Chastened and More Sober, Harry and Louise Return

On Tuesday, Ron Pollack of Families USA led a call with bloggers — unfortunately, I couldn’t be on it — to discuss  Harry and Louise Return — the new health reform campaign sponsored by five prominent organizations: the American Cancer Society’s Cancer Action Network (ASC CAN), the American Hospital Association (AHA), the Catholic Health Association (ACHA), Families USA and the National Federation of Independent Business (NFIB).

The common goal of these collaborators is to get the next President and Congress to focus on
meaningful health care solutions. Beyond that – and of course all those experienced with the
policy-based reform process are aware of this – the motivations and
objectives of the participating organizations diverge. To get an idea
of the degree of their differences, look at the ASC CAN, Families USA and NFIB sites.

The first three groups are provider organizations. Naturally,
they’re concerned that money is evaporating for their services, and
they want to make sure they’ll get paid for any services they provide.

Families USA is an idealistic consumer advocacy organization that
believes the US should provide universal coverage because it’s the right
thing to do. (They tend to pay less attention to the structural
problems in health care that have created runaway cost.) While its an
admirable perspective, it also willfully ignores the fact that Congress
hasn’t passed any major social-justice-based laws for more than 40
years, and that as long as special interests continue to be allowed to
exchange financial contributions for influence over policy, it is
unlikely we will return to policy in the common interest.

It’s the fifth organization that’s interesting and unexpected. The
National Federation of Independent Business is the generally
conservative association representing small business. Here they join
with past adversaries, though NFIB’s mantras – affordable, stable
coverage with choice guided by knowledge of price and performance – are
at odds with some of their current pals.

The ad itself has a winning earnestness. The new one is above, and here is the one from the Clinton period. Like the country, now chastened
and more sober after its indulgence in patriotic zeal during the early
Bush years, Harry and Louise, older and wiser, aren’t so cavalier about
Congress making decisions without their input. The health care crisis
is all around and they need help. The punchline has Louise, with
heartfelt concern (against a plaintive musical score), saying, "Whoever
the next President is, health care should be at the top of his agenda,
bringing everyone to the table, and make it happen!"

It seems so straightforward! When I was working day-to-day on national
health care reform people would call to tell me what needs to happen.
As it turns out, knowing what needs to be done isn’t the hard part.
Most everyone inside and outside of health care who’s thought about it
even a little knows most of those answers.

No, the hard part is making it happen within a policy framework that’s
controlled by money and power. Displacing the status quo isn’t easy at
all. And as it turns out, its pretty clear that, while each
organization at this table dearly wants reform, they each, like all of us,
want it on THEIR terms.

I attended and blogged Family USA’s big meeting some months ago in DC. It had a range of terrific speakers, but the politicians among them —
Ms. Pelosi included — pretty much told them what they wanted to hear,
that health care reform can happen if people like them just stand up
for it. Feeling empowered, the audience LOVED that message. It didn’t
particularly matter that it wasn’t true.

The truth is that unless the nation’s most influential power brokers
mobilize to make changes in policy, it’s not likely to happen.
Consumers certainly aren’t galvanized around any specific health care
reform agenda or project that I’m aware of, so they don’t have a
significant power base on this issue. The good news is that a range of
non-health care Fortune organizations ARE working, quietly but
forcefully, on the problem, through the Patient Centered Primary Care Collaborative and other efforts.

More on that soon.

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Brian KlepperMatthew HoltPaul McGeeMGMaggie Mahar Recent comment authors
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Brian Klepper
Brian Klepper

Paul, While I wouldn’t even think of besmirching the good name and work of the ACS, it is hardly pure as Caesar’s wife. It does accept very substantial support from firms that develop and market products for the extremely lucrative oncology community. As someone who is in the thick of what transpires in the cancer economy, I’m sure you’re aware that rebates and other unsavory tactics have made cancer care, and community oncology particularly, into one of the most conflicted areas of medicine. I’ve written about this problem a great deal – see http://www.communityoncology.net/journal/articles/0406367.pdf. Now none of this negates your… Read more »

Matthew Holt

“ill informed & inflammatory” I’d say. Oh and too much data
(sorry, private joke I’m trying to get Brian to share….)


OK, Paul. How does that ad we saw at the beginning of the post do that, exactly?

Paul McGee

Brian. Interesting take and you make some good points. However, one thing I would like to make note of. You wrote: “To get an idea of the degree of their differences, look at the ASC CAN, Families USA and NFIB sites. The first three groups are provider organizations. Naturally, they’re concerned that money is evaporating for their services, and they want to make sure they’ll get paid for any services they provide.” Perhaps I’m reading it wrong. Are you implying the American Cancer Society or the American Cancer Society Cancer Action Network are involved with access to care because we… Read more »


Its amazing that Harry and Louise have aged incredibly well over the past 15 years. Maybe it would have been more useful for them to share their health/lifestyle tips instead of the generic platitudes of this commercial.

Maggie Mahar

Brian– What’s remarkable is how you and I often seem to be writing on the same topic at exactly the same time. And, as usual there is a weird overlap in what we are saying as well as notable disagreement. Yesterday, I posted a piece about “Health Care Reform, Interest Groups and the “Collective Good.” (See http://www.healthbeatblog.org) I was responding to Nicholas Lemann’s piece in The New Yorker where he suggests that there is no such thing as “the collective good” or “the common good” and that policy can only emerge from a battle among interest groups, each fighting to… Read more »

Gregg Masters

OK, I want at that table. Here’s one insiders voice about that “devil in the details” of health care reform. For years, I set up and managed the physician entities, and wrote the business plans, that afforded coordinated and occasionally strategically aligned contracting between hospitals, their parent systems, physicians and the payor community. In all cases we attempted to consolidate provider assets aggressively within FTC/DOJ safe harbors, in order to build leverage to extract best price and terms from the payors on a discounted (non risk) fee for services basis. In others, we assumed partial or global risk for the… Read more »


As a 35 year old cancer survivor, I am forced to rely on employee based insurance. However, I am trying to start my own online business instead. If I am unable to obtain insurance for my check ups then that could be a death sentence for me. I don’t have the answers nor do I necessarily advocate universal coverage but something needs to be done to fix the current coverage issues. One call that we do need to make is with the politicians in congress. If they are unwilling to work together or they act with special interests in mind… Read more »

William Bennett

I am amazed at the amount of cynacism that abounds in and out of the healthcare industry – though I should not be after four decades in the industry. I keep saying that if you are going to be a change agent of any kind you need to step to the other side of the door and not decide you can solve the issue by looking through the keyhole. There are so many moving parts and concentrating on just one does not assure the rest will be addressed in any way. Brian, as you indicated there are a number of… Read more »


What a waste of money! Tired boomers spouting platitudes. I wonder what the message is going to be in the third, fourth and fifth versions of this ad: “Just make sure all of our services are covered?”
Who watches TV anyway? Obama will text his VP choice.