Newton ("Newt") Gingrich is a former U.S. Representative from the State of Georgia, serving in that role from 1978 to 1999. Over a period of 10 terms in the House of Representatives, he became the foremost, and most vocal, voice for conservative causes, perhaps best known for pushing forward what was called The Contract with America, a proposed variety of reforms. During the administration of Bill Clinton, he was the face and frequent proponent of GOP opposition to the Clinton presidency, and as a result of his activist role, he was named House Minority Whip in 1989 and then Speaker of the House in 1995, succeeding Dick Cheney, after Cheney was named Secretary of Defense.

Gingrich was the leading figure in the drive which resulted in Republicans gaining a majority of seats in the House in 1994, thus overturning 40 years of Democratic majorities, an achievement cited by Time magazine in selecting him "Person of the Year" for 1995. He also was a major figure in calling for, and achieving, the impeachment of President Clinton.

He eventually attracted criticism from inside his own party, and after the GOP lost a handful of House seats in the 1998 elections, Gingrich resigned as Speaker of the House as well as seat as representative.

A professor of history before entering politics, Gingrich has continued his interest in that arena by writing a series of historical novels, including the Civil War and World War II. He has written several other books on a variety of high-profile technological, social and economic issues, pushing his proposals and strategies for reforming the U.S. healthcare system.

He is perhaps best known for his continued work in debating these national issues — as a consultant, social commentator and analyst, frequently providing analysis and commentary for Fox TV News. He is a fellow at the American Enterprise Institute and the Hoover Institute. He is the founder of the Center for Health Transformation, and he most recently (September 2007) founded American Solutions, described as an organization promoting grassroots efforts "to transform all levels of government." He serves as that group's chairman.

Gingrich is a frequent speaker at healthcare conferences, where he presents his views on healthcare policies and the changes needed in those policies.

Over the past two years he considered, but then rejected, running for the U.S. presidency this year, but recently told an interviewer than he will continue to evaluate the possibilities of presidential candidacy in 20012 or 2016.

Biomedical Business & Technology sent a series of questions to Gingrich concerning healthcare reform and issues related to healthcare insurance and technological innovation, to which he replied by email.

(Among the questions that he declined to answer was: If it should transpire that he ran and was elected U.S. president, what would his initial act be in the reform of the U.S. healthcare system?)

Biomedical Business & Technology: Do you have any particular views on which of the med-tech arenas provide the most benefit to patients and best able to transform healthcare?

Gingrich: Ideally, comprehensive personal health records (PHRs) are the most beneficial technologies to engage individuals to improve their health and manage their healthcare. A technology that replaces inefficient paper records with a secure, online personal portal, PHRs allow patients to create a thorough, lifelong record of their healthcare. This record, which should over time grow to include information on physician visits, test results, hospitals stays, prescription drug information, etc., should be accessible anytime, anywhere.

And the benefits are compelling. PHRs encourage individuals to be proactive in their care, to improve communication with their physicians, to receive better disease management information, and to participate in preventive care and wellness activities.

BB&T: Paper kills is one of your books related to your proposals for healthcare system reform, emphasizing the need go electronic — to computerized health records and so on. We're obviously moving in this direction, but where do you think we are now (on a scale of 1 to 10, or some other metric)?

Gingrich: Though we're moving in the right direction with more and more providers adopting information technologies, progress has been painfully slow. On a scale of 1 to 10, I would say we are at a 3.

Convincing healthcare systems and physicians to invest in these technologies has been difficult. Many fear the out-of-pocket, start-up costs and the time lost to training staff. Others are simply opposed to change and embracing modernity.

A recent study from SureScripts estimates that only 2% of the estimated 1.47 billion new prescriptions and renewals are being transmitted electronically, while the American Medical Association estimates that only 6% of office-based physicians (the majority of e-prescribers) currently use e-prescribing today. This technology saves lives and saves money. It is inexcusable for doctors to not use it.

