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Why No National Health Insurance in the U.S.? The Limits of Social Provision in War and Peace, 1941–1948

Published online by Cambridge University Press:  14 October 2011

Colin Gordon
Colin Gordon
Affiliation:
University of Iowa
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Extract

Why, alone among its democratic capitalist peers, does the U.S. not have national health insurance? This question has invited a range of replies; some focusing on specific historical episodes, some invoking grand political or cultural or economic explanations for the peculiar trajectory American social policy. For the most part, the historical accounts have trouble climbing from narrative to explanation; little of the scholarship on the failure of health reform in 1920 or 1935 or 1948 or 1970 or 1994 makes any substantial contribution to our larger understanding of the American welfare state and its limits. And the theoretical accounts often stumble on the descent to historical context; the largely artificial debate between “state-centered” and economic explanations, for example, rests largely on abstractions which are either not unique to the American setting (capitalism, industrialism, liberalism) or which are offered in such broad strokes that they make little sense in specific historical contexts. In explaining this “hole” in the American welfare state, it is necessary to pursue two lines of inquiry; to consider both the relative success of other American social programs during the years in which health insurance was beating at the door, and the relative success of public health insurance in other national settings. Our understanding of the American health debate of the 1940s, in other words, must in part explain both the distinct trajectory of health policy during the formative years of Social Security, and the “exceptional” character of the American welfare state.

Type
Articles
Information
Journal of Policy History , Volume 9 , Issue 3 , July 1997 , pp. 277 - 310
Copyright
Copyright © The Pennsylvania State University, University Park, PA. 1997

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References

Notes

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6. Quote from full-page newspaper ad (April 1949), Box 212, Edwin Witte Papers, State Historical Society of Wisconsin [SHSW], Madison, WI; AMA, “The Voluntary Way is the American Way” (1948), Box 206, Witte Papers; Forest Harness, “Forcing Socialized Medicine on America By Use of Federal Employees and Government Money” (Sept. 1947), Reel 6, Michael Davis Papers, Truman Library, Poen, Truman Versus the Medical Lobby, 105; Misc. documents Re FBI Investigation, Box 49:331–342, Series II, Isidore Falk Papers, Sterling Library, Yale University, New Haven CT; “Statement of the Executive Council,” AFL Committee on Social Security (1950), Box 16, Nelson Cruikshank Papers, SHSW; see also Healing Arts Committee Spot Announcements (1950), OF 103, Box 575, HST Papers; American Medicine and the Political Scene (1947–1949), Box 212, Witte Papers.

7. George Addes, Secretary-Treasurer UAW, “The Plot Against the W-M-D Bill” (17 Feb. 1944), Box 60:519, Series II, Falk Papers; Ohio Chamber of Commerce, “A Death Thrust…” (1943), President's Official File 4351:2, Franklin D. Roosevelt Papers, Franklin and Eleanor Roosevelt Library, Hyde Park, NY; Memo: “Doctors Threaten to Quit” (Oct. 1943), Box 50:368, Series II, Falk Papers; Wilson, Compulsory Health Insurance, 93; Oklahoma State Medical Assoc. to HST (7 July 1947), Official File 286A, Box 930, HST Papers

8. Westbrook, Robert, “Fighting for The American Family: Private Interests and Political Obligation in World War II, in Power as Culture, ed. Jackson Lears, T. J. and Fox, Richard Wightman (New York, 1993), 135–160Google Scholar; Gerstle, Gary, “The Protean Character of American Liberalism,” American Historical Review 99:4 (1994): 1045–1047CrossRefGoogle Scholar; Steinmo, Sven and Watts, Jon, “It's the Institutions Stupid! Why Comprehensive National Health Insurance Always Fails in America,” Journal of Health Politics, Policy, and Law 20:2 (1995): 331–2.CrossRefGoogle Scholar

