Parting at the crossroads: The development of health insurance in Canada and the United States, 1940-1965

Comparative Politics

Volumn 29, Issue 4, 1997, Pages 411-431

  Maioni, Antonia ^a  

^a NONE

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EID: 0039338505     PISSN: 00104159     EISSN: None     Source Type: Journal    
DOI: 10.2307/422012     Document Type: Article

References (101)

1. U.S. General Accounting Office, Canadian Health Insurance: Lessons for the United States (Washington, D.C.: GAO, 1991); Theodore R. Marmor, "Canada's Health Care System: A Model for the United States?," Current History, 90 (December 1991), 422-27: Morris L. Barer and Robert G. Evans, "Interpreting Canada: Models, Mind-Sets, Myths," Health Affairs, 11 (Spring 1992), 44-61.
2. U.S. General Accounting Office, Canadian Health Insurance: Lessons for the United States (Washington, D.C.: GAO, 1991); Theodore R. Marmor, "Canada's Health Care System: A Model for the United States?," Current History, 90 (December 1991), 422-27: Morris L. Barer and Robert G. Evans, "Interpreting Canada: Models, Mind-Sets, Myths," Health Affairs, 11 (Spring 1992), 44-61.
3. U.S. General Accounting Office, Canadian Health Insurance: Lessons for the United States (Washington, D.C.: GAO, 1991); Theodore R. Marmor, "Canada's Health Care System: A Model for the United States?," Current History, 90 (December 1991), 422-27: Morris L. Barer and Robert G. Evans, "Interpreting Canada: Models, Mind-Sets, Myths," Health Affairs, 11 (Spring 1992), 44-61.
4. See Gøsta Esping-Andersen, The Three Worlds of Welfare Capitalism (Princeton: Princeton University Press, 1990).
5. Canada and the United States experienced comparable timing of industrialization and levels of economic development, have federal structures of government, and are generally considered to have similar political cultures relative to European nations; neither has developed fully corporatist policy-making arrangements or strong national social democratic or labor parties, and the organized labor movement in both countries has been historically weak and fragmented. See Antonia Maioni, "Explaining Differences in Welfare State Development: A Comparative Study of Health Insurance Legislation in Canada and the United States" (Ph.D. diss., Northwestern University, 1992); Robert T. Kudrle and Theodore R. Marmor, "The Development of Welfare States in North America," in Peter Flora and Arnold J. Heidenheimer, eds., The Development of Welfare States in Europe and America (New Brunswick: Transaction Books, 1981).
6. Canada and the United States experienced comparable timing of industrialization and levels of economic development, have federal structures of government, and are generally considered to have similar political cultures relative to European nations; neither has developed fully corporatist policy-making arrangements or strong national social democratic or labor parties, and the organized labor movement in both countries has been historically weak and fragmented. See Antonia Maioni, "Explaining Differences in Welfare State Development: A Comparative Study of Health Insurance Legislation in Canada and the United States" (Ph.D. diss., Northwestern University, 1992); Robert T. Kudrle and Theodore R. Marmor, "The Development of Welfare States in North America," in Peter Flora and Arnold J. Heidenheimer, eds., The Development of Welfare States in Europe and America (New Brunswick: Transaction Books, 1981).
7. Paul Starr, The Social Transformation of American Medicine (New York: Basic Books, 1982); C. David Naylor, Private Practice, Public Payment: Canadian Medicine and the Politics of Health Insurance 1911-1966 (Montreal: McGill-Queen's University Press, 1986).
8. Paul Starr, The Social Transformation of American Medicine (New York: Basic Books, 1982); C. David Naylor, Private Practice, Public Payment: Canadian Medicine and the Politics of Health Insurance 1911-1966 (Montreal: McGill-Queen's University Press, 1986).
9. John D. Stephens, The Transition from Capitalism to Socialism (London: Macmillan, 1979); Vicente Navarro, "Why Some Countries Have National Health Insurance, Others Have National Health Services and the U.S. Has Neither," Social Science and Medicine, 28 (September 1989), 887-98.
10. John D. Stephens, The Transition from Capitalism to Socialism (London: Macmillan, 1979); Vicente Navarro, "Why Some Countries Have National Health Insurance, Others Have National Health Services and the U.S. Has Neither," Social Science and Medicine, 28 (September 1989), 887-98.
