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Interview with Dr. William Kissick Date: March 19, 1993 Location: University of Pennsylvania Philadelphia, PA Interviewer: Stephen P. Strickland Strickland: Did You come to the University of Pennsylvania from some where else? Kissick: No, I did all of my education work here, my undergraduate and medical, internship, then a masters of public administration then a doctorate in Criminology then as a residency in public health. I was appointed as health officer in training at the New York City Health Department and worked with George Silver. He is an extraordinary and exhilarating leader. Strickland: I talked to George Silver two or three months ago about the RMP program generally, more specifically about the situation in Connecticut. it was a very unusual situation. You are certainly right that everyone was distinctive, but there was a pattern to some of them. I want to talk a little bit about the history, but I also want to get your judgement about which elements of RMP might in fact have relevance for the reform of the health care system now. Kissick: You want it historically or just RMPs role? Strickland: Let's have it historically. Kissick: The key player in the early days of RMP was -- like the voice, or its father -- was Wilbur Cohen. Wilbur Cohen was a key player in everything of the Great Society. There were two parallel activities in '64. The President's Commission on Heart Disease, Cancer and Stroke, was appointed, as I recall in March of 1964, and then in April, Johnson created a dozen task Forces to craft his agenda for the Great Society. There were people who were small on the commission, but they also had a lot of real heavy- weights, some like John Gardner who chaired the education task force... Strickland: This was 1964? Who was the Assistant Secretary? Kissick: Beaufeuillet Jones. Strickland: He never actually held the title. Kissick: No, he had the title of Special assistant to the Secretary for Health and Medical Affairs. Beaufeuillet was the De Facto Assistant Secretary and his office consisted of three people: Bo, Bill Stewart, and myself. The White House task force on health had eight members and George James chaired it. Strickland: He was the health official of New York? Kissick: Yes, he, Bill Steward and 1. Funny compared with Hillary's cast of 500. So there were eight members of the task force and three of us on the staff. And the link between the task force and the Commission was through Bo's office because Bo had been a member of the last two task forces. Strickland: A close friend of Florence Mahoney. Kissick: Yes, on good terms with Mary Lasker, very good terms with Senator Hill and a comfortable associate of Mike DeBakey and all of the Key Lasker people. And Bo stayed as the de facto assistant secretary through the work of the commission, through the elevation and he was there when we presented the report to Johnson. Then he left to take a foundation presidency. Bill Stewart was really the lynch pin. Strickland: At that point, was he also the Surgeon General of the Public Health Service? Kissick: No, he was Surgeon General in October of '65, after the legislation had passed, Bill and Karl Yordie were together in the Heart Institute and they had been trying to implement the Regional Medical Programs and Bill was in the process of being recruited out to the Heart Institute when he was made assistant deputy. At that point I was in Phil Lee's office. Phil was one of the key players because as the new official assistant secretary he designed the commission. And Bill Stewart had elected to write the report of the President's commission and it was his staffer -- including myself -- that drafted and redrafted the report. The president's task force was really the blueprint to Johnson's heal message. Strickland: And the commission and the task force were going on simultaneously. Kissick: Yes. Strickland: And you were one of the links? Kissick: I was staffing both. I was staffing Ed Dempsey on the Commission and Bill Stewart on the Task force. Strickland: I see. Well then, you were the lynch pin. Kissick: Yes, but a very inconsequential staffer. Do you know Bill? Strickland: I have met him in years past but I haven't seen him in a very long time. I don't even know where he is. I'm sure I could find him. Kissick: I think that everything that has been said about Bill is in a positive light. He really is incredibly perceptive in a very modest way. And a very dedicated public servant. Strickland: Do you happen to know where he is? Kissick: Yes, I'll give you his phone number, he's in New Orleans. Bill was my mentor for seventeen years, but Bill would sit down and go over the commission and task force arrangements and see where things were coming out. I think Bill would have to be a principal if you look at its evolution. He was responsible for drafting. He was int the legislative thick of it when the whole thing was a go. Strickland: This is after they got over AMA's opposition to centers of excellence.... Kissick: No, I think he was in before that. After the health message, he began to work on the legislation and he knew that NIH had a legislative base and began to articulate it. I think a lot of his work by Luther Tariot formed the committee concerned with who should administer it. Conceptually it had a lot to do with the Bureau of State Services as well as the National Institutes of Health. Strickland: Right. Then you had to talk Terry Shannon into it or at least get him to... Kissick: Shannon was ambivalent, he didn't want to do it. Strickland: Yes, exactly. Kissick: He depended a lot on his constituents. Strickland: I haven't talked to Karl. I know him, but I am sort of saving him a little bit. Kissick: That's a good idea. But getting back to the... Strickland: Well, one of the things we were talking about is the confluence of the past work. Kissick: Yes, I am just trying to think of how to articulate that succinctly. There was one knock-down-drag-out fight. That was George James said "if we finance this without restructuring, its going to be a financial disaster." Red Summers... Strickland: Of Princeton... Kissick: Professor of Political Science at Princeton, says "theoretically, all you can get is financing." History has proved both of them wrong. Strickland: You are absolutely right. Editors note: This interview was conducted in the Faculty Club at the University of Pennsylvania, and at this point the tape becomes blurred with background noises.