Wonderful chapter as always, Vidal. The fact healthcare went up a 1,000% in three decades is just mind-boggling. Never considered how much of a barrier hospital cost was to healthcare reform. Wish the ACA in OTL had done more to tackle that particular beast.
 

Deleted member 145219

Wonderful chapter as always, Vidal. The fact healthcare went up a 1,000% in three decades is just mind-boggling. Never considered how much of a barrier hospital cost was to healthcare reform. Wish the ACA in OTL had done more to tackle that particular beast.
Health Care costs are a Budget Buster. And did a lot to badly damage the competitiveness of American Industry. And bankrupt a lot of families.
 
Amazing update as always. Really made me understand the stress and strain of passing legislation, in a way a lot of timelines seem to gloss over. I hope Carter has the same fight in him when it comes to passing CarterCare itself.
 

Deleted member 145219

CARTERCARE

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“Sometimes a party must sail against the wind.”
-Ted Kennedy​

September 1, 1981
Russell Senate Office Building — Washington, DC


The Senate Caucus Room was not the most usual location for a press conference, but this was one of enormous size and notoriety. Ted Kennedy walked into it through a blaze of camera flashes. He was followed by Robert Byrd, Russell Long, Alan Cranston, and Gaylord Nelson.

It was the room where his brothers Jack and Bobby declared their presidential campaigns. It was the home of William Fulbright’s hearings on Vietnam and Sam Ervin’s hearings on Watergate. The room pulsed with history, and this morning was no exception. The Democrats were here to announce a path forward on healthcare reform after a summer of hearings and internal deliberations.

Robert Byrd went to the podium first.

“For the last several months, the Senate Finance Committee and the Senate Health, Education, Labor, and Pensions Committee have been convening hearings on the issue of reforming our current health insurance framework. Those hearings have been instructive, and I want to thank Chairman Long and Chairman Kennedy for their diligence and attention to such a crucial issue.

“President Carter and the Democratic Party are committed to using our Congressional majorities in this session to ensure that Americans can more affordably access healthcare, and that we provide for this in a way that is respectful of the present economic realities.

“We are here today to update the American people on the progress that we have made on healthcare reform and to provide the public with a sense of where we are now in terms of legislation and of our path forward. In two days, President Carter will address a joint session of the Congress and give his own summation of the issue.

“I will leave the details to Senators Long and Kennedy, but I want to say unequivocally that I thank them for the work they have done, and will continue to do, to get this legislation to a vote and — eventually — into law. Senator Long?”

Long now assumed the podium. “Mr. Leader, thank you for your words of appreciation. I am particularly proud of the work we have done in the Senate this past summer, and I want to echo the gratitude expressed to Senator Kennedy and extend it to Senators Nelson and Ribicoff who have been diligent in their commitment in the health area.

“Since mid-July, the Senate Finance Committee has been examining the issue of bringing better healthcare to the people, and we have focused our hearings on two main areas: containing the costs of healthcare and improving the quality, efficiency, and price of health insurance.

“I have met with the Democrats and with Senator Dole, and we have come to an understanding that the next step is for the Senate Finance Committee to proceed with marking up Senator Nelson’s hospital cost containment bill.

“President Carter has been very clear that the only way to realize a more total reform of the health insurance industry is to address the issue of hospital costs. He knows my views on this, and we are not in total agreement on everything, but given the importance of this issue, we are ready to move forward with Senator Nelson’s bill. We will continue to negotiate the details of that legislation, but I want to thank Senator Nelson for his work in putting forward a proposal upon which we can all voice our thoughts and make amendments.”

Senator Nelson nodded from behind Long.

Then came Kennedy’s turn to speak. With the cadence employed more for a speech than a press conference, Kennedy thanked his colleagues and launched into his remarks: “We have to pass this legislation. We have to pass this legislation because it is the right think for American families.

“I had a father who was touched by stroke and sick for seven years. We were able to get the very best in terms of healthcare because we were able to afford it. It would have bankrupted any average family in this nation — any family in Boston or Bilox, Atlanta or Akron, Cincinnati or Chicago.

“I had a son who was touched by cancer. It was an extraordinary expense, but I was able to afford it. It would have obliterated the savings of any average family. It would have mortgaged their savings, their children’s educational futures.