9. In the late 1940s, an AMA-sponsored comic book lampooned socialized medicine in these terms: “When do we get free ice cream and marbles?” asked one character; “I wanna free doll carriage and roller skates!” demanded another. In the early 1950s, the Chamber of Commerce echoed this logic, arguing that “apparently, many people want other things far more than they want medical care. For example, we spend in total more for TV sets, cosmetics, recreation, [and] tobacco.” And even some workers, when faced with the establishment of a company-initiated health insurance plan, objected “on the theory that a purchaser has a right to know the price he is expected to pay on an article before accepting it” and reasoned that “after all, you or anyone working with your company wouldn't buy a pair of shoes without seeing them or trying them on to see if you like them of if they fit.” See “The Sad Case of Waiting Room Willie” (1949), OF 286A, Box 931, HST Papers; Chamber of Commerce, “Free Health Care for Everyone?” (1955), Box 206, Witte Papers; Raymond Cannon to Travelers Insurance (25 Feb. 1955), Box 849:9, Pennsylvania Railroad Papers, Hagley Museum and Library, Wilmington, DE.

10. Handwritten Comments (27 Sep 1946); “National Health Bill—Coverage” (6 Nov 1946), both in Box 63:579, Series II, Falk Papers.

11. “Principles of a Nation-Wide Health Program” (1945), Box 4, National Association of Manufacturers (NAM), Industrial Relations Department (IRD) Papers, Hagley Museum; Frank Dickinson, “An Analysis of the Ewing Report” AMA Bulletin #69 (1949), 12; Altmeyer, “Draft Notes Re: amendments to insurance title” (30 Oct 1947), Box 4, Alanson Willcox to Watson Miller (13 Nov. 1945), Box 3, Arthur Altmeyer Papers, SHSW; “Legislative Strategy on National Health Insurance” (1948), Reel 1, Davis Papers

12. Alanson Willcox to Harry Rosenfeld (25 Nov. 1946), Box 63:579; “National Health Bill—Coverage” (6 Nov 1946), Box 63:579; Rosenfeld Memo (10 Mar 1946), Box 64:601, Series II, Falk Papers.

13. Draft of President's Message (May 1939), Box 45:281, Series II, Falk Papers; Labor's Monthly Survey (Oct 1943) in President's Official File 142:1, FDR Papers; FSA recommendations for 1950 State of the Union Address (2 Nov 1949), Official File 419F, Box 1264, HST Papers; NPC Pamphlet, Reel 11, Davis Papers; Mahoning Valley Industrial Council, “Clinic on Health in Industry” (1940), Box 21, NAM IRD Papers, Hagley Museum; Miller, Jerome, Selling Accident and Health Insurance (New York, 1940), 4–5.Google Scholar

14. Minutes of the 14th Annual Meeting of the Board of Trustees [Bethlehem Relief Plan] (February 1940), in imprints collection, Hagley Museum; Baker, Helen, “Women in War Industries,” Princeton Industrial Relations Series 86 (1942), p. 56Google Scholar; William Smith to Branch Secretaries (26 July 1947), Series 3, Box 11, American Federation of Hosiery Workers [AFHW} Papers, SHSW; International Harvester, “Group Hospital and Surgical Benefit Plan” (1946) in imprints collection, Hagley Museum; Anne Murkovich to Branch Secretaries (21 May 1951), Series 14, Box 1, AFHW Papers; Kessler-Harris, Alice, “Designing Women and Old Fools: The Construction of the Social Security Amendments of 1939,” in U.S. History as Women's History, ed. Kerber, Linda, Kessler-Harris, Alice, and Sklar, Karhryn Kish (Chapel Hill, 1995), 95–100Google Scholar; Klein, Jennifer, “The Business of Welfare: The Growth of Commercial Health Insurance, 1940–1955” (Paper Delivered at the Hagley Museum and Library, October 1995), 1–20.Google Scholar

