Frist Faces the Challenge of Running From the Senate
By Alan K. Ota | 11:14 AM; Jun. 20, 2006 | Email This Article
What makes Bill Frist run? What kind of ambition leads a risk-taking transplant surgeon — one who’s used to making life-and-death decisions with the flick of a scalpel — to think he has the patience, listening skills and legislative sophistication needed to run the United States Senate?
Indeed, what kind of naked ambition gives a man who did not register to vote until he was 36 years old — and who has yet to score a significant legislative achievement to call his own — the utter confidence that he can win the Republican nomination for president in 2008?
You only begin to find out the answers to these questions in Washington, where the Tennessee Republican’s star has flashed, briefly soared and then repeatedly threatened to implode into a black hole. From the moment he burst on the national stage less than four years ago, as President Bush’s hand-picked candidate to succeed Trent Lott as the Senate’s majority leader, Frist has struggled to appreciate, much less master, the peculiarities of the fractious and hidebound Senate. He still seems unable to gauge what motivates his own GOP caucus or what resonates with the voting public.
From the “nuclear option” to immigration policy, from stem cell research to his run-ins with the Securities and Exchange Commission over sales of his family stock, from his incorrect snap diagnosis of Terri Schiavo to his stillborn idea for a $100 gasoline rebate, Frist has on many occasions seemed as miscast a Washington power player as any self-styled “citizen legislator” could be. He could well become a historic example of a failed Senate leader.
“Right now, he’s giving the dross standard for majority leaders, William F. Knowland, a run for his money,” said Lewis L. Gould, an emeritus history professor at the University of Texas who has written a history of the Senate, “The Most Exclusive Club.” (Knowland, a Californian, was the GOP leader from August 1953 through 1954, when the party lost its Senate majority.)
“How can he rally the country around his ideas if he can’t rally the Senate?” Gould said.
Even the communications adviser for the Volunteer Political Action Committee — Frist’s leadership PAC, which has been laying the fundraising groundwork for a national campaign — concedes that his boss has made something of a hash of it at the moment. “It’s been a rough year,’’ concedes the spokesman, Jim Dyke. “He has had problems in politics and policy. It wasn’t any one thing. But he still has a lot of time to get back on track.”
Laying the Groundwork
But follow Frist to South Carolina, which will be the site of a potentially pivotal early Republican presidential primary about 20 months from now, and another side of his striving ambition begins to emerge.
At a roadside cafe in Rock Hill on Memorial Day weekend, the shirt-sleeved, straight-backed Frist walked one afternoon into a middling crowd to give a speech in behalf of a state legislator who is running for a seat in the House.
It was the start of a recess week in Congress, a time when Frist more often than not flies home to Nashville or off to Africa to perform pro bono medical mission work for starving refugees and AIDS victims. This time, however, he was taking the unusual step of campaigning against an incumbent House Democrat, John M. Spratt Jr., in behalf of challenger Ralph Norman.
Perhaps Frist had special reasons for doing Norman this personal favor, though there is no evidence that the two know one another well. Frist campaigned for many challengers when he ran the Senate Republican Campaign Committee in 2001 and 2002. And two years ago he went to South Dakota to campaign against the Senate’s other party floor leader at the time, Tom Daschle — an unprecedented thumb in the eye of tradition and senatorial courtesy.
But a Senate majority leader campaigning for a House challenger in an uphill race? Although Frist insists that he won’t make up his mind until after he retires from the Senate at year’s end, his trip to South Carolina was a clear signal that his sights are set firmly on the White House.
From that perspective, it’s not at all surprising to find him in the state where George W. Bush vanquished his biggest rival for the GOP nomination in 2000, Sen. John McCain of Arizona. South Carolina’s primary followed McCain’s strong showings in Iowa and New Hampshire and proved his downfall as a would-be spokesman for conservatism. He stumbled badly, for instance, on the question of whether the state should fly the Confederate flag over the capitol. He never recovered after his downfall in the Palmetto State.
Frist clearly is determined not to let that fate happen to him. At the cafe, he explained his rationale for putting a proposed constitutional amendment before the Senate this month. “Who thinks we should desecrate the American flag?” the Nashville native said in his Tennessee twang. “And who doesn’t?”
