The idea of policy history arises from an awareness of“something missing.” In the view of some social scientists, politics and public policy too often have been treated ahistorically by their disciplines, with evidence subordinated to theory. For some historians, the apparent waning of disciplinary interest in political history has been similarly distorting. Because of these things, social scientists, political historians, and more than a few social historians increasingly function as “policy historians,”as scholars especially alive to the vagaries and contingency of public policy and its history.

It has become an article of faith that political history has fallen on hard times in recent years. “[T]he status of the political historian within the profession,” William E. Leuchtenburg observed in his 1986 presidential address to the Organization of American Historians (OAH) has “sunk to somewhere between that of a faith healer and a chiropractor.” Hugh Davis Graham, in an insightful analysis of policy history, reached a similar conclusion. “The ranks of traditional political history are depleted,” he wrote in 1993, “their assumptions and methods discredited along with the Great White Men whose careers they chronicled.”

During the Clinton administration, for the first time in almost twenty years, the character and direction of the U.S. industrial relations regime has become a matter of serious public debate. Clinton-appointed chair of the National Labor Relations Board (NLRB) William Gould IV has sought with some success to revivify an agency that in the 1980s had come to seem almost superfluous. The 1994 report entitled The Commission on the Future of Worker-Management Relations (Dunlop Commission) stirred debate on the role of unions in the nation's future. Organized labor has sought, with some limited success, to place such critical topics as striker replacement on the national agenda. Meanwhile, congressional conservatives have sponsored measures to curb new organizing strategies such as “salting” anti-union workplaces with union activists. Even more moderate politicians, with support from at least some sections of the labor community, have proposed measures aimed at drastic recasting of the Wagner Act's Section 8(a) (2), which outlawed company unions, so as to permit so called “team” approaches to employee representation. The shake-up in the leadership of the AFL-CIO and the federation's launching of an unprecedented program of political mobilization, which in turn has drawn Republican counterfire reminiscent of the rhetoric of the 80th Congress, increases the possibility that basic matters of federal labor policy may, after a long absence from mainstream public discourse, may return to center stage.

In the summer of 1989, an extended strike by the various “Baby Bell” telephone companies, including those of New York, Massachusetts, California, and thirteen other states in the Northeast, Midwest, and West Coast, brought to public attention the importance of health and hospital insurance to the nation's workers. In what the Los Angeles Times headline proclaimed was a “Phone Strike Centered on the Issue of Health Care,” workers at NYNEX, Pacific Bell, and Bell Atlantic went out on strike over management's insistence that the unions pay a greater portion of their hospital insurance premiums. In contrast to their willingness to grant wage concessions throughout most of the 1980s, the unions and their membership struck to protect what was once considered a “fringe” benefit of union membership. What had been a trivial cost to companies in the 1940s and 1950s had risen to 7.9 percent of payroll in 1984 and 13.6 percent by 1989. Unable to control the industry that had formed around hospitals, doctors, drug companies, and insurance, portions of the labor movement redefined its central mission: the fringes of the previous forty years were now central concerns. In the words of one local president engaged in the bitter communication workers strike: “‘It took us 40 years of collective bargaining’ to reach a contract in which the employer contributed [substantially to] the costs of health care, ‘and now they want to go in one fell swoop backward.’”

Sheldon Reed coined the expression “genetic counseling” in 1947, the same year he succeeded Clarence P. Oliver as Director of the University of Minnesota's Dight Institute for Human Genetics. In reflections written more than a quarter-century later, Reed noted that the term had occurred to him “as a kind of genetic social work without eugenic connotations.” Sharply distinguishing the aims of eugenics and counseling, he explained that whereas the former promotes the interests of the larger society, the latter serves the interests of individual families—as families perceive them. Reed never denied that he or other postwar medical geneticists were concerned with population improvement. But he maintained that counseling served a different purpose. Commenting on the history of the Dight Institute, Reed asserted: “There were certainly no attempts to benefit society as a whole in dealing with these families. This was not thought of as a program of eugenics.”

Quackery forms a gaudy thread in the fabric of health care through the course of American history. In the colonial years, the American market for commercial self-dosage was dominated by “patent medicines”—some of them actually patented—shipped overseas from the mother country. Packed in containers of distinctive shape, sealed in wrappers printed with boastful therapeutic claims, advertised in the slender newborn press, these British nostrums far overshadowed occasional American imitators.

By the middle 1990s the recovery movement for personal self-esteem and, thus, mental health for the individual, had reached a new level of penetration into American culture. Many commentators and interpreters of contemporary affairs judged the President of the United States, Bill Clinton, a potential recruit. As the archetypical adult child of an alcoholic parent—the product of a dysfunctional family if there ever was one, according to the movement's clerics-Clinton seemed lacking in selfesteem. His painful childhood was the culprit. And recovery was the solution. In a word, he was too anxious to please his critics—the classic trademark of the adult child of an alcoholic parent. Contemporary therapists taught that such persons were placaters of their critics because of the emotional abuse that their parents had inflicted on them, often for no apparent reason. The damaged child, regardless of his or her chronological age, could not, without appropriate therapy and personal “recovery,” ever get over such incidents, which were seared into their psychological and neurophysiological apparatus.