David Blumenthal and James A. Morone, The Heart of Power

I’ve just finished David Blumenthal and James A. Morone’s The Heart of Power: Health and Politics in the Oval Office (University of California Press), which discusses eleven presidents’ encounters with illness alongside their attempts to influence health care policy. Blumenthal, professor of medicine and health policy at Harvard Medical School and an adviser to Barack Obama, and Morone, a professor and chair of political science at Brown, are certainly up to this task, and the book is a pretty good, if sometimes repetitious, read. Particularly engaging are chapters on the Democrats who dreamed of Heart_of_Powernational health insurance, from FDR and Harry Truman to JFK and Lyndon Johnson. The chapter on Johnson draws on newly released archival material to present a “secret history of Medicare” that counters the popular narrative granting credit for the program to Senator Wilbur Mills. It turns out that LBJ, master manipulator of Congress that he was, was in on Mills’s “surprise” packaging of three separate bills—the ones that became Medicare Part A, Medicare Part B, and Medicaid—all along, graciously working behind the scenes to clear the path for the senator to dramatically reverse his longstanding anti–health insurance stance (and even following this narrative line in his autobiography).

I’m neither a health care expert nor a scholar of Johnson, so I can’t assess how fresh this “secret history” really is. Yet the book, published by the University of California Press, is obviously aimed at a broad audience, ostensibly offering ballast to anyone debating health care in 2009 and 2010. The final chapter goes so far as to offer “eight rules for the Heart of Power,” among them “passion,” “speed,” “hush the economists,” “go public,” and “manage Congress.” Curiously, though, it seems that Sam Tanenhaus, editor of both the New York Times Book Review and the Times’s Week in Review section, is among the only editors to have responded to the book. I guess the vicissitudes of book publicity will always escape me: I would imagine that powerhouse academic authors plus reputable academic press plus hot-button topic would equal widespread review attention. But despite the fact that The Heart of Power was featured on the cover of the NYTBR, where it was reviewed by former Secretary of Labor Robert Reich, and was the prompt for an article in the Week in Review, there’s not much else out there. (I canvassed the web and Lexis-Nexis.) Here’s an interview with Morone on Open Source, a radio program based at Brown. These pieces came out in September, so perhaps others are on their way. For what it’s worth, Reich’s assessment of the book, and his description of Obama’s action on the authors’ lessons, seems to me insightful and fair. Here are his thoughts on the latter topic:

The book was written before President Obama began his push for universal health care, but he seems to have anticipated many of its lessons. He’s moved as quickly on the issue as this terrible economy has let him, and he has outlined his goals but left most details to Congress. Nor has he been too rattled by naysaying economists (although the cost estimates of the Congressional Budget Office set him back). The question remains whether, in the months ahead, he can knock Congressional heads together to clinch a meaningful deal, and overcome those who inevitably feed public fears about a “government takeover” of health care and of budget-busting future expenditures. “The Heart of Power” suggests that the odds are not in his favor.