The healthcare lobbyist as diplomat

“Being a good lobbyist is knowing what you want — and what you can live with,” says Mary Grealy, president of the Healthcare Leadership Coalition (HLC), an umbrella group consisting of the CEOs of some of the biggest companies in the United States.

The corollary to this axiom? Knowing how long to keep to yourself what you can live with.

After being at the center of the biggest healthcare fights in Washington over a more-than-30-year career — the Medicare prescription-drug bill, the Clinton healthcare plan and the Carter administration’s efforts to set price controls for healthcare, to name a few — Grealy speaks from a position of considerable experience.

Since 1999, Grealy’s role has been a peculiar one compared to that of a traditional trade association president. The HLC was created to represent a cadre of healthcare companies that usually are aggressive competitors, or even rivals, in Washington and the marketplace.

The organization focuses on advocating private-sector-based reforms to the healthcare system and has been instrumental in fending off efforts to increase the federal government’s role in financing and administering healthcare benefits. The CEOs who control the group must agree on their role in healthcare reform not only on a moral basis, Grealy says, but on a business basis.

A big part of Grealy’s job is to convince these top executives that the first step toward succeeding at shaping healthcare policy in Washington is to “check your weapons at the door” and work together.

“We make sure that those conflicts don’t come into this room,” she says of the conference room at the HLC’s headquarters on Pennsylvania Avenue N.W., where the walls are adorned with the corporate logos of companies such as drug maker Pfizer, medical wholesaler Cardinal Health and the Tenet hospital chain.

Being able to manage the demands of a coalition of very large companies requires a deft touch and a special knack for disarming arguments, building alliances and making deals.

Grealy was lucky enough to get an early education at the feet an all-time master of the art of the deal: Dan Rostenkowski.

In 1971, the up-and-coming Rostenkowski (D-Ill.) was chairman of the House Ways and Means Committee’s Health Subcommittee and was on his way to becoming one of the most powerful figures in Congress.

Grealy’s break came when a call from an acquaintance included a fateful recommendation: “Go talk to this guy, Dan Rostenkowski, and he’ll help.” She admits, “I didn’t know who Dan Rostenkowski was.”

After a meeting in the House Cloakroom and for the next three summers during law school, Grealy was “probably the Hill’s oldest intern.”

The Fort Lauderdale, Fla., native graduated from Michigan State University and was a speech and hearing pathologist before studying law at Duquesne University. “I’ll never forget how nice people were to me” when she was trying to find work in D.C., she says, “so I’m a strong believer in helping anyone when they’re looking for a job.”

Her move from the Hill to lobbying began with another fortuitous telephone call, this time from Rostenkowski to Mike Bromberg, president of the Federation of American Hospitals. Grealy signed on for a two-year hitch working for the federation that turned into more than 15 years and rose to the post of chief operating officer and executive counsel. Bromberg was her mentor, she says, and continues to command her undying respect.

Bromberg wasn’t so enthusiastic at first. When Rostenkowski called to recommend her as a perfect candidate to be a legislative assistant at the federation, Bromberg wondered why the chairman would want to part with such a talented young attorney. “You wouldn’t be telling me that if she was any good,” Bromberg recalls telling Rostenkowski.

He soon warmed up to her. In fact, he says, she became indispensable.  “She was my conscience” and was always there to “stop me from shooting myself in the foot.”

Grealy’s strengths lie in her professionalism and her demeanor, Bromberg says. She has a special talent for bringing people together that stems from her innate likeability, he adds. “She’d be a good secretary of state.” Running the HLC requires the same talents, Bromberg says.

Grealy likens the work of keeping a disparate group of CEOs working together to what it takes to captain a sailboat during a race. An experienced and passionate sailor, Grealy compares lining up the CEOs on common priorities with corralling the crew of one of her boats to work as one during the chaos of a race.

“She’s a very calm person in the midst of a storm,” says American Hospital Association (AHA) Executive Vice President Rick Pollack. Grealy was chief Washington counsel for the AHA for about four years between leaving the federation, after Bromberg’s departure, and taking the helm at the HLC.

These days, the healthcare companies that make up the HLC are more likely to find themselves allied with the Bush administration and the Republican Congress than with Democrats, Grealy concedes, but she maintains that reaching out to both sides is crucial to her work.

Like most people with long tenures working with lawmakers, Grealy laments the intensification of partisanship on the Hill. The narrow GOP majorities in Congress mean the parties are apt to move in lockstep, she says.

Grealy expresses frustration with the Democratic leadership in Congress. During the debate on the Medicare prescription-drug benefit in 2003, Democrats were given “marching orders” and were fearful of backing the legislation — even though Grealy felt certain that many supported its aims. She continues to wonder how Democrats who “pretend to represent” the poor could have fought so hard against a bill that aimed to provide help with drug costs to low-income older Americans and the disabled. Election-year politics were a huge factor, she says.

The GOP majority does not escape criticism, of a kind, from Grealy. When the Democrats had a stranglehold on both houses of Congress, they didn’t need to build coalitions with the minority Republicans — but they often did, she says. Rostenkowski in particular tried to find the middle ground, she recalls.

Lobbying itself has also changed since she arrived in Washington after her first year of law school. Lunch and drinks don’t do the trick anymore, she says. Lawmakers and their aides expect good information and a high level of professionalism.

Professionalism is a trait Grealy has in abundance, friends and colleagues agree. Grealy is “a model of integrity and dedication and hard work,” remarks Julie Goon, a former healthcare lobbyist who now heads up the administration’s efforts to sell Medicare drug coverage to beneficiaries. In Grealy, Goon says she found her mentor when she first came to town.

“She’s a first-class professional,” Pollack says. “She enjoys the trust of an awful lot of people.”