In such settings, Frist assumes the role of the impassioned outsider — a stand-in majority leader bent on forcing symbolic votes, win or lose, on signature themes while distancing himself from an unpopular president and a chaotic Senate. His stump speech, for example, begins by evoking Edward Everett Hale, the Senate chaplain a century ago. When Hale was asked if he prayed for the senators every day, Frist says the Unitarian clergyman and author would reply, in effect: “I take one look at all the senators, and I pray for the American people.”
Frist’s approach appeared to play well in Rock Hill. After the rally Ernest Cogdell, an Assemblies of God lay minister, said he would back the majority leader in a primary against a less conservative rival such as McCain because “I’m sure Frist would defend moral values.’’ Curwood Chappell, a local county councilman, promised his support, too, because “he’s been in the limelight; he’s been tested.’’
But the current dynamic for the 2008 GOP nomination is different from 2000. McCain looms as the clear front-runner — especially if the other person near the top in GOP opinion polls, former New York Mayor Rudolph Giuliani, opts out of the race — and several others appear better positioned than Frist to become McCain’s principal rival. (latest Gallup Poll numbers)
“Frist has got to be the conservative alternative to McCain coming out of Iowa, and then win in South Carolina,” says Charles Black, a Washington lobbyist who is a longtime GOP activist. “It’s going to be tough. He’ll need red meat in the primaries. Health care only helps in the general election.”
What that advice means, Black and several other party tacticians say, is that Frist should spend his final six months in the Senate honing themes that resonate with the social conservatives who are the base of the GOP primary vote — then campaign for president on the theme that only from the White House can he accomplish the goals that eluded him at the Capitol. In other words, to have a chance in 2008 he must position himself as the anti-Washington candidate, the anti-Senate candidate and, most importantly, the anti-McCain candidate.
Neal Thigpen, a professor of political science at Francis Marion University in Florence, S.C., says Frist has a shot at picking up anti-McCain conservatives in the state, but that another senator, George Allen of Virginia, has a head start because of his focus on moral values. “Frist is low-voltage, anything but a firebrand. He can’t decide whether he’s running as the religious right candidate or as a physician,” Thigpen said.
‘Leading on Principle’
For his part, Frist takes great care not to talk about even the possibility of having a lust for higher office. He straight-out denies that his actions as Senate leader have been driven by presidential ambitions.
“Every article starts off: That’s what he’s thinking about; that’s what dictates his thought process,” Frist said in a recent interview in his Capitol office. “They’re absolutely wrong. They’re wrong.”
And in describing his plans after leaving Congress, he makes no mention of politics or the nation’s capital. “Eight months from now, I might just as well be back in Nashville doing heart transplants,” he said. “I might be back there working in an HIV-AIDS clinic. And I might do what I do every year and go to Africa and do medical mission work, which is in the Sudan and is part of my life. I don’t have to pretend it. I don’t have to act like I’m doing anything. That’s my real life.”
After offering those scenarios, however, he volunteered that he has made no decisions about the future.
But by not backing away from fights on matters he holds dear — such as stem cell research, where he departs dramatically from the president and a majority of his caucus by advocating the use of unused embryos from fertilization clinics — Frist said he is hoping to reassure party loyalists that he’s driven not by political ambition but by his deep convictions as both a conservative and a physician.
“Leading on principle is my style,” he said. “I’m right up front about it. It’s honest. It’s true. It’s what I stand for. It’s why I came to Washington.”
Prodding colleagues toward the center on landmark legislation, however, has been the hallmark of standout Senate GOP leaders in the modern era. Everett McKinley Dirksen of Illinois is revered for helping to complete the 1964 Civil Rights Act. Bob Dole of Kansas assembled the bipartisan coalition that passed the Americans with Disabilities Act in 1990. Howard H. Baker Jr., a fellow Tennessean whom Frist identifies as his political hero, was famous for describing the job as “majority pleader.”
His allies in the Senate GOP say it’s still too early to exclude Frist from a place in that pantheon. “He’s been a good leader, given the cards he’s been dealt,” said Gordon H. Smith of Oregon. “He’s held things together,” said James M. Inhofe of Oklahoma
For much of his first three years on the job, Frist seemed to be as focused as his predecessors on cutting deals.