11. Hugh Heclo, Modern Social Policies in Britain and Sweden (New Haven: Yale University Press, 1974); Theda Skocpol and G. John Ikenberry, "The Political Formation of the American Welfare State in Historical and Comparative Perspective," Comparative Social Research, 6 (1983), 87-148; Ann S. Orloff and Theda Skocpol. "Why Not Equal Protection? Explaining the Politics of Public Social Spending in Britain. 1900-1911, and the United States, 1880s-1920," American Sociological Review, 49 (December 1984), 726-50.
12. Hugh Heclo, Modern Social Policies in Britain and Sweden (New Haven: Yale University Press, 1974); Theda Skocpol and G. John Ikenberry, "The Political Formation of the American Welfare State in Historical and Comparative Perspective," Comparative Social Research, 6 (1983), 87-148; Ann S. Orloff and Theda Skocpol. "Why Not Equal Protection? Explaining the Politics of Public Social Spending in Britain. 1900-1911, and the United States, 1880s-1920," American Sociological Review, 49 (December 1984), 726-50.
13. Hugh Heclo, Modern Social Policies in Britain and Sweden (New Haven: Yale University Press, 1974); Theda Skocpol and G. John Ikenberry, "The Political Formation of the American Welfare State in Historical and Comparative Perspective," Comparative Social Research, 6 (1983), 87-148; Ann S. Orloff and Theda Skocpol. "Why Not Equal Protection? Explaining the Politics of Public Social Spending in Britain. 1900-1911, and the United States, 1880s-1920," American Sociological Review, 49 (December 1984), 726-50.
14. James L. March, and Johan Olsen, "The New Institutionalism: Organizational Factors in Political Life," American Political Science Review, 78 (September 1984), 734-49; Theda Skocpol, "Bringing the State Back In," in Peter B. Evans, Dietrich Rueschemeyer, and Theda Skocpol, eds., Bringing the State Back In (New York: Cambridge University Press, 1985).
15. James L. March, and Johan Olsen, "The New Institutionalism: Organizational Factors in Political Life," American Political Science Review, 78 (September 1984), 734-49; Theda Skocpol, "Bringing the State Back In," in Peter B. Evans, Dietrich Rueschemeyer, and Theda Skocpol, eds., Bringing the State Back In (New York: Cambridge University Press, 1985).
16. Here, I am referring to James Q. Wilson's typology of entrepreneurial politics and the way in which certain political actors can produce policies with concentrated costs but widely distributed benefits. James Q. Wilson, Political Organizations (New York: Basic Books, 1973), ch. 16. I am indebted to my colleague. Christopher Manfredi, for bringing this useful analogy to my attention.
17. On the comparative historical method, see Charles C. Ragin, The Comparative Method (Berkeley: University of California Press, 1987); Theda Skocpol, "Emerging Agendas and Recurrent Strategies in Historical Sociology," in Theda Skocpol, ed., Vision and Method in Historical Sociology (New York: Cambridge University Press, 1984).
18. On the comparative historical method, see Charles C. Ragin, The Comparative Method (Berkeley: University of California Press, 1987); Theda Skocpol, "Emerging Agendas and Recurrent Strategies in Historical Sociology," in Theda Skocpol, ed., Vision and Method in Historical Sociology (New York: Cambridge University Press, 1984).
19. Sven Steinmo and Jon Watts, "It's the Institutions, Stupid! Why Comprehensive National Health Insurance Always Fails in America," Journal of Health Politics, Policy and Law, 20 (Summer 1995).
20. Kathleen Thelen and Sven Steinmo, "Historical Institutionalism in Comparative Politics", in Sven Steinmo, Kathleen Thelen, and Frank Longstreth, eds., Structuring Politics: Historical Institutionalism in Comparative Analysis (New York: Cambridge University Press. 1992). For an examination of how institutions condition the strategy of social groups in health policy, see Ellen M. Immergut, Health Politics: Interests and Institutions in Western Europe (New York: Cambridge University Press, 1992).
