by Jim Newton
Warren’s approach did not thrust him immediately to national prominence. There was too little controversy about him to bring on instant reviews. But California, which had struggled so mightily under his predecessor, came to life with Warren in the governorship. As jobs filled and the state budget swelled, national political attention overcame its Eastern bias and the limelight found California’s governor. Once it discovered him and his photogenic family, it would never again leave him for long.
On January 31, 1944, Time magazine published its first issue ever printed in California (a breakthrough it announced with a special banner across the cover). On its cover was Earl Warren. Beside him was an elephant—Time, like Warren, was Republican. The elephant held an orange that radiated beams of energy. The story was an homage to Warren, championing him for national office despite what it called his “safe, dull political prose.” His record, however, was big and growing, and Time imagined great things for Warren. “Big, blond, blue-eyed Governor Warren seems to radiate goodness and warmth,” the magazine reported. “Impressed by his relaxed good nature, his evident simplicity, the eager ‘yes-yes’ and ‘uh-huh, uh-huh’ with which he indicates earnest interest in everything they have to say, his visitors often begin to fit him into a scheme of history. They see him not merely as a perfect political candidate, but as the forerunner in U.S. politics of a new era of friendly men to succeed the recent era of angry men.”60
As the 1944 Republican National Convention approached, many party leaders sought to persuade Warren to join the ticket. He was, in the thinking of the day, the perfect counterpart to New York governor Tom Dewey, two moderate Republicans from opposite coasts, each compiling impressive records of management in two of the nation’s largest states. Roosevelt, his health failing, was seeking a fourth term, and some Republicans hoped the country might at last have wearied of his stewardship.
Warren knew better. Although his instincts for national politics would prove erratic in the coming years, in 1944 Warren saw more clearly than many of his Republican allies the strength of Roosevelt’s appeal. He determined to keep his distance from the ticket and succeeded in fending off Dewey’s advances to join as vice president. At one point, Warren pushed back too hard, publicly suggesting that to leave the governorship so soon would be a dereliction of his duty to his state, an awkward pronouncement given that Dewey was preparing to do just that. “I have made certain commitments and assumed certain obligations to my state which are yet unfulfilled,” Warren wrote to members of the Oregon delegation when they attempted to draft him. Warren emphatically urged the delegation not to nominate him for vice president.61
Warren escaped the vice presidential nomination—it went to Ohio governor John Bricker—and instead delivered a keynote address to the delegates gathered that year in Chicago. He prepared carefully for the occasion, soliciting and receiving help from, among others, Raymond Moley, by then a disenchanted New Dealer working at Newsweek magazine. Moley advised Warren to stay “far above the political battle. It is a time,” he stressed, “for the eternal verities.”62 Warren strove for that, continuing to labor over drafts only days before the convention opened, but what he produced was less lofty than it was obvious. Where his strength at home was always in his devotion to facts and practical solutions, he found it difficult to project those virtues to the nation, where he had less command of his subject and where audiences, less familiar than Californians with his record, craved a more effusive personality. So Warren fell back on rhetoric, never his strength, and he teetered between appeals to national unity and to Republican enthusiasm. States with Republican governors, Warren argued, were producing much of the American war machine. “From the record of those states,” he concluded, “it is clear that Dr. Win the War is a Republican.”63 In the next breath, however, he insisted that the war tolerated no partisan differences—generals and admirals served their nation, not their party. Warren renounced the New Deal, blaming it for centralizing power under one man, destroying the Democratic Party, and threatening basic American freedoms. But he offered little in its place other than the assertion that Republicans were better.
Returning to California and more comfortable terrain, Warren did his best for the doomed Republican ticket of 1944. Bricker brought little strength to the campaign. His ardent isolationism reassured the piece of the Republican Party that was uncomfortable with Dewey, but he alienated many moderates, including Warren. Still, Warren understood his duty. He praised the ticket and urged support for it. In October, Bricker came to California, where Warren and he made a joint appearance at the Senator Hotel, a Sacramento office building across from the capitol.64 Warren introduced him there and at a second appearance that day in San Francisco. Bricker praised Warren as “one of the finest Governors you have ever had,” and Warren returned the compliment. “No one who meets and hears him,” Warren said of the Ohio senator, “but realizes he has lifted the candidacy of the Vice Presidency to a new high level.”65
On October 17, with the election just weeks off, Warren arrived for work as usual and put in a few hours. He and Sweigert went to lunch together at the Sutter Club, a short walk from the capitol. Warren excused himself at one point and went to the men’s room. Returning, he was pale. “You know,” he said to Sweigert, sitting down, “I just passed some blood.”66 Warren secured an appointment with his doctor, Red Harris, who concluded that Warren was suffering from a kidney infection and required hospitalization. Warren was admitted the same day.
