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Robert Ball, Commissioner Of Social Security, 93

Robert M. Ball died Jan. 29, 2008, at the age of 93.

If I tell you that he was the social conscience of Social Security, and the social conscience of Medicare, you may think he was a dull and boring bureaucrat. He wasn't. He was a twinkly guy, but exacting too. And he had an unerring sense of the right thing to do.

Here was Bob Ball's big idea: If you link a government program like Medicare or Social Security to people with low incomes, it wouldn't have much long-term support in Congress, it would quickly become underfunded, and many people who need the benefits would be too embarrassed to apply for them. But if you make them available to everyone of a certain age, you'll have a lot of political support and a solid program.

Ball joined the Social Security Administration as a low-level bureaucrat in 1939, four years after the program started. He was commissioner from 1962 to 1973. And he was one of the architects of the Medicare program, which began in 1965. He was deeply involved in President Lyndon Johnson's successful effort to limit Medicare funds only to hospitals that had desegregated. That approach led to the quick desegregation of virtually all American hospitals.

Ball never bragged about that or any of his other achievements. He had the utilitarian point of view that the people over him and under him would work harder and smarter if he made sure they, not he, got the credit.

Keeping his idea going meant a lot of public and private "encounters" with presidents, Congress members and their staff. Money was always at stake. So was ideology. Ball's ideas cost money, and some of his ideas looked quite socialist.

He won his battles, maybe not immediately, but he won them in the long run. He did it by being unfailingly polite, incredibly well-prepared, and outlasting everyone in the room.

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Joanne Silberner
Joanne Silberner is a health policy correspondent for National Public Radio. She covers medicine, health reform, and changes in the health care marketplace.