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A Closer Look at the “Last Decade”



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President Obama said in his non-State of the Union address that “we have done more to advance the cause of health-care reform in the last 30 days than we have in the last decade.” This is at least the second time he has used this line; he said pretty much the same thing after the stimulus package passed last week. The “last decade” phrase is clearly a dig at President Bush, and an unfair one at that.  
 
The Bush administration accomplished a great deal on health care: prescription-drug benefits under Medicare, with choices for seniors; PEPFAR, the President’s Emergency AIDS Relief, which created a new paradigm for foreign aid based on goal-setting and accountability; the improvement and expansion of Community Health Centers, which now serve 16 million Americans; and setting the goal and the path forward for half of Americans to have electronic health records by 2014. President Bush’s domestic health-care efforts had a unifying principle, that of value-driven health care — the use of incentives and new technologies to make patients better and smarter purchasers of health care. I know some conservatives may not like all of these changes, but that does not mean conservatives should let the new president write these developments out of history.  
 
Secretary Leavitt used to call the Bush administration “the most consequential administration with respect to health care in four decades.” Given President Obama’s grandiose pronouncements on health care last night, it is quite possible that his administration could be more consequential — at some point. But not yet, and not based on 35 days, an SCHIP eligibility expansion, $2.1 billion for comparative effectiveness, and a still-to-be-written plan for using $20 billion to promote electronic medical records.  
 
– Tevi Troy is the former deputy secretary of health and human services, and author of Intellectuals and the American Presidency.



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