The Dilemma of Mutual Societies
Among the many unresolved problems of public health in late nineteenth-century France, none was more crucial than the fate of mutual aid societies (socuts de secours mutuels). Indeed, it is surely correct to say that mutualism represented the most reliable bellwether of the social question. Its evolution would indicate the outcome of reformist efforts in France after 1870 to construct a national health system worthy of the name.
Curiously, this subject has heretofore received scant attention from historians. No comprehensive study of mutual societies exists, despite the conspicuous fact that they became a quintessential French institution well before 1914 and remained so throughout half of the twentieth century.1 Although it is beyond the scope of this work to recount that long and complex story, there is reason to sketch its main outlines and to delve into some of its details. Specifically, we need to determine how the development of the French mutual society differed from that of the German Krankenkasse, to which it posed a characteristic Gallic counterpart.
One of the clues to this analysis, already suggested by the discussion of matters financial, was an increasingly manifest polarization of the political spectrum toward right and left. The former espoused doctrinaire liberalism, opposed the income tax, and supported the mutual societies. With equal consistency, the latter professed socialist principles, favored a progressive reform of the tax structure, and regarded the mutual societies at best as an interim solution pending adoption of social security. Between these opposite poles the transient political regimes of the early Third Republic shifted in search