Here’s the deal: If you’re over 50, for just $12.50 a year, AARP will give you a magazine and newsletter subscription, as well as allow you to “receive discounts on car rentals, lodging cruises” and a host of other wonderful things. And the same time, it will argue for your most vital political interests in Washington. You’re a Republican? Democrat? Anarchist? It doesn’t matter; it knows what you want. At AARP, one lobby fits all.
—Dale Van Atta (2006)
Though the former New York advertising guru Bill Novelli would initiate substantial organizational and cultural change when he became AARP’s CEO in 2001, Novelli and other AARP spokespersons have always made sure to regularly, ritually invoke the fifty-year-old organizational mantra “What we do, we do for all.” The slogan was established in 1958 by the organization’s founder, a former California school principal, Ethel Percy Andrus (1884–1967), who was outraged by elderly Americans’ poor living conditions and lack of health insurance. Major speeches by AARP leaders usually contain at least one reverential reference to Andrus, a ritual especially obvious during 2008, when the organization celebrated its fiftieth year. Despite its enormous growth in membership, complexity, and political clout, AARP remains rhetorically faithful to Andrus’s simple, high-minded mission: building an unusual, hybrid profit/nonprofit “social entrepreneur” organization that sells reasonably priced financial and insurance products to older Americans and then plows the proceeds back into social services, policy advocacy, and an overall “positive aging agenda.”
AARP’s increasing media presence, its 2005 high-profile campaign against President George W. Bush’s Social Security “privatization” reforms, its aggressive boomer and diversity outreach projects, and its very expensive but ultimately successful “Divided We Fail” campaign for comprehensive health care reform are viewed by AARP faithful as well within the context of the historical “big picture.” For these loyalists, AARP is still on the course Andrus charted fifty years ago. New CEOs come and go, but Andrus remains a revered, pioneering titan of change who fought the early, decisive battles to found a unique organization and to instill an enduring public service spirit.
Nevertheless, even Andrus probably didn’t foresee that AARP would evolve into the nation’s second-largest membership organization at forty million (only the Catholic Church is larger)—though critics claim that actual membership may be closer to half of the claimed forty million because dues-paying members’ spouses and domestic partners are automatically enrolled. There is little doubt about AARP’s lobbying clout: it has been the fourth-highest-spending lobbying group from 1998 to 2009 (ranked second or third highest in four out of six years from 2003 to 2008).1 It’s a remarkable saga.
In 1947, nearly twenty years before the advent of Medicare, Andrus founded the National Retired Teachers Association (NRTA). The original modest mission was to organize a pool of consumers who, collectively, could obtain reasonably priced health insurance. Many retired teachers were too old, sick, or poor to purchase individual policies—some were so impoverished that Andrus allegedly discovered one of them living in a converted chicken coop. Ten years later, NRTA became a subunit in a larger organization offering insurance and a slowly widening range of products to all Americans over fifty: the American Association of Retired Persons (AARP). By 1999, nearly half of all members were still working—so the organization dropped its full name and retained the well-known initials.
In subsequent decades, AARP’s fusion of profitable insurance and financial products with social services and policy advocacy has stoked the ire of conservatives bent on curbing or replacing Social Security and Medicare. Following the 1994 “Republican Revolution” electoral landslide, GOP politicians took vengeance via a series of investigations about AARP’s conducting for-profit business under its “nonprofit” 501(c)(4) legal status. The former U.S. senator Alan Simpson (R-WY) was especially combative. He grilled AARP officials about the organization’s finances and its tax-exempt status. Simpson kept up his criticisms even after retiring from the Senate. “AARP could be such a force for good . . . but they’re not. They’re selfish, greedy. They don’t care about their grandchildren a whit. . . . Now I have the freedom to just beat the brains out of the AARP and I do that all over America.”2
Simpson’s and others’ investigations had consequences. In 1994, AARP paid IRS $135 million to settle a dispute over its business income from 1985 through 1993; another $15 million in 1994–95; and still another $52 million in 1999. Also in 1999, the U.S. Postal Service fined AARP for $5.6 million for illegally using nonprofit mailing rates for insurance and other service mailings.3
As a result of the 1990s investigations and fines, the main, nonprofit AARP formed two “affiliated entities,” the philanthropic AARP Foundation and a for-profit AARP Services. The latter controls licensing and endorsement deals, AARP discounts, and—most important—various forms of health insurance, including its Medicare “Medigap” supplemental policy—in alliance with United Health Services, the largest in the land. In 2006, a new subunit was formed, AARP Financial Services. (AARP’s new Global Network also files separate accounting reports.) Membership services remain housed in the nonprofit “mothership,” including an increasingly active AARP Grassroots America, the advocacy arm that (quite effectively) mobilizes members who register to receive its e-mails and bulletins. (There is also a “Government Watch” portal that tracks congressional legislation.)
“AARP is powerful because of their sheer numbers,” messaging consultant Rich Tau told me. “All they have to do is whisper.” The former head of the now defunct Third Millennium association for younger Americans explained, “Even if they mobilize 1 percent of their base, it generates impact and looks very impressive.”4 (Indeed, in its 2009 annual report, AARP proudly states that 1.1 million of its members signed petitions to Congress.)5
Tau thinks that AARP is so large that the organization can quickly absorb major policy blunders and simply keep on rolling. (Under Novelli’s predecessor, Horace Deets, AARP made two infamous political miscalculations: supporting the ill-fated 1993 Clinton health care reforms and sponsoring the successful enactment of the Medicare Catastrophic Coverage Act in 1988. The latter—intended to provide universal “Medigap” coverage to supplement private policies that varied enormously in terms of adequacy—was hurriedly repealed a year later by Congress after widespread and intensely negative feedback from high-income senior citizens who were hit with substantial Medicare premium increases.)6 Finally, Tau emphasized: “AARP has no competitors. Conservatives and young people are not predisposed to mobilize collectively.”7
Conservative activists such as the direct-mail guru Richard Viguerie have tried to establish rival senior organizations: United Seniors Association (now USANext), the Seniors Coalition, and the Sixty-Plus Association. Two newer, conservative AARP alternatives arose during the health care reform battles: the American Seniors Association, headquartered in Atlanta, and the Austin-based Generation America. However, these associations have remained relatively small and ineffective; some appear to be only sporadically active and some have dated Web pages.
The Wall Street Journal, the Cato Institute, the Heritage Foundation, the Business Roundtable, and the Concord Coalition have been persistent, sharp AARP critics. “Jabba the AARP,” jeered the editorial page of the Wall Street Journal, comparing the “great and grabby” organization to the criminal empire of an especially corpulent “Star Wars” villain.8 In vain.
