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George W. Bush on Health Care

President of the United States, Former Republican Governor (TX)


PEPFAR changed AIDS from death sentence to treatable

In 2003, George had proposed a $15 billion US initiative to combat the overwhelming devastations of AIDS around the world, particularly in Africa. Called PEPFAR, the President's Emergency Plan for AIDS Relief, it focused on cutting transmission rates between mothers and children, lowering the rate of new infection among youth and adults, and putting those who were infected on antiretrovirals. PEPFAR also devoted resources to caring for the vast numbers of AIDS orphans. The 15 focus countries targeted by the plan had 50% of all AIDS infections around the world.

For well over a decade, people across the African continent were not being tested for AIDS. A positive test was a death sentence because there were almost no medicines available in these nations to treat or manage AIDS. But now having treatment available [would help] to halt the spread of HIV/AIDS and to care for the sick would have a transformative effect on the continent as a whole.

Source: Spoken from the Heart, by Laura Bush, p.328 , Apr 5, 2011

PEPFAR: $15B "medical Marshall Plan" to fight AIDS in Africa

In 2003, Laura and I visited Entebbe, Uganda, a clinic run by The AIDS Support Organization, TASO. I saw their suffering as a challenge to the words of the Gospel: "To whom much is given, much is required."

America had been given a lot, and I resolved that we would answer the call. Earlier that year I had proposed, and Congress had passed, a $15 billion initiative to fight HIV/AIDS in Africa. The President's Emergency Plan for AIDS Relief, PEPFAR, constituted the largest international healt initiative to combat a specific disease. I hoped it would serve as a medical version of the Marshall Plan. "This is my country's pledge to the people of Africa and the people of Uganda," I said at the TASO clinic. "You are not alone in this fight. America has decided to act."

In five years, the number of Africans receiving AIDS medicine had risen from 50,000 to nearly three million--more than two million of them supported by PEPFAR.

Source: Decision Points, by Pres. George W. Bush, p.333-334 , Nov 9, 2010

5-year $1.2B malaria-eradication program in Africa

Unfortunately, AIDS wasn't the only disease ravaging Africa. By 2005, malaria was killing approximately one million Africans a year, the majority of them children under age 5. Transmitted by a mosquito bite, malaria accounted for 9% of all deaths in Africa, even more than AIDS.

Every one of those deaths was unnecessary. Malaria is treatable & preventable. The US had eradicated malaria in the 1950s, and there was a well-established strategy: a combination of insecticide sprays, bed nets, & medicin for infected patients. The remedies were not particularly expensive. Bed nets cost $10 each, including delivery.

In 2005, I announced a five-year, $1.2 billion program that would find malaria-eradication efforts in 15 countries. The President's Malaria Initiative would empower Africans to design strategies to meet their needs. We would work toward a measurable goal: cutting malaria mortality rates by 50% over the next five years. In its first two years, the initiative reached 11 million Africans.

Source: Decision Points, by Pres. George W. Bush, p.345 , Nov 9, 2010

AIDS Relief: largest int'l health initiative in history

Our soft-power advantages should also be derived from our manifest generosity: Americans make up just 4.5 percent of the world's population, yet we donate 12 percent of global foreign aid, an amount almost twice as much as any other country. We provide the most funds for humanitarian relief and global charities, and former president George W. Bush's Emergency Plan for AIDS Relief is the largest international health initiative in history dedicated to fight a single disease.
Source: No Apology, by Mitt Romney, p. 76 , Mar 2, 2010

2007: Vetoed SCHIP expansion; Obama later expanded it

Republicans created SCHIP in 1997 to cover health insurance for low-income children whose families were not poor enough to qualify for Medicare.

In August 2007, Congress passed a bill to extend the program by loosening eligibility standards, providing incentives for states to enroll more customers, and making it easier for states to enroll higher-income families. Funded by raising cigarette taxes, the measure was vetoed by President Bush, who argued the expansion violated the program's original purpose. Democrats passed it a second time, and Bush vetoed it again. Eventually Democrats settled on passing a temporary reauthorization of the program until March 2009, when there would be a new president. And sure enough, Congress passed a bill expanding SCHIP in January 2009, and President Obama signed it as soon as he took office.

Source: Obamanomics, by Timothy P. Carney, p. 75 , Nov 30, 2009

Preferred that seniors use Medicare to buy private insurance

Only about 25% of seniors were without insurance for prescription drugs, but the Democrats insisted that any plan had to be universal; it had to cover everyone. Bush's initial proposal would give Americans the choice to keep their private health insuranc after retirement, with Medicare helping pay for the cost of the premium. This would save the government money and give older Americans more choices of coverage. To get the Democrats on board, however, Bush gave up this provision and dramatically expanded the cost and size of the program. Medicare was already in financial trouble and the addition of universal drug coverage created a huge new unfounded liability.

Today a large majority of senior citizens are dependent on the federal government for their health care and prescription medication, the Medicare program is trillions of dollars in debt, and because of exploding costs, Medicare often pays physicians less than their cost to treat senior citizens.

Source: Saving Freedom, by Jim DeMint, p. 25-26 , Jul 4, 2009

Tax credits to address crisis of health insurance

Bush & McCain both proposed to address the crisis of health insurance with new programs of tax credits. This approach does nothing to reform the structural flaws in the current health insurance system--it merely subsidizes demand; and the credit is too low a level to allow the beneficiary to afford decent health insurance. So when they propose mainly tax credits, Democrats increasingly play on Republican turf: Government bad, tax cuts good. The game becomes a battle merely over which taxes to cut.
Source: Obama`s Challenge, by Robert Kuttner, p. 96 , Aug 25, 2008

FactCheck: Tax deduction insures at most 9M, & not poorest

Bush repeated his call for a tax deduction for those who buy their own health insurance, saying “millions” would gain coverage, saying, “I propose 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.”

Actually, there is a lot of uncertainty as to how many would benefit from Bush’s proposal. The projected number of uninsured in 2010--51 million--would be reduced by about 6.8 million to 9.2 million, according to different studies. One study calculated that the number of uninsured would actually increase by 1.5 million, because some employers would be prompted stop giving health insurance benefits.

These studies agree that the proposal gives much greater tax benefits to those with higher incomes. A majority of the uninsured, however, couldn’t benefit from the proposed tax deduction at all, because they don’t pay federal income taxes.

