The Accountant Is In

Regina Herzlinger '65 has strong medicine for the health-care industry.

It may be 7:00 a.m. in a darkened auditorium at Massachusetts General Hospital, but it's not too early for Professor Regina Herzlinger '65 to deliver her prognosis.

Credit: John Soares

"It is possible to make health care cheaper and better in this country," she tells the audience of doctors and medical residents gathered for her talk on consumer-driven health care, "if we would give consumers more power, more information, more choice." It's an argument that the Nancy R. McPherson Professor of Business Administration at the Harvard Business School has been making for nearly three decades.

"Choice is good," she declares to the sea of white coats, citing Alfred Sloan and the rise of General Motors as exhibit A. "It spurs competition, which spurs innovation, which makes things better and cheaper in every industry. But we don't get that choice in health care."

Bemoaning the fact that "Larry Summers [the former president of Harvard University] purchased my health insurance for me," she goes on to protest, "I wouldn't permit him to buy my house or my clothing or my food for me. Yet as my employer, he could take up to $15,000 of my sala­ry each year and buy my health insurance for me, without knowing anything about my preferences or needs. It's ridiculous."

It's hard to imagine this trenchant critic and industry reformer as a stricken young HBS accounting professor with a dark bun and oversized spectacles, unable to decide in 1972 which fact she wanted to camouflage more: that she was pregnant or that she was scarcely older than her students. Yet ­Herzlinger, now a sought-after public speaker and frequently quoted consumer advocate, can still recall the stage fright of her first class. "I thought I was going to faint," she says.

The first woman to achieve tenure and hold a chair at the Harvard Business School, Herzlinger has become many things over the years--award-winning teacher, prolific author, public intellectual, conservative provocateur, grandmother--but she is still an accountant at heart. So she prefers to judge performance by the data, and the harder the numbers, the better.

Consider, then, these metrics from her CV: two best-­selling books; more than two dozen articles; a dozen or so awards; about 50 HBS case studies; more than 100 speeches. And this in just the last five years of a 36-year career.

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Herzlinger's dignified, deep voice seems tuned for the lecture hall. Her wide-ranging erudition bespeaks a scholar. But for two decades, that scholarship has been pressed into the service of a not-so-quiet revolution, which she's been fomenting well beyond the halls of Harvard Business School. "I have never wanted to confine my influence to the realm of abstract thought," she says. "My interest is in effecting change."

Reluctant to call herself a "public intellectual"--it's "too highfalutin," she demurs--this impassioned champion of health-care reform refuses to limit her audience to the readers of peer-reviewed journals. She continues to churn out case studies for her MBA and executive education courses on innovation in health care. She continues to teach governance and financial control for corporate and nonprofit management. But in recent years she has also become a regular contributor to the op-ed page of the Wall Street Journal (she's usually at her writing desk before dawn); she gets quoted in the New York Times and interviewed on national television. She's been invited to the White House to advise the Bush administration on health-care policy. In conservative circles, her ideas have come to define the political agenda on health care.