Three years ago this month, Presidential candidate George W. Bush released a policy document entitled, "Blueprint For the Middle Class," designed to appeal to middle-income voters based largely in America's politically competitive suburbs.
Bush explained his views on traditional issues that are often of concern to suburban families and their communities: education, health care, Social Security, conservation programs and crime reduction.
Republicans were beginning to make headway on issues that Democrats usually dominated in public opinion polls.
One issue outlined in the health care section of Bush's campaign document was the modernization of Medicare, which many members of Congress considered long overdue.
The section includes a prescription drug benefit and a greater choice in plans with more options and the common ability to make use of medical breakthroughs.
Medicare modernization has been a hot-button topic in recent months.
Late last June, the U.S. House and Senate passed Medicare legislation that fit the outline of Bush's original proposal.
But, many Senate Republicans, who voted both for and against modernization, questioned the need to pass a bill.
The bill included a provisions to target a prescription drug benefit at low-income seniors and individuals with excessive drug costs.
The Medicare Modernization and Prescription Drug Act of 2003 was designed to establish a prescription drug benefit that would save taxpayers money in the long run.
Those drugs would reduce the need for more expensive health care measures in the future.
Quality care, preventive health care services and disease management are also included in the bill.
They were also priorities for many Congressional Republicans concerned with consequences of the upsurge in Medicare costs on the federal budget.
Bush's health care strategy focused on Medicare basically in the same light.
Reforms in Medicare would be used to reform health care in America.
This would bring costs down while maintaining the highest standard of care available anywhere in the world.
Without reforms, the system will eventually become financially unsustainable.
The continuing rise in health care expenditures only reinforces the industry's standing as the most expensive sector in American life.
Suburban voters want quality health care at reasonable cost.
Any Congressional efforts to reform America's health care system should be done with Medicare as an archetype and an instrument for change in the entire industry.
But members of Congress should realize that medical coverage should set different priorities today.
They should not follow the same mindset of legislators who supported the creation of the program in 1966, when Medicare cost almost nothing to operate.
Medicare is not designed to accept change very easily, either through changes in law or changes initiated by providers of medical services.
At this point, the system is very difficult for consumers to work with compared to other industries in which buyers know exactly what they are looking for and what they will receive.
Legislators have to adopt changes to make senior citizens less inclined to use Medicare by avoiding the need to use Medicare payments for expensive procedures.
At some point, it will no longer be realistic for Medicare to pay all medical expenses for seniors if they get sick, but rather do anything to make sure seniors avoid reaching that point.
This can be done by incorporating certain strategies into the Medicare program where minor health costs would be applied to Medicare recipients.
People should also watch their health largely through physical fitness - use preventive medicine.
Medical Savings Accounts provide an opportunity to individualize health care plans through maintaining collective insurance that will provide incentives for users to calculate their health care needs more carefully.
The health care system should accommodate providers and communities at the local level to run their own programs.
The system should see what works, and create models of health care innovation that could provide answers on how health care in America could operate most efficiently.
The Medicare Modernization Act is a dramatic step forward and further health care reforms should be implemented in the future.