Source: FactCheck.org on 2008 State of the Union address , Jan 28, 2008

$7,500 tax deduction for health insurance

When it comes to health care, government has an obligation to care for the elderly, the disabled, and poor children. For all other Americans, private health insurance is the best way to meet their needs.

Tonight, I propose a standard tax deduction for health insurance that will be like the standard tax deduction for dependents. Families with health insurance will pay no income or payroll taxes on $15,000 of their income. Single Americans with health insurance will pay no taxes on $7,500 of their income.

At the same time, this reform will level the playing field for those who do not get health insurance through their job. And for the millions of other Americans who have no health insurance at all, this deduction would help put a basic private health insurance plan within their reach. Changing the tax code is a vital and necessary step to making health care affordable for more Americans.

Source: 2007 State of the Union address to Congress , Jan 23, 2007

Support wider use of electronic records for health care

Keeping America competitive requires affordable health care. Our government has a responsibility to help provide health care for the poor & the elderly, and we are meeting that responsibility. For all Americans, we must confront the rising cost of care, strengthen the doctor-patient relationship and help people afford the insurance coverage they need. We will make wider use of electronic records and other health information technology to help control costs and reduce dangerous medical errors. We will strengthen health savings accounts by making sure individuals and small business employees can buy insurance with the same advantages that people working for big businesses now get. We will do more to make this coverage portable, so workers can switch jobs without having to worry about losing their health insurance.
Source: 2006 State of the Union Address , Jan 31, 2006

FactCheck: British blocked flu vaccine, not Bush

BUSH: We relied upon a company out of England to provide about half of the flu vaccines for the US, and it turned out that the vaccine they were producing was contaminated. And so we took the right action and didn’t allow contaminated medicine into our country.

FACT CHECK: It’s not true, as Bush claimed, that “we took the right action” in blocking “contaminated” influenza vaccine from entering the US. Actually, it was the British and not the US that blocked shipment. The British Medicines and Healthcare products Regulatory Agency, according to an Oct. 6 news release, suspended the license of Chiron Corp., the manufacturer of approximately 50% of the US supply. In fact, the Bush administration seems to have been caught by surprise when Chiron Corp. notified the US Center for Disease Control Oct. 5 that the company wouldn’t be shipping the vaccine due to the British action. The US Food & Drug Administration didn’t begin an investigation until five days later, according to an FDA news release .

Source: Analysis of Third Bush-Kerry debate (FactCheck 2004) , Oct 14, 2004

I haven’t gotten a flu shot, and I don’t intend to

Q: Suddenly we find ourselves with a severe shortage of flu vaccine. How did that happen?

BUSH: We relied upon a company out of England to provide about half of the flu vaccines for US citizens, and it turned out that the vaccine they were producing was contaminated. And so we took the right action and didn’t allow contaminated medicine into our country. We’re working with Canada to help us [get the] vaccines necessary. My call to our fellow Americans is if you’re healthy, if you’re younger, don’t get a flu shot this year. Help us prioritize those who need to get the flu shot, the elderly and the young. I haven’t gotten a flu shot, and I don’t intend to because I want to make sure those who are most vulnerable get treated.

KERRY: This really underscores the problem with the American health-care system. It’s not working for the American family. And it’s gotten worse under President Bush over the course of the last years.

Source: Third Bush-Kerry Debate, in Tempe Arizona , Oct 13, 2004

Kerry’s health care plan is an empty promise

KERRY: Bush has turned his back on the wellness of America. And there is no system. In fact, it’s starting to fall apart not because of lawsuits, though they are a problem and John Edwards and I are committed to fixing them, but because of the larger issue that we don’t cover Americans. Children across our country don’t have health care. We’re the richest country on the face of the planet, the only industrialized nation in the world not to do it. I have a plan to cover all Americans. We’re going to make it affordable and accessible, and let everybody buy into the same health care plan senators and congressmen give themselves.

BUSH: A plan is not a litany of complaints and not to lay out programs that you can’t pay for. The same plan that senators and congressmen get costs the government $7,700 per family. If every family in America signed up like the senator suggested it would cost us $5 trillion over 10 years. It’s an empty promise. It’s called bait and switch.

Source: [Xref Kerry] Third Bush-Kerry Debate, in Tempe Arizona , Oct 13, 2004

The US healthcare system is the envy of the world

The Lewin report accurately noted that there are going to be over 20 million people added to government-controlled health care. It would be the largest increase in government health care ever. If you raise the Medicaid to 300 percent, it provides an incentive for small businesses not to provide private insurance to their employees. It’s estimated that 8 million people will go from private insurance to government insurance. We have a fundamental difference of opinion. I think government-run health will lead to poor-quality health, will lead to rationing, will lead to less choice. Once a health-care program ends up in a line item in the federal government budget, it leads to more controls. And just look at other countries that have tried to have federally controlled health care. They have poor-quality health care. Our health-care system is the envy of the world because we believe in making sure that the decisions are made by doctors and patients, not by officials in the nation’s capital.
Source: Third Bush-Kerry debate, in Tempe AZ , Oct 13, 2004

Veterans are getting very good health care

KERRY: Bush said government-run health care results in poor quality. Maybe that explains why he hasn’t fully funded the VA and the VA hospital is having trouble and veterans are complaining. Maybe that explains why Medicare patients are complaining about being pushed off of Medicare. He doesn’t adequately fund it. I am not proposing a government-run program. That’s not what I have. I have Blue Cross/Blue Shield. Senators and congressmen have a wide choice. Americans ought to have it too.

BUSH: Talk about the VA: We’ve increased VA funding by $22 billion in the four years since I’ve been president. That’s twice the amount that my predecessor increased VA funding. Of course we’re meeting our obligation to our veterans, and the veterans know that. We’re expanding veterans’ health care throughout the country. We’re aligning facilities where the veterans live now. Veterans are getting very good health care under my administration, and they will continue to do so during the next four years.

Source: [Xref Kerry] Third Bush-Kerry debate, in Tempe AZ , Oct 13, 2004

FactCheck: Kerry’s plan doesn’t put bureaucrats in control

BUSH: Kerry said he’s going to have a novel health care plan. You know what it is? The federal government is going to run it. It’s the largest increase in federal government health care ever. Government-sponsored health care would lead to rationing. It would ruin the quality of health care in America.

