Conversation 786-021

On September 25, 1972, President Richard M. Nixon, Dr. Charles A. Hoffman, Kenneth R. Cole, Jr., James H. Cavanaugh, and White House photographer met in the Oval Office of the White House from 12:49 pm to 1:09 pm. The Oval Office taping system captured this recording, which is known as Conversation 786-021 of the White House Tapes.

Conversation No. 786-21

Date: September 25, 1972
Time: 12:49 pm - 1:09 pm
Location: Oval Office

The President met with Dr. Charles A. (“Carl”) Hoffman, Kenneth R. Cole, Jr., and James H.
Cavanaugh; the White House photographer was present at the beginning of the meeting.

             Greetings

             [Photograph session]

             Edward M. Kennedy health insurance plan
                -Political aspects
                    -Democratic platform
                    -1972 election
                    -Philosophy
                    -Cost
                    -Numbers of doctors, hospitals, nurses
                          -Medicare
                    -Hoffman's forthcoming talk to dentists, doctors
                          -Hoffman’s recent talk to insurance group
                              -Kennedy’s 1971 statement to American Medical Association
                              [AMA]
                                   -Dr. Benjamin Rush Award

             Medical profession
                -The President’s personal contacts
                     -Dr. John C. Lungren
                     -New York
                          -Dr. Victor DeLuccia
                -Public relations
                     -Business community
                -International cooperation
                     -Soviet Union
                     -The People’s Republic of China [PRC]

                          (rev. Nov-03)

        -Developments in medicine
            -Youth, women
            -Cancer, heart disease, arthritis
        -The President’s previous meeting with Soviet Union Minister of Health
         [Boris V. Petrovsky]
            -Petrovsky’s health
            -Open heart surgery
            -US-Soviet Union
                 -Resident’s interchange
                 -Specialty groups
                      -Hoffman’s letter to the President
                        -New York
                 -Hospitals
                      -Rural areas
                 -Soviets
                 -The PRC
                      -Genetics
                         -Asians
                           -Japanese, Chinese
                             -Caucasians
                      -Acupuncture
                      -The President’s conversation with Chou En-
                       Lai and other leaders
                         -Cancer
                 -Political barriers
                      -Medical cooperation

Hoffman’s forthcoming trip to American Indian reservations, January 1973
    -Audrey Cameron
    -Hoffman’s age
    -Hoffman’s interests

Medical profession
   -International cooperation
        -The President’s conversation with PRC nurses
             -Arms control
             -Disease
   -Hoffman’s previous trip to the Soviet Union
        -Georgia’s Minister of Health
             -The PRC
                 -Health care

                          (rev. Nov-03)

                     -Fact finding
    -Japanese
    -Western Europe
    -US
    -Cooperation with smaller countries
        -Africans
        -Latin America
            -Number of doctors
    -Hoffman’s visit to Nairobi, Kenya, 1971
        -Medicine
    -Latin America
        -Hoffman’s possible trip to encourage doctors

Hoffman's plans
    -The PRC situation
    -Schedule
        -Hawaii, December, 1972
        -Possible trip to PRC
        -Chicago [?]
    -AMA
    -Doctors in rural areas
        -Richmond, Milwaukee, Denver
        -Cavanaugh
    -Resident interchange

U.S. medical system
    -Lawyers
        -The President’s background
    -Doctors
    -Change
        -Kennedy health insurance plan
    -Quality
        -Comparison to Great Britain
    -Changes
        -Catastrophic insurance coverage
             -Burns, strokes
        -Distribution of physicians
        -Catastrophic insurance coverage
             -Hoffman’s background in Urology
             -Avoiding abuses
                 -Listing conditions

                            (rev. Nov-03)

                       -Hemophilia, strokes, heart surgery
                       -Time
                   -Hoffman’s previous dinner with unknown
                    Department of Health, Education an
                    Welfare [HEW] official
                       -Burn cases

The President’s family
    -[Harold Nixon]
        -Health
             -Tuberculosis
             -Frank Nixon, Hannah Milhous Nixon

Hoffman’s first wife
    -Tuberculosis

The President’s family
    -Harold Nixon
        -Pneumothorax

Improvements in medicine
    -Pneumonia
    -Carbuncle
        -Compared to boil
        -Antibiotics

The President’s family
    -Frank Nixon
        -Health
             -Age at death
             -Arthritis
             -Gout

The President’s previous meeting with Petrovsky
    -Arthritis

The President's previous visits to senior citizens home
    -Cortisone

Medical research
   -Arthritis

                                        (rev. Nov-03)

                 -Cancer
                     -Urology
                     -Progress
                 -Arthritis
                     -Types
                           -Atrophic
                           -Hypertrophic
                     -Therapy

Hoffman, Cavanaugh, and Cole left at 1:09 pm.

