W.’s Legacy
Remembering the best and the worst of the eight years



In his first term, President Bush and congressional leaders knew there was a strong political imperative to add a prescription-drug benefit to Medicare, and they enacted the Medicare Modernization Act with a squeaker of a vote in November 2003. The law continues to draw criticism from conservatives for adding a $400 billion drug benefit to Medicare. But because the benefit was created by conservatives and not liberals, it relied on competition and consumer choice, not government price controls. It has demonstrated over time that these market forces can drive down government spending (40 percent below estimates) while increasing consumer satisfaction. Medicare Part D was the model and continues to be the model for overall Medicare reform going forward.

The law also created health savings accounts, the fastest-growing health-care option in the private sector (threatened with annihilation under Obamacare). And it saved the private-plan option in Medicare (which Obamacare is also trying to suffocate).

In his second term, President Bush outlined a health-reform initiative to expand coverage to the uninsured that was bold, visionary, and undeniably free-market. It would have solidified the U.S. as the leader in high-quality health care while addressing the growing problem of the uninsured and middle-class anxiety about high health costs. It offered new incentives for consumers that would have made our health sector more efficient, more responsive to consumer needs, and more affordable. (I explained the details in this lecture for the Heritage Foundation.)

The president described his basic philosophy to enthusiastic applause on both sides of the aisle during his 2007 State of the Union Address, saying, “In all we do, we must remember that the best health-care decisions are made not by government and insurance companies, but by patients and their doctors.”

The president won support from the Washington Post, the Wall Street Journal, and experts from think tanks as traditionally divergent as the Urban Institute and the Heritage Foundation. But Republicans had lost control of Congress in the 2006 elections, and his proposal never got a hearing. Had the president pushed harder for health reform earlier in his presidency, the nightmare of Obamacare likely could have been avoided, because Americans would have had access to what they really want: personal, portable, affordable health insurance that they own and control.

 Grace-Marie Turner is president of the Galen Institute.



President Bush’s best moment was during his first visit to Ground Zero after 9/11. He had not yet given an inspiring post-attack speech when he joined a retired firefighter named Bill Beckwith on top of a destroyed fire truck. He began slowly, and someone in the crowd shouted: “We can’t hear you!” This seemed to inspire Bush, who replied: “Well, I can hear you. I can hear you. The rest of the world hears you. And the people who knocked down these buildings down will hear all of us soon.”

The forceful comments reassured a worried nation, and the crowd at Ground Zero responded with chants of “USA! USA!” 

His worst moment, alas, was being photographed on Air Force One flying over New Orleans after Hurricane Katrina. There were sound logistical reasons for not taxing the city with the pressures of a presidential visit, but the picture gave the false impression that the president didn’t care enough to land. It was a shame, since all of us working at the White House at the time knew that he cared very much indeed. 

 Tevi Troy was a senior official in the Bush administration working on domestic policy, at the White House and at the Department of Health and Human Services. He is a senior fellow at the Hudson Institute and author of the upcoming What Jefferson Read, Ike Watched, and Obama Tweeted: 200 Years of Popular Culture in the White House.