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Newt vs. Newt: Gingrich’s evolving views on healthcare

With Gingrich’s supporters often casting him as a font of policy wisdom, it’s fair to wonder exactly what the American healthcare system look like under a Gingrich presidency.

Newt Gingrich is (or was, depending on your perspective) the latest flavor of the month in the run for the GOP presidential nomination.

With Gingrich’s supporters often casting him as a font of policy wisdom, it’s fair to wonder exactly what the American healthcare system look like under a Gingrich presidency.

For some clues that go beyond the broad, soundbite-like statements on Gingrich’s campaign website, we examine some of his recent and (not-so-recent) statements on three key healthcare issues: federal health reform’s individual mandate, electronic health records and comparative effectiveness research.

In examining Gingrich’s record, it appears that he understands the issues well enough to arrive at sensible positions — but he then feels forced to abandon those sensible positions so he can fall in line with conservative orthodoxy. These positions could serve him well in the primaries, but weigh him down if he’s lucky enough to make it to a face-off with President Obama next November.

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Goodbye, individual mandate
In their attempt to cast federal health reform or ObamaCare as unconstitutional, conservatives have largely focused on opposition to the individual mandate: the law’s requirement that Americans buy health insurance or face penalties. Gingrich calls the mandate “fundamentally wrong” and “unconstitutional,” which seems predictable enough for any Republican presidential candidate.

The problem for Gingrich? Reporters have fallen all over themselves pointing out past instances in which Gingrich cast himself as a clear supporter of the mandate. In 1993, he said the following: “I am for people, individuals — exactly like automobile insurance — individuals having health insurance and being required to have health insurance.” Contrast that with a recent campaign video below.

Support waning for EHRs?
It would seem that technology could be one of the few topics in American life that transcends partisanship. Everybody loves Facebook and iPhones, right? Alas, when it comes to Gingrich, things aren’t so straightforward. He was once an outspoken advocate for electronic health records, stating in 2009, “I am delighted that President Obama has picked this as a key part of the stimulus package.” In wake of the stimulus’ passage, Gingrich joined with tech companies like like Allscripts and Microsoft for an “EHR Stimulus Tour” that traveled the country encouraging physicians and hospitals to adopt EHRs to secure federal incentive payments.

But now? Gingrich seems to be distancing himself from his former enthusiasm towards EHRs, perhaps as he’s come under increasing fire for his lobbying efforts for big health companies. As The Hill noted, a brain science initiative recently unveiled by Gingrich makes no mention of electronic health records. That’s a significant change, because EHRs were a major component of his brain science proposals when he began pitching the idea over the summer. Here’s a 2008 video in which Gingrich advocates for a national electronic health records system.

Comparative health effectiveness = rationing
Comparative effectiveness research (CER) refers to the idea of investigating which types of treatment alternatives work best for a certain medical condition. Sounds harmless enough on the face of it, though Cleveland Clinic CEO Toby Cosgrove has spoken out against CER … and so has Gingrich, though not before praising it, of course.

In 2008, Gingrich penned a New York Times op-ed column with Sen. John Kerry and former Oakland A’s general manager Billy Beane (huh?) in praise of CER. Here’s a snippet of what they wrote: “Studies have shown that most health care is not based on clinical studies of what works best and what does not — be it a test, treatment, drug or technology. Instead, most care is based on informed opinion, personal observation or tradition.”

Sounds like a pretty strong argument for CER, and the Gingrich/Kerry/Beane piece is exactly that. But, again, Gingrich has reversed course, and rather unequivocally at that. He wrote the following in the conservative publication Human Events in August: “In our country, the road to dehumanizing, bureaucratic healthcare rationing begins with something called comparative effectiveness research.”

So what would the U.S. health system look like under a Gingrich presidency? Given Gingrich’s recent penchant for choosing conservative orthodoxy over what had been his own well-informed, independent-thinking positions, the answer seems clear: Pretty much the same as it would under any Republican. So much for Newt being an “ideas man.”