15. Virginia Sapiro, “The Gender Basis of American Social Policy,” in Gordon, Women, the State, and Welfare, 44–45; Mink, “The Lady and the Tramp,” 105–7; Interdepartmental Committee on Health and Welfare, “Draft Report and Recommendations on National Health” (January 1939), Box 5, Oscar Chapman Papers, HST Library; Barbara Nelson, “The Origins of the Two Channel Welfare State: Workmen's Compensation and Mothers' Aid,” in Gordon, Women, the State, and Welfare, 133, 134–135; Michel, Sonya and Rosen, Robyn, “The Paradox of Maternalism: Elizabeth Lowell Putnam and the American Welfare State,” Gender and History 4:3 (1992): 364–383CrossRefGoogle Scholar; “Dan Gilbert's Washington Letter” (December 1948), Reel 7, Davis Papers.

16. See Quadagno, Jill, The Color of Welfare: How Racism Undermined the War on Povervy (New York, 1994), 19–25.Google Scholar

17. Medical Advisory Board [CES], Minutes of Meetings (29 Jan. 1935), 149–150, and “Abstract of a Program for Social Insurance Against Illness: Preliminary Draft” (1935), 88, both in Box 67, Witte Papers; Bachman, George and Merriam, Lewis, The Issue of Compulsory Health Insurance (Washington D.C., 1948), 20, 16–17Google Scholar; Chamber of Commerce Proceedings 37 (May 1949), 190–191, Hagley Museum; see also American Medicine and the Political Scene (2 July 1947), Box 210, Witte Papers; Falk to Davis (22 May 1944), Reel 8, Davis Papers.

18. Whatley, Warren, “Labor For the Picking: The New Deal in the South,” Journal of Economic History 63:4 (1983): 905–908CrossRefGoogle Scholar; Katznelson, Ira, Geiger, Kim, and Kryder, Daniel, “Limiting Liberalism: The Southern Veto in Congress, 1933–1950,” Political Science Quarterly 108 (1993): 284–286CrossRefGoogle Scholar; Skocpol, Theda and Amenta, Edwin, “Redefining the New Deal: World War II and the Development of Social Provision in the United States,” in The Politics of Social Policy in the United States, ed. Skocpol, Theda, Weir, Margaret, and Orloff, Ann (Princeton, 1988), 102–103Google Scholar; Falk to Davis (27 January 1949), Reel 8, Davis Papers.

19. J. K. Williams to Marvin McIntyre (9 June 1933), President's Official File 95d:8, FDR Papers; Theo. Bilbo to Omar Bradley (19 Nov 1945), Official File 8B, Box 91, HST Papers; see also I.C Rayner to John Rankin (22 June 1945), John Rankin to I.C Rayner (27 June 1945), H 79A–38.2, RG 233, Records of the House Committee on World War Veterans, National Archives. My thanks to Roger Horowitz for pointing out the importance of this debate.

20. For variations on the institutionalist view, see Steinmo and Watts, “It's the Institutions Stupid!” 330–368 (quote 330); Ann Orloff, “The Political Origins of America's Belated Welfare State,” in The Politics of Social Policy in the U.S., 37–80; Skocpol, Theda and Amenta, Edwin, “Taking Exception: Explaining the Distinctiveness of American Public Policies in the Last Half-Century,” in The Comparative History of Public Policy, ed. Castles, Francis (New York, 1989)Google Scholar; Skocpol, Theda, Protecting Soldiers and Mothers: The Political Origins of Social Policy in the United States (Cambridge, Mass., 1992), 41–62.Google Scholar

21. “Progress of the Campaign” (unsigned, 1948), Box 23, Clark Clifford Papers, HST Library, CNH Executive Committee Notes (25 Nov. 1947), Reel 1, Davis Papers, HST Library; Cruikshank to Green (14 May 1948), Box 16, Cruikshank Papers; Clifford “Memorandum for the President” (1947), Box 23, Clifford Papers; CNH, “Considerations for 1948,” Reel 1, Davis Papers; Republican National Committee, “The Truth About Socialized Medicine” (1949), SHSW Pamphlet Collection.