21. Kathleen Thelen and Sven Steinmo, "Historical Institutionalism in Comparative Politics", in Sven Steinmo, Kathleen Thelen, and Frank Longstreth, eds., Structuring Politics: Historical Institutionalism in Comparative Analysis (New York: Cambridge University Press. 1992). For an examination of how institutions condition the strategy of social groups in health policy, see Ellen M. Immergut, Health Politics: Interests and Institutions in Western Europe (New York: Cambridge University Press, 1992).
22. This point is stressed by Leon D. Epstein, "A Comparative Study of Canadian Parties," American Political Science Review, 58 (March 1964), 46-59 and Seymour Martin Lipset, "Introduction," Agrarian Socialism: The Cooperative Commonwealth Federation in Saskatchewan (Berkeley: University of California Press, 1971).
23. This point is stressed by Leon D. Epstein, "A Comparative Study of Canadian Parties," American Political Science Review, 58 (March 1964), 46-59 and Seymour Martin Lipset, "Introduction," Agrarian Socialism: The Cooperative Commonwealth Federation in Saskatchewan (Berkeley: University of California Press, 1971).
24. Maurice Duverger, Political Parties: Their Organization and Activity in the Modern State (London Methuen, 1954). This dynamic is traced in E. E. Schattschneider, Party Government (New York: Rinehart, 1942); and by Alan C. Cairns, "The Electoral System and the Party System in Canada, 1921-1965," Canadian Journal of Political Science, 1 (March 1968), 55-80.
25. Maurice Duverger, Political Parties: Their Organization and Activity in the Modern State (London Methuen, 1954). This dynamic is traced in E. E. Schattschneider, Party Government (New York: Rinehart, 1942); and by Alan C. Cairns, "The Electoral System and the Party System in Canada, 1921-1965," Canadian Journal of Political Science, 1 (March 1968), 55-80.
26. Maurice Duverger, Political Parties: Their Organization and Activity in the Modern State (London Methuen, 1954). This dynamic is traced in E. E. Schattschneider, Party Government (New York: Rinehart, 1942); and by Alan C. Cairns, "The Electoral System and the Party System in Canada, 1921-1965," Canadian Journal of Political Science, 1 (March 1968), 55-80.
27. Canada is in fact a notable exception to the single member plurality, two party system rule, due to the existence of "local" minority parties. Douglas W. Rae. The Political Consequences of Electoral Laws (New Haven: Yale University Press, 1971); William Riker, "Duverger's Law Revisited," in Bernard Grofman and Arend Lijphart, Electoral Laws and Their Political Consequences (New York: Agathon Press, 1986).
28. Canada is in fact a notable exception to the single member plurality, two party system rule, due to the existence of "local" minority parties. Douglas W. Rae. The Political Consequences of Electoral Laws (New Haven: Yale University Press, 1971); William Riker, "Duverger's Law Revisited," in Bernard Grofman and Arend Lijphart, Electoral Laws and Their Political Consequences (New York: Agathon Press, 1986).
29. Steven J. Rosenstone. Roy L. Behr, and Edward H. Lazarus, Third Parties in America: Citizen Response to Major Party Failure (Princeton: Princeton University Press, 1984). Two twentieth century exceptions stand out: Theodore Roosevelt's candidacy under the Bull Moose Progressive label, which won 27 percent of the vote in 1912 and helped swing victory to the Democratic party, and Ross Perot's 1992 campaign, which attracted 19 percent of the vote. J. David Gillespie, Politics at the Periphery: Third Parties in Two-Party America (Columbia: University of South Carolina Press, 1993), ch. 8.
30. Steven J. Rosenstone. Roy L. Behr, and Edward H. Lazarus, Third Parties in America: Citizen Response to Major Party Failure (Princeton: Princeton University Press, 1984). Two twentieth century exceptions stand out: Theodore Roosevelt's candidacy under the Bull Moose Progressive label, which won 27 percent of the vote in 1912 and helped swing victory to the Democratic party, and Ross Perot's 1992 campaign, which attracted 19 percent of the vote. J. David Gillespie, Politics at the Periphery: Third Parties in Two-Party America (Columbia: University of South Carolina Press, 1993), ch. 8.
