OPERATING

The Price of Power (DAVID GRANN, May 11, 2003, NY Times Magazine)

When Frist first arrived in the Senate in 1994, he quickly discovered what every new member did -- that despite holding one of the highest offices in the land, he had little influence within the institution. Ranked No. 99 out of 100 in seniority, Frist wasn't even initially given permanent office space. After the first State of the Union address, his wife recalled: "We just stood there by ourselves. No one came up to him, and I felt so bad. I wanted to go out and grab one of these reporters, and say: 'Please talk to my husband. He's a senator from Tennessee.'"

Until then, there were primarily only two routes to power within the institution: one, which had prevailed for centuries, was through the back alleys of the institution; the other, which had become more prevalent in recent years with the advent of cable news channels and C-Span, was by building up a base of power outside the institution -- by, in effect, running against its tradition of horse trading, as someone like John McCain had. But while the former route could take years and taint your image, the latter never allowed you to truly dominate the institution. And Frist, who had become one of the quickest studies in politics, seemed to pursue a different path, one that had rarely, if ever, been tried. "I don't have time to pay my dues, to be congressman, a cabinet member, another senator," he said.

At first, it appeared that he intended to rise only by adhering to tradition, by bending to the will of his party patrons. Where he had once expressed doubts about his party allegiance, he now voted, with rare exceptions, the party line. He voted against gay employment rights and the Endangered Species Act. He voted for Bill Clinton's impeachment and against campaign finance reform. He voted for reducing Medicare growth and minimizing the role of government in health care, though a close friend told me that before running for office Frist had expressed a desire for a universal health care system like Canada's. And though other friends told me that they were certain Frist was for abortion rights, he voted steadfastly anti-abortion. (Even on one of the few occasions that he bucked his party and voted for Henry Foster as surgeon general, it seemed more personal than political. Foster, whom conservatives opposed because he had performed abortions as an obstetrician, was from Frist's home state and an old medical colleague.)

Before long, Frist's voting record was nearly indistinguishable first from Bob Dole's and then Lott's. Each told colleagues privately that Frist had the makings to one day be majority leader. And while Lott promoted him as the "resident doctor," Frist began his own crusades not just to serve people but also to save them -- to rescue thousands of Americans dying from lack of organ donations and millions decimated by AIDS in Africa. But when his initiatives clashed with the entrenched powers in his party, he nearly always tailored them to appease his Republican patrons. After the Bush administration objected to his provision to increase emergency spending on AIDS to $500 million in 2002, he withdrew it at the last minute, cutting the initiative by more than half for that year. "It was devastating," said Dr. Paul Zeitz, executive director of the Global AIDS Alliance. "He had the right instincts, but he refused to stand by his own policy." While Frist told Zeitz and others to be patient -- that he would eventually prevail by working within the system -- he also spoke of the competing instincts within him. "There is this tension between two forces I am engaged in," he once told The Boston Globe, "between raw political power versus what is probably a little more deeply inside of me, the real quest, the real drive for substantive issues, of really changing things for these few years I am in the United States Senate."

After he joined anti-abortion conservatives and opposed creating human embryos for research, many in the medical establishment complained that he had finally turned his back on his own profession -- denying patients the best chance for a cure for diabetes and Parkinson's disease. Charles Barnett, a Tennessee doctor, told National Journal: "Bill Frist is the biggest disappointment to me. . . . He took this political stand not to help people, but to pay off the far right so nobody would get mad at him."

Frist said to me: "Are there things I've done -- or have I voted certain ways -- that if I could, I'd take them over and go back and redo them? The answer is yes." When I asked him for examples, he cited only one: the farm bill.

Finally in 2000, after six years of accumulating the goodwill of his Senate leaders, Frist started to construct his own political machine with the help of a new powerful patron: George Bush. Already connected to Karl Rove, Frist took several unheralded jobs -- including Senate liaison to the campaign -- that cemented his ties to the Bush team, which soon put him on the short list of vice-presidential candidates. During his own Senate re-election bid that year, Frist even coordinated his advertising with Bush -- a little-noticed gesture that helped deliver Gore's home state to Bush.

