The idea that America needs transforming, and that he is the man to do it, did not start with Barack Obama. The grandiosely named Center for Health Transformation (CHT) was started by former House Speaker Newt Gingrich.
In 2003, Newt Gingrich wrote Saving Lives & Saving Money: Transforming Health and Healthcare
. It does offer some “free market” solutions. But doctors are apparently free only as long as they do what Newt thinks they should.
The backup plan is: “When all else fails, mandate.” Specifically, physicians who “insist on doing it the old way...should simply not be allowed to practice medicine.” As far as I know, even Obama doesn’t go this far.
In developing his plans and strategies, the CHT boasts a lot of allies: along with top leaders in federal and state governments, it includes “key corporations, top hospitals, disease advocacy groups, professional and industry associations, and leading research institutions.” Many if not all of them probably endorsed the Patient Protection and Affordable Care Act (“ObamaCare”).
Newt has embraced the key fallacy that “the number of uninsured in America is a threat to our civilization.” He thinks that medical errors are “morally unacceptable,” and that they could somehow be prevented by forcing everybody to use the health information technology that his supporters, just coincidentally, happen to sell. He speaks favorably of outgoing CMS director Donald Berwick, an avowed admirer of the British National Health Service’s rationing system. He is convinced that “disease management programs” can” dramatically improve outcomes.”
Apparently, what Newt thinks we need to do is to get all medical care paid for (or denied) by approved third parties and all health information into a form that permits monitoring and surveillance. Cost escalation because of third-party payment; difficulty defining what a “medical error” is in the absence of an infallible judge; potentially deadly outcomes related to software flaws; absence of evidence that existing disease management and other schemes either save money or improve health—none of these are problems for a big-idea man like Newt.
Newt avoids obvious gaffes like accusing doctors of taking out tonsils or cutting off legs just to make more money. He sticks to generalities such as the need to “drag the medical system into the 21st
century.” That system provides miraculous imaging technology and marvelous advances in noninvasive surgical techniques, but falls down on having information on your every sniffle accessible to the System.
Although he has no apparent qualifications in medicine or science, he seems to think all doctors could benefit from government supervision, and he freely offers his own health advice. For example, you should vote for zoning changes that encourage walking, and wash dishes with your nondominant hand.
The Gingrich “transformation” doesn’t look all that different from Obama’s to me—either in concept or in the cheerleaders it appeals to. Based on the tone of the book, the two men also don’t seem to be that different in level of self esteem, condescending attitude, or tendency to sermonize.
In my review of the book
for the Journal of the American Medical Association
on Jan 14, 2004, I wrote that “this book is primarily useful as a guide to the mind of Newt Gingrich.” It also showed his political ambitions, featuring 14 pages of photographs of himself with dignitaries, babies, and constituents.
Perhaps Newt has been converted from his dedication to top-down central planning for American medicine, and really would repeal ObamaCare without “replacing” it with something very similar. He should know that before absolution comes confession and repentance. So far, I haven’t heard a disavowal of this book.