Newt Gingrich Changes What’s Left of his Mind on End-of-life Care

Matt Taibbi
Taibblog

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.

via Health Care Rx: Across the Country, Some Systems Are Getting It Right – Newt Gingrich.

That was Newt Gingrich just a few months ago praising the “Advance Directives” practiced by a hospital in Wisconsin. Advance Directives are another word for the end-of-life consultations that the teabggers have been flipping out over of late. Gingrich loved them a few months ago. This is Gingrich a few months before that, responding to a PBS query:

Let me give you an example that I find fascinating. In LaCrosse, Wisc., the Gundersen Lutheran Hospital system is, according to the Dartmouth [Atlas of Health Care], the least expensive place in America for the last two years of life. They have an advanced directive program, and over 90 percent of their patients have an advanced directive. They have electronic health records, so everybody on the staff knows what the advanced directive is. They have a very strong palliative care program for using drugs to manage pain. They have a hospice program.

The result is today, the last two years of your life in costs are about $13,600. The last two years of your life at UCLA are $58,000. Now, why should Medicare pay $58,000 for the same outcome if it could pay $13,600? You can say, well, Los Angeles is more expensive; they do a couple of more complicated things. So fine. So let’s say it ought to be $20,000 at UCLA. That’s still [$38,000] less than it currently is. …

We don’t think the politicians can ever fix this because the hospital lobby is so powerful, and the doctor lobby is so powerful, and the pharmaceutical lobby is so powerful, and the medical technology lobby is so powerful…

And we also know — this is the great irony — the best places in America are always less expensive than the worst places. Health is not like jewelry and automobiles. In jewelry and automobiles you pay a lot more to get a lot better. In health, because the best places do it right the first time, they do it very efficiently, they pay real attention to quality, they’re actually less expensive than the places that are bad.

(Full story here, with video.)