Making Security Social: Disability, Insurance, and the Birth of the Social Entitlement State in Germany

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Making Security Social: Disability, Insurance, and the Birth of the Social Entitlement State in Germany

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Figures 1. Apparatus for passive bending at the waist 2. Apparatus for passive movement of shoulder joint 3. Apparatus for passive movement of finger joints 4. Modified saw 5. Modified spade Page viii →

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Tables 1. Accident Insurance in Germany, 1886–1982 2. Invalid and Old-Age Insurance in Germany, 1891–1935 3. Annual Pension Decisions and Litigations, 1901–12 4. Annual Social Insurance Benefits Paid (in Marks), 1895–1913 Page x →

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Acknowledgments It is hard to know where to begin in acknowledging all those who contributed over the years to this project. It is probably most apt to start with the University of Chicago, where I first developed the idea for this book. To say that John Boyer and Michael Geyer were instructive and supportive advisers and mentors is an understatement. Both have generously offered their insights and assistance at every stage in my studies, and in the process shown me by example the vitality and responsibilities associated with the historian’s craft. Along with them, a number of other faculty, fellow graduate students, and postdoctoral fellows have been a source of intellectual inspiration and emotional comfort. So much of what is here are notions that arose out of discussions with them. Matt Berg, Dan Beaver, Paul Betts, Jan Goldstein, Sue Marchand, Moishe Postone, Peggy Rosenheim, Dan Wolk, and all the members of the Workshop in the History of the Human Sciences and the Workshop in Central European History deserve special mention. I also owe a debt of gratitude to colleagues and friends in Milwaukee, particularly Gareth Evans and Erik Lindberg. Along the way, a number of scholars have offered sage advice and criticism: Kathleen Canning, Adelheid Gräfin zu Castell Rüdenhausen, Geoff Cocks, Roger Cooter, David Crew, Peter Fritzsche, Rick Hoefer, Young-Sun Hong, Paul Lerner, Uli Linke, Mark Micale, Steve Reinhardt, Jürgen Reulecke, William Walters, and Silke Wenk. I hope they can detect evidence of their influence here. I particularly wish to thank Geoff Eley and an anonymous reader for their comments and suggestions. I would like to also extend my thanks to the staffs of the Bundesarchiv, the Friedrich-Ebert-Stiftung, the Hauptverband der gewerblichen Berufsgenossenschaften (especially Dr. Hans Michael von Heinz), the Niedersächsisches Hauptstaatsarchiv, the Nordrhein-Westfälisches Hauptstaatsarchiv, and the former Zentralen Staatsarchive Merseburg and Potsdam. All proved to be extremely professional and kind in their attention to my research needs. The Deutscher Akademischer Austauschdienst made possible my research in the Federal Republic, while the International Research and Exchanges Board (with funds provided by the National Endowment for the Humanities and the United Page xii → States Information Agency) supported my research in the former German Democratic Republic. I thank both of them for their generous support. Naturally neither organization is responsible for the views expressed here. Finally, I single out Melissa Watts. She has worn many hats during the course of my writing this book: editor, advocate, critic, friend. I can think of no better way to acknowledge her substantial contribution than to say that without her, the process and the product would have been all the poorer.

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Abbreviations BAK BAP

Bundesarchiv Koblenz Bundesarchiv Potsdam


Berufsgenossenschaft Geheimes Staatsarchiv Kulturbesitz Merseburg


Hauptverband der gewerblichen Berufsgenossenschaften, St. Augustin Landesversicherungsanstalt Niedersächsiches Hauptstaatsarchiv


Nordrhein-Westfälisches Hauptstaatsarchiv Düsseldorf Reichsarbeitsministerium Reichsversicherungsamt

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CHAPTER 1 Introduction: Social Security, Rationality, and the German Welfare State By the end of the twentieth century, European and American governments and publics came to question one of the most prominent features of their societies: the welfare state. Once trumpeted as signaling “the end of the ideological age,” the welfare state enjoyed its broadest base of support in the three decades after the Second World War. From 1945 to 1975, social-policy measures insinuated themselves—sometimes gradually, sometimes quite rapidly—deeply and widely into civil society. Social rights were extended to greater numbers of citizens, public assistance and social-service programs grew in size and variety, and social expenditure represented an ever greater percentage of gross domestic product.1 Trends in West Germany mirrored those in Western Europe as a whole. Between 1950 and 1980 annual spending on health care grew from 3 billion to 121 billion marks, while expenditure for pensions (keeping prices constant) rose more than elevenfold. By 1975 nearly one of every two marks spent in the Federal Republic went through a public institution, with around two-thirds of all public funds being claimed by the welfare state.2 While European social-democratic and labor parties and the Democratic Party in the United States openly acted as welfare-state advocates, we should remind ourselves too that none of the major conservative parties seriously opposed the expansion of the welfare state. Indeed, Konrad Adenauer’s Christian Page 2 → Democrats, the Conservative Party under Edward Heath in Great Britain, the center-right coalition of Valéry Giscard d’Estaing in France, and Richard Nixon’s administration all took steps to expand social-welfare provisions. By the mid-1970s, some began to speak of the emergence of welfare societies, “countries in which nonmarket transfers to households and public provision of services constitute . . . ‘the quantitatively predominant everyday routine spending and activities of the state and its employees,’ and in which the social wage—publicly derived income or the equivalent—complements, if not rivals, the market wage for most workers.”3 Like the capitalist economy, the welfare state appeared to have no foreseeable limits to growth. This began to change in the mid-1970s, however. Over the course of the 1970s and 1980s economic growth in Western Europe slowed and stagnated, inflation and unemployment rates rose, and states developed unprecedentedly large budget deficits. These changes brought with them a public preoccupation with government spending, and the welfare state became the object of criticism and budgetary cuts. Conservative political parties, now campaigning on antiwelfare platforms, were elected to run governments in Great Britain (1979), the United States (1980), West Germany (1983), and Canada (1984). In many industrial countries the goal of full employment was abandoned, means testing was expanded, and housing and poverty programs directed at low-income citizens faced cutbacks.4 Just as with earlier social-welfare expansion, these changes were not party-specific. Retrenchment first emerged in West Germany under the Social Democrats in 1975 with the passage of a law aimed at limiting access to unemployment benefits, education allowances, and housing subsidies. Jimmy Carter’s administration after 1978 sharply reduced levels of spending in selected social-welfare programs. In France, where a socialist-communist coalition took over the government in 1981, the Left found it necessary to adopt a policy of so-called rigor from 1982 to 1984. Introducing a number of measures designed to combat increasing inflation and slow growth, the Left instituted price increases for public services, set budgetary restrictions, allowed overstaffed industries to trim their labor forces, and more strictly controlled health insurance benefits and costs.5 More illustratively, in Scandinavia, home to what has traditionally Page 3 → been considered the ideal welfare state, Norway, Denmark, and Sweden witnessed the emergence of antitax parties in the 1970s and adopted policies of fiscal restraint in the 1980s.6 Some of the principal, long-standing assumptions and policies of the Western welfare state thus find themselves today challenged, but not only by resurgent neoconservatism and neoliberalism. Rather, a whole host of

interrelated structural changes have combined to make many traditional social policies unsuitable or untenable. The rise of new technologies of mass communication, transnational social and ecological problems, and the internationalization of the production, exchange, distribution, and consumption of goods and services has, to use Bob Jessop’s term, “hollowed out” the nation-state. Globalization has fostered a marked transfer of decision making from national and public to international, local, and private authorities. At the same time, it has redirected the social and economic policies of nation-states toward supply-side strategies.7 All this further coincides with a profound demographic change. Improvements in nutrition and medical technology, combined with a significant decline in fertility, have contributed to the aging of European society. A 1989 study by the International Labor Office calculated that by 2025 European Community/European Union countries could be expected to have 12.7 million fewer young people (ages 0–19) than in 1985, and 15.1 million fewer young adults (ages 20–39), but 9.3 million more citizens ages 40–59 and 4.3 million more 80 years of age or older. With most pension systems financed according to a “pay-as-you-go” scheme, this change threatens employees and pensioners alike.8 As social scientists in Germany have emphasized, the social safety net has been pulled taut. Social insurances, which receive contributions and pay benefits according to employment history, may be able to do neither as the number of working women in low-paying jobs increases, unemployment stays high, illegal Page 4 → work thrives in the east, and “flexibility” reorganizes the workplace.9 In addition, the Federal Republic of the 1990s shared with Eastern Europe a set of problems posed by decommunization. On the one hand, it wished to promote high productivity, a high standard of living, and world economic competitiveness; on the other, to meet the demands of former East German citizens accustomed to comprehensive medical care, free and low-cost services, affordable housing, the right to work, generous family assistance, and government subsidy of food staples.10 This came at a time when acute fiscal problems made it more and more difficult for states to fulfill even their customary obligations.11 In the wake of these conundrums, past decades have seen the emergence of a new “critical welfare consensus.”12 Politicians, academics, public-policy analysts, and administrators of social services have crossed the political divide of Right and Left and agreed on a relatively coherent set of axioms: the state is overburdened; the expansion of the welfare state has hindered economic growth; the social safety net has created an inflation of needs; welfare bureaucracy is too big, too inefficient, and more adept at creating problems than solving them; the sovereignty of the individual and of civil society has been eroded by the proliferation of state welfare activities; welfare has created institutional and electoral interests that irrationally prop it up; the entire system is overprofessionalized; welfare promotes antisocial values.13 Retrenchment and criticism have not been directed at the welfare state as a whole, however. There is general agreement that, in aggregate, the reforms and cuts have been modest. Reductions have been successful mostly in containing the rate of increase in public expenditure, shifting some costs from government to individuals and the private sector, and making the assessment of social Page 5 → programs be based on their impact on the economy.14 The reason for these unspectacular results is that policymakers have expended most of their energy targeting certain areas and activities of social assistance (e.g., poor relief), while leaving other, more expensive ones relatively untouched (e.g., pensions). More stringent and widespread eligibility requirements, cuts in housing subsidies, and the privatization and decentralization of services have led some to see an “Americanization” of the European welfare state: in other words, the emergence of a “dual welfare state” in which sharp distinctions are made between those who are considered entitled to benefits on principle (e.g., the elderly and the disabled) and those who are deemed less deserving and therefore warrant close supervision (e.g., the unemployed poor).15 The welfare backlash has largely focused on this latter group and the programs that service them. The distinction that has been drawn is between social security on the one hand—insurance programs providing cash benefits and services to sick, disabled, unemployed, and elderly individuals who have contributed to general funds—and welfare on the other—means-tested programs financed solely or primarily by taxpayers. While welfare has been the object of criticism and restrictions, health care and pension systems have continued to grow. Thus, the chief casualties of privatization, decentralization, and debureaucratization have been welfare programs and their beneficiaries, as the social goal of redistribution has increasingly taken a backseat to income maintenance over the life cycle.16

