Witness Gingrich's appearance as the opening keynote speaker at this week's Emerging Issues Forum at N.C. State University, which focused on health care. Before a crowd of 600, former Gov. Jim Hunt--the forum's founder--introduced Gingrich as "the man with a lot of big ideas," many of which "have a lot of appeal across the party lines.
"Health care is not something new for him," Hunt added, citing Gingrich's work in Congress, and his recent founding of the Center for Health Transformation in Washington, D.C.
Hunt didn't mention that the bulk of the new center's funding comes from corporations that pay annual membership fees of up to $200,000. The center is linked to Gingrich's consulting firm, the Gingrich Group, which forum organizers say received $40,000 for his Feb. 7 appearance in Raleigh.
At the podium, Gingrich still had his trademark mop of silver hair and bulky frame. He'd also retained his rhetorical ire and his penchant for academic-speak ("iterative" was a favorite adjective).
Insisting that "the current system is not fixable," Gingrich laid out his vision for "21st century intelligent health care." It includes better use of information technology ("paper kills," he said, citing the 44,000 Americans who die in hospitals each year due to medical errors); more access by consumers to information about quality and cost; and more "individual responsibility" through programs such as health savings accounts and strategies such as better diet and exercise.
The former Republican House Speaker urged audience members to leave their preconceptions about health care at the door ("discipline yourself to say 'yes, if' instead of 'no, because'") and painted himself as someone who thinks big.
"We have to understand the difference between transformation and reform," Gingrich said. "Reform is making something marginally better. Transformation is creating a completely new system."
Despite such bold strokes, some conference participants found his prescriptions--particularly those dealing with information technology--on the tame side.
"These are interesting ideas that have been promoted by Kaiser Permanente for the past five years," said state Rep. Verla Insko (D-Orange), one of several legislators attending the forum. "I don't disagree that people should take more responsibility for their health care. But the real challenge here in this state is access. He didn't say a thing about how to deal with the 1.4 million uninsured." (Insko will reintroduce a bill this session to amend the state constitution to make health care a right of all citizens, similar to education.)
Others found Gingrich's proposals for sweeping technology upgrades impractical, given the current precarious state of hospital finances.
"Many of our hospitals would love to do some of those things," said Don Dalton, spokesman for the N.C. Hospital Association, another conference attendee. "Some have the margins to do that, but two-thirds do not at this time."
One idea that definitely wasn't tame was Gingrich's call to "voucherize" Medicaid, the state and federally funded healthcare program for the poor, elderly and disabled. His speech came the same day the Bush administration unveiled a budget that will result in an expected $1.4 billion cut in Medicaid funds to North Carolina.
At a press conference following his talk, Gingrich elaborated on his idea to divide Medicaid into separate programs for the elderly, those with disabilities--or "capabilities" as he pointedly called them--and those with low incomes. People in the "working poor" category would be issued vouchers for Medicaid and tax credits for health savings accounts. The idea, Gingrich said, is to "apply the same standards as in welfare reform to health care."
As for the uninsured, he said he would support a law requiring everyone to have health insurance, adding, "The real problem with the uninsured comes from people at the higher incomes who choose not to have coverage."
When told of Gingrich's remark, conference participant Adam Searing of the N.C. Health Access Coalition said that notion is "like saying the earth is flat. The majority of people without health insurance are low income. If you privatize Medicaid, you will be seeing the state making money on the poorest and sickest."
At the press briefing, Gingrich was asked about partisanship, "litigation reform" and privacy concerns related to his proposals for online health records. He was also asked whether he had an interest in any of the companies he'd cited as examples of "best practices" in his speech.
"No," Gingrich replied. "Some of them are members of the center [for Health Transformation] and some are not." (In other words, "Yes.")
The dominance of corporate voices at the forum was the subject of a protest by the N.C. Committee to Defend Health Care held on the steps of the McKimmon Center while conference participants lunched inside.
"Conservatives are touring the country putting on these shows which claim that America can't afford health coverage for everyone," said Dennis Lazof, a leader of the group, which had sought to get more consumer-oriented speakers on the program. "Funny how the rest of the industrialized world can afford to cover all their people for health care needs with spending about half per capita what we spend."
Lazof, whose group has been pushing for a Right to Health Care bill in North Carolina, said forum organizers had "intentionally avoided" important questions about access to care and had made the event unaffordable to most citizens. (The registration fee was $175).
Forum leaders insisted they had no agenda beyond sparking broad debate. "Healthcare is an issue where good ideas meet unfriendly political realities," said Roland Stephens, an associate professor of political science at N.C. State who helped plan this year's forum. "Our aspiration was to get providers, businesses and advocates in the same room hearing each other's ideas in an atmosphere that promotes change."
But Insko--who spoke at the protest--said that despite the late addition of some consumer-friendly panelists, the forum "missed the mark" in doing so.
She urged citizens to get involved in the town hall-style meetings that will be held as a follow-up to the conference.
For details on those, go to the Emerging Issues Web site at www.emergingissues.org.