RENEE MONTAGNE, host:
One of the big fears among those crowding town hall meetings this summer is that their coverage under Medicare will be cut back. The debate was just as passionate 45 years ago when Congress was considering creating Medicare and Medicaid during the Lyndon Johnson administration.
James Morone is co-author of a new book about that that time, "The Heart of Power: Health and Politics in the Oval Office." In researching the book, he listened to phone conversations that Lyndon Johnson secretly taped in the White House. We'll hear a couple of those in a moment, including a discussion he had with a young senator from Massachusetts, Ted Kennedy.
James Morone joined us from Vermont Public Radio to talk about what Johnson did to push Medicare through Congress. Good morning.
Professor JAMES MORONE (Political Science, Brown University; Author): Good morning.
MONTAGNE: What happened in the middle 1960s? Was this an idea whose time had come?
Mr. MORONE: Several things happened - one thing, the Democratic landslide of 1964, LBJ running against Goldwater and the Democrats swept into office. But a second thing happened, and that's Lyndon Baines Johnson in the White House. He was brilliant at maneuvering Medicare through, and that's one of the great untold stories. It was a president who was very adept in the White House, who managed to make it happen.
MONTAGNE: Give us an example of Lyndon Johnson in action.
Mr. MORONE: When Lyndon Johnson is elected, the first thing he decides is he wants Medicare, and he knows he needs Congressman Wilbur Mills, chair of the Ways and Means Committee. Wilbur Mills has single-handedly fought Medicare and kept it bottled up in his committee.
Lyndon Johnson calls him and tries to get Medicare out of it, and Wilbur says I can't - I've been fighting this thing. I'll look like a fool. And Johnson has the idea to triple the size of Medicare, to take the Republican proposals and add them on. And the two of them, these veteran, brilliant legislators, they concoct this whole new proposal that's the administration proposal plus the Republican proposals.
MONTAGNE: Well, we have a little clip of tape of Johnson speaking to Wilbur Mills. It may give you a sense of how Lyndon Johnson worked.
President LYNDON JOHNSON: I've looked at some of the stuff that's being considered from the press and other people, and it looks like to me that you're approached it right and that you're getting it in shape. And I just say this, that there's not anything that's happened in my six months, or that will happen in my whole term in my judgment that'll mean more to us as a party or me or you as individuals than this piece of legislation.
MONTAGNE: Now there are other tapes of Lyndon Johnson showing a different side of how he worked this.
Mr. MORONE: Johnson maneuvered every step of the way, getting this bill through Congress. And one of the things he did - and this is a little dicey in today's climate. One of the things he did was suppress the costs. So this young kid gets elected from Massachusetts, Ted Kennedy, in 1962. And Johnson is explaining to him how you get a health bill through. And what he tells him is don't let them get the cost projected too far out, because it'll scare other people.
Pres. JOHNSON: A health program yesterday runs 300 million, but the fools had to go to projecting it down the road five or six years. And when you project the first year, it runs 900 million. Now I don't know whether I would approve 900 million the second year or not. I might approve 450 or 500. But the first thing Dick Russell comes running in, saying my God, you've got a billion dollar program for next year on health, therefore I'm against any of it now. Do you follow me?
Senator EDWARD KENNEDY (Democrat, Massachusetts): Yes, right.
Mr. MORONE: We believe after looking at the evidence - my co-author and I -that if the true cost of Medicare had been known, if Johnson hadn't basically hidden them, the program would never have passed. America's second-most beloved program would never have happened if we had had genuine cost estimates.
MONTAGNE: Now it isn't as if President Johnson did not have opposition. In fact, he had quite a bit of public opposition, a lot of hand ringing. And one of the most prominent opponents was Ronald Reagan, who was then a candidate for the governor of California. Let's hear an excerpt from a speech that Ronald Reagan recorded, opposing Medicare.
President RONALD REAGAN: One of the traditional methods of imposing statism or socialism on a people has been by way of medicine. It's very easy to disguise a medical program as a humanitarian project. Most people are a little reluctant to oppose anything that suggests medical care for people who possibly can't afford it. Now, the American people, if you put it to them about socialized medicine and gave them a chance to choose, would unhesitatingly vote against it.
MONTAGNE: Socialism, socialized medicine, that was - just as scary today for a lot of people as it was in Ronald Reagan's time.
Mr. MORONE: If this program passes, Ronald Reagan said in another speech, one of these years we will tell our children and our children's children what it was like in America when men were free. What you have to understand when you hear the town hall meetings and you hear all the anger today, is that it sounded just the same across the media in 1963, '64, '65, as the Medicare debate heated up. Indeed, Ronald Reagan cut his national teeth opposing Medicare and rallying Republicans against it.
MONTAGNE: Well, just what is different now? And you might even say for both sides, maybe: What are the pitfalls for opponents of the health care overhaul? And what are the pitfalls for the Obama administration that didn't exist in President Johnson's time?
Mr. MORONE: For one thing, the sides won't come together. The Medicare opponents last time voted against it, but when it became inevitable, they all went across the aisle and voted for it. That's not likely to be true this time. For the Republicans, the great danger is that the program passes and becomes very popular. Democrats spent years and years feasting off Republican opposition to Medicare. There's even a word in Washington. It's a Medagouge. A Medagogue is someone who demagogues Medicare.
On the Democratic side, what Lyndon Johnson could do is much harder now because the financial situation is so much more complicated. There's an Office of Management and Budget that projects the costs out to the penny way off into the future. There are rules in Congress that say for every penny you spend, you have to find a penny in savings. All this makes it much more difficult. But even more than all of that, this battle is not just a battle about our health care system, it's a battle - Waterloo, as James DeMint put it, senator of South Carolina. It's a battle over who's going to control Washington.
If Obama fails, he's deeply injured - much more so than Lyndon Johnson would have been. And if he succeeds, why, he's succeeded at something that Roosevelt and Truman and Kennedy and Carter and Clinton couldn't do. He's bigger than life.
MONTAGNE: Thank you very much for joining us.
Mr. MORONE: Thanks, Renee. It was fun.
MONTAGNE: James Morone is a professor of political science at Brown University. He co-wrote the new book, "The Heart of Power: Health and Politics in the Oval Office." His co-author, David Blumenthal, is now an official at the Department of Health and Human Services.
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