The fact is, those four did me a favor--they and the others who voted to oust me as whip. Robert Byrd went on to do an admirable job in the role, and eventually became a distinguished majority leader. As for me, the defeat served as a prompt to immerse myself more deeply in the necessary basic work of a U.S. senator.
And so I burrowed in. I gave myself over to contemplation and study. I absorbed the Senate's history, the careers of its greatest members, the principles that lent it constancy over the years, and the many social movements and powerful figures that at times altered its influence and character. I reread the Constitution in the context of the mandates it prescribed for the Senate; and, in doing so, reexperienced the awe of this document that had first been opened to me by the likes of the great Arthur N. Holcombe, my teacher at Harvard.
I grew interested in every aspect of the Senate: its arcane rules both permanent and new; its parliamentary procedure; the functions of its many committees and subcommittees, some of which were well known and others half-forgotten or unsuspected, and therefore of potentially great use. I doubt that anyone has ever managed to completely internalize the immense font of knowledge that these areas comprise, but I committed myself to learning it as thoroughly and in as much minute detail as I could.
As I had during my hospital days in 1964, I sought out mentors. I called once again on John Kenneth Galbraith of Harvard and on another distinguished economist, Carl Kaysen of MIT, who had once been an aide to Jack in national security affairs. I also asked business executives and union leaders to meet with me for luncheons at which I asked endless questions about their expectations of this body and about its impact on their lives.
Always available to me in his office, or so it seemed, a pipestem caught between his fingers and a scowl of contemplation narrowing his dark eyes, was Senator Mike Mansfield. In his late sixties now, the majority leader looked every inch the statesman he was. Mansfield conveyed his understanding of and reverence for that institution to me.
Instead of doing this research during my Senate workday, I always did it outside the Senate: it was genuine "homework." I have a policy of not reading memos or signing letters during office time. I use that time for Senate business, committee work, meetings with other senators and constituents. My homework begins as soon as I'm in the car, headed to or from Capitol Hill. A staff member drives me, so I can use that time to make phone calls or read memos. And then, after dinner, I make my way through The Bag.
The Bag is divided into several compartments. There is the "must do" compartment, which includes material that needs action ASAP. Another section holds briefing memos from the staff on various issues, correspondence to be signed, correspondence to be read. Then I might dive into the section jammed with news clips from Massachusetts and around the country, Capitol Hill news, current newspapers, and magazines that I might not have yet seen.
By definition, we senators are generalists. But we must at least know more about the issues that fall under the jurisdiction of our committees than about other issues. That's one of the main reasons for my "policy dinners" and for my regular meetings and talks with experts.
I'm certainly not alone in my determination to master policy. I had a wonderful experience a few years ago with Mike Enzi, the popular Republican senator from Wyoming. I was chairing a subcommittee meeting on safety in the workplace. The first item on my agenda was toxins in the workplace, and Mike spoke up, saying that he'd just gone to a conference on that issue and had very specific recommendations. A little later I said, well, let's move on to poisons in some other aspect of the workplace, and he had specific recommendations on that too. He had gone to a conference on that. I raised a third issue, and Mike knew all about that issue as well, because he'd gone to another conference on that one. In just a few minutes, Mike Enzi showed us what a superb legislator he was and what it took to be a good one: knowledge, information, hard work. There's no substitute.
As I studied and contemplated the Senate, I kept myself involved in the great issues that had always mattered to me. Refugees, to name but one example. I had led the fight for U.S. aid to the millions uprooted from their homes and communities in Vietnam. Now a fresh wave of terrified, starving victims of war welled up--this time in Africa.
Biafra, a territory of seven million people, most of them Catholic Ibos, on the southeastern coast of Nigeria, had declared its independence from the much larger and heavily Muslim federation in May 1967. (Nigeria itself had only just gained independence from Great Britain in 1960.) Riots and armed fighting between these religious and ethnic adversaries had flared up for years, but Biafra's secession triggered an immediate fullscale civil war, with catastrophic results. It took weeks of horrific fighting, marked by massacres on both sides, but a quarter million Nigerian troops finally overwhelmed the tiny breakaway state, gunning down and starving the Ibos by the tens of thousands. By the time of Biafra's capitulation in 1970, the total dead on both sides exceeded one million. Well before that, the victors' merciless crushing of the rebel state had begun to smack of genocide.
In my first Senate speech following Bobby's death, on September 23, 1968, I pointed out that while the United States and other nations did nothing to intervene, more than seven thousand Biafrans were dying of starvation each day. After that I spent weeks pressing administration officials and State Department leaders to do their humanitarian duty. By the end of that year, my lobbying had produced results. Some relief planes were flying into the devastated area, but several were shot down--by both Nigerians and Biafrans.
The war itself was nearly at an end when I called hearings before my refugee subcommittee in early January 1970. But the suffering was far from over: the victorious Nigerian armies were running unrestrained through Biafra, ransacking households, murdering and raping. After testimony on the extent of the brutality, I renewed my call for America to intervene in this open-ended massacre. The hearings generated enough press coverage that President Nixon, encouraged by Henry Kissinger, joined with Great Britain to once again ship tons of food and medicine to the helpless Ibos.
