After George W. Bush defeated John Kerry in 2004 to win re-election, he claimed he had earned the political capital to enact his agenda during his second term in office. He hardly won a sweeping victory, though: He only narrowly won both the popular vote and the Electoral College.

So, while Bush did earn the right to set the agenda in Washington simply by virtue of having won another term in the Oval Office, he hardly could claim a major mandate. It wasn’t just that he narrowly won, either: while the Republican Party had an 11-seat majority in the Senate, it wasn’t enough to overcome filibusters, and they had just a 31-seat majority in the House. Given those numbers, it wasn’t the time to go after a domestic agenda that was controversial within his own party, but that’s exactly what Bush did.

Having passed both major tax cuts and education reform during his first term, Bush decided that during his second term, he’d address entitlement reform. He did so by proposing a plan to reform and partially privatize Social Security. To his credit, Bush was at least trying to address an issue that most politicians in both parties tried to avoid completely. The long-term solvency of Social Security was an unresolved problem 13 years ago, and it remains one today – little progress has been made in the area since.

During the debate over Bush’s reform proposals, though, Democrats essentially refused to engage. Bush’s plan floundered, even within his own party, and instead of engaging in constructive policymaking, Democrats just sat back and reaped the political rewards. They successfully used the debate over Social Security – along with the ongoing controversy over the American presence in Iraq – to first win back Congress in 2006, and then to help get Barack Obama elected president two years later. Indeed, they’ve successfully used it as a wedge issue against Republicans at all levels ever since.

The truly compelling question is not whether George W. Bush was right to propose reforming Social Security at the time – it was a necessary policy debate, even if it was unwise politically. Instead, it’s fascinating to consider what might have happened had Bush tackled a different major domestic issue right out of the gate during his second term: health care reform. Then, as now, health care was one of the most important issues the country faced: It was a point of contention during the re-election campaign. Kerry proposed a plan that would have covered more uninsured Americans than Bush’s plan, but also would have cost more and involved repealing some of the tax cuts passed earlier in the Bush administration.

It would have been interesting to see what would have happened if Bush had asked a Republican Congress to focus on health care reform, with his campaign proposal as a starting point. If Republicans had taken on the issue, their final draft might have contained more than a few elements that were found in Obamacare. Bush had already expanded Medicare to increase prescription drug coverage, so embracing some sort of Medicare expansion wouldn’t have been surprising. It surely would have looked differently than it did in Obamacare: For one, it may have been an opt-in proposal from the beginning, rather than being forced that way by the courts. That might have allowed more states to experiment with proposals to reduce the cost of health care.

Bush’s campaign did not embrace the individual mandate as a way to expand coverage, instead proposing tax credits to help low-income Americans buy health insurance, but it may have popped up during congressional debate. The idea originated from conservatives, having first been proposed by the Heritage Foundation. Fifteen years ago, the idea was not hated on the right as it is now, so it too may have been adopted by the Republican Party.

Regardless whether they passed something, having a debate about health care when Republicans had full control in Washington would have had a major political impact. If Republicans failed to pass a plan, Democrats might have ducked the issue for a while and addressed something else in 2009, like campaign finance, the environment or gun control. If they’d succeeded, Democrats might have shifted their proposals to the left in response, embracing a public option or Medicare for all. Either way, the past 15 years of American politics would have looked very different if the Republican Party had the chance to frame the discussion on health care.

Jim Fossel, a conservative activist from Gardiner, worked for Sen. Susan Collins. He can be contacted at:

jwfossel@gmail.com

Twitter: jimfossel