22. CNH Executive Committee Notes (25 Nov. 1947), Reel 1; Donald Kingsley to Senator Murray (25 March 1949), Reel 8, Davis Papers; on the morass of legislative-administrative relations, see Poen, Monte, Harry Truman Versus the Medical Lobby (Columbia, Missouri, 1979).Google Scholar

23. On the Democrats, see Piven, Frances Fox, “Structural Constraints and Political Development: The Case of the American Democratic Party,” in Labor Parties in Postindustrial Societies, ed. Piven, Frances Fox (New York, 1992), 251–254Google Scholar; Katznelson, Geiger, and Kryder, , “Limiting Liberalism,” 285–288Google Scholar; Rogers, Joel and Ferguson, Thomas, Right Turn: The Decline of the Democrats and the Future of American Politics (New York, 1986), 40–61.Google Scholar

24. Senator quoted in Pemberton, William, Bureaucratic Politics: Executive Reorganization During the Truman Administration (Columbia, Missouri, 1979), 118Google Scholar; Poen, Truman Versus the Medical Lobby, 122; Davis to the CNH Executive Committee (13 May 1948), Reel 1, Davis Papers; Transcript of Robins Statement (24 Aug. 1949); Welfare Legislation Luncheon (15 May 1950), Box 4, Democratic National Committee Files, HST Library.

25. See Lichtenstein, Nelson, “From Corporatism to Collective Bargaining: Organized Labor and the Eclipse of Social Democracy in the Postwar Era,” in The Rise and Fall of the New Deal Order, 1930–1980, ed. Fraser, Steve and Gerstle, Gary (Princeton, 1989), 138–139Google Scholar; Davis, Mike, Prisons of the American Dream (New York, 1986), 52–101Google Scholar; Ruether quoted in Derickson, “Health Security For All?” 1344.

26. Lindblom, Charles, “The Market as a Prison,” Journal of Politics 44 (1982): 324–336CrossRefGoogle Scholar; Gordon, New Deals, 11–14.

27. Chamber of Commerce, “Business Support of Private Enterprise” (1950), Box, 11:18, Chamber of Commerce Papers; Elmer Henderson, Report on National Education Campaign (8 September 1950), Box 60, Caroline Ware Papers, FDR Library; James Foristel in AMA Law Department, “Conference of Legal Counsels for Medical Societies” (Chicago, April 1956), p. 269, Box 53; and Confidential memo (1952?), Senate Committee to Investigate Lobbying file, Box 57, Frank Kuehl Papers, SHSW.

28. Fred Stein to Davis (28 Sept. 1945) and Misc. Clippings Re; NPC, Reel 7, Davis Papers; Polenberg, Richard, Reorganizing Roosevelt's Government: The Controversy Over Executive Reorganization, 1936–1939 (Cambridge MA, 1966), 55–78.CrossRefGoogle Scholar

29. Confidential RNC study of Pennsylvania District 26 and New York Senate Races in Official File 103, Box 575; and Summary of RNC document in Official File 103G, Box 177, HST Papers; NPC Statement of Income and Expenditures (9 January 1948), Margaret Stein Memo (27 Oct. 1948), Box 45:288, Series II, Falk Papers; NPC Statement of Income and Expenditures (January 1949), Reel 8, “Contributions by Large Drug Companies to the NPC” (1948), Reel 7, Davis Papers. Support from drug companies, as Paul Starr notes, reflected “the strategic location [doctors] held in the marketing of drugs; their gatekeeper function allowed them to collect a toll for use in political agitation.” Starr, Social Transformation, 288.

30. Whitaker quoted in CNH Release (28 August 1950); Elmer Henderson, Report on National Education Campaign (8 September 1950); CNH Release (25 Sept 1950); “To Newspaper Advertising Directors …” all in Box 60, Ware Papers; Editor and Publisher (Sept. 1950) clippings, Box 209, Witte Papers; George Addes, Secretary-Treasurer UAW, “The Plot Against the W-M-D Bill” (17 Feb. 1944), Box 60:519, Series II, Falk Papers.

