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§8. Standards for a compensation law. The standards which, in detail, in one jurisdiction or another, have already been attained, and which are the provisional ideals now sought by reformers, may be briefly stated as follows. All employments should be included, although as yet there are various exceptions, such as farm labor and domestic service, employers, with but few employees (the number excepted being from one to five), and non-hazardous employments. Compensation should be granted for all injuries, suffered in the course of employment, that cause disability beyond a definite waiting period of from three to seven days. Compensation should include medical attendance for a limited period, and two thirds of the estimated loss of wages for disability, either total or partial, during its continuance; and, in case of death, funeral expenses, and from one to two thirds of the estimated wages to the widow (or dependent widower) and children, or to other dependent relatives. To secure the full benefit of the plan it must be made the exclusive remedy, replacing entirely the old remedy of suits for negligence. The employer should be required to insure his risk, and general sentiment is moving rapidly toward the plan of a state insurance bureau as the exclusive agency. For the administration of the system, an accident and insurance board should be created in each jurisdiction. Experience shows the importance of careful attention to numerous other details, and many amendments will be made as the needs become manifest in practice.

§9. Old-age and invalidity pensions. Insurance to provide pensions for old-age and permanent (partial or total) disability is in nature but an extension of the insurance against accident and sickness. In a relatively small number of cases accidents result in permanent disability, and it is both illogical and inhumane to limit, arbitrarily, the compensation in such cases to a certain period, as two or three years, as is done in many compensation laws. The disability due to advancing years is in nature a chronic illness, inevitable, sooner or later, to all who survive. The movement to provide some indemnity in such cases has been rapid in European countries, doubtless because the problem was a very pressing one where the average earnings are low. In Germany and Austria this development has been more in connection with other forms of insurance; in Denmark, Great Britain, and France it has had more the aspect of an extension of poor relief. In the United States little has been done to provide for these great needs. Massachusetts in 1907 authorized savings banks to sell insurance and old-age pensions to those who applied. An increasing number of corporations, especially railroads, are adopting a pension system for men growing old in their service; but nothing had been done of a general public nature toward compulsory and universal protection against these misfortunes until the enactment of the federal law, in 1920, establishing compulsory contributory old-age and invalidity insurance for the employees in the classified civil service, now half a million in number.

The following table shows the situation in some of the leading countries:

Old-Age And Invalidity Pensions

Voluntary.

Belgium, 1850, 1903 (voluntary except for miners).

Online Library of Liberty: Economics, vol. 2: Modern Economic Problems

Italy, 1898, 1907 (all wage-earners).

Compulsory.

Belgium, for miners, 1868.

Germany, 1889, 1899, 1911.

Austria, 1889 (miners only); 1906 (office employees).

Denmark, 1891, 1908 (non-contributory).

France, for seamen, 1850, 1881; for miners, 1894, 1905, 1907 (non-contributory, all indigent citizens); 1910 (contributory, all workmen and employees; was voluntary by laws, 1850, 1886).

Great Britain, 1908 (non-contributary, old-age pensions, granted by the government).

Sweden, 1913 (universal, contributory).

§ 10. Life insurance for wage-earners. Life insurance for salaried men and the higher paid wage-earners is provided in many cases by the regular reserve companies, but only a small proportion of the fifteen million “ordinary policies” in force touch the mass of the wage workers. The assessment companies (including fraternal orders), with something like nine million certificates in force and collecting about $150,000,000 annually from members, likewise serve mainly either the élite of the wage workers or the farmers and the business men of the small communities. But the greatest increase of life insurance for wage-earners has come of late in the form of “industrial policies” (for less than $1000 each), of which (in 1919) there were fortyfour million in force, three times the number of “ordinary” policies. The premiums received were $225,000,000, of which $181,000,000 were either paid to policyholders or added to reserves (ultimately for the benefit of policyholders). There are, of course, a good many cases (the number undeterminable) in which two or more of these assessment and industrial policies are held by one insured person, and many other cases where the insured is a minor. But the figures show, nevertheless, that provision of a minimum of life insurance is becoming wellnigh universal among wage-earners. This result, surely desirable, is due in large part to the active efforts of solicitors of the companies working on commission. The cost of doing business, or deduction (about 20 per cent) from premiums paid, is perhaps not too much to pay for this educational work in the formative period of popular insurance experience. Less gratifying is the thought that these policies provide in most cases quite insufficient indemnities for the surviving members of the family, the proceeds frequently being barely sufficient for funeral expenses (“grave-yard insurance”), and in the great majority of other cases the meager proceeds quickly disappear, unwisely invested or foolishly spent, leaving the family quite unprovided for.

