NYT Book Review: Tips for Obama from LBJ
President Obama faces perhaps the ultimate presidential test in the weeks ahead: maneuvering a big health care bill through a fractious Congress. For tips on how to manage it, there’s no better advisor than Lyndon B. Johnson, who won Medicare over fierce opposition in 1965.
In their new book, “The Heart of Power: Health and Politics in the Oval Office,” David Blumenthal, a professor at Harvard Medical School, and James Morone, a political science professor at Brown University, reviewed the nation’s many attempts at health care reform to find some “rules of success.” Here are six lessons from Mr. Johnson’s triumph — captured in his own words, at least those that can be published. It appears that President Obama has studied at least some of them closely.
Speed
Right after his landslide election in 1964, Johnson called together all the people who were handling the legislation and gave them a pep talk, according to an account by one of his top aides: “Now, look, I’ve just been re-elected by the overwhelming majority. And I just want to tell you that every day while I’m in office, I’m going to lose votes. I’m going to alienate somebody. ... We’ve got to get this legislation fast.”
Keep the Economists Quiet
Getting health care to large populations is expensive. President Johnson sought to bury or minimize economic projections to smooth the passage of Medicare. An honest economic forecast could have sunk the program.
In a phone conversation with Senator Edward M. Kennedy, Mr. Johnson said he was furious with his Bureau of the Budget:
“A health program yesterday runs $300 million, but the fools had to go projecting it down the road five or six years. And when you project it, the first year it runs $900 million. Now I don’t know whether I would approve $900 million second year or not. I might approved 450 or 500. But the first thing, Dick Russell [a Democrat senator from Georgia] comes running in saying, ‘My God, you’ve got a one billion-dollar program for next year on health; therefore I’m against any of it now.’ Do you follow me?”
At one point, Wilbur Mills, the powerful chairman of the House Ways and Means Committee, expressed concern to Mr. Johnson about the cost of expanding the Medicare proposal. The president told him not to worry.
“I’ll take care of [the money]. I’ll do that ... We had an old judge in Texas one time ... we called him Al Caldy ... old Al Caldy Roberts, and he said, when they talked to him one time that he might’ve abused the Constitution and he said, ‘what’s the Constitution between friends?’ And I say..., that 400 million’s not going to separate us friends when it’s for health. ...
Master the Congressional Process
When Democratic House leaders called with the cheerful news that Medicare had passed in the Ways and Means Committee, Mr. Johnson quickly reminded them that the Rules Committee might introduce fatal delays:
“For God sakes, don’t let dead cats stand on your porch, Mr. [Sam] Rayburn [the former House speaker] used to say, ‘They stunk and they stunk and they stunk.’ When you get one [of your bills] out of that committee, you call that son of a bitch up before they [the opposition] can get their letters written.”
Months before Medicare passed, opponents proposed a large and popular increase in Social Security benefits (and taxes) which would have made passage of new Medicare taxes almost impossible. At the last minute, Senators George Smathers of Florida and Russell Long of Louisiana, both Democrats but Medicare opponents, switched and voted to save Medicare. “Lyndon told me to,” Senator Smathers explained.
About six weeks later, Senator Long called in his chip. He heard that the Department of Defense was closing military bases and that Fort Polk in Louisiana was on the hit list. Long called President Johnson for help.
Johnson: “If it’s on there, ain’t all the king’s horses can’t change it because it will just blow right up in my face.”
Long: “Mr. President, when I had that vote to kill Medicare..., that’s not the attitude I took on you.”
The president said he would check and called Long back a few minutes later.
Johnson: “I don’t think you’ve got anything that will keep you awake.”
Long: “Thank you, Mr. Boss Man. You can count on old Long.”...
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Read entire article at NYT
In their new book, “The Heart of Power: Health and Politics in the Oval Office,” David Blumenthal, a professor at Harvard Medical School, and James Morone, a political science professor at Brown University, reviewed the nation’s many attempts at health care reform to find some “rules of success.” Here are six lessons from Mr. Johnson’s triumph — captured in his own words, at least those that can be published. It appears that President Obama has studied at least some of them closely.
Speed
Right after his landslide election in 1964, Johnson called together all the people who were handling the legislation and gave them a pep talk, according to an account by one of his top aides: “Now, look, I’ve just been re-elected by the overwhelming majority. And I just want to tell you that every day while I’m in office, I’m going to lose votes. I’m going to alienate somebody. ... We’ve got to get this legislation fast.”
Keep the Economists Quiet
Getting health care to large populations is expensive. President Johnson sought to bury or minimize economic projections to smooth the passage of Medicare. An honest economic forecast could have sunk the program.
In a phone conversation with Senator Edward M. Kennedy, Mr. Johnson said he was furious with his Bureau of the Budget:
“A health program yesterday runs $300 million, but the fools had to go projecting it down the road five or six years. And when you project it, the first year it runs $900 million. Now I don’t know whether I would approve $900 million second year or not. I might approved 450 or 500. But the first thing, Dick Russell [a Democrat senator from Georgia] comes running in saying, ‘My God, you’ve got a one billion-dollar program for next year on health; therefore I’m against any of it now.’ Do you follow me?”
At one point, Wilbur Mills, the powerful chairman of the House Ways and Means Committee, expressed concern to Mr. Johnson about the cost of expanding the Medicare proposal. The president told him not to worry.
“I’ll take care of [the money]. I’ll do that ... We had an old judge in Texas one time ... we called him Al Caldy ... old Al Caldy Roberts, and he said, when they talked to him one time that he might’ve abused the Constitution and he said, ‘what’s the Constitution between friends?’ And I say..., that 400 million’s not going to separate us friends when it’s for health. ...
Master the Congressional Process
When Democratic House leaders called with the cheerful news that Medicare had passed in the Ways and Means Committee, Mr. Johnson quickly reminded them that the Rules Committee might introduce fatal delays:
“For God sakes, don’t let dead cats stand on your porch, Mr. [Sam] Rayburn [the former House speaker] used to say, ‘They stunk and they stunk and they stunk.’ When you get one [of your bills] out of that committee, you call that son of a bitch up before they [the opposition] can get their letters written.”
Months before Medicare passed, opponents proposed a large and popular increase in Social Security benefits (and taxes) which would have made passage of new Medicare taxes almost impossible. At the last minute, Senators George Smathers of Florida and Russell Long of Louisiana, both Democrats but Medicare opponents, switched and voted to save Medicare. “Lyndon told me to,” Senator Smathers explained.
About six weeks later, Senator Long called in his chip. He heard that the Department of Defense was closing military bases and that Fort Polk in Louisiana was on the hit list. Long called President Johnson for help.
Johnson: “If it’s on there, ain’t all the king’s horses can’t change it because it will just blow right up in my face.”
Long: “Mr. President, when I had that vote to kill Medicare..., that’s not the attitude I took on you.”
The president said he would check and called Long back a few minutes later.
Johnson: “I don’t think you’ve got anything that will keep you awake.”
Long: “Thank you, Mr. Boss Man. You can count on old Long.”...
Read more