A case study in corporate philanthropy: The Money Value of Risk

In 1909, the Metropolitan Life Insurance Company created a sea change in the way that it handled policyholder risk, no longer merely excluding “poor risks” but instead working to improve the public's health and help eliminate risk all together. It accomplished this by launching its new Welfare Bureau, which would soon pay for widespread care from visiting nurses, the distribution of health literature, legislative lobbying, support for health organizations such as APHA, and scientific surveys of the health status of vast segments of the population. The industry's contributions were as expansive as they were expensive, but they brought little pecuniary gain to participating companies; no data ever conclusively demonstrated that company public health activities lowered policyholder mortality enough to increase profits. This presentation will investigate some theories of why the life insurers chose to put forth such a tremendous outlay toward public health at that time, and how the legacy of those efforts is still reflected in the structure of private insurance and the practice of public health today.

In particular, this paper will examine the applicability of different scholars' explanations for corporate-philanthropic enterprise during the Progressive Era and 1920s to Met Life's public health work: The “corporate liberalism” theory (ventures taken by business leaders along with labor to better living and working conditions for the good of corporations and individuals alike), and the “corporate capitalism” explanation (palliative measures taken to reduce radicalism and to defuse the call for statist solutions). It will demonstrate that neither explanation proves sufficient: Met Life's public health adventure can be viewed most accurately as tangled web of optimism and concern, greed and altruism, and moral condemnation and compassion. It is on this edifice, I will argue, that the modern model of health insurance and medical risk now sits.