WASHINGTON – Seeking a second opinion on heart surgery, Democratic Sen. Bob Graham called a Republican.
He conferred with the top GOP lawmaker in the Senate - Majority Leader Bill Frist, a cardiac surgeon from Tennessee, who not only provided referrals but visited Graham during his hospital stay.
Unlike many Americans, the Florida senator had access to a wealth of advice, was operated on by a team of first-rate physicians and treated at one of the nation's leading medical facilities, the National Naval Medical Center in Bethesda, Md.
Notwithstanding the special access, Graham, 66, said his experience gave him "a renewed and personal" appreciation of the need for all people to have access to quality health care.
"It may have reinforced what has been a long, long concern of mine," Graham said in an interview. "There's not an adequate emphasis on early intervention."
Under the Blue Cross-Blue Shield system through the Federal Employee Health Benefits Program, Graham got the referrals, was examined by the doctors and his surgery was scheduled. He did not have to get clearance from a so-called "gatekeeper" as many in health maintenance organizations are required to do.
The process began in January when Graham, who had set his sights on a presidential bid, underwent a heart catheterization test to determine whether he could withstand the rigors of a tough campaign.
Doctors discovered that calcium deposits had built up in a heart valve, restricting blood flow. Tests in the 1990s had indicated problems with the valve; now doctors felt immediate surgery was warranted.
When former Sen. Connie Mack, R-Fla., heard of his friend's predicament, he called Graham and suggested he talk to Frist. The quick recommendation from Frist was Dr. Alan Speir, a northern Virginia heart surgeon who would perform bypass surgery on Sen. Mitch McConnell, R-Ky., four days after operating on Graham.
"It was overwhelming," Graham said of the extensive advice he received from friends, including Frist, about getting the best medical care. Despite his long involvement in health issues on Capitol Hill, Graham, nevertheless, had been unsure about where to turn, he conceded.
"I felt like I had fallen into a deep pool," he said.
Finally, no fewer than seven doctors consulted before the senator's surgery Jan. 31.
Speir led a team of doctors who replaced Graham's defective valve, performed a double bypass and closed a pinpoint hole between the upper chambers of his heart. Two days later, Graham was walking the hospital halls and within a week chatting with McConnell before he was released on Feb. 6.
He stayed at his daughter Suzanne's home in Great Falls, Va., in large part because it did not have the stairs of his Washington, D.C., town house.
Graham believes the insurance he has with Blue Cross-Blue Shield will cover most of his bills. The surgery and hospital stay are expected to cost $55,000. Bills on the follow-up visits and diagnostic tests haven't arrived.
Although he is eligible, Graham is not enrolled in Medicare.
His plan, the federal employee health benefits program, "is comparable to health benefits by other large employers, probably more generous than some small employers," said Alwyn Cassil, a spokesman for the nonpartisan Center for Studying Health System Change.
The plan is available to all federal employees, said Edmund Byres, a spokesman for the Office of Personnel Management.
During his three terms in the Senate, Graham has shown particular interest in health care issues.
Last summer, he was the leading sponsor of a Democratic measure to include prescription drug benefits under Medicare. When that failed, he worked on a bipartisan proposal that also failed.
Graham says he believes in the goal of universal health care, but argues that the most realistic way to achieve it politically is through incremental change.
"If there was one lesson from President Clinton's efforts to pass a one-step reform of health care, it's that it was a bridge too far, there were too many obstacles," he said.
Graham's goals include expanding existing health care programs, such as the Children's Health Insurance Program, to cover more children who are unable to get help and possibly their mothers. He also wants to see some flexibility in the income threshold for Medicaid to ensure that individuals whose incomes are just above the cutoff get some assistance.
As for Graham's condition, "he's markedly improved," said Dr. Richard Elias, a cardiologist who is chief medical officer at the Miami Heart Institute and has been overseeing Graham's care. "He'll be in better shape than he was for the last five years. I would think that in two more weeks he'll be able to do most anything."