These developments resonate with public sentiment. Throughout the period of retrenchment, Europeans have consistently voiced their support for the entire range of social insurance programs referred to as “social security” (soziale Sicherung).17 Results from German public opinion surveys have mirrored this international trend, showing that support for social security has been persistent Page 6 → and virtually universal (a 90 percent approval rating), cutting across all class and party affiliation boundaries.18 Similarly, none of the principal political critiques (remoralizing neoconservatism, free-market neoliberalism, and left-leaning communitarianism) have challenged the legitimacy of social security as an ideal.19 Instead, the alternatives that critics proffer (reprivatization, “a democratic and socialist welfare society,” a universal minimum income) simply aim to displace the locus of social security production and distribution. What has developed in recent years, however, is a desire for programs to be more tailored to individual circumstances and needs. Thus, the Federal Republic, like many other industrial states, is moving away from collective solutions to social problems in order to embrace a widespread enthusiasm for individualization.20 This trend has been widely interpreted as an abandonment of the solidaristic principle behind the notion of a social security. If anything, however, it may testify to social security’s remarkable popularity. As Martin Greiffenhagen has pointed out, “[i]ndividualization and high regard for social security systems are only superficially in mutual opposition. To the extent that state policies have an influence on biographies, the interest in security guaranteed by the welfare state increases with the conscious planning of one’s own biography.”21 Thus, the welfare state must be credited with successfully promoting the very life planning, life-historical identities, and political values that have gone into forging the Betroffenheitskultur (the political culture of being personally affected as an individual) of contemporary Germany. Eastern German reactions to the reunification process further reinforce the view that social security has been instrumental in fashioning a contemporary sense of Betroffenheit within the German public. Swift reunification meant that the Federal Republic instantly inherited all the social problems of the former GDR in addition to its own.22 As they did in every other area of public policy, Western German officials largely transplanted Federal Republic social laws, Page 7 → policies, and programs to the East. This resulted in a lower level of benefits for Eastern Germans relative both to Western Germans and to earlier provisions in the GDR.23 With unemployment higher and wages lower in the East in comparison with the West, a state of mass discontent has persisted among Eastern Germans since 1991.24 A 1994 survey showed that at least a plurality of Easterners believed health care, pension security, future prospects, public safety, and occupational opportunities were better under communism than under the Federal Republic.25 Such disillusionment and nostalgia suggest to what extent any legitimacy garnered by the East German state was primarily a function of its fulfilling demands for social security. Now over one hundred years old, social insurance is universally accepted, virtually taken for granted, by German, European, and American publics alike. But why? How did social insurance come to occupy this privileged place in a modern, market-driven, industrial society like Germany? When did social security become the raison d’être of the German nation-state? These are the principal questions this book tries to answer. The Legitimacy of the Modern State and the Rationalities of Government The contemporary retrenchment of and backlash against the welfare state highlights two things. By calling into question the policies and premises of the welfare state, it reminds us of the historical contingency of the institution. Beyond this, the direction, form, and limits of the cuts and criticisms indicate that its ability to secure a sense of social well-being has generated popular acceptance and support for the twentieth-century welfare state. A history of the German welfare state, then, must necessarily include a genealogy of social security, an inquiry into the sources of this authoritative twentieth-century political ideal. Such a project necessarily converges on a theme that has preoccupied modern social and political theory: the legitimacy and form of the modern state. With the fall of the Old Regime, the state was challenged to justify itself anew and to find novel ways of addressing the social and economic changes that accompanied modernity. The social scientist Lorenz von Stein (1815–90) was Page 8 → among the first in central Europe to systematically analyze this problem. Stein recognized that, with the advent of a distinct sphere of socioeconomic relations, the modern state was required to provide more than an institutional space for defining the legitimacy and rationale of

government through lawmaking and legislation (Staatsverfassung). It also needed to provide administration (Staatsverwaltung). Modern administration, however, is a peculiarly practical affair. It operates in functional terms, serving as a medium in the relations between state, society, and the individual, while simultaneously playing the role of the state itself in the very act of administrating.26 Under the influence of the liberal theory of political legitimacy, Stein cautioned, we have allowed ourselves to misrepresent the modern state in solely juridical terms, seeing it as an abstraction that simply weighs and balances the “totality of maxims” against the “inviolability of the One by the Other.” In doing so, however, political analysis overlooks the very arena in which the state plays its greatest role in the lives of human beings: the practical world of administration in action, where social conflicts are pragmatically mediated and managed.27 Like Stein, Max Weber (1864–1920) argued that the modern state addressed the question of legitimacy by functionalizing it, by reducing it to an assessment of the state’s rather mundane problem-solving technology. In this regard, Weber saw the bureaucratic process as paradigmatic: a mundane means of doing business that “develops the more perfectly, the more it is ‘dehumanized,’ the more completely it succeeds in eliminating from official business love, hatred, and all purely personal, irrational, and emotional elements which escape calculation.”28 Weber’s innovation was to (1) understand bureaucracy as a social logic, a “rationality” at work, and (2) see in bureaucratization an example of a pervasive instrumental rationalization of modern society and the modern individual. As The Protestant Ethic and the Spirit of Capitalism argues, the modern West’s attempts to master and domesticate the world required not only new institutions but a new self as well, one that endlessly and ascetically Page 9 → strives for self-mastery.29 The distinctive rationality of bureaucratic domination, Weber concluded, therefore has had a hand in directly shaping personal values, public identities, and political desires in a “disenchanted” society shorn of any transcendent meaning.30 The contemporary German sociologist Niklas Luhmann has carried on the Weberian tradition of grand sociological theory about institutional rationalization.31 Luhmann shares with Weber the view that bureaucracy rationally creates relative, circumscribed possibilities of individual thought and action. Like every other “system,” however, institutions and administrations are constantly engaged with an outside world (“environment”) that regularly resists their superimposed rationalities. This produces a variety of unintended consequences of institutional action. Thus, a central problem facing any state administration is reproducing trust in the system itself: the bureaucracy must somehow incorporate and account for the risks, contingencies, and insecurities that invariably accompany its work.32 In Luhmann’s view, legitimacy is not something granted, but rather an inherent commitment to administrative procedure itself (what he refers to as “legitimation through procedure”).33 As long as they provide an adequate measure of security in a world of contingent futures, institutional rationalities selfreflexively justify themselves every time individuals relinquish personal responsibility to administrative process.34 While historians (particularly in the United States) have made little or no mention of the work of Luhmann, the ideas of Michel Foucault (1926–84) have enjoyed a wide circulation inside and outside the historical community. Like Stein, Weber, and Luhmann, Foucault also concerned himself with those rationalities (“epistemes” and “discourses”) that have historically provided the conditions of possibility for modern action and thought in the Western world. Read within the context of these thinkers, Foucault’s works appear at once less Page 10 → groundbreaking than his supporters yet more constructive than his critics frequently purport.35 Politics (relations of force and power) in the modern period, Foucault maintained, have no fixed center, and thus the ability to effect change cannot be definitively located in nor identified with any one arena, set of individuals, or institution.36 Instead, in a similar vein as Weber, Foucault emphasized the increasing, pivotal role played by scientistic knowledge systems (“disciplines”) in mediating actual and potential social encounters. In order to promote civic peace, economic productivity, and military prowess, modern political and social institutions embarked on social-engineering projects that involved studying, monitoring, and molding human desires and conduct more intimately than ever before. The result was an explosion of the human sciences (disciplines with human beings as their object of inquiry) and the attempt to integrate “life and its mechanisms into the realm of explicit calculations.”37 It is this line of thinking that eventually led Foucault and others to discuss more directly the state and its peculiar

