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◆ Health Economics Policy and Law2026-06-22· Authoritarianism

Capitulating to populism: how American institutions enabled authoritarian drift

Martin McKee, Christina Pagel

原始摘要(英文原文)· Original abstract
This paper contributes to this special issue by exploring the act of capitulation to populist authoritarianism, focusing on American universities under Donald Trump's second administration. Despite threats to funding and autonomy, especially around health-related issues, many universities capitulated. Yet, while universities might be seen as especially vulnerable due to their dependence on federal funds and international students, we show that actors with far greater power exhibited similar behaviour. Elements of the legal profession enabled authoritarian legalism, while corporations, once defenders of democratic norms, largely retreated into silence or complicity. Drawing on contemporary and historical examples, we situate these responses within broader patterns of democratic backsliding. Institutions are shown to be vulnerable to legal manipulation, financial coercion, and ideological alignment. Yet, resistance persists. Some universities have fought back through litigation, and judges have blocked unconstitutional orders despite personal risk. The paper reframes institutions not as passive structures but as active agents that can either resist or enable authoritarianism. It argues that democratic commitment is not inherent but must be cultivated and defended. Ultimately, democracy requires ongoing engagement, ethical leadership, and a willingness to bear short-term costs for long-term preservation.
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