Reagan, for whom Washington held a state funeral on Friday, believed that less government was vastly better than more government. His ideas on healthcare policy fell along those lines.
It's not that he did nothing to better America's healthcare policies. He just didn't do anything that could be regarded as a major public initiative. Translate that into spending lots of money, which is why he has gotten low marks and lots of criticism from the HIV/AIDS community.
Reagan, along with the former first lady Nancy Reagan, will be remembered for their courage, dignity and willingness to share with the public his struggle with Alzheimer's, which affects more than 4 million Americans.
"They've had an enormous impact," Kathryn Kane, senior vice president at the Alzheimer's Association told United Press International. "What they did raised public awareness but allowed people to talk about it in a way they hadn't before."
Reagan, in fact, had been a supporter of Alzheimer's research since the early 1980s when he feared his mother suffered from the disease.
Since his declaration that he had Alzheimer's -- in a letter to the nation in 1994 -- Kane said, "the situation with Alzheimer's is in a totally different place. We've made such progress in research."
There are now five Food and Drug Administration approved drugs for Alzheimer's treatment and "more in the pipeline that could slow and reverse progress of the disease," Kane said.
In 1995, the Reagans helped establish the Ronald and Nancy Reagan Research Institute for Alzheimer's research.
There are many experts who believe stem cell research holds the key to Alzheimer's but the Bush administration has banned federal research money from going to projects involving embryonic stem cells.
Now, Reagan's death has spurred a bipartisan call for a reversal of that policy, especially in light of Nancy Reagan's comment last month that stem cell research could provide scientists many answers now beyond their grasp.
The current first lady, Laura Bush, told a CBS interview this week that "we have to be really careful between what we want to do for science and what we should do ethically," signaling no change in the Bush administration's stand that embryonic stem cell research that results in destruction of the embryo is unethical.
"I can't think of a way with which we could honor President Reagan more than that, by passing meaningful support for Alzheimer's research and specific support for stem-cell research that so far has eluded our ability because of administration opposition," Sen. Tom Daschle, D-S.D., told reporters on the Hill this week.
The 1980s, the decade of Reagan's presidency, the domestic theme was welfare reform, a small federal role and a nod toward business and industry. In 1981, under his watch, the Mental Health Systems Act, fought for by healthcare advocates in the 1970s was rescinded. Reagan tried to keep a lid on entitlement spending increases -- specifically for Medicare -- but supported legislation that helped spur private company drug research. The Orphan Drug Act passed in 1983 that allows for fast-track approval and marketing exclusivity for drugs used to treat rare diseases.
The FDA, however, floundered in the Reagan decade -- and came under fire from Congress and health policy critics for alleged corruption, its inefficient and ineffective approval process and several key blunders that resulted in serious harm to patients.
Then came AIDS -- which critics contend Reagan did his best to ignore regardless of what health policy experts were telling him.
A few years after Reagan took office in 1981, it became apparent that AIDS/HIV was going to become a major health policy issue. Congressional hearings on AIDS began and the Centers for Disease Control and Prevention in Atlanta made predictions on the many thousands of people who would die from the disease.
Though the administration left AIDS to state and local communities to deal with, and research funding sputtered and stumbled forward, Surgeon General Dr. C. Everett Koop finally took up the reins and called for more money and testing -- although he got into serious battles with other Reagan cabinet members and administration hierarchy. Koop even issued a special report on AIDS in 1986, which was well received publicly but did not translate into all the action the AIDS community had hoped it would.
For Reagan, AIDS amounted to a gay community problem -- and regardless of his friendship with actor Rock Hudson, who died from the disease -- this went against his conservative stands on family and values.
UPI reported in April 1987 that Reagan finally had broached the subject of AIDS publicly for the first time when he and French Prime Minister Jacques Chirac jointly announced settlement of a dispute between French and American laboratories over the discovery of the AIDS virus.
"After almost six years of silence on the epidemic," said Rep. Henry Waxman D -Calif., chairman of the House Energy and Commerce Subcommittee on Health, "the president has finally said that he will fight the disease."
That was met with comments by Reagan spokesman Marlin Fitzwater, "It was quite a natural evolution. This is a national disease that has come upon the public very rapidly. A year ago ... people didn't understand AIDS or thought it was confined to a small segment of society."
Later that year, however, UPI reported the administration opposed a bill that would ban discrimination against people infected with the AIDS virus, boost funds for AIDS services and ensure confidentiality for those tested, leaving such issues for states to decide.
Reagan went around his own AIDS commission, which had proposed a $1 billion annual budget for treatment and education and instead supported a watered-down plan calling for additional support for his war on drugs.
Critics of his lack of action included even members of his own party.
"This peril that confronts the nation is not comprised of words," Sen. Lowell Weicker, ranking Republican on the Senate appropriations subcommittee that oversees acquired immune deficiency syndrome research, told UPI in 1987.
"It's comprised of very complex viruses and a medical mystery that nobody has been able to unlock, and it ain't going to be unlocked by the speech in Philadelphia by the president.
"The most damaging piece of deception as far as the president is concerned is that he says, 'I'm asking for $100 million more in AIDS research.' That sounds very good until you hear that he is asking for a $600 million cut in the funds to go to the National Institutes of Health for basic biomedical research. The net of all that is he has cut $500 million for AIDS," Weicker said.
Whether Reagan chose to ignore the AIDS issue or whether he was protected from its true reality by his staff, the AIDS epidemic will forever be seen as one of the biggest shortcomings of his presidency.
It may well be overshadowed, however, by his foreign policy victories, his immense popularity and his courageous fight with Alzheimer's disease, which will resonate well into the future.
Ellen Beck is UPI's Health Policy Editor. E-mail email@example.com
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