Richard S. Schweiker

A Republican on the health committee

Schweiker won his Senate seat in 1968 as the only Republican to carry Pennsylvania statewide that year, and he went straight onto the Committee on Labor and Public Welfare (later Labor and Human Resources), which handled nearly every federal health, labor, pension and education law. He stayed there for all twelve years, becoming the ranking Republican on its health subcommittee in 1975 and on the full committee in 1979.

It was a committee of strong Democratic chairmen and activist liberals, and Schweiker worked alongside them more than against them, often with Edward Kennedy and New York's Jacob Javits. Of the bills and resolutions he introduced as a senator, health was the largest single subject. His labor record was strong enough that in 1974 he became the first Republican senator the Pennsylvania AFL-CIO had ever endorsed. His work on the Church Committee's intelligence investigation (1975–76) and on the 1977 MKUltra hearings has its own Deep Dives: The Schweiker-Hart Report and MKUltra and the Ethics of Human Experimentation.

"Patron Saint of the Pancreas"

His signature law was the National Diabetes Mellitus Research and Education Act. He introduced a diabetes bill in the first week of the 1973 session, refined it that December, and saw it signed in July 1974 as Public Law 93-354. The act created a National Commission on Diabetes to draw up a long-range national plan; the commission's December 1975 report found that diabetes had become the country's third-leading cause of death and called for a sustained federal research effort.

He followed through. The Arthritis, Diabetes, and Digestive Disease Amendments of 1976, his bill with 28 cosponsors, became Public Law 94-562 and carried the commission's work forward, and in 1979 he introduced legislation to extend the National Diabetes Advisory Board and its research and training programs. The diabetes advocates he worked with called him the "Patron Saint of the Pancreas."

Building the HMO

Schweiker was one of the Senate's steadiest backers of prepaid group health plans, known as health maintenance organizations, as a way to restrain medical costs. His committee files include the 1973 HMO Act, which Kennedy led, and its floor amendments; in 1975 he introduced the follow-on HMO Amendments, which passed in their House version.

In 1978 he and Kennedy pushed a further expansion, seeking $500 million over five years to help new HMOs get started. The New York Times editorial page endorsed the "Schweiker-Kennedy bill," and the Carter administration came around to supporting it. The Senate passed a scaled-back version, $170 million over three years, by 71 to 1, and his bill became law that fall as the Health Maintenance Organization Amendments of 1978 (Public Law 95-559).

Pensions, mines and the workplace

In July 1972 he presided over the last of five Labor subcommittee hearings on private pensions, arguing that workers were losing pension rights when their employers went bankrupt, merged or closed, and predicting that pension insurance and early vesting would pass within a year. They passed two years later in the Employee Retirement Income Security Act of 1974, which Javits and Harrison Williams wrote and Schweiker's committee shaped.

He was among the senators who wrote the Coal Mine Health and Safety Act of 1969, and after two methane explosions killed miners at Kentucky's Scotia mine in 1976, he joined Williams and Javits in faulting the law's enforcement and pressing for stronger protections. He repeatedly introduced bills backing the Opportunities Industrialization Centers, the job-training network the Rev. Leon Sullivan had founded in Philadelphia. Late in his Senate career his approach to workplace safety turned more market-minded: his 1979 Occupational Safety and Health Improvements Act, cosponsored by Williams and Orrin Hatch, would have exempted workplaces with good safety records from routine inspections so the agency could concentrate on the most dangerous ones. OSHA and the AFL-CIO opposed it.

Consumer and public-health causes

Much of his work was smaller-scale consumer protection, often years ahead of the law. In 1971 he introduced a bill requiring food labels to list vitamin, fat, calorie and protein content, two decades before nutrition labeling became mandatory. He joined Kennedy in 1972 on legislation against lead-paint poisoning in children, pressed regulators to move faster on flammable children's sleepwear, and introduced bills to confine smoking to designated sections of airlines, trains and buses. In 1972 he proposed taking radiation-safety regulation away from the Atomic Energy Commission because of its conflicting roles as promoter and regulator of nuclear power; Congress split those roles two years later.

On medical ethics, he joined Kennedy and Javits in 1975 to propose making the national commission on human research subjects a permanent body. In 1977 he was among the health subcommittee members who gave a skeptical hearing to the campaign to legalize laetrile as a cancer treatment. In 1980 he worked with Kennedy on the Mental Health Systems Act, which President Carter signed that October; the budget act he carried out as Secretary repealed most of it a year later (see Two Years at HHS).

War, the draft and the Nixon years

In the Senate he turned against the war in Vietnam, which as a congressman he had voted to fund, and his first Senate years were spent largely at odds with the Nixon White House. He voted against the Supreme Court nominations of Clement Haynsworth and G. Harrold Carswell, joined William Proxmire in 1970 to try to restrict federal aid to Lockheed, and in 1971 offered, with Iowa's Harold Hughes, an amendment to extend the draft by one year instead of two, as a step toward the all-volunteer force he and four House colleagues had argued for in their 1967 book How to End the Draft. It failed, 49 to 43. By 1974 Pennsylvania papers were reporting that he was on the White House "enemies list," and that year he called on Nixon to resign. He never stopped opposing conscription: in 1979 he wrote to the Times against reviving peacetime draft registration, warning it would invite "military adventurism."