“For seven months, I lay in the hospital with a broken back able to access to the very best healthcare. I was able to receive all of this because of my wealth. It is wrong that all over this land there are families who have to choose between life-saving care and putting food on their tables or clothes on their back. We are the greatest nation in the world. The richest, most prosperous nation in the world. It is time we make this a reality for our people.

“I am thankful to President Carter who has shown a genuine commitment to bring this issue to the forefront during his second term, and I am pleased that we will be able to pass legislation that guarantees healthcare coverage for aaaaaall Americans.” [1]

The reporters launched into questions about process — hearings, timings, votes. The Senators alternated their remarks, pressing the House to bring-up the legislation, explaining that they were on board with the president’s plan to pass hospital cost containment legislation before universal coverage. Kennedy was emphatically on board — a cheerleader for the Carter plan, which did not mean universal coverage but instead set-up the framework for gradually expanding care.

“Senator Kennedy, just two years ago you launched a primary challenge campaign against President Carter because of this very issue. Why are you on board with him now?”

Kennedy tucked his glasses into his coat pocket and looked straight at the camera. “Because the time has come.”


September 3, 1981
Capitol Building — Washington, DC


Many presidents believed that they could turn the tides with a speech. Carter was never one of them — at least not until that Oval Office address in July of 1979, which had undeniably set him on course for the second term he now enjoyed. Carter did not believe that a speech to a joint-session of Congress would magically bring them all on board. He did not think that he could solidify public sentiment — or even Congressional sentiment — with his words. But he did believe that his speech was needed to set the tone and the path forward for the present debate. The members of Congress had done their part, and now he wanted to offer America the clarity of his convictions.

The Sergeant-at-Arms exclaimed his arrival, as the grinning Carter made his way to the Speaker’s rostrum. Fritz Mondale was beaming and gripped the president’s hand firmly. It was a proud moment for the Son of Minnesota. With a courteous nod, the Speaker acknowledged the president and grasped his hand before announcing him to the raucous Congress.

“Mister President, Mister Speaker, members of Congress, fellow Americans:

“I come here to talk to you tonight about one of the most important issues facing our nation at the present time. I am speaking, of course, of the current inflationary pressures that are halting our economic growth as a nation and proving burdensome to the average American family.

“There can be no mistaking one of the most profound causes of our current inflation, and that is the cost of healthcare in this country.

“Since 1950, the cost of health has risen 1,000 percent. Let me say that again: In the last three decades, the cost of health has risen 1,000 percent.

“Today, the average American I devoting one month’s worth of wages to cover health care costs — an entire month’s work simply to afford to be healthy.

“So, we need to do this because the costs are too high for the average American. And they are too high for our economy to sustain. If we can limit the increases in hospital charges as outline in the legislation before you today, we can save more than $5 billion for the government and consumers. Imagine what that will do for our national budget, and for restraining inflation.” [2]

Carter hoped, perhaps foolishly, that if he were able to convince Republicans that the cost containment bill was necessary for economic reasons, they would come on board. His words did not resonate with those in the room that night, but his framing of the issue as one of economic necessary did help change minds at home. It also gave the Democratic Party an effective message moving forward on the issue.

The president then launched into his own vision for expanding healthcare coverage to all Americans. He explained his idea for a new government program, which combined Medicare and Medicaid, into HealthCare. The new HealthCare would be set up to cover an expanded group of Americans and when certain benchmarks were met, it could be expanded to encompass everyone.

Some in the White House feared that bringing attention to universal coverage would cost Carter voters, potentially imperiling both bills, but Jordan and Eizenstat disagreed, believing that Carter had to show weary liberals that he was serious about national insurance so long as they could get his cost containment bill through. Eizenstat was particularly clear-eyed throughout the process, saying, “We are never going to get a Republican vote for this bill. We have to go it alone, and we have to keep the Party’s coalition together.”

The speech was just the beginning of Carter’s dramatic effort in the press to sell the bill as necessary for the economy and good for the average American. In the weeks ahead, the president refused to let up, knowing that his political capital (and his ability to pass future legislation) hung in the balance. He felt confident in victory, knowing that he had nearly united the Democratic Party behind him, but nearly uniting them was not quite the same as unification.


September 6, 1981
R Street — Washington, DC


Sunday, September 6, 1981, was the start of the 1981 NFL season. At 1:00pm, the Atlanta Falcons were playing the New Orleans Saints, and Caddell was having Jordan, Powell, and a whole slew of West Wingers over to the R Street Beach to watch the game. Before they watched the game, however, the senior staff had to engage in a Washington tradition: Meet the Press.

