In D.C., a rising star

Stephen Ubl admits he was a tiny bit nervous.

The Mounds View native was headed to the White House last May to chew over health care reform with President Obama and several titans of the industry, and he wasn't sure whether he'd be called upon to speak up for the medical technology industry.

As it turned out, Ubl stayed in the background and let the titans speak for themselves that day. It didn't matter: He'd done his homework and he could have answered any question about the $130 billion industry he represents -- an industry that defines his home state and one that has made him a player in Washington's debate over health care legislation.

That, in a nutshell, explains why Ubl's influence has steadily risen on Capitol Hill in recent years, and why he's now one of the top lobbyists in health care as president and chief executive of AdvaMed, the Washington, D.C.-based med-tech industry organization with some 1,500 member companies.

"He personifies the Minnesota work ethic, he outworks everyone else," said Jim Ramstad, a former Republican member of Congress from Minnesota who, over the years, has worked with Ubl on Capitol Hill.

"In health policy, there's no substitute for substantive knowledge," said Tom Scully, who headed the Centers for Medicare & Medicaid Services from 2001 to 2003. "Whether you're a Democrat or a Republican, generally the person with the best argument wins. Steve knows health care policy inside and out."

Now 40, Ubl confronts perhaps the biggest challenge of his 20-year career in Washington: making sure med-tech is represented in the contentious debate surrounding the historic remaking of the nation's health care system.

That involves meticulously batting down the oft-repeated premise that medical technology is expensive, and representing it instead as a preventive and cost-saving way to treat chronic, expensive diseases.

"It's certainly been the most intense year we've ever had," Ubl said in a recent interview. "I look at it as a maturation of the industry. The industry flew below the radar for a long time. That's no longer the case."

Ubl (pronounded YOU-bull) still lacks the profile of some other big-name health care lobbyists (think: Billy Tauzin, the former Louisiana congressman and oft-quoted head of PhRMA, a powerful organization that represents drugmakers.)

"I would say [Ubl's] an unknown quantity," said Ken Thorpe, chairman of health policy at Emory University in Atlanta, and a senior official in the Clinton administration's failed health care reform effort. But this time around, the interests of medical technology are well represented, Thorpe said. "I think they've done a pretty good job at laying out the case for innovative technologies."

Translating medical technologies for the layman in the context of heated and partisan debate can be challenging.

It helps that, as colleagues point out, Ubl could talk the stripes off a zebra. He is erudite and plain-spoken, but in an oddly substantive and soothing way. A way that seems uniquely Minnesotan.

"Steve is able to put things in concise, understandable form,'' said Rep. Jason Altmire, a Blue Dog Democrat from western Pennsylvania and a longtime Ubl acquaintance.

"It's hard to explain what a lot of the devices do, the research that goes into them and their cost-benefits. You have to boil it down to someone in Congress who, as soon as you walk out the door, is going to be talking to someone else about Iraq policy or education.''

Following the meeting with Obama in May, Ubl e-mailed photos to family and friends ("I'm sitting behind the president," he wrote), along with a CNN clip from YouTube.

Ubl said he was impressed by the new president.

"[Obama] was deep on substance, he didn't take notes, he clearly knows the subject matter well. He was engaging, funny and collaborative; he made it clear he wanted to work with us."

While AdvaMed supports the concept of reform, parts of the actual legislation concern Ubl, who will no doubt be in the middle of the fray when Congress returns next month. AdvaMed is particularly concerned that proposals that would centralize medical decisionmaking will stifle innovation, which, Ubl says, "thrives in a pluralistic, private market where patients can vote with their feet."

He also worries about proposals that would finance reform through "meat-ax cuts" to technology, particularly imaging and laboratory services.

A Minnesota childhood

It's all heady stuff for a skinny kid who grew up in a modest rambler in Mounds View, still a grassy, pastoral sliver of the northern suburbs, an area that is the nexus of an industry he would grow up to represent. "Nobody grows up saying, 'Boy, I want to be a lobbyist.' It certainly wasn't my plan," Ubl laughs.

