Presidential Oral Histories

Joseph Califano Oral History

About this Interview

Job Title(s)
Secretary of Health, Education & Welfare, 1977–79

Joseph Califano speaks of the surtax issue during the Johnson administration. There is extensive discussion of health insurance and welfare reform under Jimmy Carter. He speaks of his collegial relationship with Edward Kennedy and of Kennedy’s Presidential campaign, with observations on the effect of Chappaquiddick on the campaign. Califano touches briefly on Kennedy’s staff and extended family.

Presidential Oral Histories |

Joseph Califano Oral History

Transcript

Heininger

This is an interview with Joseph Califano in New York, on the 23rd of January. Why don't you tell me when you first met Edward Kennedy?

Califano

I don't remember. It was probably in the 1960s, when I was working for President [Lyndon B.] Johnson.

Heininger

What was your relationship with the Kennedy family then?

Califano

Well, I didn't know Ted Kennedy well at the time. When did he get elected to the Senate?

Heininger

Sixty-two. He came in in '63.

Califano

All right. I probably didn't know him when I was in the Pentagon. I probably met him in '65, then, I would guess. I knew Robert Kennedy, I knew Ethel [Skakel Kennedy], I knew [Robert Sargent] Sarge Shriver, Eunice [Kennedy Shriver]; I guess I knew them all.

Heininger

In your book, you talk about, with Johnson being--

Califano

Which book?

Heininger

Your autobiography.

Califano

The book that has the most about Kennedy is Governing America.

Heininger

Yes.

Califano

You've read that too?

Heininger

Yes.

Califano

All right, go ahead.

Heininger

You talk about being squeezed between Johnson and Kennedy. Do you want to tell us about the discussions over whether Johnson wanted to continue the surtax or whether he wanted to leave the mess to [Richard] Nixon, and what Kennedy's role was in that?

Califano

I have to tell you, what is in the book is accurate. I had plenty of notes. We wanted to continue the surtax. I just remember, dimly, the meeting in which Kennedy raised questions about it, and I remember Kennedy calling me. My memory is not that good on that. I remember him calling me. I remember dealing with Johnson. Whatever is in the book is right.

Heininger

It was a very interesting incident, because it was an early incident that we had not heard anyplace else.

Califano

Maybe you can refresh me a little bit.

Heininger

You had been very strong with Johnson about the surtax and he wasn't happy with you, and you went into the meeting and he structured the meeting in such a way that he got the answers that he expected to get, which was against the surtax.

Califano

Except from Kennedy.

Heininger

Except from Kennedy.

Califano

Yes, that's right, and he teased me a little bit about setting Kennedy up, which I didn't do. It all happened, but I just can't--you know it's not--of all the things that happened during that four years of working for Johnson--

Heininger

It's obviously a minor incident. It struck me as something we haven't--a very early incident of--apparently Kennedy called you later in the day--

Califano

Yes that's right.

Heininger

And said, "Hmm, I don't think this is such a great idea. Why don't you pass that on?" And you said, "No. Why don't you get in touch with--" I guess it was Johnson's scheduler.

Califano

Jim Jones or Marvin Watson or somebody.

Heininger

Jim Jones. And he said, "No. Why don't you do it?"

Califano

Yes.

Heininger

And I thought, That's a very interesting little anecdote about how Kennedy operates.

Califano

Yes, OK. That did happen and I did tell Johnson. It may even be a memo. I don't know whether I told Johnson orally or sent him a memo, but if I sent him a memo it's in the LBJ Library.

Heininger

Why don't we skip ahead to [Jimmy] Carter?

Califano

OK.

Heininger

Why did there seem to be another moment of opportunity for enacting national health insurance?

Califano

Well, Carter talked about a lot in the campaign, but two of the major things were health insurance and welfare reform. We made a judgment to go with welfare reform first, which, in the context of getting national health or getting some health insurance plan passed, in retrospect, was probably a mistake because by the time we proposed a health insurance plan, Kennedy was running for President and it was just trampled in the effort to get to the White House. That's my view of what happened. If we had gone with health insurance first instead of welfare reform, before Kennedy saw an opening to go for the Presidency, we probably could have gotten some kind of health bill passed.

But don't have any illusions about the ease of passing health legislation, because the economic interests, by and large, have the power to veto anything that hurts them too much, whether it's the pharmaceutical people, the hospitals, the doctors, the medical equipment manufacturers, and the insurers. It's a tough--

Heininger

Did you want to do welfare reform first? Which did Carter want to do first?