On the domestic front, I committed myself to the issue that had already caught my passion. I recognized that improving health care, and ensuring Americans' ability to pay for it, would be my main mission, and I would fight for it for however long it would take.
I knew that this mission would require many years and a great deal of energy. How many years, and how much energy, I could not then imagine. Health care, and its inadequacies, have been woven into the fabric of my life.
As a young boy I had witnessed Rosemary's struggles. I had watched Jack endure his many ailments, diseases, and near-death experiences. I had shared the family's shock over my father's stroke in 1961 that robbed him of his speech. I had tried to comfort Jack and Jackie in 1963 as they grieved the loss of the newborn Patrick Bouvier, who died from inadequate lung development. In 1964, with my broken back, I had been personally introduced to the pain and helplessness of a debilitating injury, and to the numbing routine of lengthy hospitalization. And these family crises of health were but prologue for what was to come.
My family's good fortune had insulated me from the desperation that for most Americans compounds the trauma of drastic illness or injury--the effort to meet crushing medical bills and, often, of having to make life-and-death decisions imposed by the enormity of those bills. Perhaps it has been this acute awareness of my own good fortune, as well as the suffering of so many of my loved ones, that has spurred me to always look beyond mere statistics, beyond conventional cost-benefit analyses, and to insist that "health care" be rooted in care.
I was in fact an activist in this area--a "foot soldier," as I've called myself--even before I entered the Senate. As I've mentioned, I had the extraordinary privilege of working with Dr. Sidney Farber in 1961 on the Massachusetts Cancer Crusade. Dr. Farber is recognized as being the father of both modern pediatric pathology and of chemotherapy as a treatment for neoplastic (tumor-forming) disease. He taught me about the
ravages of cancer in American society, the depths of suffering caused by it, the self-defeating and unnecessary shame felt by victims and their loved ones, and the staggering costs of the disease.
I could never have dreamed back then how intimately I was destined to experience cancer's dark realities. Or how transformative those informal seminars were to prove, to me personally as well as to the cause of cancer research. It was this singular physician who ignited my long campaign as a senator to increase funding for this research.
The morass of genetic, environmental, and human-intake causes and the intricacies of its play among human cells, make cancer perhaps the greatest of all challenges to medical science. In 1971, still inspired by Farber and aware that the annual death toll from cancer was at nearly 340,000 and rising, I felt the time was right for a major offensive against the disease. I wanted to pass a National Cancer Act, and bolster it with enough funding to offer realistic hope for new discoveries and breakthroughs. I had recently become the chairman of the health subcommittee, and I was in touch with several of America's most distinguished health advocates and economic experts who felt the same way.
Besides Dr. Farber, these included some giants of their times, people whose contributions, like those of Walter Reuther, have regrettably faded in the public memory. One of them was Mary Lasker. The wife of the wealthy Albert Lasker, a pioneer of modern advertising, Mary was herself a pioneer: she fought for higher health standards and for medical research in America for most of her long life, and received a Congressional Gold Medal before her death at ninety-four. Mary brought prestige and tactical wisdom to our efforts.
Another valuable partner was Benno Schmidt. The well-connected New York investment banker shared my belief that cancer research was a critical national duty. His financial expertise told him that the country could and would support our quest for as much as one and a half billion dollars, a fourfold increase in research funding. That estimate became our figure in the bill.
Our intention, expressed in the legislation's early drafts, was to bypass the then ineffectual National Cancer Institute, an appendage of the National Institutes of Health, by creating a new independent agency structured along the lines of NASA. Mary Lasker had long advocated for such an agency. In her early seventies then, she lent her distinguished reputation to a round of speeches and published essays advocating for our bill.
We faced a powerful competitor for our goal: the Nixon administration, anxious to put its own stamp on cancer research, but at a much lower price tag than ours. In January, the president proposed a bill with an increase of $100 million in spending for this purpose, thus capturing temporary cachet as the leader in the fight. "Temporary" could easily become "permanent" unless we outflanked him: he was hardly likely to cede the momentum, and the credit, to a liberal Democrat in Congress--especially one named Kennedy.
My allies and I were now in a fight for the initiative and, along with it, a truly adequate research budget. We needed a bipartisan thrust; this effort must not get tangled up in partisan politics. And so I formed a partnership with an eager Jacob Javits, the Republican senator from New York, to get our bill written and moving through Congress.
A final obstacle remained: Nixon could not bring himself to sign a landmark bill that had the Kennedy name attached. So I immediately said to take my name off the bill, though I felt badly that Jacob Javits was also being denied the credit he deserved because of Nixon's feelings about me.
Nixon had insisted that his own bill, not the one created by our team, be the one submitted. So we replaced the language of the Nixon bill with the language of ours, and kept it labeled as the Nixon bill. The measure passed by a vote of seventy-nine to one and was signed by Nixon in 1971. The new department created by the act, the Conquest of Cancer Agency, remained within the NIH, as the Republicans wished. But administratively it would report not to NIH but directly to the president. And it carried our budget figures. The important point was that cancer research had entered a new era of federal funding and productivity.
