Sec. 9. #Historical roots of sick-insurance.# Sick-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 sick-insurance.  This movement had made large 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 rather than the centralized British system.  While it is impossible to describe the various systems in detail, the situation in the leading industrial countries of Europe may be indicated as follows.

  SICK-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.

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

Sec. 10. #Need of sick-insurance in America#.  Contrary to the usual opinion in America, the sick-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