Califano

I don't think there was any disagreement about doing welfare reform first. There wasn't the kind of pressure to do something about healthcare that there is today. I mean, healthcare costs were rising. When I first went into HEW [Health, Education and Welfare], the main focus was getting a handle on the costs; a House bill cost containment and a whole series of things we tried to do. My recollection is that healthcare costs were rising at about 2 percent a year.

Heininger

It was bad.

Califano

Nixon had slapped controls on it and then lifted the controls, and we had what usually happens when you lift the controls, sharp increases. So, the initial focus in the health area was cost control. There was a lot of feeling in the Democratic Party, and in the country, that we had to reform the welfare system. You can go back to Johnson and see his statements in those years about reform.

We tried in the LBJ years--interestingly enough, both about welfare reform and the need to have a system that encouraged people to go to work, that trained people, and that got them off the welfare rolls. LBJ also tried to control healthcare costs, but we didn't have the horsepower in 1968. But his last message on health said, "You've got to change the system. You've got to stop paying doctors their reasonable, customary, and prevailing fees; you've got to stop paying hospitals on a cost-plus basis; and you've got to provide incentives for efficiency."

With the Carter years, our initial focus in the health arena was cost control.

Heininger

How much of that had to do with what the composition was in Congress, and the committee structure, with [Daniel Patrick] Moynihan in charge of Finance?

Califano

Carter genuinely wanted to reform the welfare system. That was probably his top priority. Remember, Carter also had a problem with the doctors. He did something as Governor that really angered the doctors in Georgia. I think they even took a full-page ad out, signed by most of the doctors in the state, when he was running for Governor the second time, or when he was running for President, opposing him.

In any case, he genuinely wanted welfare reform. I wanted welfare reform. Sure, Moynihan was for welfare reform, but so were Jim Corman and Charlie Rangel in the House. We actually put a special committee together. I asked Tip [Thomas P.] O'Neill and he put a committee together. The Ways and Means Committee, the Agriculture Committee--I think because of the food stamps--and Labor and Health, or whatever it was in those days, with [Albert] Ullman and Corman, and somebody else. We lost that one when Proposition 13 passed in California. It passed, and that was the end of any chance at welfare reform.

Meanwhile, we were working on healthcare. I had Hale Champion (Undersecretary of HEW) going around the country, and we'd hold meetings. The pressure for Carter to then produce a healthcare plan grew as Kennedy started beating that drum. It was clear that Kennedy was going to run for President. It was clear that would be a big battle in the Democratic Party. We proposed a plan, which was actually quite similar to what they're proposing today, with the mandate on employers. Kennedy wanted the traditional labor movement, national health insurance plan.

Heininger

How serious was Carter's commitment to welfare reform, and where did it come from?

Califano

I think he cared about it. I don't know whether this was because there were a lot of other things going on. He was so into the details of welfare reform that I really became like a staffer. He was asking questions about details of welfare reform that I would not have ordinarily asked.

If Lyndon Johnson wanted to propose a welfare reform bill, he would have said, "Look, I want a bill that gets people to work, that provides incentives for them to work, that trains them, gets them off drugs or whatever. Put it together, OK?" And he wouldn't have looked at that matter again until we'd come in with maybe three major issues to be resolved.

Carter--I'm sure it's in his library, but if I ever kept a copy of it, it's in the LBJ Library, too. Carter made like 75 decisions on welfare reform, and a long, long memo, single-spaced with a bunch of boxes to approve that I sent him at his request. I couldn't believe it. I mean, I couldn't believe he wanted that, but he not only wanted it, he read it and he checked every box. He acted on every issue. I would not have even gotten into that many issues. I would have had Henry Aaron, who was working on it, decide all but the biggest issues.

Heininger

But this was not the way you handled health?

Califano

No. On health, I think he dealt with the large issue. I don't have any recollection of the kind of detailed meetings.

Heininger

Do you remember how he became committed to healthcare?

Califano

Have you read Governing America?

Heininger

Yes.

Califano

Yes, well, that's probably all I know about it, and whatever is in there is accurate, if I say something different. It was part of the Democratic agenda. There were two big things. The two big legislative proposals were welfare reform and healthcare reform.

J. Califano, January 23, 2008 6

? 2020 The Miller Center Foundation and the Edward M. Kennedy Institute for the United States Senate

[Interruption]

Heininger

But did you have a sense he was as personally committed to it?

Califano

Well, he wasn't as personally involved. But the problem with saying, "Was he as committed or not as committed," is that, by that time--we're now into 1979--he's faced with a very strong opponent, as perceived at that point in time, in Teddy Kennedy. If you put the question another way, he had to get a healthcare bill out because Kennedy was making it such an issue that he (Carter) hadn't done it. We'd failed on the first major legislative proposal. The odds against passing healthcare reform, in the wake of Proposition--

Heininger

Thirteen.