The Sunday shows reigned supreme for their coverage of the national debate, and with a busy week for healthcare reform, the senior staff turned to Bill Monroe and his program to see how the debate was playing. Bill Monroe turned to Bob Dole. And that meant trouble for the West Wing.

Dole was one of the Party’s best hatchet men. In 1976, as the running mate to Gerald Ford, he’d notoriously referred to World Wars I and II as “Democrat Wars” and blasted Mondale for the number of men who died during them.

Dole was quick to blast the Carter administration as inept and ineffective, but privately he was relieved to have an ally on the budget. Carter and Dole both agreed on the need to bring forth a balanced budget, and Dole was pleased with the Carter administration’s emphasis on responsible spending and taxation policy. As far as he was concerned, Carter’s approach was more measured and more conservative than anything Ronald Reagan had espoused on the campaign trail. And that’s why Bob Dole couldn’t wrap his head around the healthcare proposal.

“Bill, I’m frankly surprised to see this proposal from a president who has said he supports a balanced budget,” Dole said. “There is nothing in this bill that is fiscally responsible. It may seem like a good idea now, but Americans will be paying the bill for CarterCare long after he leaves office…” Cartercare. The word had slithered off of Dole’s tongue with such contempt.

Watching at the R Street Beach, Jordan couldn’t help but laugh. “CarterCare? That’s a new one, Bob!”

Caddell had the opposite reaction. This was bad. “We don’t want this bill named after us!”

“Why not? Better CarterCare than KennedyCare,” Powell said.

“If people look at this issue of supporting healthcare reform as an issue of supporting Jimmy Carter…” Caddell’s voice trailed off. He would need to run the numbers, put a poll in the field. But he didn’t have a good feeling.

Jordan waved him off. “The guy’s been elected president twice. The people like Jimmy Carter.”

“This’ll make the bill his legacy.”

“And to that I say again: Better ours than Ted’s!”

They turned their attention back to the television, where Dole was listing off all kinds of scary numbers about how America couldn’t afford CarterCare.

“Oh come on, Bill, you piece of shit! Hospital costs are the number one factor contributing to inflation right now. If we pass this, if we kill inflation, we can afford anything we want!” Jordan yelled. He wasn’t sure if he was remembering it exactly right. Is it the number one factor? But his general point was nonetheless correct, at least as far as he was concerned. If they passed the healthcare reform bill, it would go a long way in helping curb inflation, and that would only mean good things for the economy — and government revenue.

“The Democrat bill ignores a free market approach to reform,” Dole was saying, “and it comes at the problem by instituting mandates and price controls that are going to put our hospitals out of business and stifle our ability to pay for good doctors. It is short-sighted.”

Powell yawned.

“CarterCare is a bad deal for the American people.”

Jordan let the television have it again. “Who wrote that line for you, Bob? Huh?” He groaned.

“Should we go back to the office?” Powell asked.

“Nothing for me to do there,” Jordan said in a rare acknowledgement of his loosening grip on the West Wing. Powell excused himself to call Jack Watson and see if the White House wanted to put out some kind of a response.

“It’s all bullshit, Jody,” Jordan called after him. “They could’ve had Kennedy on the show, but instead they chose Dole. Total bullshit!”

Powell ignored him, and so Jordan turned to Caddell to continue his point. “The press hates us, Pat. They always have.”

“I know,” he grumbled. But he also couldn’t shake the feeling that the American people were about to start hating this bill.

• • •​

“Who knows what will come next?!” Jerry Falwell roared from the lectern, bringing his fist down to the wooden podium with a sanctimonious thud.

“We must be clear-eyed about what is coming next: abortion-on-demand —” There were gasps from the pews before him. Falwell interrupted himself and nodded. “Yes! Abortion-on-demand! And your child sick with cancer, your grandmother sick from a stroke, your wife the victim of a tragic accident — it will be the government that decides whether or not they get care, the government that decides what kind of care they get. The government will be deciding between life and death, it will usurp the role of God!”

More gasps came up from the congregation. This was Sunday in Jerry Falwell’s America.

With Reagan defeated, Falwell felt his grip on the Republican Party slipping, and so he injected himself directly into the healthcare debate.