Conscience

A member of the small Schwenkfelder Church, whose forebears had come to Pennsylvania for religious liberty, he returned again and again to questions of conscience: a sixteen-year effort, begun in his first year in the House, to let the Old Order Amish opt out of Social Security; school-prayer amendments; and in 1979 a protection for medical students on both sides of the abortion question that Congress enacted that year. That record, and the church behind it, is told in Faith and Conscience.

The turn

Some of his positions had always been conservative. He generally opposed gun control and abortion, and in 1973 he proposed constitutional amendments to allow voluntary prayer in public schools and public buildings. On most other questions the scorecards of the mid-1970s placed him near the liberal end of his party: in 1975 Americans for Democratic Action rated him 89 out of 100, and the American Conservative Union 9. Nor was he a Reagan man before that summer. In February 1976 he warned that nominating Reagan would bring "many of the same problems of 1964" and "narrow our base and restrict our Party membership," and in May he welcomed the Pennsylvania delegation's 88-to-9 resolution backing President Ford. When Reagan chose him that July, the ACU called him "totally unacceptable."

After joining Reagan's ticket (told in The Schweiker Stratagem), the rest of his voting record moved toward his conservative positions. His ADA rating fell to 15 in 1977, and some of the change showed on civil rights. In the House he had voted for the fair-housing law of 1968 and sponsored the Equal Rights Amendment in 1965 and 1967. In the Senate he voted in October 1978 against extending the ERA's deadline for ratification, voted from 1977 on for limits on court-ordered busing, and in December 1980 voted against ending debate on the Fair Housing Amendments, a filibuster that killed them. The roll calls are on the Votes page. A former adviser told the Times in December 1980 that the change was more gradual than it looked: "He has a way of sensing which way political trends are moving and getting out in front earlier than some others."

The clearest expression of where he ended up was his 1979 Comprehensive Health Care Reform Act. Instead of the government-run coverage he had cosponsored with Kennedy in 1975, it proposed that employers offer workers a choice of at least three health plans and give tax-free rebates to those who chose the less expensive ones, using competition to hold down costs while covering catastrophic and preventive care. It was an early version of the consumer-choice approach that would recur in health reform debates for decades, and it was the outlook he took to the Department of Health and Human Services two years later, as told in Two Years at HHS.

A search built for an election Reagan wasn't sure he'd reach

Ronald Reagan disliked the tradition of naming a running mate in a midnight scramble after the nomination was decided. Heading into the summer of 1976, neither he nor President Gerald Ford had the delegates locked up, so shortly after the last primaries he asked campaign manager John Sears and campaign chairman Paul Laxalt to bring him a recommendation in advance. His instructions were narrow. He wanted someone who could unite the party and someone he could trust. Given his long-standing opposition to ideologically split tickets, he also did not want someone chosen simply to bring in votes he couldn't win himself.

Sears, a tactician more interested in winning than in ideological purity, first floated the name of a man who had nothing to do with Reagan's delegate math, William Ruckelshaus, the former deputy attorney general who had resigned in the Saturday Night Massacre rather than fire Watergate prosecutor Archibald Cox. That conversation went nowhere. Working down a short list of Republican senators and governors young and prominent enough to be plausible, Sears and Laxalt kept landing on the same name: Richard Schweiker. He carried a perfect rating from the AFL-CIO's political arm, real appeal with Catholic and Jewish voters where Jimmy Carter was already showing weakness, and, as a Northeasterner, the potential to free Reagan to spend the fall campaigning in the South instead of defending it.

Others in Reagan's camp read the move more bluntly: Schweiker, they believed, could crack open Pennsylvania's uncommitted delegation, with a possible spillover into New Jersey. That was why the pick had to be announced before the convention. It was also why Sears, selling the idea to Reagan's inner circle, spent more time arguing for naming a running mate early than for Schweiker himself.

The offer

Sears and Laxalt had settled on Schweiker by Friday, July 16, but Laxalt could not reach him until the following Monday, July 19, when Schweiker, vacationing with his family at Ocean City, New Jersey, returned the call from a pay phone. Their rented cottage had no phone, so a neighbor had carried the message down to the boardwalk. They met the next morning in Laxalt's Capitol Hill office. Schweiker suspected it had something to do with the vice presidency, but he wasn't prepared to be offered the spot outright. "We did it rather crisply with him," Sears recalled, "and we didn't allow him a lot of time to think it over."

What struck Schweiker most was what wasn't asked of him: no one requested that he deliver Pennsylvania's delegates in return. "They made clear they weren't expecting me to deliver delegates," he said later, adding that the absence of any such condition was part of what persuaded him. A month before the convention, after a bruising twelve-month primary fight, he wasn't in a position to guarantee anyone's vote. He spent that night talking it over with his wife, Claire, who favored it, and called Laxalt back the next morning. Reagan himself had not yet been told. Sears flew to Los Angeles on the night of Thursday, July 22, and gave Reagan and Nancy Reagan the name the next morning, by which time Schweiker had already agreed. Schweiker followed under the name of his press secretary, Troy Gustavson, to meet the Reagans directly.