An admirable plan that is making very rapid progress is “group insurance,” issued by the regular companies to industrial establishments, covering all the persons in their employ during the year. In 1919 there were more than six thousand of these group

Online Library of Liberty: Economics, vol. 2: Modern Economic Problems

contracts in force. This is but one of the ways in which private employers are now increasingly providing insurance for the survivors in the families of their employees. The ideal to be looked toward is a general plan that will make possible universal and adequate life insurance for all income-earning members of the community.2

§ 11. Historical roots of health insurance. Health insurance (called also sickness insurance) had its origin partly in trade-unions and in fraternal societies voluntarily organized by workers, and partly in the system of public poor relief. The voluntary societies were first recognized, regulated, and encouraged by law (in some cases being given state subsidies), and later, in some cases, being made compulsory for some classes of members (i. e., such as miners and seamen). On these institutions have been built the later state systems of social health insurance. This movement had made great headway by the end of the third quarter of the nineteenth century in various European countries. The two systems that are the most typical and influential examples are those of the German Empire and of Great Britain, the former local and the latter national in organization. The British plan of national health insurance promises to be, on the whole, of the greatest influence upon American opinion and policy. However, the best informed American students favor in some features the more decentralized German system, as fitting our conditions rather better than the centralized British system. While it is impossible to describe here the various systems in detail, the situation in the leading industrial countries of Europe may be indicated as follows.

Health Insurance

Voluntary.

France, 1850, 1898 (voluntary except for miners).

Belgium, 1851, 1894.

Italy, 1886.

Sweden, 1891.

Denmark, 1892.

Holland (authorized private societies and poor relief).

Compulsory.

Germany, 1883, 1911 (voluntary for others with earnings of $500).

Austria, 1888 (voluntary for some classes).

France, for miners, 1894.

Norway, 1909.

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Great Britain, national system 1911 (was voluntary 1875-1911).

§12. Need of health insurance in America. Contrary to the usual opinion in America, the sickness insurance in Germany is, both in amount of contributions collected and in importance to the welfare of the workers and their families, of more importance than is either accident compensation or the system of invalidity pensions. Yet, thus far, our interest and efforts in America have been directed almost entirely toward the reform of accident compensation, and almost everything remains to be done in the matter of social insurance against sickness. It is true that in recent years there has been a rapid development, in some of the larger cities, of medical insurance clubs conducted by private companies, with dues of ten cents weekly. They give medical care in ordinary cases, but require extra payments for surgical treatment and for medical supplies. They as yet touch only the outer fringe of the problem; but they testify to the need and to the increasing desire of the wage workers for insurance of this kind. It is believed that at least 4 per cent of the income of wage workers now is expended for the care of sickness and for burial insurance. The losses of wages meantime remain unequalized by insurance indemnities. An Illinois commission reported in 1919 that the loss in wages and medical bills averaged 5½ per cent or more of the family incomes. A large proportion of the cases of temporary destitution in ordinary self-supporting families is due to sickness, at least 25 per cent, as shown by various investigations. The German experience shows that 4 per cent of wages, collected in part from employers and in part from wage workers, is sufficient to give a far better medical service than can be had through private effort, to give some indemnity for loss of wages, and to carry on a very useful hygienic work for the families and for the public health.

§13. Unemployment insurance. The most difficult of all the problems of social insurance is that of unemployment. There the amount of the risk in most cases is largely dependent on the personal qualities of the worker. There are obvious objections to making the competent, steady, sober members of any trade pay the penalty for the faults of their fellows. But, on the other hand, as we have seen,3 a large part of the problem of unemployment is chargeable to social maladjustments rather than to individual faults.

At present, development in this field is along two lines, that of subsidized trade-union relief (the Ghent system), and that of compulsory state insurance in certain industries. By the Ghent plan the public pays a certain proportion (from one sixth to one half) of the amounts of the benefits paid by the unions or other associations. This plan, originating in Belgium, had been adopted before 1914 in many cities and by some countries in Europe, and in the war period was extended to other countries. Great Britain is the first country to adopt a compulsory state system, and it virtually incorporated the Ghent system by providing for grants out of state funds to associations that grant out-of-work benefits. It began operation in 1912, and applied to 2,500,000 persons, or one sixth of all the wage-earners. The contributions are made as follows: ⅜ by employers, ⅜ by wage-earners, and 2/8 by the state. The application of the law was extended in 1916 to workmen engaged in any of the war industries. There are several original and interesting features of the act, such as rewarding, by the refunding of dues, those employers who provide regular employment, and older workmen who have received benefits amounting to less than their contributions. Its

Online Library of Liberty: Economics, vol. 2: Modern Economic Problems

administration in close connection with the labor exchanges is giving valuable experience in this field. The working out of the many minor problems of classification, assessment, and administration of unemployment insurance will require many years of experimentation.