“You need to tell Washington that we are watching them. We will not let them assume the powers of God for their own misinformed vanity projects! We will not let them become arbiters of life and death! Every Senator, every Congressman must respect the sanctity of human life, and the government has no business making decisions to the contrary!”

Falwell encouraged his congregants to go to a rally in Washington while the bill was being debated and protest against the bill’s passage. “I fear that if we do not take up this issue, we will watch as our nation continues the backsliding towards Sodom and Gomorrah.”


October 17, 1981
Children’s Hospital of Philadelphia — Philadelphia, PA


The reporters and their cameramen followed close behind the president. Grin on, Carter turned to face them as he walked into the hospital. “Please, keep your attention on the families,” he said, “this isn’t about me being here. If y’all had reported these stories sooner, I wouldn’t have to be.” The feigned humility. Some in the press corps rolled their eyes. Pastor Jimmy. They’d seen him many times before.

The president, dressed in khakis and a button down shirt without a tie, made his way through the hospital. He was greeted by nurses and doctors who showed him around to various patients. There was a child fresh out of surgery on a broken arm — expected to make a full recovery. Carter kneeled down to ask her about her friends at school and what she wanted to be when she grew up. Then, he turned his attention to the parents.

“Now, what’s a trip like this cost you?”

“Oh, I can’t even think about it, Mr. President,” the father said. “I don’t wanna, anyway.”

“Do y’all have insurance?”

“Yessir, Mr. President, we do. Through my job. But we have a high deductible, and this surgery was expensive.”

Carter shook his head. He clicked his tongue against the back of his front teeth and put his hands on his knees. “Mr. Walsh, I hear ya,” he started, raising his voice so that the reporters and their microphones could pick him up clearly. “We’ve got to do something about hospital costs. Did you know they’re one of the leading causes of our current inflation? I keep trying to get Congress to pass this bill of mine, but you know what the problem is, don’t you, Mr. Walsh? You’re a smart man.”

Mr. Walsh thought for a minute. “Oh, I don’t know. They’re all corrupt down there.”

Carter nodded. “That’s the problem. These doctors and these hospitals — they’ve got all these lobbyists down there, and they keep putting pressure on the House and Senate, telling them that they’ll go out of business if they can’t charge folks like you as much as they do.”

That got a bit of a laugh out of Mr. Walsh. “This place? Going out of business?”

Carter shrugged. It said everything. I don’t believe it either.

The president thanked the Walshes for their time and moved throughout the hospital. A boy being treated for leukemia. He had already surpassed his lifetime insurance cap, and he was just 14 years old. His parents had sold their house and moved into a two-bedroom apartment to pay for his care. Carter put his arm around the father, Rosalynn put her hand on the mother’s knee.

Jack Watson and Jerry Rafshoon stood off to the side and admired the president’s work. It had all been his idea.

In the White House a few weeks earlier, the senior staff sat huddled around the desk in the Oval Office and offered only grim news about the state of the hospital cost containment bill. Carter made it clear that he was not willing to pass universal coverage without first controlling the costs from providers — otherwise, he reasoned, the government would just be on the hook for it all. But the staff had been meeting with members on the Hill and coming up short.

Democrats feared what would happen during the Midterm Elections in ’82, and they didn’t want to be seen as too close to Carter when election time rolled around. Carter was beside himself at their logic. After all, passing healthcare reform had been their idea.

“I don’t understand. What do they plan on running on if they’ve been too scared to pass anything all session?” He tossed a pen onto the Resolute Desk and it slid to the edge and dropped off. “What are they doing?”

He had never understood the creatures of Washington.

“Mr. President, I think they’re worried about what these groups are going to do if they vote for the bill. The doctors. The hospitals. The insurance companies. There’s a lot of money out there that they don’t want to attract into their campaigns.”

Hadn’t they passed campaign finance reform to prevent all of this from happening?

With usual frustration, he stood from his chair and paced around the Oval. By now, his steps were a familiar pattern for the president and for his staff.

“We’ve got to show them how popular this bill is. If we do that, they won’t be worried about the outside spending on their campaigns,” Carter thought aloud.

Wexler agreed with him, and said she’d been running outreach with a number of organizations and advocacy groups. She was lining them up for meetings on the Hill. But Carter waved her off.

“Do you remember the summer we were at Camp David?”

