by Bill Frist
After a long discussion during the conference call, I sealed my decision. “I will not be running for president in 2008,” I said, as I closed the call. I knew that I was disappointing many of my closest friends, men and women who had spent hundreds, even thousands of hours working on my behalf, and I sorely wished, for their sakes, it could have been otherwise. But when I considered the matter carefully, the choice was obvious. It was right for me, right for Karyn and my sons, and right for the country.
ON DECEMBER 7, 2006, AFTER THE USUAL FLURRY OF LATE-NIGHT legislative bargaining that occurs near the end of every session of Congress, I stood at my majority leader’s desk—my name now indelibly carved in the drawer—to give my farewell address to the Senate. The chamber was full that day, as most senators tend to honor the tradition of a departing majority leader’s final formal address.
The galleries were lined with spectators as well. One entire section was given over to my family members and close friends who made the trip to Washington to share in these special moments. Karyn, of course, was there, as were Harrison and Bryan (Jonathan was attending classes at Vanderbilt); so were my brother Tommy, Trisha, and my sister Mary, and her husband Lee. Barry and Jean Ann Banker and Steve and Denise Smith made the trip as well. It was an emotional, bittersweet day, to say the least, as we all had special memories of why I ran for office in the first place, what it took to get here, then to have risen to be the leader of the Senate in such a short time. And now I was preparing to leave.
The audience in the Senate was quiet and respectful as I spoke of some of the successes and challenges of which I had been a part over the preceding twelve years. I thanked my fellow senators, the people of Tennessee, my staff and family. My voice thickened and I nearly choked up as I said:
The two people who won’t hear me thank them today directly are two who were here at my swearing-in, but who have since passed on—my parents, Dorothy and Tommy Frist. They left a great legacy of honesty, civility, fairness, hard work, and service. They passed that legacy to my own brothers and sisters, Mary, Bobby, Dottie, and Tommy, who all in their own way, with their children and grandchildren, live lives of service to others.
I’ve spent a lot of time these past few weeks reflecting, but I’ve also spent a great deal of time thinking about the future of this institution. As I prepare to leave here and return to my home, many people have asked me if I regret the promise I made to serve two terms. “If you knew then what you know today, would you have made that same promise?” they ask.
And my answer is “Yes.”
I believe today, as I believed when I came here, in the ideal of a citizen legislator. And bittersweet though it might seem today, it is right.
I hope that my service, that the example of someone who had never served before, spent his life pursuing another profession, coming here and rising from one hundredth in seniority to majority leader, the example of a committed doctor who has been able to find purpose and fulfillment in serving others through public service, through elected office, will inspire others to seek office. And those that come to serve after me as true citizen legislators will bring fresh perspective and ideas that will in ways small and large make this country and this institution better.
I closed with a word of hope: “I have spent a lifetime learning, ‘To everything there is a season.’ And today, my season in the Senate draws to a close. Tomorrow is a time for new rhythms.”
I paused briefly, looked up toward the Senate chamber ceiling, and said:
And under the dome, it is a time for fresh faces and fresh resolve. Change is good. Change is constructive. The Senate changes, the people who serve change, but what doesn’t change is that every one of us who serves believes deeply in the genius of the American democracy.
So, it is with the deepest appreciation that Karyn and I thank you all for twelve wonderful years. There are no words to describe the honor it has been.
My Senate colleagues and the audience in the gallery rose in what seemed a single motion into a somewhat overwhelming standing ovation. I looked up at Karyn and my other family members and friends in the gallery. Many of them had tears in their eyes, as did many of my staff members. It had truly been the time of our lives.
Harry Reid was one of the first to come across the aisle to wish me well, as did Ted Kennedy, and many others. For a few moments, anyhow, we were all on the same team.