Califano

In the wake of that, and just the general pressure, were high. The country was getting more conservative. There was more pressure on the government to hold down costs. So I'd say there was probably not the same emotional commitment that he had to welfare reform. But everybody in the Democratic Party wanted a healthcare bill. The issue was what kind of a healthcare bill.

What had happened here was I had gone to three or four countries; Hale had gone around the country, and every country that covered all their people had built on the existing system, which is what led us to go to a mandate. Basically, in an oversimplified way, if we could have had exactly what we wanted, we would have combined Medicare and Medicaid into one program. The government would have paid for the poor and the old, and we would have mandated employers--starting the way [Franklin] Roosevelt started the minimum wage--we'd mandate the big employers, who were already providing more than the mandate, to provide mandated coverage, and then gradually, over a period of time, cover everybody.

You know, the minimum wage didn't cover farm workers and small business until Lyndon Johnson, so you're talking 30 years. That's what we kind of envisioned, not 30 years, but maybe 10 or 20. The breakdown came because as soon as we put that bill out, Kennedy proposed the Doug Fraser--UAW [United Auto Workers] national health insurance plan, for the government basically to take over the healthcare system. That's when I said it would be easier to get an elephant through a keyhole than pass the Kennedy plan, and Kennedy sent me a poster board with a big keyhole cut in it and with the elephant swinging through. I don't know if I wrote that or not.

Heininger

What was your relationship with Kennedy?

Califano

It was good. It was fine. I wasn't a close friend but we were colleagues. We got along well. On Good Friday of 1979, I went out to his house to have lunch. It's funny, I remember--I'm Catholic and all I remember was Kennedy eating meat and knocking off an entire bottle of red wine after a couple of Bloody Marys. He was trying to get me to leave the government. I had started the anti-smoking campaign in '78, and he said, "Carter can't run again. He's got Kentucky, North Carolina, Virginia, even Georgia at risk with you there, so get out now." Actually, he was right. [laughs]

When I was nominated to be Secretary, at the hearing you had to go through two committees: the Senate Finance Committee and the Senate Health Committee. It was like eight or ten hours of testimony. Aside from the issue of abortion--Carter and I both were opposed to Medicaid funding for abortion--the most aggressive questioning was from Kennedy. If you go back and get the transcripts, probably an hour-and-a-half of trying to nail me into positions. You know, he was old enough to know I wasn't going to be nailed into positions, but he was relentless.

But no, I never had any problem with--I didn't have any animosity with the Kennedys at any level. I think it was Bobby's 40th birthday when I was in the Johnson White House--but it was a hell of a good birthday party, and then Johnson razzed me the next morning for being there, because it was all in Style in the Washington Post. No, no problem. I got along well with him.

Heininger

What did you think of him?

Califano

I thought he was incredibly dedicated. Garry Wills' book about Kennedy said if you want to understand Ted Kennedy, you have to think of a guy trying to climb a sheer ledge, carrying two bodies. I was conscious of that. He did drink too much. He did screw around a lot, obviously. There was lots of tension with him and Joan [Bennett Kennedy], and she was really drinking a lot, I remember that at parties, years before they ever got divorced. I probably wasn't in the White House any longer (after January 1969), but I just remember her in terrible pain. I mean, I didn't know her closely, but you can look at somebody and have a sense of that.

Heininger

It was a very difficult life to lead, by anyone, but obviously the special circumstances in that family--how does anybody live with that?

Califano

Yes. In any case, I wasn't close to him. But he still called a couple of months ago on some drug bill. After I left the Johnson White House and before Carter, in that eight years, I periodically saw him because I was so involved with the Democratic Party, and I also talked to him many times about health, welfare, education issues after I got out of HEW. And after I did leave and I was up on Cape Cod writing Governing America, he tried--I'd say, energetically tried--to get me to join his campaign in some way, and I told him I couldn't do that. I told him I hoped he'd win, but that if I joined his campaign, everyone would then say that Carter was right, that Carter fired Califano because he wasn't loyal to him. That wasn't true, and I wasn't going to give him that opening. But Kennedy tried more than once to get me to join his campaign.

Heininger

Well, obviously he cared about you.

Califano

Whether he cared about me or not, he cared about running.

Heininger

When did you have a sense that he truly was running? Do you remember the mid-convention speech in Memphis?

Califano

Yes. I have a great picture of myself with both Kennedy and [William] Clinton. I'll show it to you before you leave. He was running then. It became clear, I guess, if not within a year, certainly by the end of Carter's first year, that Carter was not going to be a strong President. He didn't like politics. He really didn't like Washington. He really did think there was a lot of corruption there, and there is, and he wasn't willing to do the things you have to do to get something done.