“Since 1995,” Alan Simpson reluctantly concedes, “AARP has gotten stronger, more savvy, more staffed, more alert to their image, hiring more people to soap-suds the American people and their own membership to show that they’re doing more and more for the seniors.”9 Simpson credits AARP’s continuing success to the work of Bill Novelli, a former New York advertising executive who became AARP’s CEO in 2001. Under Novelli, AARP’s membership dues increased by 52 percent; its royalties from alliances with insurance and other commercial organizations increased 515 percent. “He [Novelli] is the Wizard of Oz,” Simpson admits, and “AARP is a gargantuan marketing organization, a money-making giant.”10
The man who transformed AARP for the twenty-first century is Bill Novelli, who, at age sixty, became the CEO in 2001. The co-founder of the famous Porter-Novelli public relations and advertising agency, Novelli brought to AARP a remarkable blend of private- and public-sector leadership experience. He succeeded Horace Deets, a soft-spoken former Catholic priest who guided AARP through twenty years of growth and increasing political confrontation with Republicans and other critics. Changes were already under way to make AARP “Boomer Central” before Novelli arrived. But he considerably expanded and deepened those transformations. Novelli stepped down in 2009, but his impact on organizational restructuring and policy remains very strong.11
Novelli’s biography is an all-American success story. The son of a steelworker father who once dug graves to support his family during a steel mill strike, Novelli obtained an undergraduate degree from the University of Pennsylvania and an MA from its Annenberg School for Communications. He began his career working as a salesman for Unilever, then joined a major advertising agency. Eventually, he sought a greater degree of personal fulfillment and social relevance by taking his marketing skills into the public sector—initially as a director of advertising and creative services for the Peace Corps. After a brief foray into political marketing (to reelect Richard Nixon), Novelli and his former Peace Corps boss, Jack Porter, co-founded Porter-Novelli, which quickly become one of the world’s largest public relations and advertising agencies. Novelli became known as a marketing “guru” for public service and social causes in both domestic and international realms. He retired from the firm in 1990 and began a second career in the public sector, first as executive vice president of CARE. He next managed the Campaign for Tobacco-Free Kids and then moved to AARP in 2000 as associate executive director of public affairs.12
Starting in 2002, Novelli restructured AARP’s Washington workforce and began appointing a new executive team and board of directors congruent with helping him achieve three new organizational goals: (1) to be the most successful and acknowledged organization in America for positive social change; (2) to deliver on its promise to each member: to help them make their own choices, reach their goals and dreams, and make the most of life after fifty; and (3) to be a leader in global aging.
Novelli recruited a highly talented and professionalized board of directors, leaders, and staff. Like Novelli, many in this leadership cadre brought a mix of experience in both the private and public sectors in fields ranging from business to health care, government, and social and civic activism. Most board members had had long-term involvement with AARP—some for over twenty years—before ascending to their current position. Nearly every member of the board of directors had achieved distinction at the state or regional level rather than nationally. Several were president of their state AARP. By 2007, one-third of the twenty-four board members were female, and one-third were black, Hispanic, or Asian American.13
Novelli closely aligned AARP’s agenda with the corporate and political elites’ commitments to globalization and internationalism—and also with their deepening concerns about economic polarization and demographic change. Shortly after his appointment as AARP’s CEO, Novelli stated that “by serving our members, we serve all generations and, because of the demographic and economic shifts taking place in America and throughout the world, they are more important now than ever before.”14 (Novelli later admitted to me that there was substantial initial resistance to his international emphases from the board of directors.)15
Novelli continued Horace Deets’s bipartisan outreach, specifically with the former House Republican majority leader, Newt Gingrich. Gingrich nominated Deets to a congressionally appointed commission to recommend changes in Social Security. Deets invited Gingrich to be a featured speaker at AARP’s 2002 “Life @ 50+” megaconference in San Diego. Novelli wrote the preface for Gingrich’s 2003 health care book, Saving Lives and Saving Money. Gingrich was a member of Novelli’s advisory bipartisan “kitchen cabinet” that suggested changes at AARP.16 (“Newt has a new idea every two minutes!” Novelli told me.)
Some left-wing critics suspected that AARP’s increasing policy emphases upon markets, technology, and individual control and choice reflected creeping business-Republican bias via the Gingrich-Novelli relationship. When I asked Novelli directly in 2007 about Gingrich’s influence, Novelli portrayed himself as a pragmatist interested in “what works” compared to a far more ideologically oriented Gingrich somewhat inflexibly committed to free-market/small-government principles. “What we need is a real dash of cold-water pragmatism,” Novelli emphatically told me. “We need a problem-solving perspective instead of [strictly adhering] to the principle that government is good or bad.”17 Novelli channeled his eclectic, can-do pragmatism into two change manifestos designed not only for AARP but for the entire nation.
As part of Novelli’s organizational overhaul and “rebranding” efforts, in 2001 AARP acquired newly crafted vision and mission statements. AARP envisions “a society in which everyone ages with dignity and purpose and in which AARP helps people fulfill their goals and dreams.” It is “dedicated to enhancing the quality of life for all as we age. We lead social change and deliver value to members through information, advocacy and service.” AARP will help “people 50+ have independence, choice and control in ways that are beneficial and affordable to them and to society as a whole.” The organization’s revised logo sports an activist, boomer-oriented, social movements theme—“AARP: The power to make it better.”18
In an era of declining faith in institutions, the public’s high level of trust in the AARP brand and reputation is seen by its leaders as paramount; but there is tension between this consumer services brand and a more aggressive “warrior brand,” wielded by the organization when it moves more actively into the political and policy arenas.19
And Novelli’s political and policy agenda for AARP was bold, broad, and ambitious. The two major goals have been transforming the U.S. health care system and helping members achieve long-term financial security. Related to this are helping family caregivers (including adult children caring for older parents and more grandparents taking on child-raising tasks); tackling issues of nursing homes and long-term care; developing “livable communities” amenable to senior citizen needs; addressing ethnic diversity; and encouraging volunteer activities and philanthropy. Defense of Social Security remains steadfast, though the door has been opened to limited changes to preserve the system. And achieving comprehensive health care reform is viewed as an essential first step in preserving Medicare.
AARP’s policy agenda has been harnessed to its renowned research and marketing engine, with a direct-mail operation so finely tuned that it locates nearly every American who turns fifty and extends a membership invitation—a darkly humorous rite of passage routinely mocked by late-night television comedians. But it’s a good deal. For a mere sixteen-dollar annual membership, AARP offers an expanding bounty of benefits: travel and business discounts, insurance, investment services, low-cost mutual funds, tax assistance, advocacy, civic involvement opportunities, newsletters, and monthly magazines. About seven million people have AARP-branded health insurance, the vast majority being subscribers to Medigap and/or Medicare Part D prescription drug coverage.
By the end of 2009, AARP’s total operating revenue was more than $1.4 billion—a nice recovery from $1.08 billion in 2008 due to the stock market decline and an increase from the precrash 2007 total operating revenue of $1.2 billion. About 40 percent of these funds come from royalties and service provider relationship fees with commercial partners—such as United Health Insurance and Metropolitan Life Insurance. The AARP-United Healthcare supplemental insurance for Medicare “Medigap” coverage dominates that market. AARP monitors other organizations that compete with them in terms of both service and advocacy.20
AARP’s economic and political clout is symbolized by its massive Washington, D.C., headquarters: a block-long, twin-tower, ten-story, Romanesque office structure. Built in 1991 at a cost of $131 million, with more than 820,000 square feet and a high-ceilinged marble lobby, the building houses approximately two thousand employees. So much mail comes and goes that the building has its own zip code. (Once there was spare office space to rent out; no more. AARP’s expanding Financial Services Division has spilled over into adjacent buildings.) AARP has offices in every state and citizen chapters in hundreds of locales.
The revamped monthly AARP Magazine, which has the largest circulation base in the nation (23.7 million), is a major profit center—in stark contrast to the financial difficulties and bankruptcies confronted daily by other national magazines and publishers. The online version of AARP Magazine won a 2009 National Magazine Award for its interactive feature “1968: The Year That Rocked the World.” AARP’s monthly, issues-oriented AARP Bulletin is a newspaper-style publication with a circulation of 24.2 million.21
AARP sponsors concerts by famous musicians and advertises on commercial television and PBS programs (such as the nightly News Hour). The organization also houses its own profitable media center and produces its own radio and television programs. Most are available on its increasingly sophisticated, information-rich Web page. In 2010, AARP hired former NBC Today show host Jane Pauley to anchor a monthly television segment, “Your Life Calling,” and to moderate the new Web site offering AARP.org/Jane. Both the television segment and the Web site focus upon how people are reinventing themselves and “trying new things.” AARP Magazine sponsors an annual “Movies for Grown-Ups” awards show that has obtained a measure of Hollywood clout.