rationality. In the last decade of his life, he and a number of his colleagues began exploring the historical development of what he called “governmental rationality,” meaning a way or system of thinking that establishes the roles, rules, and limits of who can govern, what governing is, and what or who is to be governed.38 The principal methodological implication of this line of inquiry is to emphasize the need to assess how the state not only addresses, but also defines and perceives, public problems. For the manner in which social problems have been posed is inseparable from the very principles and rationality of public policy. Health insurance, child welfare, and worker safety, like other instruments of government, problematize the world in distinctive ways. By extension, economy, society, work, poverty, unemployment, and disability “are entities whose very intelligibility depends on ways of coding and articulating the real that have had to be invented. . . . [T]hese objects of governing have particular material and conceptual pre-conditions, which depend Page 11 → for their existence and their operability on specific knowledges, techniques, expertises.”39 Stein, Weber, Luhmann, and Foucault together articulate a common theme in the social theory of modernity: the structural disciplining and construction of human subjectivities. If there is a shortcoming they all share, however, it is their tendency to reduce subjectivity to the status of an object, i.e. to treat individuals as nothing more than passively manipulated entities. A contemporary of Weber’s, the German sociologist Georg Simmel (1858–1918), made it his ambition to return subjectivity to the modern individual. From Simmel’s perspective, modernity was first and foremost a unique form of lived experience. Compelled to live in a “jungle” of highly rationalized institutions, the resulting depersonalization of authority also offered a kaleidoscope of choices by which moderns could differentiate themselves from one another. Nothing demonstrates this more clearly, he believed, than the role of money. “The power of money to bridge distances enables the owner and his possessions to exist so far apart that each of them may follow their own precepts to a greater extent than in the period when the owner and his possessions still stood in a direct mutual relationship, when every economic engagement was also a personal one, and when every change in personal direction or position meant, at the same time, a corresponding change in economic interests.”40 As David Frisby has observed, Simmel saw modern life as a world of meanings, an essentially aesthetic experience.41 Whereas Stein, Weber, Luhmann, and Foucault understand modernity from the perspective of the producer and manager, Simmel, akin to Kafka, reminds us that the role of the consumer (the pensioner, the claimant, the indigent, the neurasthenic) offers creative and meaningful possibilities for the individual. In invoking the ideas of these social theorists, I do not intend to imply that I subscribe to their individual projects and agendas in toto.42 But taken together, Stein, Weber, Luhmann, Foucault, and Simmel have identified a problem and a Page 12 → set of terms by which to pose fundamental questions about the modern welfare state. What rationalities have governed the ways in which the modern state has construed and handled the problems (dislocation, conflict, insecurity, mistrust) that have accompanied modernity? What consequences have these rationalities had for modern understandings of health, work, political participation, and government? How have consumers within the welfare state adapted to bureaucratic categories and processes? What reciprocal impact have these consumers had on the welfare state? In answering these questions, I wish to bring the methods and concerns of social and cultural history as well as the history of science and medicine to the political history of the welfare state. The Historiography of the German Welfare State This then will not be a conventional political history of the German welfare state (Sozialstaat).43 My focus requires that I deviate from traditional histories of German and European social security systems in two important ways. First, it necessitates a different approach to the German state. It has long been the accepted wisdom of German historiography that central Europe has been the home of a strong central-state tradition. Classical legal theory in Germany has characterized the state as uniquely composed of three features: the subjects of the state (das Staatsvolk), the territory of the state (das Staatsgebiet), and state power (die Staatsgewalt). Emphasis has conventionally been placed on the latter, resulting in an understanding of the state primarily as an instrument of domination.44 This view of modern German society as subject to an authoritarian central state now appears less compelling. This

is certainly due in part to those criticisms lodged against a presumed German Sonderweg.45 But the image also Page 13 → fails to heed innovations in contemporary social theory that make the practice of statecraft the focus of attention.46 Granted that domination (Herrschaft) represents a long-standing, self-avowed prerogative of the state, as a social practice, however, it has assumed many historical forms and cannot easily be equated with physical force and absolute compulsion.47 Historical changes in the development of the state also lend credence to the idea that statecraft be seen as more than a matter of domination. In the nineteenth century, European states increased their functions by assuming new responsibilities, for example participating in the banking structure, protecting private investments, encouraging industrialization, and renovating urban centers. Yet, at the same time, they retreated from other arenas of social conflict, for instance in the relations between capital and labor, producer and consumer, believer and nonbeliever, and lender and borrower.48 By the late nineteenth century, the European state was assuming more formative functions, taking over “the provision of services that hitherto had been left to private hands, whether it entrusted private persons with public tasks, coordinated private economic activities within the frame of an overall plan, or became active itself as a producer and distributor.”49 State action in many domains after the fall of the Old Regime therefore appears to have been more pervasive, yet less coercive, than classical legal theory has held.50 Historical inquiry into the significance of the welfare state for modern and contemporary German society therefore needs to address the matter of the forms of state activity. This means, as Geoff Eley has observed, reconsidering what the German state has actually done and recognizing “that the authoritarian parameters Page 14 → of the Imperial Constitution allowed much latitude for maneuver, negotiation, and compromise.”51 What goals, technologies, and social interactions have informed the state’s practices? What structural assumptions and oppositions have framed its perceptions and interventions? What changes, if any, have its forms of action undergone? These questions should be the point of departure for any investigation into modern statecraft. A genealogy of social security also requires—the second contrast with the conventional historiography of the welfare state—a shift in the object of inquiry. Until recently, most histories of social policy have adopted a political-economic perspective, assuming the significance of the welfare state to lie in its redistribution of income and resources. These histories, in turn, treat individual social programs as a “black box,” entities assessed in terms of inputs and outputs and whose inner workings are left opaque. This has had the effect of largely restricting scholarly discussion to two themes. First, the history of welfare-state politics is thereby reduced to a history of debates and negotiations between political parties and interest groups over legislation. This has been the case especially in the historiography of German social insurance. Accustomed to seeing nineteenth-century Germany as the vanguard of conservative and reactionary politics, analysts of the German social state have found it necessary to explain how such a state could have enacted the innovative and socially progressive legislation of the 1880s. Historians have typically attributed this to, among other things, Germany’s constitution, the strength and prestige of its bureaucracy, the paternalism of its social and economic forces, the timing of worker mobilization, the vitality of self-help schemes among artisans and miners, and, of course, Bismarck’s unique political leadership.52 The common and widely disseminated explanation has been that Germany’s powerful political and social interests used social policy as part of a larger strategy of “defensive integration and stabilization.” The social policies of the 1880s, in this argument, represented a way to simultaneously undermine the labor movement and buttress both feudal and industrial elites.53 Page 15 → Social insurance was therefore “an historical innovation that was radical in its methods, but conservative in its goals.”54 Debate about the history of German social policy, following the well-worn groove dug by the debate over a supposed German Sonderweg, has remained narrowly fixed on whether this constituted change from “above” or from “below.” In stating that “the history of social insurance is the history of its expansion,” Zöllner succinctly expresses the second fundamental theme that has emerged from the fixation on the redistributive functions and effects of social policy.55 For many historians and sociologists, the development of social insurance (and by extension, the welfare state) is synonymous with its proliferation: to study the history of social insurance has meant to study its growth. This equation carries with it a bias for the quantitative assessment of social policy. The meaning of programs like

social insurance is supposedly captured in an abstract language of statistics of income transfers and social expenditures. As Flora and Alber express it, the expansion of social security can be described “qualitatively by the risks and social categories successively covered, as well as in quantitative terms by the number of insured persons.”56 The significance of social policy is thereby reduced to that which can be measured in one of two ways: with reference to the kinds and size of expenditure or to the kinds and number of individuals covered. There are both theoretical and empirical problems with equating the history of the welfare state with organized interest politics and with the growth of expenditure. For one, such an equation often ignores the fact that the distribution of benefits has invariably involved defining the moral status of individuals, debating what constitutes proper collective action, and contesting political values, all issues that cannot be expressed in the numerical language of “social expenditure.”57 Second, it assumes what it should explain: how and why Page 16 → interest groups developed around welfare-state institutions and the extent of their influence. Above all else, however, it is worth asking whether the expansion of programs like social insurance is alone the defining feature of their histories. Recent years have witnessed a revival of interest in the history of German social policy, this time largely propelled by social, cultural, and gender-historical concerns. The result has been studies that have emphasized an alternative array of topics and developments. Monographs by Peter Baldwin, Hermann Beck, and George Steinmetz have shown that the Wilhelmian welfare state emerged out of a quite modern and novel set of political compromises and social adaptations on the part of nobles and the bourgeoisie.58 Historians also have identified a host of social questions besides class conflict that preoccupied the modern German welfare state: fertility; the public status of women; youth; and the “new poverty” caused by war, inflation, and mass unemployment.59 Within the history of social insurance in particular, Christoph Conrad and Deborah Page 17 → Stone, for instance, have demonstrated that German workers’ insurance was not a static “black box,” but rather was actively involved in defining, identifying, examining, and monitoring the elderly, the invalid, and the disabled.60 Jean Quataert has shown that German social insurance historically discriminated on the basis of a peculiarly gendered set of presuppositions.61 Finally, Florian Tennstedt’s and Christoph Sachße’s extensive research indicates that German social insurance over the last century has been marked by growing comprehensiveness and increasing centralization and professionalization.62 Clearly, then, in addition to legislative expansion, there are other features and trends in the one-hundred-year history of German social welfare worth emphasizing. From Disability to Entitlement My remarks up to now have been intended to make four basic points. First, social security has proven to be a powerfully attractive ideal and tool of the modern welfare state. Second, modern social theory has provided useful ways for understanding ideals and tools like social security as manifestations of certain forms of rationality. Third, a key to making sense of these rationalities of government lies in appreciating what any system historically means to both producers and consumers of policies and services. Last, recent research on the history of social welfare provides ample justification for seeing “Bismarck’s” welfare state in a broader European context as an innovative institution grappling with thoroughly modern problems. I therefore wish to enter the discussion of the history of German social policy in a particular way. I will assess the place of social security in modern German statecraft and politics by determining how and with what consequences Page 18 → social insurance operated. This means, above all, detailing the manner in which German social insurances took certain human concerns and conditions and translated them into specific policy problems with an accompanying set of remedial measures. At the same time, I will also assess the broader cultural meanings of those concerns and conditions that service providers and consumers brought with them into their bureaucratic encounters with one another. I will argue that German social policy and the problems and people it historically has attempted to treat have reciprocally defined one another. By understanding public policy as a knowledgeproducing enterprise, we will find that the modern German welfare state has been preoccupied less with the redistribution of wealth than with the risks, accidents, shocks, afflictions, and insecurities generated by industrial society.63 The state’s approach to addressing these challenges, I contend, was to attempt to transform the social conflicts generated by modern change into purely administrative matters and thereby tame them. This

