Published: Friday, 17 Jul 2009 | 10:22 AM ET

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Harry and Louise have changed their minds about health care reform.

The fictional suburban couple featured in a series of national television spots sponsored by the health insurance industry in 1993 and 1994 stoked fears that helped doom a government-created health plan promoted by a Democratic president, Bill Clinton.

“Having choices we don’t like is no choice at all,” the Louise character fretted to her husband in one spot set around a kitchen table stacked with medical bills.

Now, the same actors are back in a new campaign, this time to support a government overhaul of the medical system promoted by a Democratic president, Barack Obama.

The ad’s sponsors — a trade group representing drug makers and Families USA, a nonprofit group advocating affordable medical care — reflect the strange bedfellows lining up behind the latest reform effort.

“A little more cooperation, a little less politics,” Louise says to Harry in the new spot, scheduled to appear on cable and network stations this weekend, “and we can get the job done this time.”

The main issues — accessible, affordable and portable medical coverage — have not changed since the 1990s. But the reappearance of Harry and Louise as the avatars of health care reform dovetails with a new economic reality for consumers.

The early-middle-aged Harry and Louise in the 1990s ads were concerned about their own welfare and their own pocketbooks. They were white middle-class me-generation professionals scripted to raise red flags about the fear of losing private health insurance. Now, the mellowed AARP-eligible Harry and Louise of this campaign seem more charitable and outward-directed. They even invoke the plight of the uninsured.

Which either means that Harry and Louise have changed, or that the actors who play them — Harry Johnson and Louise Caire Clark — are adept at emoting whatever political point of view they are paid to evoke. For their sponsors, the characters’ seeming empathy is meant to reflect a climate in which mounting unemployment, combined with the high cost of health insurance for individuals and small businesses, has created a new urgency for change.

“We ought to work together to find a good and successful health care compromise,” said Billy Tauzin, the president of the Pharmaceutical Research and Manufacturers of America, or PhRMA, a sponsor of the new spot. “Middle-class people like Harry and Louise are not going to be living in a successful society if we don’t do something about it.”

The campaign could also garner good will from politicians for the group, which last month pledged $80 billion in savings to help further health reform.

This is actually the fifth television campaign for Harry and Louise.

The first tour placed the couple in familiar suburban scenes to raise pointed questions about the Clinton health care plan. At a time when the insurance industry felt excluded from the process, which was led by Hillary Rodham Clinton and an adviser, Ira C. Magaziner, Harry and Louise were meant to galvanize the kind of middle-class Americans who might be talking about health care reform as they sat in their kitchens looking at bills. More than a dozen different commercials ran in 1993 and 1994, at a cost of about $14 million.

“Harry and Louise began a dialog with the American people in a sense,” said Charles N. Kahn III, who oversaw the original campaign as the executive vice president of the Health Insurance Association of America, a trade group that later merged with another group to become America’s Health Insurance Plans. “This was not done to beat health reform. It was done to get the attention of policy makers.”

But many industry analysts viewed that series as attack ads that helped scuttle the Clinton version of health reform.

Mr. Kahn reincarnated Harry and Louise in 2000 for a campaign to urge legislators to adopt an industry proposal to help people buy private insurance.

Ben Goddard, a public affairs executive whose firm, Goddard Claussen, created all of the campaigns, used the couple a third time in ads to oppose a bill that would have curbed stem cell research. In 1997, Mr. Goddard married the actress Ms. Clark.

But the real comeback for the couple occurred last year, when a group of nonprofit associations, including Families USA, sponsored ads before the presidential election in which the couple urged candidates of both parties to put health care at the top of their agendas.

Now Families USA has teamed up with PhRMA for a $4 million campaign to be broadcast starting this weekend on channels like CNN, MSNBC, Fox, Comedy Central and on some network news and Sunday talk shows.

“This is really a historic opportunity,” said Ron Pollack, the executive director of Families USA. “We have a better chance of getting health reform done than ever before.”

For political news media analysts, however, Harry and Louise signify more than mere icons of health reform. The original ads represent the first successful political issue campaign to activate consumers en masse to put pressure on Washington. The ads ushered in the era of political issue advertising as a major component of lobbying, said Evan Tracey, the chief operating officer of Campaign Media Analysis Group, which tracks political advertising.

Since that time, “there hasn’t been a major piece of policy, federal or state, that hasn’t had an issue advocacy campaign,” said Mr. Tracey. “That’s what, in essence, Harry and Louise gave birth to.”

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Mr. Tracey said the new ads, endorsing change, were unlikely to have the same impact as the first, more negative campaign. With Congress seemingly determined to pass a health care package this year, the return of Harry and Louise as cheerleaders for reform may be aimed mainly at keeping the issue at the top of the news cycle.

Instead of framing the debate, in other words, Harry and Louise may now be symbols of going with the flow. “What would health care reform be without them?” Mr. Tracey said.

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