Six and a half hours in Pacific Palisades

Briefing Reagan beforehand, Sears worked methodically through the list of eligible governors and senators, saving Schweiker's name for last. Reagan's first question was "Do you think he'd do it?" Told that Schweiker was already flying out to meet him, Reagan seemed pleased.

The two men and their wives talked for six and a half hours on July 24. Schweiker, before going in, had mispronounced his host's name ("Ree-gan" rather than "Ray-gan"). Reagan's first real question was whether Schweiker would defend the administration's positions once in office; Schweiker answered with an analogy from growing up in his family's business: "As long as I'm on the plane on the take-off, I'll be the first one out defending it after the crash." As the conversation warmed, Reagan told him, "I have a strong feeling that I'm looking at myself some years ago," a reference to his own move away from an earlier, more liberal politics. Schweiker smiled: "Well, I'm no knee-jerk liberal." "And I'm no knee-jerk extremist," Reagan replied. About three hours in, Reagan made it formal: "I've made a decision, Senator, and I'd like you to be my running mate." The rest of the meeting was spent planning how to spring the news as a surprise. Schweiker kept the secret from his own five children until the night before the announcement.

Announcement day, and the Drew Lewis problem

On July 26, Reagan and Schweiker announced the pairing in simultaneous press conferences, Reagan in Los Angeles and Schweiker in the Senate Caucus Room in Washington. Ford heard the news first from aides Jack Marsh and Dick Cheney, who brought it to him grinning, treating it as good news for their own campaign. Ford's own reaction was disbelief: "Oh, come on," he recalled saying. "You guys are pulling my leg." Schweiker had told him months earlier that he supported him, with no hint of a change of heart, and Ford himself found the pairing strategically baffling. He and Reagan, he later wrote, were "poles apart on issue after issue," from the Humphrey-Hawkins full-employment bill to a push to delay the B-1 bomber.

The announcement went badly for Schweiker almost immediately: asked his position on the Panama Canal, he had none, and wandered through an answer on détente instead. Conservative reaction was swift and unsparing. The American Conservative Union, which had scored his 1975 record at 9 out of 100, called him "totally unacceptable." Conservative Caucus director Howard Phillips accused Reagan of having "betrayed the trust of those who look to him for leadership." Ohio Rep. John Ashbrook, a conservative who had made his own run at the nomination in 1972, called it "the dumbest thing I ever heard of," and Illinois Rep. Henry Hyde compared it to "a farmer selling his last cow to buy a milking machine." Not every conservative group agreed: the National Conservative Political Action Committee praised the choice. From the Ford campaign, Stu Spencer needled: "They stepped on old Oscar. Schweiker is one of the libs of all time."

The real test was Pennsylvania, and it turned on one man: Drew Lewis, a close friend of Schweiker's and his former campaign manager, who in 1976 was chairman of Ford's Pennsylvania campaign. It was, by coincidence, an especially awkward tangle: Schweiker's resignation as a delegate-at-large to join the ticket would hand his own seat to its first alternate, who was Lewis himself. Schweiker phoned Lewis within hours of the announcement hoping to bring him over, and the two spoke four times over four hours in the days that followed. Lewis wouldn't move. He called Ford directly to pledge his loyalty ("Pennsylvania will deliver you ninety delegates," he promised; Ford ultimately got ninety-three) and later told Schweiker plainly: "the issue was not Dick Schweiker, it was Reagan and Ford. I felt Reagan could not win, and I told Dick I felt he was being used." Six previously uncommitted Pennsylvania delegates declared for Ford within hours of the announcement.

The fight for Clarke Reed

With Pennsylvania closed off, the battle shifted south, to Mississippi's mercurial, uncommitted delegation chairman, Clarke Reed. White House aides Dick Cheney and Harry Dent spent three days working him, while Reagan's Dave Keene fought to hold Reed in place. Ford himself placed the closing call, after Reed asked for forty-eight hours to decide; Ford recalled telling him bluntly that the train was pulling out of the station, and if he wanted to go anywhere at all he had better climb aboard. On July 28 Reed, reluctantly, endorsed Ford, and said publicly that the Schweiker pick had cost Reagan his support, though his delegation stayed in play until the convention. Reagan and Schweiker made a joint trip through the South in early August, including a stop in Jackson, Mississippi, to argue in person that Schweiker "was not all that liberal." By Schweiker's own account, "the shock had worn off" by then, but informal delegate polling still favored Ford.

Forcing Ford's hand: Rule 16-C

Having tested the tactic of naming a running mate early, Sears tried to force Ford into the same position. He proposed a rule, designated 16-C, that would have required every presidential candidate, Ford included, to name a running mate before the balloting began. The Republican National Committee's rules committee voted it down. He then took it to the convention's separate rules committee, where it lost again, 59 to 44. That was close enough to revive on the convention floor, which kept the Ford campaign uneasy until the evening of Aug. 17, when the full convention rejected 16-C, 1,180 to 1,069. Mississippi, voting as a unit, cast all its votes against it, and Sears called that decision crucial. Ford's own supporters had a name for it: the "misery loves company" amendment. The maneuver was Sears at his most transparently strategic: having lived through what an early disclosure could do, he wanted Ford to have to make and defend his own version of the Schweiker choice publicly. It failed, and consumed one of the last real opportunities the Reagan campaign had to shake the outcome loose.

