Uwe E. Reinhardt, an economist who gained international renown for diagnosing the ills of the U.S. health-care system, and who drew on ethics as well as data in offering remedies to policymakers and physicians, patients and the public, died Nov. 13 in Princeton, N.J. He was 80.
His death was announced by the Woodrow Wilson School of Public and International Affairs at Princeton University, where he had taught for nearly five decades. Other details were not immediately available.
Few scholars had greater influence than Dr. Reinhardt on the analysis of health care in the United States. Ezekiel J. Emanuel, chairman of the University of Pennsylvania’s Department of Medical Ethics and Health Policy, described him in an interview as “one of the giants of health care policy and economics.”
Dr. Reinhardt provided a “great moral conscience” and was an “educator in the widest sense,” Emanuel said, not just for “his students at Princeton but everyone in America.” Emanuel credited him with showing that a more equitable health-care system was both desirable and possible.
During the political battles over the 2010 Affordable Care Act, and discussions of the failed Clinton health-care plan in the 1990s, and long before, Dr. Reinhardt was a preeminent source for lawmakers, business executives and journalists on the economics of medical care. Born in Germany and educated partly in Canada, he brought to the fraught debate the clarity of one who has experienced several different health systems firsthand.
He described Americans as “the least well-insured people on Earth” and U.S. employers, who often provide employees with insurance, as arguably the “sloppiest purchasers of health care anywhere.” (Known for a plain-spoken style, he boasted of making similar remarks directly to the Business Council, an association of executives.)
Appearing before congressional panels, on the speaking circuit and in the media, Dr. Reinhardt enumerated the flaws of the U.S. system as he saw them — the fragility of employment-based plans, the number of people who carry no insurance, and the unpredictable and often exorbitant cost of services.
Victor R. Fuchs, a Stanford University professor emeritus of health policy, said in an interview that Dr. Reinhardt was a leading advocate for “some form of national health insurance,” such as the German system.
“I believe it is still the best model there is, because it blends a private health-care delivery system with universal coverage and social solidarity,” Dr. Reinhardt told the New York Times in 2009. “The financing is simple. It’s inexpensive and equitable. Coverage is portable. You’re never uninsured in Germany. No family goes broke over health care bills.”
Emanuel remarked that Dr. Reinhardt escaped the flaw — popularly attributed to economists and cynics — of knowing “the price of everything but the value of nothing.” Dr. Reinhardt knew well, Emanuel said, “that price was just one aspect of the value of health care.” He spoke with grief about uninsured women who “think twice” before seeing a doctor for lumps in their breasts because care is so costly.
Yet price did matter, Dr. Reinhardt argued. Americans in different parts of the country are often charged wildly different fees for the same services — with no regard for quality.
He decried the “shroud of secrecy” covering the U.S. “health care fortress” and saw hope in reference pricing, in which insurers pay a set amount for a set service and the patient must cover the difference if he or she visits a provider who charges more.
He also called for a stricter individual mandate — a means of distributing risk by requiring everyone to enroll in insurance — than the one in the Affordable Care Act. Many congressional Republicans have vowed to eliminate the mandate as part of the dismantlement of the legislation, which was dubbed Obamacare.
To those who argue that government involvement in personal matters violates some fundamental American ethic, Dr. Reinhardt declared the notion “utterly ridiculous.”
“Just try taking Medicare away from the elderly,” he told the Times. “In the decades I have lived here, I have discovered this about America’s legendary rugged individualists: when the going gets rough, the rough run to the government.”
Uwe Ernst Reinhardt — his first name was pronounced OOH-vah — was born in Osnabrück, Germany, on Sept. 24, 1937. His father was a chemical engineer, and his mother was an artist.
He grew up on the edge of the Hürtgen forest, the site of a horrific battle in the waning days of World War II. Years later, he would defend the members of his generation whom, he wrote in the Times, “many Americans now disparage so contemptuously as pacifists” for their aversion to war.
Dr. Reinhardt left Germany for Canada, where he received a bachelor of commerce degree from the University of Saskatchewan in 1964. He came to the United States to attend Yale University, receiving a PhD in economics in 1970.
At Princeton, where he joined the faculty in 1968, his students included future heart transplant surgeon and Senate majority leader Bill Frist (R-Tenn.). As Dr. Reinhardt established himself in his field, he advised policymakers abroad as well as in the United States. He nurtured a particular interest in medical care for veterans, one of his sons having served as a Marine Corps officer in the 2003 invasion of Iraq.
Dr. Reinhardt’s survivors include his wife, Tsung-Mei Cheng, who is known as May, of Princeton; three children, Dirk Reinhardt of New York City, Kara Reinhardt Block of Wellesley, Mass., and Mark Reinhardt of San Francisco; two sisters; a brother; and two grandchildren.
Emanuel commended Dr. Reinhardt for maintaining a sense of optimism where health care was concerned, despite political and other obstacles to change. Dr. Reinhardt quipped that, perhaps for the United States, the best solution was “the K.I.S.S. principle” — “Keep It Simple, Stupid.”
“If you can do something in a complicated way, trust Americans to discover it,” he told the Times, “certainly in health care.”