Session 10: The Health Insurance Business: From Marginality to the Fastest Growing Sector in the First Decades of the 21st Century

Thursday, July 21th 2022, 13:45–15:45 (CEST), Room U1 191

Zoom-Link: | Meeting ID: 674 8824 6911

Session Organisers: Jerònia Pons-Pons (University of Seville), Margarita Vilar-Rodríguez (University of a Coruña)


In the late nineteenth and early twentieth centuries, when some European countries were initiating social insurance schemes, coverage of the risk of sickness was largely excluded from private insurance business, a sector that was more interested in lines such as fire, life and industrial accidents, among others. Consequently, this field was limited to non-profit civil society initiatives in the form of friendly societies or other types of mutuals and commercial companies linked to health professionals, especially doctors and surgeons. Most of these companies, with limited capital and with management that was partly outside the scope of the insurance business, save exceptions, remained active at least until the Second World War, although with a very limited capacity and slow growth. The creation of welfare states, including national health systems or something similar in many Western European countries during the post-Second World War period, restricted the activity of these entities to the demand of certain groups. However, other countries such as the United States chose to give priority to the market, which boosted this line of insurance both qualitatively and quantitatively, thereby establishing a prominent position within the private insurance industry. The triumph of the so-called economic neo-liberalism in the richest countries from the 1980s and welfare state cutbacks favoured the greater participation of health insurance companies, which saw their role and their business increase. Furthermore, over time they attracted the interest of investment funds, large insurers and banks, which acquired specialised companies and increased their activity in this branch. All this process and these changes, which moreover have intensified in times of pandemic, focus the interest of a debate on the role of private healthcare in the health cover of contemporary societies. Within this framework, this session is open to studies employing a variety of approaches that focus their interest on the historical evolution of this line of insurance, including its role in today’s society.

1. The Health Insurance Business in Spain: From Medical Companies and Associations to the Emergence of Financial Capital (1950-2019)

  • Jerònia Pons-Pons, Faculty of Economics and Business, University of Seville
  • Margarita Vilar-Rodríguez, Department of Economics, University of Coruña (online)

2. Health Insurance in Context – Health Insurance in Germany in the 20th Century between Private and Public, Patients and Physician, Politics and Profit

  • Axel Hüntelmann, Institute for History of Medicine and Ethics in Medicine, Charité – Universitätsmedizin Berlin

3. You Can’t Understand Healthcare Politics Without it: The History of Health Insurance in the United States

  • Christy Ford Chapin, Department of History, University of Maryland Baltimore County

4. The Conquest of the Middle Class: The Creation of a Mass Market for Health Insurance in Switzerland (1920-1970)

  • Geoffroy Legentilhomme, Social and Economic History, University of Zurich