The first big deal he cut effectively limited the 2003 tax cut to only half the amount President Bush wanted — a decision that reflected the political realities of the Senate’s narrow GOP majority at the time but infuriated his own party’s leaders in the House, who accused Frist of reneging on a promise to insist on much deeper cuts in his very first handshake agreement with Speaker J. Dennis Hastert of Illinois.
Later that year, Frist helped cultivate support from both Democrats and AARP, the pre-eminent lobbying group for the elderly, to create the prescription drug benefit under Medicare. Frist participated in the early negotiations on the final bill, and when the conferees appeared to stall, he and Hastert drafted proposals that helped break the impasse.
But Frist says his vision for leadership has always embraced ideas beyond pragmatism. His former political consultant, Tom Perdue, says Frist has long regarded the majority leader’s job as a forum to promote long-range goals that might have little chance of enactment but that reflect his deeply held conservative beliefs.
Perdue, who crafted the hard-right campaign that Frist ran in unseating three-term Democrat Jim Sasser in 1994, said Frist is well aware of what has amounted to the majority leader’s curse. In the last half-century two of them — Dole in 1996 and Democrat Lyndon B. Johnson of Texas in 1960 — were unable to leverage their strong records for bipartisan legislative accomplishment into winning presidential bids.
Yet Perdue said Frist was enthusiastic about the opportunity to take the job — he secured it, with a just-barely-behind-the-scenes assist from the White House, after Lott lost it with his Strom Thurmond gaffe at the end of 2002 — and was determined to use the Senate floor as a forum for articulating his own ideas, not only as a place to blend into the ranks of former floor leaders.
“I advised him to try to follow his beliefs,” Perdue said. “Majority leaders have been too willing to compromise in the past. They were paper shufflers who just warmed the chair. I had this discussion with Bill. He was determined to make a difference. He had a lot of ideas going in.”
Perdue told Frist that by standing up for his own principles, he could become a formidable national candidate because “the base wants someone who is passionate about certain issues.”
Frist said he sought advice from several senior Republicans, including Baker, but concluded that he would not emulate Baker or any other majority leader and would instead try to develop his own style.
He agreed with Perdue that it was important to fight for principles on some issues even though doing so would create conflict in the Senate and within the GOP caucus. And he says that, from the start, he made no apology for operating beyond the early stereotype of him — that of a “doctor-senator” who would apply a family practitioner’s gentle bedside manner to get his way. Rather, Frist says, his approach as leader has been to treat the Senate like the operating rooms where he has spent most of his life. “I approach things by listening like a doctor does,” he said, “and then acting like a surgeon.”
Too Far in Front?
As a result, in the past year there’s been no small amount of trauma on the Senate floor.
With the resolve of a man used to making choices of life and death, by the end of the summer Frist wants to end Bush’s ban on expanding federal funding for embryonic stem cell research. By fall, he wants to finish an immigration policy overhaul that, as passed by the Senate, was opposed by nearly three out of five of his GOP colleagues.
Frist argues that Bush’s stem cell restrictions are wrongly preventing scientists from finding treatments that could save lives. And he portrays the immigration bill as a step toward a signature goal — cutting medical care costs — because it could force perhaps several million undocumented workers to pay their back taxes and hospital bills as a condition of getting on a path toward citizenship.
But because both issues offer Democrats prime opportunities to point to deep divisions in the Republican ranks, some GOP operatives and lawmakers are wondering aloud whether Frist is shaping his legislative agenda for the fall with selfish priorities in mind. And such questioning has emboldened rank-and-file lawmakers to test his authority and work to stymie his initiatives, raising the prospect of gridlock in the weeks before the midterm election.
“It’s hard to lead a group of people if you’re not in front of them. If he gets too far out front, or gets way out front too many times, he may find there’s no one behind him,” said Sen. John Cornyn of Texas, who has been urging Frist to temper his penchant since last year for taking high-profile stands that set him apart from fellow Republicans. “He’s clearly looking to 2008. But he’s trying to lead the majority. He’s got to balance what he’s doing.”
Frist’s demurrals about the presidency have done little to quiet the doubts in his caucus. “The perception has been that he has been motivated by his presidential ambition,” says Alan K. Simpson of Wyoming, a former Senate GOP whip. “People have been questioning his authority and blocking things he wants to do.”
