Tipper Gore

The marble echo of my own To footsteps down the long, hallowed hallway of the Old Executive Office Building sounded ominous as I headed toward Tipper Gore’s office. As Murphy’s Law would have it, I had chosen the building entrance farthest from Mrs. Gore’s office and there were extra moments to ponder enticingly contradictory images of the Tipper Gore Capitol Hill personality.

There was the image of the staunch, ultra-conservative, politically-correct wife of Vice President Al Gore. There was the image portrayed with considerable media focus of the outspoken activist. The activist who went head-to-head with notables of the rock music world to promote labeling of albums containing explicit lyrics as a warning to teens and their parents. And yet another image came to mind of the outrageous prankster of whose antics I had heard. Of course, there was also the image of a indefatigable humanitarian working within the Administration for more comprehensive healthcare.

“Who is the real Tipper Gore?” I wondered. Which, if any, of these images would dominate in our interview-political spouse, dedicated activist, prankster, humanitarian?

As I entered the small reception area to Mrs. Gore’s office, I was struck by the number of pictures mounted on the wall. I knew the lady’s reputation as an avid photographer, and the pictures displayed reflected considerable talent. There were photographs of a variety of political and administration figures taken at angles only an insider could have managed.

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Soon after my arrival Mrs. Gore appeared, flanked in Washington style by two aides and accompanied by the mandatory Secret Service agent. In the free moments prior to Mrs. Gore’s appearance, I had gotten on the phone to retrieve my messages. Mrs. Gore, too, was waylaid by conversations with a few of the numerous people crowding the room. Although not certain who I was, she exchanged a humorous glance of exasperation with me at the business demands at hand for both of us.

When I was off the phone and Mrs. Gore was available for our meeting, she acknowledged me with both the customary handshake and a sincere touch on my shoulder as she ushered me to her office. The earlier glance we had exchanged and the touch of her hand on my shoulder worked to soften the isolated images I had conjured earlier.

As we began to speak, the real Tipper Gore started to emerge. Tipper Gore with the heartfelt commitment to serving a particular population in need. Her dedication to relieving the plight of children and adults suffering illnesses of the mind, emotions, spirit, and circum- stances became evident.

As we addressed these issues, a glimpse of a playful Tipper Gore surfaced when I asked her about her sense of humor and her hobby of roller blading.

Chet Cooper: I have heard you’re a whimsical character. Are there any stories you can share?

Tipper Gore: Hmmmmmmm……. (Laughter. On the side with her aides. “Should we tell him about the …? (Aide replies) “No, not that!” “Well, how bout when…?” (Another aide interrupts) “I don’t think so!” (After much chuckling among Mrs. Gore and the aides, she finally responds with: Well, one time, before I was getting ready to speak, somebody called my office and said, “What is your title?” I said, “I don’t have a title, but I suppose that if you really need one then it would be ‘The Second Lady’. But I don’t really like that very much because it always makes me feel as if, ‘gosh, if I had just tried a little harder!””

CC: And the toilet gag when you were in school? Wrapping the toilet in clear plastic as a joke on your teacher?

TG: Oh yeah, that was hilarious. Who doesn’t want to do that to their teacher when they’re in 7th or 8th grade. Having fun is such a part of my life. We work hard and we have fun.

CC: And I’ve heard you enjoy roller blading. Are you able to go often?

TG: Not lately; there isn’t any place to do it. The C&O canal is where I usually go, but it was just damaged tremendously by the flood. The C&O canal goes along the Potomac River and it is very old. I am just sick about it.

But anyway, there is one path which I run along and then there is another path which is paved with asphalt where I go roller blading. If I am traveling, I will event bring my roller blades with me. Have you heard of “Rails and Trails”?

CC: No, I haven’t.

TG: It’s taking old railroad bed ding and converting it to path ways for bicyclists and rollerblades. There are many, many miles of this in and around the country.

CC: What are some of your other hobbies?

TG: I like water sports and snow sports,

CC: Have you tried snowboarding?

TG: No, I want to live! (Laughter all around.) Even my kids say that the first couple of times you try snow boarding you feel as if somebody beat you up. Personally, that does not make me wish to try it. I like downhill skiing, water skiing and bicycling. I just like to be outdoors.

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CC: What do you think is the reason you became an activist for mental health?

TG: It’s because my own mother suffered from depression when I was growing up.

I became very interested in mental health and interested in studying as much [about it) as I could. I ended up with a Master’s Degree in Psychology and was going to go into practice. I feel that people with mental health issues have been treated unfairly and discriminated against. It’s time to end that.

I have been working toward making the stigma surrounding mental illness go away by focusing on educating people. It’s the brain that can get sick, either temporarily or chronically. We shouldn’t treat these people any differently just because it is the brain, as opposed to the heart, liver, or circulatory system.

I think we have made a lot of progress in the last few years by getting the word out to the public that one in four families will experience. at some point, a mental health issue.

CC: I have here the November 1994 issue of USA Today and in it there is a list of tough questions that they say you haven’t answered. I don’t think they even interviewed you. The headline reads, “You should avoid mental health insurance.”

TG: Aaaaah! Yes, I remember that. I believe one of the authors did an article in the Wall Street Journal and USA Today. He is an editor at USA Today and his anti-mental health message got out and I was trying to combat it. No, they never talked to me.

CC: The author definitely has his own agenda in the article. It’s very surprising. What I would like to do is ask you the questions that they said you wouldn’t answer.