“Mr. President, you just gave a speech, I don’t think —”

Carter shook his head. “I’m not talking about another speech. But you remember how I wrote that speech? How I went out into the towns around Camp David and met with everyday folks? Yeah, we called up governors and senators and businessmen, but those meetings with the people wrote that speech. That’s how I knew what to say.”

Jordan couldn’t help but crack a smile at Carter’s own revisionist history. It was true that Carter had gone out and had dinner and coffee with regular folks, but to suggest the speech wasn’t a near copy of Caddell’s asinine memo was too much for Jordan.

“That’s what we need to do,” his boss was still saying. “Let’s go talk to the people who are paying these costs. Let’s put them on television. Let’s show Congress what’s happening out there.”

And now they were there — at the children’s hospital in Philadelphia, watching Carter and his wife talk to sick kids and their parents about the costs of care. It was worth a thousand words — no, a thousand speeches. But privately, Watson held his doubts that Carter could get the bill through the House and Senate. There was a lot of work left to do back in Washington.


November 24, 1981
Capitol Building — Washington, DC


Jimmy Carter did not always learn the lessons he was supposed to. His entire first term could be used (and soon would be by historians) as a case study in the breakdown of relations between Congress and the chief executive. Some expected that the second term Carter won might mollify his penchant for quarreling with Congress. They overlooked the far more likely outcome: Winning a second term emboldened Carter, convinced him that he was right, and gave him the validation needed to continue his efforts to bend Congress to his will. The president lacked the relationships and political acumen necessary to make his vision a reality.

In the summer of 1981, the defeat of his dear friend Charlie Kirbo’s nomination dealt Carter another opportunity to learn a lesson or continue down a path of executive obstinance. He was angry at those in the Senate who had let his friend’s reputation wither while their own political standings solidified. As far as Carter was concerned, they were nothing but a motley crew of attention-seeking glad-handers. Carter, of course, was different. He was the anti-politician.

Nonetheless, Carter knew that the momentum was building for some kind of Congressional action around healthcare reform, and he was unwilling to support it if there wasn’t first a measure aimed at controlling hospital costs, and so the president determined he needed to work with his fellow Democrats in Congress and steer the cost containment bill towards passsage.

Carter convened regular meetings with individual lawmakers who were crucial to the bill’s success, such as Charlie Rangel from New York and Henry Waxman from California. Both had been among Carter’s proponents throughout the first term push. But Carter’s attention on select supporters meant one member of the House was being ignored — and he wasn’t happy about it.

Tip O’Neill never understood Jimmy Carter or his Georgian way of doing things. For that matter, Carter had never appreciated the Irish boss image of the Speaker of the House, but when it came to the House, Tip O’Neill was the boss, and he was tired of Carter consistently working around him. And word soon got back to the president through Charlie Rangel, who informed him that there was an obstacle on the road to hospital cost containment, and it rhymed with “hip.”

Carter, bored by the personalities of the Beltway, summoned O’Neill for dinner in the White House Residence in an effort to bring him around on the issue of hospital cost containment.

The dinner was stiff and uncomfortable, and there was no time nor desire to share the kinds of intimate and philosophical anecdotes that made up Carter’s Air Force One conversation with Kennedy. Instead, Carter cleared his throat and put his napkin on the table after the main course. It was time to talk business.

Jack Watson wasn’t in the room for the dinner, but he’d prepped Carter thoroughly for the meeting. “Be humble,” he pleaded.

Carter took it.

“Mr. Speaker, the reality is, we can’t get this passed without your full support. Nobody can count votes in the caucus like you can, and we’re running into opposition on all sides, mostly from the conservatives, of course, and from some of the new thinkers like Gephardt. I can’t figure a way around them, and I can’t get healthcare reform through without first passing the hospital cost containment bill.” Carter drew a breath, prepared to enter a winding soliloquy about inflation and the need to be fiscally responsible in passing national healthcare coverage. O’Neill didn’t need to hear any of it.

“Mr. President, I will find the votes.”

Carter cleared his throat again. He was almost too surprised to speak, but he shouldn’t have been. For Tip O’Neill, the act of governing had always been about making people’s lives better. That meant making sure the costs at the hospital weren’t too high after a visit, and while he didn’t completely agree with the president that the cost containment bill was a prerequisite for universal coverage, he knew that the president wasn’t budging. If they wanted to deliver healthcare coverage, they had to pass the containment bill. He just wanted the president to ask.