Even longtime supporters such as conservative activist Paul Weyrich say Frist faces a crisis of credibility. “He knows it’s do or die for the remainder of this Congress,” Weyrich said. “If he gets bills passed, he’ll emerge in good shape. If not, he’ll be hard-pressed to run for president.”
The challenge for Frist in the final months of the 109th Congress will be to resonate with the national Republican electorate without alienating the 54 others in the Senate GOP who are for the time being his principal constituents.
“He’s been riding two horses in the circus. He’s in an impossible position,” says Smith, one of Frist’s closer friends in the Senate Republican Conference.
But deep worries within the GOP about the coming midterm election have raised the pressure on Frist to explain the calls he makes in allotting precious floor time to pet issues.
Frist arranged for the vote two weeks ago on the constitutional amendment to ban same-sex marriage, and this week the Senate will take up the flag desecration constitutional amendment — both of which send conservatives an unambiguous message. But earlier this spring he confused and then annoyed the base by appearing to part company with Bush on the immigration issue, then suddenly embracing a compromise that the president backed and most conservatives derided.
“I’m not sure anymore where he wants to end up,” said Jeff Sessions of Alabama, chairman of the conservative Senate Republican Steering Committee.
As the immigration fight simmers, some Republicans say Frist could face an outright revolt in his caucus if he presses for a Senate vote on the House-passed bill to expand federal stem cell research. Frist says the stem cell debate is precisely the sort of thing he hoped he could use his medical background to influence when he first ran for office.
Conservative Backlash
William Donohue, the president of the Catholic League, which works to combat prejudice against Roman Catholics, has dubbed Frist “Dr. Duplicity” for his strong public stand against a broader ban on stem cell research, which he once supported.
Catholics and many other religious conservatives view such research as akin to abortion, and their attitude toward the GOP this fall could turn markedly sour if Frist presses ahead. “I’ve advised him not to bring the bill up,’’ says Lott, Frist’s predecessor as GOP leader, because “it would be very divisive for the party.”
Frist says he is undeterred by those warnings because of his conviction that embryonic stem cell research eventually will yield tissue and druglike compounds that could repair a broad range of physical ills.
Helping spur on such medical advances could help Frist position himself for a national campaign as the physician with a commitment to cutting the cost of medical care. In the January 2005 issue of the New England Journal of Medicine he described a world of medical innovations that could come on the market in the next decade — and would be affordable for most Americans so long as they could draw from tax-advantaged health savings accounts.
He followed that up by introducing a bill that would have created a series of health tax breaks, but by the fall he had decided to let that measure languish in the face of the crush of Senate business in other areas. Instead, he has settled in the past year for a series of relatively low-profile accomplishments on the health care front: a law enacted last year to provide aid for global water projects; legislation, which the House is on course to pass this month, to promote the use of electronic patient files; and a crusade a year ago against the aggressive marketing of drugs as soon as they have won federal approval, which prompted pharmaceutical makers to issue voluntary guidelines curtailing such advertising.
Meanwhile, Frist continues to make the courting of health care professionals an essential part of his nascent presidential campaign. After campaigning for the House candidate in Rock Hill, for example, he toured the nearby Piedmont Medical Center, then arranged to meet with a group of 15 physicians at his next stop: a hot air balloon festival 100 miles west in Anderson, S.C.
A History of Risks
Frist’s allies say he’s at his best in small groups of voters and potential donors, and they say he’s made improvements in his rhetorical style, which from the well of the Senate comes off as halting and stiff. They say he has a history of taking risks that stretches to his youth — and to a pair of his heroes whose principal shared flaw, in the senator’s view, is that each was overly cautious.
Frist often speaks of the rewards of audacity learned in his upbringing. It was his older brother Thomas who secured the family fortune in the late 1960s with his innovative vision of applying the economies of scale that benefited fast-food chains and other industries to create the first successful national hospital chain, which has evolved into HCA Inc. Frist often speaks of his own passion for risk-taking both when flying small planes and when simultaneously transplanting both a heart and a lung.
In a 1989 autobiography, “Transplant,” he concluded that Norman Shumway, his surgical mentor, had cheated himself of a place in history. Shumway described his plan for the world’s first human heart transplant in the Journal of the American Medical Association in November 1967, after spending years perfecting his techniques on animals. A month later, Christian Barnard, a South African who had studied Shumway’s techniques, became a global celebrity by transplanting a heart into the chest of a 55-year-old grocer.
