Century, took place last Tuesday and was organized by the Delaware chapter of HIMSS and sponsored by Siemens Medical Solutions, Microsoft, Intel, and the Center for Health Transformation, of which Gingrich is founder.

Given Gingrich's unique perspective, it will be interesting to see how accurate his near-term prognostications are. We are entering a fascinating three-to-four-year period, said Gingrich: "Election results of '06 and [the] upcoming '08 [elections mean] you're going to hear a lot more talk, some partisan, but a fair amount is going to turn out to be non-partisan. Many of the nation's governors are moving in the same direction. Health information technology is a big part of where we are going."

He pointed to diabetes - treatment costs of which now represent one fourth of "every Medicare dollar" spent - as the perfect example of the current healthcare system's flaws. He argued again for replacing the emphasis on treatment with prevention, "so you don't end up losing limbs, going blind [etc.]. The difference in outcomes, both human and financial, is breathtaking." He cited an experimental project in Georgia to pay doctors up front to treat diabetics before patients incur more costly problems.

Trying to fix the current system is "a long-term waste of energy," Gingrich said, a futile effort he likened to trying to save the horse buggy industry from the rise of autos by coming up with a better axle.

Managed care's big mistake, said Gingrich, was its emphasis on money over health. People concluded "it was a conspiracy to save money over saving lives. We [Gingrich's approach] put saving lives first, but also believe if you redesign systems, you will save money."

Don't get the wrong idea. Gingrich remains an ebullient free marketeer, but now believes that some regulation is necessary. He argued it should still be possible to go broke giving good care but not possible to be profitable while providing poor care. To a large extent, specialization, transparency, and individual responsibility are the keys to a new healthcare system, he argued.

He championed the push for electronic health records (EHRs). Retaining paper means "you're willing to kill people," he said. Consider the Katrina aftermath.

"I've been advocating but failing to convince people that we need a national defense highway system, an electronic highway system. We would have saved a lot of lives [after hurricane Katrina] if we had electronic records. What did it cost the government to rebuild the lost records? MD Anderson Cancer Center had 400 people arrive in mid-cancer therapy with no records; how hard is that? Patients went in one direction and their doctors went in another. I haven't succeeded, so we are where we are, [but there is] pretty strong bipartisan support toward moving to health-IT technology."

Gingrich also praised Leavitt. "I give him a lot of credit. He was more cautious than I would have been, and in retrospect I think he was right. He does not want to impose a bad decision. The federal government doesn't have knowledge to impose [such standards] with clarity. Also, whatever standard we impose this year will be wrong in five years, which the French did with their telephones system, which was obsolete by the time they built it."

Maneuvering effectively through Congress is a challenge Gingrich knows better than most, and he again praised Leavitt for polite placation of Congress in public but shrewd behind-the-scenes advocacy: "He's very determined to move to e-prescribing and EHR reform."

Gingrich said he is currently working on an article calling for genetic non-discrimination legislation, which is interesting and perhaps hopeful, given the fate of such bills in the past (approved by the Senate and bottled up in the House). Such protection is necessary, Gingrich argued, to instill confidence and encourage use of EHRs by patients. Click here for the full webcast.

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