Sunday, December 18, 2011

The New York Times, Newt Gingrich's Sins and The Merits of Creative Destruction

Where's Newt?
After watching the last Iowa Caucuses Republican Presidential debate, the Disease Management Care  Blog continues to be fascinated by The Newt's repartee prowess.  Maybe it's because the starstruck DMCB has seen the former Speaker in the flesh on a number of occasions.  National health policy conference organizers have known for years that the logorrheic and futuristic Newt Gingrich Big Idea Factory could be counted on to deliver the goods to any audience.

Yet, keynoting prowess is one thing, but being a contender for President an another.  Now that Newt has clawed is way into a leading position in the polls, greater visibility has prompted greater scrutiny. 

That's why the DMCB likes this New York Times article on Newt's unseemly mix of health advocacy and business ties.  It's not pretty, portraying Newt as a cynical political opportunist who has been brazenly willing to ally himself with popular "big-government" ideas.  What's more, The Times darkly implies that consulting fees from big pharma and insurance companies caused him to promote their business interests.

So what, according to The New York Times, are Newt's five sins?

1. While every other service industry relied on information technology, Newt had little patience for a health care system system that perpetuated reliance on pen and paper.  When HITECH passed, private citizen Newt had little problem taking some of the credit and collecting some fees while he was at it.

2. Newt repeatedly observed that ATMs could reconcile complex financial records and yield hard cash from any ATM in the world within seconds, yet Medicare's payment systems were inaccurate, byzantine and highly vulnerable to fraud. He called for the reform of Medicare, which later also turned out to be one of the bedrock principles of the Democrat's modernizing health reform agenda.

3. Then there's this 1995 "wither on the vine" quote in which he maps out the demise of Medicare because of reforms leading Americans to "voluntarily [going to] leave it -- voluntarily."  Fast forward 15 years and Newt is supporting the Ryan-Wyden bipartisan compromise legislative proposal that is likewise based on voluntary choice and doesn't end Medicare as we know it.

4. Newt was also an ardent supporter of comparative effectiveness research (CER)  Newt specifically cited not-for-profit Cochrane as an example of the kind of CER he supported. He doesn't like this $1.1 billion boondoggle.

5. As for funding from insurers and pharma, Newt's ideas on enhanced coverage of children and diabetes care attracted like-minded companies and allies.

"Big deal," says the yawning DMCB.  The Time's concerns about Newt's past lack substantive ballast.  If nothing else, Newt's pugilistic skills will make Mitt Romney a stronger contender - assuming he makes it to the championship round .

While the DMCB is at it, it can't help but take a quick look at two other arenas of alleged Newty nuttiness:

1) That infamous criticism about his fellow conservatives' dangerous "social engineering" in the Ryan Ver. 1.0 plan:

The DMCB thinks Newt personally liked the plan but disliked the prospect of having it pass over the objections of a leery electorate.  It's one thing to dream up a good plan, but it's another to craft it behind closed doors and impose it on an unwilling citizenry.

By the way, that some logic seemed to underlie his recent debate commentary over abolishing "activist" federal courts.  He's warning that in a divided powers representative democracy, the co-equal legislative and executive branches and grumpy voters could be pushed into neutralizing flashpoint judges at either end of the political spectrum with recalls, subpoenas, impeachment and defunding.  He's not only consistent, he has a point. (A 12/22 addendum - A point which Newt is provocatively willing to to back up with U.S. Marshals.  Of course, he could just sandbang them during State of the Union Addresses.  What's next: pieing?)

2)  Being too incendiary, zany and mercurial to be President

This was best portrayed by Peggy Noonan's December 10 Wall Street Journal "Declarations"  description of Newt as a human "hand grenade" who delights in being to ready "watch this!" pull the pin at a moment's notice. 

Good point, but there is also something stubbornly dysfunctional in many parts of the health care system.  If Obamacare doesn't work out as planned, there may be merit to the notion rejecting the Republican mainstream and applying a heavy dose of creative destruction.  Newt certainly has the "creative" and "destruction" chops.  Absent anyone else with this particular skill set, Newt's biggest problem may be that we're just not ready for him to combine them... yet.

Newt's problem is that he's still far ahead of the curve.

Let the games continue.

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