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Why healthy political parties seek healthy candidates

Democratic presidential nominee former Secretary of State Hillary Clinton waves before boarding her campaign plane at Reagan National Airport on September 16, 2016, in Arlington, Virginia. Clinton is back on the trail and campaigning in DC after taking some time off to recover from pneumonia.
Democratic presidential nominee former Secretary of State Hillary Clinton waves before boarding her campaign plane at Reagan National Airport on September 16, 2016, in Arlington, Virginia. Clinton is back on the trail and campaigning in DC after taking some time off to recover from pneumonia.
Justin Sullivan/Getty Images

In an episode of Dr. Who called "The Christmas Invasion," the Doctor ends up in a political feud with Harriet Jones, the fictitious prime minister of the United Kingdom. Jones has ordered a military action that the Doctor finds inexcusable. The furious Doctor tells her that he can end her political career with six simple words. He then whispers to her aide, "Don't you think she looks tired?" thus beginning a tide of rumors about her health that results in Jones losing a vote of no confidence.

I'm not a regular viewer of Dr. Who (thanks to Andrew Boies for pointing out this episode to me), but this particular scene, released in 2005, seems rather prescient when considering recent turns in the 2016 American presidential race. Hillary Clinton's bout with pneumonia, which interrupted her campaigning for most of last week, added fire to earlier conspiracy theories about her health.

It is notable that the victim of the whisper campaign in Dr. Who was a woman. While I'm unaware of studies showing that voters hold female politicians to a higher health standard than male politicians, it would hardly be surprising to learn that. Illness rumors play into persistent stereotypes of the frailty of women professionals, and indeed Clinton may well have been seeking to work through an illness for fear of being perceived as not "tough" enough for the job. And just in case the politics of health disclosure wasn't gendered enough, Donald Trump generously revealed his testosterone levels.

But combine Clinton's brief illness with Trump's own bizarre health disclosures and you get sudden concerns about the physical well-being of our presidential candidates. This has led to proposals for an independent panel of medical experts to evaluate the physical and mental fitness of presidential candidates.

Is this needed? To be sure, we want presidents of sound mind and body, particularly in the nuclear age. And it's a bit flip to note that we've had presidents suffering physical and mental illnesses and gotten through that just fine.

Did Lincoln's depression affect the conduct of the Civil War? Did Kennedy's physical pain and excessive painkillers and stimulants make him more prone to risk-taking behavior, such as in the Cuban Missile Crisis? What decisions might Reagan have made differently had he not have been suffering the early symptoms of Alzheimer's disease? Just because our nation is still standing doesn't mean that everything up until this point has gone well.

But a medical review board for candidates seems unnecessary because, at least up until this year, we've largely had such a system in place. This is one of the functions of political parties.

Parties have many factors they take into account when evaluating prospective presidential nominees, including the candidates' perceived electability, their stances on issues, and their relationships with interest groups. They also want to know that a nominee will not behave catastrophically while in office and will actually live through his or her term. Parties have little interest in nominating someone who they think will die within a year or two, throwing their governing agenda into doubt, or who will suffer a debilitating illness and lose influence to an ambitious House speaker, vice president, or adviser.

Cancer fears probably contributed to the failure of Paul Tsongas's 1992 presidential campaign, and with some justification, since he died at the end of what would have been his first term in office. Republicans at least considered John McCain's medical history (including several bouts with cancer) when he ran for president in 2000 and 2008, and he provided an overwhelming amount of medical documentation to help allay fears.

(To be sure, no amount of medical screening will completely remove uncertainty about the health of presidential candidates. Could anyone have predicted Woodrow Wilson's 1919 stroke or Dwight Eisenhower's 1955 heart attack?)

Now, it's not obvious parties can do this task better than some nonpartisan medical review board. But it's not like such a review board would be broadly accepted as nonpartisan, any more than the media is. Campaigns that don't like what the board announces would then spend their time researching and trashing the doctors involved. Besides, a party has the advantage of considering medical information far earlier than such a board likely would, long before a potentially problematic candidate has a chance to build a popular campaign.

An evaluation of Donald Trump's physical and mental fitness for office is just one of the many things missing from this cycle's Republican nomination process. All Republicans really had to go on was a forced note from a gastroenterologist claiming that a 70-year old Trump would be "the healthiest individual ever elected to the presidency." As detailed here and elsewhere, the Republican Party did not behave as parties typically behave during nomination processes, and Trump essentially achieved the nomination despite the wishes of party elites.

But if parties could screen candidates as they once did, an independent medical review just wouldn't be necessary. The parties don't want sick or dead presidents any more than the rest of us do. Indeed, it's in their interests to minimize that.

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