AARP recently expanded its Latino-oriented, Spanish-language media through AARP VIVA. The new enterprise will expand upon AARP’s Spanish-language quarterly magazine Segunda Juventud and into radio, the Web, and television, including a new hourlong Spanish-language television series, Viva su Segunda. And AARP is going global as its Global Network division is linking up with similar organizations worldwide, including the Canadian Association for Fifty-Plus (CARP), Italy’s Fenacom, and Copenhagen-based Daneage. A primary purpose is to share research and information, but AARP for-profit services may also go global. It may become somewhat apt to wryly observe that “the sun never sets on the AARP empire.”22 (However, the empire was not immune to the stock market crash and the Great Recession. In 2009, AARP suffered its worst financial setback in history, which resulted in layoffs of 10 percent of its staff and cutbacks in all major programs.)
AARP aims to have a membership that mirrors the nation’s fifty-plus population, but it remains disproportionately middle class and about 88 percent white. Nearly half the members are under age sixty-five; the average age of all members is sixty-four; and they join AARP at an average age of fifty-four. About 32 percent have at least “some college” and another 33 percent have at least a four-year college degree. Nearly one-third of members work full time, and only 47 percent are retired; half of member households earn $50,000 and 28 percent earn $75,000 or more. Eighty percent own their homes.23 Inasmuch as men die earlier than women, there is a female tilt to membership, 55 to 45 percent. (Female members seem to be more active participants in the organization, especially in volunteering and in attending AARP “Life @ 50+” annual megaconferences). AARP officials would like to increase the 58 percent renewal rate for first-time members (about average for similar organizations). Attracting Hispanics and blacks remains problematic: in 2008, only 5.6 percent of members were African American, 4.1 percent were Hispanic, and only 1.4 percent were “non-Hispanic Asian.”24
AARP is increasingly pondering its postboomer future. Its “Future Champions” campaign was launched to raise AARP awareness and allegiance among younger, more ethnically diverse Americans. That is the strategy behind the television advertisements featuring people of all ages and ethnicities who happily inform viewers that “AARP is for everyone who has a birthday.” “Project Prepare” was a major new AARP research effort to map the characteristics and needs of the under-fifty population. The same multigenerational mission under-girded the high-budget “Divided We Fail” campaign for comprehensive health care reform (focus group tested, crafted, and launched in alliance with the Business Roundtable and the Service Employees International Union).
The culmination of AARP’s research and outreach to younger generations was the 2009 launch of its “Lifetuner” Web page (www.lifetuner.org), designed to encourage younger Americans to become “financially literate” and consider “8 Money Habits for Lifelong Financial Health” (especially in saving for retirement via the new norm of individual retirement accounts). The site gives AARP yet another rebranding tweak designed to deflect its “greedy geezer” stereotype by proclaiming: “Lifetuner is brought to you by AARP, a non-profit dedicated to helping people of all ages make smarter choices today for a better life tomorrow.”
Novelli’s increasingly busy, multipurpose agenda, coupled with intensified drives for greater ethnic diversity, generational inclusiveness, and international alliances, led some senior-level staff to worry about loss of identity and mission. “Why don’t we just re-name ourselves the ‘American Association of Persons’?” was a sarcastic, sotto voce complaint I occasionally heard.
Overall, though, the board members, management team, and staff members with whom I spoke seemed remarkably happy to be working for AARP—despite what one officer termed “the loss of a family feeling” due to recent reorganization and downsizing. There is limited in-house grumbling about what some perceive as a growing subordination of policy and research functions to the business-services ends of the organization. And some voiced the oft-heard suspicion of outside critics that “AARP is really all about making money.” Yet it was the savvy combination of forward-looking policy research and marketing acumen that led AARP to anticipate and assess the boomer age wave and its many consequences—long before any other institution took note.
But will AARP be aging boomers’ ally, championing their interests? Or is AARP more likely to broker and compromise boomers’ concerns as the organization increasingly eyes the financial needs and future political preferences of a younger, more diverse America?
AARP’s fusion of financial products services with politics draws its sharpest conflict-of-interest critics on the political right; but there are those on the political left as well. The American Prospect author Barbara Dreyfuss regarded Novelli’s ascent with suspicion. She saw Novelli’s bipartisanship tilt as part of an ongoing “seduction” of the organization by business and Republicans. She found that Novelli had “centralized policy making by limiting input from local AARP leaders and brought with him a team of corporate executives to run the group’s federal and state policy—people much more comfortable with Republicans, open to private plans and market-oriented policies and more willing to make deals than many of the veteran staff.”25 Dreyfuss was especially galled by the Novelli and Newt Gingrich association.
Dreyfuss’s article reflected liberal anger and betrayal over Novelli’s controversial decision in 2003 to throw AARP’s support behind a Republican-driven, business-friendly Medicare Prescription Drug and Modernization Act. The act created new Medicare prescription drug coverage plans largely administered by private insurers—the largest of which would turn out to be AARP’s own brand of Medicare supplementary insurance (in partnership with United Health). The legislation provided good coverage to those with low or high levels of pharmaceutical needs but permitted a sizable coverage gap (the so-called “donut hole”) for those with moderate-to-heavy needs. The act also prohibited bargaining for low drug prices between Medicare and pharmaceutical companies and authorized more widespread offerings of insurance featuring individually managed health savings accounts.
Novelli and AARP’s officers defended their actions on the organization’s Web page, in AARP magazines, and at the Life @ 50+ conferences. Their rationale was that the Medicare Modernization Act was the best deal they could obtain at the time—that half a loaf was better than none. Novelli and his team were well aware that Bush wanted to tout this accomplishment in his reelection campaign; and they also knew that if Medicare reforms weren’t enacted in 2003, and if Bush won reelection in 2004, there would likely be no reform at all. Nevertheless, sixty thousand AARP members reportedly resigned in protest, and Beltway liberals fumed that AARP had caved in to a conservative agenda of privatizing Medicare and gutting employer-provided health insurance.26
In 2005 Novelli steered AARP back toward its New Deal ideological moorings, vigorously defending traditional Social Security against President George W. Bush’s efforts to open the program to privately managed equity accounts. As opposed to AARP’s hesitant “neutrality” on proposed Social Security reforms during the 1990s, Novelli’s campaign featured a devastating television advertisement featuring a woman who summons a plumber to fix a clogged sink—only to have her entire house demolished. (The obvious message was that Social Security has minor problems requiring a limited fix, not total destruction.) This successful campaign partially mollified disgruntled liberals inside and outside AARP—and, once more, infuriated conservatives.27
In late 2008, however, AARP again aroused critics’ “money machine” suspicions when it became the target of a lawsuit and an investigation by Senator Charles Grassley (R-IA), who was responding to constituent complaints about AARP/United Healthcare limited-benefit and indemnity health insurance policies. Sold under the names of Medical Advantage, Essential Plus, and Hospital Indemnity Plan, the policies were designed as essentially supplemental coverage for early retirees in their fifties and early sixties. People who bought the policies charged that the limited nature of the policies wasn’t made clear.
Grassley and his staff conducted an investigation of AARP using “secret shoppers.” He concluded that “AARP is systematically misleading its members by failing to ensure that they are fully apprised of the risks and underinsurance associated with indemnity plans that are being sold under its name.”28 In January 2009, Bloomberg News aired a critical, hourlong expose based on the lawsuit and Grassley’s investigations titled “AARP: Making Money, Losing Trust.”
