I have three items for my write-up today on Newt Gingrich's Saving Lives & Saving Money: Transforming Health and Healthcare.
1.
On page 55, Newt states: "In the airline industry, we insist on safety
first and profits second. In providing care we should insist on value
for the patient before the provider or insurer can try to make a
profit. Any other focus risks lives and is inherently immoral."
This
should be obvious. Unfortunately, as Newt notes and as many of us have
experienced, our health care system does not run that way.
2.
On page 63, Newt states: "We should incentivize providers to achieve
certain outcomes. For example, the national rate for hospital-induced
illnesses is about 4%. If Medicare had an incentive program in which
hospitals reporting an error rate under 1% received a substantial bonus
(say one-half the amount they saved Medicare by creating fewer
hospital-induced illnesses), we would begin to see dramatic decreases in
hospital-induced illness."
Although Newt is talking specifically
here about hospital-induced illness, what he says reminds me of
something in Michael Moore's Sicko. Michael Moore was
interviewing a physician in the United Kingdom (if I'm not mistaken),
and the physician was telling Michael Moore that the government gives
him a bonus when his patients are healthy. Suppose that Medicare did
that here in the U.S.: it gave hospitals or doctors incentives if most
of their patients were healthy, thereby saving Medicare money. That
could encourage preventative care. At the same time, a potential
problem could be that doctors would not see the very sick, for the
doctors would want for most of their patients to be healthy so they
could collect that bonus, and thus they'd cherry-pick. Hospitals, of course, have to see everyone, but, if I'm not mistaken
(and I welcome tactful correction), doctors can limit the patients they
see.
3. On page 64, Newt states: "...if Congress adds a prescription
drug benefit to Medicare that is similar to the House bill passed in
2002, the cost of the drug benefit over 75 years will equal the current
national debt. To pay for those kinds of programs we must transform the
system."
I remember Newt saying in one of the debates that the
prescription drug benefit was good policy because it saved money. In a
sense, it's preventative care: it costs less to pay for prescriptions
that alleviate illnesses than it does to allow those illnesses to become
an emergency. In the passage I just quoted, however, Newt acknowledges
that the benefit could get costly, and he appears to think that it
could function best within a profound transformation of the health care
system, not the status quo.