Noble Conspirator: Florence S. Mahoney and the Rise of the National Institutes of Health (review)

Florence Mahoney called herself “a non-paid lobbyist in the health field for many, many years” (p. 270). Judith Robinson, former investigative reporter and congressional aide, tells the story of Florence Mahoney, who, working in partnership with Mary Lasker, Representative John Fogarty and Senator Lister Hill, and journalist Mike Gorman, played a catalytic role in advocating for an expanded federal role and funding for medical research in the United States in the second half of the twentieth century. As the wife of Daniel Mahoney, publisher of the Miami Daily News and former son-in-law of James Cox, Governor of Ohio and Democratic presidential candidate, Mahoney had easy access to and developed friendships with many key Congressional leaders and future presidents. Mahoney was relentlessly self-educated in health care issues as well as a skillful advocate—whether in her own dining room in Georgetown or in the offices, committee hearing rooms and halls of Congress. She knew when, with whom, and how to champion her causes. She knew the power of the press and the value of a well-timed news story.

While Robinson adequately covers and convinces readers of her thesis—that Mahoney played an important role in the expansion of the National Institutes of Health, medical research, and federal funding research. and successfully advocated for the establishment of the National Institute of Aging in 1974, readers may wish she explored in greater detail Mahoney’s advocacy of mental health clinics and reform in Florida in the 1940s. This experience was formative in Mahoney’s education as a lobbyist and her work on behalf of mental health services and support both at the national and state level. This aspect of her story deserves more exploration.

As “benevolent plotters” Florence Mahoney and Mary Lasker, health activist and wife of advertising executive Albert Lasker, were relentless, but in markedly different ways, in advancing medical research on the health problems of the American people in the post World War II period. Robinson recounts this relationship between Lasker and Mahoney and their common work and bonds as well as the differences in Lasker and Mahoney’s interests and lobbying styles. “Lasker . . . was a strong advocate of applying discoveries to treatment at the earliest possible times. Mahoney . . . had confidence in the long-term benefits of basic research, which did not always produce instant cures and whose advantages seemed remote and mysterious to laymen.” (p. 68) “Mahoney, while not as empathetic as Lasker in pressing for applied over basic research, wanted to see results and support of innovative research.” (p. 200) This is critical to understanding Florence Mahoney’s success as a lobbyist at the national level and in dealing with the ill concealed hostility of medical and professional groups fearful of the burgeoning role of the federal government in health care. Advocacy for research, especially basic research, would become more acceptable and successful than pushing for universal health care coverage. Both Mahoney and Lasker learned this lesson after the defeat of Truman’s national health insurance initiative in 1947.

Access to Mahoney’s personal papers, interviews, and secondary literature form the core of Robinson’s sources. The story could have been enhanced by additional review of recent scholarly literature in medical research, and archival sources on the National Institutes of Health and federal health policy. The Mary Lasker Papers, recently organized and available at Columbia University, are a potentially rich well of material that remains to be drawn from to enhance the story of Florence Mahoney and her partnership with Mary Lasker. Readers and future scholars would have welcomed a detailed bibliography and notes on sources used in Robinson’s biography. This omission hampers scholars wishing to explore in greater detail some of...