The push to dump him

Talk of dropping Schweiker began early in August, when Sen. James McClure, a Reagan backer, said that some delegates, party activists and a few senators had discussed removing him from the ticket, and that he had talked it over with Jesse Helms; Reagan's aide Michael Deaver said Reagan would resist any such effort. As the convention opened, Schweiker, hearing that the effort was still alive, offered to step aside. Reagan refused outright ("Dick, we came to Kansas City together and we're going to leave together") and, according to Witcover's account of the same episode, praised Schweiker for having taken the chance with him in the first place. Early that same Wednesday morning, a separate group of Reagan's own supporters made the identical pitch directly to Reagan, who cut them off before they could finish: "If you could guarantee me the nomination, I still wouldn't do it."

What it cost, and what it built

Ford was nominated on the first ballot, 1,187 votes to 1,070, with 1,130 needed; about 60 delegates switching would have reversed the result. That is close enough that the Schweiker gambit is still argued over, though the press at the time judged that it had cost Reagan ground, and the decisive test had come the night before, on 16-C. Not everyone had been convinced by the pairing's logic, and columnist George Will's line stuck: "If the Reagan-Schweiker ticket is a political coalition, then sauerkraut ice cream is a culinary coalition."

The general election that fall added an odd coda. Having lost, Schweiker worked hard for the ticket that had beaten him; Ford later recalled telling Reagan how hard Schweiker was campaigning for him in Pennsylvania. Reagan, by contrast, campaigned for the ticket that fall with little enthusiasm, so the most energetic Pennsylvania campaigning came from the man Reagan had tried to make his running mate.

What the maneuver didn't win in 1976, it built for later. The week of secrecy, the six-and-a-half-hour meeting, and the month spent defending each other through a Mississippi delegate fight forged a lasting alliance. Four years later, with Reagan finally elected, Schweiker let it be known through Laxalt that he wanted the Health and Human Services post; Reagan, who by his own aides' account ordered the appointment on the spot, was rewarding a running mate whose loyalty, as Cannon later put it, had held since 1976. What Schweiker did with the job is told in Two Years at HHS.

A department built to outgrow its secretary

Confirmed as the 14th U.S. Secretary of Health and Human Services on January 22, 1981, Schweiker took charge of a department whose budget, he liked to note, was the third-largest of any government entity in the world, behind only the U.S. and Soviet governments themselves. Pennsylvania's other senator, John Heinz, called him uniquely suited to it: "Personally, I can think of no other individual who is more qualified." At his confirmation hearing, Schweiker made Social Security's solvency his top stated priority, pledging to "maintain the integrity of the Social Security system."

Three ways to close a shortfall

The system faced a genuine, near-term financing gap, and Schweiker laid out the standard menu for closing it: raise taxes, slow the growth of benefits, or raise the retirement age. He preferred to avoid both of the politically painful last two. Instead he wanted to broaden the system's tax base, folding in government and nonprofit employees who ran their own separate retirement plans and so had never paid into Social Security at all. That approach would have spread the fix across a wider pool of future taxpayers without cutting anyone's current benefit.

OMB Director David Stockman had a harsher alternative in mind, and he won the internal argument, persuading White House adviser Martin Anderson first and then winning Schweiker's acceptance. The resulting plan relied on benefit cuts.

The May 1981 proposal

Presented in May 1981, the plan would have trimmed the system's future replacement ratio (the share of a worker's prior earnings replaced by their benefit) from 41 to 38 percent, with projected savings of roughly $24 billion a year by 1986. Its most severe provision cut the benefit for anyone retiring at 62 from 80 to 55 percent of the normal amount, applied immediately instead of phased in for people who hadn't yet had time to adjust their retirement plans. That provision was Stockman's, pressed for the near-term budget savings it promised, and it became the plan's most politically damaging feature. Robert Myers, the Social Security Administration's longtime chief actuary, later resigned in protest, blaming the budget office for it.

"Dick Schweiker's plan"

Hours after Reagan approved the proposal, White House Chief of Staff James Baker made two decisions that would define how it was remembered: it would be announced from HHS rather than the White House, and it would be known publicly as "Dick Schweiker's plan." Schweiker and Stockman both objected to the maneuver, which put distance between the President and an unpopular cut, but were overruled, and Schweiker announced it as directed the next day.

The rebranding didn't survive contact with the coverage. The next day's Washington Post headline read "Reagan Proposes 10% Cut in Social Security Costs," naming the President regardless of whose office had made the announcement. The political fallout arrived immediately and squarely on the administration: House Speaker Tip O'Neill called the plan "despicable," and Democrats, who hadn't expected an opening on Social Security, sensed a lasting advantage.

