This year as the top person on the annual reader poll, Keehan leads a flock of organizers, innovators, dissidents and faithful whose one commonality seems to be a renewed hope for fundamental reform in healthcare. Many of the usual suspects, including President Bush (No. 9) and HHS Secretary Mike Leavitt (No. 11), have been pushed down at least several notchesif not tiersto make room for newcomers who are actively agitating for change.
Regional players whose ideas and innovations are sparking interest at a national level also have contributed to a surprising restructuring of the 100 Most Powerful list. Perhaps not as surprisingly, several presidential hopefuls who have put healthcare at the top of their platforms also cluster at the highest echelons of the list.
I think people realize the next president is going to have to make dramatic changes in the way healthcare is financed in this country, says Thomas Dolan, president and CEO of the American College of Healthcare Executives and another perennial who ranks No. 59 this year, up from No. 65 last year. I think what were finding is an expanded power structure.
Maybe what we are seeing with the growing importance of healthcare in the country is a growing democratization of who the important people are.
Former Massachusetts Gov. and Republican presidential hopeful Mitt Romney and California Gov. Arnold Schwarzenegger follow Keehan at No. 2 and No. 3, respectively, no doubt in recognition of the groundbreaking efforts to insure all individuals in those states. Schwarzenegger rocketed on the list this year for the first time, but Romney debuted last year at No. 13.
The plan in Massachusetts was approved under Romneys watch as governor and is now in its devilish detail stage, but the effort in California is an ongoing drama. Romney wasnt the driver (behind the Massachusetts plan) but Schwarzenegger is taking an enormous healthcare economy and trying to move to universal coverage, says another perennial, Donald Berwick, president and CEO of the Institute for Healthcare Improvement in Cambridge, Mass., who ranks No. 24the same spot as in 2006. Thats very bold and very important. Its real leadership. You might see that in the current absence of federal leadership, the state-level activities seem more important in the political landscape.
Following Schwarzenegger at No. 4 is a relative unknown. Just like the California governor, Deborah Peel leaped right to the top tier. The privacy advocate made a mark by founding a grass-roots Internet-based group of some 4,000 e-activists who are fiercely defending the privacy of medical records as the healthcare industry becomes more comfortable and adroit with information technology. A practicing psychiatrist who never graduated high school and takes no pay for her position as founder and chairwoman of the Austin, Texas-based Patient Privacy Rights Foundation, Peel boasts that she has put the ultra-left-wing American Civil Liberties Union at the same table as the ultra-conservative Family Research Council.
I spent 30 years at the bottom of the pyramid sitting in my office and hearing from patients what happens when (medical) information goes places they dont want it to, and its always bad, Peel says. Im speaking for all the peoplepatients and consumerswho have never been at the table as Washington and major corporations are trying to design the healthcare system. The people that need to be at the table havent been there, and thats consumers.
In another restructuring of the power base, prominent union officials also climbed to the highest echelon.
We are at a unique moment in history for change in our healthcare system, says Andy Stern, president of the 1.8 million-member Service Employees International Union, and No. 5 in this years readers poll. I think those of us willing to be both forceful advocates and also good partners are now creating the environment to finally solve this problem.
Dennis Rivera who was president of Local 1199 of the SEIU in New York until recently taking the chairmanship of a new national healthcare union within the SEIU, debuts at No. 6, right behind his boss, Stern, who squeezed onto the list last year at No. 99.
Rivera does not register surprise at his strong showing, noting that SEIU Healthcare boasts 1.1 million members, including 84,000 nurses and 12,000 doctors. Working with a budget topping more than $500 million, SEIU Healthcare has earmarked more than $100 million to organize workers and is poised to embark on a political action fund drive to collect more than $40 million over the next two years, he says.
Echoing one of this years major themes in regard to coalition-building, Rivera notes that SEIU Healthcare is actively working with the most unlikely of partnersemployersto advocate for the adoption of a national healthcare plan. I think that there is ferment in this country that we need to change the healthcare systemthat we need to fix it, Rivera says.
I think there is a moment of change in healthcare that is being accelerated by new partnerships, Stern says, highlighting the Divided We Fail partnership that the union has undertaken with the AARP and the Business Roundtable to spark action in healthcare. The SEIU has also teamed up with large employers such as AT&T, Intel Corp. and Wal-Martorganizations the union has tangled with beforeto address the issue of healthcare reform. This is different from 1993 when (healthcare reform) was strictly a moral issue. Now it is a moral and economic issue. I think that has increased the chances for success, Stern says.
It was perhaps this high-profile campaign that has vaulted William Novelli, CEO of the AARP and a former public relations scion, to the list for the first time at No. 19. Although with nearly 39 million members and healthcare always a top issue on its agenda, I think the head of AARP should have been on the list a long time ago, he says. Maybe this year people took notice of what were doing. Basically we made healthcare front and center in the presidential debates, Novelli says.