More important, Frist decided in 2000 to take the largest political gamble since he ran for office and to assume the chairmanship of the National Republican Senatorial Campaign Committee, which controls every race across the country by recruiting candidates and disbursing millions of dollars. "Most of my colleagues advised me not to do it," Frist explained. "Most said, You're a policy maker, you pull people together. Then all of a sudden you're a raw political figure. You're out there with the harshest political rhetoric. You have to be shrill and tear into the guts of people."

As he had in 1994, he immediately showed how aggressive he could be, releasing a series of attack ads that exploited Bush's popularity on the war on terrorism. "That comes from Frist," said his old mentor, Perdue, who at the time was running the Senate campaign of Saxby Chambliss in Georgia. "That was not just one day, 'Let's use the president.' That was well thought out." He added: "Frist didn't do that without a tacit approval. He would never violate his relationship with the president, and that was a very good strategy."

While some Democrats claimed that Frist was calling into question their patriotism, Frist relied again on Perdue, who unleashed what was considered the most devastating ad of the cycle: it showed a picture of Osama bin Laden and Saddam Hussein that eventually faded into the Democratic incumbent, Max Cleland, a Vietnam war hero who lost both his legs and his right arm in battle. Perdue told me that he sent each commercial he made to Frist and his staff to "let them be another focus group," and "they never told us not to do anything."

Hunkered down at his campaign headquarters, Frist spent hours recruiting candidates with Rove, with whom he communicated on his BlackBerry, and raising money. Just as he had once found a way to legally circumvent the accounting system on his college exam, he now found loopholes in the campaign finance system. Rather than divest his stocks from his family's company, which in 1994 merged with another company and was later fined $1.7 billion for the most massive health care fraud in history, he simply kept his stocks in a blind trust. And while the company still donated to his own campaign and to the Senate campaign committee, Frist specifically targeted pharmaceutical companies for donations -- and in particular Eli Lilly, which along with its employees gave more than $400,000 to the senatorial war chest during the election cycle. The company went so far as to buy 5,000 copies of Frist's new book, "When Every Moment Counts: What You Need to Know About Bioterrorism From the Senate's Only Doctor," which it distributed to doctors around the country. In contrast to Jim Wright, the former speaker of the House who had to resign over selling his book to lobbyists, Frist made sure he didn't receive any financial remuneration and instead gave the profits to charity. Meanwhile, Frist offered his own boost to the company -- introducing a provision that, among other things, protected Eli Lilly from lawsuits over a vaccine that thousands of parents maintained caused autism in their children. After the bill stalled, the same exact language mysteriously appeared in the Homeland Security Bill and consequently passed. (Representative Dick Armey belatedly took credit for inserting the language several weeks after his retirement, though few believe he acted alone. In January, Frist honored a deal brokered by Lott to remove it. But after he tried to reintroduce the bill again this year, angry families declared in a press release, "Frist tries to move under the veil of war.") By the eve of the 2002 election, Frist had raised more money than any G.O.P. senatorial campaign chairman in history. "All of a sudden, he became a natural," Perdue said.

What is striking is not that Frist has increasingly mastered the art of politics -- after all, he is in a profession that demands it -- but that unlike other politicians, he has mastered the art of seeming above it. Rather than act like a consummate insider, he maintained the glow of a noble outsider. Once, while other senators were in committee meetings, he resuscitated a tourist dying of a heart attack. Another time he ran from a leadership meeting to rescue Senator Strom Thurmond after he collapsed on the Senate floor. Unlike John Glenn or John McCain, who entered politics as heroes, he had become a hero while in politics.

By the time he defied all expectations and delivered the Senate back to Republicans in the fall election, he had quietly amassed one of the most formidable political machines in Washington, commanding the loyalty not only of the senators he had brought into power but the entire G.O.P. caucus and the White House as well. When Lott's status as majority leader came under siege barely a month later, Frist emerged as the most likely candidate for a job that most spend their entire careers seeking. "He was tough enough to make it happen," Bob Dole told me of Frist's positioning himself to be a potential majority leader. "I think he knew there might be an opportunity when he was ready."

The true test for Mr. Frist will come in 2005, when he has a majority of 5-6 (or more) seats to work with. If he can get some bills like Social Security reform through at that point, he'll be positioned to run for President in 2008. Posted by Orrin Judd at May 11, 2003 8:19 AM