From social security to sex, AARP’s Bill Novelli is working to make aging safe—and cool—for the baby-boom generation and the rest of us.
By Dennis Drabelle
We’re sitting around a table in downtown Washington, D.C., staring at a triangular pod that looks a bit like the head of a golf-course sprinkler. The item, in fact, is a speakerphone, and we’re in the office of William D. Novelli C’63 ASC’64, CEO of AARP (formerly the American Association of Retired Persons). We’ve gathered for a conference call to Dr. Donald Berwick, who runs the 100,000 K Lives Campaign out of Boston. I’m here because Novelli is allowing me to shadow him this morning. Joining us is Cheryl Matheis, AARP’s director of health strategy.
Novelli’s assistant places the call, and after some endearing fumbles with the pod’s controls, Novelli makes contact with Berwick, who explains what the campaign is about. Under the aegis of the Institute for Healthcare Improvement, a group of physicians drew up a list of six things hospitals could do to reduce the number of patient deaths. All procedural reforms, the six lifesavers include putting together rapid-response teams to combat cardiac arrest and making sure that when patients are transferred from hospital to hospital—or even within the same facility— their medications don’t get screwed up. To sell the idea, the physicians estimated a saving of 100,000 lives if 2,000 hospitals were to adopt the reforms, and gave themselves a year and a half to make this happen. If that first number remains speculative, the second was too timid: 2,400 hospitals have signed up since the campaign’s kickoff last December. “We believe this translates into half the hospital beds in the U.S.,” says Berwick. Characterizing the response so far as “a stunning outpouring of energy,” he expresses the hope that AARP, with its vast membership—“Thirty-five-point-seven million exactly, but who’s counting?” Novelli interjects—can help.
Novelli is bullish, throwing out the possibilities of an AARP endorsement and a lobbying campaign for legislation to make the new rules mandatory, should it come to that. But he wants to dig deeper. As a self-styled veteran of “campaigns to change behavior” (one of his previous jobs was the presidency of the Campaign for Tobacco-Free Kids) [“Taking on the Tobacco Giants,” January/February 1999], he looks for ways to involve AARP’s sizable corps of volunteers. The six reforms strike him as not very average-Joe-friendly. “Are there some things that consumers would feel comfortable asking hospitals for?” he wants to know. “Patients generally don’t order their doctors around, but a generation ago the National High Blood Pressure Education Program got people asking for their blood pressure to be taken, and that’s become a routine thing now.”
Seeing the point, Berwick promises that he and his staff will work on formulating demands that patients can realistically be expected to make. And since he frequently travels to Washington on business, he and Novelli agree to meet face-to-face as soon as their schedules permit.
“This is a hell of a feat,” Novelli comments after hanging up. He tells Matheis to put together a “creative team” to break down Berwick’s six reforms into components that consumers can get a handle on. It’s been a fruitful call. Two organizations with a natural fit have taken the first steps toward forming an alliance. Novelli has lent his expertise in grass-roots activism to a campaign that might gain from operating at a less abstract level. And the talking pod has performed flawlessly.
Said to be the second-largest membership group in the United States—behind only the Roman Catholic Church—AARP has an annual budget of $800 million, five times that of the country’s biggest business association, the U.S. Chamber of Commerce. The behemoth traces its ancestry to a little old lady named Ethel Percy Andrus, who founded the National Retired Teachers Association in 1947 to provide health insurance for retired teachers. So many retirees from other walks of life coveted this and other NRTA benefits that in 1958 Andrus expanded the organization into the American Association of Retired Persons. Taking into account the growing number of older Americans who choose to keep working, the group shortened its name to the now-famous four letters in 1999. According to its mission statement, AARP exists to enhance “the quality of life for all as we age.” Anyone age 50 or older can join; astonishingly, almost half of the eligible pool has done so. A year’s membership costs $12.50; benefits include the bimonthly AARP The Magazine, whose circulation is the largest in the land.
Bill Novelli came to AARP as associate executive director in 1999; in 2001 he was elevated to CEO. Before heading the Campaign for Tobacco-Free Kids, he’d been executive vice-president of CARE. He embarked on this second, public-spirited phase of his career at age 49, after leaving Porter-Novelli, the public-relations firm he had co-founded (and which included AARP among its clients).
Novelli’s eagle-eyed monitoring of AARP’s membership rolls may be an outcome of the rebellion that broke out two years ago, when the group threw its support behind the Republicans’ Medicare prescription-drug bill. AARP is officially non-partisan, but if you couldn’t guess from its policy stances that the group has a natural affinity for the New Deal and its legacy, a perusal of its literature would soon lead to the same conclusion: the mission statement, for example, goes on to speak of instigating “positive social change,” a phrase redolent of 1960s activism. Or you could go by the right wing’s tendency to regard the organization as a bete noire. An upstart called the United Senior Association, whose consultants include several masterminds of the Swift Boat Veterans ads attacking John Kerry in the 2004 election, has claimed that AARP endorses gay marriage (AARP calls this statement “spurious”); and the editor of The National Review recently blasted it as a “greedy, scaremongering, reactionary lobby group.”
