We progressives thought we were done with Newt Gingrich when he resigned as Speaker of the House in 1999 after an ethical investigatory slap for using tax-exempt contributions for political purposes. But he’s back and he’s got some big ideas for reforming American healthcare on his mind.
First of all, he wants to force the healthcare industry to update its IT systems. No problem with that—there’s plenty of room for efficiency improvements in healthcare—but the claim that doing so will reduce errors is dubious at best. On a good week I spend at least 12 - 14 hours rubbing up against the healthcare system and, for the most part, patient records are already computerized and hospital ceilings have sprouted as many WiFi antennae as fire sprinklers. As long as Gingrich focuses on improving healthcare IT systems, it’s all good.
But Newt has a larger agenda in mind that, in true libertarian fashion, is based largely on penalizing the poor and the sick. Incorporating President Bush’s “ownership society” lingual gymnastics, Gingrich wants to provide tax breaks for individuals who assume more direct responsibility for their healthcare costs, relying less on government and insurers. As a result, the almighty market will increase patient options, lower costs, and boost quality. Just as has happened in other sectors like, say, oh I don’t know, corporate media maybe?
The “ownership society” part of Gingrich’s agenda isn’t just wrong-headed; it’s dangerous. As Harvard health economist David Cutler told the New York Times, “The danger here is that all you’re doing is creating incentives for rich, healthy people to break away from poor, sick people. You end up penalizing sick people, making their insurance more expensive and harder to obtain. That may just increase the burden on community hospitals, states, and the federal government.”
Gingrich has established a healthcare consultancy, the Center for Health Transformation, for his policy work. So far, 65 corporate members have paid annual dues of up to US$200,000 to bend Gingrich’s ear.
The Times article cites insignificant passages from a few of Gingrich’s recent speeches, like the bromide delivered to technology executives and hospital administrators in October: “First you save lives, and then you save money. You have to put the moral dimension first.” But then, the Gingrich Express leaves the tracks at close to full speed:
“At the same conference, explaining why people would take better care of their health if they had to pay more of their own medical bills, he said: ‘No one washes a rental car. We have turned our health care system into a rental car.’ And, discussing the looming health crisis from bad diets and sedentary lifestyles, he said: ‘Obesity and diabetes are the first information-age epidemics. We need to treat them as epidemics.’
“Then, in a December interview, after proposing that daily physical education classes be made mandatory from kindergarten through high school, he said: ‘So we’re going to say to people, ‘We’re going to pay for your dialysis at age 45, but we’d hate to make you exercise regularly.’ What kind of a society is that?’”
Crack addicts and the insane exhibit more logic, insight, and thought process acuity than comparing healthcare in arguably the most advanced nation on the planet to washing a rental car. Such an assertion is so far off the bizarre scale it can’t be charted.
As a dialysis patient, I continue work more than 70 hours a week and exercise regularly, just like I did before my kidneys failed. I’m the exception, though; most dialysis patients are too ill to either work or exercise. If Gingrich had bothered to do his homework, or spent some of those US$200,000 consultancy fees to have a minion do it for him, he’d have known that one of the most debilitating complications of end-stage renal disease is life-threatening anemia. Worse, cardiovascular disease is the predominant cause of death in end-stage renal disease patients. There’s a disconnect that’s far too wide and deep to ignore.
One bright spot in Gingrich’s dismal agenda seems to be preventive healthcare. He’s gotten Dr. Dean Ornish of the Preventive Medicine Research Institute in the same room with the administrator of Medicare, for example.
The key component of Gingrich’s healthcare agenda appears to be the health savings account. According to the Times article, “The accounts allow people to set aside tax-free savings but typically require individuals to pay the first $1,000 of their yearly medical expenses, and families the first $2,000.” Hey! If you’ll limit my annual healthcare financial exposure to US$1,000, sign me up right now; that’s way, way less than what I pay now. I don’t see the insurance companies or providers cutting their prices in the foreseeable future, so I’ll leave it to Gingrich to find a way to make up the difference.
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