administrative (verwaltungstechnische and staatswissenschaftliche) solution was the distinctly German solution to the nineteenth-century Social Question, but one that was only partly successful in realizing its pretensions. Social security, however, was and is a vast enterprise. Those institutions designed to assure it not only touch on worker safety, sick pay, pensions, employment assistance, labor rights, and job retraining, but also on macroeconomic policy, crime prevention, immigration, and environmental protection. To chronicle how all these concerns and undertakings became part of the general project of social security, however, is beyond the scope of any single monograph (or at least mine). While I will mention the broader features and implications of social insurance throughout this study, I will restrict myself to investigating one pivotal issue within social insurance: the problem of physical and mental disability. The study of disability is enjoying something of a resurgence in the humanities and social sciences. American sociologists of deviance in the 1950s and 1960s were among the first to give the topic systematic attention. New studies are revisiting the subject, however this time largely informed by the agendas of cultural anthropology and the critical theory of difference. This more recent research indicates that the experience, representation, and treatment of disabilities provide a unique window into the values of a society. Modern disability exists as both a socially and a biologically defined fate, has been frequently engaged as an object of both sentimentalization and demonization, and is associated with deviation from recognized norms. It therefore reveals a great deal about the status of the individual, ideals of achievement, access to power, Page 19 → and the terms of social inclusion and exclusion.64 All these matters lay firmly at the heart of the modern welfare state. There is also a second reason for focusing on disability: the presence, absence, or degree of a disability (Unfähigkeit) was the central criterion for compensation within modern German social insurance. Sickness insurance (instituted in 1883) offered strictly limited sick pay and ambulatory treatment to those suffering from acute ailments and deemed incapable of working. Chronic disabilities fell under the domain of the other three branches: accident insurance (1884) compensated eligible workers for chronic injuries suffered on the job, while invalid and old-age insurance (1891) provided benefits to those deemed for all practical purposes unemployable. All three of the latter insurances awarded deserving workers pensions, while accident and invalid insurance also offered rehabilitative services. If social insurance was designed to promote a measure of income security for workers, it did so only conditionally. Until 1927, benefits were awarded almost solely in cases of sickness, debility, decrepitude, or death of a breadwinner. German social insurance of the late nineteenth and early twentieth century was therefore conceived primarily as an insurance against risks to employees’ health and their ability to work.65 Disability in modern Germany therefore existed at the intersection of medical, actuarial, social, scientific, fiscal, bureaucratic, and legal reasonings. This places the topic firmly at the center of historical discussions over what has been termed “the politics of the body” or “biopolitics” (the politics of the productive and the reproductive self). Historians of German medicine and public health, more specifically, have attempted to assess the influence of natural science and clinical medicine on social policy in the nineteenth and twentieth centuries.66 But while Foucault understood biopolitics generally as a Western development dating back to early modern population policy, in the case of the modern German variant one cannot overlook its implication in genocidal politics. The biological chauvinism of the Nazi regime has understandably led numerous scholars to study the history of German hygiene, eugenics, pronatalism, and antinatalism in order to explain how the National Socialists so effectively and Page 20 → gruesomely equated social policy with racial policy.67 Like much of German historiography, however, the historical literature on modern German medicine has often been driven by a teleology that reads the specter of National Socialism into the nineteenth century. Seeking to explain the ease with which doctors and medicine were integrated into the Nazi order, scholars have singled out fields such as social hygiene and processes like the professionalization of physicians as symptomatic of medical complicity with authoritarianism, elitism, racism, and prophylactic intervention. The result has been the almost axiomatic acceptance of the thesis that, since the nineteenth century, the German welfare state and its beneficiaries were victims of a profound “medicalization” of everyday life. This contention, I will argue, is not borne out by the evidence. While physicians played a prominent role in social

insurance administration, their jurisdiction was clearly limited by other professionals involved. Likewise, social problems were not solely pathologized in clinical terms, but also were shaped by legal, bureaucratic, statistical, and economic rationalities. Moreover, insured workers, pensioners, and the disabled were far from passive objects, as they successfully invoked extra-institutional values and symbols to fight administrative decisions. Rather than being subject to the social control of modern experts and technologies, social insurance beneficiaries developed a deep-seated sense of entitlement to benefits that translated into an influential and overwhelming litigiousness. Social administration was therefore not only unable to domesticate the conflicts under its domain, but in fact was itself transformed by these conflicts. The development of a popular sensibility of social entitlement and how it emerged out of disability insurance is my central concern. This then is a history of the birth of the social entitlement state in Germany, the moment when individuals first came to articulate their sense of obligation and deservedness before the state in the terms of social security. Together, insured workers, pension claimants, and disabled pensioners around the turn of the century represented the first generations of a new, distinctly twentieth-century category of citizens characterized by their potential or persistent dependence on the welfare state. Unlike welfare recipients they owed their benefits not to local governments but to the national state. Moreover, receiving a benefit was not tainted with the stigma that had always accompanied poor relief, since the contributions of the recipients themselves helped finance the system. Theirs, I will argue, was a very different relationship to social bureaucracy than that of past or contemporary welfare beneficiaries: not simply permanent, but invested with a sense of proprietorship. The history of the social entitlement state must necessarily Page 21 → begin, then, with how the disabled were treated, and how they behaved both as objects and subjects within the bureaucratic world of social insurance. Social security and the politics of entitlement did not suddenly appear at the end of the nineteenth century, however. Developments in German statecraft dating back to the fifteenth century made the discovery of a “social” security and a sense of entitlement possible. But the pivotal moment in the emergence of a state in Germany defined and legitimated by its entitlement functions occurred between the years 1884 and 1933. From the founding of accident insurance under Bismarck to the passage of retrenchment measures under Brüning and Papen, the social entitlement state took shape. Since that time, social security in Germany has retained the same basic principles and techniques, albeit inflected by radically different ideologies. Thus, I mean something quite specific when I speak of the “birth of the social entitlement state” in Germany during the years 1884–1933. I do not intend to imply that social insurance constituted a revolutionary rupture in history, nor that social security did not change under the Third Reich, the Federal Republic, and the German Democratic Republic. Rather, I wish to emphasize that this period witnessed the emergence of a historically distinctive set of terms that informed both the politics and the structure of the German welfare state. Social insurance provided an idiom by which administrators, proponents, and critics alike of the modern welfare state have all been able to invoke its name. Not only the construction and expansion, but the criticism and dismantling, of German social policy follow from the ethos of social security and the politics of entitlement that first arose around 1900. Thus, attacks on the welfare state along with retrenchment policies should not be construed as part of the demise of social security, but rather as further manifestations of its making. Social insurance gave birth to its critics, and its critics returned the favor. The history of the social entitlement state is also a history of the modern form of political complaint.68 The historical investigation of social insurance practice requires peculiar kinds of sources. Standard histories of the welfare state have primarily confined themselves to laws, party and parliamentary protocols, and the publications of organized interest groups and contemporary analysts. These sources certainly must play a part in informing any history of social insurance, but they are inadequate to reach the problems I want to discuss. An alternative source of information is the vast files of the social insurance bureaucracy. German state archives possess a plethora of holdings documenting virtually every stage in insurance administration.69 This is due to the Page 22 → central state’s historical role as supervisor and mediator in insurance affairs. In this capacity, state offices routinely received records relating to any local event or development deemed important. The archives of the Prussian Ministry of Public Welfare, the Reich Ministry of Labor, and the Reich Insurance Office, to name

just a few, contain the traffic of correspondence between insurance claimants, insurance providers, hospital and sanatorium staff, consulted physicians, and state officials. Here in the utterances of the participants themselves—and in the very process of administration—are the pension claims of the insured, the assessment of claims by insurance boards, the physical exams carried out by attending physicians, the treatment programs of rehabilitative centers, the various judicial hearings, and the debates and discussions within state offices. Perhaps the most compelling cache of documents is that in the Federal Archive in Koblenz among the records of the Reich Insurance Office. Here I have examined detailed records of over two hundred individual pension cases in Germany between the years 1884 and 1933. Owing to the Reich Insurance Office’s position as the last instance of appeal for social insurance claims, the holdings provide an abundant and dense fund of source material for studying social insurance in its very making: petitions from individual claimants and insurance providers in their own handwriting, medical reports of certifying physicians, written testimony of witnesses, records of judicial hearings including the arguments of all parties concerned, the complaints of organized interest groups, and the internal discussions of Reich Insurance Office judges. This material has not yet been systematically exploited by historians of the welfare state. Social insurance was and is a nationwide service that is regionally and locally administered. Thus, while I will follow national trends, attention will also be paid to regional and local developments and peculiarities. In this regard, I have limited myself primarily to Prussia and its former provinces. I begin in chapter 2 by outlining those currents in German institutional history that helped to inform social insurance’s understanding of disability, from the early modern concept of security to the mid-nineteenth-century notion of public hygiene. Chapters 3 and 4 provide a general map of the work of late-nineteenth- and earlytwentieth-century social insurance, exploring the compensation procedure, the rehabilitation process, and the politics of both. The effects of the First World War and the revolution of 1918–19 on social policy and health care in Germany are examined in chapter 5. Chapter 6 then explores how the hyperinflation of the early 1920s affected public values and behavior toward debility, poverty, and entitlement in Germany. The chapter concludes with a discussion of the collapse of the nineteenth-century system of social insurance and Page 23 → the institutional merger of insurance with welfare and compensatory public assistance during the Weimar Republic. Chapter 7 traces the sources of the social-policy backlash of the late 1920s and early 1930s to the strange case of “pension neurosis,” a phenomenon that came to symbolize the failure of treatment programs, the promotion of greed and dependency, and the overpoliticization of policy matters. The concluding chapter chronicles the major developments after 1933 and assesses social security’s contribution to twentieth-century German political culture. Page 24 → 1. Peter Flora and Arnold J. Heidenheimer, eds., The Development of Welfare States in Europe and America (New Brunswick: Transaction, 1981); Gaston V. Rimlinger, “Capitalism and Human Rights,” Daedalus 112 (1983): 51–79; Douglas E. Ashford, The Emergence of the Welfare States (New York: Basil Blackwell, 1986); Peter Flora, ed., Growth to Limits: The Western European Welfare States Since World War II, 5 vols. (Berlin and New York: Walter de Gruyter, 1986–88). 2. Jens Alber, Der Sozialstaat in der Bundesrepublik 1950–1983 (Frankfurt and New York: Campus, 1989), 84–85. 3. Michael K. Brown, “Remaking the Welfare State: A Comparative Approach,” in Remaking the Welfare State: Retrenchment and Social Policy in America and Europe, ed. Michael K. Brown (Philadelphia: Temple University Press, 1988), 4. 4. Ramesh Mishra, The Welfare State in Capitalist Society: Policies of Retrenchment and Maintenance in Europe, North America, and Australia (Toronto and Buffalo: University of Toronto Press, 1990). 5. See the essays in Brown, Remaking the Welfare State and John S. Ambler, ed., The French Welfare State: Surviving Social and Ideological Change (New York and London: New York University Press, 1991). 6. Richard Hoefer, “Postmaterialism at Work in Social Welfare Policy: The Swedish Case,” Social Service Review 62 (September 1988): 383–95; Pekka Kosonen, “Flexibilization and the Alternatives of the Nordic

