During the century prior to the outbreak of World War II, the most important sources of sick benefits and health insurance in the U.S. were fraternal charities. The Independent Order of Odd Fellows was a leading example. In 1819, the first U.S. branch of the British Odd Fellows lodge opened in Baltimore. Throughout the following decade the fraternal group spread across four states, and attracted more than 6,000 members drawn from all economic classes. In 1842 the American lodges formed their own fraternal order, the IOOF.
Like dozens of other fraternal organizations at that time, the Odd Fellows offered financial support to members who fell sick, and the IOOF made these offerings much more uniform and predictable. Any member who became too ill to work could claim a weekly stipend ranging between $3 and $6, paid by his fellow lodge members. Most other lodges referred to these mutual benefits as charitable relief, but the Odd Fellows called them benefits and treated them as “every Brother’s right, and paid to every one when sick, whether he be high or low, rich or poor.” There was accountability, however: payments were withheld in cases of habitual drunkenness, adultery, or anti-social behavior.
From 1830 to 1877, IOOF membership soared from 3,000 to 465,000. It and other fraternal orders dispensed many millions of dollars in sick benefits (as well as funeral benefits) to their participants. Lodges also provided charitable aid to thousands of orphans of deceased members. These valuable benefits were supported by a broad base of voluntary contributors—at least one third of all U.S. adult males age 20 or older belonged to one or more of the voluntary fraternal organizations in the early decades of the twentieth century.
- David Beito, From Mutual Aid to the Welfare State (University of North Carolina, 2000) pp. 10-16.