Administering Entitlement: Governance, Public Health Care, and the Early American State

Abstract

This article explores the federal marine hospitals of the early republic, the first public health care system in US history. Beginning in 1798, the federal government collected twenty cents per month from mariners' wages and used this revenue to subsidize medical care for sick and disabled merchant mariners. Previous studies have traced links between marine hospitals and modern public policy. By studying governance from the bottom up, this article takes a different approach. I argue that jurists, physicians, and officials' regulation of sailors' entitlement to public health care facilitated and reflected a transformation of national authority. Between 1798 and 1816, sailors' entitlement was a local matter, based on the traditional paternalist understandings of maritime laborers as social dependents. By 1836, though, the federal Treasury redefined entitlement around a newly calculus of productivity: only the productive were entitled to care at the marine hospitals. This story about governance, federal law, and political economy in the early United States suggests that the early American state was a more vibrant participant in the market and society than has been previously understood.

Social Movements and the Politics of Bureaucratic Rights Enforcement: Insights from the Allocation of Disability Rights in France

“…This policy context increases the autonomy of the local levels of government in “administering entitlement” (Rao 2012). What has been described in political science as bureaucratic discretion (Lipsky 1980; Weller 1999; Maynard-Moody and Musheno 2003; Dubois 2010) is reinforced and transformed by these new institutional arrangements, with this unprecedented role allotted to civil society organizations in rights allocation.…”

American Political Development and Political History

“…The history of communications is but one of several institutionally oriented realms into which historians have moved in recent years that they had been reluctant to tackle in 1982. Among these realms (and this list is by no means exhaustive) are federalism (Edling 2013a(Edling ,b, 2010Morser 2011;Gerstle 2009;Lacey 2000); law (Witt 2012;Mashaw 2012;Novak 2010Novak , 2008Novak , 2002Novak , 2001Novak , 1996Tomlins 2010;Wilson 2008;Usselman and John 2006;Willrich 2003); taxation (Mehrotra 2009(Mehrotra , 2013Michelmore 2012;Martin, Mehrotra, and Prasad 2009;Einhorn 2006Einhorn , 1991; regulation (Churella 2013;Grisinger 2012;McCraw 2012;Rao 2011Rao , 2012Irwin and Sylla 2011;John 2006aJohn ,b, 2010Berk 2009Berk , 1994Adams 2006;Childs 2005;Klein 2003 (Wilson 2006a(Wilson ,b, 2013Watson 2006Watson , 2012Watson , 2013Sparrow 2011;Angevine 2004); citizenship (Thompson and Onuf 2013;…”

“…Yet APD monographs on slavery-related topics are often narrowly cast and display a selective engagement with recent historical writing on related topics (Ericson 2011). Other topics of interest to political historians that APD practitioners have mostly neglected include the foundations of public finance (Einhorn 2006;Edling 2003); public administration in the early republic (Watson 2012(Watson , 2013Rao 2012;John 1995), Civil War military procurement (Wilson 2006a,b), municipal government in the progressive era (Radford 2013;John 2010;Willrich 2003;Rodgers 1998), and the transformation of public finance since the First World War (Mehrotra 2009(Mehrotra , 2013Smith 2006;Sparrow 2011).…”