31. John Peters to Allan Butler (22 June 1939), Box 1:24; Financial Report (1952), Box 2:43, Series 1, John Peters Papers, Sterling Library; Robert Goor to Esselstyn (7 Dec 1960), Box 55:53, Series III, Caldwell Esselstyn Papers, Sterling Library.

32. Poen, Truman Versus the Medical Lobby, 42–3, 83.

33. Davis to Marion Hedges (19 June 1944), and “Report of January 14, 1944 Meeting at the Hotel Barclay,” both in Reel 11, Davis Papers; “Report of Meeting of Informal Health Insurance Conference Group” (Sept. 1945), Box A:15, Research Files, American Federation of Labor Papers, SHSW; “Report to the Executive Committee” (15 Nov. 1946), “Financial Report” (June 1947), Davis Memo (23 Dec 1947), “Confidential Progress Report” (31 March 1948), Reel 1; Davis Memo (15 Oct. 1948), Reel 8; Davis Memo (27 Jan. 1950) and “CNH Activities in 1950” (January 1951), Reel 2, Davis Papers; Rep. Biemiller (WI) to William Green (30 November 1949), AFL Committee on Social Security Meeting (16 January 1950); AFL Committee on Social Security Meeting (12 November 1953), Box 16, Cruikshank Papers; Robin to Executive Committee (2 July 1952), Reel 4, Davis Papers; Poen, Truman Versus the Medical Lobby, 177, 207; CNH memo to Directors (25 January 1956), Box 156:2254, Series III, Falk Papers.

34. Derickson, “Health Security For All?,” 1343–4; Oscar Ewing OH, p.1934–4, HST Library; Robins quoted in Poen, Truman Versus the Medical Lobby, 182

35. Gordon, New Deals, 240–279; Wilson, Elizabeth, Compulsory Health Insurance (NICB: Studies in Individual and Collective Security, 1947), 3–24Google Scholar; Goldmann, Franz, “Public Policy in Organizing Medical Care,” The Annals of the American Academy of Political and Social Science 273 (1951): 68CrossRefGoogle Scholar; Gordon, Linda, Pitied But Not Entitled: Single Mothers and the History of Welfare (New York, 1994), 15–33, 148–167Google Scholar; Alanson Willcox to Watson Miller (13 Nov. 1945), Box 3, Altmeyer Papers; David Stowe, “Administration's Health Program” (12 Oct. 1951), SMOF (Stowe) 2; Springarn to Elsey (24 Aug 1950), HST Papers; Pemberton, Bureaucratic Politics, 54–55; Luncheon Meeting on The Return of the Veteran to Civilian Life, Chamber Proceedings, 34th Annual Meeting (April 1946), 172, Box 1:9, Chamber of Commerce Papers.

36. Beth Stevens, “Complementing the Welfare State: The Development of Private Pension, Health Insurance and Other Employee Benefits in the United States” International Labour Office, Labour-Management Relation Series No. 65 (Geneva, 1986), 23; Testimony of Harry Becker (24 June 1946), Box 96, Papers of the Cooperative League of the United States of America, HST Library: Statements of E. Murnane (WI-UAW), David Burgess (GA-CIO), Anthony Remuglia (CA-C1O), Box 55, Records of the President's Commission on the Health Needs of the Nation, HST Library.

