Our Insurance DystopiaRoundup
tags: capitalism, health care, history of capitalism, business history, health insurance, insurance
Caley Horan is Associate Professor of History at MIT, where she specializes in post-1945 U.S. history. Her research and teaching interests include business history and the history of capitalism, risk and uncertainty, and the history of gender and sexuality. Her first book is Insurance Era: Risk, Governance, and the Privatization of Security in Postwar America (University of Chicago Press, 2021).
In 1914, on the eve of World War I, Harvard philosopher Josiah Royce celebrated the utopian promise of insurance. In an address delivered at the University of California at Berkeley, Royce welcomed what he called “the coming social order of the insurer”—a new system of global governance based on the model of mutual insurance. Building on the work of fellow philosopher Charles Sanders Peirce, Royce imagined on the horizon a global “community of insurance” made up of all the nations of the world.
Under this new system, Royce predicted, every nation would contribute to a large insurance pool overseen by an independent world body. The result would not only insure the peoples of the world against future disasters, natural and manmade. It would also help bring them closer together by encouraging a spirit of interdependence and mutual aid—a “genuine community of mankind” that would contribute “to peace, to loyalty, to social unity, to active charity, as no other community of interpretation has ever done.”
Forty years later, American science fiction authors Frederik Pohl and Lester del Rey imagined a vastly different insurance future. Their 1955 novel, Preferred Risk, depicts a dystopian insurance era ruled by “The Company,” a massive insurance firm that achieves total global domination, displacing state governments. The Company rises to power by distributing insurance for everything imaginable: hunger, natural disasters, reproduction, war. It rules over humanity by refining every action and consequence down to a scale of precise probabilities, represented in complex actuarial tables decipherable only by experts. Most people embrace the new era, despite being permanently segregated into risk classes that dictate what they eat, where they live, how they work, and who they meet. Others struggle simply to survive. A desperate group of outcasts—the “uninsurables”—live miserably on the outskirts of society, shunned as deviants by those lucky enough to be classified as “preferred risks.”
Neither of these accounts successfully predicted the course insurance would take in the United States over the twentieth century, which was defined instead by complex relationships between private corporations and the state. But taken together, these two visions reveal the range of possibilities inherent in insurance as a system of social governance. Decades before sociologists and legal scholars spoke of “insurance as governance,” Royce imagined insurance as a powerful form of social and political organization. More than a risk-spreading mechanism, he argued, it could also function as a powerful mode of governance, a form of association capable of shaping social understandings of responsibility and dictating relationships between individuals and groups. Yet Royce failed to predict the forces that would oppose the collective nature of insurance and seek to privatize the management of risk and the provision of security. Instead, Preferred Risk proved eerily prescient. From the omnipresence of corporate-controlled data to the plight of “uninsurables” and the risk classification schemes that severely limit access to social goods, Pohl and del Rey’s dystopian vision mirrors our own insurance era in striking ways.
Those dystopian elements are increasingly facing resistance. Calls to check the power of private insurers and more equally distribute access to security have multiplied over the past decade. Gallup polling, for example, shows a steady and significant uptick since 2010 in American support for replacement of private health insurance with a government-run system—support that has reached levels unseen since the 1940s. As we think about how to imagine new insurance futures, we will have to reckon, in particular, with two broad features of insurance provision in the United States: the fraught relationship between the private insurance industry and the state, and the growing power of insurance companies in gathering and wielding data about individuals and groups. Each presents unique obstacles to the more utopian possibilities Royce envisioned.
Editors’ Note: This essay is adapted with permission from Insurance Era: Risk, Governance, and the Privatization of Security in Postwar America by Caley Horan, published by The University of Chicago Press. © 2021 by The University of Chicago Press. All rights reserved.
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