Fred Mogul, a health reporter at WNYC, called to discuss the latest Harry and Louise comeback. The infamous duo appeared in health insurance commercials in the early 1990s, raising doubts about the Clinton health reform plan. Although press lore now credits them with killing the Clinton plan, the National Federation of Independent Business (NFIB), the small business lobby, and New York Sen. Daniel Patrick Moynihan also had a lot to do with it, as I recall.
Harry and Louise resurfaced last week in a new ad that’s running now during the conventions. This time, their message is more positive: “Health care costs are up again. Too many people are falling through the cracks,” says Harry. “Whoever the next president is, health care should be at the top of his agenda. Bring everyone to the table and make it happen,” says Louise. The ad sponsors are a puzzling mix: the very same NFIB that scotched reform before; Families USA, which claims to be the voice for health consumers but allies itself with groups that hardly have consumers in mind; the American Cancer Society’s Action Network; and hospitals represented by the Catholic Health Association and the American Hospital Association. Though not an official sponsor, Karen Ignani, president of the insurers’ trade group Americas Health Insurance Plans (AHIP), also showed up at a press briefing announcing the pair’s return and lent support for the effort. “AHIP Welcomes New Pro-Reform Ad Featuring Harry and Louise,” said its press release. So reassuring!
WNYC’s Mogul unearthed a couple of old stories from 2000 that give important clues to the subtext of the new ad campaign. Mogul found that, contrary to popular opinion, this is really the third Harry and Louise commercial. CBS News noted that “Version two of Harry and Louise, by the way, features the very same actors, but the starting budget is one tenth of the original, sources say.” An Associated Press story said “Harry and Louise are back for an encore.” It didn’t say which one.
Mogul found that, at the beginning of the presidential primary season in January 2000, the Health Insurance Association of America (the old name for the insurers’ trade group) and Families USA worked together on a conference that USA Today called “the strange bedfellows conference.” The paper reported that both groups agreed that big reform wouldn’t sell. That still seems to be the operating principle today. From another conference participant, representing the Catholic Health Association, came this prescient quote: “I think there is a growing awareness that having 44 million of our fellow country-persons without access to health care is unacceptable.” Eight years later, quotes like that are everywhere.
Ron Pollack, who then and now heads Families USA, said that universal health coverage had a better chance if, rather than drastically changing the whole system, policymakers expand existing programs and allow more low income people to qualify for Medicaid. Bien sur! The insurance trade group agreed and called for programs that gave vouchers to help poor people buy their own coverage. At the time, The New York Times reported that Harry and Louise were starring in television commercials to promote the industry’s plan to make it easier for people to buy private insurance, with new government subsidies for low-wage workers and new tax credits for small employers. Sounds familiar, doesn’t it?
The solutions advanced by these groups in 2000 are the same ones candidates and interest groups talk about today—tax subsidies and tax credits to promote private insurance, building on the existing system, avoiding radical reform. And to build consensus for those recycled solutions, the ad sponsors and the insurance industry have dusted off Harry and Louise. Even the press has dusted off its slant. In 2000, the lead of a New York Times story said “Harry and Louise, featured in television commercials that helped kill President Clinton’s plan for universal health insurance in 1994, are back.” The lead from CBS News last week: “They were television icons back in the 1990s—a fictional couple starring not in a sitcom, but in political ads that transformed a very real national debate.”
Ron Pollack is back, too, saying: “I think it shows that the American people are coming together.” Really? The significance of the current Harry and Louise redux is not that groups with wildly different agendas can now play nicely together—although arguably that’s the message the sponsors want to send. It’s that the range of acceptable solutions to the health care crisis hasn’t advanced much since 2000. Or since 1994, for that matter. University of North Carolina health policy professor Jonathan Oberlander made that point recently on NPR. “A lot of things have happened in 16 years; the health care system is much worse than it was, but we pretty much have the same solutions that we’ve always had.” That’s the story Fred Mogul was beginning to sniff out; that’s the story that needs to be told.
Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for CJR's Covering the Health Care Fight. She also blogs for Health News Review and the Center for Health Journalism. Follow her on Twitter @Trudy_Lieberman.