Welfare States,” in The Politics of Flexibility: Restructuring State and Industry in Britain, Germany, and Scandinavia, ed. Bob Jessop, Hans Kastendiek, Klaus Nielsen, and Ove K. Pedersen (Aldershot, England: Edward Elgar, 1991), 263–81; Arthur Gould, “The End of the Middle Way? The Swedish Welfare State in Crisis,” in New Perspectives on the Welfare State in Europe, ed. Catherine Jones (London and New York: Routledge, 1993), 157–76; Sven E. Olsson, Social Policy and Welfare State in Sweden (Lund: Arkiv, 1993), 245–87. 7. David Held, Political Theory and the Modern State (Stanford: Stanford University Press, 1989), 214–42; Bob Jessop, “Post-Fordism and the State,” in Post-Fordism: A Reader, ed. Ash Amin (Oxford and Cambridge, Mass.: Blackwell, 1994), 251–79; Malcolm Waters, Globalization (London and New York: Routledge, 1995), 96–123. 8. International Labour Office, From Pyramid to Pillar: Population Change and Social Security in Europe (Geneva: International Labour Office, 1989). The ILO predicts that this problem will be especially acute in Germany. 9. Hans Braun and Mathilde Niehaus, eds., Sozialstaat Bundesrepublik Deutschland auf dem Weg nach Europa (Frankfurt and New York: Campus, 1990); Reinhard Hujer, Hilmar Schneider, Wolfgang Zapf, eds., Herausforderungen an den Wohlfahrtsstaat im strukturellen Wandel (Frankfurt and New York: Campus, 1992). 10. Bob Deacon, “Developments in East European Social Policy,” in New Perspectives on the Welfare State, ed. Jones, 177–97; Jürgen Zerche, ed., Vom sozialistischen Versorgungsstaat zum Sozialstaat Bundesrepublik: Ausbau oder Abbau der sozialen Lage in den neuen Bundesländern? (Regensburg: Transfer, 1994). 11. Theo Sommer, “Der Riese schwankt,” Die Zeit 29 (23 July 1993): 3. 12. Joel F. Handler, “The Transformation of Aid to Families with Dependent Children: The Family Support Act in Historical Context,” New York University Review of Law and Social Change 16 (1987–88): 457–523. 13. Offering a good summary of the kinds of criticisms that have been waged against the contemporary welfare state even before the concerted backlash of the 1980s is Hugh Heclo, “Toward a New Welfare State?” in Development of Welfare States, ed. Flora and Heidenheimer, 383–406. For a summary of specific criticisms of the German welfare state, see Volker Hentschel, Geschichte der deutschen Sozialpolitik 1880–1980 (Frankfurt a.M.: Suhrkamp, 1983), 210–15; Lothar F. Neumann and Klaus Schaper, Die Sozialordnung der Bundesrepublik Deutschland (Frankfurt and New York: Campus, 1990), 214–24. 14. Robert Morris, ed., Testing the Limits of Social Welfare: International Perspectives on Policy Changes in Nine Countries (Hanover and London: University Press of New England, 1988); Paul Pierson, Dismantling the Welfare State? Reagan, Thatcher, and the Politics of Retrenchment (Cambridge and New York: Cambridge University Press, 1995). 15. Peter E. Abrahamson, “Welfare and Poverty in the Europe of the 1990s: Social Progress or Social Dumping?” International Journal of Health Services 21 (1991): 237–64; Stephan Leibfried, “Towards a European Welfare State? On Integrating Poverty Regimes into the European Community,” in New Perspectives on the Welfare State, ed. Jones, 133–56. 16. Jean-Pierre Jallade, “The Redistributive Efficiency of European Welfare States: Basic Issues,” in The Crisis of Distribution in European Welfare States, ed. Jean-Pierre Jallade (Stoke on Trent, England: Trentham, 1988), 1–23; “Is the Crisis Behind Us? Issues Facing Social Security Systems in Western Europe,” in Social Policy in a Changing Europe, ed. Zsuzsa Ferge and Jon Eivind Kolberg (Frankfurt a.M. and Boulder, Colo.: Campus/Westview, 1992), 37–56. 17. Tom W. Smith, “The Polls—A Report: The Welfare State in Cross-National Perspective,” Public Opinion Quarterly 51 (1987): 404–21; Jens Alber, “Is There a Crisis of the Welfare State? Cross-National Evidence from Europe, North America, and Japan,” European Sociological Review 4 (1988): 181–207. 18. Edeltraud Roller, Einstellungen der Bürger zum Wohlfahrtsstaat der Bundesrepublik Deutschland (Opladen: Westdeutscher, 1992). 19. On these critiques, see Claus Offe, “Democracy against the Welfare State? Structural Foundations of Neoconservative Political Opportunities,” Political Theory 15 (1987): 501–37; Boris Frankel, The PostIndustrial Utopians (Madison: University of Wisconsin Press, 1987); Pierre Rosanvallon, “The Decline of Social Visibility,” in Civil Society and the State, ed. John Keane (London and New York: Verso, 1988), 199–220; Neumann and Schaper, Sozialordnung der Bundesrepublik Deutschland, 214–24.

20. Wolfgang Zapf, Sigrid Breuer, Jürgen Hampel, Peter Krause, Hans-Michael Mohr, and Erich Wiegand, Individualisierung und Sicherheit: Untersuchungen zur Lebensqualität in der Bundesrepublik Deutschland (Munich: C. H. Beck, 1987). 21. Martin Greiffenhagen, “Aspects of Postmodernism in German Political Culture,” Debatte: Review of Contemporary German Affairs 5 (1997): 154–55. 22. One scholar has likened the reunification process in this regard to an insurance policy. See Wolfram Schrettl, “Transition with Insurance: German Unification Reconsidered,” Oxford Review of Economic Policy 8 (1992): 144–55. 23. Winfried Schmähl, ed., Sozialpolitik im Prozeß der deutschen Wiedervereinigung (Frankfurt a.M. and New York: Campus, 1992); Hujer, et al., Herausforderungen; Zerche, Versorgungsstaat. 24. Manfred Kuechler, “Political Attitudes and Behavior in Germany: The Making of a Democratic Society, ” in From Bundesrepublik to Deutschland: German Politics after Unification, ed. Michael G. Huelshoff, Andrei S. Markovits, and Simon Reich (Ann Arbor: University of Michigan Press, 1993), 33–58. 25. Göran Therborn, European Modernity and Beyond: The Trajectory of European Societies, 1945–2000 (London, Thousand Oaks, Calif., New Delhi: Sage, 1995), 299. 26. “Here again [in the realm of administration] pure theory cannot be of much use, and the influence of given circumstances is so great that any and all boundaries for the same task of administration at different times and places are by nature very different. That which here appears absolutely correct and necessary becomes in another time and place, because of concrete circumstances, too much, in a third too little. Nothing is therefore more absurd than to assess the value of administration solely according to the existing content of its statutes, and to reduce that which is called settlement [Vergleichung] to a simple weighing and calculating [Messen und Rechnen].” Lorenz von Stein, Die Verwaltungslehre, Bd. 2: Die Lehre von der Innern Verwaltung (Stuttgart: J. G. Cotta, 1866), 60–61. 27. Lorenz von Stein, System der Staatswissenschaft, vol. 1 (Stuttgart and Tübingen: J. G. Cotta’schen Verlag, 1852), 16. 28. Max Weber, Economy and Society: An Outline of Interpretive Sociology, vol. 2 (Berkeley, Los Angeles, London: University of California Press, 1978), 975. 29. Harvey S. Goldman, “Weber’s Ascetic Practices of the Self,” in Weber’s Protestant Ethic: Origins, Evidence, Contexts, ed. Hartmut Lehmann and Guenther Roth (Cambridge and New York: Cambridge University Press, 1993), 161–77. 30. Scott Lash, “Modernity or Modernism? Weber and Contemporary Social Theory,” in Max Weber, Rationality, and Modernity, ed. Scott Lash and Sam Whimster (Boston: Allen & Unwin, 1987), 374. 31. For a general introduction to Luhmann’s work, see Detlef Horster, Niklas Luhmann (Munich: C. H. Beck, 1997). 32. Georg Kneer, Rationalisierung, Disziplinierung, und Differenzierung: Zum Zusammenhang von Sozialtheorie und Zeitdiagnose bei Jürgen Habermas, Michel Foucault, und Niklas Luhmann (Opladen: Westdeutscher, 1996), 397–98. 33. Niklas Luhmann, Legitimation durch Verfahren (Neuwied am Rhein and Berlin: Luchterhand, 1969). 34. Manfred Kopp and Hans-Peter Müller, Herrschaft und Legitimität in modernen Industriegesellschaften: Eine Untersuchung der Ansätze von Max Weber, Niklas Luhmann, Claus Offe, Jürgen Habermas (Munich: tuduv, 1980), 90–98. 35. For a good recent assessment of the uses and limitations of Foucault’s notions in historical research, see Jan Goldstein, ed., Foucault and the Writing of History (Oxford and Cambridge, Mass.: Blackwell, 1994). 36. Some of Foucault’s most relevant works in this regard are The Archaeology of Knowledge and the Discourse on Language (New York: Pantheon, 1972); Discipline and Punish: The Birth of the Prison (New York: Vintage, 1979); Power/Knowledge: Selected Interviews and Other Writings, 1972–1977 (New York: Pantheon, 1980). 37. Michel Foucault, The History of Sexuality: An Introduction, vol. 1 (New York: Vintage, 1990), 143. I emphasize the word “attempt” here, because Foucault makes it clear in the sentence that follows that he did not believe this project had succeeded: “It is not that life has been totally integrated into techniques that govern and administer it; it constantly escapes them.” 38. Colin Gordon, “Governmental Rationality: An Introduction,” in The Foucault Effect: Studies in Governmentality, ed. Graham Burchell, Colin Gordon, and Peter Miller (Chicago: University of Chicago

