Senate Majority Leader Bill Frist likes to tell a story from his days as a pioneering heart surgeon back in Tennessee. A lot of times, Frist recalls, you'd have a critical patient lying there waiting for a new heart, and you'd want to cut, but you couldn't start unless you knew that the replacement heart would make it to the operating room. You didn't want a mistake like opening up the transplant cooler and seeing it filled with Coca-Cola. "A lot can happen at the end," Frist says with a laugh.
A politician, like a surgeon, is tested on deadline, when all the preparation and the pressures come together to be manipulated into success by a cool professional. Frist, the politician, will look back on this time as the moment when his operating skills either saved or failed him. At stake are nothing less than the most sweeping energy bill in 11 years and the biggest overhaul of Medicare since the health program for the nation's seniors was enacted in 1965.
When he succeeded Trent Lott as Republican leader in the Senate in December, Frist seemed the ideal replacement. Jetting to Africa often to perform surgeries, he was a contrast to Lott, whose racially insensitive remarks drove him from the leadership. With his Princeton-Harvard pedigree, youthful looks and daily running schedule, he was a perfect fit for the hyperathletic President, who portrays himself as a compassionate conservative.
But in the 11 months since he took over from Lott, Frist has confounded critics and admirers alike--proving himself both more nimble and less adroit than many expected. Despite his discipline--he sleeps only four hours a night--critics accuse him of making amateurish mistakes in managing the Senate calendar. And despite his gentle bedside manner, he is a ruthless, crafty warrior for George W. Bush, not afraid of doing what it takes to outmaneuver the Democrats.
Medicare could turn out to be his--and the President's--grand domestic prize going into the election. The proposal before Congress would reform the program in myriad ways, most notably by giving seniors their first prescription-drug benefit. Democrats, who also know that a Bush victory on prescription drugs would be politically devastating, are scrambling to stop the $400 billion measure. More important, Democrats oppose the bill's embrace of private-style health care, its failure to rein in pharmaceutical companies and its generous subsidies for HMOs. The House narrowly passed the controversial measure early Saturday morning, 220-215, but only after the vote was held open for nearly three hours so both Republican leaders on the floor and Bush on the phone could browbeat G.O.P. conservatives, angry that the bill didn't contain enough market reforms, into switching their votes.