Friday, September 04, 2009

Dr. Bill Roy: "Sen. Ted Kennedy during the Nixon years, up close"

Senator Ted Kennedy, America’s third longest serving senator, champion of the less fortunate, and untiring advocate for universal health coverage, was laid to rest last week.

One thing in particular caught my eye. The senator, it was said, had expressed regret he had not worked more closely with Richard M. Nixon, our last liberal president, to establish universal health insurance back in the year 1974.

Nixon stated in his 1974 State of the Union speech, “I shall propose a sweeping new program that will assure comprehensive health-insurance to protect millions of Americans who cannot now obtain or afford it, with vastly improved protection against catastrophic illness.” This proposal was consistent with Nixon’s previous positions on improving and paying for health care.

In 1947, Nixon, a junior congressman from a poor family that had lost two sons to tuberculosis, offered similar legislation. In 1945, President Harry Truman proposed a single-payer program that people could join voluntarily (public option?). In its opposition, the American Medical Association did learn the propaganda power of crying “socialized medicine.”

In 1971, Nixon requested federal assistance in establishing Health Maintenance Organizations, setting the goal that one-quarter of Americans become members of HMOs in five years. He was correct in his affirmative evaluation of20highly efficient, less costly Kaiser Permanente clinics and hospitals that serve 8.6 million patients today.

Working with the Nixon administration, our office immediately began writing legislation for not-for-profit HMOs. Senator Kennedy carried similar legislation in the Senate, and it became law in 1973. Regrettably, the Reagan administration let all regulation expire, and insurance companies made our good idea their own, quickly turning their HMOs into cash-cows.

While the ink was still wet, I dropped Nixon’s Comprehensive Health Insurance Program bill into the legislative hopper. A couple of things happened in addition to Senator Kennedy withholding his support at labor‘s insistence.

Nixon left Washington in August, driven into retirement by the Watergate scandal, and I left the Congress in December, after failing to win a Senate seat in part because I had testified for passage of the 1969 “liberal’’ Kansas abortion law on behalf of the Kansas Medical Society.

Both the Kansas law and a nearly identical abortion law earlier signed by Governor Ronald Reagan of California, were based on the 1962 Model Penal Code written by the American Law Institute. That 1969 abortion law remains the law of Kansas and many states.

Having several parallel bills with Senator Kennedy taught me he was much more than the last son of a famous family. After each chamber of Congress passes legislation, a private conference committee is convened to reconcile any differences.

Our health law conferences often consisted of several House members and Senator Kennedy, which may seem imbalanced. Not so, because Kennedy, unlike many of colleagues who made only cameo appearances at conference committees (no cameras), knew the legislation, and he had a pocketful of proxies from absent senators, making his word the last word from the Senate.

Sometime early in 1974, I went to Senator Kennedy’s office to ask him to campaign for me in Kansas. He agreed quickly over coffee and cookies.

But I recall most vividly lending a doctor’s ear to his grief and fears about his son Ted, Jr., who had had his leg amputated to stop the advance of an osteosarcoma. Now, young Ted was becoming deathly ill with each chemotherapy treatment. His dad said, “I clear my calendar to sit with him for two days each time.”

In 1974, Ted Kennedy was a handsome, smiling, magnetic young man. I have somewhere a political cartoon sent to me by the Kansas City Star artist. Everyone was crowding Kennedy and I, the local candidate no less, stood alone in the corner (maybe an omen).

I did not know Senator Kennedy well, but I was briefly in the right places to observe those exceptional qualities mentioned repeatedly at his death--his hard work and mastery of the legislative process, and his love and care of family; plus his willingness to spend a day in Kansas on my behalf, no questions asked.

Dr. Roy may be reached

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