Press, 1991), 3. 39. Colin Gordon, “The Soul of the Citizen: Max Weber and Michel Foucault on Rationality and Government,” in Max Weber, ed. Lash and Whimster, 298. See also Jacques Donzelot, The Policing of Families (New York: Pantheon, 1979) and François Ewald, Der Vorsorgestaat (Frankfurt a.M.: Suhrkamp, 1993). 40. Georg Simmel, The Philosophy of Money (Boston: Routledge & Kegan Paul, 1978), 333. He also contended that money’s abstract character granted greater freedom from institutions and peers and, thereby, of expression and conduct. 41. David Frisby, Fragments of Modernity: Theories of Modernity in the Work of Simmel, Kracauer, and Benjamin (Cambridge: MIT Press, 1986), 38–108. 42. As this book makes clear, I depart from each of them in significant ways. Stein, I conclude, was far too optimistic about the potential for administration to solve social problems. Weber too loosely periodized the phenomenon of disenchantment and overestimated bureaucracy’s intention and ability to dehumanize. Luhmann’s autopoietic model is too deterministic and disembodied to be usefully extended very far in historical writing. Recent medical and social histories show that Foucault periodized incorrectly, universalized singularly French developments, and all too rarely considered the claims that subjects made on objective structures. Finally, Simmel’s perspective appears rather historically limited, his methods and conclusions best confined to mass consumer society. 43. Germans during the period I am examining typically spoke of the “Sozialstaat,” the “sozialen Volksstaat,” or the “sozialen Rechtsstaat.” Rather than referring to the “social state,” I will use the less awkward English term “welfare state” to generically refer to German social policy and its institutions. On these distinctions, see Werner Abelshauser, “Die Weimarer Republik—Ein Wohlfahrtsstaat?” in Die Weimarer Republik als Wohlfahrtsstaat: Zum Verhältnis von Wirtschafts- und Sozialpolitik in der Industriegesellschaft, ed. Werner Abelshauser (Stuttgart: Franz Steiner, 1987), 9–31. 44. Roman Herzog, “Der Staat in der deutschen Staatsrechtslehre des 20. Jahrhunderts,” in Vom Wohlfahrtsausschuß zum Wohlfahrtsstaat: Der Staat in der modernen Industriegesellschaft, ed. Gerhard Ritter (Cologne: Markus, 1973), 13–28. 45. The chief question in this debate has been whether Germany in the nineteenth century followed a similar path to modernization and liberalism as the rest of Europe (in particular, England) or whether it in fact charted its own “special path” into modernity, one which rejected the basic tenets of liberal democracy and buttressed the elites of the old regime. For the classic, programmatic statements of the two camps, see HansUlrich Wehler, The German Empire, 1871–1918 (Leamington Spa, England, and Dover, N.H.: Berg, 1985) and David Blackbourn and Geoff Eley, The Peculiarities of German History: Bourgeois Society and Politics in Nineteenth-Century Germany (Oxford and New York: Oxford University Press, 1984). 46. Most notably, the French sociologist Pierre Bourdieu has criticized the manner in which social scientists treat their own abstractions “as realities endowed with social efficacy.” Bourdieu, on the other hand, seeks to “reintroduce time into the theoretical representation of practice,” sees relationships as something people make and do, and understands structures as mediating, not determining, human interactions. See Pierre Bourdieu, Outline of a Theory of Practice (Cambridge: Cambridge University Press, 1977) and The Logic of Practice (Stanford: Stanford University Press, 1990). 47. Alf Lüdtke, “Einleitung: Herrschaft als soziale Praxis,” in Herrschaft als soziale Praxis: Historische und sozial-anthropologische Studien, ed. Alf Lüdtke (Göttingen: Vandenhoeck & Ruprecht, 1991), 9–63. 48. Raymond Grew, “The Nineteenth-Century European State,” in Statemaking and Social Movements: Essays in History and Theory, ed. Charles Bright and Susan Harding (Ann Arbor: University of Michigan Press, 1984), 83–120. 49. Jürgen Habermas, The Structural Transformation of the Public Sphere: An Inquiry into a Category of Bourgeois Society (Cambridge: MIT Press, 1992), 147. 50. Eve Rosenhaft and W. R. Lee, “State and Society in Modern Germany—Beamtenstaat, Klassenstaat, Sozialstaat,” in State, Social Policy, and Social Change in Germany, 1880–1994, ed. W. R. Lee and Eve Rosenhaft (Oxford and New York: Berg, 1997), 1–36. 51. Geoff Eley, “German History and the Contradictions of Modernity: The Bourgeoisie, the State, and the Mastery of Reform,” in Society, Culture, and the State in Germany, 1870–1930, ed. Geoff Eley (Ann Arbor: University of Michigan Press, 1996), 95.

52. W. J. Mommsen, ed., The Emergence of the Welfare State in Britain and Germany (Kent: Croom Helm, 1981); Detlev Zöllner, “Germany,” in The Evolution of Social Insurance, 1881–1981: Studies of Germany, France, Great Britain, Austria, and Switzerland, ed. Peter A. Köhler, Hans F. Zacher, and Martin Partington (New York: St. Martin’s, 1982), 1–92; Gerhard Ritter, Social Welfare in Germany and Britain: Origins and Development (Leamington Spa, England, and New York: Berg, 1986) and Der Sozialstaat: Entstehung und Entwicklung im internationalen Vergleich (Munich: R. Oldenbourg, 1989). 53. Gaston V. Rimlinger, Welfare Policy and Industrialization in Europe, America, and Russia (New York: John Wiley & Sons, 1971); Peter Flora and Arnold J. Heidenheimer, “The Historical Core and Changing Boundaries of the Welfare State,” in Development of Welfare States, ed. Flora and Heidenheimer, 17–34; J. Tampke, “Bismarck’s Social Legislation: A Genuine Breakthrough?” in Emergence, ed. Mommsen, 71–83; H.-P. Ullmann, “German Industry and Bismarck’s Social Security System,” in Emergence, ed. Mommsen, 133–49; Monika Breger, Die Haltung der industriellen Unternehmer zur staatlichen Sozialpolitik in den Jahren 1878 bis 1891 (Frankfurt: Haag und Herchen, 1982); Lothar Machtan, “Workers’ Insurance versus Protection of the Workers: State Social Policy in Imperial Germany,” in The Social History of Occupational Health, ed. Paul Weindling (London: Croom Helm, 1985), 209–22. 54. Gaston V. Rimlinger, “The Emergence of Social Insurance: European Experience Before 1914,” in Beiträge zu Geschichte und aktueller Situation der Sozialversicherung, ed. Peter A. Köhler and Hans F. Zacher (Berlin: Duncker & Humblot, 1983), 122. 55. Zöllner, “Germany,” 81. This view has been particularly popular with sociologists such as Alber, Flora, and Heidenheimer. 56. Peter Flora and Jens Alber, “Modernization, Democratization, and the Development of Welfare States in Western Europe,” in Development of Welfare States, ed. Flora and Heidenheimer, 52. 57. Morris Janowitz, Social Control of the Welfare State (Chicago and London: University of Chicago Press, 1976). In more general terms, historian William Reddy has criticized historians for their “paycheck fetishism” that reduces social relations to the exchange of monetary values. See William M. Reddy, Money and Liberty in Modern Europe: A Critique of Historical Understanding (Cambridge: Cambridge University Press, 1987). 58. Peter Baldwin, The Politics of Social Solidarity: Class Bases of the European Welfare State, 1875–1975 (Cambridge and New York: Cambridge University Press, 1990); George Steinmetz, Regulating the Social: The Welfare Sate and Local Politics in Imperial Germany (Princeton: Princeton University Press, 1993); Hermann Beck, The Origins of the Authoritarian Welfare State in Prussia: Conservatives, Bureaucracy, and the Social Question, 1815–1870 (Ann Arbor: University of Michigan Press, 1995). 59. On fertility as a public-policy issue, see Gisela Bock, Zwangssterilisierung im Nationalsozialismus: Studien zur Rassenpolitik und Frauenpolitik (Opladen: Westdeutscher, 1986); Cornelia Usborne, The Politics of the Body in Weimar Germany: Women’s Reproductive Rights and Duties (Ann Arbor: University of Michigan Press, 1992); Atina Grossmann, Reforming Sex: The German Movement for Birth Control and Abortion Reform, 1920–1950 (New York and Oxford: Oxford University Press, 1995). Regarding the renegotiation of women’s role in German public life, see Christiane Eifert, Frauenpolitik und Wohlfahrtspflege: Zur Geschichte der sozialdemokratischen “Arbeiterwohlfahrt” (Frankfurt and New York: Campus, 1993); Kathleen Canning, Languages of Labor and Gender: Female Factory Work in Germany, 1850–1914 (Ithaca and London: Cornell University Press, 1996); “Women and the Welfare State in the Weimar Republic,” Special Issue, Central European History 30 (1997). On youth as an object of social policy, see Elizabeth Harvey, Youth and the Welfare State in Weimar Germany (Oxford: Clarendon, 1993); Marcus Gräser, Der blockierte Wohlfahrtsstaat: Unterschichtjugend und Jugendfürsorge in der Weimarer Republik (Göttingen: Vandenhoeck & Ruprecht, 1995); Edward Ross Dickinson, The Politics of German Child Welfare from the Empire to the Federal Republic (Cambridge, Mass., and London: Harvard University Press, 1996). Finally, for discussions of the “new poverty” and its potential for political mobilization, see Gerald Feldman, The Great Disorder: Politics, Economics, and Society in the German Inflation, 1914–1924 (Oxford: Oxford University Press, 1993); David F. Crew, Germans on Welfare: From Weimar to Hitler (Oxford: Oxford University Press, 1998); Young-Sun Hong, Welfare, Modernity, and the Weimar State, 1919–1933 (Princeton: Princeton University Press, 1998); Belinda Davis, Home Fires Burning: Food, Politics, and Daily Life in World War I Berlin (Chapel Hill: University of North Carolina Press, 1999).