Fortunately for AARP, the controversy faded rather quickly. And the Bloomberg expose was balanced by a largely positive CBS Moneywatch four-part series on AARP’s mutual funds, life insurance and annuities, auto and homeowners’ insurance, and health and long-term care insurance.29
But the Bloomberg “Losing Trust” documentary title stung. Trust is the paramount value for AARP’s “member value” division—and its legal staff. And they are not necessarily pleased when AARP’s leaders take the organization into battles in controversial policy terrain.
AARP’s dual business/politics model leads not only to conflict-of-interest charges but also to competing organizational identities—or “brands,” in the lingo of Novelli’s public relations field. These dual personalities continue to make AARP “a seriously schizoid organization”—a diagnosis made more than a dozen years ago by Charles Morris.30 To maximize its consumer base, AARP’s products-and-services “member value” function requires high levels of nonpartisan public trust unsullied by controversy. But strong political stands or controversial compromises required for political advocacy—what Novelli terms the “warrior brand”—jeopardize broad public trust and risk alienating politically attuned customers.
Midway through Novelli’s tenure as CEO, AARP was still struggling to integrate these competing “member value” and “social impact” agendas—a tension quite evident in the organization’s 2006 “Strategic Plan.”31 This organizational blueprint blends a general social change outlook with a more market- and choice-oriented, risk-shift America. Thus, in addition to being a “champion brand to enrich the lives of all people and enhance society as a whole,” AARP is also a partner that “helps people navigate life’s on-going and changing needs (health, finances, connecting, giving, enjoying).”
“Engagement on social issues” is one the five major goals of member value. The latter has its own set of four goals: (1) economic security—ensuring a Social Security that is solvent for the long term, enabling age fifty-plus Americans to remain in the workforce, helping Americans accumulate and manage retirement assets, and protecting low-income and vulnerable populations; (2) health and supportive services—promoting quality health care access and coverage and encouraging improved health status through healthy behaviors; (3) livable communities—encouraging local governments and business to provide affordable and appropriate housing options and to sustain mobility options for aging populations for whom driving is problematic; and (4) global aging—encouraging governments to better serve the needs of older citizens and informing businesses of the needs, talents, interests, and marketing possibilities of older populations.
Insofar as the social impact and member value agendas overlap on providing information and services, a nonpartisan, noncontroversial brand works fine. But the social impact goals of maintaining economic security (including Social Security) and quality health care for age fifty-plus Americans (through general health care reform and through Medicare) are inextricably linked to AARP’s policy advocacy and its “warrior brand.”
AARP’s legal and media relations departments are hawkish in protecting the nonpartisan consumer trust brand. The two departments seem extremely cautious and conservative. Not only are they understandably sensitive about public relations gaffes, but they have reasonable fears of “deep pockets” lawyers looking for excuses to sue the forty-million-member organization. Thus AARP’s legal department has reportedly come to exercise an extraordinary amount of control over routine communications of AARP staff with outsiders, even by AARP’s resident scholars and researchers. (The only two AARP officials who refused to be interviewed for this book first sought official permission through “legal.”)32
AARP’s legal and media relations departments are also wary of long-term foes such as the former U.S. senator Alan Simpson (R-WY), who loves to tweak the tensions between AARP’s business and policy advocacy goals. Simpson is fond of deflating AARP’s claim that it represents the political interests of its millions of members with his trademark jeer that AARP’s members are merely “bound together by a common love of airline discounts and automobile discounts and RV discounts.”33
At least one AARP board member ruefully acknowledged a good measure of truth in Simpson’s putdown. But the former senator’s characterization has also served as a call to action. AARP leaders not only want boomers’ membership fees and business; they also covet boomers’ political respect and, especially, boomers’ trust. This is why, more than a decade ago, AARP officials set out to make AARP “Boomer Central.”34
For the past decade, and probably throughout the next one, AARP’s most vital task is to recruit and retain aging baby boomers. Attracting and keeping members of this keenly consumer-oriented and politically volatile generation is vital to AARP’s survival. There is an understandably high mortality rate when members must be at least fifty years old to join: two million die each year. Therefore, the organization has a special imperative to “grow or perish.” Since 2000, AARP has more than compensated by adding more than 2.5 million new members annually via its famously thorough direct-mail campaigns—increasingly supplemented by television advertisements and a sophisticated Web page.
The key task for AARP has been to transform middle-aged boomers’ competitive individualism and relative lack of interest in civic involvement into social activism and the desire to “leave a legacy” through working with others. AARP’s leaders believe that, as boomers enter retirement and old age, there might be a partial revival of the 1960s’ change heritage. Chief operating officer Tom Nelson insisted to me that “boomers want to be a part of something that has impact.” An oft-heard slogan was “Changing ‘me’ into ‘we.’ ”
Even before Novelli’s appointment as CEO in 2001, an organizational facelift called “Today’s AARP” was under way to attract baby boomers. First to go was the dowdy Modern Maturity magazine that boomers grimly remember seeing on their parents’ coffee tables. For about two years new boomer members received a separate, slick monthly publication entitled My Generation. The response, however, was underwhelming. My Generation disappeared and boomer members were integrated into the mailing list for a retitled and substantially revised general monthly publication AARP: The Magazine—quietly tailored to different age subgroups in terms of format, style, and content. A Spanish-language monthly magazine, Segunda Juventad, was also launched—recently complemented by a Spanish-language television broadcast. As mentioned above, all of AARP’s publications and radio and television programs are available online at AARP.org, a repeatedly upgraded and increasingly sophisticated Web site. The result: one-third of AARP is now under age sixty.
Though AARP is a huge organization, its drive since 2000 to become “Boomer Central” was originally initiated by one man: AARP’s director of strategy and public policy, John Rother, a savvy and tireless Capitol Hill veteran and political tactician.
“Most Americans haven’t heard of John Rother, but he may have more influence than most senators when it comes to Social Security,” observed the New York Sun reporter Luiza Savage. AARP’s sixty-four-year-old executive vice president of policy, strategy, and international affairs is a bearded, affable man, the son of a Methodist minister, a graduate of Oberlin College and the University of Pennsylvania Law School.
Rother has become known as a skilled negotiator and a mild-mannered lobbyist who practices the art of “maintaining good lines of communication with everyone”—especially with Congress. He honed such skills by working there. For eight years he was special counsel for labor and health to former senator Jacob Javits. He then became staff director and chief counsel for the Special Committee on Aging under its chairman, Senator John Heinz. He moved to AARP in 1984 and has also become a member of several boards and commissions dealing with aging and health care.
The energetic Rother’s wide span of Washington contacts ranges from the president of the United States to Hans Riemer, the former Washington director of “Rock the Vote.” Riemer cooperated with Rother on a massive 2005 public relations campaign to defeat George W. Bush’s efforts to creative private accounts within Social Security. Reimer characterizes Rother as “inspirational” and as a central figure in the social welfare policy community. (Reimer later joined the staff of AARP’s “Create the Good” Web site that is geared to promoting volunteerism.)
Rother was the prime mover in getting AARP to anticipate the advent of the boomer age wave, to understand how that generation was different from older constituents—and how to appeal to them.35 Rather like CEO Bill Novelli, Rother is a somewhat center-left pragmatist who firmly insists that “politics is the art of the possible.”
I interviewed and talked informally with Rother many times over the past decade. He probably understands his generational peers better than anyone else in the nation. He is adept at grasping underlying common characteristics and outlooks rooted in boomers’ shared childhood and young adult experiences—while trying to avoid over-generalizations about a huge age cohort subdivided by gender, class, education, race/ethnicity, and religion. In this effort, he has had the aid of AARP’s large and talented research staff. (AARP has so much more data about boomers than any other American institution that they have undertaken a major outreach to corporate America by forming “Focalyst” in partnership with the New York–based research and consulting Kantar Group.)