(Mrs. Gore reviewed the questions.)

TG: No, they never asked me these questions. This was a major battle health insurance. The writer was Richard Backs and another person I am not familiar with. He wrote articles in a number of publications regarding this.

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CC: Then there are a few of these questions that I would like to ask. First, since many so-called ill nesses are simply about problems that are part of life and they have no medical cause, should counseling be covered as a basic health care package?

TG: I think if a person is disabled by mental health problems to the point where they can’t function, can’t go to work and, if a doctor says that counseling is the recommended answer for them, then, yes, I do think [counseling] should be [covered]. We have evidence that psychotherapy alone can help people who are very distressed with a psychological, emotional. or mental problem.

We have researchers at NIH (National Institute of Health) who have shown slides at their lectures comparing MRI’s and PET-scans of people who are suffering from a variety of [mental illnesses]. They compared psychotherapy treatment by itself with a combination of psychotherapy and medication treatments and they found that, for some individuals, just the psychotherapy provided the changes that were need ed to cure or help a person manage.

Now, what people are afraid of is that they are going to be financing healthcare for the person who is like the Woody Allen character on the couch, in a darkened room, talking to an analyst for 18 years. People say, “This is where your tax dollars will be going if you say it’s okay to cover counseling.”

We have always argued that very specific counseling that is ordered by a doctor is legitimate. Back during the national healthcare debate, when talking about coverage for mental health, we discussed medical diagnosis of mental health problems. There are a number of different treatments that work: counseling, medication, [a combination of] medication and counseling. These should be covered if they are prescribed by a doctor within the medical community.

We are not talking about people who are unhappy or, what we call, the “worried well”. Some people thought that we should cover these [types of people] as well, but we said no. We are talking about serious, diagnosable mental health issues.

The argument [that is made] is, if a problem is at all connected to the brain-mental disorder it is not treated with equity. It is not treated the same at all. It is subject to either no treatment, no insurance coverage, or very limited coverage. [Compare this] to what the same individual would have if they had diabetes. That is at the heart of the argument.

CC: If you’re calling this a medical issue, should psychologists and social workers be allowed to diagnose and deal with this area, rather than just medical doctors?

TG: I think that is up to the community itself. The way it works now, as far as I have been told by people in the profession and by my own observation, usually [patients] will have [either] a psychiatrist or a medical doctor working with [either] a psychologist or a social worker. If medication is involved, [psychologists and social workers] can’t prescribe medication. They have to work with a psychiatrist [who can prescribe medications]. So, what you usually find is a practice where there is a psychiatrist working with psychologists and social workers and vice versa. I find it is more of a team approach and I think it will continue that way.

CC: What do you think is the future of mental healthcare coverage?

TG: Unless we can stop this Congress, I think that we are going backwards. I think that this is a time that Congress would like to say, “No, we are not going to have healthcare for everyone. We want to slash Medicare and Medicaid.”

Medicare and Medicaid are essential healthcare for people, including six million adults with dis abilities and one million children with disabilities. Congress wants to slash the funding for that. To me, that’s going backwards. It’s also leaving people unattended in their homes or in the streets and forcing society to go back to a model that is based on institutionalization which is highly expensive.

I am very hopeful [though] because we are moving toward community-based programs which help people to stay in their homes, to be independent. [Programs which] allow children with disabilities to continue to be educated in the public school system. And, programs that do away with the discrimination that people with disabilities continue to find even after the passage of ADA (Americans with Disabilities Act).

So, the battle is going to be between the people, the disability community, and the Clinton Administration which stands for no slashing of funds for Medicare and Medicaid, and, in an ideal world, the expansion of Medicare and Medicaid.

What we would really like is expanded healthcare coverage for all people, and especially people with disabilities. We think that if it is delivered correctly in a community-based setting, then it is actually cost effective. It is not going to cost more. It will actually cost less because people are going to be able to take care of themselves or a family member in the least restrictive setting, whatever that is. Whether it is partial hospitalization or just being at home and going for outpatient services. It just makes sense.

CC: Did you read the recent report from Richard Foster, the Chief Actuary? It stated that there is a shortfall in Medicare this year and will still be a shortfall two years from now. It also reported that it has happened earlier than anyone expected.

TG: Yes, I think we all understand that there is a problem and that is one reason why the Clinton Administration pushed so hard to have reasonable, well-thought-out healthcare coverage for everyone. Unfortunately, the Congress chose to reject that because they are looking at slashing Medicare and slashing Medicaid and moving toward block grants to the states.

We all recognize that there is a reason to move toward a balanced budget in general and, specifically. to make sure Medicare remains sol vent. This Administration doesn’t believe the way to do it is by slashing programs because that would mean people who are more vulnerable than others are going to be thrown into a reality where they are going to have to fend for themselves. That is not my vision of America in 1996 as we move toward the year 2000, I know that is certainly not the vision of this Administration,

We have a clear battle shaping up between the radical right wing Republican congress (which does not represent all Republicans) and the Administration. It’s a classic battle over how we care for our people. in particular, Americans with vulnerabilities or disabilities.

I would also like to point out that Medicare and Medicaid is, for some people, the only insurance they have. It is the only kind of help they have. We are not talking about extremely wealthy people who have other [insurance] and are on Medicare because they have reached [65]. That is not who we are concerned about here. We are concerned with people whose Medicare bene fits are their lifeline and are absolutely essential.

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