As one of the first physicians to confront AIDS when it began its rampage through the gay community, Dr. Marcus Conant lobbied the Reagan administration in 1982 to launch an emergency campaign to educate Americans about the disease.
It took the president five more years to publicly mention the crisis. By then, almost 21,000 Americans had died and thousands more had been diagnosed.
Conant, who lost scores of friends and patients to the disease, is still deeply angry — one of many Americans who view Reagan's legacy in a harsh light.
"Ronald Reagan and his administration could have made a substantial difference, but for ideological reasons, political reasons, moral reasons, they didn't do it," said the San Francisco dermatologist, who now deals with a new generation of AIDS patients. "President Reagan and his administration committed a crime, not just a sin."
Despite the accolades lavished upon Reagan since his death Saturday — for ending the Cold War, for restoring the nation's optimism — his many detractors remember him as a right-wing ideologue beholden to monied interests and insensitive to the needs of the most vulnerable Americans.
Bruce Cain, a political analyst at the University of California, Berkeley (search), said Reagan singularly brought conservatism into the mainstream during his presidency, an orthodoxy that has made Democrats and liberals an enduring minority in Washington.
"What made things worse for them is that he was an extremely influential figure, and his ideas had lasting impact," Cain said.
Elected on a promise to slash taxes and crack down on freeloading "welfare queens," Reagan depicted government as wasteful and minimized its capacity to help people, ideas that survive today.
Reagan also dealt a blow to organized labor by firing the striking air traffic controllers, and appointed Antonin Scalia (search), still the Supreme Court's most conservative jurist.
Reagan's weakening of the social safety net by dismantling longtime Democratic "Great Society" programs arguably vexes his critics the most. By persuading Congress to approve sweeping tax cuts for the wealthy while slashing welfare benefits and other social services like the federal housing assistance program, Reagan was blamed for a huge surge in the nation's poor and homeless population.
Many won't forget his administration's proposal to classify ketchup as a vegetable as a way of further reducing spending on federally subsidized school lunches.
"Ronald Reagan really was a modern day Robin Hood in reverse — he stole from the poor and gave to the rich," said Michael Stoops, a longtime advocate for the homeless in Washington.
Critics give Reagan grudging credit for his ability to connect with working-class voters, who would come to be known as Reagan Democrats (search). He also galvanized conservative Christians to participate in the political process — even while putting some of their more prized goals on the back burner, such as restricting abortion rights or restoring prayer in public school.
But other activists point to Reagan's early silence on the AIDS crisis as doing the bidding of the far right, with devastating results.
In San Francisco, the number of AIDS cases peaked during the Reagan administration. AIDS activist Rene Durazzo remembers it as a frightening time when "chronic death" seemed to pervade the city streets.
"The number of people dying was horrific. The disease was very visible — people were suffering and wasting," Durazzo said. "It was a very volatile environment, there was so much anger at the government for not paying attention."
In the end, critics say Reagan's enduring legacy may be the generation of Republican leaders — including former House Speaker Newt Gingrich, House Majority Leader Tom Delay, and to some extent George W. Bush — who came of age during his presidency and have pursued a conservative social agenda with even greater gusto. That, in turn, helped create the bitterly divided political environment that exists to this day.
"The tone has gotten more venomous, largely because of the people who came after Reagan and carried the Reagan banner," said Roger Hickey, co-director of Campaign for America's Future (search), a liberal advocacy group. "I give him full credit for unleashing the vast right-wing conspiracy."