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A Tribute to Uwe Reinhardt
By Paul Krugman
Opinion Columnist
On April 21 Princeton held a memorial service for Uwe Reinhardt, one of our greatest health care economists. I had the great honor of being one of the speakers, and I thought I’d share the text I prepared.
As you might guess, over the years I’ve gotten to know quite a few economists. Some of these economists have been very smart, making important intellectual contributions. Some of them have been lovely people – friendly, funny, and engaging. To be honest, the overlap between these categories is, well, less than you might have hoped. Professional success requires a reasonably big ego – you have to believe that you can offer insights that other people have missed – and often seems to require pretty sharp elbows, if only to get a word in. These qualities may be necessary, but don’t easily go along with being nice.
All of which is to say that I count myself incredibly lucky to have gotten to know Uwe Reinhardt, who was both one of the best economists and one of the nicest people I’ve ever encountered. I only wish now that I had managed to spend more time with him and May when I had the chance.
Who was Uwe the professional economist? I didn’t know him as a teacher, although by all accounts he was one of the best, most inspiring teachers Princeton has ever known. I knew him instead from his research on health care, which was and remains incredibly important and influential.
In case you don’t know this, health economics is a hugely important subject that even now doesn’t get as much attention as it deserves. We talk endlessly about globalization and all that, yet America spends more on health than it does on imports – and spends it much worse: our health care system is hugely dysfunctional.
Although Uwe and I were colleagues at Princeton, I really got to know him – as opposed to being someone to say hello to in the hallway — as a byproduct of my other job. Around 2005 I was one of the many U.S. progressives with a public platform who decided that it was time to make another push at health reform, the push that eventually led to the Affordable Care Act. But I had a problem: I didn’t know anything about the subject. I wasn’t a real health economist, even though I was obliged to play one on TV.
Luckily, a real health economist – arguably the best health economist in America – was just down the hall. So I leaned on Uwe to lead me through; he was the person I went to and asked whether what I was about to write was stupid. (Sometimes the answer was yes.)
To understand Uwe’s role in policy debates, you need to know that health care is no country for simplistic men. There may be areas of economics where repeating easy slogans gets you somewhere; health economics, for a variety of reasons, isn’t one of those areas. The facts about health care tend to be complex, and they’re also stubbornly inconsistent with rigid ideologies of any kind.
And nobody did more to bring out these facts than Uwe did.
Uwe’s most famous paper had the not especially diplomatic title “It’s the prices, stupid: why the United States is so different from other countries.” At the time, it was common for U.S. politicians to bash the imagined horrors of foreign health care. Back in 2008, a guy named Rudi Giuliani – whatever happened to him? – warned that if a Democrat was elected, “we are in for a disaster. We are in for Canadian health care, French health care, British health care.”
But what Uwe showed was that while America spent much more on health than anyone else, we weren’t getting better care or even more care than other countries; we were just paying higher prices. That was a hugely important insight, one that Uwe delved into in a series of path-breaking papers. To give you a sense of the kinds of things he explored, another of his major papers was titled “The pricing of US hospital services: chaos behind a veil of secrecy.”
You might think that everyone would be eager to get health care facts right; that is, you might think that if you’ve been living in a cave for, I don’t know, the past 35 years or so. The reality is that policy debates over health care are, if anything, even uglier than average for U.S. economic debate, which is really saying something; the reason, I think, is because the facts – the kind of facts Uwe dedicated his working life to discovering – are so inconsistent with many forms of political orthodoxy.
So it would have been understandable and forgivable if Uwe had become a pugnacious, somewhat angry warrior. The miraculous thing is that he didn’t. In the battlefield of ideas and ideology that is health economics, Uwe was always a calm voice of reason, telling people things they didn’t want to hear but without a trace of personal rancor. I’ve run into people who vigorously disagreed with Uwe – vigorously and, invariably, wrongly. But I’ve never run into anyone who disliked him.
And while keeping an even keel amid intellectual storms, he managed at the same time to be something you might guess from his paper titles: consistently, uproariously funny. Every talk I ever heard him give was simultaneously serious in purpose and a barrel of laughs; everyone I know who ever heard him talk says the same thing.
That was Uwe Reinhardt the economist. Let me just finish up with a few words about Uwe Reinhardt the man. I’ve known a few people who were as charming, gracious, and fun to be around as Uwe; I’ve known a few couples who seemed to complement each other as well, to make the world a better place, as Uwe and May. But I’ve never known either an individual or a pair to surpass them. Uwe was a great man but also a good man, a joy to know, and his life partner was and is every bit his match. We lost him far too soon, but were blessed to have had him at all.
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