31. Among the rich literature on third parties in Canada, see W. L. Morton, The Progressive Party in Canada (Toronto: University of Toronto Press, 1950); Walter Young, The Anatomy of a Party: The National CCF (Toronto: University of Toronto Press, 1969) Maurice Pinard, The Rise of a Third Party: A Study in Crisis Politics (Scarborough: Prentice-Hall, 1971): Thomas Flanagan, Waiting for the Wave: The Reform Party and Preston Manning (Toronto: Stoddart, 1995). The emergence and role of the Bloc Québécois in Canadian political debates remains unique; see Alain Noël, "Distinct in the House of Commons: The Bloc Québécois as Official Opposition," in Douglas M. Brown and Janet Hiebert, eds., Canada: The State of the Federation, 1994 (Kingston: Institute of Intergovernmental Relations, Queen's University, 1994).
32. Among the rich literature on third parties in Canada, see W. L. Morton, The Progressive Party in Canada (Toronto: University of Toronto Press, 1950); Walter Young, The Anatomy of a Party: The National CCF (Toronto: University of Toronto Press, 1969) Maurice Pinard, The Rise of a Third Party: A Study in Crisis Politics (Scarborough: Prentice-Hall, 1971): Thomas Flanagan, Waiting for the Wave: The Reform Party and Preston Manning (Toronto: Stoddart, 1995). The emergence and role of the Bloc Québécois in Canadian political debates remains unique; see Alain Noël, "Distinct in the House of Commons: The Bloc Québécois as Official Opposition," in Douglas M. Brown and Janet Hiebert, eds., Canada: The State of the Federation, 1994 (Kingston: Institute of Intergovernmental Relations, Queen's University, 1994).
33. Among the rich literature on third parties in Canada, see W. L. Morton, The Progressive Party in Canada (Toronto: University of Toronto Press, 1950); Walter Young, The Anatomy of a Party: The National CCF (Toronto: University of Toronto Press, 1969) Maurice Pinard, The Rise of a Third Party: A Study in Crisis Politics (Scarborough: Prentice-Hall, 1971): Thomas Flanagan, Waiting for the Wave: The Reform Party and Preston Manning (Toronto: Stoddart, 1995). The emergence and role of the Bloc Québécois in Canadian political debates remains unique; see Alain Noël, "Distinct in the House of Commons: The Bloc Québécois as Official Opposition," in Douglas M. Brown and Janet Hiebert, eds., Canada: The State of the Federation, 1994 (Kingston: Institute of Intergovernmental Relations, Queen's University, 1994).
34. Among the rich literature on third parties in Canada, see W. L. Morton, The Progressive Party in Canada (Toronto: University of Toronto Press, 1950); Walter Young, The Anatomy of a Party: The National CCF (Toronto: University of Toronto Press, 1969) Maurice Pinard, The Rise of a Third Party: A Study in Crisis Politics (Scarborough: Prentice-Hall, 1971): Thomas Flanagan, Waiting for the Wave: The Reform Party and Preston Manning (Toronto: Stoddart, 1995). The emergence and role of the Bloc Québécois in Canadian political debates remains unique; see Alain Noël, "Distinct in the House of Commons: The Bloc Québécois as Official Opposition," in Douglas M. Brown and Janet Hiebert, eds., Canada: The State of the Federation, 1994 (Kingston: Institute of Intergovernmental Relations, Queen's University, 1994).
35. Among the rich literature on third parties in Canada, see W. L. Morton, The Progressive Party in Canada (Toronto: University of Toronto Press, 1950); Walter Young, The Anatomy of a Party: The National CCF (Toronto: University of Toronto Press, 1969) Maurice Pinard, The Rise of a Third Party: A Study in Crisis Politics (Scarborough: Prentice-Hall, 1971): Thomas Flanagan, Waiting for the Wave: The Reform Party and Preston Manning (Toronto: Stoddart, 1995). The emergence and role of the Bloc Québécois in Canadian political debates remains unique; see Alain Noël, "Distinct in the House of Commons: The Bloc Québécois as Official Opposition," in Douglas M. Brown and Janet Hiebert, eds., Canada: The State of the Federation, 1994 (Kingston: Institute of Intergovernmental Relations, Queen's University, 1994).