37. On the wartime developments, see misc. correspondence in OF 981–2,, FDR Papers; Staples, Clifford, “The Politics of Employment Based Insurance in the United States,” International Journal of Health Services 19:3 (1989): 419–420CrossRefGoogle Scholar; Baker, Helen and Dahl, Dorothy, Group Health Insurance and Sickness Benefit Plans in Collective bargaining (Princeton [Industrial Relations Section#72], 1945), 17–19Google Scholar (employer quoted, 25); Stevens, “Complementing the Welfare State,” 17–20; Siegel, Alan, Caring for New Jersey: A History of Blue Shield of New Jersey, 1942–1986 (Montclair, N.J., 1986), 45–7Google Scholar; Dobbin, Frank, “The Origins of Private Social Insurance: Public Policy and Fringe Benefits in America, 1920–1950,” American Journal of Sociology 97:5 (1992): 1428–31CrossRefGoogle Scholar; Becker, Harry, “Organized Labor and the Problem of Medical Care,” The Annals of the American Academy of Political and Social Science 273 (1951): 125CrossRefGoogle Scholar. On tax expenditures, see Howard, Christopher, “The Hidden Side of the American Welfare State,” Political Science Quarterly 108 (1993): 406–7, 414.CrossRefGoogle Scholar

38. NICB Proceedings, “The Insurance Drive: What's Ahead at the Bargaining Table” (May 1950), p. 35, Box 1:33, National Industrial Conference Board Papers, Hagley Museum; Davis, “Subjects for Meeting” (15 Apr. 1948), Reel 1, Davis Papers; Baker and Dahl, Group Health Insurance and Sickness Benefit Plans, 21; Lichtenstein, “From Corporatism to Collective Bargaining,” 143; Ruether in Proceedings of 8th CIO Convention (Nov. 1946), 185; Derickson, “Health Security For All?” 1350–51, 1355–56.

39. Salsman, Byrl Oral History in Earl Warren and Health Insurance, 1943–1949 (University of California, Berkeley, Regional Oral History Project, 1971), p. 12Google Scholar; Stevens, “Complementing the Welfare State,” 19–20; Cruikshank Memorandum (16 April 1945); Bittner Memorandum (12 April 1945), both in Box 60:533, Series II, Falk Papers; “Notes for Use by Mr. Watt … September Radio Forum” (1944), Files of the Director of Research, Box 3, Series 8E, AFL Papers; Derickson, “Health Security For All?” 1351–52; Lichtenstein, “From Corporatism to Collective Bargaining,” 152, n63.

40. Lichtenstein, “From Corporatism to Collective Bargaining,” 143; Derickson, “Health Security For All?” 1345–7; Green to Wagner (20 Dec 1944); Murray to Wagner (19 Dec. 1944); A.F Whitney to Wagner (20 Dec. 1944), all in Box 60:528, Series II, Falk Papers.

41. Derickson, “Health Security for All?,” 1349; Derickson, Workers' Health, Workers' Democracy, 189–219; Munts, Bargaining for Health, 8–9, 48–50; Health and Income” (1941), Files of the Director of Research, Box 2, Series 8E, AFL Papers.

42. “Notes for Use by Mr. Watt … September Radio Forum” (1944), Files of the Director of Research, Box 3, Series 8E, AFL Papers; The Travelers to Guy Wright [PRR] (2 March 1956), Box 850:1; Draft Memo (n.d. 1956) and Dulaney [Travelers] to Oram [PRR] (25 May 1956), Box 850:2, Pennsylvania Railroad Papers; New Jersey Medical Society official quoted in Siegel, Caring for New Jersey, 43; Brief Submitted by the United Steel Workers In Re: United Steel Workers of America and United States Steel Corporation et al, NWLB 111–6230-D, Box 124, Alexander Sachs Papers, FDR Library; Preliminary Draft of Proceedings, Association of Labor Health Administrators (March 28, 1957), and “History of Local 119 Health Fund of the Male Apparel Industry of Allentown” (1957), both in Box 37:212, Series II, Lorin Kerr Papers, Sterling Library; Robin Memo (2 July 1952), Reel 4, Davis Papers.

