The deuce you say.
We used to know this. In fact, we deemed it so important that we actually added a constitutional amendment to deal with presidential unfitness due to health or other reasons.
And now, of course, we have come back full circle to 1945, when the importance of transparency on the president’s health became suddenly and shockingly germane. Democrats and the media covered up the declining physical health of Franklin D. Roosevelt in the middle of World War II, allowing him to run for an unprecedented fourth term as his health failed. He only lasted less than three months as the Allies finally made their way into Germany and worked their way up the Pacific Island chain to approach Japan. FDR’s death threw an unprepared Harry S Truman into the most critical period of the war; FDR’s decline may have contributed to decisions that allowed the Soviet Union to impose an Iron Curtain around eastern Europe.
It took two decades later for the US to fully address the issue in two constitutional amendments. The 22nd Amendment limited presidents to two terms, in a direct answer to FDR’s death in office. And FDR’s death at least partially inspired the 25th Amendment two decades later, a point to which we’ll return shortly.
First, here’s the current Vice President making the obvious point about the necessity of transparency on presidential health. Considering J.D. Vance’s role in these constitutional guardrails, this sets some interesting expectations:
.@VP: “Why didn’t the American people have a better sense of his health picture….We can pray for good health, but also recognize that if you’re not in good enough health to do the job, you shouldn’t be doing the job.” pic.twitter.com/2f8xmOJzhz
— Mary Margaret Olohan (@MaryMargOlohan) May 19, 2025
We really do need to be honest about whether the former president was capable of doing the job. You can separate the desire for him to have the right health outcome with the recognition that whether it was doctors, or whether there were staffers around the former president, I don’t think he was able to do a good job for the American people. And that’s not politics, that’s not because I disagreed with him on policy, that’s because I don’t think he was in good enough health.
In some ways, I blame him less than the people around him. Why didn’t the American people have a better sense of his health picture? Why didn’t the American people have more accurate information about what he was actually dealing with? This is serious stuff. This is the guy who carries around the nuclear football for the world’s largest nuclear arsenal. This is not child’s play. We can pray for good health, but also recognize that if you’re not in good enough health to do the job, you shouldn’t be doing the job.
This is absolutely true. And yet, we have absolutely no way to enforce this, at least not from the outside. We provide presidents with world-class medical care and support in recognition of the importance this office holds. No other office in the US has this level of health-care attention and support. While Congress gets access to above-the-norm care as well, that’s mainly because Congress has carved that privilege out for themselves.
In exchange for that level of support and care, we expect presidents to be completely transparent about the state of their health. In addition, we require — constitutionally — the other senior executive branch officers to enforce that transparency. The 25th Amendment got proposed in the immediate wake of the assassination of John F. Kennedy, where the question of whether he could physically survive but be incapacitated was a brief concern about the succession of executive authority. (We had also never constitutionally ratified the practice of Vice Presidents succeeding Presidents after deaths or resignation of office.) However, the implications of incapacity clearly could have been applied to the final weeks or maybe months of FDR’s presidency.
This was the first test of the 25th Amendment since Watergate fifty years ago, and in some ways its first real test ever. And it failed, because everyone around the president had too much self-interest invested in Joe Biden’s grip on power. His family wanted to maintain their access to power for commercial reasons. Kamala Harris wanted to ride Biden’s coattails for as long as possible, perhaps to a succession after Biden’s re-election. His Cabinet members never stepped up and revealed their increasing isolation from their direct boss because they wanted to keep their own political prospects alive. And the staff in the White House never said a word, likely because they were too busy exercising Biden’s constitutional power and authority while propping Biden up as a figurehead.
The 25th Amendment is structured for officials who put the country’s interests ahead of their own, from presidents on down. That is its fatal flaw when it comes to dealing with presidential incapacity that doesn’t involve deaths or comas. No one in Biden’s orbit put the country’s interests ahead of their own, especially not the Bidens themselves. That saddled the country with a president who was clearly descending into incapacitation almost from the time he took office, and who now appears to have been seriously ill even before that.
Now that the fatal flaw has been exposed, we need to fix it.
First, we need to stop treating presidential health data as though it requires HIPAA compliance. The president (and VP) should undergo routine medical evaluations several times a year rather than just an annual assessment, and the data from tests and examinations should be made entirely public. The amount of authority invested into the presidency demands that kind of full transparency, and presidents should understand that they give up the right to privacy when they win election to the office. That information should not be controlled by the president’s family or his/her chosen physician.
Speaking of which: Let’s put an end to presidential physicians, at least in that sense. Physicians working in our military can attend to the Commander in Chief (and VP, again) on a rotation basis, lest any one physician get corrupted by access to the Oval Office. Biden’s doctors contributed to the cover-up of his incapacities, proving the need for both independence and transparency. If a president disagrees with the assessment of those doctors, he can seek out and publish second opinions. But if a second opinion is sought, that too should include total transparency.
Congress needs to step up and make these changes, in statute at least, and by constitutional amendment if necessary. However, it also needs to amend the 25th Amendment to give itself a role in determining presidential incapacity. As it currently stands, only the Vice President can initiate a transfer of authority with the concurrence of a majority of the President’s Cabinet officers. As the Biden failure demonstrates — and as the structure of the Constitution itself anticipates — the executive branch cannot be trusted to solely police itself in this matter.
Vance’s remarks today make clear that changes are needed. And it raises the stakes for Vance and all others who succeed him as Vice President: Will they stand up when needed to ensure that an incapacitated president is removed from constitutional authority and power? Will we put those guardrails in place so that they have no other option?
Read the full article here
