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Opinion Column

Newt And The Health Wonks: A Tale of Lust And Power (Guest Opinion)

When former House Speaker Newt Gingrich announced his bid for the GOP presidential nomination, I found myself singing a few bars from Night Moves, Bob Seger’s hard-driving tribute to teenage hormones: “I used her, she used me/But neither one cared./We were gettin’ our share.”

No, this isn’t one more commentary on the Georgia Republican’s checkered marital past. I’m referring to a different relationship, the one between Gingrich and the health policy community. A critical component of the climb back to prominence for a man who inspired nearly as much distrust in his own party as in the opposition was proving he could work harmoniously with those holding differing views on an important policy issue — how to reform U.S. health care.

Gingrich succeeded so well that some of the policy recommendations he was touting just a few years ago bear a close resemblance to Obama administration actions that Gingrich now denounces as leading us to “a centralized health care dictatorship.”

The romance between Gingrich and the health wonks, and Gingrich’s makeover as a leader with ideas as much substantive as political, began after the appearance of his 2003 book, Saving Lives & Saving Money. The book gave credibility and visibility to a set of ideas being talked about in the health policy world about using information technology to improve medical care.

In those early days of the Bush administration, IT types were still health policy wallflowers, sitting by a silent phone waiting for someone who wanted to talk about “computerized physician order entry.” But the wallflowers blossomed into belles of the ball after Gingrich coined the phrase, “Paper kills.” He also used his status and connections to advance the concept and capture the attention of the federal government, the news media and leaders of health care organizations.

In return, the health care world heaped rewards on its newfound friend. There were speech invitations at a reported $50,000 a pop and six-figure membership fees paid to his for-profit Center for Health Transformation. Gingrich also received honors attesting to his non-partisan good works. For instance, he and then-Sen. Hillary Clinton, D-N.Y., shared an award from the National Committee for Quality Assurance. The Healthcare Information and Management Systems Society recognized Gingrich’s “commitment and leadership in working with both Republicans and Democrats.”

New Newt neutralized the negative images of the polarizing politician. The change could be seen in a 2004 Washington Post headline that proclaimed: “As Speaker, Gingrich knew how to divide. Now he aims to unite — to transform health care as we know it.”

Old Newt stormed off President Clinton’s Air Force One miffed over a perceived lack of respect. New Newt quietly got himself appointed to a three-year term on the obscure National Advisory Council to the Agency for Healthcare Research and Quality. Old Newt was “the most divisive figure in the recent history of the House,” as the New York Times put it in 2000. New Newt had “reinvented himself as a respected entrepreneur of ideas,” concluded a 2005 Los Angeles Times profile. The stature Gingrich had gained from his work with the health policy community, along with his efforts related to national security, was a central part of that reinvention.

It was about this time that I began to feel for myself the powerful pull of the New Newt charm offensive. I had been appointed to the National Commission on Quality Long-Term Care, co-chaired by Gingrich and former Sen. Bob Kerrey, D-Neb. Up close and personal, the famed Scourge of All Things Liberal could seem positively benign: “Newt” to one and all Beatific smile… Ideas being spouted with a professorial air.

Nonetheless, unmistakable signs began to emerge that New Newt was more rebranding than reinvention. There was, for instance, the senior adviser at his Center for Health Transformation who spoke privately of proposing a real conservative plan to cover all the uninsured, a goal to which the Bush administration had only paid lip service. However, the true purpose was political — capturing enough independent voters to regain Republican control of the House in 2008.

Meanwhile, at the long-term care commission, Gingrich began inviting new members to join who fit his ideological mold. And, come to think of it, Saving Lives & Saving Money started off and ended with pages of political photos, including Gingrich and Dick Cheney, not noted for an interest in health IT interoperability.

The shiny skein of New Newt inevitably began to wear away. Our commission closed its doors at the end of the 2007, but one could see Old Newt re-emerging as the 2008 campaign beckoned. Since then, the process has only quickened.

To give just one example, Gingrich-as-health-wonk for years advocated reforms such as “data-driven reimbursement” informed by best practices, a national electronic health network and a focus on prevention and wellness. All those items — and others Gingrich supported — are contained in the HITECH Act, part of the budget stimulus package and the Affordable Care Act.

That shouldn’t be a surprise. A menu of measures to improve the efficiency of U.S. health care has long enjoyed bipartisan support. That only changed when Republican leaders decided to demonize “Obamacare” as a means of discrediting the Democratic president.

As Gingrich seeks the chance to try to defeat President Obama next year, he won’t accomplish that goal by being a consensus-seeking wonk. Nor, frankly, should he be one. Whether or not you like his views, Gingrich is a brilliant communicator and politician. Ideas he may have; an intellectual, he is not.

In the speeches Gingrich gives about leadership, he tells listeners that success depends upon a clear strategy and “entrepreneurial rather than bureaucratic behavior.” As it happens, a former colleague of Newt’s on that long-ago advisory council is now one of the Obama administration’s most prominent health care bureaucrats, Dr. Donald Berwick. Back then, New Newt must have listened and learned, since in his book he praises Berwick’s quality improvement work. But today’s Old Newt told Fox News’ Bill O’Reilly that Berwick’s appointment as head of the Medicare program was just another example of Obama’s “secular Socialist machine.”

I guess an entrepreneur running for president has to go after votes wherever he can get them.