Intro, Meet Conclusion (Another in the “right-of-center health care analysis” series)

I recently mentioned Mark Pauly’s recent book on reforming the individual insurance market, which I plan to write more on shortly. But tonight I’m reading an exchange between Pauly and Princeton health economist Uwe Reinhardt from 1995 or 1996, and I’m simply flabbergasted by two claims Pauly makes. One the one hand, we get this statement from the introduction:

It is..probably true in large part, that the health care reform proposed by the president [Clinton] failed because Harry and Louise were more effective at scaring the middle class than were Ira [Magaziner] and Hillary [Clinton].

Then there’s this from the conclusion:

It might be helpful to point out a logical contradiction: if the middle class are so concerned about the welfare of the nonpoor uninsured that they will not force them to pay for the insurance coverage, why are the middle class unwilling to pay for that insurance for them? It appears that a little altruism is a dangerous thing…If we cannot convince the decisive voters of the value of what we value, then I think we need to accept the verdict of democracy.

So let me get this straight. Health reform failed because of a year-long insurance industry-funded campaign to scare the middle class. And it failed because the middle class decided in its infinite and dispositive wisdom that there is no social obligation to aid those without insurance. Huh?

To be fair, there is also this from the introduction:

[It is] a little surprising that two economists are talking about what is essentially a political issue, but I suppose that is the way it has to be.

God I hope that’s not true.

More on Pauly’s more recent book and John Goodman’s way of thinking about health care anon.