Perhaps the most inspiring part of Otis Bowen’s legacy is that between 1946 and 1972 he delivered 3,000 Hoosier babies when he was the small town family physician in Bremen. The future Indiana governor would say that having his hands on so many emerging lives taught him “how to approach emergencies and problems with a certain amount of calmness and common sense.”
Bowen’s political career as Marshall County coroner, state representative, speaker of the House, Indiana governor and then U.S. Health and Human Services secretary gave an array of portals for him to impact these lives, from the delivery room to the morgue. His political and subsequent policy reach, however, brought tax relief to 6 million Hoosiers, and as the capstone of his career, what he believed would be catastrophic health insurance for millions of Americans.
It was, as Doc Bowen put it, his “greatest accomplishment” and worth pondering one more time in the wake of his passing at age 95 on May 4.
Bowen was no stranger to political adversity. First elected to the Indiana House in 1956, he was defeated for re-election by four votes, and refused a recount because he trusted local officials and didn’t want to be seen as a “crybaby.” A 92-year-old supporter died the day before, and her large family didn’t make it to the polls. Bowen regained his seat in 1960 and became minority floor leader in 1964 after the LBJ Democratic landslide, shepherding a caucus of just 22 Republicans.
In the political fallout of Vietnam, House Republicans ended up with 66 seats in 1966, setting up the Nov. 28 showdown at the Claypool Hotel between Bowen and state Rep. Bill Howard of Noblesville, who was backed by Marion County Republican Chairman L. Keith Bulen. On the first ballot, the two men were tied at 33 apiece.
On the second ballot, Bowen won, with speculation that Reps. Ray Crowe and Charles Bosma were the ones to shift votes. Current House Speaker Brian Bosma confirmed his father broke the tie.
“Doc and Charlie spoke of that vote on many occasions, with my Dad saying it was one of the hardest and best votes he ever cast,” Bosma said. His father would later cast a crucial vote as a senator for the property tax reforms.
Senate Finance Chairman Larry Borst would later observe, “When you think about it, if Bowen had lost as speaker, he probably never would have become governor, or secretary of the U.S. Department of Health and Human Services, and our history would have been different, all over one vote.”
In his autobiography “Doc: Memories of a Life in Public Service,” Bowen would call it his “defining moment.” He would lose to Bulen-backed Secretary of State Edgar Whitcomb for governor in 1968, and decided at the convention podium to run again in 1972.
Bowen would go on to forge property tax reforms, create a statewide medical air transport system, pass medical tort reform and complete much of Indiana’s interstate system.
In 1986, President Ronald Reagan made him the first medical doctor to serve as HHS secretary. He immediately pushed for catastrophic health insurance, first for the full population, and finally the elderly. When he found opposition from Attorney General Edwin Meese, Bowen became a “pitbull” and released his plan to the press.
Reagan would sign the Bowen plan after it was resoundingly passed by both houses in 1988. But after Reagan left office in 1989, poll support plummeted and a fearful Congress repealed it the next year. Bowen observed that President George H.W. Bush refused to defend the program. “Our lack of action is a damning indictment on our humanity and our political will,” Bowen observed. That would set in motion two decades of some of the most divisive politics over Hillarycare and Obamacare.
As Doc Bowen was taking his final, shallow breaths last Saturday, the Sunday editions of the New York Times were pounding off the presses. Included was a column by conservative writer Ross Douthat, who uncovered a 1970s era RAND Corp. study that found “that more expensive health insurance doesn’t necessarily lead to better health.”
Douthat continued: “First, if the benefit of health insurance is mostly or exclusively financial, then shouldn’t health insurance policies work more like normal insurance? Fire, flood and car insurance exist to protect people against actual disasters, after all, not to pay for ordinary repairs. Shouldn’t we be promoting catastrophic health coverage, rather than expanding Medicaid?”
You could only surmise Doc Bowen’s answer to that one.
On Dec. 16, 1986, Bowen would tell Reagan and the Domestic Policy Council: “I was a political and ideological conservative who wanted government out of individual lives whenever possible; I had succeeded in public life by listening to and acting on the concerns of people; catastrophic illness was a genuine problem that needed to be addressed; there was no private-sector answer, though that would be the best solution; and the proposal would be self-financing.”
Beneath the horn rimmed glasses and his genteel demeanor was a shrewd, cunning and intellectually robust public servant. Had Doc Bowen’s “greatest accomplishment” not succumbed to the prevailing political winds, it’s a fascinating mental exercise to wonder where we might be spending our political capital today.