"Every president has made important contributions that are found only in footnotes. The asterisk might cite a difficult decision, the launching of an innovative federal program or a signature that made a congressional act the law of the land.

"I am signing S. 522, the Indian Health Care Improvement Act," President Gerald R. Ford wrote on Oct. 1, 1976. "This bill is not without its faults, but after personal review, I have decided that the well-documented needs for improvement in Indian health manpower, services and facilities outweigh the defects in the bill. ... I am signing this bill because of my own conviction that our first Americans should not be last in opportunity."

This is a story about effective government and the genesis of a transformative idea.

The bill that finally passed Congress was the Indian Health Care Improvement Act. Nixon was no longer president, and many in Ford's Cabinet urged a veto because it would cost $1.6 billion over five years. But at the White House, Brad Patterson, who had worked on many of those issues with Nixon, told the president that this bill was important. "And our counterarguments won the day; the legislation was signed by President Ford."

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Mark Trahant: As a nation, we're better off when politicians work together (The Seattle Post-Intelligencer 12/31)

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