But Truman’s effort failed. Much of the responsibility for that failure lies with the American Medical Association, which spent $5 million opposing Truman’s plan; adjusting for the size of the economy, that’s equivalent to $200 million today. In a blatant abuse of the doctor-patient relationship, the AMA enlisted family doctors to speak to their patients in its effort to block national insurance. It ostracized doctors who supported Truman’s plan, even to the extent of urging that they be denied hospital privileges. It’s shocking even now to read how doctors were told to lecture their patients on the evils of “socialized medicine.”
But the AMA didn’t defeat Truman’s plan alone. There was also crucial opposition to national health insurance from Southern Democrats, despite the fact that the impoverished South, where many people couldn’t afford adequate medical care, would have gained a financial windfall. But Southern politicians believed that a national health insurance system would force the region to racially integrate its hospitals. (They were probably right. Medicare, a program for seniors equivalent in many ways to the system Truman wanted for everyone, was introduced in 1966—and one result was the desegregation of hospitals across the United States.) Keeping black people out of white hospitals was more important to Southern politicians than providing poor whites with the means to get medical treatment.
Truman’s failure on health care presaged the eventual collapse of the New Deal coalition. The support of Southern whites for economic equality was always ambivalent, and became more so over time. The familiar story says that the South bolted the coalition when the Democratic Party got serious about civil rights—and that’s certainly a large part of what happened. It’s also true, however, that as the South as a whole grew richer, the region had less to gain from redistributionist policies, and was set free to indulge the reactionary instincts that came from the disenfranchisement of blacks. But in the 1950s all this was far in the future.
Between 1935 and 1945 the percentage of American workers in unions rose from 12 to 35 percent; as late as 1970, 27 percent of workers were union members. And unions generally, though not always, supported Democrats. In the 1948 election, roughly three-quarters of the members of the two big union organizations, the American Federation of Labor and the Congress of Industrial Organizations, voted for Truman.
The role of unions in making the Democrats the nation’s dominant party went well beyond the tendency of union members to vote for Democratic candidates. Consider Will Rogers’s famous quip, “I am not a member of any organized political party. I’m a Democrat.” This was a fair characterization of the Democratic Party before the New Deal, as it is today. But it was much less true when organized labor was a powerful force: Unions provided the party with a ready-made organizational structure. Not only did unions provide a reliable source of campaign finance; even more important in an age before campaigns were largely conducted on TV, they provided Democrats with a standing army of campaign workers who distributed lawn signs, bumper stickers, and campaign literature, engaged in door-to-door canvassing, and mobilized for get-out-the-vote efforts on election day.
A more subtle but probably equally crucial consequence of a powerful union movement was its effect on the political awareness and voter participation rates of lower-and middle-income Americans. Those of us who follow politics closely often find it difficult to appreciate how little attention most Americans pay to the whole thing. But this apathy is understandable: Although the outcomes of elections can have large impacts on peoples’ lives, it’s very unlikely that an individual voter’s decision will affect those outcomes. Therefore people with jobs to do and children to raise have little incentive to pay close attention to political horseraces. In practice this rational lack of interest imparts an upward class bias to the political process: higher-income people are more likely to pay attention to politics, and more likely to vote, than are lower-and middle-class Americans. As a result, the typical
But unions have the effect of reducing this class bias. Unions explicitly urge their members to vote; maybe more important, the discussion of politics that takes place at union meetings, the political messages in mailings to union members, and so on, tend to raise political awareness not just among union workers but among those they talk to, including spouses, friends, and family. Since people tend to associate with others of similar income, this means more political participation among lower-income Americans. One recent statistical analysis[4] estimated that if the share of unionized workers in the labor force had been as high in 2000 as it was in 1964, an additional 10 percent of adults in the lower two-thirds of the income distribution would have voted, compared with only an additional 3 percent of the top third. So the strength of the union movement lowered the economic center of gravity of U.S. politics, which greatly benefited the Democrats.
In sum, then, the political economy of the United States in the 1950s and into the 1960s was far more favorable to income-equalizing economic policies than it had been during the Long Gilded Age. The welfare state was no longer considered radical; instead, those who wanted to dismantle it were regarded as cranks. There was no longer a large class of disenfranchised immigrant workers. The South was, conditionally and temporarily, on the side of economic equality, as long as that didn’t translate into racial equality. And a powerful union movement had the effect of mobilizing lower-income voters.
Ellis G. Arnal, the former governor of Georgia, wrote a contrarian but, it turned out, highly accurate article in the October 1948 issue of the
Urban political machines, based largely on the support of immigrants, predated the Roosevelt years. In fact, they had been a major source of Democratic support since the nineteenth century. And the New Deal’s policies had the effect, if anything, of undermining their power. The key to the machines’ appeal to urban voters was their ability to provide aid to families in trouble and patronage jobs; the New Deal’s expansion of the government social safety net and the rise in wages as a result of the Great Compression made these services less crucial. Nonetheless these urban machines were still powerful well into the 1960s, and their persistence helped Democrats win elections.
What about the “intellectual Left”? Obviously there have never been enough intellectuals to make them an important voting bloc for either party. But to focus on the mechanical side of things gives too little credit to the importance of message and ideas. In the 1930s the left had ideas about what to do; the right didn’t, except to preach that the economy would eventually heal itself. FDR’s success gave liberal intellectuals credibility and prestige that persisted long after the momentum of the New Deal had been largely exhausted—just as, in our own day, it remained common to assert that all the new ideas were on the right long after any real sense of innovation on the right was gone. In 1958 John Kenneth Galbraith wryly remarked that among liberals, “To proclaim the need for new ideas has served, in some measure, as a substitute for them.” But the sense that new ideas came from the left remained an advantage of the Democrats.
Meanwhile, by the 1950s the Republican Party was in many ways a shadow of its former self. Before the Great Depression and the Great Compression, Republicans had two great political advantages: money, and the perception of competence. Contributions from a wealthy elite normally gave the Republicans a large financial advantage; and people tended to assume that the GOP, the party of business, the party of take-charge men like Herbert Hoover, knew how to run the country.
But the Great Compression greatly reduced the resources of the elite, while the Great Depression shattered the nation’s belief that business knows best. Herbert Hoover became the very symbol of incompetence. And after the triumph in World War II and the great postwar boom, who could credibly claim that Democrats didn’t know how to run things?
Still, the Republican party survived—but it did so by moving toward the new political center. Eisenhower won the White House partly because of his reputation from World War II, partly because the public was fed up with the Korean War. But he was also acceptable because he preached “moderation,” and considered those who wanted to roll back the New Deal “stupid.” The Republican Party became, for several decades, a true big tent, with room both for some unrepentant small-government conservatives and for big spending, big-government types like Nelson Rockefeller of New York. To get a sense of just how un-ideological the Republicans became, it’s helpful to turn to quantitative studies of voting behavior in Congress.
The seminal work here, already mentioned in chapter 1, is that of Keith Poole of the University of California, San Diego, and Howard Rosenthal of the Russell Sage Foundation, who have developed a systematic way of