Many others, of course, have felt the same urgency as I about health care. Progressives' calls for some sort of federal health-cost protection for Americans had fitfully arisen and subsided since the days before World War I. President Roosevelt considered a health insurance provision in the Social Security Act of 1935, but omitted it out of concern that its projected costs would scuttle the act, a cornerstone of his New Deal. He later asked Congress to include adequate medical care as part of an "economic bill of rights," but was rebuffed. When President Truman proposed national health insurance to Congress in 1945, the American Medical Association mobilized a virulent opposition campaign, aimed at the heartland, portraying the idea as "socialized medicine." Senator Robert Taft of Ohio took up that charge, and a House subcommittee member went even further, labeling it "a communist plot." Medicare was passed in 1965 under Lyndon Johnson, with my strong support. Still, large disparities remained. With eighty million Americans uninsured and a national outlay of $60 billion in health-related costs, Time reported on May 11, 1970, that "there is a growing consensus that some national insurance blanket must be thrown over the ailing body of health care." True enough--and the scatter-quilt of federal programs was hardly a remedy.
In a December 1969 speech at the Boston University Medical Center, I declared that the time had come to begin phasing in such a program, despite its unarguably high costs. I expanded these views and enfolded them into a larger arraignment of the American health care system in my 1972 book In Critical Condition. As a member of the Labor Committee's health subcommittee, I had been in communication since the end of 1968 with Walter Reuther. Reuther is remembered as the progressive president of the United Auto Workers union, but his larger legacy, all but forgotten to history, is that of a social visionary whose humanitarian concerns included but extended well beyond the members of his union. When Reuther himself called for national health insurance in November 1968, I'd sensed an alignment of forces that could produce a new opportunity for action. In January 1969, when he invited me to join his new Committee of One Hundred for National Health Insurance, I did not hesitate. Reuther was killed in a small-airplane crash in May 1970, but the committee's work went forward, and in August 1970, drawing on its contributions, I introduced the first bill of my career for national health insurance. It was defeated: the first setback in a long, long struggle.
Still, with the help of others, I was able to gain some important early victories. In 1965, two physicians on the faculty of Tufts University, Jack Geiger and Count Gibson, came to one of the semi-regular policy dinners that I held, this time in Boston. The discussion that evening involved health care, and in the course of it the two doctors began to focus on the need to eradicate the barrier of distance that often discouraged poor and working people from visiting their doctors. From our conversation was born a plan for community health centers, modeled on experimental centers in the third world, notably Africa. The idea was not only to redress illnesses and injury, but to educate the community in prevention and healthy living. Excited by their concept, and aware of funding possibilities through the new Office of Economic Opportunity, I introduced an appropriation bill in 1966 that would expand upon their concept, providing $38 million to make it a reality. The original plan was for two neighborhood health centers, one at Columbia Point in Boston and the other in Mount Bayou, Mississippi.
In searching for allies, I approached Adam Clayton Powell Jr., the charismatic congressman and social activist from New York's 18th District, which included Harlem. As chairman of the House Education and Labor Committee, Powell had championed Jack's New Frontier programs, and helped steer many of them into law. He'd done the same for Lyndon Johnson's Great Society initiatives.
In 1966, Powell was fifty-seven, still handsome with his neatly trimmed mustache, and still very much the master of his congressional domain. When I visited his committee to make my pitch, he obliged me to wait for several hours as they went through their other business. Yet when h
e finally turned to me, I received the full force of his famous spark and dazzle. "Teddy Kennedy!" he began. "You want these neighborhood health centers?" I said that I did. "How many are you going to have for thirty-eight million?" he asked. I said that it would cover two and (quickly anticipating Powell's own interests in backing me) perhaps four. Powell shot back, "You write in there that one of them is going to be in my district, and you've got it!" I told him that that would be fine with me. I wrote it in; Powell steered the bill through the House; the Senate passed it; and that was the beginning of neighborhood health centers across the United States.
My battle against cancer first struck home in 1973.
Teddy was a seventh grader at the St. Albans School in Washington that fall. He'd turned twelve on September 26 and was proud to be a member of the Bulldogs' football team despite his slight build. Thinner and smaller than I had been at the same age, he was nevertheless a good athlete in the style of Bobby, whom he'd adored--a good runner especially.
He was an even better student, thanks in part to his own perseverance. He'd determined to keep up academically in this highly demanding school. He was exceptional at memorization. This was something he and I worked on when he was a small boy, and I remember almost to the moment when he dazzled us with his first big breakthrough. It was during a ski weekend with Bobby and his family at Stowe, Vermont, one spring. After a hearty dinner, I reminded my son that it was time for him to go and learn his next assignment: "Casey at the Bat." Triumphantly, Teddy announced that he'd already memorized it--then recited it at the table, to everyone's applause.
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