Career Frist, Constituents Last
by Clay Risen

The scene: The auditorium of Nashville's prestigious Montgomery Bell Academy, November 1994. A young man in khaki pants and a flannel shirt runs out waving an enormous Tennessee state flag; the assembled students cheer. The headmaster then comes to the podium for a few brief remarks, introducing the day's special guest. When he's done, the crowd goes wild as Senator-elect Bill Frist, a 1970 graduate of the school, walks onstage.

The scene was repeated throughout the city that week. Frist, a political novice but also the scion of one of the city's wealthiest families, had just unseated Democrat Jim Sasser, a three-term senator set to assume leadership of his party; painting Sasser as a tax-and-spend Washington insider, Frist trounced him by 14 percentage points. The brilliance of Frist's campaign was to hide his political inexperience by constantly attacking his opponent's record, all the while emphasizing his career as an accomplished surgeon and the city's latest favorite son. It worked — while the students' affection for Frist wasn't surprising, that the entire state felt much the same way was a resounding testament to his ability to hammer home an image that trumped his campaign's lack of substance.

Eight years later, Frist has again vaulted over the heads of more experienced politicians, positioning himself to take over the senate majority leader spot vacated by Trent Lott. And yet despite his newfound prominence, what most people know about Frist is in the form of sound bites: the Senate's only physician, a moderate Republican, a guy who can get things done. It's an image that Frist has worked very, very hard to project. And yet like his 1994 campaign, his Senate career writ large is a study in image over substance — though this time he is downplaying not a lack of experience but rather a conservative, pro-big business record.

In one of the few analyses of Frist thus far, Slate's William Saletan praises the senator for understanding the need to compromise on controversial issues to get through key legislation. Saletan highlights Frist's work to approve restricted stem-cell research and funding to fight AIDS in Africa; on both issues Frist was seen as promoting a middle ground between what he wanted and what knew he could expect, accepting less in the knowledge that he was at least getting people to talk about the issues at hand. Compromise, Saletan writes, is "a big part of the job of a Senate majority leader. Frist is pretty good at it."

But Saletan's glass-half-full take on Frist is naïve — given the rest of the senator's record, there's no reason to believe that his work on AIDS or stem-cell research are anything more than calculated efforts to paint himself as moderate. He took care to emphasize that the AIDS money was specifically aimed at HIV-positive mothers (and not gays or drug users), and his stem-cell proposal limited research to existing lines — thereby averting criticism from the Christian right. And soon thereafter, Frist announced his opposition to research cloning, a move that won him praise from the pro-life movement. In both cases, Frist floated generally palatable proposals to bulk up his centrist Republican image, at the same time making sure that neither bill did anything to anger his core constituencies.

That one of his other core constituencies is big business — the drug and hospital industries in particular — is hardly unusual for a Republican senator, but it may come as a shock to those who have bought into the idea that as a physician, Frist is ipso facto concerned with improving the health and quality of life of everyday Americans. Like most Republican senators — but unlike most public health officials — Frist opposed extending the USDA's meat-inspection authority, and he supported the Bingaman Amendment to the Safe Drinking Water Act, which relieved mining companies of a requirement to make sure their operations didn't contaminate local water supplies. Frist also sponsored legislation that would severely limit the rights of parents to sue drug manufacturers if their children are injured by thimerosal, a mercury-based vaccine ingredient (the legislation, included in Frist's Improved Vaccine Affordability bill, was separate from a similar restriction included in the Homeland Security Act).

In return, the health industries have awarded him nicely — in 2000 he was named the Biotechnology Industry Association's Legislator of the Year. They have rewarded him financially as well — according to TomPaine. com, Frist has received more than $2 million in campaign funds from the health care industry alone. At the same time, Frist repeatedly receives 0 percent scorecards from citizen groups like the League of Conservation Voters and Public Citizen.

Frist's record on tobacco is particularly jarring, given that most people know him as the only senator to resuscitate stroke victims in the Capitol hallways. During his career he has accepted more than $50,000 from the tobacco industry, and as the head of the Republican National Senatorial Committee has accepted another $2.2 million for the party. Public Citizen gives Frist only a 13 percent rating on tobacco-industry legislation, the eighth-worst in the Senate. Writing in the October 1998 issue of Archives of Surgery, retired surgeon Clifford Straehly wrote that because of Frist's coziness with the tobacco lobby, "In my opinion, Dr. Frist has betrayed the ideals of his profession and does not merit the support of our profession in his question for reelection."

Granted, Frist's record shouldn't condemn him — it is, after all, representative of that ubiquitous category of politicians: the rank-and-file, party-line senator. And yet it runs strikingly against his moderate and independently minded image, an image that has less basis in reality the more one examines his voting history. His Senate record is emblematic of his political career — all image, no substance. Having a physician at the helm of the Republican party may strike some as a positive step in the wake of the Lott debacle, but when that physician has a record of repeatedly putting the interests of big business ahead of his constituents, one has to wonder just where the party thinks it is going.

E-mail Clay Risen at risenc@yahoo.com.