Bush’s attack in the debate echoed a grossly misleading claim made in his earlier TV ad, which said Kerry’s health plan would put “Washington bureaucrats in control” of medical decisions. That view isn’t supported by neutral experts, however, as we reported on Oct. 4. Actually, an estimated 97% of Americans who now have health insurance will simply keep the plan they have, according to projections by the independent, politically neutral health-care research firm The Lewin Group, concluding, “I don’t see how, in Kerry’s plan, decisions on medical procedures would be made in Washington under any circumstances.” Republican partisans argue that Kerry’s plan will lead to increased government oversight.

Source: Analysis of second Bush-Kerry debate by FactCheck 2004 , Oct 10, 2004

Double the NIH budget to $28 billion

To destroy life to save life is one of the real ethical dilemmas that we face. There’s going to be hundreds of experiments off the 22 lines that now exist that are active, and hopefully we find a cure. But as well, we need to continue to pursue adult stem cell research. I helped double the NIH budget to $28 billion a year to find cures. And the approach I took is one that I think is a balanced and necessary approach to balance science and the concerns for life.
Source: Second Bush-Kerry Debate, in St. Louis MO , Oct 8, 2004

Kerry’s healthcare plan will ruin the quality of healthcare

BUSH: Kerry says he’s going to have a novel health care plan. The federal government’s going to run it. It is the largest increase in federal government health care ever. That’s what liberals do. They create government-sponsored health care. Maybe you think that makes sense. I don’t. Government-sponsored health care would lead to rationing. It would ruin the quality of health care in America.

KERRY: My health care plan is not what Bush described. It is not a government takeover. You have choice. Choose your doctor. Choose your plan. The government has nothing to do with it. In fact, it doesn’t ask you to do anything. If you don’t want to take it, you don’t have to. If you like your high premiums, you keep ‘em. That’s the way we leave it.

Source: Second Bush-Kerry Debate, in St. Louis MO , Oct 8, 2004

$15B for international AIDS treatment

America and many nations have established a global fund to fight AIDS, tuberculosis, and malaria. America has undertaken a $15 billion effort to provide prevention and treatment and humane care in nations afflicted by AIDS, placing a special focus on 15 countries where the need is most urgent. AIDS is the greatest health crisis of our time, and our unprecedented commitment will bring new hope to those who have walked too long in the shadow of death.
Source: Address to the United Nations General Assembly , Sep 21, 2004

Will enroll millions of poor children in health programs

America’s children must also have a healthy start in life. In a new term, we will lead an aggressive effort to enroll millions of poor children who are eligible but not signed up for the government’s health insurance programs. We will not allow a lack of attention, or information, to stand between these children and the health care they need.
Source: 2004 Republican Convention Acceptance Speech , Sep 2, 2004

Government-run health care is the wrong prescription

A government-run health care system is the wrong prescription. By keeping costs under control, expanding access and helping more Americans afford coverage, we will preserve the system of private medicine that makes America’s health care the best in the world.
Source: 2004 State of the Union address to joint session of Congress , Jan 20, 2004

Endorses billions more in health care funding

The President’s budget includes $1.5 billion for Community Health Centers, a $114 million increase that would continue the Bush Administration’s long-term strategy to add 1,200 new and expanded health center sites over five years and serve an additional 6.1 million patients. The increase for fiscal year 2003 will support 170 new and expanded health centers, and provide services to a million more patients.
Source: 2004 Presidential website, georgewbush.com , Aug 30, 2003

Senior Rx: “Immediate Helping Hand” now; more later

President Bush proposes to help low-income senior citizens obtain prescription drugs, but will include a message that he would consider broader Medicare changes that might speed up a prescription-drug benefit for all seniors. “We understand that there are many on the Hill who believe it should be done as part of comprehensive Medicare reform, and we will be open-minded on that,” a White House official said. The change is a new instance of Bush’s willingness to alter details of his programs to achieve his broad goals in a Congress where Republicans hold tissue-thin control.

Bush’s prescription drug plan, called “Immediate Helping Hand,” would provide $48 billion to states over four years so they could cover the full cost of drugs for the poorest senior citizens, and part of the cost for those who are slightly better off. As part of his broader plan for Medicare, Bush favors eventually paying at least 25% of the premium costs for prescription drug coverage for all seniors.

Source: Mike Allen, Washington Post, Page A12 , Jan 29, 2001

Absolutely opposed to a national health care plan

Q: Would you be open to the ideal of a national health care plan?

BUSH: I’m absolutely opposed to a national health care plan. I don’t want the federal government making decisions for consumers or for providers. I remember what the administration tried to do in 1993. They tried to have a national health care plan, and fortunately it failed. I trust people; I don’t trust the federal government. I don’t want the federal government making decisions on behalf of everybody.

Source: St. Louis debate , Oct 17, 2000

Medical Savings Accounts part of affordable access & choice

Q: Should the government let everyone set aside money in a tax-free medical savings account to help pay for their health care?

A: I believe every American should have access to quality, affordable health care by giving consumers better information about health care plans, providing more choices such as medical savings accounts and changing tax laws to help more people, such as the uninsured and the self-employed, afford health insurance.“

Source: Associated Press , Oct 11, 2000

Claims of immediate help are only true for poorer families

GORE: A married man, 70 years old, with income of $25,000 a year. under Bush’s plan, would not get one penny for four to five years.

BUSH: I cannot let this go by. Under my plan, the man gets immediate help with prescription drugs.“

ANALYSIS: This is NOT TRUE. They would not get immediate help because their income exceeds 175% of the federal poverty level. They would get help only after their bills exceeded $6,000. But a poorer family would get immediate help.