“Almost all of the basic research behind the procedure had been carried out in this country, under Shumway’s auspices. Yet the credit was going to a little-known man in South Africa who knew almost nothing about the vital underlying animal research,” Frist wrote. The global milestone would have been his mentor’s, Frist suggested, had the American surgeon not insisted on such thorough experimentation on animals before trying his technique on a human.
And in his 1999 book, “Tennessee Senators,” Frist concluded that Baker had doomed his own White House prospects by waiting until the last two weeks of 1979 to stop concentrating on his responsibilities as GOP floor leader and focus full-time on campaigning for the Iowa caucuses and the New Hampshire primary early in 1980.
Baker dropped out after finishing in Iowa behind Ronald Reagan and George Bush, neither of whom was in public office at the time, which prompted his famously rueful observation that “one has to be unemployed to be elected president.”
Recent Stumbles
Frist, of course, would be able to test Baker’s theory in a 2008 field that could include several sitting senators and a handful of governors.
Long gone are the days when a viable presidential campaign could get off the ground in the same year as the election — and when a member of Congress could wait to set aside his day job until after his presidential quest had taken off, as Dole did when he quit the Senate altogether soon after he’d secured the 1996 GOP nomination. The current environment requires presidential hopefuls serving in Congress to display early strength in both fundraising and public opinion polls to remain competitive even a year or two before the primaries begin.
And so in coming months, those friendly to him concede, the success of any national aspiration will require him to score sufficient legislative successes as majority leader to counteract a bruising recent run of embarrassments.
Those began a year ago when the autopsy of Terry Schiavo, the Florida woman who had been at the center of a national debate over the right to die, supported her doctors’ view that she had long been in a persistent vegetative state. Frist, in advocating enactment of a bill in March to have the federal courts intervene to keep Schiavo alive, had asserted on the Senate floor that her diagnosis was wrong — although he conceded that he based his conclusion only on watching some videotape of her and reading court documents.
The incident was ammunition for critics who said that Frist not only had traded inappropriately on his medical expertise, but also had spurned one conservative principle — the notion that the federal government should stay out of a state court fight — in pursuit of support from the “right to life” wing of the GOP.
Then in the fall, the Securities and Exchange Commission and Justice Department launched inquiries into Frist’s decision to liquidate the HCA Inc. in his blind trust just before the company’s stock price plunged that July. Neither investigation has been brought to a public conclusion. Frist says he informed the trustees of his decision to sell long before the stock sank and had no inside information.
More recently, anti-tax Republicans have blocked the effort Frist has endorsed to create an industry-financed trust fund that would expedite the settlement of asbestos liability claims. And his recent proposal to give taxpayers a $100 rebate to help then cope with the recent surge in gasoline prices was quickly ridiculed into oblivion, with critics complaining that the money could barely cover the cost of filling up two larger tanks — and the business community, which would have been taxed anew to pay for the rebate, crying foul.
That string of setbacks does not doom him, Frist’s promoters say.
“Look at the competition: John McCain, Rudy Giuliani. Think of all the baggage they have,” said Perdue, the consultant who ran Frist’s first winning Senate campaign. “He’s a little dented now, but he can come back by stressing what he believes in and didn’t get done.”
Tennessee’s other senator, Lamar Alexander, who himself ran for the GOP presidential nomination in both 1996 and 2000, says he has few clues about whether Frist will make such a bid. But he has some unsolicited advice for his colleague. If he fails to win the Republican nomination in 2008 or skips the presidential election entirely, Frist should consider running for governor in 2010 — a job that would position him to run for president in 2012 or even 2016, when he will still be only 64 years old.
Told of that counsel, Frist initially brushed aside the notion of seeking the Tennessee governorship, but then added, “I will keep options open on just about everything.”
Dole, now a Washington lobbyist, declined to grade Frist’s performance as majority leader but predicted a rebound after he leaves the Senate. “He’ll have time to reflect and build a campaign based on his ideas,” Dole said. “Getting away from politics will help him. . . . He won’t be an insider then. He’ll be on the outside.”
