Bush Addresses Health Care in Final State of the Union Address

President Bush on Monday delivered his final State of the Union address, in which he focused on "extending or cementing past initiatives" and "reintroduced ideas that have gone nowhere in the past," some of which involve health care, the Washington Post reports (Baker, Washington Post, 1/29).

In his address, Bush called for health care reform that involves market competition, rather than government mandates (Kranish/Milligan, Boston Globe, 1/29). Bush advocated a previous proposal that would provide tax deductions to help U.S. residents purchase individual health insurance or coverage through employers and would eliminate tax breaks for employer-sponsored health insurance in some cases.

According to Bush, Republicans and Democrats "share a common goal: making health care more affordable and accessible for all Americans." He said, "The best way to achieve that goal is by expanding consumer choice, not government control. So I have proposed ending the bias in the tax code against those who do not get their health insurance through their employer. This one reform would put private coverage within reach for millions" (Wolf et al., USA Today graphic, 1/29).

Bush also said that Congress should "expand health savings accounts, create association health plans for small businesses, promote health information technology and confront the epidemic of junk medical lawsuits," all of which would "ensure that decisions about your medical care are made in the privacy of your doctor's office, not in the halls of Congress" (Bush speech text, Washington Post, 1/29).

Bush in his address avoided one of the "thorniest domestic issues that he has raised before without success": reforms to "financially shaky government entitlement programs such as Social Security and Medicare," the Globe reports. However, he "challenged members of the Democratic-majority Congress to reach bipartisan solutions" on the issue, according to the Globe (Boston Globe, 1/29).

Bush said, "Every member in this chamber knows that spending on entitlement programs like Social Security, Medicare and Medicaid is growing faster than we can afford. Now I ask members of Congress to offer your proposals and come up with a bipartisan solution to save these vital programs for our children and grandchildren" (AP/Austin American-Statesman, 1/28).

In his address, Bush also called for Congress to:

• Double the amount of funds for HIV/AIDS programs in Africa from $15 billion to $30 billion over five years;
• Increase funds for research on "reprogrammed adult skin cells, which have the potential and do act like embryonic stem cells" (Ward, Washington Times, 1/29);
• Pass legislation that would ban "unethical practices such as the buying, selling, patenting or cloning of human life";
• Double "federal support for critical basic research in the physical sciences";
• Reauthorize and reform the Trade Adjustment Assistance Act;
• Pass legislation to implement recommendations by former Sen. Bob Dole (R-Kan.) and former HHS Secretary Donna Shalala to "improve the system of care for our wounded" veterans (Bush speech text, Washington Post, 1/29).

In the Democratic response to the address, Kansas Gov. Kathleen Sebelius (D) asked Bush to work with Congress "in the next 357 days to get real results and give the American people renewed optimism that their challenges are the top priority" (Abramowitz/Eggen, Washington Post, 1/29).

Sebelius called on Bush to support some Democratic proposals for health care reform (Lefler/Koranda, Wichita Eagle, 1/29). Sebelius also asked Bush to sign legislation to reauthorize and expand the State Children's Health Insurance Program as a "first step in overhauling our health care system" (Branigin, Washington Post, 1/29).

According to the Bergen Record, her comments do not indicate that Democrats are "holding their breath for a presidential change of heart" but that they are "aiming more for drawing distinctions with Bush ... in an election year with the presidency and their majorities at stake" (Kellman, Bergen Record, 1/29).

C-SPAN video of the complete State of the Union address is available online (Bush, C-SPAN, 1/28). C-SPAN video of the complete Democratic response also is available online(Sebelius, C-SPAN, 1/28).

NPR's "Morning Edition" on Tuesday included a "fact check" of statements in the address (Montagne, "Morning Edition," NPR, 1/29). Audio of the segment is available online. Expanded NPR analysis of the Bush health insurance proposal also is available online.