Congress kills it, and the fix comes from elsewhere

Congress turned on the plan almost at once, driven above all by the immediate cut to 62-year-old retirees: on May 20, eight days after it was announced, the Senate voted 96 to 0 for a resolution opposing any precipitous and unfair reduction in early-retirement benefits, and the next day Reagan wrote to congressional leaders that his administration was "not wedded to any single solution." Instead of sending Congress a second plan, Reagan turned the matter over to a bipartisan panel, the National Commission on Social Security Reform. That commission, chaired by Alan Greenspan, delivered its own framework in January 1983, and it became the basis for the Social Security Amendments Congress actually passed that spring. By then Schweiker was weeks from leaving the department.

The verdict

Looking back on the episode years later, Reagan economic adviser William Niskanen called the May 1981 package "the major domestic policy mistake of the Reagan administration — an extraordinary political misjudgment by Stockman and Schweiker." The criticism applies most to the cut Stockman championed and to the White House's decision to put Schweiker's name on it. It applies least to the approach Schweiker first proposed, broadening the tax base. The rest of his two years at the department, including the work that outlasted this plan, is told in Two Years at HHS.

A small church

Schweiker was a lifelong member of the Central Schwenkfelder Church in Worcester, Pennsylvania, and served on the board of the Schwenkfelder Library. The Schwenkfelder Church is one of the smallest Protestant bodies in America, a few thousand members in a handful of congregations, all in southeastern Pennsylvania. It traces its faith to Caspar Schwenckfeld, a sixteenth-century Silesian nobleman and reformer whose emphasis on inward faith and liberty of conscience set him apart from both Rome and Wittenberg, a strand of what historians call the Radical Reformation.

Pressed for two centuries by the established churches of their homeland, Catholic and Lutheran alike, to conform, Schwenkfelder families sailed for William Penn's colony in the 1730s, where religious liberty was the law. The Schweikers were among the families who settled the Montgomery County countryside. Over the generations the small church came to look much like the Lutheran and Reformed congregations around it, and the family found no contradiction in worshiping at a Lutheran church in the Washington area during his years in office. By the family's account, the Schweikers helped pay for the Central Schwenkfelder Church's present building, completed in 1951, and he is buried in its Garden of Memories.

The Amish and Social Security

In 1961, the year the federal government seized and sold an Amish farmer's horses to collect his unpaid Social Security tax, Schweiker, a freshman congressman, introduced the first of his bills to let members of churches whose doctrines forbid insurance and public pensions opt out of the system. Applicants would have had to show that their faith provided for its own elderly members. The Old Order Amish believed that insurance would "show mistrust in the providence and care of God."

The Social Security Amendments of 1965, the law that created Medicare, exempted self-employed members of such faiths in terms close to his bill's. Amish employees were left out, and he kept at it in the Senate: the Senate passed his amendment in 1970 and 1972, and both times it was dropped in conference with the House; he introduced it again in 1971, 1973, 1976 and 1977. The exemption he sought became law in 1988, after he had left public office.

Prayer in the schools

In 1970 he joined Hugh Scott on a constitutional amendment permitting "voluntary prayer or meditation" in public schools and buildings. In 1973 he introduced three of his own: in January, for "voluntary nondenominational prayer"; in March, for prayer in public buildings; and in October, for "silent prayer or meditation," a move toward the moment-of-silence approach that courts would weigh a decade later. In April 1979 he voted for Jesse Helms's amendments to take voluntary-prayer cases out of the federal courts' jurisdiction; Joe Biden, his colleague on other causes, voted against them (see Connections).

Conscience in medicine

In March 1973 he voted, with all but one senator, for Frank Church's amendment protecting doctors and hospitals that refused to take part in abortions or sterilizations on religious or moral grounds. Six years later he extended the principle to students. His S. 664 barred federally funded medical, nursing and other health schools from turning away applicants because of their "reluctance, or willingness," to take part in those procedures against their beliefs.

"I am personally opposed to abortion on demand," he said in introducing it, but "discrimination occurs on both sides of the abortion issue. No one should be forced to compromise his beliefs in order to seek his chosen profession," adding that he was "really speaking to a first amendment issue." Its language became law almost word for word that September, as section 208 of the Nurse Training Amendments of 1979, and remains in the U.S. Code. He also cosponsored a constitutional amendment for the protection of unborn children in 1979.

In his own words

He rarely spoke publicly about his faith, but it showed in what he chose to say. Urging President Nixon to resign in May 1974, he wrote that the Watergate transcripts revealed "a total disregard for the moral and ethical values upon which this nation was built." His wife, Claire, raised like him in what she called a "strictly Pennsylvania Dutch family that stressed values and service," said the two of them saw "our primary purpose in life as serving God." Their life together is told in the Biography.

A department asked to shrink

He took over a department of some 144,000 employees and roughly $250 billion a year in January 1981, facing a new administration whose budget office meant to cut it. Much of his two years was spent pushing back: he reportedly won most of his appeals against Office of Management and Budget cuts, protecting the National Institutes of Health and the research of the Alcohol, Drug Abuse, and Mental Health Administration, and as late as November 1982 he was still protesting a new round of proposed cuts directly to OMB Director David Stockman.