36. Rosenstone et al., pp. 19-21, see also Daniel A. Mazmanian, Third Parties in Presidential Elections (Washington, D.C.: The Brookings Institution. 1974).
37. V. O. Key, Politics, Parties and Pressure Groups, 5th ed. (New York: Thomas Crowell, 1964), pp. 279-81.
38. Seymour Martin Lipset, "Why No Socialism in the United States?," in Seweryn Bialer and Sophia Sluzar, eds., Radicalism in the Contemporary Age, Volume 1: Sources of Contemporary Radicalism (Boulder: Westview Press, 1977).
39. For a comparison of the Canadian and American senates, see Roger Gibbins, "A Tale of Two Senates," in David Thomas, ed., Canada and the United States: Differences That Count (Peterborough: Broadview Press. 1993).
40. For a review, see Peter McCormick. "Provincial Political Party Systems, 1945-1993," in Alain-G. Gagnon and A. Brian Tanguay, eds., Canadian Parties in Transition: Discourse, Organization, 2nd ed. (Scarborough: Nelson, 1996).
41. On the "centrifugal" nature of American federalism as opposed to the "centripetal" forces at work in Canadian federalism, see Richard Simeon, "Canada and the United States: Lessons from the North American Experience," in Karen Knop et al., eds., Rethinking Federalism: Citizens, Markets, and Governments in a Changing World (Vancouver: University of British Columbia Press, 1995).
42. An important example is the Democratic party in the 1930s; Seymour Martin Lipset, "Roosevelt and the Protest of the 1930s," Minnesota Law Review, 68 (December 1983), 273-98. Valelly's study of the Minnesota Farmer-Labor party also points to the tendency of political elites to concentrate their reform efforts in Washington, a national power center not yet developed in Ottawa during the 1930s. Richard M. Valelly, Radicalism in the States: The Minnesota Farmer-Labor Party and the American Political Economy (Chicago: University of Chicago Press, 1989), ch. 10.
43. An important example is the Democratic party in the 1930s; Seymour Martin Lipset, "Roosevelt and the Protest of the 1930s," Minnesota Law Review, 68 (December 1983), 273-98. Valelly's study of the Minnesota Farmer-Labor party also points to the tendency of political elites to concentrate their reform efforts in Washington, a national power center not yet developed in Ottawa during the 1930s. Richard M. Valelly, Radicalism in the States: The Minnesota Farmer-Labor Party and the American Political Economy (Chicago: University of Chicago Press, 1989), ch. 10.
44. The following analysis draws on a more detailed descriptive account of health politics in the two countries during the immediate postwar period, Antonia Maioni, "Nothing Succeeds Like the Right Kind of Failure: Postwar National Health Insurance Initiatives in Canada and the United States," Journal of Health Politics, Policy and Law, 20 (Spring 1995), 5-30.
45. The Royal Commission was set up in 1937, after the Employment and Social Insurance Act of 1935 was found to be a federal infringement of provincial jurisdiction in the area of social welfare, on health care, see Government of Canada, Report of the Royal Commission on Dominion-Provincial Relations, Book II: Recommendations (Ottawa: King's Printer, 1940), pp. 4-35, 42-43.
46. On the formation of the national CCF, see Young, chs. 2, 3.
47. Leonard Marsh, a student of Beveridge closely associated with the CCF's intellectual wing, drew heavily on social democratic principles in drawing up his report commissioned by the federal government's Advisory Committee on Reconstruction. Leonard Marsh, Report on Social Security for Canada, 1943 (Toronto: University of Toronto Press, 1975).
48. The CCF won forty-seven seats to the Liberal's five and formed its first provincial government in Saskatchewan after the 1944 election; Ivan Avakumovic, Socialism in Canada: A Study of the CCF-NDP in Federal and Provincial Politics (Toronto: McClelland and Stewart, 1977), ch. 6.
49. CCF support was estimated at 29 percent, the Liberals and Conservatives at 28 percent each. Gerald L. Caplan, The Dilemma of Canadian Socialism: The C.C.F. in Ontario (Toronto: McClelland and Stewart, 1973). pp. 110-11; Canadian Institute of Public Opinion, Apr. 8, 1942.