This transcript was generated automatically by AI and has not been reviewed for accuracy. Do not cite this transcript as authoritative. Consult the Finding Aid above for verified information.

Well, how are you?
Well, I certainly...
One of the reasons is that
this kind of philosophy that must be put down.
It's really not real good right now.
You know, that program costs $60 billion.
But the other thing is, it would be a problem if people
Where in the devil are you going to get the doctor?
Or are you going to get the hospital?
Or are you going to get the nurses?
Right now, you're overloaded.
You haven't got a doctor, you haven't got a nurse, you haven't got a hospital with Medicare.
Nobody ever thought of that before.
Well, of course, I cannot speak politically, but I do under the cover.
I can tell you, I'm a speaker about the dentist tomorrow and the...
And I always am able to put in a few little bars with a very simple story into what I've made.
And I like to think of it here.
I like to tell them about the fact that, like the insurance people a few weeks ago, I like to tell them the fact that I'm on a nice blue-shield board and can't be asked questions.
If you know your major problem...
medical professionals.
They do a very good job and don't do a very good job in public relations.
Now, you've heard that many, many times, and I will say it critically.
It's just hard.
Businesses do a very good job under your leadership.
So it's just, generally speaking, our systems.
But the main point, one thing that people love to hear is in this field with international cooperation.
Now, you know, and I know, that basically where the Russians are concerned, and the Chinese, and all these others for that matter, that
The extent of the cooperation is probably going to be limited.
But the thing that I find particularly hits with young people, and also hits particularly with women, is to say that who knows where the genius is that's going to find the answer to cancer or heart disease or arthritis.
It may be a black or a white woman or a man.
It may be a Chinese, a Russian, or an American.
And what we want to do is develop a system where, despite political differences between nations, we can have the people that are out fighting the disease all working together.
I do love that theme, and I believe it, too.
I do, too.
For example, the fellow that came in just three weeks ago, two weeks ago, to see me, was the Russian Minister of Health, incidentally.
He's not a very good advertisement for our department either.
He's so heavy.
But he does two open heart things a week, he told me.
Well, that's a pretty good thing to cooperate on.
Go ahead.
Well, I mean, I was thinking about it.
I had a nice interview with him.
We talked about those areas.
They're both anxious, of course.
in three particular areas.
Number one is to try to have an interchange between the residents of this country and the medicine training from there.
And secondly, to develop an interchange between the various special groups in this country and
and those over there.
Of course, I'm already working, as you brought up on my letter, to bring some group over to the American Plot Committee, and I'm good in the argument.
We want to go out there.
And, of course, secondly, we talked about the idea of hospitals, of a network of smaller hospitals, I mean, or a chain of hospitals in some of our rural areas to bring the rural picture back.
Because they have the same problem there, for instance, as we have here, as far as our adoption of rural areas.
One thing, of course, that's very important regarding the Russians,
Is there, and it's in all fields, is there a sense of basically inferiority?
You must constantly build them up.
We've got to learn from them, and they've got to learn from us.
The other thing I would emphasize is this.
While it's far further ahead in the future, always the Chinese thing.
You know, among the ageless people in the world, and I understand why you're the Asians, if you were to rate them, the Japanese and the Chinese,
There are many brilliant Chinese doctors.
When I talk to children of mine, it's fascinating how interested they were in what we were doing with cancer and other things.
Now, we have just started there.
It started at Interchange.
But I think you should point out that one of the most hopeful things in the field of foreign policy is that we've broken down this barrier.
But we will still have political differences.
I have no use for communism, and never will I.
They have no use for our system, and never will I.
But we are going to... One of the ways we can't cooperate is on the disease thing.
And this is the field of medicine.
I didn't change...
Great.
You had a member, Audrey Cameron, a nurse that you had done here two years ago.
Yeah.
Well, she and I have become very good friends.
Yeah.
You are?
I'm doing well.
But I'm still trying to take care of it.
My greatest love was what he had taken care of.
Right.
Any kind of people.
And I don't care.
That's what it is.
In fact, you can say, I found that was the interesting thing in my talk with the Chinese, is that that was one thing, that while we had tremendous disagreements on arms control and other matters, that when it came to disease, I mean, taking care of people and so forth, they felt the same way we did.
Exactly.
I was laughing at Kelly.
She and I were here just a few minutes ago.
The only time policy came out was on my trip to Russia.
I was in the Ministry of Health in Georgia.
