This president is thinking big. In his speech to the Economic Club of Chicago this week, President Bush surprised almost everyone with the size and boldness of his tax cut proposals. And when he delivers his State of the Union address on Jan. 28, all of the signals indicate that the president’s proposals for health reform also will be Texas-sized.

The budget numbers aren’t firm yet, but the president is expected to again offer refundable tax credits for the uninsured to obtain private health insurance. And the White House continues to send strong signals that Mr. Bush is determined to put his energies behind modernizing the decrepit Medicare program.

They insist it would be irresponsible to tack a prescription drug benefit on to a program that is facing trillions of dollars in unfunded liabilities. They plan to offer more choices of private plans for Medicare beneficiaries with prescription drug benefits available to all and special subsidies for lower-income beneficiaries. …

The White House is motivated because officials believe the 2004 elections could well swing on health-care issues. And the president is emboldened because, for the first time, the leadership on Capitol Hill is passionately committed to health reform.

The Wall Street Journal editorialized this week that “Republicans tend to approach health care policy the way the rest of us do a root canal,” but that is thankfully changing.

Senator Bill Frist gave up his post at the National Republican Senatorial Committee to devote his time and energies to health issues, long before he or anyone else had the slightest notion that he would soon hold the Senate’s top job. Dr. Frist has been a leader on tax credits and in introducing legislation to streamline Medicare through private-sector competition.

House Speaker Dennis Hastert and Ways and Means Chairman Bill Thomas, and other senior colleagues are even more experienced on health care and equally determined to make progress on free-market reform.

So expect big and bold proposals. It is, of course, absolutely accurate that the right way to institute a drug benefit is to make it part of an overall health plan, like virtually all plans in the private sector. But few members of Congress campaigned on the issue of Medicare modernization, and the first constituency that the president will have to convince to go along will be rank and file members of his own party.

How will all of this play out? We wish we had a crystal ball, but one thing is certain. President Bush already has recharted the debate from the dead end it hit last summer as the Senate voted on a series of mostly dreadful prescription drug bills.

The president told the Chicago economists, “The role of government is not to manage or control the economy from Washington, D.C., but to remove obstacles standing in the way?” That’s absolutely true about taxes, but it’s even more urgently important in the health sector.

There is so much private sector energy just ready to transform our health sector. The Galen Institute’s new Center for Consumer Driven Health Care, launched this week under the very able leadership of Greg Scandlen, will be working overtime to provide ideas and information to policymakers and the public about the importance of making progress on these issues. Join us on this exciting ride!

”’Grace-Marie Turner is founder and president of the Galen Institute in Alexandria, Va., which was started in 1995 to promote a more informed public debate over individual freedom, consumer choice, competition and diversity in the health sector. The Institute’s primary focus is sponsoring research and educational programs on the crucial intersection of health and tax policy. For more information, go to:”’ http://www.galen.org/ ”’To reach Grace Marie Turner, send email”’ mailto:galen@galen.org

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Hawaii Reporter is an award-winning, independent Hawaii-based news and opinion journal founded in 2001 and launched in February 2002. The journal's staff have won a number of top awards from the Society of Professional Journalists, including the top investigative news reporting awards, business reporting awards, government reporting awards, and online news reporting awards.