According to Rother, boomers did not share a widespread defining experience similar to their parents’ widespread hardship of the Great Depression followed the common cause and sacrifices demanded during World War II. Instead, raised in postwar prosperity, boomers became fiercely individualistic, wanting to be in charge and in control of their own lives. “Boomers want options and choices,” Rother explained. “They’re optimistic, self-reliant, and self-indulgent.”
Rother described boomers’ cultural identity as very loose, built primarily around their shared musical heritage. He didn’t sense a case for boomer political activism—yet. But during our first conversation in late 1999 the prescient policy analyst predicted the likely precipitating crisis: “Health care is going to be the dominant issue of the next decade if not beyond.” Boomers would be in the thick of it.
Rother was pleased to point out that boomers had already rebelled against managed care restrictions. “{hrs}‘Hard’ managed care—with gatekeepers and other restrictions,” explained Rother, “goes against the core elements of boomer culture, of ‘doing it my way’ and making choices. The 1990s HMOs just punched into that—pow!”
Boomers led the attack on hard-line HMOs formats and propelled the trend toward “soft” managed care with higher expenses and deductibles—but more options and patient choice. “And that’s what Medicare is!” Rother beamed triumphantly. Boomers will warm to Medicare because “it provide menus, options, discounting, and choice.”
Rother the optimist hoped that boomers’ inherent distrust of large institutions and especially government might lessen as they learned to access and use Social Security and Medicare. (As seen in the next chapter, in the aftermath of the battle for health care reform and the rise of the Tea Party, Rother would have to reconsider this view.) On the other hand, Rother the realist has always acknowledged that Medicare would have to cut costs and become more efficient and decentralized. Like Bill Novelli and Newt Gingrich, however, Rother had faith in new technologies and increased individual health awareness in reducing high costs. He was more pessimistic about boomer-driven changes in family structure upon an aging America—fewer children, more working women, more divorce, blended families, and geographical dispersion.
“No caregivers,” he grimly conceded.
Like nearly all high-level AARP personnel, Rother once told me he found the possibility of generational warfare “far-fetched”—at least insofar as economic conditions remained stable. In subsequent years, however, he mused more darkly that “the system pits groups against each other.” Partly for that reason—and Americans’ inherent mistrust of government—Rother has always discounted the ability of the United States to adopt a Canadian-style, government-run, universal health insurance system. “I tell liberal friends to get over it.” (He would have to restate that rationale repeatedly as AARP ramped up a “Divided We Fail” campaign that totally ignored a Canadian alternative.)
AARP’s Office of Social Impact built upon Rother and his “research shop’s” inputs to arrive at a general consensus on boomer concerns: boomers and older Americans wish to have the security choices and control to help them live actively, independently, and purposively for as long as they can. They want to leave their children and grandchildren and the nation a better place than when they found it—and not be a burden to anyone. (The office developed a series of measurable benchmark strategy goals to respond to these needs: economic security, health security and supportive services, livable communities, information and resources, and international leadership.)
Though Novelli has labored mightily to make AARP’s image more pragmatic, bipartisan, and open to “anyone who has a birthday,” big-name pundits continue to attack AARP’s “greedy geezer” stereotype. First and foremost is Washington Post columnist Robert Samuelson, who regularly charges that AARP is the “nation’s most dangerous lobby”: “Among AARP’s 36 million members, there must be many decent people who benefit from the 5 to 50 percent discounts. . . . But I won’t be joining because AARP has become America’s most dangerous lobby. If left unchecked, its agenda will plunder our children and grandchildren. Massive outlays for the elderly threaten huge tax increases and other government spending. Both may weaken the economy and the social fabric. No thanks . . . AARP’s America is an illusion. Sooner or later it will be overtaken by demographic and economic realities.”36
AARP’s strategy to counter such critical blasts was formulated in two publications. Reimagining America: How America Can Grow Old and Prosper (2005) was an in-house report, a “blueprint for the future.” One year later, much of it was recast as a heavily publicized, popular-audience book by Novelli titled 50+: Igniting a Revolution to Reinvent America (2006).37
Novelli’s book was a relentlessly upbeat and optimistic manifesto, a “call to action” aimed at baby boomers’ social movement heritage and appealing to their desire to turn “me into we” and leave a lasting legacy. Novelli also targeted boomers’ cultural preferences for individual responsibility, choice, and consumer empowerment. The book’s can-do, get-it-done spirit was activated in the book’s foreword written by the high-tech entrepreneur and AOL founder Steve Case.
The central purpose in both Novelli’s book and Reimagining America was to confront and redefine the “overstated” entitlement problem posed by Samuelson and other prophets of doom: “Can America afford to grow old? And can we do so with intergenerational fairness, without burdening our children and grandchildren with the bills?” The answer was “yes”—if appropriate political and individual steps were taken.38
The tasks of preserving Medicare and Social Security were portrayed as “opportunities” to transform the health care system, lifestyles, the workplace, and retirement.39 Social Security could be sustained through relatively minor adjustments; Medicare could be preserved through comprehensive reforms of the entire American health care system by harnessing the curative power of preventive care, encouraging technological innovation, developing “best practices” medical standards, implementing market and consumer-driven changes, and encouraging individual healthy lifestyles. (“To some extent, we can expect the marketplace to resolve these issues. The growing number of older consumers as the baby boomers age will create demands that smart business owners will hasten to answer.”)40
Both 50+: Igniting a Revolution to Reinvent America and Reimagining America clearly pulled AARP away from its implicit commitment to Franklin Delano Roosevelt’s New Deal liberalism, with its faith in big-government solutions to social problems; instead, there was movement back toward Theodore Roosevelt’s earlier progressive vision of individual-business-government cooperation and personal action and responsibility.41
Indeed, and perhaps most significantly, both Reimagining America and Novelli’s 50+ did not mention the capstone dream of the New Deal and Great Society heritage: government-funded, universal health care. Instead, proposed reforms aimed to increase access to and affordability of a system modified by large doses of boomer-based faith in markets, individual responsibility and choice, and technology: themes that would be echoed in the massive “Divided We Fail” health care reform campaign—and later the Democrats’ health care reform proposals.
Likewise, these two blueprint documents contained little protest about the decline of lifetime, “defined-benefit” pensions by the nation’s corporations. Instead, the twin manifestos urged employers to automatically enroll employees in 401(k) individual retirement accounts—rather than putting the initiative on the individual. Employers were also urged to provide more flexible time schedules and phased retirement plans. Employees were encouraged to save more and work longer.
On Social Security reforms, Reimagining America moved back to more traditionally liberal options that included (1) raising the percentage of earnings subject to payroll tax to 90 percent; (2) raising the dollar amount of earnings security payroll taxes from $90,000 to $120,000, including a 3 percent surtax over that amount; (3) indexing benefits—reducing benefits for higher-wage workers; and (4) taxing Social Security benefits like private pensions. “Personalizing” Social Security by diverting contributions into private accounts was rejected outright.
Despite the chatter of change, when all was said and done, Bill Novelli’s AARP still defended existing Medicare and Social Security programs by invoking the stark alternative: “The question really ought to be how can we afford not to sustain the monumental contributions these programs have made to the health and well being of America’s aged population?”42 And tucked away at the end of Reimagining America was a return to a New Deal remedy: raising taxes. (“Respected parties across the political spectrum all recognize that the long-term outlook is bleak unless we raise additional revenues.”).43
AARP’s social impact foci and the rest of its evolving, boomer-friendly agenda and image were gradually rolled out, refined, and tested at a series of annual megaconferences titled “Life @ 50+.” Beginning in 2001, these conferences ostensibly showcased AARP’s vast array of products and services as well as providing forums for its policy advocacy. Behind the scenes, AARP was also doing focus group research on its products, its policy positions, and the conference itself, testing the reception of various celebrities, star keynote speakers, panel topics, and evening big-name entertainment acts. The early conferences provided a window into AARP’s delicate balancing act of wooing baby boomers while also maintaining relationships with older members and AARP’s many other political and economic clienteles.
