Bush’s Rx Drug Proposal Will Help Seniors without Expanding the Federal Bureaucracy

The contrast between President Bush’s Medicare reform proposal and the national health scheme unveiled by Bill and Hillary Clinton seven years ago is as stark as the difference between a free-market democracy and a paternalistic socialist state.

A free-market democracy trusts its citizens, who are, after all, the consumers who use – and in most cases, pay – for the government’s services.

A free-market democracy believes its citizens have the right to exercise their vote in the marketplace and that they should be able to ponder as many choices as possible before making a decision.

Paternalistic states, on the other hand, believe that control-hungry politicians and government bureaucrats can make better decisions for individual consumers than the consumers themselves. Since more choices mean less control by central planners, they offer the people as few choices as possible. Consumer desires are tied to a Procrustean bedstead and lopped off until they fit government regulations. All in the name of the people, of course.

We all remember the fate of Hillarycare. The President put his wife, Hillary, in charge of his much-ballyhooed national health care initiative. After nearly a year and a half of secret meetings, she unveiled a plan that made the creaky old medical systems of Canada and Great Britain seem like shiny examples of rational modernity.

The Hillary creation would have transferred one-seventh of our nation’s Gross Domestic Product from the private sector to government control. The cost, indeed, was so prohibitive that the normally free-spending Democrats – who ruled Congress at the time – threw it out summarily.

That was the last major health care initiative launched by President Clinton. In 1997, he even turned down the recommendation of his own Bipartisan Commission on Medicare Reform – ignoring its warning that the hour for an overhaul was drawing late.

President George W. Bush, just six months into his new administration, has chosen a wiser course. A health care plan that trusts the people who are the patients as well as the people who work in the private health sector to make the right choices and do the right thing.1

The Bush proposal does not call for anything so far-reaching as national health care, but it does recognize that Medicare itself must undergo sweeping reforms if it is to remain solvent and to continue delivering quality health care in the first half of the 21st century.

It addresses one of the nation’s most pressing needs, according to ongoing public opinion polls, by providing prescription drug discounts for needy seniors through private insurers.

Under the proposal, companies that manage drug benefits would buy prescription drugs in bulk, and then sell discount cards to Medicare patients, who could use them at any pharmacy to purchase their medicines at deep discounts – up to 40% in some cases.

White House advisers believe the plan does not require congressional approval because it relies on the private sector. They say the Department of Health and Human Services could implement it in a few months – bringing instant price relief to millions of seniors.

The remainder of the President’s principles for Medicare reform will undergo intensive scrutiny in the months ahead. They will be the subjects of passionate debate.

Perhaps because President Bush no longer controls the Senate and his bully pulpit is normally drowned out by a liberal media, he has offered a plan of moderate principles short of the kind of details that would engender immediate and bristling opposition.

In this instance, moderation is the right course. As long as the President’s vision is far-sighted, and it appears to be in this case, Congress can flesh out the details. To do so, each side will have to accommodate each other and make numerous concessions along the way.

Is such an approach even a possibility in this era of “scorched earth” politics? It is heartening – and perhaps ironic – to consider that Democrats and Republicans were able to put their differences aside and find common ground on an equally momentous issue only a few years ago. It was called the Breaux-Frist Bipartisan Commission on Medicare Reform.

Every member of Congress should remember Jefferson’s famous admonition as they consider this crucial piece of legislation. In this undertaking, they should be neither Democrats nor Republicans. They should be only Americans.


Amy Ridenour is president of The National Center for Public Policy Research, a Washington, D.C. think tank.


1 Amy Goldstein, “Bush Has Pharmacy Discount Card Plan: Prescription Drug Benefit is Part of Medicare Revamp,” Washington Post, July 11, 2001, page A1.

The National Center for Public Policy Research is a communications and research foundation supportive of a strong national defense and dedicated to providing free market solutions to today’s public policy problems. We believe that the principles of a free market, individual liberty and personal responsibility provide the greatest hope for meeting the challenges facing America in the 21st century.