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Last Updated June 22, 2005
Bill Frist, first elected to the Senate in 1994, is now the 20th Senate majority leader (the title goes back only to 1925). Frist grew up in Nashville, in a well-known Tennessee family: His father practiced medicine for 55 years and was the physician for seven Tennessee governors. Both his brothers are doctors, too. Frist grew up in Nashville and was class president, football quarterback and yearbook editor at Nashville's Montgomery Bell Academy. He graduated from Princeton and Harvard Medical School, studied at Massachusetts General Hospital, in England and at Stanford, and became a heart and lung transplant surgeon, setting up the transplant program at Vanderbilt. He performed 250 transplants and in 1989 wrote a book, Transplant, on the social and ethical issues of these surgeries; he has written more than 100 peer-reviewed articles. In 1968 his father and brother, Thomas Frist Jr., set up HCA (which through a 1994 merger became Columbia/ HCA), the world's largest hospital company; the Frists lost control of the firm in the late 1980s. After it was hit with charges of Medicare violations in 1997, Thomas Frist Jr. came back from semi-retirement to run it. Bill Frist piloted his first plane at 16, and flew small planes to pick up donated organs; he runs marathons (two within 13 days in 1999). He still practices some medicine, at clinics in Washington, and on five trips to Africa, where he has tended patients in war zones in Sudan and in Uganda. He resuscitated a constituent in the Dirksen Building in September 1995, treated the wounded in the Capitol shooting in July 1998, tended Strom Thurmond when he collapsed on the Senate floor in October 2001, and treated accident victims on Florida's Alligator Alley on New Year's Day 2003. Frist is a man of intensity and focus, and for years that focus was medicine, not politics; he never voted until he was 36, after he moved back to Nashville. He decided to switch careers and run in 1994 as a Republican against Democratic Senator Jim Sasser. Frist seemed unlikely to win: Sasser was chairman of the Budget Committee and running for majority leader, and he had won his previous race in 1988 with 65% of the vote. And Frist had tough primary opposition from east Tennessee businessman Bob Corker, who attacked him for not voting and for obtaining cats from animal shelters for experiments as a medical student (which he mentioned in Transplant). But Frist, spending liberally, beat Corker 44%-32%. In the general, Frist backed welfare reform, federal spending cuts, school prayer and term limits; he followed Howard Baker in calling for citizen-politicians and pledged to serve just two terms. Sasser emphasized school prayer, the balanced budget amendment and cracking down on illegal immigrants; he portrayed Frist as a bored, rich surgeon. Frist outspent Sasser, spending $3.7 million of his own money. Sasser led in polls up through October, but in November Frist won 56%-42%. Frist is the first practicing physician to serve in the Senate since Royal Copeland of New York died in June 1938. Naturally he got involved in health issues--the Senate ethics committee ruled that he is not prohibited from voting on any "legislation of general applicability to the health care industry," and his HCA stock was put into a blind trust. He played a key role on the 1996 health care bill on portability and pre-existing conditions, working to include Medical Savings Accounts. On some health issues, Frist has worked with Democrats. In 2000, Frist and Ted Kennedy steered through a $919 million authorization for public health laws, including $540 million for research on bioterrorism and $180 million to refurbish Centers for Disease Control labs. On HMO regulation and prescription drugs, Frist took the lead in forging Republican positions. In June 2000 he sponsored a Medicare bill with commission chairman John Breaux, which would have private insurers competing to provide coverage to Medicare beneficiaries, overseen by a new government agency that would approve the content of plans, and would include prescription drug coverage with subsidies for all seniors and a progressive sliding scale of subsidies depending on income. The Breaux-Frist proposal went nowhere in 1999 because of opposition from the Clinton administration. But George W. Bush campaigned on the issue in 2000 and in early 2003 made it one of his priorities. Republicans had campaigned on the issue of prescription drugs for seniors in 2002 and House Republicans passed their version of a freestanding benefit. But Frist has argued all along that it makes better sense to make a prescription drug benefit part of a larger Medicare revision, and in 2003 he gained his chance to bring it forward. With support from Kennedy, a bipartisan bill passed the Senate in June 2003. The House passed a bill with significant differences, and Kennedy and some other Democrats attacked the result that came back from the conference committee. But Frist persisted, and in November the bill passed the Senate after, as Frist put it, "six years of empty promises, stalled negotiations and partisan gridlock." Frist has also been a leader on stem-cell research. In