The best-remembered episode of his tenure, the May 1981 Social Security proposal announced as "Dick Schweiker's plan," went the other way: the Senate repudiated it, 96 to 0, eight days after it was announced, and the fix came from a bipartisan commission instead. That story is told in "Dick Schweiker's Plan". The rest of the record is less familiar.

The budget, and the cuts he carried out

He came to the department at a hard moment for the federal budget. Inflation had run in double digits in 1980; the deficit was $74 billion that year and $79 billion in 1981, and it reached $128 billion in 1982. The gross federal debt passed $1 trillion during his first year in office, and the government's net interest payments rose from $53 billion in 1980 to $85 billion in 1982. HHS was the largest piece of the problem. Its 1983 budget, he told the Senate Finance Committee, would be $274 billion, "36 percent" of all federal spending, "more than the budget of any nation on Earth except the United States and the Soviet Union, and $56 billion more than the defense budget." Medicare spending was growing more than 20 percent a year, and health costs had risen 12.6 percent a year since 1965 against general inflation of 7.7 percent. Without changes, he warned, Medicare's hospital trust fund would be paying out 175 percent more in 1987 than in 1980. His family remembers him saying often that he worried his generation was leaving the next one more problems than it had inherited.

He made the administration's case for restraint, and carried out its cuts. The 1981 budget act, the Omnibus Budget Reconciliation Act, reduced federal Medicaid payments to the states by 3 percent in 1982, 4 percent in 1983 and 4.5 percent in 1984, and he signed the rule that put the reductions into effect. It tightened eligibility for Aid to Families with Dependent Children, the main federal welfare program; the General Accounting Office later estimated that the changes left about 493,000 fewer families on the rolls in an average month, out of some 3.6 million, and that they fell hardest on families with a working parent. The act also folded dozens of separate health and social-service grants into block grants for the states, with less money than the programs they replaced, and repealed most of the Mental Health Systems Act, the community mental-health law he had cosponsored in the Senate the year before.

He defended the next round too. "The important thing overall is that we bring reckless Federal spending under control," he told the Senate Finance Committee in March 1982, proposing modest cost-sharing for Medicaid patients and reduced federal matching for some services. That spring his department proposed to "simplify and streamline" the federal inspection and certification of nursing homes. The Times called the plan "Schweiker's Gift to Nursing Home Operators," and in August the Senate's Special Committee on Aging attacked it. The rules he signed are listed on the HHS Regulations page, and the lawsuits brought against the department over its policies on the HHS Litigation page.

Paying hospitals by diagnosis

Until 1983, Medicare paid hospitals essentially whatever they reported it cost to treat a patient. The 1982 tax act (the Tax Equity and Fiscal Responsibility Act) tightened that system with per-case cost limits, rules he approved that September, and directed him to send Congress a plan for setting hospital payments in advance instead.

His report, released Dec. 28, 1982, proposed exactly that: Medicare would pay a fixed amount set ahead of time for each type of case, varying by the patient's diagnosis and adjusted for local labor costs, with 467 diagnosis-related groups. A hospital that treated a patient for less would keep the difference; one that spent more would absorb it. "The current system actually rewards excessive costs and inefficiency because it pays virtually whatever the hospital asks," he said, pointing to Medicare records showing payments for a heart attack ranging from $1,500 at one hospital to $9,000 at another.

He left office five weeks later, but Congress enacted prospective payment that spring in the Social Security Amendments of 1983. Historian Rick Mayes calls it "the single most influential postwar innovation in medical financing," the most significant change in health policy since Medicare and Medicaid themselves, and one that "went virtually unnoticed by the general public."

Bringing Katie Beckett home

Katie Beckett, a three-year-old from Cedar Rapids, Iowa, had lived in a hospital for most of her life after viral encephalitis left her needing help to breathe. She could have been cared for at home, but Medicaid would pay for her care only in a hospital, and at home her parents' income would have disqualified her. Her mother, Julie Beckett, pressed the case with their congressman, Tom Tauke, who took it to Vice President George H. W. Bush, and from him it reached the president. At a November 1981 press conference, President Reagan held it up as an example of federal rules defeating common sense.

Two days later, Schweiker announced a waiver letting Medicaid pay for her care at home. Weeks earlier, on Oct. 1, 1981, he had approved the first rules for the home- and community-based services waivers Congress created in that summer's budget act. In 1982 Congress went further, giving every state the option to cover disabled children at home regardless of their parents' income, as long as home care costs no more than an institution. The "Katie Beckett" option has since covered hundreds of thousands of children.

After the Tylenol murders

In the fall of 1982, seven people in the Chicago area died after taking Tylenol capsules laced with cyanide. On Nov. 3 he and FDA Commissioner Arthur Hull Hayes Jr. signed the first federal tamper-resistant packaging requirements, published two days later: virtually every over-the-counter drug, along with mouthwashes, vaginal products, and contact lens solutions, had to come in packaging with a seal or barrier that would show visible evidence of tampering, plus a label telling consumers what to look for.

