Joe Biden’s health is about to be put to a severe test

The discussions concerning the incumbent US president’s age and physical condition, while not without precedent, are the most intense yet

With about half a year left until the 2024 US presidential election, the likely contenders, as in 2020, are current US President Joe Biden and the star of the Republican opposition, former president Donald Trump. By November 2024, the combined age of the two candidates will be 159 years, making them the oldest-ever contenders for the highest office in the US, surpassing the record they themselves set during the 2020 presidential race.

This raises a question in the American political discussion: How capable are the elderly Trump (77) and Biden (81) of effectively performing the functions of head of state and commander-in-chief? Public attention, in the context of this question, is primarily focused on the incumbent president. Despite Trump being only four years younger than Biden, the Republican shows virtually no signs of aging.

What’s wrong with Biden’s health?

Memory problems: Biden sometimes publicly forgets details or confuses facts, such as incorrectly remembering dates, events, or mixing up the names of key figures and world leaders. For example, he mistakenly mentioned conversations with leaders who have long since died, such as former German Chancellor Helmut Kohl and former French President François Mitterrand.

Gaffes: There are instances where Biden confuses names and details in his speeches, for example, mixing up former leaders with current ones or inaccurately recalling historical events.

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Physical awkwardness: It has been noted that Biden occasionally stumbles or loses his balance in public places, although such moments are discussed less frequently than his verbal slip-ups.

It should be noted that the issue of the main presidential candidates being too old or frail is a novelty in the recent history of the US. Presidential candidates once traditionally publish the results of their health examinations; however, over the last 24 years, no contender for the White House has had their ability to perform their duties put to the same scrutiny as Biden has.

Historical parallel: John McCain’s 2008 campaign

The last time a candidate’s health underwent intense scrutiny took place during the 2008 election race, when young Democratic Senator Barack Obama and older Republican Senator John McCain entered the fray for the presidential seat.

At that time, there were significant public concerns about McCain’s health. At the time, McCain was 72 years old, making him the oldest candidate nominated for the presidency by a major party. These concerns were exacerbated by his medical history and the grueling nature of the campaign trail.

McCain’s age was a major factor in voter skepticism. The elderly candidate provoked questions about his stamina and ability to cope with the physical and mental demands of the presidency over a potential eight years.

Moreover, McCain had a history of melanoma, a serious form of skin cancer that had been treated several times. This raised concerns about his long-term health and the possibility of his disease reappearing.

Besides melanoma, McCain had undergone several surgeries and had other health issues related to his time as a prisoner of war in Vietnam, where he suffered serious injuries and was subjected to significant physical and psychological stress.

McCain attempted to dispel these concerns by publishing over 1,100 pages of medical records in May 2008. These records detailed his treatment for melanoma, regular medical check-ups, and overall health.

His campaign also organized a meeting of a group of journalists with the opportunity to review the records under controlled conditions, allowing them to ask questions of his doctors.

As with Biden, the media often emphasized McCain’s age and medical history, sometimes questioning his fitness for the presidency. Significant public discussions about whether he could withstand the pressures associated with the position were intensified by the choice of Sarah Palin as his running mate. Palin was considered relatively inexperienced on the national stage, and her readiness to assume the presidency in case McCain was unable to fulfill his duties raised doubts. This further heightened concerns about McCain’s health and the stability of his potential administration.

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Concerns about McCain’s health were a constant issue throughout the campaign. Although they did not solely determine the outcome of the election, they contributed to forming a broader narrative about McCain’s fitness for the presidency compared to his younger opponent Barack Obama, who was 47 at the time. Obama’s youth and energy often contrasted with McCain’s age and health problems, affecting public perception and voter sentiment.

Overall, public concerns about John McCain’s health during the 2008 election were a significant aspect of the campaign, shaped by his age, medical history, and the demanding nature of the presidential office. Despite efforts to address these concerns through transparency and medical disclosures, they remained a subject of discussion and controversy throughout the campaign. 

New crisis: Special Prosecutor Hur’s report 

The Biden administration managed to keep the discourse surrounding his health out of the mainstream political discussion, and all stumbles and falls were attributed to fatigue and a heavy schedule, or written off as commonplace. However, the situation changed with the publication of Robert Hur’s report in February 2024, where the special prosecutor responsible for investigating a scandal involving Biden’s handling of secret documents commented on his health.

Hur’s report states that during his investigation “evidence was found that President Biden intentionally retained and disclosed secret materials after the end of his vice-presidency when he was a private individual.” However, Hur concluded that “the evidence does not support guilt beyond reasonable doubt.” He reasoned that “in court, Mr. Biden would likely appear before the jurors just as he was during our interview with him – a charming, affable elderly man with poor memory.” In Hur’s opinion, “it would be difficult to convince jurors that they should convict him – the by then former president, deep into his eighties – for a serious criminal offense requiring intent.”

The widespread resonance of Hur’s report required immediate action by the Biden administration to mitigate the damage caused by its publication.

This response was the publication of the president’s current health report on February 28, 2024. The examination was conducted by the president’s physician Kevin O’Connor from The George Washington University School of Medicine & Health Sciences.

According to the document, addressed to the president’s assistant and White House Press Secretary Karine Jean-Pierre, Biden is described as a “healthy, active, robust 81-year-old male, who remains fit to successfully execute the duties of the Presidency, to include those as Chief Executive, Head of State and Commander-in-Chief.”

This triggered an additional flurry of discussions about Biden’s health. Questions also arose about the position of the Democratic administration members regarding their support for Biden’s nomination for another presidential term, as Robert Hur is a subordinate of US Attorney General Merrick Garland, a very influential person in the structure of the Democratic party.

Debate Season: The first serious test of Biden’s health 

Given the realities of political life in the US, it is fair to say that a new presidential campaign begins on the day of the inauguration of the elected president. However, the last year, especially the last six months before federal elections, are the most challenging for the candidate. This stage is characterized by frequent trips to undecided states, public appearances at rallies, and participation in debates. All this requires the candidate to have robust health and a significant amount of energy.

For the incumbent president, this stage is even more challenging, as he is forced to combine election campaigning with the duties of the President of the United States.

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In April of this year, Biden stated in an interview on “The Howard Stern Show” that he plans to participate in debates with the likely candidate from the Republican party, Donald Trump. “I’m happy to debate him,” Biden said, dispelling doubts about his participation in presidential debates, which traditionally take place in three different states. Later, in May, Biden’s team agreed to participate in debates organized by CNN, which are tentatively scheduled for June 27.

Biden’s decision to participate in the debates pursues two important goals: to change the public narrative that Biden avoids direct discussion with his Republican opponent, and to improve his standing in the polls (according to most voter surveys, Biden is either trailing Trump or is on par).

If, in order to solve the first task, Biden simply needs to appear on stage at the appointed time; the second task may prove to be more challenging. The incumbent president, like any politician defending his position through participation in debates, needs to be persuasive, logical, and demonstrate mental agility. And all this in the conditions of a 90-minute live broadcast with a very strong debater – Donald Trump.

Predicting the possible consequences of Joe Biden’s health on the upcoming elections is mere speculation and guesses. The analysis of possible scenarios directly depends on the actual state of health of the president and his diagnoses, which are unknown to the general public.

But undoubtedly, Joe Biden’s health will become one of the main elements of Donald Trump’s campaign rhetoric, including during the first face-to-face debates scheduled for June. However, how convincing these arguments will be will depend on Biden’s public appearance during the main summer-autumn phase of the 2024 presidential race.