The first 2001 Life @ 50+ conference in Dallas was something of a flop, drawing only six thousand people. The 2002 Life @ 50+ conference, however, attracted nearly fourteen thousand paid registrants (at fifteen dollars a ticket) to the giant San Diego Convention Center. Just as importantly, the average age of attendees dropped from seventy-two to sixty-six. There were 272 exhibitors, nearly one hundred more than the year before. In the subsequent years, the three-day events became a major marketing success, drawing larger crowds of twenty-five thousand or more; as aging boomers took a greater interest, the average age declined to a relatively “young” sixty-two.
People were drawn to the conferences for a variety of reasons. “I’m here to meet broads,” declared Bill, a divorced, sixty-year-old luncheon companion at the San Diego conference. Bill (a pseudonym) had led a busy life as a father of five and a traveling computer programmer and entrepreneur. Bill claimed that his wife couldn’t put up with his travel schedule so they had divorced. He had acquired a girlfriend but had grown weary of her time-consuming, unsuccessful attempt to rehabilitate her drug-addicted son. “I’m not sure I’ll get married again,” said Bill. “Right now, I just want to find someone to go on cruises with.”
The gender ratio at the San Diego event (and most other Life @ 50+ conferences) favored Bill’s quest. More than 60 percent were women, as were 90 percent of the two hundred or so people who packed a workshop entitled “Dating after 50” by Tom Blake, newspaper columnist and author of Fifty and Dating Again. Blake pointed out the obvious reason for the rising female-to-male ratio among those over fifty: men die sooner. By age sixty-five, he explained, half of women are widows, and they complain that the dwindling number of prospective second husbands want a “nurse and a purse.” Nevertheless, Blake urged older women seeking relationships to be optimistic but realistic, get out the house, network, and be positive and “mentally available.” He was leery of singles clubs and the Internet. “Don’t expect someone to make your life better.” Above all, remember that, if all else fails, “being single isn’t so bad.”
A major feature of the “Life @ 50+” conferences was an annual all-star “2011 Panel” (so-named for the year in which oldest boomers turn sixty-five). The first 2011 panel at San Diego featured the actor/activist Bill Baldwin, the Washington Post–famed “Watergate” reporter Carl Bernstein, the Fear of Flying feminist novelist Erica Jong, the generations expert William Strauss, and the Brandeis law professor Anita Hill. Mostly, they argued. The panelists displayed little agreement about boomers’ key characteristics and attitudes—or anything else. Strauss offered the generalization that boomers reflected America’s postwar prosperity’s idealism and individualism. Bernstein immediately disagreed, emphasizing that the vast generation was deeply divided between older Vietnam-era boomers and their younger, postwar siblings. Anita Hill questioned whether boomers had enacted deep institutional change and produced effective politicians. Erica Jong contradicted Hill with examples of boomer presidents Bill Clinton and George W. Bush. Strauss sparked sharp disagreement from other panelists when he cited polling data showing that boomers were becoming more promilitary.
The 2004 Life @ 50+ in Las Vegas was the most star-studded convention yet. It would also attract one of highest registrations of any of the conferences before or after—twenty-seven thousand attendees. The evening entertainment headliners had a distinctly Older Baby Boomers tilt: the Smothers Brothers, Motown original Smokey Robinson, and blues singer James Taylor—the latter hurriedly evacuated from the auditorium at the end of his performance when enthusiastic AARP members rushed the stage. “When I saw that,” remembered chief operating officer Tom Nelson, “I turned to a couple of board members sitting near me and said, ‘This is a turning point. AARP members are rocking out!’ ”
The Vegas event was bankrolled by even more major corporate players: Gateway Computers, Pillsbury, and Proctor and Gamble joined prior sponsors Anheuser-Bush, Home Depot (now partners with AARP Foundation in forming a National Hiring Partnership program to employ senior citizens), and United Health Group (AARP’s health insurance partner). The television film critic Roger Ebert hosted an “AARP Celebrates Cinema” series. The Hollywood film star Danny Glover would be featured at the exhibit hall presentation “Voices of Civil Rights,” a project preserving all manner of records and documents from the American civil rights movement, co-sponsored by AARP, the National Conference on Civil Rights, and the Library of Congress. The veteran comedian Jerry Lewis would host a session called “Making the Most of Life.” The “AARP University” series featured sessions on AARP’s role in enacting the controversial new Medicare prescription drug plan, a session reflecting AARP’s civic involvement push, “Bet on Community Service!” and a panel on sex and aging featuring the television personality Dr. Ruth Westheimer.
Though not on the preconference program, the Democratic presidential nominee John Kerry and First Lady Laura Bush appeared. (President George Bush was also in Vegas but wisely avoided a potentially chilly reception by sending Laura.) The First Lady proved to be a remarkably poised speaker and was accorded an increasingly warm reception. But Kerry was the obvious favorite, initially greeted by loud ovations that grew progressively less so as he droned on too long—for fifty minutes.
The greatest public relations bomb at any of the Life @ 50+ conferences detonated in Vegas: a tempestuous annual 2011 boomer panel featuring the opinionated Hollywood star Cybill Shepherd.
The AARP Magazine editor Hugh Delahanty initially opened the panel by playfully asking, “What will baby boomers do when they grow up?” Steve Gillon, a professor and History TV host and author of the just-published Boomer Nation, offered a scholarly description of boomers as a diverse generation, animated by a “culture of choice” and individualism. Though still divided over the 1960s culture wars, boomers were conservative in many ways. He offered the baby boomer Newt Gingrich as an example.
“Newt climbed out of a swamp!” Cybill Shepherd jeered loudly. When the humorist Christopher Buckley mentioned the legacy of Vietnam, Shepherd sharply interrupted again: “We all agree about Vietnam: a waste!” Then she added for no apparent reason that women thought differently than men.
Donna Brazile, the shrewd African American strategist who managed Al Gore’s presidential campaign, described boomers as becoming more ambivalent about the changes they had set in motion in the 1960s. “They’re wondering: Is change good?” She agreed with Gillon that boomers might be turning more conservative but also turning away from politics.
Shepherd contradicted Brazile’s contentions about boomer political ambivalence. “Fifty-seven of boomers support choice!” she stated emphatically. “We are not divided! Bush wants to repeal choice! We’re fed up with it! This president was not elected!” As a trickle of walkouts was becoming a stream, Shepherd suddenly shifted to how liberated women regard plastic surgery. “We can wear our breasts up or down,” she declared proudly. “It depends on ‘How do I feel about myself?’ ” Christopher Buckley gamely chimed in that “we worry about a shortage of flu vaccine, but the problem may be a botox shortage.”
Delahanty shifted the topic onto how “boomers redefine life stages.” Gillon emphasized the point of his book Boomer Nation that boomers are ambivalent about big government: “We look to Washington, but distrust it—fear it won’t provide funds in our old age.”
“It gets better as you get older,” mused Donna Brazille, soberly reflecting on her birth in New Orleans Charity Hospital to a mother who had nine children—a mother who ultimately died at age fifty-two in the same hospital. Cybill Shepherd had a different view of women’s life passages. “Maidens, mothers, crones,” she quipped. “At forty,” she declared, “things change.” This was a segue to closing the panel with a song she’d written, “The Menopause Blues.” But not before another blast at George W. Bush. “Spit rolls downhill!” she cried. “I despise this president! He favors the rich! He talks about separation of church and state. Yet he wants to mess with states’ rights [on abortion] and my rights as a woman!”
