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Harry and Louise Make Me Sick
November 1997

There are some issues that Americans just don’t generally discuss, usually because they’re boring. Health care is one of them; it ranks right up there in the stimulating-conversation list with campaign finance reform. Until you fall off a chair while trying to change a light bulb and wind up at Mass General with a broken arm and a concussion and a nurse standing over you asking if you have health insurance. Then, as Hunter Thompson would say, “Zang! Total clarity.” All of a sudden, health care means a whole lot to you.

Send your thank-you notes to Harry and Louise.

Harry and Louise were the professional, fortyish couple who spent their evenings examining the Clinton health care bill in televised advertisements run in 1993 and 1994, the brainchildren of media consultant Ben Goddard of Goddard-Claussen/First Tuesday. They sat in their cozy living room and spoke worriedly about “hidden costs” and loss of provider choice the Clinton health plan would allegedly force on America. The steady flow of these attack advertisements, principally funded by the Health Insurance Association of America and costing nearly fifteen million dollars, proved to be one of the most successful public relations campaigns in recent history. The Clinton health care plan never had a chance.

The news coverage for the average citizen was, by choice or chance, mediocre at best; throughout the struggle over the Clinton plan, everyone knew that a terrific battle was taking place, but no one really knew why. A study conducted by the Annenberg School estimated that fewer than a fifth of broadcast stories actually addressed the details of the bill. Two-thirds of all health care reform stories, including broadcast and print, centered on strategy: i.e., the score of the game. No wonder no one understood the bill.

Our essential cluelessness as average citizens was one of the main reasons for the success of the Harry and Louise ads: Harry and Louise, people just like us, would read the bill and interpret for us what a terrible idea it was. They even used the actors’ real names as an added touch of authenticity. The commercials were primarily distributed in potentially influential metropolitan areas, including Washington and New York; what filtered out to the rest of America was a vague, free-floating disapproval of a health plan about which we knew nothing at all. The underlying message, that the Health Insurance Association of America was willing to spend serious money to protect its interests and establish its position as a power player, was not lost on Congress, which sent the bill down in flames.

The Clinton team reacted, inexplicably, by explaining and complaining, rather than by launching an immediate and widespread counterattack. Although the DNC ran a television spot declaring that “the insurance industry is scared that change is coming,” the overall response was largely restricted to bitter and ineffective noise from the Clinton camp. An angry Hillary Clinton said bluntly, “They [the HIAA] like being able to exclude people from coverage because the more they can exclude the more money they can make.” Ira Magaziner, Clinton’s senior advisor for health care reform, told the Center for Public Integrity, “The real issue is not all the groups who made their voices heard, it is all the people without an organized voice.” Even Boston Globe columnist Thomas Oliphant got into the fray when the ads were finally pulled, saying, “Harry and Louise are currently off the air. If Congress listens to real people instead of paid liars, their employers could soon be out of business.” But Oliphant’s “real people” were not the intended target of the Harry and Louise campaign.

The strategic thinking that went into the Harry and Louise ads went far beyond the concept of überyuppies translating a 1300-page bill for the ostensible benefit of the average American. The narrow release of the ads ensured their exposure to power players in Washington, and the so-called grassroots movement behind them was ready to do whatever it took to kill the Clinton bill. As Goddard explained, “We had outreach campaigns to friends and family, if you will, in the insurance industry and in other industries that were supportive.” These supportive interest groups, Goddard’s “friends and family,” went to impressive lengths to keep their influential audience: according to the Center for Public Integrity, over 85 members of Congress went on vacations to locales such as California, Florida, Jamaica, and France during 1992 and 1993, at the expense of the health care industry. And you wonder why your insurance premiums are so high.

President Clinton presented his Health Security Act to a joint session of Congress and a prime-time television audience in September of 1993. A USA Today/CNN/Gallup poll conducted shortly after the speech found that 57 percent of Americans approved of the plan. Six months later, the HIAA campaign, headed by Harry and Louise, had caused a twenty-point drop in approval ratings, prompting Senator Jay Rockefeller (D-WV) to declare it “the single most destructive campaign I’ve seen in thirty years.”

The strategy was destructive not only to Americans but to what we have left of democracy: the ultimate result of the campaign has been a nationwide increase in the number of uninsured individuals and a strengthening of the HIAA’s influence over Congress. Harry and Louise demonstrated to us how easily special interest groups with enormous budgets can influence the laws under which we all live.

My own provider recently informed me that my type of policy is being discontinued, and offered me an alternative plan at $2500 a year. I haven’t bothered to read the new plan yet. For that kind of money, I think that someone owes me a trip to Jamaica.