The requirements began taking effect Feb. 7, 1983. They are the origin of the sealed packaging that has been standard on medicine ever since.

Teenage drinking

In October 1982 he launched a Secretarial Initiative on Teenage Alcohol Abuse, calling the alcohol-linked deaths of young drivers a challenge to "our national conscience." It added regional conferences for school staff and parents, a push for private industry to fund prevention programs, and a planned national conference on the student-led Students Against Driving Drunk movement. When he resigned, officials assured advocates that his successor would carry the initiative on.

Protecting disabled newborns: Baby Doe

In April 1982 an infant with Down syndrome, born in Bloomington, Indiana, died at six days old after his parents declined surgery to repair a blocked esophagus and the Indiana courts declined to intervene. On April 30 President Reagan directed Schweiker to make clear that federal disability law applied to such cases. On May 18 the department's Office for Civil Rights notified the nation's hospitals that, under Section 504 of the Rehabilitation Act, a hospital receiving federal funds could not withhold treatment or nourishment from an infant because of a handicap.

The department followed with a stronger rule in March 1983, weeks after he left, requiring hospitals to post notices and creating a federal hotline. A federal court struck that rule down the next month on procedural grounds; the department issued revised rules in January 1984, and in Bowen v. American Hospital Association (1986) the Supreme Court set those aside, with a four-justice plurality concluding that Section 504 did not authorize them. Congress took up the cause itself, writing protections for disabled newborns into the Child Abuse Amendments of 1984.

The disability reviews

The hardest part of his record at HHS is the disability reviews. Congress ordered them in the Social Security Disability Amendments of 1980, which Schweiker voted for as a senator: most people receiving disability benefits were to be re-examined at least once every three years, starting in January 1982. The new administration, looking for savings in its first budget, had his department start the reviews early, in March 1981.

The reviews answered a real problem. Before 1981 the Social Security Administration rarely re-examined anyone, and most people stayed on the disability rolls until they retired or died. In March 1981 the General Accounting Office reported that "as many as 584,000 beneficiaries who do not currently meet the SSA eligibility criteria may be receiving disability benefits," about one in five; the agency's own later estimates ran as high as 30 percent. Starting the reviews early was the administration's response.

As first run, the reviews were conducted almost entirely on paper, and benefits stopped as soon as a state agency found someone no longer disabled, even while an appeal was pending. Many of those decisions did not hold up, though how many were mistakes was itself disputed: the department held that state examiners were applying the law's standard of disability, and that administrative law judges, who reversed most of the terminations appealed to them, were applying a looser one. A 1982 House bill would have bound the judges to the agency's standards, but the full House never took it up. The Supreme Court later cited the Social Security Administration's own estimate that about 200,000 people were wrongly cut off and then reinstated between March 1981 and April 1984, and wrote that there was "little doubt" the reviews "led to many hardships and injuries that could never be adequately compensated"; some people lost Medicare coverage along with their benefits. Federal courts ruled against the way the reviews were run, and Congress changed the law in 1983 and again in 1984.

The first fix came on his watch. In September 1982 the administration announced that, from Oct. 1, people under review would get a face-to-face interview with a Social Security representative before any decision, replacing a process conducted almost entirely by mail. Sen. Bob Dole, who had been working with the department on the problem for weeks, said Schweiker and Social Security Commissioner John Svahn "should be commended for this important and timely step forward." In January 1983, in his last weeks as Secretary, a new law let people continue to receive benefits while they appealed a termination.

The reviews also produced the one lawsuit in which he was sued personally. People whose benefits had been terminated in 1981 and 1982 and later restored sought damages from him and other officials who ran the program; in Schweiker v. Chilicky (1988) the Supreme Court held that no damages remedy was available, because Congress had already provided the remedies it judged proper, chiefly restored benefits. We have not found a public statement in which Schweiker himself assessed how many of the terminations were wrong; his April 29, 1982 press statement on disability, in Box 64, Folder 76 of his papers at Penn State, may say. The case, and hundreds of other disability appeals bearing his name, are on the HHS Litigation page.

The regulatory record

At least 380 Federal Register documents carry his signature, collected on the HHS Regulations page. They include the block grant rules that shifted a large number of federal programs to the states, the rules carrying out the 1981 budget act's tightening of AFDC eligibility, his reservation to the Secretary's office of final say over major FDA rules, the revocation of patient package inserts for prescription drugs, a Reye's syndrome warning for aspirin that he proposed and then withdrew in November 1982, and the Title X parental notification rule, which federal courts blocked in February and March 1983, before it could take effect.

The verdict

He resigned in February 1983 to lead the American Council of Life Insurance, the industry's trade association, which he headed for eleven years; within a year he was back before the Senate Finance Committee, testifying on how life-insurance products should be taxed. Sen. Edward Kennedy, his Democratic counterpart on the Senate's health subcommittee, summed up the tenure this way: "As secretary of HHS he has too often been a lonely voice of compassion and humanity. The country may never know how much greater the damage to social programs would have been without Dick Schweiker as secretary."