IT WOULD HAVE BEEN GLORIOUS TO HAVE LEFT ON THAT NOTE, BUT technically, I still had three weeks in office, and more important, we had a lot of work to hammer out before everyone left town during the Christmas break. We worked late the last two days of the session, fashioning last-minute compromises until nearly 2:00 A.M. each day. When I finally adjourned the Senate for the last time, I was joined by several of my staff members, who as usual had stayed late with me until the wee hours of the morning. I showed them my name carved in the Senate desk, and Amy and Allen took turns in further deepening the carving of my signature. We laughed and cried and reminisced about the good times. We went back to the majority leader’s office for the last time as colleagues.
In the office somebody broke out a bottle of champagne, and we toasted our tenure in the Senate—especially our four years as majority leader. Many nice comments and compliments were shared. My brief words centered on what I felt at the time, a verse from the Twenty-third Psalm, “He restores my soul,” something many expressed when reflecting on the experience of working together in service to the Senate and the country. It was a memorable evening. Close to 3:00 A.M. I raised a final toast in honor of my staff. After a few final farewell hugs, we quietly slipped out of the Capitol into the chilly December morning. Life would never be the same. When we returned in January for the swearing in of the 110th Congress, we would no longer be the majority. Harry Reid would be the majority leader, and I would be an ordinary citizen.
DURING MY LAST FEW WEEKS IN OFFICE, I HAD MANY REQUESTS for favors—some people wanted job recommendations, others needed last-minute medical advice—but perhaps the most unusual and most poignant request came from Robert (Bob) Ritchie, or as most know him, Kid Rock. Kid is a phenomenal performer who crosses musical genres from hip-hop to southern rock. He grew up in a small town north of Detroit, but for a while he had a condo just around the corner from our Bowling Avenue home in Nashville. Karyn and I had spent some time with him a few years earlier when he was in D.C. for the Kennedy Center Honors. Kid knows how to touch people. When he performed at a Republican convention party in 2004, his incredible musical range and his intense, fever-pitched energy whipped the crowd of a couple thousand young Republicans hanging from the rafters of a converted church into a near frenzy, forever putting to rest the myth that Republicans are stiff-necked, stuffed shirts.
Often characterized as one of rock’s rowdiest characters, offstage Kid Rock is a humble, deeply caring man, especially when it comes to his family. And he has got heart. Maybe that’s why we connected so easily.
On December 16, 2006, I was at my Capitol office trying to clean up some last-minute work, when Ramona called and said, “Kid Rock’s on the phone. He says it’s urgent.”
“Bill, I need some help,” Kid Rock said. “I’m having a hard time going through my divorce, and I want to do something meaningful for my son.”
I had been working night and day on last-minute legislation, so I hadn’t been paying close attention to Kid’s troubles, but I soon learned that he was going through a highly publicized, tumultuous divorce from actress Pamela Anderson. He began to share some of the details of his life with me on the phone, and then said, “The thing that bothers me most is that I have a teenage son in Detroit. As a single father, I’ve raised him with the help of my family back home, and then when Pam and I married, I uprooted him and moved to Malibu. He got close to Pam’s boys, and now that we are broken up, my son is taking it really hard, because he knows it’s been hard on me. I’m looking for some meaningful ways to spend more time with him.”
We talked a bit, and he
reminded me that we had talked in the past about how much it had meant for me and my boys to take medical mission trips to Africa together. I’d take one son at a time to maximize the experiences we could have together. Kid got excited about the concept of taking his son overseas on some sort of mission trip. I told him this would be impossible to pull off in the short term, but that maybe we could arrange something in the future.
“Well, in the short term,” he said, “I want to serve others. Could you arrange for me to get to Afghanistan or Iraq to demonstrate my support, all my fans’ support, and America’s support for the soldiers who are fighting for us every day? I want to tell them they are great Americans. I want to do something for others.”
“Great idea,” I replied, knowing from personal experience that trips like this help put life in perspective. “When do you want to go?”
“How about next week?” Kid responded. “Who is going to Iraq to do shows for the troops this Christmas?”
“I’m not sure,” I said.