And so it was Tip O’Neill, not Jimmy Carter, who held meetings with individual members and sussed out their needs like only a true boss can. A Maryland congresswoman had been denied the opportunity to appoint young women in her district as House pages. It offended her a bit. No matter, she could have some slots the next time they came up. [3] For most members, there was something they could get outside of the bill’s text that would mean they’d vote for the bill. An earmark for a school in Ohio, some money for a train station in South Carolina — such was the art of deal-making in Washington. And that was how Tip O’Neill got to 209 votes. But he was still nine votes down.

There were a number of conservative Democrats unwilling to budge. They didn’t care for universal healthcare either, so that threat didn’t faze them. They were already senior enough and plenty of them were willing to start caucusing with the Republicans if O’Neill took away chairmanships. So, the Speaker had hit a stopping point. But he’d been here before. He figured he knew the way out.

He summoned the gangly Wyche Fowler, another Georgian, to his office. Wasn’t there any way that the conservatives could fall in line? Fowler, who had already agreed to support the bill himself, tried to get away with a mere shrug, but O’Neill didn’t let him leave the office so quickly. Isn’t there a way?

Until, finally, O’Neill got an answer he could work with. Just as he’d suspected, every member had their price. For the conservative Democrats, it meant a numerical change to the legislation. They needed to lower the fine hospitals would face if they violated the cost containment provisions. Then, maybe, those members who were so fond of the American Hospital Association and the American Medical Association (and their financial support), would come on board with the bill.

Carter was irate, fearing it would render the bill meaningless, but Tip O’Neill tried to explain an important lesson of the Beltway to the president: You couldn’t always get what you want. As Tip explained, he was now actively feuding with Ways and Means Chairman Dan Rostenkowski, who was doing the bidding of the AHA. Carter needed to come around, or they’d lose the vote. Rostenkowski was a Nay regardless of how the exact wording came out, but if Carter was willing to compromise, members would see that the president was listening to them, and they would feel more comfortable about having extracted a concession from the White House. They figured they could sell that to nervous lobbyists and constituents. But Carter had to make a move to help them.

In typical fashion, Carter demanded time to think it over, and he brought in all of his advisors who stood in unanimous agreement: Take the deal. But Carter didn’t agree.

“What’s the point of passing a worthless bill?” When no one answered, he assured his staff that he wasn’t asking a rhetorical question. He wanted an answer. And so Hamilton Jordan, fed up with the temper tantrum, decided to provide him with one.

“It’s not a worthless bill, Mr. President; it’s just not the bill you wanted. Sure, some of the bigger hospitals might decide a few years that it’s worth paying the fine. But they won’t every year — not when you get universal healthcare through. But you can’t do any of that if we don’t get this bill in now. You can always go in later and amend it in the next Congress or the one after. But you’ve got to make it law first, and you’ve got to build momentum on this issue, or we’re done next November, and you’ll be forced to sit in this office with no hope of passing anything.”

Carter conceded but provided his own counter offer. They could lower the fine, but they had to tie it to inflation. Fine, the conservative Democrats agreed.

And so Tip O’Neill had found 228 votes, and the U.S. House of Representatives voted to pass Jimmy Carter’s hospital cost containment bill.

The fight in the Senate would be even more grueling. The House effort had been aided, ironically, by the defeat of the legislation years earlier. Instead, Congress had passed revised legislation, championed by Gephardt, that pushed through a national study commission analyzing costs. With that commission’s report in hand, many Democrats felt they had what they needed to go back and vote for the president’s bill. In the Senate, however, Carter needed the votes to overcome a filibuster, and he didn’t have them, and so that’s why Senator Charles Grassley rose to the Senate floor in protest, and he stood there for eleven hours.

Grassley’s filibuster of the hospital cost-containment bill focused largely on the fact that legislation passed two years earlier had enabled states to set up their own cost-containment systems, but many of them had not yet had the opportunity to do so. Grassley thought that the Carter bill impeded the ability of states to be laboratories for innovation — to find a solution to the problem on their own. “I fear, Mr. President, that we are, in our impatience, neglecting what may become one of the best opportunities to draft a successful program. My state of Iowa has already begun the work of looking at what kind of a program we could create to address these issues. Why should the United States Senate intervene in Iowa’s ability to build the program that works best for that state?” It was an argument that Republicans used on many issues. State government over federal government. Even if the 1980 election had served as a rejection of Reagan’s shrink the federal government mantra, the ideology still coursed in the veins of Republicans in Washington.

