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In Sickness and in Health

In this interview, James A. Morone speaks about how presidents' personal experiences shaped their health care policy.

By and large, our modern presidents have not been a healthy bunch. Franklin Delano Roosevelt, a victim of polio, could barely walk with assistance. Dwight D. Eisenhower had two heart attacks, a stroke and suffered from Crohn’s disease. John F. Kennedy medicated himself with 26 different drugs to combat severe intestinal problems, back pain, osteoporosis and Addison’s disease—and had the last rites of the Catholic Church read to him four times as an adult.

But how much does a president’s personal experiences shape his health care policy? David Blumenthal, M.D., a Harvard Medical School professor and a health care adviser to the Obama administration, and James A. Morone, chair of political science at Brown University, tapped into newly released White House tapes and undisclosed archival material and conducted extensive interviews with former White House staffers to learn the answers.

What they uncovered for their new book,The Heart of Power: Health and Politics in the Oval Office, allows us to understand not only the modern presidents’ positions in the great health care debate that has been part of the political landscape since the 1930s, but the individuals themselves. In the process, the authors gleaned a few insights into what might make health care reform possible today. In a conversation with AARP Bulletin Today, James A. Morone explains.

Q. Why did you write about the presidents from the health angle?

A. There’s not one book that really gets into the fascinating details of the presidents’ lives and connects that to their policies. Presidents have no direct experience with many policy areas they wrestle with. They’re not homeless, they don’t go to jail, they’re not hungry. But here’s one policy area that every president experiences personally, and it’s the most human of policy areas.

Q. You write early in the book: “Deep personal hurts are what move these men to commit themselves to a reform that they know is a long shot even in the best of times.”

A. Health care reform is so hard. Unless deep in your gut you’re willing to risk a lot to win the reform, it’s just not going to happen. We found that in presidency after presidency.

Q. FDR was plagued with “deep personal hurts.” Why didn’t he get health care on the docket?

A. Here’s a guy who took the world’s most difficult job and really couldn’t walk. He was always faking it, always hiding it. When he contracted polio, he was badly treated. One physician misdiagnoses him. Another famous one not only misdiagnoses him but charges him $8,000 (about $85,000 today) for a useless house call. FDR had every reason to be skeptical of the medical profession, but he never took it on. His advisers pleaded, but for him health care was a purely political calculation, and he decided it was not worth the fight.

Q. So what kind of “deep personal hurts” do you mean?

A. There’s a corollary we weren’t expecting. President after president, we found that the presidents’ loved ones’ illnesses really shook them up. To our surprise, their own personal stories had no influence on them. Not one of them.

Q. For example?

A. John F. Kennedy was the sickest man on earth, practically, from the time he was 2 when he got scarlet fever, an often fatal disease before antibiotics. As a kid, he caught everything—bronchitis, pneumonia, diphtheria, you name it. He spent months in the Mayo Clinic during his high school and college years. Some of his problems came from doctors who injected him with powerful hormones that caused all kinds of trouble, including crippling back pain. Even in the White House, he was getting pretty dubious health care. One doctor—Dr. Feelgood as he was known—shot him full of very dicey concoctions. His brother Robert warned Jack about this and worried about his long-term addictions. But JFK paid no mind. “I don’t care if it’s horse piss. It works,” he told his brother.

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