Membership in mutual health insurance societies spread among industrial workers in the late nineteenth century. We study determinants of such membership among male workers in Swedish manufacturing by using matched employer–employee data from three industries covering all workers (i.e. members and non-members, N > 12 000) and firms around 1900. We find remarkably high rates of membership overall, and especially among married workers. The association between marital status and health insurance suggests that selection into health insurance societies was ‘propitious’ rather than ‘adverse’. Many workers became members well before the age of 40 years, when their health began to deteriorate, and this coincided with the average age of first marriage for men, occurring in their late twenties. Being married and having membership was more marked in firms with voluntary membership and was important for the viability of the mix of voluntary and compulsory health insurance societies emerging in Nordic countries around 1900. Findings support the idea that health insurance can attract high levels of membership under voluntary schemes and suggest why it took so long before statutory health insurance covering sickness absence and workplace accidents was introduced in Sweden.

中文翻译：

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在自愿和强迫之间：瑞典制造业互助健康保险协会的成员资格，c。1900年

十九世纪末，互助医疗保险协会的会员资格在产业工人中广泛传播。我们通过使用来自三个行业的匹配雇主-雇员数据来研究瑞典制造业男性工人中此类成员资格的决定因素，这些数据涵盖了所有工人（即会员和非会员，N > 12 000）和 1900 年左右的公司。我们发现会员比例非常高总体而言，特别是在已婚工人中。婚姻状况与健康保险之间的关联表明，选择加入健康保险协会是“有利的”而不是“不利的”。许多工人早在 40 岁之前就成为会员，此时他们的健康状况开始恶化，而这恰逢男性初婚的平均年龄为二十多岁。在拥有自愿会员资格的公司中，结婚和拥有会员资格更为明显，这对于 1900 年左右北欧国家出现的自愿和强制健康保险协会的生存能力非常重要。研究结果支持这样的观点，即健康保险可以在以下情况下吸引高水平的会员：自愿计划，并说明为什么瑞典花了这么长时间才引入涵盖因病缺勤和工作场所事故的法定健康保险。