§14. Need of ideals in social insurance. The world has had forty years of experimentation of a remarkably varied kind in the field of social insurance, since the German system was inaugurated in the eighties of the nineteenth century. America stands almost at the beginning of a development along those lines that is certain to be of enormous extent and importance. It would be folly for us to repeat the costly errors of other countries by failing to recognize certain principles that have been clearly established by experience. If these could be grasped and firmly kept in mind, our progress in this field in America would be faster, more certain, less costly, and farther reaching than it promises otherwise to be. We can here attempt no more than merely to outline these principles that must be embodied in an ideal system of social insurance in America.

§15. Insurance rather than penalty. The principle of social insurance rather than that of legal penalty should be universally recognized. At present, in all countries where the several kinds of insurance are found side by side, accidents are indemnified on plans that are still rooted in the notion of employers’ liability for negligence; whereas, necessarily, the indemnity in case of sickness and of old age has no such explanation. The unfortunate result of this difference of view is that, whereas all cases of sickness and invalidity entitle to benefits, only those accidents suffered “in the course of employment” are indemnified, and the worker is left unprotected in a large share of the accidents to which he is liable. The worker’s need and the social need are thus not adequately met. We have started along the same line of development in America, and it is to be feared that only through a long series of legal fictions and contradictory judicial decisions shall we be able to work out toward the practical need in this matter. Another unfortunate result of this difference is that accident compensation, being made peculiarly the task of the employers, does not develop the spirit of responsibility on the part of the workers and of coöperation between them and employers that other forms of insurance call forth, where representatives of both parties sit together in the administration of the system.

§16. The compulsory principle. Insurance must be general in its application to all the persons within broad wage-earning classes, and in order to be general it must necessarily be compulsory, not voluntary, in its application. To leave any form of insurance optional or elective, with either employers or wage workers, is to fail of the main purpose in a large proportion of the individual cases where it is most needed, and to increase the expense to those that are included. Within a compulsory system, however, there should be given wide opportunity for the voluntary principle by admitting to the system others that are not compelled to insure, and to enable any insured person to increase his paid-up, non-forfeitable insurance at any time by extra payments made at times of unusually high wages, from legacies, or from any other exceptional income.

Online Library of Liberty: Economics, vol. 2: Modern Economic Problems

§ 17. State insurance and a unified system. The state, through the public insurance office, must ultimately be the sole agency for social insurance. Only in this way can the maximum of simplicity and economy be attained. Experience thus far has shown the much greater economy (among other advantages) of giving to the state fund a monopoly of compensation insurance: the ratio of management expense to premiums in commercial stock insurance companies is 35-40 per cent, in competitive state funds 6-9 per cent, and in the Ohio state fund (exclusive) 1.6 per cent. However, state management calls for a better appreciation of expert training and a broader sentiment in favor of the merit system in the public service than is frequently found in America.

There should be a unification of various kinds of insurance in one general plan and under one general administration for the whole state. This should be done with full regard to the actuarial differences in costs as among various kinds of insurance, various trades, various establishments, and, to some extent, even the various individuals, so as to ascertain the costs and to distribute them equitably. Only in this way can provision be made for entire mobility of labor, so that men may not be bound, as a condition for obtaining benefits, to continue in the service of any one employer. To this end there should be interstate comity and coöperation, so that the insured could at any time transfer his actuarial equity from one state to another.

§ 18. The contributory principle. The contributory principle should be adopted, employers and wage-earners contributing to the cost in equal amounts. But, further, the general public interests may be recognized through the payments in aid of the funds (subsidies, subventions). Both employers and employees usually seek to escape the burden by getting the state to bear the whole expense4 or by getting the other party to pay all or the larger part. But it is much to be desired that in large part the finances of a system of social insurance should be disassociated from the ordinary budgetary system of taxation and public expenditures. The fundamental reason why the premiums should be divided between employers and employees is that this is most favorable to the equal participation and coöperative efforts toward reducing the risk, and developing right industrial and political relations. Everywhere it is the practice to provide for representation nearly in proportion to contributions.

It is usually assumed by employers, by wage workers, and by others in the discussion of the subject, that the burden remains and is borne by those who directly pay the premiums, and just in proportion to their payments. This is an almost utterly mistaken view. There is, on the contrary, every reason to believe that the general principles of shifting and incidence of taxation apply fully here.5 Wages are not arbitrarily fixed; they result, as we must believe, from an adjustment and equilibrium of the various classes of labor in a general economic situation; therefore, after a time, compulsory insurance premiums become a part of that general situation. If premiums are paid by employers (by all, without exception) lower wages will ultimately result; and if paid by workmen, higher wages will ultimately result than if the premiums are paid by the other party. Of course, there is some delay and friction in making the adjustment; but, under any settled policy, the adjustment, once made, will be maintained.

The true benefit of social insurance to workingmen is not that their wages are increased by the direct contributions of employers to the premiums, though there are