60. Deborah A. Stone, The Disabled State (Philadelphia: Temple University Press, 1984); Christoph Conrad, Vom Greis zum Rentner: Der Strukturwandel des Alters in Deutschland zwischen 1830 und 1930 (Göttingen: Vandenhoeck & Ruprecht, 1994). 61. Jean H. Quataert, “Social Insurance and the Family Work of Oberlausitz Home Weavers in the Late Nineteenth Century,” in German Women in the Nineteenth Century: A Social History, ed. John C. Fout (New York and London: Holmes & Meier, 1984), 270–94; “Workers’ Reactions to Social Insurance: The Case of Homeweavers in the Saxon Oberlausitz in the Late Nineteenth Century,” Internationale wissenschaftliche Korrespondenz zur Geschichte der deutschen Arbeiterbewegung 20 (March 1984): 17–35; “The Politics of Rural Industrialization: Class, Gender, and Collective Protest in the Saxon Oberlausitz of the Late Nineteenth Century,” Central European History 20 (June 1987): 91–124; “Woman’s Work and the Early Welfare State in Germany: Legislators, Bureaucrats, and Clients before the First World War,” in Mothers of a New World: Maternalist Politics and the Origins of Welfare States, ed. Seth Koven and Sonya Michel (New York and London: Routledge, 1993), 159–87. 62. Florian Tennstedt, “Sozialgeschichte der Sozialversicherung,” in Handbuch der Sozialmedizin, vol. 3, Maria Blohmke, Christian von Ferber, et al. (Stuttgart: Ferdinand Enke, 1977), 385–492; Christoph Sachße and Florian Tennstedt, Geschichte der Armenfürsorge in Deutschland, 3 vols. (Stuttgart: W. Kohlhammer, 1980–92). 63. For an excellent discussion of these themes, see Dietrich Milles, ed., Gesundheitsrisiken, Industriegesellschaft, und soziale Sicherungen in der Geschichte (Bremerhaven: Wirtschaftsverlag NW and Verlag für neue Wissenschaft, 1993). 64. See Benedicte Ingstad and Susan Reynolds Whyte, eds., Disability and Culture (Berkeley, Los Angeles, and London: University of California Press, 1995); Lennard J. Davis, ed., The Disability Studies Reader (New York and London: Routledge, 1997); David Mitchell and Sharon Snyder, eds., The Body and Physical Difference: Discourses of Disability in the Humanities (Ann Arbor: University of Michigan Press, 1997). 65. As Christoph Conrad shows, up to the end of World War II, even old-age insurance—one of the original branches of German social insurance—did not operate as a simple retirement pension system. Rather, it largely defined old age as a case of invalidism, thereby placing an emphasis on medical assessment and pathologizing old age as an infirmity. See Conrad, Vom Greis zum Rentner, 130–258. It is only with the introduction of unemployment insurance in 1927 that social insurance began to seriously depart from this medical understanding of social problems. 66. See my discussion of this literature in chapter 4. 67. See chapter 8 for my discussion of the literature on National Socialism. 68. This point is also emphasized by Crew, Germans, 79–88. 69. I was unable to track down any extant records of the local insurance courts. Most archivists with whom I spoke believed they had been destroyed in the war. My requests to examine the records of individual insurance boards were consistently denied. This is certainly a loss for historians; however, many of these same documents can also be found in state archives and, in the case of accident insurance, in the small holdings of the Hauptverband der gewerblichen Berufsgenossenschaften in St. Augustin.

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CHAPTER 2 Insurance Becomes Social Policy: The Sources of Social Concern in Nineteenth-Century Germany Students of modern German history are familiar with the conventional story line about the establishment of German social insurance at the end of the nineteenth century. According to this narrative, the social policies of the 1880s and 1890s are to be understood as a partly sincere, partly cynical attempt on the part of a political coterie to stifle the labor movement and preserve an authoritarian social order.1 This depiction is not, from my perspective, wholly incorrect. It is, however, incomplete. It fails to address the question of how, at the end of the nineteenth century, it could have seemed as reasonable and compelling as it did for the German state to adopt insurance as the principal means by which it would relate to its working population. What in the history of modern Germany made this marriage of statecraft and insurance possible? How did insurance appear in the nineteenth century as a credible tool of social policy? This chapter traces the sources of this designedly “social” insurance to three discursive and institutional developments: changes in the form and mission of the German state since the end of the fifteenth century, the emergence in the nineteenth century of a concept of “society” and “social” problems, and the growth of close ties between science, medicine, Christian thought, and social reform. By 1880, these three shifts had established the terms and parameters of Germany’s public discussion about how to reorganize a society stripped of its traditional, feudal bonds. Thus, while German legislators and policymakers were indeed obsessed with combating the growth of socialism, most saw the latter as a symptom, not the disease. The forms their reformist plans assumed were dictated by a historically peculiar diagnosis: the belief that the decay of Page 26 → feudal society required a restoration of civic trust, security, and certainty, in short some form of “soziale Sicherheit.” Ideas and developments in statecraft, social thought, reform, and science together helped give shape to this specific, new policy need, one which insurance eventually appeared uniquely qualified to address. Social Insurance: The Result of Bismarckian Party Politics? Germany, more than any other nation, is credited with giving birth to the idea and institution of social insurance. With Bismarck as its influential advocate, state-sponsored, compulsory workers’ insurance was first put into practice in Germany at the end of the nineteenth century: first sickness insurance in 1883, then accident insurance in 1884, and invalid and old-age insurance in 1891.2 The three original branches of social insurance provided coverage for tens of millions of (mostly male) wage earners along with their dependents. Initially, coverage was granted to skilled manual laborers in industry and to their widows and orphans, but this was later extended to domestic servants, apprentices, agricultural workers, and junior clerks and administrative personnel. By 1911, when the three branches of insurance were codified, social insurances all told covered virtually every wage earner, domestic servant, and low-level white-collar worker in Germany (see tables 1 and 2).3 How the newly formed German nation-state arrived at this massive social project has assumed a prominent part in the historiography of modern Germany. The standard account centers on the party politics leading up to the legislation of the 1880s. In the decade following the revolutions of 1848–49, paternalistic industrialists and Conservative Prussian legislators passed a series of laws designed to reform the practice of child labor, worker self-help administration, and existing poor laws. The centerpiece of these reforms was legislation intended to promote the proliferation of self-help sickness funds among the growing industrial working class. Perceiving the rise of an urban proletariat as “the germ of anarchy,” a coalition of Conservative and Liberal politicians embraced the sickness funds as a means to, in the words of the liberal industrialist Friedrich Harkort, “create a conservative class of pensioners in place of a proletariat.”4 Page 27 →

German unification in 1871 brought with it further challenges for Germany’s leaders. Economic depression in the 1870s seemed only to feed the growth of socialism.5 In addition, Bismarck (Reich chancellor, 1871–90) had become convinced by 1877 that the new German parliament was too frequently interfering with the power of the executive branch of government. He therefore decided on a set of policies intended to address the Reich’s financial woes without at the same time increasing the Reichstag’s budgetary powers: a system of protective tariffs and state monopolies, along with measures designed to undermine Social Democracy.6 This resulted in three important changes in the configuration of German parliamentary politics of the late 1870s and early 1880s. First, the government took a decidedly conservative turn, breaking with the Liberals, who had had the single largest representation in the Prussian Assembly since 1858 and in the Reichstag since 1871. Second, now seeking the support of only the moderate and right-wing elements of the National Liberal Party, Bismarck succeeded in dividing the liberal movement. With the exception of the 1887 elections, the Page 28 → National Liberals from this moment on remained a minority in parliament. Finally, the so-called Socialist Law prohibiting all Social Democratic, socialist, and communist associations, assemblies, and pamphlets was passed in 1878 with the approval of conservatives and liberals. Abolished only in 1890, the law served to further radicalize the labor movement and did nothing to squelch increasing electoral support for the Social Democrats throughout the nineteenth century.7

On the eve of the social insurance laws of the 1880s, German lawmakers were therefore being driven by a conservative, but reformist, political agenda that understood the growth of an impoverished and propertyless working class as the force behind an axiomatically threatening socialist movement. Many in government circles were therefore receptive to the idea that other, more positive “countermeasures” than the antisocialist law were needed to solve “the Worker Question.” As far back as 1871, Conservative leaders Hermann Wagener and Karl Stumm-Halberg, officials in the Prussian Ministry of Trade, and Bismarck all touted a national insurance for industrial workers against sickness, disability, and decrepitude as a means to deal more “sympathetically” with worker demands.