“Well, I’d like to show my son that Christmas is really about being unselfish. Not presents. I want to go be with the soldiers who can’t be with their families. I want to spend Christmas with the troops. And I’d like to take my son.”
“Kid, it will be next to impossible to get you over there on this late notice, let alone your son. It’s not exactly an easy thing to do. But let me see what I can work out.”
“Please do whatever you can,” Kid begged.
I hung up the phone and stepped into Ramona’s office next door to mine. Over the years, Ramona had learned that I liked to take on the quirky, out-of-the box challenges that occasionally make it to the desk of the majority leader. “Ramona,” I said, “Kid Rock is down in the dumps and has made a personal request. Who can we contact to see about getting him over to Afghanistan or Iraq to perform for the troops…during Christmas?”
“Christmas! That’s less than ten days away,” Ramona reminded me.
“Yes, but let’s see what we can do.”
Ramona went to work on it, and I called some people at the White House, as well as former staffer and then legislative affairs director at the Pentagon David Broome, always game for the tough-to-crack problem. David magically made it happen, and a few days later, Kid Rock was performing—just him and his guitar—for thousands of American soldiers in the middle of the war zone.
On Christmas Day an IED hit a convoy, so Kid went to the hospital to visit the men who had been wounded. It was a profoundly moving experience for him, which he later described to Larry King on national television.
I went to the hospital and, I mean, to see Marines crying, grown men crying, first of all, and then to see—just go into a room where these kids have been hit and they are shell shocked…to watch the chaplain run upstairs and read last rites or whatever it is to a kid who is dying…and to imagine, who wants to call these kids’ parents on Christmas Day and say he’s gone. It makes every day so appreciative.
When I heard about the way the men in women in uniform received Kid Rock, I just smiled. He went there to serve, to give something to the troops, but he came back having received much more than he gave. That’s what happens when a person has the heart to serve; it’s a strange paradox, but you always get back more than you give.
“TOMORROW IS A TIME FOR NEW RHYTHMS.” THESE ARE THE WORDS I used to close my final remarks on the Senate floor. So what are these new rhythms for me?
I left the Senate with no clearly defined plans for the immediate future, which as far as I can tell is rather unusual. Karyn and I sold our home in Washington, a warm home that had watched our three boys mature from young kids through their frenetic high school years to become strong young men. We moved back to Nashville, where the final renovations were being made on the family home on Bowling. We became empty nesters with the move. Our youngest son, Bryan, was off to Princeton, where he is majoring in history with plans to go to medical school (my dad would be proud of him for continuing the tradition in the “greatest of all professions”). Middle son Jonathan, the one who always took the more adventuresome road and likely will proudly serve in the military, was attending Vanderbilt in Nashville; he’d thought he was “going away to school” when he left Washington, not realizing Karyn and I would be following him there for his junior and senior years. And Harrison, who confidently led the way for the other boys through their high school years, graduated from Princeton and was off to work at Goldman Sachs in New York for a couple of years, and then back to Washington to work in private equity.
When I look back on my life so far, a definite pattern emerges—a series of segmented blocks of about ten years devoted to service in some shape or form. I spent ten years training to be a surgeon in a cutting-edge field; ten years building and running a new type of heart transplant center that brought multiple specialties together; and twelve years serving Tennesseans in the U.S. Senate. Now, God willing, I have another ten to twelve years of productive professional life to look forward to. I’ve learned that there are many ways to serve; pursuing one’s passions has a way of busting open those doors of opportunities to serve.
When people ask me what I’m doing these days, I explain that my time and energy outside of family are divided into three buckets. All three continue the common thread of a lifelong commitment to health, hope, and healing.
The first bucket grows, in part, out of my years in politics. It’s focused on reform of America’s dysfunctional health-care system.
