The Magazine

A Bush Success (not that he gets credit)

The Medicare drug benefit is working better than predicted.

Apr 28, 2008, Vol. 13, No. 31 • By JAMES C. CAPRETTA and PETER WEHNER
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For conservatives, there is a need to accept the reality of measured steps in health and entitlement reform. The public will always be uneasy with abrupt changes to arrangements upon which many are dependent. The best approach is to gradually introduce markets and individual choice and ownership without threatening the security of the known. To his credit, President Bush recognized early on that adding a new drug benefit to Medicare presented a rare opportunity to introduce competition into the program, and he seized it.

Many fiscal conservatives--including Senator John McCain--opposed the drug benefit because of its undeniably high cost--$49 billion last year. Those concerns were legitimate, and it remains true that the rest of Medicare needs significant reform. But conservatives should also see that broader Medicare change is now more plausible because the public has seen competition work in the drug plan.

We won't get to where we need to be in health care all at once. But a decade from now, the importance of the Medicare prescription drug benefit's groundbreaking success will be obvious to all, including conservatives. It will rank as one of George W. Bush's best domestic legacies.

James C. Capretta is a fellow and Peter Wehner is a senior fellow at the Ethics and Public Policy Center. Capretta is also a consultant to health insurers and drug manufacturers.