The AFL-CIO held 33 rallies across the country, culminating with Kennedy's address on May 20 in Madison Square Garden; the union packed the arena with almost 20,000 older voters.
The president started his remarks by addressing criticisms that he was unduly trying to whip up the public, instead of leaving the business of government to those who govern. He argued any large piece of legislation required public consent and called on his audience to make Medicare a public crusade. He referred to his father, whom he had just visited in the hospital—much as President Obama spoke about his mother when making the case for his reforms. But where Obama had talked about his mother wrestling with medical bills, Kennedy referred to his father's good experience with the health care system and suggested the same should be available for any elderly person. Kennedy concluded by saying, "I refuse to see this country, and all of us, shrink from these struggles which are our responsibility in our time. Because what we are now talking about, in our children's day will seem to be the ordinary business of government."
The ladies in flowered hats and men in thick black glasses cheered enthusiastically, but they weren't the audience the president needed. "[T]he president had forgotten the lesson of his campaign that arousing a partisan crowd in a vast arena and convincing the skeptical TV viewer at home require wholly different kinds of presentation," wrote his closest aide, Ted Sorensen. "He already had support from the senior citizens; he needed more support from the home viewers, and that speech did not induce it."
That wasn't Kennedy's only problem. He had competition for the public mood. After the 1960 election, the American Medical Association girded for the Medicare battle, raising its dues from $35 to $70 and blanketing its members with warnings about Kennedy's plan to socialize medicine. The organization brought in doctors from England to describe the dire straits of Great Britain's insurance system. In advance of the Madison Square Garden push, the AMA said the Treasury was being "looted" to subsidize the biggest lobbying campaign the nation had ever seen.
To rebut Kennedy directly, the lobby purchased half an hour of television time and Dr. Edward Annis, a Miami surgeon, went to Madison Square Garden to deliver his own address. Annis spoke to an empty hall, where the banners from two nights before still hung, portraying himself as an underdog. "Nobody—certainly not your doctors—can compete in this unfamiliar art of public persuasion," he said, lamenting that the president appeared on all three networks but the AMA (your doctor) had to purchase time and therefore could appear on only one. "We doctors fear that the American public is in danger of being blitzed, brainwashed, and bandwagoned," he said, arguing the laws on the books allowed people to be covered through private programs. Annis then held up the legislation and attacked the president's claims one by one. Kennedy and his aides knew immediately that they had lost the battle with the good family doctor.
But the damage didn't end there. By going to the public, Kennedy antagonized the very members of Congress he needed to get the legislation moving. "To get a vote on Medicare in the House, we had to persuade Mills, and you don't persuade Mills with a rally in Madison Square Garden," said Larry O'Brien, Kennedy's close aide, who was working the bill in Congress. "Kennedy understandably wanted to take his case to the people, but in this particular instance that approach didn't work."
The last chapter of Kennedy's failure on Medicare came as a result of either being hoodwinked by members of Congress or in misreading them, which, given the nature of backroom deals in the 1960s, may have been the same thing. In a last-ditch effort, the president and Medicare proponents returned to the original strategy of trying to attach the health care program to the welfare bill in the Senate. The measure was debated for three weeks, after which Democratic leader Mike Mansfield thought he had the 50 votes needed for passage. (Vice President Lyndon Johnson would break the tie.)
The opposition, made up of Republicans and Southern Democrats, did not filibuster the bill the way they would today, but that's because they had better weaponry. Oklahoma Sen. Robert Kerr, a Democrat and one of the most powerful men in the Senate, was the leader of the opposition. He was highly skilled at manipulating his colleagues through almost any means necessary. ("Mr. Kennedy asked; Mr. Kerr decided," wrote the Wall Street Journal at the time.) Kennedy and Kerr had both been trying to win over West Virginia Sen. Jennings Randolph to their side, but according to historian Irving Bernstein, Kerr wrote a provision into the welfare bill that extended a $21 million overexpenditure to West Virginia—essentially a kickback—and Randolph voted against Kennedy.
In the end, Kennedy's attempt to play both the outside game and the inside game failed. Such defeats led to the kind of appraisals that President Obama now faces as his approval ratings and personal ratings hit new lows. "There is a vague feeling of doubt and disappointment about President Kennedy," wrote James Reston in the New York Times. "He has touched the intellect of the country, but not its heart. He has informed but not inspired the nation. ... [H]is problem is probably not how to get elected, but how to govern." Fifty years later, it’s a fitting description of another president in the midst of his own health care fight.