From behind Shepherd, her exasperated fellow panelist Christopher Buckley softly pleaded, “Shut up and sing!”
Shepherd whirled on him. “ ‘Shut up and sing’ is an insult! You’ve offended my sense of womanhood!” She berated him a bit more in this vein.44 Then the pianist began to play and Shepherd began her rather bawdy ballad, typified by the following lyrics:
If you’re feeling dry,
Just make yourself a drink!
Splash vermouth and estrogen, it’s later than you think!
I’ve got those menopause blues, those ol’ menopause blues!
You can keep your Viagra! Testosterone, too!
My libido’s on the rise, there’s honey pourin’ through!
The pace of audience walkouts quickened. Most of those exiting were white-haired folk who were plainly disgusted. The remaining audience members applauded modestly. Several rushed to the stage, mainly to visit or get autographs from Brazile or Shepherd—the latter appeared to have intimidating bodyguards.
Virtually all AARP officials I interviewed downplayed cultural or political generational tensions within AARP or the broader society. But Shepherd’s polarizing performance became the talk of the conference, and AARP officials who attended the 2004 Vegas conference still wince when the episode is recalled.
At the 2006 Life @ 50+ conference in Anaheim (described in the introductory chapter), the 2011 panel was assembled for the final time. The panelists were more sedate and reflective, focusing on boomers’ relationship to popular culture.45 There was some griping about ageism on Madison Avenue and Hollywood. The former Motown executive and now independent producer Suzanne de Passe complained that boomer-oriented films were a very tough sell. On the other hand, Larry W. Jones, president of TV Land and Nick at Night, had happily capitalized upon boomer-era nostalgia television programming. He admitted that such fare was “pure escapism”—but drew a laugh from the audience when he observed that “our ratings go up as the rest of television gets crappier.”
Ken Burns, producer of several documentary series for PBS, spoke movingly about boomers searching for continuity and community through music and memory. The music and entertainment of their youth, Burns observed, trigger memories of where they were and whom they were with—parents, family, friends. Shared entertainment and memories link the generations. Burns was surprised at the large numbers of boomers like himself who remained fascinated with their parents’ experiences and memories of World War II, the focus of The War, his then-current nine-part documentary. And today, he laughed, “if I can get my hands on my kids’ iPod, I find they’re downloading the Beatles.”
So far, Burns mused, the boomers’ story was being felt—via memory and nostalgia—more than being actively told or debated. But AARP researchers knew that boomers’ story was about to be told more darkly and seriously. It was going to be “felt” through increasing fiscal and physical pain.
“If you could point to a single type of event and cost that is the greatest source of life stage angst, it is a health care crisis and associated costs,” AARP’s senior vice president for thought leadership Jody Holtzman later told me. “There are two aspects of it. One is the financial issue—even when you assume you’re covered. All you need is a big bill or deductible—say $2,000. For the average household, that’s a lot of money when it’s cash off the top. And, for older boomers, associated with that might be a serious health outcome. That all of a sudden, they realize, ‘I can’t do what I did before, I can’t do it as easily, I can’t do it in the same way’ . . . can’t play basketball or even walk around the block. Then you start playing out the scenario. Once you start playing out the scenario—health problems and cost—you begin to wonder: ‘Is this the beginning of a snowball?’ Then comes the angst.”46
In 2007 AARP launched “Divided We Fail,” a coalition for health care reform that included the Business Roundtable, the Service Employees International Union, and the National Federation of Independent Businesses. AARP’s chief operating officer Tom Nelson explained to me that “we ramped up ‘Divided We Fail’ to build unexpected coalitions with groups like labor and business and to bridge generational interests and create a powerful movement for health care reform.”
As seen in previous chapters, aging baby boomers have become increasingly anxious about health care reform because they are entering the highly vulnerable fifty to sixty-five age range. Individual insurance policies on the open market for someone in that age range are extremely expensive and often impossible to obtain if there are preexisting health conditions. AARP had begun offering (through United Healthcare Insurance Company) a range of high-deductible policies for those aged fifty to sixty-four.
The overriding problem for the Divided We Fail coalition was: How to sell health care reform to a skeptical public?
How to Talk to the Public about Health Care Reform, an AARP PowerPoint lecture, provided a window into the research and strategy behind the Divided We Fail campaign. The AARP director of policy and strategy, John Rother, AARP board president-elect Jennie Chin Hansen, and board member Joanne Handy presented the talk at the 2007 Chicago Joint Conference of the American Society on Aging/National Conference on Aging.47
The AARP presenters first established the case for health care reform, especially for age fifty-plus Americans. A bar chart illustrated that uninsured Americans aged fifty to sixty-four constituted the fastest-growing segment of all forty-seven million uninsured Americans. Successive charts and graphs starkly portrayed current and growing inadequacies in the American health care system: (1) boomers’ health care costs would increase as they aged, while their incomes would decline; (2) average Medicare out-of-pocket expenses (including Part B premiums, private “Medigap” insurance, deductibles, and uncovered services) already took 23 percent of the average income of Americans over sixty-five and were expected to rise; (3) employers’ health costs were rising and, consequently, the percentage of firms offering any insurance coverage had steadily fallen from nearly 68 percent in 2000 to 60 percent in 2005; (4) workers’ health insurance premiums were rising faster than their wages, and the total cost of an insurance policy for a family was approaching $14,565 annually; (5) medical bills were the cause of half of all personal bankruptcies—and more than 75 percent who went bankrupt had been insured at the beginning of a bankrupting illness; (6) most Americans were totally unaware of the costs of long-term care and unaware that such costs were not covered by Medicare.
AARP’s focus groups and surveys revealed a surprising paradox: Americans didn’t see health care as a consumer good to shop for but as a fundamental right that no one should be denied. This was very close to the views of Canadians and Europeans. Yet the research also confirmed Americans’ abiding mistrust of government (except as a watchdog) and their resentment toward unflattering comparisons with other nations—notwithstanding the success of Sicko, Michael Moore’s documentary that indicted America’s health care system while praising that of France and even Cuba.
Flawed as it is, Americans still think they have the best system. Therefore, “Talk about improving the system, not overhauling it,” instructed Rother. “And present it as an American solution.” Americans preferred private-public, not government solutions. Hence, the terms comprehensive and universal were to be avoided.
The high costs of care and the limited access to it were market issues that were clearly understood as problems. However, many Americans believed it was possible to address these without spending more money. Therefore, reformers had to stress that any new taxes would be limited.
Medicare remained popular, said Rother, though it was both amusing and infuriating that some citizens didn’t recognize it as a government program. “They’ll say, ‘Keep government out of my Medicare’ ” Rother joked. Cost reductions in Medicare had to be seen as part of broader reforms.
Quality and affordable were among the “words that work,” according to AARP research. “Access to quality health care” was a magic slogan. So were the phrases “patient-centered care” and “freedom and flexibility.” The term consumer did not test well, nor did social science jargon like systems or systemwide or disease management. People in the AARP studies did understand the concept and importance of prevention as long as it was presented in terms of personal action (such as cancer screenings).
Finally—and in line with Bill Novelli’s increasing emphasis on generational outreach—the AARP PowerPoint blueprint presented the normative maxim that “intergenerational support is the mark of a civilized society.” In discussing health care reform, the benefits to family and all generations had to be stressed.