Source: Presidential Debate, Boston Globe, “Number Crunch”, p. A15 , Oct 11, 2000

Invest $27B in NIH to cure Alzheimer’s & other diseases

Bush proposed spending an additional $67 billion over the decade to search for cures for age-old afflictions, including Alzheimer’s disease. “As president, I will fund and lead a medical moonshot to reach far beyond what seems possible today.’’ Specifically, Bush would complete a five-year plan already in progress in Congress to double NIH funding by 2003, to about $27 billion.
Source: AP Story, NY Times , Sep 22, 2000

Government HMOs not the answer for Social Security

Bush said the vice president’s prescription drug plan would force seniors into “government HMOs,” give them one chance to enter the plan at age 64 and cost certain seniors more money than they currently pay. “That’s not fair and that’s not right.”
Source: AP story, NY Times , Sep 11, 2000

Family Health Credit: pay for 90% of basic low-income policy

[My proposed] “Family Health Credit” would make a basic health plan more affordable. It would pay for 90%of the cost of an insurance policy, up to $2,000 a year, for every family making less than $30,000. Every family that is not already covered by government programs or an employer plan would be eligible. This Family Health Credit would help to buy a basic policy that covers visits to a doctor, discounted prescriptions, and hospitalization.
Source: USA Today editorial by Bush, page 16A , Apr 13, 2000

$3.6B for 1,200 new community health centers

I support increasing the number of community health centers across America. Community health centers are community-owned, locally administered medical clinics where people can receive preventive care, free vaccine clinics, health alerts, disease screening, and counseling. They have become America’s health care safety net. Under my plan, we would provide $3.6 billion in federal money over a five-year period to create 1,200 new centers from coast to coast.
Source: USA Today editorial by Bush, page 16A , Apr 13, 2000

Expand and Reform Medical Savings Accounts:

Source: Fact Sheet: “New Prosperity Initiative/Renewing America” , Apr 11, 2000

Opposes doctor assisted suicide

Opposes doctor assisted suicide, believes the role of a doctor is to relieve pain and suffering, not to end life
Source: GeorgeWBush.com: ‘Issues: Policy Points Overview’ , Apr 2, 2000

Restrict teenage smoking by tough state & federal laws

Bush, in a statement issued by his campaign headquarters, called on Congress and state legislatures to pass laws to restrict access to tobacco by minors. Texas, he said, had already passed some of the toughest such laws in the nation.
Bush did not address the question that faced the Supreme Court today, whether the FDA should be empowered to regulate tobacco as a harmful and addictive drug. A spokeswoman said the governor had never answered that question and was not prepared to do so today.
The Bush statement said the governor “believes Congress should pass tough laws to keep tobacco out of the hands of kids similar to strict anti-teen smoking laws he advocated and signed in Texas.”
Texas imposes fines on retailers who sell cigarettes to minors, prohibits cigarette vending machines in areas accessible to children and restricts tobacco advertising within 1,000 feet of schools and churches.
Source: NyTimes.com , Mar 22, 2000

Health insurance for kids from tobacco settlement

Bush provided health insurance for kids. He used Texas’ tobacco settlement fund to provide health insurance to children whose families do not qualify for Medicaid and whose family income is 200% or less of poverty level.
Source: GeorgeWBush.com/News/ “1999 Texas Legislative Record” , Jun 25, 1999

More funding for disability assistance

    Our goal now is [to remove] the last barriers to full, independent, productive lives for every person, with or without disability. I support the Americans with Disabilities Act, [which bans] discrimination against a person with a disability. But the banning of discrimination is just the beginning of full participation. Barriers remain. My administration will act in three specific areas:
  1. We will promote independent living [via] tripling the current funding, to $33 million annually, for research on assistive technology like text telephones for the deaf and computer monitors with braille display for the blind.
  2. We will help citizens with disabilities to claim their rightful place in the workforce [via] $20 million to create an Access to Telecommuting Fund.
  3. We will help Americans with disabilities to gain fuller access to community life [via] $10 million each year to aid religious and civic groups in making their facilities more accessible.
Source: “New Freedom Initiative” Speech, part of “Renewing America” , Jun 15, 2000


George W. Bush on Insurance coverage

Expand consumer choice, not government control

To build a future of quality health care, we must trust patients & doctors to make medical decisions and empower them with better information and better options. We share a common goal: making health care more affordable and accessible for all Americans. 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, and I call on the Congress to pass it this year.

The Congress must also expand health savings accounts, create Association Health Plans for small businesses, promote health information technology, and confront the epidemic of junk medical lawsuits. With all these steps, we will help ensure that decisions about your medical care are made in the privacy of your doctor’s office--not in the halls of Congress.

Source: 2008 State of the Union address to Congress , Jan 28, 2008

Association health plans for small business

To make our economy stronger and more productive, we must make health care more affordable and give families greater access to good coverage and more control over their health decisions. I ask Congress to move forward on a comprehensive health care agenda with
Source: 2005 State of the Union Speech , Feb 2, 2005

Allow small firms to join together to purchase insurance

We must allow small firms to join together to purchase insurance at the discounts available to big companies. We will offer a tax credit to encourage small businesses and their employees to set up health savings accounts, and provide direct help for low-income Americans to purchase them. These accounts give workers the security of insurance against major illness, the opportunity to save tax-free for routine health expenses, and the freedom of taking your account with you whenever you change jobs.
Source: 2004 Republican Convention Acceptance Speech , Sep 2, 2004

Health savings accounts with choice of coverage

Starting this year, millions of Americans will be able to save money, tax-free, for their medical expenses in a health savings account. I signed this measure proudly, and any attempts to limit the choices of our seniors or to take away their prescription drug coverage under Medicare will meet my veto. On the critical issue of health care, our goal is to ensure that Americans can choose and afford private health care coverage that best fits their individual needs.
Source: 2004 State of the Union address to joint session of Congress , Jan 20, 2004

100% tax deduction for catastrophic health insurance

On the critical issue of health care: I ask you to give lower-income Americans a refundable tax credit that would allow millions to buy their own basic health insurance. By computerizing health records, we can avoid dangerous medical mistakes & reduce costs. We must eliminate wasteful and frivolous medical lawsuits. And tonight I propose that individuals who buy catastrophic health care coverage, as part of our new health savings accounts, be allowed to deduct 100% of the premiums from their taxes.
Source: 2004 State of the Union address to joint session of Congress , Jan 20, 2004

Everyone should be able to choose a health plan

The President believes that everyone should be able to choose a health care plan that meets their needs at a price they can afford. When people have good choices, health plans have to compete for their business - which means higher quality and better care.
Source: 2004 Presidential website, georgewbush.com , Aug 30, 2003

Lift restrictions on Medical Savings Accounts

The President’s plan lifts the excessive restrictions on Medical Savings Accounts which will allow many more Americans to set up tax-free accounts to protect themselves from high out-of-pocket costs. [And it would] modernize Medicare with prescription drug coverage that enables seniors to get the medicines they need, without the government dictating their drug choices.
Source: 2004 Presidential website, georgewbush.com , Aug 30, 2003

Ask “are we getting health care?” not “are we uninsured?”

