At last week’s presidential debate, Newt Gingrich resurrected the claim that the Affordable Care Act includes “death panels” — Sarah Palin’s description of a provision in health care reform that would compensate providers for counseling patients about end-of-life care. Gingrich incorrectly applied the phrase to the U.S. Preventive Services Task Force’s draft recommendation that men shouldn’t be routinely tested for prostate cancer.
Jonathan Cohn and I debunked the claim here and here, and now the New Republic’s Alec MacGillis is out with an interesting piece noting that Gingrich’s statements are not only wrong, but also highly disingenuous. The former speaker of the House had supported advanced directives in 2009, lauding the practice of talking patients through all medical options — and in many cases avoiding unnecessary end-of-life care — as an important cost-containment mechanism:
Not surprisingly, the hospital relies more heavily than others on palliative care and spends 30 percent less than the national average on end of life medical treatment. As one admirer put it in a July 2009 blog post, “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 admirer? Newt Gingrich. The former House Speaker had close knowledge of Gundersen’s approach: in 2006, the father of his wife Callista passed away at Gundersen after a battle with lung cancer. Gingrich has been open about how well the hospital handled his father-in-law’s end of life care. “What they create is a family relationship in a difficult period so that the familiesup being very satisfied,” he said in an April 2009 article in the Columbia (Mo.) Daily Tribune. “The families feel there was dignity, there was dialogue, people were collectively doing something.”
Prior to joining the presidential field, Gingrich had regularly supported sensible health care reforms from the individual health insurance mandate to delivery reform. For instance, Gingrich has promoted CMS administrator Don Berwick, praising the physician for what Republicans (including Gingrich himself) are now characterizing as “rationing”: his work to improve the quality of the nation’s health care system. In early part of the last decade, Gingrich “gave credibility and visibility to a set of ideas being talked about in the health policy world about using information technology to improve medical care.” He advocated “reforms such as ‘data-driven reimbursement’ informed by best practices, a national electronic health network and a focus on prevention and wellness.
An Amazon search of Gingrich’s Saving Lives & Saving Money reveals three separate references to Berwick — who was and still is a national leader in improving health care quality — in which Gingrich praises the current CMS head for his passionate belief that quality-care focused systems improve health outcomes and reduce health care spending. Gingrich even included a plug for Berwick’s nonprofit, the Institute for Health Improvement, reprinting the organization’s website on page 122 of his book. In an August 2000 Washington Post op-ed calling on President Bill Clinton to “stop defending inefficiency and to drag health care into the 21st century by insisting on modern management and information systems,” Gingrich singled out Berwick for spreading the word about “quality control.”