The PowerPoint slides shifted to the red-and-white color scheme and bulleted goals of “Divided We Fail.” Among them:
• Access to affordable, quality health care, including prescription drugs, in a way that costs will not burden future generations
• Wellness and preventive care priorities should include changes in personal behavior, such as diet and exercise
• All children should be covered
• Health information technology must be improved and updated
• Defense of Medicare
• Support of innovative state health reforms
• Provide choice and flexibility in long-term care
As was often the case when Rother spoke publicly about the Divided We Fail plan, the first questioner challenged Rother about why AARP wasn’t pressing the case for government-financed, single-payer “Medicare for all”—similar to the Canadian health care system. As he was used to doing, Rother cited American’s long-standing mistrust of government but also hinted that the goals of “Divided We Fail” involved substantial bargaining and compromise in order to entice the Business Roundtable into the AARP-SEIU alliance. AARP’s strenuous efforts to be bipartisan carried a price. Indeed.
As this blueprint was put into action, the Divided We Fail alliance initially helped raise political awareness about the need for major health care reform. AARP members wearing bright red “Divided We Fail” T-shirts were highly visible during the early presidential primaries—raising public awareness and pushing the candidates to talk about health care.
In early 2008, AARP California rallied to support Governor Arnold Schwarzenegger’s major policy push for state health care mandates. AARP’s Bill Novelli flew out to join Schwarzenegger in the opening ceremony for the campaign. But Schwarzenegger’s ambitious blueprint collapsed in the legislature partly because the issue of health care reform in California and elsewhere was upstaged by the collapsing bubble in real estate prices, a summer spike in energy and food prices, and, of course, the autumn stock market meltdown.
Between February and July 2008, according to a Pew Research Center poll, the percentage of Americans ranking “prices” as the “most important economic problem facing the nation” nearly doubled from 24 to 45 percent. Concern over “gasoline/oil/energy” led this concern, nearly tripling from 11 to 38 percent; cost-of-living worries jumped from 5 to 9 percent; but concern over health care and medical prices fell from 9 to 2 percent.48 The autumn stock market crash further eclipsed almost all other noneconomic issues.
Still, AARP kept pouring money into the Divided We Fail campaign via very visible television and full-page magazine advertising. Such persistence kept health care reform on the political agenda and paved the way for the new Obama administration to make the issue its top priority. Even after the 2008 elections, AARP’s advocacy network urged members to again send e-mails to the new Congress and president-elect, reminding them of their campaign pledges on health care reform. The e-mail barrage was followed up by face-to-face meetings between congressional representatives and AARP members (in red “Divided We Fail” T-shirts).
As will be discussed in greater detail in the next chapter, the Divided We Fail campaign’s core emphases on “access, affordability, and quality” (as well as the more specific tactics and goals outlined in the AARP PowerPoint presentation) were picked up by other lobbying groups and incorporated into the language of the congressional bills that ultimately became the signed legislation. The 2008 elections also focused professional, public, and news media interest in the nation’s cultural diversity and changing demographics. A 2008 census bureau study advanced the date when whites would be less than 50 percent of the nation’s population from 2050 to 2042. The surge in minority populations was becoming especially evident among youth.49 These changes were embodied in the emergence of a postboomer political wave that powered election of the first biracial “postboomer” Democratic Party presidential candidate, Senator Barack Obama.
Once again, though, AARP was ahead of the curve.
African rhythms pounded out by a local African American folk drumming group greeted about 850 registrants for the AARP “Diversity and Aging in the 21st Century” conference as they filed into the main ballroom at the Los Angeles Bonaventure Hotel. The three-day conference in late June 2007 was designed to highlight AARP’s escalating interest in the nation’s rapid demographic change and burgeoning cultural diversity. Many of AARP’s board of directors were present, as were Bill Novelli and most of his management team. In 2009, AARP would select A. Barry Rand, a former executive at Xerox and Avis Car Rental, as its first African American CEO.
Affirmative action and other efforts to increase female and minority representation have long been woven into AARP’s organizational procedures and culture. Since 1998, there have been two black female AARP presidents. Retired or still employed African American teachers and public employees are visible constituencies at AARP conferences. Diversity is a criterion in selecting AARP’s board members, its officers, and its staff and is evident in feature stories and advertisements in AARP’s publications. The organization celebrates Black History Month, Hispanic Heritage Month, Gay Pride Month, and so on. A special Hispanic-themed conference in Puerto Rico 2007 sold out its fifteen thousand capacity. During its fiftieth anniversary year, 2008, AARP distributed $1 million in Legacy Awards to (mostly minority and/or inner-city) high school programs demonstrating “a commitment to connect generations and foster greater civic engagement among students and their communities.”50 AARP has become a major sponsor for a range of ethnic and gender special interest conferences ranging from the annual NAACP conference to smaller events such as “It’s About Time: LGBT [Lesbian, Gay, Bisexual Transgender] Aging in a Changing World.”
Diversity and the Divided We Fail campaign were constantly coupled at the “Diversity and Aging in the 21st Century” conference. Thus, in his official welcome, AARP chief diversity officer Percil Stanford was quick to get on message by declaring, “We need to work together—or ‘Divided We Fail.’ ”
“We are all part of change,” Stanford explained, warning that “diversity may be difficult to accept, for it means sharing or giving up of power and resources.” Stanford ritually invoked AARP’s founder, Ethel Percy Andrus, describing how proud the retired school principal would have been of the dedication ceremony he had just attended at the brand-new Ethel Percy Andrus Center for the Performing Arts at inner-city L.A.’s Abraham Lincoln High School. “All the kids there had AARP T-shirts,” he happily observed, and concluded, to a wave of applause, that “we need to give every kid [in the country] an AARP T-shirt!”
Board of directors president Erik F. Olsen, a former dentist and for fifteen years the director of the giant Delta Dental insurance corporation, quickly linked diversity and health care reform by mentioning that Delta Dental had worked with Cesar Chavez to obtain affordable health care for farmworkers. “Throughout much of my life, America looked like a microcosm of Europe,” said Olson. “Today, we are a microcosm of the world.” To remain a leader, AARP must embrace diversity. Olson then launched into discourse on the nation’s health care problems and the goals of “Divided We Fail.”
L.A.’s first Hispanic mayor, Antonio Villaraigosa, extended his official conference welcome, emphasizing L.A.’s historically global nature. He described its origins as a mostly Mexican-majority city in the mid-1800s that became majority Anglo during the twentieth century and is today again becoming a predominantly Latino city—the latter statement eliciting scattered applause. He stressed the mutual dependence of younger immigrants and the elderly. Villaraigosa joked that the full impact of his identity as a grandfather hit home when AARP asked him to be on the cover of its monthly magazine. On behalf of the city, he accepted a diversity sculpture from AARP presented by CEO Bill Novelli, who proudly observed that Villaraigosa was wearing an AARP “Divided We Fail” pin. (The next day, another celebrity speaker, the civil rights activist, former congressman, and NAACP president Julian Bond, publicly signed a “Divided We Fail” pledge that Novelli promised to publicly display at AARP headquarters. AARP has also become a primary sponsor for NAACP’s national conferences.)
The two-day “Diversity in the 21st Century” gathering featured a variety of lectures, panels, and workshops on topics ranging from the changing markets for age fifty-plus Americans to growing ethnic diversity in elderly communities, aging gay men and lesbians, aging in prison, long-term care in a diverse society, and reshaping the images of aging. AARP president-elect Jennie Chin Hansen chaired a roundtable discussion for reporters from ethnic media sources. Luncheons, a lavish evening reception-and-multicultural buffet, and a tour de force one-woman show by the writer-performer Anna Deavere Smith were underwritten by official sponsors United Health Group and the giant California Endowment.
I encountered Erik Olsen and AARP’s chief operating officer Tom Nelson standing together in the middle of the bustling outdoor reception-buffet. The two white men seemed to be deeply pondering the sights and sounds of their three-day immersion in L.A.’s ethnic and cultural landscape. “We’re taking this all in,” said Olsen. “Now we’ve got to back and figure out how to process and act on all this.”