George W. Bush's vision's for health

Do you ever wonder how long our current president of the United States will continue to blame the prior administration for our current economy and blame the Iraq War for our current foreign policy concerns?

For a study in contrasts, I spent some time last week with our most recent former president, George W. Bush, mountain biking on his pastoral ranch in Crawford, Texas with former and current soldiers -- referred to as "warriors."

The grounds of the ranch are gorgeous, with many sections restored to native Texas prairie by Mrs. Bush and 43 miles of mountain bike trail built by President Bush and his biking experts.


While I was there I got to know a humble, thoughtful, caring man with a scathing wit (when I took of my shirt he acted horrified), who always takes the high road, refuses to directly criticize his predecessor, and also declines to take personal credit for successes that occurred during his administration.

I interviewed him about the future of health care in the U.S., and it quickly became apparent that his philosophy and focus differs from our government’s current emphasis on entitlements.

Though he wouldn’t criticize President Obama or ObamaCare directly, he told me he believes in “ preventing disease by staying fit. If people make better choices than the demand for health care will decline.”

That wisdom sounds simple until you consider that most of America’s expensive chronic health problems including heart disease, high blood pressure, diabetes, cancer, and stroke are directly linked to inactivity and weight.

President Bush by contrast is 66-years-old but looks much younger because of his physical fitness. He laughed when I asked him if he suffered from premature aging associated with the presidency. “No, I really don’t. I’m riding better than I’ve ever ridden in a long time and I feel younger, I think it’s all in the mind,” he said. “If you don’t eat well, if you don’t exercise, if you don’t sleep well you, are going to feel older.”

Bush praised our health care system as “the best, most modern, most technically advanced health care system in the world.”

His optimism and belief in America’s greatness is infectious. He also said he believes that “eventually we will figure out the most efficient way to pay for it.”

It was clear that he believes that preventing disease by staying fit is the place to start, but emphasized, “there’s no law you can pass to get people off the couch."

Bush’s emphasis is on a personal responsibility for health rather than extending an expensive, easily overused and comprehensive insurance program to more and more people.

“If people are held responsible for their behavior they might help effect behavioral change,” he said to me as we spoke following the bike ride. He emphasized the need for health savings accounts and the use of market forces to help ensure that “the individual will realize the benefits of a healthy choice.”

I asked President Bush about PEPFAR (President’s Emergency Plan for AIDS Relief), a very successful program initiated in 2003 which has helped bring life-saving retroviral treatments to millions of people in Africa and other underdeveloped countries.

Characteristically, the former president wouldn’t take personal credit for it, “Well it happened during my administration,” he said humbly,”I view it as an American initiative and I wish the American people could see the joy and the faces of people who’s lives have been saved as a result of our aid.”

With funding now in jeopardy, President Bush emphasized the initiative’s importance. “The key thing for our congress to recognize is that the program has been successful ... it’s saving lives, and if structured properly, the program can serve as a bridge with these African countries to develop their own health care systems and their own funding,” he said.

At the conclusion of his 100 kilometer mountain bike ride, President Bush stood close to me in the wind and mist of a rainy Texas day on his 1,500 acre ranch under the awning of a tent constructed on the helicopter landing area.

I understood that he is a man very comfortable with himself and others.

He looked into the distance, exploring his vision for the future of HIV disease, a scourge which consumed my early days as a physician and has cost us so many lives worldwide.

“We are close to not only reversing the infection but giving stability on the continent of Africa which I think is important for our national security and for our moral conscience and I hope people in Congress recognize that and will not shortchange the program.”

I knew he was right. Bush's vision of a healthy America was connected to his vision of a healthy world.