Here is something you can take to the bank. If politicians don’t have a vision of healthcare reformone they understand and can articulatethe special interests will supply the vision for them. That is what happened with Obamacare. It’s what has happened with a number of recent Republican health reform proposals. And it is what happened 13 years ago when George W. Bush and a Republican Congress decided to add a Part D prescription drug benefit to Medicare.
What brings this to mind is a scathing biography of President Bush by Edward Smith. The first sentence of his book: “Rarely in the history of the United States has the nation been so ill-served as during the presidency of George W. Bush.” The main reason? “[H]is decision to invade Iraq is easily the worst foreign policy decision ever made by an American president.”
Strangely missing from the indictment is Medicare. In fact, Smith actually likes what Bush did to Medicare. But that’s because he doesn’t understand health policy any better than the Bush White House understood it. In fact, what the Bush administration did to Medicare is arguably the worst domestic policy decision in history of the country.