Not everyone saw his tenure so kindly. The Times editorial page criticized his department's health and welfare policies through 1981 and 1982, under headlines such as "The Reckless War on Health Costs" and "Some Safety Net," and the courts ruled against the department in a long run of disability and benefits cases. Both views are part of the record.

A two-man assignment inside a bigger investigation

The Senate Select Committee to Study Governmental Operations with Respect to Intelligence Activities, known as the Church Committee after its chairman, Idaho's Frank Church, formed in 1975 to investigate a wave of disclosures about domestic surveillance and abuse by the CIA, FBI, and NSA. Schweiker sat on the full committee. Out of it, he and Hart were given a narrower, specific assignment: go back through how the FBI and CIA had handled the original 1963-64 investigation into President Kennedy's assassination, and assess whether either agency had held back information the Warren Commission should have had. The Schweiker archive's own paper trail includes S. Res. 243, "Investigation of President Kennedy's Death," filed the same year the subcommittee took shape.

An audit of the investigators, not a new investigation

The subcommittee was not reopening the assassination itself. Its job was to examine the FBI and CIA's own files and internal communications from November 1963 forward, looking for gaps between what the agencies actually knew and what they had told the Warren Commission. Getting that access at all, from agencies with a well-documented history of resisting congressional oversight, was itself a meaningful outcome of the broader Church Committee's work.

"Seriously flawed"

The report, "The Investigation of the Assassination of President John F. Kennedy: Performance of the Intelligence Agencies," became Book V of the Church Committee's final report (Senate Report 94-755); Frank Church's letter of transmittal credits Schweiker and Hart for this phase. Although the volume carries a printing order of April 23, 1976, the committee did not vote to release it until May 26, over the objections of John Tower and Barry Goldwater, and it was made public in June. Its central finding was carefully hedged: the original investigation had been seriously flawed, but the subcommittee did not allege a conspiracy. Substantiated criticism of the agencies' conduct, without endorsing an alternative theory of the assassination, was the harder position to hold in 1976. It is the one Schweiker and Hart took.

Legacy

The Church Committee's broader findings, including the Schweiker-Hart subcommittee's work, fed directly into the pressure that led Congress to reopen the assassination question with a dedicated House Select Committee on Assassinations in 1976-79. Decades later, the Assassination Records Review Board, created by the 1992 JFK Records Act to force the release of the government's remaining assassination files, drew on the Church Committee's record, the Schweiker-Hart review among it, in assessing just how much the intelligence agencies had originally withheld. It's also why Schweiker still appears today in documentary treatments of the case, identified in archive footage as a Church Committee member from Pennsylvania. The committee's other inquiry that drew him in, into the CIA's drug experiments, is told in MKUltra and the Ethics of Human Experimentation; the rest of his Senate career is in The Senate Years.

Extending protections to the Pentagon and the CIA

In September and November 1975, Kennedy's Health Subcommittee and his Judiciary Subcommittee on Administrative Practice and Procedure held joint hearings on experimentation by the Defense Department and the CIA, the two kinds of government research that had operated furthest outside the normal rules, and on November 7 took up S. 2515, a bill to extend federal human-subject protections to them. Schweiker attended all three sessions and was the second-most active questioner after Sen. Edward Kennedy, in what the record shows as his most substantive bioethics engagement in the Senate.

He personally questioned the wife of an Edgewood Arsenal LSD test subject and the daughter of Frank Olson, an Army scientist who died in 1953 after being covertly dosed with LSD as part of a CIA drug test. He pressed a former CIA physician on the agency's Hunt/Liddy-era request to identify a drug "target," and traced the Defense Department's stated opposition to the bill back to the Office of Management and Budget. On addicts who had been recruited into drug testing for payment, he put the coercion plainly: "They gave you a choice, but you really had no choice. You had the habit, and the Government was hooking."

Turner's testimony

On August 3, 1977, Schweiker helped lead a joint hearing of the Senate Select Committee on Intelligence and the Subcommittee on Health and Scientific Research, alongside Kennedy, taking testimony from CIA Director Stansfield Turner on recently surfaced documents about Project MKUltra, the agency's Cold War research program into behavior modification and interrogation. Most of the program's own records had been destroyed on orders from a former CIA director in 1973; what the committee had to work with in 1977 was a set of financial files that had been misfiled and so survived by accident.

Schweiker's own statement at the hearing expressed distrust of the CIA's pattern of disclosure over the years, even while crediting Turner personally for candor, and drew a pointed parallel to the intelligence community's separate practice of using journalists as intelligence assets.

One continuous thread

The 1975 and 1977 hearings were not two separate episodes so much as one investigation that ran for two years: the 1975 hearing had already surfaced the Edgewood Arsenal and Frank Olson cases that would later become emblematic of MKUltra itself, and the 1977 hearing picked the thread back up once the surviving financial records gave the committee something concrete to put to Turner directly. Taken together, they represent Schweiker's deepest engagement with the intersection of two subjects that don't usually overlap in one senator's career: medical ethics and intelligence oversight. His other major intelligence assignment, the review of what the CIA and FBI told the Warren Commission, is told in The Schweiker-Hart Report; the rest of his Senate career is in The Senate Years.