July 2001 he set out ten "essential components" of policy, including funding adult stem-cell research, banning human cloning and using excess embryos from in vitro fertilization procedures which otherwise would be discarded. Frist became a member of the Africa Subcommittee in 1997, which led to his medical trips to Africa. After treating AIDS patients, he showed Jesse Helms pictures of them and got him to co-sponsor $500 million for a global AIDS fund. He backed down to the Bush administration and agreed to seek only $200 million, and was much criticized by Democrats, but he got Bush in 2003 to commit to spending $15 billion over several years. In August 2004, on a trip to the Darfur region of Sudan, he said that people in the region were undergoing genocide. After letters with anthrax were sent to Majority Leader Tom Daschle's office, Frist stepped forward and used his expertise to provide information and reassurance. He emphasized anthrax's sensitivity to antibiotics and encouraged anyone who might be exposed to take drugs; mistakenly, as he admitted, he underestimated the danger from anthrax in envelopes. In November 2001 he and Kennedy sponsored a bioterrorism preparedness bill, with $3 billion to expand the nation's supply of vaccines, expand the Centers for Disease Control and Prevention, beef up state public health laboratories and provide training for response to a bioterrorism attack. It became law in June 2002. In March 2002, his book, When Every Moment Counts: What You Need to Know About Bioterrorism from the Senate's Only Doctor, was published in English and Spanish, with royalties going to the Tennessee Public Health Association. In 2002 he wrote a bill restricting lawsuits against pharmaceutical companies that used the mercury-based preservative thimerosal as a preservative; his approach was that parents claiming that thimerosal caused autism in their children should go through the vaccination compensation process established by Congress in the 1980s. This provision was put into the homeland security bill by House Majority Leader Dick Armey in November 2002, and was attacked as a special interest provision to help Eli Lilly, which had contributed to Republicans. Frist continued to argue it was good public policy, but after he was elected majority leader agreed to honor Trent Lott's commitment to several Republican senators to allow the issue to be revisited in 2003, and said he would argue for the bill on its merits. Frist got his start as a national Republican leader when he was chosen to deliver the response to Bill Clinton's State of the Union address in January 2000. He chaired the Platform Committee at the Republican National Conventions in 2000 and 2004. In December 2000, this surgeon who had no experience in politics a few years before was elected chairman of the National Republican Senatorial Committee, with the assignment of regaining a Senate majority in 2002 when 20 Republican and 14 Democratic Senate seats were up. He did it. He excelled in fundraising--the NRSC outspent its Democratic counterpart by $66 million--and in political strategy. He kept in close touch with White House political strategist Karl Rove but also made decisions on his own, as when he ran ads showing Bush in March 2002 in five states where Democratic incumbents seemed vulnerable; Republicans picked up seats in two of the states. In November 2002 Republicans gained two seats, enough for a 51-vote majority. Never since popular election of senators came in had a president's party regained a Senate majority in an off-year election. Frist was suddenly a party hero and, interested in concentrating on health care issues, declined a second term at the NRSC three days after the election. Then Majority Leader Trent Lott made his now famous but then little-noticed statement at Thurmond's 100th birthday party December 5. As the furor began, Frist told a reporter December 10, "The statement was unfortunate, and it was off the cuff and casual. I know Trent Lott and he's not a racist. It's important people understand the Republican party leads on issues of equity and fairness and nondiscrimination. Any implication otherwise would be a disappointment to me." On December 15 Don Nickles called for a Republican Conference meeting January 6 to reconsider Lott's leadership. Frist, who had voted for Lott for whip in December 1994, when Lott won by one vote, started making calls by December 19 seeking support should Lott step down. On the morning of December 20 Lott bowed out. By the end of the day it was clear that Frist would be the new majority leader. He was officially chosen in a conference call December 23. Frist was elevated after only eight years in the Senate (Lyndon Johnson had only six years in the Senate when he was elected majority leader in 1954) and to a position that confers less power than many people assume. The majority leader has the right of recognition, which means he can offer amendments and speak before any other senator. But Senate rules require supermajorities and unanimous consent for many procedures; the majority leader is less often the tamer of lions than the herder of cats. Frist generally but not always deferred to committee chairmen; he worked closely but