There is an issue with the uninsured. There sure is. And we’ve got uninsured people in my state. But we’re providing health care for our people. One thing about insurance, that’s a Washington term. The question is, are people getting health care? And we’ve got a strong safety net. And there needs to be a safety net in America. There needs to be more community health clinics where the poor can go get health care. We need a program for the uninsured. They’ve been talking about it in Washington, D.C. The number of uninsured have now gone up for the past seven years.

We need a $2,000 credit, a rebate for working people who don’t have insurance, that they can use in the marketplace and start purchasing insurance. We need to allow small businesses to write insurance policies across jurisdictional lines so small business can afford health care. Health care needs to be affordable and available.

Source: St. Louis debate , Oct 17, 2000

Link small businesses together in large insurance pools

Q: What will you do for uninsured people under 65?

BUSH: For working folks that want health care, that can’t afford it, a couple of things: I’ve put money in my budget to expand community health centers all around the country. These are places where people can get primary care. Secondly, you get a $2,000 rebate from the government if you’re a family making $30,000 or less - it scales down as it gets higher - that you can use to purchase health care in the private market. Allow business associations to write association plans across jurisdictional lines so that small businesses have got the capacity of national pooling to drive the cost of insurance down.

GORE: I’d like to see some form of universal health care, but I’m not for a government-run system. We should start by greatly expanding the so-called child health insurance, or CHIP program, to give health insurance to every single child in this country.

Source: Presidential Debate at Wake Forest University , Oct 11, 2000

Cover 3 million uninsured at a 10-year cost of $135 billion

Source: The Economist, “Issues 2000” , Sep 30, 2000

Small business health insurance via trade associations

We will increase the number of good, lower-cost plans available to workers. Small businesses should be allowed to buy insurance from a trade association, giving them the same purchasing power as a large company and bringing down the cost. This would allow a family restaurant, or a local hardware store, to insure their workers through the National Restaurant Association or the US Chamber of Commerce.
Source: USA Today editorial by Bush, page 16A , Apr 13, 2000

More CHIPs; more multistate HMOs

George W. Bush’s plan:Al Gore’s plan:
Tax credit for 90% of health insurance costs for families making up to $60,000, individuals up to $45,000Tax credit worth 25% of premiums paid by people who buy insurance on their own
Flexibility for states to expand coverage under the federal Children’s Health Insurance Program (CHIPs)Coverage for more children under the Children’s Health Insurance Program (CHIPs)
Help for small businesses to buy cheaper insurance through multistate organizationsEnact a Patient’s Bill of Rights, with access to specialists, emergency rooms, and the right to sue HMOs
Source: USA Today editorials, page 16A , Apr 13, 2000

New Prosperity Initiative: $2,000 health ins. tax credit

To Provide Access to Affordable Health Care [as part of the New Prosperity Initiative], Governor Bush will:
  • Provide a health credit of up to $2,000 per family ($1,000 per individual) to cover 90% of the cost of health insurance for low-income, working Americans who are not covered by a government program or their employer. As income increases, the share of the cost covered by the health credit will decrease.
  • Lower the cost of health insurance for small businesses and their employees by allowing these businesses to purchase more affordable policies through multi-state Association Health Plans.
  • Strengthen the State Children’s Health Insurance Program, giving states more flexibility to innovate and reach out to eligible people.
  • Empower people through Flexible Savings Accounts and Medical Savings Accounts.
    Source: Fact Sheet: “New Prosperity Initiative/Renewing America” , Apr 11, 2000


    George W. Bush on Medicare + Medicaid

    OpEd: Medicare Part D is largest entitlement in 40 years

    We don't have to go far to find examples of conservatives going astray. One such example was the creation of a subsidized prescription drug program for senior citizens called Medicare Part D. It was the largest entitlement program in 40 years, and it was created under Republican president George W. Bush and passed by a Republican-controlled House and a Republican-controlled Senate in 2003. While there may have been some good intentions involved, this was George W. Bush using taxpayer dollars to buy seniors' votes for his 2004 reelection campaign, pure and simple. And the Republicans in Congress generally went right along with it.
    Source: Last Line of Defense, by Ken Cuccinelli, p. 63-64 , Feb 12, 2013

    We got Medicare reform done

    KERRY: He put $139 billion of windfall profit into the pockets of the drug companies right out of your pockets. That’s the difference between us. Bush sides with the power companies, the oil companies, the drug companies; and I’m fighting to let you get those drugs from Canada and I’m fighting to let Medicare survive. I’m fighting for the middle class.

    BUSH: If they’re safe, they’re coming. I want to remind you that it wasn’t just my administration that made the decision on safety. Clinton did the same thing because we have an obligation to protect you. Kerry’s been in the US Senate 20 years. Show me one accomplishment toward Medicare that he accomplished. I’ve been in Washington 3-1/2 years and led the Congress to reform Medicare so our seniors have got a modern health care system.

    KERRY: In 1997 we fixed Medicare, and I was one of the people involved in it. We not only fixed Medicare and took it way out into the future; we did something that you don’t know how to do, we balanced the budget.

    Source: [Xref kerry] Second Bush-Kerry Debate, in St. Louis MO , Oct 8, 2004

    Medicare bill uses market-based solutions to reduce costs

    The December 2003 Medicare Prescription Drug, Improvement, and Modernization Act embodied Bush’s approach. On the one hand, it helped seniors, many with low incomes, by covering prescription drugs and checkups that were not covered before. While coverage would not start until 2006, a prescription discount card was to start giving seniors savings of 10% to 25% in June 2004. On the other hand, by introducing competition, free enterprise, deductibles, and preventive health care, the new law used free market approaches of the private sector to keep costs in line.

    The Bush approach was to use elegantly simple market-based solutions to reduce costs. Under the old Medicare, there was no preventative care. Now when you are a senior and turn sixty-five, you will get a physical. Medicare can identify problems rather than waiting until you are seventy-five and they are more serious. And how could anyone be against giving the elderly prescription drugs that they did not have before?