But looking back, there were hints that a political career might be in the making.

"In hindsight, it fits," said Ubl's dad, Patrick, a retired electronic technician from what is now Unisys. "If you asked him a question, he'd never answer yes or no. He'd go on a five-minute spiel. I'd wait until he got done and then I'd say, 'OK -- yes or no, which is it?'''

Although deeply proud of their son, the Ubls admit they sometimes chafe a little when they tell others he's a Washington lobbyist. "That Abramoff guy really gave it a bad name,'' the elder Ubl says.

Ubl's mom, JoAnn, says, "When people ask, I try to slip in that a lot of Steve's work involves Medicare approving more technology to help people."

Ubl's childhood was "quintessential American suburbia," says childhood friend Jay Hallberg, now a software entrepreneur in Austin, Texas. Along with another buddy, Jerry Seppala, the triumvirate played golf at Brightwood Hills in New Brighton, talked about girls and ended the day with a Mr. Misty at the local Dairy Queen. Occasionally, there was some "mischief," although all three declined to elaborate.

Ubl played trombone in the school band -- performing, ironically, at the grand opening of the old Medtronic Inc. corporate headquarters in Mounds View. He even worked at the Arden Hills tennis club, now part of Boston Scientific's complex, where pacemakers and defibrillators are made.

Making a political career

While majoring in political science at St. Cloud State University, Ubl interned for then-U.S. Sen. Rudy Boschwitz. The work fascinated him, and he decided on a career involving politics. He moved to Washington after graduating and landed a job with Minnesota fundraiser Steve Gordon.

There, Ubl briefly roomed with his childhood friend Seppala. "It's an exciting city for a young, single person," Seppala said. "It's a very transient city, so people forge relationships very quickly."

Said Ubl: "The great thing about Washington is that it gives young people a lot of responsibility early. If you really apply yourself, you can move quickly into greater positions of responsibility."

Ubl did just that, landing a job as a staffer for Sen. Charles Grassley, an influential Iowa Republican who, ironically, is now leading the charge against the med-tech industry's controversial consulting relationships with doctors.

Grassley, he said, "is a very honest, hardworking guy, who is very shrewd politically."

Ubl moved on to the Federation of American Hospitals, where he served as vice president of legislation and where, notably, he met his future wife, Anne, an Edina native. "She's one of my tribe from Minnesota," Ubl says. "There was an instant kind of understanding between us. Plus, our parents got along famously. You put them in a room, and they talk about the weather for 45 minutes."

Ubl actually has done two tours at AdvaMed. From 1998 to 2004, he served as executive vice president of federal government relations, then left briefly to run his own health care consulting firm.

In 2005, when Ubl interviewed for AdvaMed's top position, there was some concern that, at 36, he was too young to run such a large organization, according to Scully.

"I told [the AdvaMed board] Steve has a great way with people, and he knows health care policy inside and out,'' Scully said. "I don't think anyone ever regretted hiring him."

Ubl's age wasn't an issue for Art Collins, former CEO of Medtronic, who led the search for AdvaMed's top officer. "The biggest question for me was that Steve had never run a large organization."

But since Ubl's hiring, AdvaMed's membership has increased 55 percent. "Steve is very motivated, he has just boatloads of energy and enthusiasm," Collins said.

Ubl also hired top talent as lieutenants. "A lot of people in Washington are not comfortable hiring people who are as good as they are to be their deputies," Scully said. "Steve has the skill to do that."

Ubl isn't handicapping the outcome of this year's health-care debate, and he has other, pressing concerns as well. The Food and Drug Administration's regulation of medical devices, as well as Medicare reimbursement of them, is still a question mark in the new administration.

Congress is also considering a bill that would make it easier for consumers to sue med-tech companies over faulty devices -- a legal right that was knocked down by the U.S. Supreme Court during the Bush administration.

With so much on his plate, Ubl says he hasn't had much time to mull what his supporters agree is a promising, almost limitless, future.

"There's still a whole lot of job here,'' he said.

Janet Moore • 612-673-7752