Rep. Jim Santini (D-Nev.) still recalls with some bemusement the Saturday midnight his telephone rang at home early last year. The White House was calling.
Santini's pulse quickened. "Ah," he thought in a fleeting fancy, "it must be my appointment to the Cabinet."
It was nothing so simple.
The White House congressional liaison office wanted Santini to know that President Carter had decided not to cut off funds for a major water supply project in Arizona.
Why, Santini asked, was he being called at that hour to be told of such a matter? Arizona, after all, is not Nevada.
It's in the West, came the answer. You must be interested in that.
Santini decided the White House didn't know who he was or where he was from and that did not please him. His displeasure formed in an instant that Saturday night, would become important later when the Carter administration turned to him for help on the president's plan to control the quickly rising cost of hospital care.
Even before the bill was sent to Capitol Hill in April 1977, it was clear that Carter would need all the help he could get. Costs were rising about 15 percent a year. Carter wanted to hold the increase to 9 percent. He was asking Congress to enact a form of wage-price controls on one of the country's most respected and influential industries.
There were key people the administration would need, whose support they would have to seek, to get the bill. They were the 74 Democrats and the 39 Republicans on four committees that would handle the measure.
Some, of course, were more important than others. For instance, without the interest of Sens. Russel B. Long (D-La.) and Herman E. Talmadge (D-Ga), little would move through the Senate Finance Committee. The same was true in the Senate Human Resources Committee, where Sens. Edward M. Kennedy (D-Mass.) and Gaylord Nelson (D-Wis.) had strong ideas about controlling hospital costs.
On the House side, two health subcommittee chairmen, Reps. Paul Rogers (D-Fla.) of Commerce and Dan Rostenkowski (D-Ill.) of Ways and Means, would be crucial. If they felt no compelling reasons to push the bill, its chances would dim.
But the Jim Santinis of the four committees - the other 107 members whose votes would determine what, if anything was done about hospital inflation - were also important.
Hospital administrators and doctors would be telling them why cost controls wouldn't work. The administration would be telling them why they would work and why they were needed. The administration would need a majority of the Santinis on each committee.
What it would come down to, in part would be old-style politics: who could flex the most muscle, who could be presuasive beyond the good sense of the bill itself, whose ego could be stroked the most effectively.
But at one turn after another. It was being said even by congressional Democrats, the administration's political generalship proved wanting. It was an assertion repeated continually during the 95th Congress on all kinds of legislation. The administration, the story went, just didn't understand legislative politics. The Georgians did not know how the game was played.
In the case of the hospital costs bill, it was one of the the few Washington insiders in the Cabinet - Health, Education and Welfare Secretary Joseph A. Califano Jr. - who took the brunt of the criticism for administration missteps.
"Joe took on the hospitals in a personal way," say one HEW health adviser. "I think he assumed the people of the United States felt the same way. But this was an issue that had to be negotiated and compromised. Joe seemed unable to compromise or unwilling to do it himself or to delegate it out. The real compromises as we went along were the work of congressional people."
Califano acknowledged some of the difficulties."We may have been getting to know each other in the beginning . . . We had some disagreements among the philosophical and the political types in the early months, but there is no failure to delegate authority now," he said.
But it proved difficult for the administration to overcome the mistakes made at the beginning.
In the days that followed that curious midnight telephone call in early 1977, Jim Santini became more convinced that the new administration, intentionally or not, was making his life extraordinarily difficult. His feelings were not unlike those of other congressional Democrats, who perceived the Carter White House as more foe than friend.
Santini was not inclined to support the administration bill in the first place. But the White House and HEW made it easier for him to oppose it. He saw the administration making moves that hit tourist-dependent Nevada in the pocketbook and he didn't like it at all: A proposed end to the "three-martini" lunch tax break, a plan to stop passenger train service to Reno, new federal mining and grazzing regulations.
"Every time I turned around something was coming off the wall at me," he said. "There was never any effort to forewarn me. I didn't owe them anything, but I was constantly on the defensive in my own backyard."
He continued, "I have yet to have someone come in here and say, 'How can we help you?' . . . Califano called me and said, 'Jim, I hope you go with us on this.' It was the 11th hour, the last-minute - the hardest way to make their case. If they just knew I existed before the fact, it would make it better when they need my help."
It was not just that Califano came late to ask for help, it was the way he came that rebounded against the administration Rep. Marty Russo (D-Ill.) is still angry.
Just after Russo came to Congress in 1975, he went to an Italian-American foundation dinner, where he met Califano, then a high-priced Washington lawyer. Russo remembers the meeting well. He was impressed; thought it was important.
But by last summer, Califano seemed to have forgotten. "I'd known him for 3 1/2 years," Russo said. "Then when he calls me about the hospital bill, instead of saying, 'Marty, what the hell are you doing?" he's very formal. Didn't know who I was. I was insulted . . ." When the showdown came last summer, Russo deserted the administration and helped kill Carter's plan in the Commerce Committee.
Some of Santini's and Russo's criticisms may be the result of wanting to be courted more than any administration could have. But the way the administration handled Rostenkowski and Talmadge, two of the four health barons in Congress, shows the extend of the mistakes that were made.
Rostenkowski, who chairs the Ways and Means subcommittee on health, is a free-enterprise Democrat who didn't cotton to the idea of mandatory controls.
The administration made it easier for him to remain lukewarm toward the bill by refusing to play the political patronage game with him.
When Rostenkowski asked Califano to make Chicago's deputy mayor, Kenneth Sain, head of HEW's regional office there, the secretary turned him down. Califano picked a less-experienced alderman, Christopher Cohen, son of Wilbur Cohen, HEW secretary for the job. Cohen happened to be the son of Wilbur Cohen, HEW secretary when Califano worked in the Johnson White House.
When Rostenkowski proposed that Califano name William D. Fullerton, a former Ways and Means staff worker, as HEW's legislative director, Califano turned him down. He chose Richard Warden, a former United Auto Workers lobbyist, then a month or so later hired Fullerton for another HEW post.
Rostenkowski denied that those turndowns altered his attitude toward the cost-containment bill. He emerged nonetheless as the chief proponent of a voluntary cost-control scheme that the hospitals subsequently embraced and are now using as a lever against federal intervention.
The administration's dealing with Rostenkowski's Senate counterpart, Talmadge, was more puzzling. Talmadge, chairman of Finance's health subcommittee, was pushing a plan to limit only the most increases connected with Medicare and Medicaid.
The hospital industry supported that approach, but many felt the hospitals would simply shift their cost burdens to private patients and insurers and continue their inflation unchecked. The Talmadge controls, the argument went, would be a mirage.
But Talmadge was not completely unyielding and he let the administration know that he might be willing to compromise. After aides of Fullerton and Talmadge worked out a deal, Califano waited for weeks before answering.
The deal later fell apart, particularly after Califano publicly criticized the senator's approach as a "sham" and as "the Talmadge tax." Georgia newspapers picked up the quote and Talmadge - involved in a nasty divorce and under fire for his financial affairs - decided he didn't need that kind of help from the Carter administration.
If there was a touch of insensitivity in that approach, it was compounded by another bit of political unreality involving Talmadge. During the early maneuvering it became clear that the administration had hoped to pressure Talmadge - the most vigorous of the bill's supporters among the key subcommittee chairmen - by getting its measure past the other three chairmen.
Talmadge would become, in effect, the man holding up the administration program. The resulting public pressure presumably would be so intense that he would buckle.
The administration strategy backfired when the bill stumblle earlier at House Ways and Means and [TEXT OMITTED FROM SOURCE]