Book Review The heart of power: Health and politics in the oval office

The opening paragraph of The Heart of Power by David Blumenthal and James Morone describes a conversation that Blumenthal, then an undergraduate at Harvard College, had with Richard Neustadt, the noted presidential historian and one time member of John F. Kennedy’s White House staff. Blumenthal credits Neustadt, his course on the American presidency, and their subsequent long friendship with the inspiration for his and Morone’s new book. I’m certain that professor Neustadt would be proud of the product he inspired. In this readable, well-documented, and comprehensive study, the authors lucidly explore how presidential personalities, priorities, political philosophy, and personal health experience have influenced their approaches to health policy. They analyze legislative and policy successes and failures in 11 US presidential administrations, ranging from Franklin D. Roosevelt to George W. Bush. (They omit only the brief presidency of Gerald Ford.) From FDR’s New Deal to George W. Bush’s Ownership Society, Blumenthal and Morone explain how each president, cognizant of the unique history, political opportunities, and risks they faced, learned (or didn’t) from their predecessors and built on what had gone before. Their source material includes presidential library archives plus interviews with former presidential staff, and staff of the libraries. Despite my lifelong involvement in and study of American healthcare policy, I learned a great deal from this book. I was not fully appreciative, for example, of the depth and passion of Truman’s commitment to a social insurance model of national health insurance, nor was I aware of the level of detailed involvement by Lyndon Johnson in the birth of Medicare, the federal insurance