Bush has a very good campaign mind, but as President he is completely paralyzed by his arrogance, fear, and personal weakness. He likes feeling like he makes big decisions and has 'the vision thing' (as another Bush once put it), so power rests with infighting advisors who tell him what to do in the guise of 'taking care of the details'. All problems are ascribed to as ones of 'communications' as the AM talk radio circuit has been spewing for months, which allows blame to go to the communications staff instead of those with the real power. That's why Scott and Card don't matter; Scott is a press release shaped like a human (nothing really changed when Ari Fleischer left), while Card was a glorified office manager. The Rove 'demotion' is in all likelihood a sham, since he's kept his security clearance and is gearing up for the midterms. The only serious member of the White House to leave is actually Scooter Libby, and that wasn't Bush's doing.
This is an awful situation. We have a man frightened to be President clinging desperately to the comforting adults who tell him what to do. These 'adults' happen to be vicious ideologues bent showing the world their manliness no matter how weak they transparently are. In other words, this isn't a real shake-up, because at this point Bush can't shake up the White House staff.
November is an interim step which can help improve things, but as Greg Mitchell points out we face a crisis: these idiots are in charge for 33 more months.