Former Speaker of the House Newt Gingrich defended former Governor Sarah Palin’s “Death Panel” claims on TV last weekend. Yet just like Mrs. Palin, Mr. Gingrich has advocated advanced care directives, especially their adoption by entire healthcare communities. And unlike Mrs. Palin, his reasons for doing so were economic.
As reporter Matt Taibbi points out, Mr. Gingrich has long been a vociferous proponent of advance planning for end-of-life care. As recently as July, Newt Gingrich wrote in the Washington Post:
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.
Wisconsin, like every other state and the District of Columbia, has laws to facilitate Advance Care Directives, but no one has claimed they were euthanasia before. And the last part of the paragraph sounds like Mr. Gingrich cribbed it from the Republicans’ latest Demon Doctor of the OMB (on detail from NIH) Ezekiel J. Emanuel, MD, PhD.
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Comments are welcome if they are on-topic, substantive, concise, and not obscene. Comments may be edited for clarity and length.
Tags: Ezekiel Emanuel, Gingrich, Healthcare, Medicare, Newt Gingrich, Palin, Republicans, Sarah Palin
NotionsCapital 
August 14, 2009 at 6:40 pm
Nowhere do I see the government involved in counseling seniors to create advanced health care directives, like the house bill did. If you cannot see the difference between folks discussing these things with spouses, family and friends, and a clipboard from the government providing “counsel” to a senior..well..then I don’t know what else to say.
[Edited here due to excessive length and off-topic subjects].
August 14, 2009 at 7:16 pm
hardhat40: The House Bill does not authorize anyone from the government to counsel anyone about anything. It allows doctors to counsel their patients on Advance Care options, should the patient wish it, and allows Medicare to pay for this.
There is no use “discussing these things with spouses, family and friends” without accurate knowledge of medical facts. Advance Care Planning takes place while patients are in good health, well before such directives might be needed.
At this point, as we understand it, the Senate Finance Committee omits the Advance Planning clause due to the disinformation campaign about it. Cooler heads may prevail in conference, assuming passage of the legislation.
August 15, 2009 at 3:43 pm
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August 16, 2009 at 9:42 am
This I know from personal experience. It is standard procedure for nursing homes in LA and AR to offer advance directives re. health care .
It is up to the patient to make the decision. I also know that doctors
may refuse to take an insurance supplement, thus denying anyone unable to pay health care that is needed. Health care is indeed already rationed and “end of life” decisions are already being made. What other foolishness are Sarah Palin, etal going to come up with to throw a monkey wrench into the two parties in power coming up with a sensible, workable solution to health care problems? Scare tactics should not work to derail an issue so important.
August 16, 2009 at 1:14 pm
Anyone that reads Newt’s article you have linked to will see the important differences between what he proposes and what Obama and congressional Democrats are pushing forwar
.””We propose creating a PRIVATE -sector led best-practice initiative that educates the industry on documented practices that work. This initiative should support the development and diffusion of knowledge for the purposes of expanding care, improving outcomes, and lowering costs — with the EXPLICIT PROHIBITION that government CAN NOT use the data to RATION care.”
Edited here – ml
August 16, 2009 at 2:57 pm
Shawn Seneca quoted Newt Gringrich: ””We propose creating a private-sector led best-practice initiative … with the explicit prohibition that government can not use the data to ration care.”
No where in HR 3200 does the bill say that Advanced Care Planning is mandatory or used to ration care. It merely allows people to discuss this matter with their own physicians, if they so choose, and permits doctors to be reimbursed by Medicare for this service. The result, as Mr. Gingrich and Dr. Emanuel agree, is that unnecessary services will not be provided to patients who will not benefit from them. In the absence of advance directives (living wills, health care power of attorney), medical ethics require continuation of treament even when it is futile.
The bill leaves private insurance in place, does not review patient health care through some government Health Choices Commissioner or otherwise come between doctor and patient.