House Republicans want to cut funding for health programs abroad and for community clinics here at home. And although the projected savings are small, at least relative to the size of the federal budget, the philosophical shift they signal is big. This is the end of compassionate conservatism.

You remember compassionate conservatism, don't you? It was George W. Bush’s slogan, going back to the late 1990s, when, as a candidate, he told audiences that “Prosperity without purpose is just materialism” and vowed to “rally the armies of compassion in our communities to fight a very different war against poverty.”

Cynics saw it as empty rhetoric or, worse, a deliberate distraction from policies that were actually quite harsh to the nation’s least fortunate. The cynics had a pretty good point. Bush raided the treasury, in order to give wealthy people huge tax cuts, and the resulting budget crunch has forced all sorts of cuts to vital programs over the years.

Still, Bush never gave up the rhetoric of compassion. And on at least a few occasions he lived up to it. Community clinics were one example: As president, he doubled their funding. According to an account by Kevin Sack in the New York Times, that led to the creation or expansion of more than 1,200 clinics around the country. “This is a really good use of the taxpayers’ money,” Bush said at the time, noting that good primary care helps keep people out of the emergency room.

Bush’s commitment to global health was even stronger. In 2003, he called for a five-year, $15 billion initiative to fight HIV around the world through the President’s Emergency Plan for AIDS Relief (PEPFAR). It was a dramatic effort. Previously, the U.S. had spent less than $1 billion a year on HIV abroad. And it yielded dramatic results. According to official PEPFAR statistics, the program had, by the fall of 2008, provided life-sustaining treatment to more than 2.4 million people and allowed more than 200,000 infants to be born HIV-free.