In July 2009, before the health care debate became a topic of angry discussion around the country, Newt Gingrich weighed in on what would be one of its flashpoints — end-of-life care provisions to help families decide whether terminally ill patients should avoid aggressive, and costly, medical measures.

Writing on the Web site of The Washington Post, Mr. Gingrich praised Gundersen Lutheran Health System of LaCrosse, Wis., for its successful efforts to persuade most patients to have “advance directives,” saying that if Medicare had followed Gundersen’s lead on end-of-life care and other practices, it would “save more than $33 billion a year.”

But within weeks, Mr. Gingrich would find himself on the wrong end of what some Republicans labeled the “death panel” issue. Many conservatives had begun expressing anger at town hall meetings that summer because the proposed Democratic health-care law would have allowed Medicare to finance beneficiaries’ consultations with professionals on whether to authorize aggressive and potentially life-saving interventions later in life.

On Thursday, Mr. Gingrich’s spokesman confirmed that Gunderson was one of the paying clients of Mr. Gingrich’s Center for Health Transformation, a health consulting firm whose other clients have included WellPoint, the American Hospital Association, and various other major health care concerns. His spokesman, R. C. Hammond, said the center has revenues of about $5 million a year.