And when it also became clear to me that the country was--I don't know whether Kennedy saw this, but I certainly saw the party, everything, going to the right. It was very difficult to pass legislation, which led me to conclude that what I ought to do was move aggressively on things like smoking, and things I could control: radiation immunization, stuff that we could really get something done about, and not be banging against a stone wall. I would guess that Kennedy started running--well, he probably started running within a year after Carter got elected--his people did. But I think he started really seriously in early '78, Carter's second year. I can't give you a rational explanation, but I certainly had a sense that he was going to run.

Heininger

How much do you think the whole issue of healthcare fed into that for him?

Califano

Oh, it was important, but the larger issue was just the whole Democratic commitment to healthcare, welfare, poor people. I may have put it in the Johnson book, or in my memoir, but Lyndon Johnson thought that, of all the Kennedys, he would have been the greatest President; that he had the greatest potential. I don't know for sure the reason Johnson thought that, but two of the reasons he might think that were: One, Kennedy liked the Senate and he understood the Senate and he knew how to move the Senate, and Johnson would of course admire that, since he was "Master of the Senate," as [Robert] Caro put it.

Heininger

As Caro puts it.

Califano

But secondly, I think he felt that Kennedy had the same kind of commitment that he, Johnson, did to all these progressive programs and progressive government. It's interesting--I was driving when I heard about Chappaquiddick. I remember calling Larry O'Brien and saying, "He's cooked." And Larry said to me, "His best chance to be President is if he runs in 1972."

Heininger

Really?

Califano

It was '72? When did Chappaquiddick occur?

Heininger

Sixty-nine.

Califano

Sixty-nine, yes. "It's just going to get worse." And he was right.

Heininger

Yes.

Califano

In any case, he was certainly running.

Heininger

How much of an effect do you think Chappaquiddick had on the outcome of the '80 election?

Califano

Oh, it was devastating to Kennedy. It would kill him today. Nobody believes him. You know, Monica Lewinsky didn't die.

Heininger

No.

Califano

It was devastating to him, and Carter knew it. Carter knew he would beat Kennedy. He knew it would be tough. I don't think he thought it would be as easy as it was to beat him, but he knew he'd beat him, and he knew that Chappaquiddick was--I don't have a recollection of Carter mentioning Chappaquiddick, but I think he knew. I don't think Carter ever respected Kennedy. He may have thought of him as a good politician, but I don't think he respected him as a person.

Heininger

Do you think because of the Chappaquiddick issue?

Califano

I think that had a lot to do with it, yes.

Heininger

It just didn't jive with his moral compass.

Califano

Yes.

Heininger

When you saw interaction between Kennedy and Carter, what was your sense about Kennedy's feelings about Carter?

Califano

You know, I think Kennedy thought he could have easily beaten Carter, I really do. I have no idea what happened in his inner circle. I was not part of it, and I don't know, but my hunch is they said, "You're the guy. You can win for the Democratic Party. Carter can't win again." All of that, and playing down Chappaquiddick: "It's over, it's over, it's over." I don't know. I have no idea what Kennedy thought of Carter. The only conversation I remember about Carter was when he told me I ought to quit because Carter was going to have to fire me before he ran for reelection.

Heininger

So why did healthcare break down? Was it never in the cards, or were there specific issues, or was Kennedy willing to compromise?

Califano

There was no compromise. Healthcare became a chip in the Presidential campaign. Whether we could have done something if Kennedy hadn't been running? We did have a Democratic Senate; we did have a Democratic House. The Senate in those days was more liberal than the House; they didn't routinely operate on the 60-vote rule the way they operate now. We certainly could have gotten--if there hadn't been a Presidential competition, we could have gotten a bill out of the Senate.

It probably would have been closer to our bill, much closer than to Kennedy's bill. I don't know if there's ever any way to pass a national health insurance bill. I don't think you can pass it today. Whether we could have gotten it out of the House, I don't know. It was a much more difficult body, much more conservative, and you could almost feel it getting more conservative every week. I don't know if you've interviewed Hale Champion. You should, probably. I don't know how well he is.

Heininger

Where is he now?

Califano

He was my Under Secretary.

Heininger

I know.

Califano

He's up in Cambridge.

Heininger

He's in Cambridge, OK. We've interviewed James Mongan, and we've interviewed Stu Eizenstat, so far. But not Hale Champion.

Califano

He's not well. If you can get him, I'd get him soon. He'd probably be better than anybody else on this subject, and he's probably closer to having a really good sense of what a headcount would have been without the Presidential campaign, which was brewing.