not slavishly with the Bush White House; he seems to have created a sense of common good feeling among his Republican colleagues. In 2003 he led the Republicans to many victories. The third round of Bush tax cuts were quickly approved. The Medicare prescription drug bill, after a long process and with some of the Medicare competition and medical savings accounts Frist has long favored, was passed. The partial-birth abortion ban was passed and signed into law. He also pushed through the corporate tax bill with a tobacco buyout. On some things he was less successful. Democrats filibustered successfully against 10 Bush judicial appointees--the first filibusters against appeals court nominees in Senate history. In November 2003 Frist held the Senate in session for 30 hours in a sort of protest; but to no avail. His most embarrassing setback came on the bill to limit class action lawsuits. In early 2004 there seemed to be 62 votes in favor, enough to defeat any filibuster or delaying tactic. Frist delayed action until July, at which point Minority Leader Tom Daschle wanted to add a minimum wage increase and reauthorization of the assault weapons ban to the bill. Frist decided to pull the bill instead. Nor was he successful on the asbestos liability bill or medical malpractice. He angered Senate Democrats when in May 2004 he traveled to South Dakota and campaigned against Daschle. He also angered Democrats when he agreed to House Ways and Means Chairman Bill Thomas's demand that House Democrats and all Senate Democrats except Max Baucus and John Breaux be excluded from the conference committee on the Medicare/prescription drug bill. He failed to gain agreement with the House on a budget resolution, and none passed; similarly, the transportation bill failed when both houses insisted on more spending than was acceptable to the Bush White House. He did shepherd the intelligence bill to passage, but did not resist when its chief Senate sponsor, Susan Collins, saw her Governmental Affairs Committee lose jurisdiction over several homeland security functions to established committees. Republicans gained four Senate seats in the November 2004 elections, which put Frist in a stronger position. Nine days later, he signaled that he would change the rules--presumably by getting the vice president to rule that filibusters were not in order and then upholding that with 50 votes--in a speech to the Federalist Society. "The minority seeks nothing less than to realign the relationship between our three branches of government. … One way or another, the filibuster of judicial nominees must end." Just after the election Arlen Specter said that it would be hard to confirm a Supreme Court appointee who opposed Roe v. Wade; conservatives threatened to deprive Specter of the chairmanship of the Judiciary Committee. Frist pointedly did not back Specter. That forced Specter to make commitments to move nominations forward promptly, which he might not otherwise have made. A few days later Republican senators, by a 27-26 vote, gave Frist the right to choose senators to fill half the vacancies on committees, instead of having them all chosen by seniority; this gave him leverage over colleagues inclined to differ with party positions. Frist was reelected in 2000 against weak opposition by a 65%-32% margin, with the highest number of votes cast for a senator in Tennessee history. He has stayed involved in Tennessee matters, publicizing the new Medicare/prescription drug discount charges and supporting the TennCare changes of Democratic Governor Phil Bredesen. But he has given every indication that he will stick to his promise not to run in 2006. Tennessee politicians have taken him at his word. In October 2004, his 1994 primary opponent, Bob Corker, now mayor of Chattanooga, announced he was running for the seat, and raised $2 million by December. Other Republicans also said they were running, including former Congressman Ed Bryant, who lost to Lamar Alexander in the 2002 Senate primary; state Representative Beth Harwell; and former Congressman Van Hilleary. In November 2004 Democratic state Senator Rosalind Kurita announced her candidacy. And in May 2005 Democratic Congressman Harold Ford said he was running too. In January 2007 Frist will be 54 and will have risen to the top of two professions and then moved on. In Washington political circles there was little doubt in early 2005 that he would run for president. Out of office, he could spend all his time campaigning; he could easily raise money. But Frist has taken pains to say his plans are uncertain. In August 2004 he said, "Whatever [my future] is, it will be in some kind of public service, but public service to me is working in delivering health care to people who wouldn't otherwise get it, or it could be in government. I just don't know." But his Tennessee colleague Lamar Alexander, who ran for president twice himself, seemed to have fewer doubts. In September 2004 he said, "He's got the pole position in practical, tactical terms, which means: Can you raise the money, are you right on the issues, do you have that slightly irrational sense of purpose, good temperament, tough enough persistence?"
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