Exactly 40 years ago, Sen. Ted Kennedy popularized the idea of universal health care, saying the country needed a program “capable of bringing the same amount and high quality of health care to every man, woman and child in the United States.”
Seven presidents and millions of uninsured Americans later, the Massachusetts Democrat is still chasing that elusive goal.
Despite a legislative portfolio bulging with accomplishments that position him as the father of the modern health care safety net, the one that matters most to Kennedy — guaranteed health coverage for every American — has remained stubbornly out of reach.
He fell short with Richard Nixon, clashed with Jimmy Carter and lost the health care reform battle with Bill Clinton.
Now, his own yearlong battle with brain cancer is lending a dose of urgency to finally finish what he started decades ago, when personal and family health crises compelled him to embrace the cause.
“He will move to get the best bill possible,” said Robert Blendon, a health care policy expert and pollster at Harvard University. “He is so concerned about the end of his career that he will not stand there and say you can’t take two-thirds of the loaf because the whole loaf would be better. He will be the great pragmatist looking for a compromise.”
Kennedy no longer puts in 16-hour days, as he did throughout his entire Senate career. The diagnosis of brain cancer in May 2008 forced him to slow his pace and narrow his focus.
These days, his daily schedule is more condensed and balanced with the cancer treatments, but he spends almost 90 percent of his time on health care reform, aides say. While his physical absence from the Capitol through early April has prompted endless speculation about his role in what he has described as “the cause of my life,” his voice has been heard at key moments.
When the White House was debating early on whether President Barack Obama should pursue health care this year or later in his term, Kennedy phoned key aides and pushed for the former. Kennedy also pressed Senate Budget Committee Chairman Kent Conrad (D-N.D.) on the need for “reconciliation,” a procedural maneuver that would alienate Republicans but allow the Senate to sidestep a filibuster on health care.
Hoping to avoid the interest-group warfare that marred the Clinton health care push, Kennedy launched a project last year that brought together major players in the debate, gathering them for two-hour meetings, twice a week, with a staff assembled largely for the purpose of advancing health care reform. The meetings continue to this day.
“Sen. Kennedy gets more done promoting legislation when he is out of town, having to deal with his health, convalescing, than most senators do when they are in town,” said Ron Pollack, executive director of Families USA, a leading consumer group involved in the negotiations.
Kennedy did much of this work from Miami, where he spent the winter, drawn to the warm weather that allowed him to sail and stay active while receiving treatment. Even in his scaled-back role, both sides of the aisle recognize that Kennedy is an essential player.
Conservative Republicans like Sen. Orrin Hatch (R-Utah), who has worked closely with Kennedy through the years, argued that a deal can’t be reached without him. Kennedy may be caricatured as Washington’s leading liberal, but among his colleagues he is considered a shrewd pragmatist who, through nearly half a century in the Senate, has proved himself a legislator with few equals.
“I’m asking you all to pray for Ted Kennedy, and why would I do that?” Hatch said to lawmakers, administration aides and lobbyists at the White House health care forum in March. “Because Kennedy is the one guy that brings all of the Democrat major interest groups together, the unions, the trial lawyers. ... You can go right on down the line. I’d all pray for Ted.”
Before the cancer diagnosis, few could have envisioned anyone other than Kennedy in the central role.
He has almost single-handedly kept the issue alive through the years, a reminder of which came recently when The Boston Globe unearthed a grainy, black-and-white 1962 campaign ad titled “A Man Who Cares,” which shows a young Ted Kennedy talking with an older woman in pearls about her struggle with rising health care costs.
“Too many of our senior citizens are being forced to choose between neglecting their ailments or being pauperized by them,” Kennedy said in the ad.
His rhetoric is strikingly similar to what he argues today.
“If you listen to what he said about it in the 1960s and in 2009 — it has been an unchanging anthem,” said John Seigenthaler, a close Kennedy family friend. “If there is a bill passed this year, they would say in a minute, he was the one who kept it on the legislative agenda all these years and through all these administrations.”
His interest was piqued during a 1966 visit to a health center in a Boston housing project, according to Adam Clymer’s 1999 biography, “Edward M. Kennedy.” Impressed by its ability to serve low-income populations, Kennedy began directing millions of dollars to community health centers around the country.
He went on to co-sponsor some of the most important health care measures in recent decades: the right to keep health insurance between jobs, the expansion of the federal children’s health insurance program and the push for equal coverage for those who suffer from mental illnesses and substance abuse. The list of accomplishments compiled by his Senate office fills 13 pages.
Along the way, the issue of comprehensive health coverage became increasingly personal.
Kennedy spent months recuperating from a plane crash in 1964. His oldest son, Ted Jr., learned he had cancer as a seventh-grader, a diagnosis that ultimately led to the amputation of his leg. His daughter has battled lung cancer, and his youngest son, Rep. Patrick Kennedy (D-R.I.), was hospitalized once with a noncancerous tumor on his spine.
Kennedy was particularly struck by the experience with Ted Jr. They participated in a clinical trial, and when it was over, Kennedy could continue to afford health coverage. Others in the trial could not.
“It brought it home in a personal way for him,” one of his senior Senate aides said.
As Medicare spending ballooned through the early 1970s and President Richard Nixon declared a “cost crisis,” Kennedy worked with Nixon on a bill proposing mandatory employer-provided health insurance. They failed at reaching a compromise.
Kennedy tried again under President Jimmy Carter, but the two never got along, Clymer wrote. The idea revived then faded again under President Bill Clinton, despite eleventh-hour attempts by Kennedy to forge a compromise.
Learning valuable lessons each time, Kennedy remains optimistic about the potential this year, those close to him say.
“You can’t have a major illness and not wonder, ‘How much time do I have in life to do what I want to do?” said Andy Stern, president of the Service Employees International Union. “I don’t think there is anything that Sen. Kennedy has wanted more in Washington, that brought him to Washington, than to make sure every man, woman and child has health insurance.”