The South killed the safety net
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Thus, while America’s peer nations across the Atlantic were experimenting with forms of universal old age pensions and healthcare coverage—to tackle the extremes of poverty that had driven so many Europeans to migrate to the United States in search of higher living standards—when it came to the creation of nationwide safety net protections America stalled. Hobbled by the South’s antipathy to any form of welfare, and by a broader national reluctance to corral citizens into insurance programs against their will, advocates for the sorts of reforms occurring in Europe ran up against a brick wall. It would take the Great Depression, and the collapse of both the working and the middle classes’ sense of stability and burgeoning economic possibility, to shift public opinion behind the establishment of Social Security and government aid in the arena of housing and employment. In fact, it wasn’t until 1935, six years after Wall Street’s catastrophic collapse, that Congress legislated into being Social Security, disability and unemployment insurance, and Aid to Families with Dependent Children. And it was not until 1937 that Congress would take the lead on funding large-scale public housing.
As for healthcare reform, long a holy grail of social reformers, attempts by Franklin Roosevelt before World War II and Harry Truman at the end of the war to create universal healthcare foundered on the rocks of opposition from the American Medical Association, as well as more general hostility from the same political wellspring that had opposed Social Security’s creation. Truman’s proposal for a 4 percent payroll tax to cover a national health insurance system, which he proposed in a special message to Congress on November 19, 1945, was denounced as being an attempt to “socialize medicine.” It was a critique that would crop up repeatedly over the decades, when Presidents Truman, Kennedy, Johnson, Nixon, Carter, Clinton, and finally Obama proposed significant overhauls to the country’s dysfunctional and inequitable healthcare systems. Ultimately, it would take the upheavals of the 1960s to partially get around this critique and pave the way for Medicaid and Medicare—though in the case of Medicaid, Congress gave the states considerable leeway as to whom they covered and what services they provided. And it would take the 2008 financial collapse to create just about enough momentum for President Obama to get Congress to pass a watered-down version of universal healthcare. Even then, the backlash was massive, the acrimonious debate creating a climate in which the conservative Tea Party movement could flourish.
