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In the past a family's chief cost of sickness was loss of the family head's earning, not expenses for health care. Since there were no government programs, sickness insurance provided by friendly societies, commercial insurers, and other institutions was important in partially replacing the wage earner's lost income. The Independent Order of Odd Fellows (IOOF) was the largest social society in Canada and the United States and also the largest provider of sickness insurance.
Using cliometric methods and records from six grand-lodge archives, A Young Man's Benefit rejects the conventional wisdom about friendly societies and sickness insurance, arguing that IOOF lodges were financially sound institutions, were more efficient than commercial insurers, and met a market demand headed by young men who lacked alternatives to market insurance, not older men who had an above-average risk of sickness disability.
Emery and Emery show that many young men joined the Odd Fellows for sickness insurance and quit the society once self-insurance - savings - or family insurance - secondary incomes from older children - made it feasible for them. The older men, who valued the social benefits of membership and did not need the sick benefit, gradually became a majority and dismantled the IOOF's insurance provisions.