Abstract: Reinventing Health Care: Corporate Health Care before the Welfare Movement, Lowell 1839-1890
Most American historians point to the welfare movement of the late nineteenth century as the start of employer interest in workers' well-being. Yet, on May 11, 1840, the Lowell Corporation, cotton manufacturers in Lowell, Massachusetts, opened the first industrial hospital in America. The Corporation provided the operating funds and medical care, but patients were expected to pay for their keep. The cotton manufacturers provided a surety so employees were not denied care. This paper addresses the reasons why the Lowell Corporation established and continued support for a hospital at a time when manufacturing interest in workers centered on profit. It argues that Lowell manufacturers were the first group of American employers to believe that a healthy workforce was valuable for business success, although the hospital was not profitable. It also provides insight into the varying working conditions and employees' health between companies. Individuals remained in control of their health because workers were not forced to enter the hospital when ill. Workers continued to rely on self-help, home remedies, and local medical care. Thus, although the Boston Associates had transformed business practice, their efforts were not complete without employee compliance.