It was in the context of this left-leaning tradition that the membership backlash occurred, after AARP changed partners during the run-up to the 2003 law adding a prescription-drug benefit to Medicare. Among other provisions, Democrats objected to one barring the Medicare and Medicaid programs from using their bargaining power to negotiate prices with drug companies. Seventy thousand AARP members resigned, some of them in a card-burning protest outside the group’s headquarters, and a poll showed that only 18 percent of members backed AARP’s endorsement of the bill. The vehemence of the dissent caught the group’s hierarchy by surprise, and the way in which the bill passed the House—after a roll call held open for hours while the Republican leadership twisted the arms of balky legislators—sharpened the controversy. AARP was left to clean up what Novelli calls “a mess.”
Though standing by the decision to support the bill—and AARP has followed up with a campaign to get seniors to avail themselves of its benefits—Novelli admits that AARP “could talk to our members better, listen to them better.” In the meantime, some of the lost sheep have returned to the fold, and the group is now a couple of hundred thousand members heftier than it was when the flap started. Moreover, AARP is poised for a surge of growth as the baby-boom generation starts hitting age 65 in 2011.
As if to allay fears that stepping out with the GOP might be habit-forming, AARP has been leading the attack on President Bush’s concept of privatizing social security. It’s not that AARP opposes all reform of the system; on the contrary, the group’s strategic plan envisages a future in which “Americans can rely on Social Security that is solvent for the long term.” But AARP fiercely opposes letting people risk their late-in-life well-being in the stock market. In a speech to the National Press Club earlier this year, Novelli argued that “taking money out of Social Security payroll taxes to invest in private investment accounts would worsen the solvency outlook rather than improve it. And it could lead to large benefit cuts. This approach is risky, it’s hugely expensive, and it’s unnecessary.” Full-page ads with the same message have been appearing in newspapers around the country, AARP members regularly show up to denounce the president’s idea at local appearances by members of Congress, and a TV campaign is in the offing. This time there is no significant internal discord. “When AARP has a consensus among its members, it’s difficult to stop,” lobby expert James A. Thurber, who directs the Center for Congressional and Presidential Studies at American University, recently told The Washington Post. “On this issue it has a consensus.” Former Senator John Breaux of Louisiana has called AARP’s opposition to private social-security accounts “close to fatal.” Novelli believes that he and the group have a lot riding on the outcome. “We’ve got to win this one,” he says.
A Penn caucus could be pulled together within the AARP hierarchy. Besides Novelli there are John Rother L’75, director of policy and planning, and David Certner C’80, director of federal affairs. As it happens, a second highlight of my morning with Novelli is a pitch by yet another Penn grad, Nancy R. Lewin WG’92, director of Johnson & Johnson’s Caregiver Partnership.
A few years ago, Lewin explains, Johnson & Johnson scored a big success with its campaign for nursing, a profession that had been suffering from an unglamorous image and a shortfall of recruits. Now the company wants to improve the lot of private caregivers, especially the 22 million Americans helping someone over 50, usually a relative, who is chronically ill. A survey has shown that caregivers for the elderly are 63 percent more likely to die prematurely of stress-related illnesses than people with no such burden to bear.
AARP is well aware of this problem. Information put out by its Public Policy Institute notes that the plea heard most often from caregivers is for “a little time to myself” and summarizes a Medicaid program that lets them take breaks by hiring substitutes or checking their loved ones into facilities for brief stays. More important, Elizabeth Clemmer, the institute’s associate director, has brought personal experience to the table. Her husband is at the point where he can’t be left alone when she goes to work, and she has just completed the sensitive task of hiring someone to be with him.
Despite Lewin’s zesty presentation and Clemmer’s familiarity with the issue, the AARP contingent responds guardedly. Lewin mentions the possibility of AARP’s lobbying on behalf of caregivers, something she says Johnson & Johnson is not in a position to do. But above all she is pushing an interactive website with message boards for beleaguered caregivers to vent their frustrations and share their stories, and she would like to set up links to AARP’s website. One problem is that the AARP website is a daunting affair. “We’ve got 5,000 pages,” says Mike Lee, who is second in command of the group’s 46-person web team. He frets about creating “a giant hairball of links.”
Another possible hitch is that, as Lewin freely admits, Johnson & Johnson is not a charitable institution. “Somewhere down the line, three or four years from now,” she says, “my boss thinks it might be nice if we made a little money on this. The possibilities include selling ads on our website or even introducing a new line of products, such as skin remedies for bedsores.”