50. Robert Bothwell and John English, "Pragmatic Physicians: Canadian Medicare and Health Care Insurance, 1910-1945," in S.E.D. Shortt, ed., Medicine in Canadian Society: Historical Perspectives (Montreal: McGill-Queen's University Press, 1981); CMA, Submission to the Special Committee on Social Security, Apr. 6, 1943.
51. House of Commons, Special Committee on Social Security, Minutes of the Proceedings (Ottawa: May 18, 1943).
52. House of Commons, Special Committee on Social Security, Fourth Report of the Special Committee on Social Security (Ottawa: July 23, 1943).
53. On Canadian conservatism and the Conservative party, see William Christian and Colin Campbell, Parties, Leaders and Ideologies in Canada (Toronto: McGraw-Hill Ryerson, 1996), ch. 2.
54. The federal government would contribute to the costs of such plans in the provinces, in return for control in the collection of personal and corporate taxation; on the development and demise of those proposals see Malcolm G. Taylor, Health Insurance and Canadian Public Policy: The Seven Decisions That Created the Canadian Health Insurance System and Their Outcomes (Montreal: McGill-Queen's University Press, 1987), ch. 1.
55. The 1945 federal election was part of the "contest for labour" between the CCF and the Liberal Party. Janine Brodie and Jane Jenson, Crisis, Challenge and Change: Party and Class in Canada Revisited (Ottawa: Carleton University Press, 1988), ch. 7.
56. National Archives of Canada, RG 29, vol. 1063, file 502-1 Pt. 11; Paul Martin to W. L. Mackenzie King, Jan. 5, 1948; Paul Martin, A Very Public Life, vol. 2 (Toronto: Deneau, 1985), ch. 2.
57. Stanley Knowles, the CCF party whip, was particularly effective in this area; see, for example, House of Commons, Debates, Dec. 1, 1952, 339; and Nov. 23, 1953, 258.
58. Stanley Knowles, the CCF party whip, was particularly effective in this area; see, for example, House of Commons, Debates, Dec. 1, 1952, 339; and Nov. 23, 1953, 258.
59. Donald Swartz, "The Polities of Reform: Conflict and Accommodation in Canadian Health Policy." in Leo Panitch, ed., The Canadian State: Political Economy and Political Power (Toronto: University of Toronto Press, 1977), p. 323.
60. Sixty-two percent of Canadians responded positively in an April 1956 Gallup Poll that asked: "Would you favor, or oppose, a government-operated plan whereby any hospital expenses you incurred would be paid for out of taxes, even if it meant higher taxes?" The Montreal Star, Apr. 18, 1956. By September support increased to 72 percent. Toronto Daily Star, Sept. 5, 1956.
61. Sixty-two percent of Canadians responded positively in an April 1956 Gallup Poll that asked: "Would you favor, or oppose, a government-operated plan whereby any hospital expenses you incurred would be paid for out of taxes, even if it meant higher taxes?" The Montreal Star, Apr. 18, 1956. By September support increased to 72 percent. Toronto Daily Star, Sept. 5, 1956.
62. Taylor, p. 105.
63. On the development and passage of the legislation, see Taylor, pp. 211-34.
64. On the conflict over medical insurance in Saskatchewan, see Robin F. Badgley and Samuel Wolfe, Doctors' Strike: Medical Care and Conflict in Saskatchewan (Toronto: Macmillan, 1967).
65. National Archives of Canada, RG 33, volumes 6 to 24 and 44 to 60.
66. Government of Canada, Report of the Royal Commission on Health Services, Final Report, vol. 1 (Ottawa: Queen's Printer, 1964), p. 19.
67. On the renewal of the Liberal party, see Lester B. Pearson, Mike: The Memoirs of the Right Honourable Lester B. Pearson, Volume 3: 1957-1968 (Toronto: University of Toronto Press, 1975); and Joseph Wearing, The L-Shaped Party: The Liberal Party of Canada 1953-1980 (Toronto: McGraw-Hill Ryerson, 1981).
68. On the renewal of the Liberal party, see Lester B. Pearson, Mike: The Memoirs of the Right Honourable Lester B. Pearson, Volume 3: 1957-1968 (Toronto: University of Toronto Press, 1975); and Joseph Wearing, The L-Shaped Party: The Liberal Party of Canada 1953-1980 (Toronto: McGraw-Hill Ryerson, 1981).
