“I don’t mean to be argumentative,” he says, as he scribbles a chart on the history of management reform, tucking dates alongside names like Motorola and Deming and Ohno, all the while peppering the group with questions. “But I’m dubious about externalized systems. It becomes a cult.”

No one is insulted. On the contrary, everyone is enthralled by Gingrich and his well-informed romp through management history. (”There’s this whole romantic side to him,” Gingrich says enthusiastically about management guru W. Edwards Deming. “He wrote religious songs.”)

What Gingrich has to say is not so much a unified theory as a way of rearranging the way we look at things - a refusal to accept the cultural status quo. At the Tempe conference, Gingrich politely listens to such proposals as applying Toyota-style production-control techniques to the health system - and then slices through them with an alternative mantra of competition, deregulation, modernized information systems, and personal responsibility.

Leave the middleman out. Force doctors and hospitals, Medicare and Medicaid, to disclose pricing and compete with one another. Put all the latest information on databases so that American consumers can go online, plug in their personal health profile, and shop for the best prices on drugs and services.