As the global covid-19 pandemic enters another phase, we are once again reminded of how unprepared and wholly inadequate our political institutions are for dealing with large-scale public health emergencies. The United States leads the world in most confirmed covid-19 cases and has the highest proportional mortality rate. While the Trump administration has blundered in approaches to stave off greater calamity, the outcome of the 2020 presidential election has raised hopes that the United States might turn a corner in its response to the pandemic.
Yet, the election of Joe Biden, a long-established political figure, is hardly a fundamental political recalibration. Progressives on issues from immigration to climate change to criminal justice reform are wary of Biden’s bipartisan approach and centrist orientation. Such concerns are hardly unfounded, given Biden’s track record of concessions to the credit card industry, his role in the 1994 crime bill, the fact that just last year he promised corporate billionaire donors that under his administration, “nothing would fundamentally change,” and the fact that his current transition team includes high-ranking members of the banking and defense industries. But on covid-19, there may be reason for hope that even the most corporate-friendly politician can lead a somewhat effective response to public health emergencies.
An apt historical comparison is center-right conservative Sen. John C. Spooner (R-Wis.), who, albeit in a different context, led congressional efforts to modernize federal public health infrastructures around the turn of the 20th century. Then as now, corporate interests understood that only a coordinated federal response could tackle the dangers of large-scale public health crises. Thus, Biden would not be the first moderate political figure to be concerned about too much structural change while at the same time embracing moderate reforms to meet a public health emergency.
At the turn of the 20th century, Spooner enjoyed the reputation of being a noted friend of corporate interests in Washington. After having spent much of his early career as a railroad lawyer, Spooner, as one of the most influential power brokers on Capitol Hill, often facilitated corporate-friendly legislative compromises, even on ostensibly progressive landmark achievements such the Hepburn Act on railroad regulation or the Pure Food and Drug Act of 1906.
But while looking out for big business first and foremost, Spooner also understood when more nuanced reform was critically needed, especially during a public health crisis. Already during the late 1890s, as yellow fever outbreaks were spreading across the United States, Spooner had been instrumental in efforts to restructure the Marine Hospital Service. Spooner supported proposals such the expansion of the Marine Hospital Station in New Orleans, as did other notable conservatives such as House Speaker Joseph ‘Uncle Joe’ Cannon.
In 1898, Spooner had introduced a bill in the Senate intended “to establish a commission of public health and to define its duties.” The proposal — sometimes also referred to as the Wingate bill in reference to Secretary of the Wisconsin State Board of Health U.O.B Wingate — sought to centralize maritime and interstate quarantine regulations under the federal government. At a time when America was expanding its own imperial aspirations abroad and was experiencing immigration in greater numbers at home, corporate bodies and professional organizations alike frequently called for federal centralization and regulation that would help further advance their interests.
The 1898 Wingate bill gained the support of a variety of medical professionals, such as H. V. Würdemann from Milwaukee, who was not only Spooner’s constituent but also his ophthalmologist. Würdemann considered the Wingate bill an urgent matter of public health policy but also a matter of the “economy, the control of epidemics, [and] of quarantine.” Würdemann was convinced that this law would “save the country millions annually,” as it would “prevent […] business depression” caused by epidemics of yellow fever, the bubonic plague, or smallpox in various regions of the country. He argued that only a “centralization of power” could solve these issues and that it would be of “incalculable advantage” for public health as well as the economy.
Würdemann’s support for the Wingate bill was part of a larger institutional push for public health regulations among the medical profession. Spooner admitted that the proposal had been “drawn up under the auspices of the American Medical Association and the American Public Health Association.” But the bill was staunchly opposed by Surgeon General Walter Wyman, as well as the editorial boards of several medical journals. Wyman believed that this bill “practically disorganizes the Marine-Hospital Service.” He argued that “the interior States, which outnumber the coast States, would have a dominant influence in the making of rules for maritime quarantine, outvoting the maritime States,” and potentially rendering these rules “very oppressive” to the latter, since the former had “no practical experience in maritime quarantine.”
While Wyman asserted that “quarantine regulations properly belong to the Treasury Department,” he believed that specific decisions on quarantine regulation were best “left to the local quarantine officers,” whom he considered to be “far more competent” in these matters “than the State boards of health.” This discord within the medical community and more broadly between congressional regulatory policies and more localized approaches reflected the complexity of crafting a coherent public health infrastructure in the United States.
Spooner’s quarantine bill met defeat in Congress in 1898. However, Spooner did not abandon the matter. During the next congressional session, he was placed on the Committee on Public Health and Quarantine, where he continued to push for more centralized federal quarantine regulation. In 1902, Spooner eventually brokered compromise legislation that upgraded the Marine Hospital Service to the Public Health and Marine Hospital Service (PHMHS) and provided for greater federal oversight over quarantine and public health policy, as well as for increased collaboration and exchange between PHMHS and the individual boards of health in the states and territories. In 1906, he helped pass a bill “to further enlarge the powers and authority” of the PHMHS, at a time when public health was of heightened national concern, not least because of American economic and military activity in regions such as Cuba and Panama, and amid concerns that diseases such as yellow fever might spread further throughout the United States.
In the years following, the work of Spooner and others carried over into further centralization of national public health organs. In 1912, at the height of the progressive wave in American politics, Congress fundamentally reorganized PHMHS into the Public Health Service, which administered comprehensive health policy guidance and directives, research, education and disease prevention. The active involvement of conservatives like Spooner in efforts to modernize the national public health infrastructure suggests that even corporate-friendly politicians can be key players in national public health reforms.
As the current coronavirus outbreak has shown, large-scale pandemics hurt working people and business interests alike, and thus public health measures should be as important to corporate America as they are to the public at large. As the United States continues to struggle in responding to the global covid-19 pandemic, even a Biden administration that retains friendly ties with corporate America may prove to be more adequate in taking decisive steps toward improving public health policies, unlike the chaos and ineptitude that has marred President Trump’s entire term. Although it may not work toward true universal health care, a Biden administration will at least be more responsive toward taking the necessary steps in battling the current pandemic.