69. On the formation of the NDP, see Desmond Morton, NDP: Social Democracy in Canada (Toronto: Hakkert, 1977).
70. Statement by Prime Minister Lester B. Pearson, Federal-Provincial Conference, Ottawa, July 19, 1965, 16-17.
71. Extra-billing was later banned by the federal government in the 1984 Canada Health Act. Monique Begin, Medicare: Canada's Right to Health (Montreal: Optimum Publishing International, 1988).
72. Naylor, p. 233.
73. J. L. Granatstein, Canada, 1957-1967 (Toronto: McClelland and Stewart, 1986), p. 196; only two MPs voted against the bill, Conservative Howard Johnson (from British Columbia) and Social Credit leader Robert Thompson. House of Commons, Debates, Dec. 8, 1966, 10881-2.
74. J. L. Granatstein, Canada, 1957-1967 (Toronto: McClelland and Stewart, 1986), p. 196; only two MPs voted against the bill, Conservative Howard Johnson (from British Columbia) and Social Credit leader Robert Thompson. House of Commons, Debates, Dec. 8, 1966, 10881-2.
75. See note 23.
76. On early developments in health insurance, see Ronald L. Numbers, Almost Persuaded: American Physicians and Compulsory Health Insurance, 1912-1920 (Baltimore: The Johns Hopkins University Press, 1978).
77. Quoted in Monte M. Poen, Harry S. Truman versus the Medical Lobby: The Genesis of Medicare (Columbia: University of Missouri Press, 1979), p. 32. Senators Robert Wagner and James Murray had sponsored health insurance bills in the 1930s; the 1943 bill, cosponsored by Representative John Dingell, was supported by organized labor. Influential bureaucrats in the Social Security Board included Arthur Altmeyer, Wilbur Cohen, and Isidore Falk, all New Deal veterans who had witnessed the failure of health insurance initiatives in the 1930s. Daniel S. Hirshfield, The Lost Reform: The Campaign for Compulsory Health Insurance in the United States from 1932 to 1943 (Cambridge, Mass.: Harvard University Press, 1970).
78. Quoted in Monte M. Poen, Harry S. Truman versus the Medical Lobby: The Genesis of Medicare (Columbia: University of Missouri Press, 1979), p. 32. Senators Robert Wagner and James Murray had sponsored health insurance bills in the 1930s; the 1943 bill, cosponsored by Representative John Dingell, was supported by organized labor. Influential bureaucrats in the Social Security Board included Arthur Altmeyer, Wilbur Cohen, and Isidore Falk, all New Deal veterans who had witnessed the failure of health insurance initiatives in the 1930s. Daniel S. Hirshfield, The Lost Reform: The Campaign for Compulsory Health Insurance in the United States from 1932 to 1943 (Cambridge, Mass.: Harvard University Press, 1970).
79. In 1942 support for national health insurance was estimated at 74 percent. Poen, p. 30. The evolution of attitudes toward social security are compiled in Michael Schiltz, Public Attitudes toward Social Security, 1935-1965 (Washington, D.C.: U.S. Department of Health, Education, and Welfare, Social Security Administration, Office of Research and Statistics Research Report No. 33, 1970).
80. Poen, pp. 39-40, 62-63; Harry S. Truman, Public Papers of the Presidents, 1945, Nov. 19, 1945, 475-94.
81. U.S. Congress, Senate, Committee on Education and Labor, National Health Program: Hearings on S. 1606, 79th Cong., 2nd Sess., Apr. 17, 1946, 551-604.
82. The "barren marriage" between labor and the Democratic party is discussed in Mike Davis, Prisoners of the American Dream: Politics and Economy in the History of the U.S. Working Class (London: Verso, 1986).
83. In particular, they refused to support desegregation policies; William Pemberton, Harry S. Truman: Fair Dealer and Cold Warrior (Boston: Twayne Publishers), pp. 110-13.
