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Even the most powerful men in the world are human—they get sick, take dubious drugs, drink too much, contemplate suicide, fret about ailing parents, and bury people they love. Young Richard Nixon watched two brothers die of tuberculosis, even while doctors monitored a suspicious shadow on his own lungs. John Kennedy received last rites four times as an adult, and Lyndon Johnson suffered a "belly buster" of a heart attack. David Blumenthal and James A. Morone explore how modern presidents have wrestled with their own mortality—and how they have taken this most human experience to heart as they faced the difficult politics of health care. Drawing on a trove of newly released White House tapes, on extensive interviews with White House staff, and on dramatic archival material that has only recently come to light, The Heart of Power explores the hidden ways in which presidents shape our destinies through their own experiences. Taking a close look at Franklin D. Roosevelt, Harry S. Truman, Dwight Eisenhower, John Kennedy, Lyndon B. Johnson, Richard Nixon, Jimmy Carter, Ronald Reagan, George Herbert Walker Bush, Bill Clinton, and George W. Bush, the book shows what history can teach us as we confront the health care challenges of the twenty-first century.
- Sales Rank: #550230 in Books
- Published on: 2010-09-21
- Original language: English
- Number of items: 1
- Dimensions: 9.00" h x 1.25" w x 6.00" l, 1.45 pounds
- Binding: Paperback
- 500 pages
From Publishers Weekly
Starred Review. In this engrossing text, the history of American health-care policy, from the New Deal to the Medicare Modernization Act of George W. Bush, becomes a frame through which the authors illuminate the leadership qualities of late-20th-century presidents in the arena of domestic affairs. The authors present biographies of presidents from FDR on, investigating potential influences (e.g., heart attacks, abusive parents, deceased siblings) on their attitudes toward health policy. Blumenthal, a Harvard Medical School professor, and Brown University political scientist Morone (The Democratic Wish) draw on White House telephone tapes and memos in a laudatory chapter on Johnson's role in passing Medicare, and reserve their harshest criticism for Jimmy Carter, whose administration unwittingly killed the late effort at health reform. The authors offer evenhanded critiques and conclude with lessons for future chief executives about the importance of political savvy, economic flexibility and popular appeal in determining the success of health-care initiatives. More than an excellent primer on American health policy, the book offers a thorough, incisive look at the presidency as an institution and the men who have occupied the office. (Aug.)
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.
Review
"A book that sets a standard for the study of the presidency and of health policy."--"Congress & the Presidency"
"A riveting history of health-care politics."--Atul Gawande"New Yorker" (04/05/2010)
"This timely and insightful book puts Barack Obama's current quest for universal health insurance in historical context and gives new meaning to the audacity of hope."--Robert B. Reich"New York Times Book Review" (09/06/2009)
"A masterpiece and a valuable primer for future presidents as they wrestle with the dragon of health reform."--Jeff Goldsmith"Health Affairs" (09/01/2009)
A riveting history of health-care politics. --Atul Gawande"New Yorker" (04/05/2010)"
This timely and insightful book puts Barack Obama s current quest for universal health insurance in historical context and gives new meaning to the audacity of hope. --Robert B. Reich"New York Times Book Review" (09/06/2009)"
A masterpiece and a valuable primer for future presidents as they wrestle with the dragon of health reform. --Jeff Goldsmith"Health Affairs" (09/01/2009)"
From the Inside Flap
"David Blumenthal and James Morone break new ground in our understanding of health policymaking in the White House, notably the tie between presidential policy actions and the personal medical problems that have faced each of our Presidents since Franklin D. Roosevelt. Once again, the nation faces the urgent need for health reform, and Heart of Power is essential reading for anyone who cares about improving our health care system to meet the challenges of the 21st century."—Senator Edward M. Kennedy
"A fascinating story of personalities, politics, and pratfalls of the presidents in their shaping of American healthcare. Written with deep insight and fluid prose, this unique contribution from a physician and an historian is a must read for all who wish to understand how we arrived at our current system and what is needed to advance it."—Jerome Groopman, M.D., author of How Doctors Think
"A revelation! This creative and compulsively readable book offers a genuinely new approach to the problem of leadership in large causes. Instructive in many ways, The Heart of Power is a moving testament to the power of the heart, in high places.”—David Hackett Fischer, Brandeis University
Most helpful customer reviews
17 of 20 people found the following review helpful.