By the time the Iowa Senator yielded the floor and allowed debate to continue, the Republican caucus had lined up to kill the bill through amendments. It was a tactic that Senator James Abourezk had used during the energy fight in Carter’s first term, and just like that fight, Senate Majority Leader Bob Byrd was ready. He called in Fritz Mondale to sit and preside, and together they once again dispatched with the long list of amendments prepared to stall the bill.

Just as he did during the energy debate, Byrd enforced a Senate rule that all dilatory motions or amendments and all amendments deemed not germane would be found out of order. Immediately, that complicated the Republican effort — they had hoped that they could introduce several amendments that were politically toxic to key Democratic senators, which would then force them to vote against the final bill. Byrd sidestepped them.

Over the span of half an hour, Byrd called hundreds of amendments put in by Republicans, and within seconds of Byrd calling them, Mondale brought his gavel down. Out of order. Out of order. It was a rare, though not unprecedented, maneuver, and it enraged the Republican minority. After Byrd had dispensed with the proposals, Howard Baker took to the floor and decried the lack of respect for the minority.

Baker’s tone was far from scolding. Instead, it was somber.

“This chamber is no stranger to conflict. Once, Representative Preston Brooks of South Carolina, who was born in Strom Thurmond's hometown of Edgefield, came into this Chamber and attacked Senator Charles Sumner of Massachusetts with a cane.

“It feels a bit today, at least to this Senator, that today’s actions — not employed for the first time by this tyrannic majority — underscore a weakening of that unspoken rule of this chamber: That we work together. This institution is said to be the world’s greatest deliberative body. I wonder, now, how that can be true. I cannot hide my concern this evening, but I can offer hope.

“I can offer a reminder about why it is that this place — where we have debated civil rights and the Panama Canal treaty; where differing visions on taxes, on environmental protection, on relations with the Soviet Union have been presented — why is that this place works.

“The answer is this: What makes the Senate work today is the same thing that made it work in the days of Clay, Webster and Calhoun, in whose temple we gather this evening.

“It isn't just the principled courage, creative compromise and persuasive eloquence that these men brought to the leadership of the Senate — important as these qualities were in restoring the political prestige and Constitutional importance of the Senate itself in the first half of the 19th century. By the way, it is interesting to me that at that time an alarming number of our predecessors in the office of the Senate found the House of Representatives more attractive and more promising and left the Senate to find their careers over there.

“It isn't simply an understanding of the unique role and rules of the Senate, important as that understanding is. It isn't even a devotion to the good of the country, which has inspired every Senator since 1789.

“What really makes the Senate work — as our heroes knew profoundly — is an understanding of human nature, an appreciation of the hearts as well as the minds, the frailties as well as the strengths, of one's colleagues and one's constituents.

“We have to know that at the end of a long debate, we can come together, shake hands, and love those on the other side. Yes, love. That is what Calhoun himself said of Clay. Yes, he said, ‘I don't like Henry Clay. He is a bad man, an imposter, a creator of wicked schemes. I wouldn't speak to him. But by God, I love him.’

“But what we have to keep in mind is that in those days, the debates were fair. Both sides felt that their viewpoints were respected. Combined, my side of the aisle represents millions of Americans. Their voices, their ideas, their amendments deserve to be heard in this body, even if we are not the majority. We deserve to be heard. We deserve a vote. The promise of this body — this institution — is that the rules are fair. They must be fair.

“I do not agree with this legislation, but it does not offend me. I am offended, however, by the manner in which the majority has conducted itself. I can promise only that if it is our party that holds the most seats come next November, the minority will not be treated the way we were this evening, for we must remember the lessons learned by our colleagues who were here for the bruising moments, the fraught moments, the time that Sumner was caned.

“It is at those times we have learned the hard way how important it is to work together, to see beyond the human frailties, the petty jealousies, even the occasionally craven motive, the fall from grace that every mortal experiences in life.” [4]

Years earlier, when they had used a similar strategy to preserve what remained of Carter’s energy bill, the president later expressed regret. He said to Byrd directly that he believed they had employed the “wrong tactic.” [5] But when the opportunity presented itself to save his hospital containment bill, which was the key to any healthcare reform, Carter did not flinch. He did not think twice. He knew what they had to do, and he told Byrd to do it once more, and he told Mondale to sit in that chair.

