HJAR May/Jun 2026

DIALOGUE turn with more emphasis on prevention. I would really, really push teaching nutrition in schools and I would put more money in school lunch programs that emphasize more nutrition. You’d obviously continue promoting healthy lifestyles. But my main position would be to try to shift resources gradually away from treatment and toward prevention. Editor Do you believe the financial burden of healthcare on the middle class and America is sustainable? Carville Well, anything is sustainable if it doesn’t change — but you’re going to continue to have poor outcomes. It starts with educating voters to understand that prevention actually saves money over time — a lot of money. You hear some people say, “Well, if people die young, that reduces the burden on government.” I don’t buy that. I hope I don’t. The truth is, the best way to treat disease is to prevent it from happening in the first place. Editor I agree. Last questions. As your generation retires from leadership, do you believe that you’re leaving our country better than you found it? And what advice would you give for those stepping into leadership now? Carville I think what I’ll tell you is that I agree with Jamie Dimon, who said, “No one ever went broke betting on America.” We have different challenges. We are certainly in the midst of catastrophic leadership in this country, but we’ve come through these things before, and I suspect we will again. We have a lot of assets here. We’ve got a lot of resources. We’ve got systems of higher education — no one else is even close to educating, in higher ed, the number of people we do. There’s a lot of ingenuity in this country. And I think that when we get a wise leader — and I assume we will at some point — we’ll understand the strength we have as a country and what we can be, not what we are. Editor Thank you, again. Carville You are welcome. n James Carville is a political consultant with a long list of electoral successes and a knack for steering overlooked campaigns to unexpected victories, remaking political underdogs into upset winners. His most prominent victory came in 1992, when he helped William Jefferson Clinton win the U.S. presidency. His winning streak began in 1986, when he managed Robert Casey’s successful gubernatorial campaign in Pennsylvania. In 1987, Carville helped guide Wallace Wilkinson to the governor’s seat in Kentucky. He continued that streak in New Jersey, helping Frank Lautenberg win election to the U.S. Senate. He next managed the successful 1990 gubernatorial campaign of Georgia lieutenant governor Zell Miller, including a tough primary win over Atlanta mayor Andrew Young. In 1991, Carville — already prominent in many political circles — drew national attention when he led Senator Harris Wofford from 40 points behind in the polls to an upset victory over former Pennsylvania governor and U.S. attorney general Richard Thornburgh. In recent years, Carville has not worked as a paid political consultant for domestic politicians or candidates, instead focusing on campaigns in more than 23 countries around the globe, stretching from South America to Europe, Africa, and, most recently, Asia. Carville is also a bestselling author, actor, producer, talk-show host, speaker, and restaurateur. His books include Love & War: Twenty Years, Three Presidents, Two Daughters and One Louisiana Home; It’s the Middle Class, Stupid!; All’s Fair: Love, War, and Running for President, with his wife, Mary Matalin; We’re Right, They’re Wrong: A Handbook for Spirited Progressives; And the Horse He Rode In On: The People vs. Kenneth Starr; Buck Up, Suck Up . . . and Come Back When You Foul Up; Had Enough? A Handbook for Fighting Back; Stickin’: The Case for Loyalty; his children’s book, Lu and the Swamp Ghost ; and 2006’s Take It Back: Our Party, Our Country, Our Future . Along with pollster Stanley Greenberg, Carville founded Democracy Corps, an independent nonprofit polling organization dedicated to making government more responsive to the American people. Carville also serves as a professor of practice at Tulane University in New Orleans, where he lives with his wife, Mary Matalin, and their two daughters. 14 MAY / JUN 2026 I  HEALTHCARE JOURNAL OF ARKANSAS