I walked in, of course, she's about my height.
I said, well, it's nice to have somebody as tall as I am.
She said, I hope we have the same vision on our philosophies.
I said, well, we might.
She started off immediately about the Chinese situation and all that.
I said, I went to this minister.
I said, I'm here to discuss the health care of our people and nothing else.
And he said, but you know, these are the laws.
We must think about the laws if we're talking about health care.
I said, yes, there's a lot of effects on health care of our people.
Well, you stop and change something.
That night at a dinner on Earth, again, he brought up, and I just ignored it, but that's the only time in the time I was there, I heard that politics was ever mentioned.
I refused to get into it because I didn't think this was my job.
Well, actually, today I don't hang out with the Chinese, and I hang out with the Chinese everywhere with much greater regard on them because the Chinese are so much weaker.
The main thing we want to do is just blindly say we want to be friends with everybody.
Well, I think this is my attitude.
That's what I've been doing.
I've been, you know, quite a bit of speaking in every town.
But I went over there not to fight fault with the system, but to see what they had that we might use.
And I think that there was a lot of goodwill created.
How about in the middle, you know, many times, the smaller countries,
After all, let's face it, you don't need to worry about the Japanese, or the Western Europeans, or the Americans.
We're all confident in the Western perspective and the Western perspective here.
So when you look at the smaller countries, the African, well, let's leave them out here so far and so low.
But the Latin Americans are the proudest of them.
And I imagine, and of course, they have doctors around them.
I mean, everyone wants to be a doctor.
Do you have opportunities to sort of praise that work?
I was under it last year, January, a year ago, and I went down to it, and I wrote it, and all, and of course, it's...
It's an actor.
An actor, right, right.
A very, very poor, I mean, you say, a very, very...
They do the best they can, but they've got, they're just, they're like we were 60 years ago.
Or worse.
Or worse.
Or, you know, in the ignorance.
How about Latin America, too?
Latin America, I haven't gone into too much.
I'm always going to sign a big paper or something.
I think that you ought to, if you can, you and your colleagues should do that.
The Latins are so sensitive.
about, you know, they're very close and all that to us.
Kind of a little attention goes a long way.
Well, I'm sincere.
They probably need it.
They probably need one.
I've made up my mind that I am dedicating myself for the few years I have left to improve and help as much as I can do that.
And I'm a fighter when it comes to this type of thing.
So I don't know how it will come out.
I'd even like for the Chinese situation to be the same.
I'm going to be in...
I mean part of the way around, I would love to go to China for about 10 or 12 days and see what they have to offer.
So how many are you working on?
And when I have something to report, of course I keep reporting along with Sherry, but I'll see if Sherry can do it.
Well, it's a fine work.
whether it be a surgery or an EMA.
You know, I have an idea, too.
I have an idea, too, on this question.
The doctors were hilarious, which I was talking about, which I think that's there, which I threw to the press in Richmond and Milwaukee and Denver recently, and I had no adverse reaction.
So I think it's an American way, and it's one of those things.
So I have information I'd like to work with that.
from where we've designated here, and Jim suggested he might be the one to see.
I'm talking about the sort of plan that the vote would interchange, particularly of our residents.
This is a little difficult to do, but I think we can start the ball rolling.
Absolutely.
Look, I think that any information you have is very welcome, because you've got to face it.
I see this in all your lawyers.
We all fight for the establishment.
We don't want to change the way things are.
We don't want to do things in a different way because it may in some way endanger our way of doing things.
But that is not the way to go at it.
I don't think you can tear up the defense if you revolutionize something.
In other words, some screwball scheme like this 60-foot column.
But on the other hand, you must not just stand on the status quo and say, this is the best
Oh, it is the best.
Ours is the best, but we must not just stand there.
You know, I really think, seriously, that we have, because I know we have an excellent system at this time.
We have a certain amount of finance quality in the world.
Quality in the world.
That's why everybody comes here.
That's why everybody comes here.
Even from England.
But I think there are two or three areas which I do believe that we are, we must change.
This is number one, catastrophic coverage because
It can break anything.
I'm thinking about your hemophilia, actually, your severe burns, your strokes, and all this stuff.
And then I think, too, about our distribution, which I think can be worked out.
I think this is very, very important.
But I think if we think the catastrophic problem and the distribution of physicians, I think we've done by far.
But we'd be so far ahead of everyone else coming to our meeting.
I'm speaking on the catastrophic side.
All right.
different forms of insurance.
