Forget Compassionate Conservatism, President George W. Bush’s campaign mantra. Nobody knew what it meant anyway. Did conservatives feel the pain of the welfare mother as they whittled away at her benefits? Or did the whittling make her pull herself up by the proverbial bootstraps? Push her toward self-sufficiency? The mantra, which engendered too many confusing cliches, deserves the dustbin.
But Pragmatic Optimism suits this new President. And people concerned with health insurance – which is everybody who inhabits a doomed-to-fail body — should take heart, because the mixture of this President’s sunny can-do disposition and lack of ideological fervor presages health reform. At least I hope it does.
After all, the number of uninsured will surely top its current peak of almost 44 million. The wondrous economy has started to dip: The Nasdaq launched the New Year by plunging to a 22-month low, which may nudge the unemployment rolls up.
The number of underinsured too will rise, as hard-pressed companies scale back benefits. We don’t know precisely how many people have inadequate insurance: their policy excludes pre-existing conditions, caps benefits, restricts rehabilitation, and/or requires strict pre-authorization before payment. Most Americans won’t know how inadequate their policy is until they file for benefits. Yet we do know that millions of policy-holders have abysmal policies.
So in this backdrop of impending gloom, here are a few hopeful portents in a new year’s new administration:
- President George W. Bush’s lack of ideological fervor. This decidedly anti-intellectual President does not cling to ideological convictions — all to the good for health care reform, because it will not happen when the rabidly conservative battle the rabidly liberal.
- His father’s plan. Liberals bemoan the relics of his father’s administration who have cropped up in Administration photo-ops. Yet his father had proposed subsidized vouchers that would let people buy private insurance — much like Senator Bradley’s plan. Optimistically, the current President Bush will re-introduce this notion.
- His campaign promise to give low-income elderly prescription coverage quickly. Candidate Bush promised prescription relief for low-income Medicare beneficiaries (in contrast to Candidate Gore, who proposed the longer-range solution of adding prescription coverage to Medicare).
- His experience with immigration. Texas topped the nation in the number of uninsured (almost 25 percent), due in part to the waves of immigrants from Latin America.
- His vice-president. In the last decade a coterie of healthy people have set policy- – only the healthy could work marathon days in the White House. Yet we now have a vice-president who has recently been a patient, in a hospital, taking medications, recovering from surgery. Optimistically, Vice President Cheney will want to give more Americans ready access to the good doctors and good hospitals that enable him to work marathon days.
Perhaps my optimism reflects the after-glow of too much New Year’s champagne. Yet surprises happen: just as President Nixon went to China, this new pragmatic President, who never proposed to do anything grandiose or even substantial, may launch health care reform, extending insurance to millions of Americans. If this is not quite a New Year’s prediction, it most definitely is a New Year’s hope.
(Joan Retsinas is former executive director of the Rhode Island Health Care
Policy and Planning Consortium. Her column appears frequently.)
