HJBR May/Jun 2026

8 MAY / JUN 2026 I  HEALTHCARE JOURNAL OF BATON ROUGE The Politics of Healthcare Editor’s Note: As someone with deep Louisiana roots, I always appreciate seeing one of our own excel on the national stage. James Carville is one of those figures. Love him or hate him — and I have probably done both — the strategist behind Bill Clinton’s 1992 presidential campaign gave American politics one of its most enduring catchphrases: “The economy, stupid.” What I did not fully appreciate at the time was that Carville’s now-famous campaign office reminder included two other lines: “Change vs. more of the same” and “Don’t forget health care.” Over the years, I’ve followed congressional and policy conjecture on healthcare and what has struck me, as I’ve pulled back the layers of a system with the very word “care” in it, is how often our leaders acknowledge the same truths: the system is broken; Americans are sicker than people in other developed nations; we pay far more for healthcare and often get worse outcomes. And yet, meaningful change remains elusive. At some point, we have to ask whether telling ourselves we are the best — without honestly comparing outcomes — is doing a disservice to the very people the system is meant to serve. Leadership requires the willingness to measure, to compare, and to improve. So when Carville recently brought up Louisiana and healthcare on his podcast, “Politics War Room,” we thought we would ask the Democratic master strategist — who happens to be married to a Republican master strategist and who understands the inner workings of Washington better than almost anyone —what he thinks about health, money, politics, and why this system remains so hard to change. I hope you enjoy the conversation. One on One with James Carville