Novelli replies that he worries “a bit about straddling the line between helping and maintaining the proper arms-length relationship” with a profit-making entity like Johnson & Johnson. There appears to be a subtext here. AARP itself has a commercial wing—a wholly owned subsidiary that sells its members such items as insurance, travel packages, and mutual funds. Revenue from these and other product lines accounts for about a third of the group’s income, and critics of the organization have accused it of having conflicts of interest or at least talking out of both sides of its mouth. For instance, James K. Glassman of the American Enterprise Institute charges that it’s inconsistent for AARP to oppose privatizing Social Security while peddling mutual funds, which he claims are “by any conventional standard … far riskier than anything anybody has contemplated” for Social Security investments.
Aside from the tidy sum they contribute ($350 million last year), these ventures would not be easy for AARP to walk away from: as mentioned, some of them hark back to the group’s original reason for being. Novelli has defended the services by emphasizing that AARP plows all profits back into the group’s main work of advocating social change. But his caution this morning about finding the right relationship between the giant nonprofit and the giant pharmaceutical suggests that the criticisms have had an effect.
After consulting the palm-size cheat sheet that displays his schedule for the day, Novelli says: “I think we need to get to the next step. The question is how can we connect?” A few minutes later, the meeting breaks up on an inconclusive note. AARP will designate another team, which will ponder Lewin’s ideas and arrange for a second get-together within 30 days.
In a recent speech at Georgetown University, Novelli touched upon differences between leading a profit-making firm and a nonprofit entity. He seemed to envy corporations their single-minded focus on the “financial bottom line,” so crisp and measurable compared to the nonprofit goal of influencing hearts and minds. But he found a compensating strength in nonprofits’ mission to make the world “a better place,” which translates into a level of employee satisfaction that corporations can only approximate by encouraging their people to get out in the community as volunteers.
Novelli also told the Georgetown audience that nonprofit CEOs don’t get the heels-clicking respect that corporate titans do: “In a nonprofit, board members and other powerful stakeholders often have different goals and agendas. This is much more complex to manage and requires more consultative and inclusive decision-making.”
Half-a-day is a limited time in which to size up someone’s leadership style, but Novelli’s way of handling himself seemed to bear out these words. He didn’t crush his underlings with charisma or bark out Trump-like commands. He paid close attention (pointing out, in the middle of Nancy Lewin’s presentation, that her written material was missing a transitional “bullet”); asked questions, especially ones designed to arrive at the proper match between AARP’s capabilities and the proposal being floated; solicited opinions from his staff; and ended meetings with precise directives as to what should happen next.
He showed impressive familiarity with his employees as individuals—the one who had just come back from a Caribbean vacation, the one who is working with a personal coach to smooth out his rough edges—and his diction was jargon-free (he majored in English). Rather than bowl over his subordinates with look-at-me-I’m-leading bravado, Novelli simply led them.
Lately AARP has been addressing an image problem not directly related to its policies: the perception that an outfit catering to a gray-haired population can’t help appearing rather gray itself. The July-August issue of AARP The Magazine featured a Hot Fifty List, including the likes of Denzel Washington and Liam Neeson (“Leading Men”); Kim Basinger and Susan Sarandon (“Leading Women”); and Sting and Tina Turner (“Coolest Crooners”). The same issue reported the results of a senior sex survey, with the curve skewed to take in respondents as young as a lusty 45. A follow-up to one conducted in 1999, the new poll debuts in a climate where Viagra and its competitors are firming up the sex lives of millions: 22 percent of the men surveyed say they take one of the libido-enablers, more than double the response in the first survey. More than a quarter (28 percent) of all couples have watched adult (XXX-rated) films together, and 9 percent have made their own erotic photos or videos. Around 10 percent overall have engaged in phone sex or exchanged erotic notes or e-mails. These were especially popular with the younger crowd: 17 percent of men and 18 percent of women in the 45-49 age group admit to having talked dirty on the phone, while 22 percent of both sexes have sent naughty notes or emails.
All this ribaldry has its serious side. Over lunch, Novelli observes that AARP’s membership-renewal rate is not what he’d like it to be. With more baby boomers—the generation that starred in the summer of love, championed feminism, and marched for gay rights—approaching the age of eligibility, watch for AARP to get funkier still. As a slightly older brother to that generation (he is 64), Novelli is well-placed to observe them. And indeed he is writing a book, scheduled for publication a year from now, on boomer aging. In his view, far from being the demographic disaster that many people predict, the entry of such a large cohort into old age offers an opportunity to change our whole outlook on aging. Bill Novelli would surprise no one if he stayed on as AARP’s master of the revels for some time to come.
Dennis Drabelle G’66 L’69 is a contributing editor of The Washington Post Book World.