As I’ve explained, health-care issues were the major policy concern of mine during my two terms in the Senate—a somewhat unusual choice for a conservative Republican, but a natural one for me. The most significant legislation that I helped develop and bring to fruition was the Medicare prescription drug bill, which brought affordable coverage of life-saving drugs to millions of older Americans. This bill introduced many reforms, but it represented just a first step in the more comprehensive overhaul that our national health-care-delivery system needs. True reform has been on the national agenda for the past fifty years, but it has not yet been accomplished. It will take a huge public-private partnership and commitment, even after legislation passes.
I’m often asked to describe my blueprint for an improved U.S. health-care system. Naturally, I don’t have all the answers—no one person does—and this book is not the place for a detailed discussion of health-care policy. But there are a handful of guiding principles that I’ve come to focus on, both as a physician in the field and as a policy maker shaping the landscape, principles that I hope will be in the forefront of any plans to be developed by the new administration and Congress.
For me, a twenty-first-century American health-care system should be patient-centered, consumer-driven, and provider-friendly. Patient-centered, in that the well-being and needs of individuals must be at the heart of every decision we make. Consumer-driven, in that individuals should make decisions that drive value and quality. Those who receive care should retain the ultimate control and authority over their treatments, rather than ceding that control to government bureaucrats, insurance companies, or professional organizations that may have their own agendas. And provider-friendly, in that the system must make medical professions for nurses and doctors rewarding and fulfilling, limiting the impact of problems like excessive paperwork, intrusive regulation, and out-of-control malpractice suits that too often drive good people away.
That 46 million people are uninsured is wrong. The uninsured die earlier. They represent a major moral and economic challenge for our country—a moral challenge because it’s simply unconscionable that citizens of the richest nation on earth can’t afford routine medical checkups, preventive care, and essential treatments for curable diseases; an economic challenge because the cost of emergency care for the uninsured represents an unrecognized burden on taxpayers and health-care providers that drags down the efficiency and effectiveness of the entire system.
Most agree today that somehow the millions of hare-core uninsured
Americans must be brought into the health-care system. But doing so without creating costly additional layers of bureaucracy, or a gigantic new entitlement program that we simply can’t afford in this time of economic recession, represents a genuine challenge. It’s not easy to do responsibly. The whole TennCare story in Tennessee demonstrates that the system will implode if you try to insure everyone without intelligently and realistically addressing rising costs. Only by reducing the upward slope of health-care spending—rising almost twice as fast as inflation every single year—will we be able to provide all Americans with a decent, basic level of care over a sustained period of time. So I would advise: Don’t legislate universal coverage without simultaneously putting in place a framework to slow the growth of spending. To do otherwise at a time of estimated doubling of our national debt and insolvency of Medicare in just eight years could be devastating to our country.
Fortunately, there are some practical steps that can help us achieve these goals. Implementing twenty-first-century information technologies across the entire health sector will improve efficiencies, reduce errors, make it easier to prevent fraud and abuse, and eliminate countless hours of work by physicians and other professionals who now wastefully reduplicate patient information that has already been gathered and recorded. The legislation on health information technology I introduced with Senator Hillary Clinton in 2005 took a first crack at this. And President Obama’s first stimulus package has heavily invested in adoption of electronic medical records. Now it’s up to doctors and hospitals to adopt information technology and take full advantage of the promising potential benefits produced by connectivity, data mining, and decision support.
Funding objective comparative effectiveness studies of alternative health-care strategies for particular conditions and treatments and then making the resulting data widely available to both providers and patients will encourage wiser and more efficient choices that will produce better outcomes while saving time and money. Such information empowers consumers to maximize value in health care and eliminate waste. When you make a health-care purchase today, you typically don’t know exactly what you are getting or how much it costs. No wonder markets in health care are not working and prices are going sky-high. Making accurate, understandable information about outcomes achieved by particular physicians, medical groups, clinics, and hospitals widely available will lead to improved quality. And let’s keep walking down the path that our 2003 drug bill set us on—expanding the use of generic medicines, in place of more costly brand-name drugs.