the right balance of detail and insight
By Timothy Ferris
As a health policy researcher and doctor, I approach this book with some trepidation. I did not want a book that was going to feel like "work" to read, and yet I am genuinely interested in the details. Blumenthal and Marone got it just right. They move through a mountain of material in a well paced mix of interesting (often original) detail and insight. It could not be more timely given the debate in the country right now. This is the best available lense through which to watch how the national health reform process is playing out. Disclosure: Blumenthal used to be my boss.
10 of 12 people found the following review helpful.
Timely! Timely! Timely!
By Thomas J. Farrell
At nearly 500 pages in length, this well-researched book may contain more historical information about the politics of health care than many people would care to read carefully.
After a 20-page introduction, the authors survey eleven successive presidents in eleven chapters:
(1) Franklin D. Roosevelt
(2) Harry S. Truman
(3) Dwight D. Eisenhower
(4) John F. Kennedy
(5) Lyndon B. Johnson
(6) Richard M. Nixon
(7) Jimmy Carter
(8) Ronald Reagan
(9) George H. W. Bush
(10) Bill Clinton
(11) George W. Bush
But the 12-page conclusion is worth the price of the book. In the conclusion, the authors set forth what they consider to be "eight rules for the heart of power" -- rules that President Barack Obama and others in his administration might want to consider carefully as the August recess of Congress draws to a close and the battle in Congress over health-care-reform legislation resumes in earnest.
2 of 2 people found the following review helpful.
The Heart of the Matter
By P. Goode
I've read many books that expanded my store of knowledge, but few that changed my perspective. The Heart of Power changed the way I view health care policy and the ongoing debate about it.
Although the book covers the policies of each presidential administration from Franklin Roosevelt to George W. Bush (Gerald Ford excepted), it lays a foundation for an historical understanding of why Barack Obama made the critical decision to endorse a plan based on a public-private partnership. Blumenthal and Morone show convincingly that while liberals promoted and sustained the *idea* of universal health care access, conservatives were, over time, able to redefine the terms of the debate. The authors also include an important humanizing twist: Each president's personal -- and often traumatic -- experience with the health care system.
After WW2, no Democrat (save Jimmy Carter, who ran under unique circumstances) successfully ran for president without a major commitment to health care reform. And yet, once in office, each found passing legislation to be a maddening affair complicated by an arcane process, other priorities, formidable lobbying (first the AMA and the insurance industry). Truman never tried, and Kennedy and Clinton failed. Lyndon Johnson succeeded in enacting Medicare, but it was a surprisingly near thing.
Among Republicans, the private insurance market grew under Eisenhower and Nixon encouraged the development of HMOs. Concerned about the inevitability of a liberal government program, Eisenhower developed and Nixon refined Republican thinking about universal health insurance as a public-private partnership. Ronald Reagan pursued a massive extension of Medicare, later repealed when it proved unpopular with seniors. Bush I cared little about health policy, but his administration came up with ideas that Obama eventually coopted. In 2003, Bush II retreated on plans to offer privatized Medicare, Part D (a prescription drug benefit) when -- as incredible as it seems just seven years later -- the Republican leadership balked.
I have two criticisms of the book. First, the copy editing is execrable -- I'd estimate an error in punctuation, spelling, or conjugation every 10-15 pages. For example, President Obama's name is "Barack," not "Barak," and Bob Dole is from "KS," not "KA."
The Heart of Power would have been even stronger had it consistently considered the state of American health care in the context of each presidency, especially once more Americans had health insurance than did not, which occurred during the Eisenhower Administration. Sometimes, it's a little difficult to figure out exactly what problem a president is attempting to address and why. For example, was Bush I's disinterest in health policy a matter of disinclination or philosophy, or did he believe that there was no problem?
Overall, though, this is one of the few books that, without reading it, the individual citizen has an incomplete picture of an issue. We need more books like The Heart of Power that cover the history of a policy from its inception through the tumult of changing times. Highly recommended.
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