During the industrialization period, the rate of workplace-related accidents increased. Because of the lack of public insurance, mutual health insurance societies became the main providers of workplace accident insurance among workers. Due to large differences in accident risk, health insurance societies were potentially exposed to the risk of adverse selection, since they employed equal pricing for all members regardless of risk profile. This article investigates the impact of workplace accident risk on health insurance selection and outcomes. We employ household budget surveys encompassing urban workers in Sweden during the early twentieth century. We find evidence for a redistribution from low- to high-risk-exposed workers, as workplace accident risk had a significant and positive impact on receiving health insurance benefits, also when controlling for a variety of factors. Workers exposed to greater risks in the workplace were more likely to have health insurance but did not pay higher premiums. The redistribution from low- to high-risk-exposed workers was largely accepted and viewed as an act of solidarity between workers. Given that health insurance societies were aware of this redistribution, we argue for the presence of informed, rather than adverse, selection.

中文翻译：

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工作场所事故与工人团结：20 世纪初瑞典的相互医疗保险†

在工业化时期，与工作场所有关的事故率有所增加。由于缺乏公共保险，相互健康保险协会成为工人工伤保险的主要提供者。由于事故风险的巨大差异，健康保险协会可能会面临逆向选择的风险，因为它们对所有成员采用相同的定价，而不管风险状况如何。本文调查了工作场所事故风险对健康保险选择和结果的影响。我们在 20 世纪初对瑞典的城市工人进行家庭预算调查。我们发现了从低风险到高风险工人重新分配的证据，因为工作场所事故风险对获得健康保险福利产生了重大而积极的影响，在控制各种因素时也是如此。在工作场所面临更大风险的工人更有可能拥有健康保险，但没有支付更高的保费。从低风险到高风险工人的重新分配在很大程度上被接受并被视为工人之间的团结行为。鉴于医疗保险协会已经意识到这种重新分配，我们主张存在知情而不是不利的选择。