    Source: A Matter of Character, by Ronald Kessler, p.267-68 , Aug 5, 2004

    Medicare Rx plan: immediate help, then senior choice

    GORE (to Bush): Under the Medicare prescription drug proposal I’m making, here’s how it works: You go to your own doctor and your doctor chooses your prescription, and no HMO or insurance company can take those choices away from you. Then you go to your own pharmacy, you fill the prescription and Medicare pays half the cost. If you’re in a very poor family or you have very high costs, Medicare will pay all the costs, a $25 premium and much better benefits than you can possibly find in the private sector.

    BUSH: I’ve got a plan on Medicare that’s a two-stage plan that says we’re going to have immediate help for seniors in what I call “Immediate Helping Hand,” a $48 billion program. [Then,] seniors are going to have not only a Medicare plan where the poor seniors will have their prescriptions paid for, but there will be a variety of options. My plan not only trusts seniors with options, my plan sets aside $3.4 trillion for Medicare over the next 10 years.

    Source: Presidential debate, Boston MA , Oct 3, 2000

    Cap senior prescription costs at $6,000 per year

    Healthcare comparedGore’s planBush’s plan
    Poor seniorsAll drug costs would be covered for those with incomes below $12,000 (single) or $14,000 (couple).All drug costs would be covered for those with incomes below $11,300 (single) or $15,200 (couple). Seniors with incomes below $14,600 (single) or $19,700 (couple) would get a partial subsidy of prescription drug premiums from the government. The lower one’s income, the higher the subsidy.
    All other seniorsHalf of drug costs, up to $5,000 a year, would be paid by the government. After that, seniors would have to pay out of pocket. Once the senior has paid a total of $4,000 for the year, the government would pick up all remaining drug costs. The government would pay for 25% of drug premiums. After a senior has paid $6,000 in a year, the government would pick up all remaining costs.
    Source: Boston Globe, p. A8 , Sep 6, 2000

    $158B for Medicare prescriptions & subsidized premiums

    Medicare reform comparedGore’s planBush’s plan
    PremiumsStart at $25 per month, increasing to $44 by 2008.Will be determined by individual private health insurance companies, with higher premiums for more extensive coverage.
    Projected Cost$253 billion over 10 years$158 billion over 10 years, of which $48 billion would go for immediate prescription aid by 2004.
    Source: Boston Globe, p. A8 , Sep 6, 2000

    Choice of Medicare, free equivalent, or adding own $

    [Seniors under Bush’s Medicare plan] will have a system with a proven track record. Nine million federal employees already have a similar plan. Seniors will get a book each year, listing all the health plans, and comparing their benefits. Seniors can stay in the current Medicare system, with no changes. They can choose another basic plan, for no cost at all. Or they can choose to pay a little more for a plan with additional benefits. And every low income senior will get a high-option plan for free.
    Source: Speech “Modernizing Medicare,” Allentown, PA , Sep 5, 2000

    Second bill to Congress: $48B for immediate Rx help

    During the transition to better Medicare coverage, we will provide $12 billion a year in direct aid to low-income seniors. My plan sets aside $158 billion additional dollars for Medicare over the next ten years. Four years to provide “An Immediate Helping Hand,” and an additional $110 billion for Medicare modernization. I have said that education reform will be the first bill I propose to Congress. The measure I am proposing today-immediate prescription drugs for seniors-will be my second bill.
    Source: Speech “Modernizing Medicare,” Allentown, PA , Sep 5, 2000

    All seniors entitled to Medicare; poor seniors subsidized

    Source: Speech “Modernizing Medicare,” Allentown, PA , Sep 5, 2000

    $7.4B for nursing home insurance via tax deductions

    Bush proposed tax breaks yesterday to help older Americans with nursing home insurance and those caring for relatives at home. The governor said his plan, at a cost of $7.4 billion over five years, was an effort to steer people off “a path to financial ruin.”

    Bush wants to provide an income tax deduction to anyone buying long-term care insurance. The deduction, now available only to people who itemize and have big medical expenses, would apply to everyone except those on employer-subsidized long-term care plans. The campaign estimated the cost of that portion of Bush’s proposal at $5.1 billion.

    Also, Bush proposed an additional tax exemption for elderly spouses, parents, or other relatives cared for in one’s home. That exemption is currently $2,750 a year. The campaign estimated the cost of that second proposal at $2.3 billion over 5 years.

    Source: Boston Globe, p. A29, part of “Renewing America’s Purpose” , May 11, 2000

    Replace 132,000-page Medicare document with senior choice

    As far as the elderly, [their health care is] controlled by a 132,000-page document to determine how to allocate and ration Medicare dollars to the seniors. It is a plan that is inefficient, it is a plan that’s antiquated. And what our government must do is empower our seniors to be able to make choices for themselves and support premiums for the poorest of seniors.
    Source: GOP Debate in Johnston, Iowa , Jan 16, 2000


    George W. Bush on Patient Rights

    Supports passage of Patient’s Bill of Rights

    The President strongly supports the passage of a Patients’ Bill of Rights that leaves medical decisions in the hands of physicians, instead of insurance companies - and urges Congress to reconcile differences and complete its work this year.
    Source: 2004 Presidential website, georgewbush.com , Aug 30, 2003

    Patient Rights: No gatekeepers for gynecologists

    BUSH: [A Patients’ Bill of Rights] requires a different kind of leadership style to [accomplish]. In order to get something done on behalf of the people, you have to put partisanship aside. And that’s what we did in my state. We’ve got one of the most advanced patients’ bill of rights. It says, for example, that a woman doesn’t have to go through a gatekeeper to go to her gynecologist. It says that you can’t gag a doctor. The HMO or insurance company can’t gag that doctor from giving you full advice. It allows patients to choose their own doctor if they want to.

    And you can sue an HMO for denying you proper coverage. Now, there’s what’s called an Independent Review Organization that you have to go through first. If you’ve got a complaint with your insurance company, you can take your complaint to an objective body. If they rule on your behalf, the insurance company must follow those rules, or that becomes a cause of action in a court of law.