As Election Day approached, Warren reached out from his hospital bed to make one last effort on behalf of the Republican ticket. “The New Deal machine,” Warren said of FDR’s coalition, “is being held together today by the domination of one man, not by a common philosophy of government or by any common program for the future of America.” By contrast, Dewey and Bricker, “men of youth and courage and determination,” stood able to conclude the war and prepare America for a lasting and prosperous peace, Warren declared.67 He was still too sick even to speak into a microphone, so his comments were transcribed and read over the radio, as well as widely published in the state’s appreciative Republican press.
Roosevelt and Truman thumped Dewey and Bricker. The Democrats carried all but twelve states. And in California, Warren’s pleadings had little effect: The same state that had resoundingly elected a Republican governor in 1942 went heavily for FDR in 1944, delivering him a 13-point victory over Dewey.
It would be nearly three more weeks before Warren dragged himself to the office, ending the longest illness of his life. When, just before Thanksgiving, Warren reappeared at work, he confided to Robert Kenny that the experience had been enlightening. Not only had he weathered a painful ordeal, the governor said, the long rest had given him a chance to consider the difficulties of working people forced out of a job for weeks or months at a time, with little cushion to support them financially. Recalled Kenny:
[W]hen he got back to his desk, he told me he’d done a lot of thinking while he was flat on his back. “What does a fellow on a fixed income do when he has to go to the hospital?” he said, and then he told me what had happened to him when he was attorney general and having trouble stretching his salary from payday to payday. His check was late one month and he missed a payment on his health insurance, so it was cancelled. He called the company and got it reinstated right away, but he couldn’t help wondering what an ordinary working man would have done in a case like that.68
Earl Warren returned to work and announced that in the coming term, just a few days away, he would propose that California become the first state in America to create and support a system of compulsory health insurance. No longer, Warren said, would middle-income residents need to worry about the financial effects of a catastrophic illness. This governor, a Republican, would see that the common men and women of California were protected by their Progressive, activist, compassionate government. Warren intended to offer them health care, fulfilling the message of his inaugural and the spirit of his campaig
n. It was a natural response to his personal experience and utterly in line with his compassion for others. For Warren, health care for working people was as logical as accident insurance, as indisputable as public sanitation or unemployment relief. For his enemies—and Warren was about to discover just who they were—it was something else entirely.
Chapter 11
CALIFORNIA’S FAIR DEAL GOVERNOR
He’s trying to out-New Deal the New Deal.
ASSEMBLYMAN GEORGE COLLINS1
WARREN’S HEALTH CARE INITIATIVE was self-consciously aimed at helping California’s working class. The wealthy did not face sudden ruin because of illness—and neither did the very poor, those qualified under California law to receive state government assistance. But the middle, the same middle whose politics Warren was pioneering in California, had neither personal resources nor public help. They were left to fend for themselves in a system that could swallow them with a single illness or accident. Having pondered that question while sick himself, Warren returned to work and decided to fix it.
It was a prototypical Warren exercise: The problem was broad and tangible, the victims spread across ideological lines. The path to success was satisfyingly strewn with surmountable obstacles. By avoiding partisanship, Warren believed he could create a program that would help common Californians through one of their most persistent worries. The governor was no New Dealer, contrary to the grumbling of George Collins and others. He was not prepared to put the state budget into the red to finance the program, and he did not launch his health care initiative to stimulate the economy or create jobs. But he was clearly no conservative, either: Warren saw the opportunity for state action, and believed the needs of common people were sufficient to justify an entirely new system of health insurance, backed by an assertive government paying its way as it went forward.
Warren may have been relatively new to the governor’s office as 1944 closed, but he was sufficiently seasoned in politics to know that his program would founder if he could not win at least the acquiescence—and with luck, the support—of those most affected by it. In this case, that meant a visit to one of California’s most slavishly conservative organizations, the California Medical Association. In mid-December, Warren met with Philip Gilman, president-elect of the CMA.2 Warren had reason to believe that he might win the backing of the association, at least in principle, for an insurance system paid for by worker and employer contributions. The association had supported a version of such a program in 1935, when the Depression had cut badly into the medical profession. The desperation of those years, however, had jarred many people and organizations into aberrant positions; stability had cooled the CMA’s ardor for reform. By 1944, it had settled back into its habitual complacency.