84. The AMA's two million dollar "national education campaign," directed by Whitaker and Baxter, the California public relations agency that was also hired to campaign against Governor Earl Warren's health reform proposals in California earlier in the decade, proclaimed "the voluntary way is the American way." Frank Kennedy, "The American Medical Association: Power, Purpose, and Politics in Organized Medicine," The Yale Law Journal, 63 (May 1954), 938-1022.
85. Although 58 percent of Americans supported Truman's health initiatives in 1945, by the end of 1949 support dropped to 36 percent. The Gallup Poll, vol. 2, pp. 801-03, 886. Several pro-health insurance Democrats targeted by the AMA eventually were defeated in 1950 and 1952. Kennedy, pp. 1015-17.
86. Although 58 percent of Americans supported Truman's health initiatives in 1945, by the end of 1949 support dropped to 36 percent. The Gallup Poll, vol. 2, pp. 801-03, 886. Several pro-health insurance Democrats targeted by the AMA eventually were defeated in 1950 and 1952. Kennedy, pp. 1015-17.
87. Memo from Cornelius A. Wood to Oscar Ewing, Jan. 20, 1950, National Archives file 011.4, box 7, FSA.
88. In the 1950s over 60 percent of Americans were covered by hospital insurance, while a third had some form of medical insurance, but less than a quarter of total private health expenditures were covered by insurance. Louis Reed, "Private Medical Care Expenditures and Voluntary Health Insurance, 1948-60," Social Security Bulletin, 24 (December 1961), 3-11.
89. This theme is explored further by John Myles and Jill Quandagno, "The Politics of Income Security for the Elderly in North America: Founding Cleavages and Unresolved Conflicts," in Theodore R. Marmor et al., eds., Economic Security and Intergenerational Justice: A Look at North America (Washington, D.C.: The Urban Institute Press, 1994).
90. The proposal had its origins in a 1952 bill introduced by Senator Murray and Representative Dingell. The 1957 bill was drafted by Nelson Cruikshank and Andrew Biemiller of the AFL-CIO and sponsored by Aimé Forand of Rhode Island, the fourth-ranking Democrat on the Ways and Means Committee. On the Forand bill, see James Q. Sundquist, Politics and Policy: The Eisenhower, Kennedy and Johnson Years (Washington, D.C.: The Brookings Institution, 1968), pp. 296-308; 391-92; and Richard Harris, A Sacred Trust (New York: New American Library, 1966), pp. 72-73.
91. The proposal had its origins in a 1952 bill introduced by Senator Murray and Representative Dingell. The 1957 bill was drafted by Nelson Cruikshank and Andrew Biemiller of the AFL-CIO and sponsored by Aimé Forand of Rhode Island, the fourth-ranking Democrat on the Ways and Means Committee. On the Forand bill, see James Q. Sundquist, Politics and Policy: The Eisenhower, Kennedy and Johnson Years (Washington, D.C.: The Brookings Institution, 1968), pp. 296-308; 391-92; and Richard Harris, A Sacred Trust (New York: New American Library, 1966), pp. 72-73.
92. Rosemary Stevens, American Medicine and the Public Interest (New Haven: Yale University Press, 1971), p. 434.
93. The vote was seventeen to eight. Led by Ways and Means chairman Wilbur Mills. seven southern Democrats joined the Republicans, Congressional Quarterly Almanac (1960), 154.
94. Sundquist, pp. 311-18.
95. For an analysis of the role of public opinion in the 1960s health reform debate, see Lawrence R. Jacobs, The Health of Nations: Public Opinion and the Making of American and British Health Policy (Ithaca: Cornell University Press, 1993).
96. "Health and Hospital Care Message from the President," Congressional Record, Feb. 9, 1961, 2000-2003.
97. Theodore R. Marmor, The Politics of Medicare (Chicago: Aldine, 1973), p. 24.
98. Ibid., p. 46.
99. John F. Kennedy, Public Papers of the Presidents, 1963-64, pp. 620-622.
100. On the Mills compromise, see Martha Derthick, Policymaking for Social Security (Washington, D.C.: The Brookings Institution, 1979), pp. 331-33; and Marmor, The Politics of Medicare, p. 63.
101. On the Mills compromise, see Martha Derthick, Policymaking for Social Security (Washington, D.C.: The Brookings Institution, 1979), pp. 331-33; and Marmor, The Politics of Medicare, p. 63.