    Source: St. Louis debate , Oct 17, 2000

    Give seniors choice, not bureaucrats; give incentives too

    Source: Speech “Modernizing Medicare,” Allentown, PA , Sep 5, 2000

    Health care access via empowerment, not nationalizing

    These health care proposals will increase access to better health care and health insurance for millions of low-income Americans. And unlike my opponent’s approach, my proposals will not nationalize our health care system; they will empower our patients.
    Source: USA Today editorial by Bush, page 16A , Apr 13, 2000

    Private alternatives & state reforms come first

    Source: GeorgeWBush.com: ‘Issues: Policy Points Overview’ , Apr 2, 2000

    HMOs should cover emergency room; & gynecology directly

    On HMOs: Favors requirement that patients be covered for hospital emergency care, that women be able to go directly to gynecologist, and patients with ongoing illnesses not be forced to change doctors, among other protections. Also favors independent review process and ultimate avenue for legal action by patients, but says any federal move on this front should not supersede protections in place in states.
    Source: Associated Press , Mar 14, 2000

    Create Review Board to hear HMO complaints

    Q: Do you believe patients should have the right to sue their HMO? A: I do. A Texas law says if you’ve got a complaint with your HMO and you’re the patient, you can take your complaint to what’s called an Independent Review Organization. It’s a group of objective minded people that hear your claim, that hear your cause. If they decide that the HMO is wrong, and the HMO ignores the finding, that then becomes a cause of action. I would have a National Review Board and make that possible for everyone.
    Source: Des Moines Iowa GOP Debate , Dec 13, 1999


    George W. Bush on Prescription Drugs

    2000: market-based program for Medicare Rx drugs

    Medicare was created in the 1960s, and was stuck in that era. While the medical profession developed new treatments and a new reliance on drugs to manage disease, Medicare's model still relied heavily on surgery and long hospital stays. By 1998, private health insurers paid more than half of all prescription drug expenditures while Medicare paid to operate on a stomach ulcer but not for pills that could have prevented the ulcer. That didn't make sense.

    Bush wanted to use free market forces to shape a Medicare prescription drug program that would be responsive to consumers, cost less than federal entitlements typically do, and provide seniors with a wide range of choices that would evolve over time to meet changing needs. He had run on creating a market-based--not government-run--program in the 2000 campaign.

    But creating one was not a universally popular thing to do among Republicans. Some GOP members of Congress opposed the drug program because they believed it enlarged the welfare state.

    Source: Courage and Consequence, by Karl Rove, p.372-373 , Mar 9, 2010

    FactCheck: Bush opposed drug reimports, but so did Clinton

    KERRY-EDWARDS CLAIM: “In the Senate we passed the right of Americans to import drugs from Canada. But the president and his friends took it out in the House, and now you don’t have that right. The president blocked you from the right to have less expensive drugs from Canada.”

    CNN FACT CHECK:Bush did oppose a measure to import inexpensive prescription drugs from Canada, but Clinton killed a similar measure. Clinton signed a Canadian drug reimportation bill in Oct. 2000, but cited various problems including safety concerns. Two months later, the Clinton administration invoked a provision in the law to kill the program entirely. In the second presidential debate this year, Bush explained his position: “When a drug comes in from Canada, I want to make sure it cures you and doesn’t kill you.” However, in the 2000 presidential debates, Bush did indicate support for drug reimportation: “To allow for drugs that were sold overseas to come back into the US-that makes sense.”

    Source: CNN FactCheck on 2004 statements by Bush and Kerry , Oct 29, 2004

    FactCheck: Only 19% of poor seniors use Drug Discount cards

    BUSH: There are other ways to make sure drugs are cheaper [instead of allowing reimportation from Canada]. One is to get our seniors to sign up to these drug discount cards, and they’re working.

    FACT CHECK: In fact they’re not working nearly as well as originally advertised. Seniors complain the cards are confusing, and healthcare advocates fault the Department of Health and Human Services for failing to effectively publicize the program. The Associated Press reported that of the 7 million poor seniors who are eligible for the card and a $600 subsidy, only 1.3 million (19%) have actually signed up to receive the discount. And as widely reported, total enrollment-counting both poor and non-poor-is at 4.4 million, and over half of those were enrolled automatically by heath maintenance organizations. The overall total is still 3 million shy of the number the administration predicted would be enrolled by the end of 2004.

    Source: Analysis of second Bush-Kerry debate by FactCheck 2004 , Oct 10, 2004

    Make sure the drugs from Canada cure and don’t kill you

    Q: Why did you block the reimportation of safer and inexpensive drugs from Canada?

    A: I just want to make sure they’re safe. When a drug comes in from Canada, I want to make sure it cures you and doesn’t kill you. And that’s why the FDA and that’s why the surgeon general are looking very carefully to make sure it can be done in a safe way. I’ve got an obligation to make sure our government does everything we can to protect you. And my worry is is that, you know, it looks like it’s from Canada; it might be from a Third World. We’ve just got to make sure before somebody thinks they’re buying a product that it works. And that’s why we’re doing what we’re doing. Now, it may very well be here in December you hear me say I think there’s a safe way to do it. Other ways to make sure drugs are cheaper. One is to speed up generic drugs to the marketplace quicker. Pharmaceuticals were using loopholes to keep brand drugs in place, and generics are much less expensive than brand drugs.

    Source: Second Bush-Kerry Debate, in St. Louis MO , Oct 8, 2004

    Senior Rx coverage without government dictates

    Source: 2004 Presidential website, georgewbush.com , Aug 30, 2003

    Give states money to help poor seniors buy medicine

    Q: What about expensive prescription drugs?

    BUSH: Step one is to reform the Medicare system. I want to call upon Republicans and Democrats to take care of a senior prescription drug program. I think it’s important to have what’s called Immediate Helping Hand, which is direct money to states so seniors don’t have to chose between food and medicine.

    GORE: I have never been afraid to take on the big drug companies. They are now spending more money on advertising than they are on research. They’re trying to artificially extend the monopoly so they can keep charging high prices. I want to streamline the approval of generic drugs so that we bring the price down. I proposed a prescription drug benefit under Medicare. You pick your own doctor and the doctor chooses the prescription and nobody can overrule your doctor. You go to your own pharmacy and Medicare pays half. If you’re poor, they pay all of it. If you have extraordinarily high costs, then they pay all over $4,000 out of pocket.

