The Magazine

Putting Patients First

Bush's health care agenda.

Feb 6, 2006, Vol. 11, No. 20 • By DAVID GRATZER
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But if the president is on the right path, he walks gingerly. In 2005, he stood before Congress and offered a sweeping plan for Social Security; this year, he offers some important tinkering--but tinkering, nonetheless. In part, the White House remembers too well last year's failure. But it's also true that Congress has done little with Bush's health reforms to date. Tax credits for the uninsured, association health plans, Medicaid block grants--in each case, White House enthusiasm has been met by congressional apathy.

President Bush now promotes small goals. But it may be in his interest to be bolder. This, after all, is an election year, and congressional Republicans can anticipate an attack on their health care flank. Why not push the HSA idea further? President Bush could outline a new vision for American health care--where people are able to get health insurance across state lines, thereby avoiding the hyper-regulation of certain states; where Medicaid recipients are given their own HSAs, empowering them with health dollars; where HSAs are flexible in structure, so that the chronically ill aren't stuck in the same model as their coworkers at the workplace.

Ultimately, American health care needs to devolve decision-making back to the individual. President Bush can help make that happen.

David Gratzer, a physician, is a senior fellow at the Manhattan Institute.