Well, you see, the way I feel about this, of course, again, I'm a neurologist.
And I think about it from a doctor's point of view.
Anything we do is going to be abused.
I don't care what we do.
And I have a feeling this is an interest.
And I say it's not for sure.
I don't accept it.
That actually, I think we could list 25 conditions in this country.
Well, I'm talking about hemophilia, strokes, heart surgery.
So, listen, spell it out.
Spell it out.
Then you will not have this abuse.
Spell out the time.
Spell out the time.
so that you don't fear it, because otherwise you can have some people, you know, some people are heart patients from the day they're born.
That's right, sure.
So you want to keep that away.
But it's got to be smelled.
I was having dinner a few months ago with one of the top AGW people, and he was talking about a burger case which cost $33,000.
And I'm trying to say the man's life is terrible, but what's a man's life's worth?
I mean, let's look at it like this.
We have to worry about it.
I'll tell you, this is not fun.
We'd be very interested.
I'd be very interested in what you have to offer us.
Well, I'm going to ask you to offer any suggestions.
Well, I'm going to... You're going to blind ourselves to a problem.
No, I have a problem, of course, and that's the...
Some of my thoughts never even appeared to the American Labor Association.
My idea was...
And they'll never get it clear.
So I just go along and tell them, I tell them, I just say to them, somebody says it's a team job.
Yes, it is, and I pick up a funnel.
I'm going to run with the goal.
I don't want to block it, but I want to get some structure.
We have a little experience with this person's career and age.
This person was not in control.
The only known therapy was bedresting.
My older brother was in tuberculosis.
He contracted it when he was 17 and died when he was 22 for five years.
My parents, they earned enough.
But they borrowed.
They sold property.
They did everything.
They put him in hospitals.
They took him to Arizona for two years.
He stayed in a very expensive hospital and finally died.
But I know what it did to that family.
It was just, it was, you know, because my father and others were proud people, they wouldn't, they wouldn't put in public health, and they wouldn't pay it all themselves.
But I think the rest of their lives, they owed money.
My first point, that was the murder of Mrs. Hughes and Senator for two years, and I was in medical school, and I couldn't have no money, because we were absolutely, I remember that's what they did then.
They put him in the staff, you know, and he was a lay, lay there with his bed rest, right?
Remember my brother had, well the only thing they knew they had then was pneumothorax, you know.
They asked her to relax the lungs.
Didn't work.
You know, when I think of when I was in medical school and 40% of the people had pneumonia die, and I think of that.
Fortunately, they don't.
No, they had carpals when their neck died.
I mean, what's this change?
What is a carpal?
infection of these deep fascias here.
It's different from a boil.
Boil is above the fascia, so it can point out.
But they carve up with this spread.
But what do you do with it now?
Well, it's only slices.
Oh, it's only slices, but the drug is the end of the line.
I mean, in fact, we all understand the infection.
Well, the one thing I can serve without, like a dark cup.
I guess you could call it gout, but gout is a drink you could throw to that stranger.
The point is that I told this Russian, I said, you mentioned all of these things.
You don't mean an arthritis?
He said, yeah.
I said, well, why don't you add that to your list?
That seems to be one group who don't have anything to do with it.
They have nothing at all.
They have a foundation.
But, you know, I've been to visit a lot of old folks on this, you know, and it's so tragic.
It's a deal, just sitting there waiting to die.
But to see them all, it's horrible.
Of course, we do have parts of those severe cases in the very late years.
Yeah, but what does it do?
Of course, I had a fair amount of it.
But very little result.
But, you know, one of the new cancer, you know, I go on the floor of the cancer ward in the book, I have many people with cancer in my field of urology.
I feel so helpless.
And I have made a statement time and time again, say it time and time again, how far have we gone?
I mean, we've tried millions upon millions of dollars and hours at the center, and yet, you know, we haven't gone very far.
You get it right.
We've got to find a call.
We're really pouring in the door.
We've got to find the hell out of her mind.
And our threat is that there's something there.
Of course, if it comes, it's a strange kind of a deal because it can come and go, too.
Oh, yes.
Exactly.
Of course, you know, there are two different types of arthritis.
One is the crippling kind, the so-called atrophic, in which you just cripple up, and the hypertrophic, which is you, is the age situation.
And this guy, of course, I've got it.
I expect you have some of it.
We all have it after about four years of age.
And, of course, the best treatment is moving.
You've got one.
You get your fingers and so forth.
That's right.
And don't worry about it.
No, I don't worry about it.
It gets worse.
I'd say about 3,000 life equipment years ago.
Well, that's very good.
And I shall keep you informed about everything.
And if you'd like me to do it, if I need it, I won't pay you.
I appreciate it.
Thank you.