    Source: St. Louis debate , Oct 17, 2000

    Medicare Rx drug coverage for low-income seniors

    Medicare is one of the most important contributions to seniors’ health care ever enacted. I will work to strengthen Medicare by enhancing its financial stability and ensuring seniors have access to more comprehensive coverage better tailored to their health care needs. We now have an inefficient system that is run by a 132,000-page document where the government makes all the decisions. I support increasing competition and giving seniors the right to choose their health care plans that include basic coverage such as prescription drugs. We should also ensure prescription drug coverage is available for low-income seniors who otherwise cannot afford it.
    Source: Associated Press, in Brockton (MA) Enterprise, p. B6 , Mar 1, 2000


    George W. Bush on Tort Reform

    Flu vaccine shortage from litigation worries

    Q: What should be done about the severe shortage of flu vaccine?

    A: We’re working with Canada to help us [get] the vaccine necessary to make sure our citizens have got flu vaccinations during this upcoming season. If you’re healthy, if you’re younger, don’t get a flu shot this year. Help us prioritize those who need to get the flu shot, the elderly and the young. We have a problem with litigation in the US. Vaccine manufacturers are worried about getting sued and so therefore they have backed off from providing this kind of vaccine. One of the reasons I’m such a strong believer in legal reform is so that people aren’t afraid of producing a product that is necessary for the health of our citizens and then end up getting sued in a court of law.

    Source: Third Bush-Kerry Debate, in Tempe Arizona , Oct 13, 2004

    Lack of market forces and lawsuits increase healthcare costs

    Q: Health insurance costs have risen over 36% over the last four years. Who bears responsibility for this?

    A: There’s a systemic problem. Health-care costs are on the rise because the consumers are not involved in the decision-making process. Most health-care costs are covered by third parties. And therefore, the actual user of health care is not the purchaser of health care. And there’s no market forces involved with health care. Secondly, I do believe the lawsuits are causing health-care costs to rise in America. That’s why I’m such a strong believer in medical liability reform. The defensive practice of medicine costs the federal government some $28 billion a year and costs our society between $60 billion and $100 billion a year. Thirdly, one of the reasons why there’s still high cost in medicine is they don’t use any information technology. It’s the equivalent of the buggy and horse days, compared to other industries here in America. And finally, moving generic drugs to the market quicker.

    Source: Third Bush-Kerry debate, in Tempe AZ , Oct 13, 2004

    FactCheck: Frivolous lawsuits do not cost government $28B

    BUSH: Kerry says that medical liability costs only cause a 1% increase. That shows a lack of understanding. Doctors practice defensive medicine because of all the frivolous lawsuits that cost our government $28 billion a year.

    FACT CHECK: Bush recycled his claim that lawsuits force physicians to practice “defensive medicine” that adds substantially to medical costs, and increases federal spending for health-care programs by $28 billion a year. We de-bunked that one back in January. The non-partisan GAO and CBO agencies criticize the study the Bush administration uses as their main support for that claim. These agencies suggest savings from passage of limits on malpractice damages-if there are any savings at all-would be relatively small. Bush’s claim rests mainly on a single 1996 study by two Stanford economists who said caps on damage awards could hold down overall medical costs by 5% to 9%. The CBO found “no evidence that restrictions on tort liability reduce medical spending.”

    Source: Analysis of second Bush-Kerry debate by FactCheck 2004 , Oct 10, 2004

    Pass medical liability reform to make health care affordable

    I have met too many good doctors, especially OB-GYNS, who are being forced out of practice because of the high cost of lawsuits. To make health care more affordable and accessible, we must pass medical liability reform now. And in all we do to improve health care in America, we will make sure that health decisions are made by doctors and patients, not by bureaucrats in Washington, DC.
    Source: 2004 Republican Convention Acceptance Speech , Sep 2, 2004

    Lower care costs; reform taxes; limit lawsuits

    Source: 1998 National Political Awareness Test , Jul 2, 1998

    Voted NO on adding 2 to 4 million children to SCHIP eligibility.

    Allows State Children's Health Insurance Programs (SCHIP), that require state legislation to meet additional requirements imposed by this Act, additional time to make required plan changes. Pres. Bush vetoed this bill on Dec. 12, 2007, as well as a version (HR976) from Feb. 2007.

    Proponents support voting YES because:

    Rep. DINGELL: This is not a perfect bill, but it is an excellent bipartisan compromise. The bill provides health coverage for 3.9 million children who are eligible, yet remain uninsured. It meets the concerns expressed in the President's veto message [from HR976]:

    1. It terminates the coverage of childless adults.
    2. It targets bonus payments only to States that increase enrollments of the poorest uninsured children, and it prohibits States from covering families with incomes above $51,000.
    3. It contains adequate enforcement to ensure that only US citizens are covered.

    Opponents recommend voting NO because:

    Rep. DEAL: This bill [fails to] fix the previous legislation that has been vetoed:

    Veto message from President Bush:

    Like its predecessor, HR976, this bill does not put poor children first and it moves our country's health care system in the wrong direction. Ultimately, our goal should be to move children who have no health insurance to private coverage--not to move children who already have private health insurance to government coverage. As a result, I cannot sign this legislation.

    Reference: Children's Health Insurance Program Reauthorization Act; Bill H.R. 3963 ; vote number 2007-403 on Nov 1, 2007

    Protect state tobacco settlement funds from federal seizure.

    Bush adopted a letter to Congressional leaders from 53 Governors:

    As you know, preserving and protecting the state tobacco settlement funds is the nation’s Governors’ highest priority. We strongly urge you to reach final agreement and pass the conference report on the emergency supplemental appropriations bill soon, and to retain the Senate provision that protects our settlement funds from federal seizure.

    Many of our state legislatures are currently in session, and some have already completed work on their budgets. Therefore, it is critical that conferees reach agreement quickly on this issue. Governors are unified in their commitment to ensuring that the funds remain in the states and that there be no restrictions on states’ ability to tailor spending to meet the needs of their citizens.

    We offer our strongest support for conferees to recede to the Senate version of the bill containing the Hutchison/Graham bipartisan tobacco recoupment protection legislation.

    Source: National Governor's Association letter to Congress 99-NGA31 on Apr 14, 1999

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