Yes, the provider payment system is backwards, which leads many to not adopt information technologies, but it hasn't stopped many others. Look at Piedmont Hospital in Atlanta; Alegent Health in Nebraska; Intermountain in Utah; and tens of thousands of community physicians across the country.

These ground-breaking systems are leaders in the industry and should serve as role models for other systems across the country to follow. At The Center, we encourage our members to embrace these innovative ideas and adopt technologies that bring us into a 21st Century Health System.

BB&T: What do we have to do to reach maturity in this arena, to fully develop the potential of medical record use, electronic prescribing, and the other non-paper systems needed for healthcare?

Gingrich: Through the Center for Health Transformation, I argue there are two essentials.

First, we must adopt and implement a unified set of open interoperability standards for data exchange. This is not hard to do. Get people in a room and figure out which standards we're going to use. Once these standards are in place, we can lay the foundation for a nationwide health information network, similar to the structure and connectedness of a national highway system.

Second, we need to dramatically change the way we pay doctors and hospitals. We need to focus on outcomes. Through changes to payment and reimbursement based on quality and outcomes, we can incentivize doctors and hospitals to adopt the technology that will deliver better results.

BB&T: Healthcare plans for either stripe — public or private — have built-in pitfalls. Universal government-sponsored healthcare comes with obvious bureaucratic inefficiencies. But private health coverage is considered one of the sources of a large percentage of waste in the system, massive amounts of paperwork, haggling with insurers over non-coverage. What's the answer?

Gingrich: Expanding coverage to the uninsured must be an absolute priority. The heart of the problem is the cost of healthcare, of which the uninsured is a consequence. If we had a functioning system with rational costs, there would be enough money to insure every American. But to bring down costs and build what we at the Center for Health Transformation call a 21st century intelligent health system, we must implement four fundamental changes.

First, individuals must take an active role in becoming healthier. We can do this by incentivizing individuals to make responsible decisions through closer relationships with their healthcare providers and through wellness programs that reward healthy living.

Second, we must create a culture of health that leads to responsible choices. We can do this by redesigning public and private institutions to encourage better individual choices when it comes to health and wellness.

Third, we must fundamentally change our current provider reimbursement model from a transaction-based to an outcome-based model. This will have second-order effects of driving the adoption of modern tools and techniques that produce better outcomes.

Lastly, we must radically change the way we finance health insurance and healthcare. We can do this by increasing competition in the insurance market and by giving consumers more access to cost and quality data.

BB&T: You're organization, American Solutions, has established a second office in Silicone Valley, obviously one way of emphasizing your interest in supporting technology. What do you think this country should be doing to advance young people's interest in science and high-tech development?

Gingrich: I helped found and later served on the Hart-Rudman Commission on National Security. Our final report indicated that the failure of our math and science education system was the second greatest threat to our national security, behind only a weapon of mass destruction going off in an American city. So I view math and science education as a national security issue, essential to our survival. Keep this in mind if any of the measures suggested below seem too radical.

We should experiment with offering direct financial incentives to students to excel in math and science courses. If we are serious that the failure of our math and science education is the second greatest threat to America's national security, there is nothing wrong with providing extra motivation for students to succeed in areas where we have the most urgent need. Money is a powerful motivator in every other area of American life. Why should education be any different?

Further incentives should be offered to encourage students to learn as rapidly as possible. Imagine if students who graduated high school early were given the cost of their remaining years as scholarships. To encourage rapid learning, the federal government should contributing to the website of the Library of Congress free online learning programs that teach the physical sciences, basic math through trigonometry and calculus as well as the history and other standard courses.

This initiative would be especially powerful combined with initiatives like Nicolas Negroponte's One Laptop per Child, which has produced a durable, $189 laptop specifically designed for young children. This would immerse all students from a very early age in an interactive, dynamic learning environment where students are allowed to learn at their own pace on the paths of their choice.

These are a few simple steps that could rapidly accelerate the interest and achievement level of young people in math and science. However, they are very different than the education models we are used to.