43. Forbath, Law and the Shaping of the American Labor Movement, 25–29: Rogers, Joel, “Divide and Conquer: Further “Reflections on the Character of American Labor Laws'” Wisconsin Law Review 1 (1990): 29–59Google Scholar; Gordon, New Deals, 88–92; Mink, “The Lady and the Tramp,” 99.

44. In Mahoning Valley Industrial Council, “Clinic on Health in Industry” (1940), Box 21, NAM IRD Papers, Hagley Museum; “American Beveridge Plan and American Business” (1943), OF 1710:3, FDR Papers.

45. Control of Employee Benefit Plans During World War II, Box IV:109, NAM Papers; Resolutions, Chamber Proceedings, 35th Annual Meeting (April 1947), p. 132–135, Box 1:10, Chamber of Commerce Papers; NICB Proceedings, “The Insurance Drive: What's Ahead at the Bargaining Table” (May 1950), p. 81, Box 1:33, NICB Papers; Mahoning Valley Industrial Council, “Clinic on Health in Industry” (1940), Box 21, NAM IRD Papers; Sachs, “Notes on the Coal Agreement,” (7 June 1946), Box 123, Sachs Papers. Sachs went on to note that union welfare funds, “under the absence of legislative democratic regulations, becomes a pocket borough so far as the power of the funds, as distinguished from diversion to personal use, is concerned.” This reasoning set the stage for the Landrum-Griffith campaign against union corruption, in many respects a backhanded attack on union-controlled welfare funds.

46. E S. Willis (GE) in NICB Proceedings, “Getting the Most for Your Insurance Dollar” (January 1953), 130, Box 1:43, NICB Papers; NAM Employee Health and Benefits Committee, “Industry Looks at the Welfare and Pension Plans Disclosure Act” (Feb. 1959), imprints collection, Hagley Museum; “To Members of Health and Benefits Committee” (2 March 1962), Box 1:23, NAM Papers.

47. “Discussion on Developments, Trends, and Outlook in Collective-Bargaining Welfare Plans” (Nov. 1949), Box 77:839, Series II, Falk Papers; Davis, “Subjects for Meeting” (15 Apr. 1948), Reel 1, Davis Papers; John Brumm [CNH], “Some issues Raised by Union Health and Welfare Plans” (Oct. 1954), Box 67:655, Series II, Falk Papers; Clem Whitaker, “Medicine's Campaign Objectives for 1951” (Dec. 1950), Reel 6, Davis Papers; files on Steel and Coal in Boxes 79 and 80, Series II, Falk Papers; correspondence re “Bear Mountain Conference” (July 1955), Box 156:2255, Series III, Falk Papers; Derickson, “Health Security For All?” 1334; Root, “Employee Benefits and Social Welfare,” 105; Stevens, “Complementing the Welfare State,” 3.

48. E. R. Brown, “Consumers' Cooperatives and Labor Unions” (1940), Box 103, Papers of the Cooperative League; Robert Goor to Esselstyn (7 Dec 1960), Box 55:53, Series III, Esselstyn Papers; (quote) John Brumm, “Relating Cooperative and Community Prepaid Group Practice Health Plans to Labor Health Programs” (July 1955), Reel 5, Davis Papers; “Preliminary Proposals for a Labor-Federal Government Partnership for Improving Health Care” (1966), Box 38:229, Series II, Kerr Papers; CNH Bulletin (Sept. 1954), Box 67:655, Series II, Falk Papers; Derickson, “Health Security For All?” 1336–7, 1351–52.

49. For these reasons, the UAW, which had originally been a strong supporter of community care, dug in against efforts to turn the Detroit Community Health Association into a full-fledged community-based program. See Address of Frederick Mott to the Economic Club of Detroit (10 Feb 1958), Box 4 (Mss 400), Altmeyer Papers; Lane Kirkland Memo (6 July 1967), Box 10:250, Series I, Esselstyn Papers.

50. The USWA, for example, proposed using pension funds to improve facilities in steel communities. See background materials and clippings in Box 110, Series II, Falk Papers.