Warren may or may not have sensed that, but he knew enough not to rely solely on the organization’s good will. Beneath his pitch, then, was a subtle threat. California’s working middle class, Warren reminded the doctors, lived with the danger of a catastrophic health event. And that situation—millions of people living in fear—was not suited to stability. Stimulated by the promises of the New Deal, those residents would demand more from their government. If they did not get something soon, Warren warned, they might well demand a program more far-reaching than Warren was prepared to give or than the medical establishment could endure. Many of those who wanted better health care, Warren reminded Gilman, did not share their appreciation for private enterprise. They could not be expected to remain silent forever. Having posed the threat, Warren then, in broad strokes, proposed a publicly financed insurance program, guaranteed by the state but designed to be self-supporting.3 Employees would pay 1.5 percent of their salaries, up to $4,000 a year, into the system, an amount that employers would match. The money would be collected by the state and administered by an eleven-person board overseeing the new California Health Service Authority. Those members would be appointed by the governor. The act specified that three would represent employers, two would be drawn from organized labor, and one from a state employee association; three would be doctors, one would be a dentist, and one member would be the state director of Public Health. Any California worker earning more than $300 a year would be eligible for coverage—the very poor already received health care through the publicly funded system of county hospitals. Benefits would pay for doctors’ services, specialty care as ordered by a doctor, hospitalization for up to three weeks, drugs, X-rays, nursing care, and treatment of severe dental problems. Dependents also would receive coverage. Crucially, patients would be free to choose any doctor who was enrolled in the system. The authority would set “rates, fees or charges” for doctors in the system, but no doctor would be required to register, and those charges would not necessarily be uniform throughout the state.
Warren emphasized that the program did not compel patients to use the insurance, nor did it compel doctors to enroll in the system. Only one aspect of the proposal was compulsory: workers and employers would be bound to contribute to it, and their mandatory contributions would provide the pool of capital that would pay for insurance for all those who qualified.4
Warren saw himself not as an advocate for a radical notion but rather as a proponent of a sensible, modest social program. He compared it to California’s Workmen’s Compensation System (now known as Workers’ Compensation). That program, adopted during Hiram Johnson’s years, provided for worker and employer payroll deductions, which were pooled and used to underwrite insurance that paid medical bills for employees who were hurt at work. “Before adoption of Workmen’s Compensation in California in 1915, an employee injured on the job was in very much the same situation as an employee and his family today when confronted with serious illness or non-industrial injury,” Warren’s staff emphasized in an internal memo.5
Discussing this with Gilman, Warren thought he sensed the doctor’s support, and he moved to capitalize on it. At his request, Gilman arranged for Warren to make a presentation to the CMA’s executive committee, which Warren did on December 13, appearing on a stage at the Family Club in San Francisco with Gilman and John M. Cline, another leader of the association.6 Cline remembered the discussion as “very vague,” with Warren parrying the doctors’ queries but offering few specifics. In hindsight, it seems obvious that the doctors interpreted Warren’s vagueness as tactical, but their suspicion reflected their basic misunderstanding of the governor. Warren was principally interested in a program that would insure middle-income Californians; he was, as he often was in complex and important matters, flexible on the details. Concerned that Warren was playing them, the doctors hedged. “This is a matter far too important to the health and welfare of the people of California and to the medical profession for any group of twenty men to decide,” Cline concluded. “This will require a special meeting of our House of Delegates to discuss.”7
While the doctors misjudged Warren, he did the same with them. In his case, wishful thinking clouded his analysis of the CMA. He left their initial gathering believing that the reaction was at worst noncommittal and at best promising—Sweigert, for instance, described Warren as having gotten “a nice reception”8—when in fact the doctors harbored grave doubts that they withheld from him. Compounding the misjudgments on both sides was a misunderstanding about the process: Cline said he concluded the meeting believing he had a promise from Warren that no public statement would be forthcoming until the legislature convened in January and that the CMA had until then to formulate its response. Warren had no intention of waiting that long.
On December 29, the governor unveiled his plan to the public. “I am not for State medicine,” he declared. But he had given up on voluntary programs, Warren added, “because everybody will not join.”9 In support of his argument that health care was lacking, Warren noted that more than a third of Californians called to military service in the war—“38 out of every hundred of our boys,” as he put it10—were rejected as “medically substandard.” He thereby linked his program to the national defense effort, s
eemingly a strong argument in those still-tense days of war.
Early reaction was temperate, as the state’s Republican press contemplated this latest move by the governor. The proposal, the Los Angeles Times offered cautiously, “raises questions that need mature consideration.” Tactically, the governor also bolstered his case by embedding the proposal in his larger package of legislative proposals for the coming year. That package also included Warren’s support for an extension of the tax cuts enacted in 1943, the single aspect of his record that had the strongest support among conservatives.11
For the Medical Association, however, the public announcement was not only a surprise but one with the strong suggestion of a betrayal. They countered with an insistence that they would not accept any plan that in any way hampered the medical profession’s control over medical services.12 And when they began to raise the alarm, Warren too felt deceived, believing he already had secured the association’s support or at least neutrality. “The doctors thought he’d double-crossed them, and he thought they’d double-crossed him,” one member of Warren’s staff confided to biographer John Weaver. “I believe he thought at first he could win them over, but we couldn’t even get a doctor to come help us draw up a bill.”13