While I made that crack about Kennedy's bill, even when we proposed our bill I had no illusions about what was going to happen. There just was no way he would give an inch, because if you look at it from his point of view, sure, he wants healthcare, but he also wants the labor movement with him when he runs. Labor was very important, even more important in those days than it is today, in terms of both money and troops for somebody running for President.

Heininger

Certainly then it was more important than now. Did you see a change in him after the '80 election?

Califano

I guess, I mean, he certainly wasn't going to run again.

Heininger

You had that sense really clearly after the '80 election?

Califano

Absolutely, yes. It was not in the cards and I think he decided to be comfortable in the Senate.

Heininger

How do you think that's worked out for him?

Califano

Oh, he's gotten some things done that wouldn't have otherwise been done. I can't get specific about them. He's fought, by and large, for what he believes in. He's made compromises to get things done, but he took on [Robert] Bork--and he really took on Bork.

Heininger

Yes he did, didn't he?

Califano

He even got me to write an op ed in the Times.

Heininger

Did he?

Califano

Yes. He called me in New York. The Republicans were saying that they didn't--there were issues about what a guy believes, or a filibustering--I can't remember what it was, but in any case, he called me and asked me to write an op ed, which I did, making an analogy to the--it's in the Times. You can get it, I'm sure. I was making an analogy to the [Abraham] Fortas thing.

Heininger

So he's continued to maintain the relationship with you?

Califano

Yes, but this was whenever the Bork--when was the Bork thing, in the mid-'80s?

Heininger

About '88. Yes, I think about '88 or '89.

Califano

I know I was in New York because I remember getting--it was early in the morning and I was at our apartment. In any case, I wrote it.

Heininger

What did you think of Kennedy's staff? Did you have any dealings with them?

Califano

Yes. I thought the guy that--

Heininger

Larry Horowitz?

Califano

No. I had dealings with Larry Horowitz, the doctor, and he was fine, but there was another guy who went back to Massachusetts. I can't think of his name. He always had a very good staff, very loyal, but very good. I don't know what it's like--I mean I haven't dealt with anybody there in the last few years. I talked to him a couple of times but I haven't dealt with anybody.

Heininger

People say the same about his staff now: aggressive but very competent.

Califano

Yes, but that's him.

Heininger

What did you think of Larry Horowitz? The doctor.

Califano

I thought he was fine. You know, he did what Kennedy wanted him to do. I have such dim recollections of these guys. I talked to him a few times on the phone. Sure, they were all aggressive, but they were doing what Kennedy wanted to do. That's sort of a Kennedy trademark. Bobby Kennedy's staff was aggressive. I was in the Pentagon when John Kennedy was President, and the few dealings I had with Kenny O'Donnell, I mean, they were aggressive. You know, "Hire this guy." "We want this tailor shop in Fort Bragg.?" You know, "We've got to get him in there," or whatever it was.

Heininger

Any last comments about Kennedy and your relationship with the Kennedy family?

Califano

No. Most of it is in those books. I'm actually dealing with Maria Shriver right now, on Family Day. I was out there two years ago. We have something called Family Day that we promote here, because we've learned that the more often kids have dinner with their parents, the less likely they are to smoke, drink, or use drugs. So Family Day, the fourth Monday in September, is just a reminder, like the Great American Smoke Out. We want to remind people that it's important to have dinner with your kids. Two years ago, Maria and I did a big thing in California on Family Day. I actually was talking to her last week, because I'm trying to get her to be national chairman of Family Day next year.

Heininger

Is she willing to do it?

Califano

Oh, I think she will. I mean, I knew her when she was--

Heininger

They do grow up, don't they?

Califano

But they're all aggressive. [laughs] She's no different.

Heininger

And the jaw is the same on all of them.

Califano

Yes. I got a lot of nice notes from Ethel, in the wake of the Bobby Kennedy funeral, because we did a lot of the arrangements, and I dealt with the family. Johnson had me deal with the family. Then I got a lot of nice notes from Eunice when I was at HEW. Whenever I fought for something she was for, if we got it or came close, I'd get this handwritten note.

Heininger

Do you like him?

Califano

Teddy?

Heininger

Yes.

Califano

Yes, I do. I think he's fine.

Heininger

Have you met Vicki [Reggie Kennedy]?

Califano

No. I may have met her but I don't think so. My wife has. She was down at the Kennedy Center Honors or something. But I guess he's happy and she's finally really settled him down.

Heininger

Yes.

Califano

Which is extraordinary.

Heininger

Yes. Well, this has been very helpful.