Can Obama fix the Health Care Issue in America?

The issue that the world's biggest and most expensive health care system is beginning to fall apart. Can George Bush mend it?

GEORGE BUSH had big ideas for his second term. He promised to fix Social Security, America's public pensions system, and revamp the tax code. Despite his best efforts, Social Security reform sank last year. Working the tax code has proved so politically tricky that the White House dare not push it. With almost three years to go, Mr Bush seems less a radical reformer than a struggling lame duck.

White House officials, desperate to show that the president still has a domestic agenda for America, have now changed the subject—to the health care issue in America. The buzz in Washington, DC, is that the health care issue in America will loom large when Mr Bush gives his annual state-of-the-union address on January 31st. Al Hubbard, Mr Bush's top domestic policy adviser, adds that the focus will be on ideas that control costs, boost access and improve quality.

The health care issue in America? The idea seems preposterous. How can an administration that is too timid to push tax reform tackle one of the most complicated challenges facing America's economy? What's more, the timing looks terrible. Mr Bush's team is under fire for botching the health care issue in America initiative to date, the introduction of a prescription-drug benefit for elderly people covered by its Medicare program.

Thanks to bureaucratic tangles, thousands of poor old folk have been denied drugs they used to get free, and more than 20 state governments have had to step in to pay for the medicines. Republican lawmakers dread what this fiasco may cost them in November's mid-term elections.