Mondale, sitting and listening to Baker that night, wondered at what cost they had just passed the hospital containment bill. Ted Kennedy, on the floor for the entirety of the debate, his arms crossed, his eyes fixed, did not share the same doubts. He, like Carter, knew that they had done what must be done. It was what the moment called. Sometimes a party must sail against the wind. And when, days later, he stood behind President Carter as the president fixed his signature on the bill, and when Carter turned around to shake Kennedy’s hand and give him one of the pens used, Ted Kennedy knew in his heart that the end had justified the means. America was sailing forward.

>>>>>>>>

[1] Based on Kennedy’s remarks here.
[2] States come from here with language inspiration from here.
[3] Based on an actual request of the Speaker around this time. Tip and the Gipper, 305.
[4] Baker’s speech is based heavily on his speech about the Senate as an institution, which you can read here.
[5] Stu Eizenstat, President Carter: The White House Years, 188.
Tip’s been gone 30 years ago today.
 
At least he passed when he did and not a year later and have to witness the 1994 disaster. I worry that with Cost Containment passed, Carter won’t give as big of a push as Carter Care needs to pass, it fails and Tip decides it’s time to head out.
If Carter did that then it would show Congress he only wants to do half-measures. Congressional Democrats will refuse to pass president initiatives, or at least contentious ones.

CarterCare will get passed but likely with caveats and more asterisks of exception than anyone would like, especially Ted Kennedy. But it’ll be a start to better and hopefully universal healthcare down the road.
 
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Deleted member 145219

If Carter did that then it would show Congress he only wants to do half-measures. Congressional Democrats will refuse to pass president initiatives, or at least contentious ones.

CarterCare will get passed but likely with caveats and more asterisks of exception than anyone would like, especially Ted Kennedy. But it’ll be a start to better and hopefully universal healthcare down the road.
I hope you are right.
 
At least he passed when he did and not a year later and have to witness the 1994 disaster. I worry that with Cost Containment passed, Carter won’t give as big of a push as Carter Care needs to pass, it fails and Tip decides it’s time to head out.
I think you are quite correct. A product of a more civilized age
 
I think it would be interesting to see James "Bonecrusher" Smith ittl because iotl he ran for commissioner in Harnett County(a majority white county), NC and won the first round but lost in a pretty close runoff. He's quoted as "It really bothered me that we never had a black elected to county government in Harnett County,' said Smith, who is black. 'But we don't want to bill it as a racial campaign -- we have a lot of white supporters." which kinda reminds me of Douglas Wilder's "I'm running to win not inspire" and he pretty constantly fought drug abuse and crime which would be a plus in the 80s, he also later became a ordained minister
 
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I think it would be interesting to see James "Bonecrusher" Smith ittl because iotl he ran for commissioner in Harnett County(a majority white county), NC and won the first round but lost in a pretty close runoff. He's quoted as "It really bothered me that we never had a black elected to county government in Harnett County,' said Smith, who is black. 'But we don't want to bill it as a racial campaign -- we have a lot of white supporters." which kinda reminds me of Douglas Wilder's "I'm running to win not inspire" and he pretty constantly fought drug abuse and crime which would be a plus in the 80s, he also later became a ordained minister
I don't know as much as I'd like about him, He seems like a true leader.
 
Most of your other notes here pre-date the J2 POD, but I wasn't really settled on an an alternative Pope until writing the chapter. Originally, I had considered Giovanni Colombo, assuming that with two popes dead in such quick succession, he would feel compelled to emerge as the compromise. Then, I planned for Sebastiano Baggio, but I didn't feel there was enough about his theology to go back to him if I wanted to. I settled on Hume because I felt he could represent a good compromise ideologically, even if regionally he was a dark horse.
Colombo was a character, Father Andrew Greeley's Cardinal Sins, discusses him a bit.
 
Just a quick update that we've reached one of those periods where the posted chapters have basically caught up to the written ones and the outline -- will be spending some time over the next few weeks extensively outlining some of the remaining plot points of Mr. Carter's second term, and then we'll get this show back on the road.

In the meantime, worth noting that this weekend marked one year of the 39th president in hospice care. I, for one, feel lucky to have had the chance for this extended goodbye, and I am sure he and his family have been warmed by 365+ days of remembrance and well wishes.
 
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