The passage of social insurance legislation in the 1880s came about, then, through the support of four major sets of political actors:8

1. Bismarck. As chancellor, Bismarck was the leading advocate of workers’ insurance. His vision was of a comprehensive and obligatory insurance, firmly centered in accident insurance, that excluded private insurance companies and made the central state the direct provider of benefits. Parliamentary opposition to a centralized system eventually forced him to compromise, however. Sickness insurance, passing easily in 1883, simply consolidated the existing system of self-administered sickness funds, while invalid and old-age insurance legislation (1889) created a pension system subsidized by the state. Bismarck was pivotal, nonetheless, in organizing employers into corporative occupational associations to administer accident insurance and in ensuring that all insurances were compulsory and public. 2. Bureaucrats. Social insurance legislation was, to a great extent, the product of German state bureaucracy. Numerous Reich and Prussian officials—including Robert Bosse in the Reich Ministry of State, Karl Heinrich von Boetticher and Tonio Bödiker in the Reich Office and Ministry of Interior, and Theodor Lohmann and Karl Hofmann in the Prussian Ministry of Trade—were among its first advocates and its most influential developers. Their approach to social problems combined a pragmatic, empirical, and bureaucratic liberalism with socially conservative anxieties and aims. This was a social conservatism that had influenced Prussian social policy since 1815: an overriding devotion to the interests of the liberal state coupled with a belief in the duty of imperial authority to paternalistically ensure the moral and social well-being of its subjects.9 It was these civil servants who collected data, came up with concrete insurance schemes, and prepared bills for the Reichstag. 3. Industrialists. While small- and medium-sized firms were reserved or downright antagonistic toward social insurance, heavy industry and big business were vocal supporters of the idea, actively cooperating Page 30 → with officials in drafting legislation. Indeed, industrialist Louis Baare’s (director of the Bochumer Association for Mining and Cast Iron Manufacturing) proposal for an insurance against all occupational accidents, written at the request of the Prussian Ministry of Trade, provided the blueprint for legislative debate over accident insurance.10 In part, the backing of industrialists was a function of two goals: to undermine socialism and the trade unions by stabilizing factory and political hierarchies and to promote and maintain labor power (Arbeitskraft). Their support also derived from their distinctive self-image. Many saw themselves as the new feudal lords of bourgeois society, their factories an extension of their households. Thus, they genuinely felt a sense of Christian, paternalistic responsibility toward their workers, who were treated as little more than dependents.11 By the time debate over a proposed social insurance began, some of Germany’s most famous industrialists (including Hansemann, Mevissen, Harkort, Siemens, Borsig, Krupp, Stumm, and Dolfuss) already had experience creating pension funds, hygienic workplaces and residences, infant-care facilities for working mothers, and schools for children. 4. The Reichstag. The German parliament approved the social insurance laws of the 1880s with a majority composed of Conservatives and members of the Catholic Center Party, along with a handful of Liberal representatives. The Conservatives, wedded to the idea of a paternalistic state, had been for some time one of the leading advocates of workers’ insurance. The Center Party, becoming the single largest bloc in the Reichstag after elections in 1881, needed convincing, however. Prussian policies of the 1870s directed against Catholic clergy combined with a strong particularism among Bavarian Catholics made representatives fearful of central state authority. The government was successful in gaining the backing of the Catholic contingent in the Reichstag only by conceding a corporative (ständisch), self-administrated structure to the insurances.

It is not my contention that the preceding description of the party politics leading up to social insurance legislation is incorrect: one cannot fail to acknowledge the prominent roles played by Bismarck, conservatism, industrialists, Page 31 → bureaucrats, and antisocialist sentiment. The shortcoming of this narrative is what it leaves largely undiscussed. Why insurance? How was insurance, of all things, supposed to solve the social conflicts and publichealth problems facing the German nation-state? The answers to these questions require ascertaining just what

statecraft, insurance, and public-health administration had been until this point. Explaining their convergence necessarily leads us away from narratives of legislative history and toward those ideas and institutions that provided the “mental tools” and material precedents which made it possible to think social insurance. Security, Welfare, and the State in Post-Reformation Germany The coupling of the German state and insurance can be directly linked to a tradition with a long history in central Europe.12 A long-standing principle of governance in German states held that (1) the economic prosperity, the territorial security, and the general welfare of the realm were all contingent upon one another, and (2) together, their fates were inherently determined by and in terms of the state. This principle informed German statecraft well into the twentieth century. Over time, however, social and economic changes led to a rethinking and revision of both the aim and form of the state in modern times, thereby opening up new possibilities for government activity. The Police State: Managing the Ökonomie The first comprehensive articulation of this approach to government came in the form of the late medieval and early modern police state.13 From the late fifteenth century, the notion of policing (Polizei) appeared in the political theory of cities, as German municipalities began codifying regulations designed to look after the “public order.” These measures, aimed at regulating behavior and disciplining attitudes, covered a wide range of activities: the observance of Page 32 → Christian ritual, the settling of family conflicts, the institutionalization of the poor and the insane, the promotion of productive enterprises, the protection of forests, the training of lawyers, doctors, pharmacists, and teachers, and the introduction of building and hygienic codes, to name just a few. Central European principalities joined in administering these police ordinances in the late sixteenth century to likewise ensure the public peace and security of the realm. Over the course of the seventeenth and eighteenth centuries, absolutist theories of legitimation and the doctrines of cameralism made their way into police administration, helping to justify the notion of “good policing” (guter Policey). The latter approached the problem of public order in terms of promoting the “common good” (gemeines Bestes) and of enhancing the “welfare” (Wohlfahrt) of the state’s subjects. By the 1800s, police regulations routinely assumed the administrative responsibility of caring for the “well-being” (Wohl) and “good fortune” (Glück) of the population, all in an effort to improve and maintain the productivity of the sovereignty.14 Above all else, this form of governance must be seen as self-consciously paternalistic and patriarchal. The territorial state’s relationship to the social order was patterned on the ideal of the Greek household (oikos). The wealth, power, and security of the ruler were presumed to be rooted in the economic welfare of the realm. Since, however, there existed no “state” or “economy” apart from the sovereign’s household, governing meant regulating, maintaining, and reproducing the human and natural resources of the Ökonomie as an autonomous unit.15 Three concepts were implicit here: the notion of the Wirt, or caretaker, hearkened back to the agricultural foundations of the social order and to the director who centrally and hierarchically managed a variety of relations and tasks; Haus or das ganze Haus (the complete household), represented as a place where a special “peace” prevails, remained a persistent feature of most corporate constitutions at this time; and, finally, both concepts were understood to imply Herrschaft (domination). The father, the lord, and the sovereign were considered to share a common and necessary ability to give orders and to thereby serve as the organizing, unifying principle within their respective domains.16 Page 33 → The key to managing the sovereignty lay, then, in the corporately appropriate administration of needs within the territory.17 The police state looked to the ruler as an informed, paternal figure who used administration to thoughtfully, but forcefully, manage his jurisdiction. Policing as a system of rational thought and practices conflated politics, economics, householding, morality, statistics, medicine, pedagogy, and agronomy under one governing science. In this way, sovereign rule in the territorial police state was understood to be constitutive of general prosperity, welfare, and security.18

The Emergence of a New Sphere of State Action By the mid-nineteenth century, two important revisions in the police notion of statecraft had led to the demarcation of a new sphere of public action. The first relevant change came in the seventeenth century. Security (Sicherheit) since the Middle Ages had commonly been associated with “securing peace” and providing general protection over the land and its people. The development of the princely state and its military apparatus, however, reinforced a nexus that linked war, peace, and security. This ultimately gave rise to the idea of “assurance” (Versicherung) through peace treaties, alliances, defensive organizations, and waging war. The strong martial elements of this kind of assurance emphasized relations between European states and led some theorists to distinguish between internal, domestic security (domestica securitate) and security from foreign, external threats. By the mid-eighteenth century, the “external” elements had largely been excised from the police notion of security. Policing became an extension of domestic security, acquiring its own idea of assurance, now associated with the police state’s domestic goal of promoting the common good.19 The second modification in police administration came with the gradual emergence of the Rechtsstaat (state of law). By the sixteenth century, German law and legal theory had begun to secularize the medieval vision of Respublica christiana, as concepts such as state reason, sovereignty, and contract gained ever wider currency. Over the next two centuries, German jurists turned to seventeenth-century constitutional theory, natural right theory, and the philosophy of rationalism to construct a domain of public law (ius publicum) whose task, Page 34 → among others, was to determine the boundaries of the state’s power to rule. By the end of the eighteenth century, Germany in general, and Prussia in particular, had evolved a general legal code of state (Allgemeines Staatsrecht) designed to discern these boundaries on what was considered to be a scientific and rational basis.20 It was during the course of the reforms of the Prussian state in the years 1791–1848, however, that the Rechtsstaat came into serious conflict with traditional police measures. The implementation of the Allgemeines Landrecht (1791–94) over and against traditional, feudal laws and the institution of political reforms (1808–25) that liberated the peasants, established municipal self-administration, introduced free trade, and reconfigured the civilian and military administrations followed established precedent by retaining the state as the locus for managing society. The Prussian reformers were concerned less with questions of sovereignty and citizenship—recall that no notion comparable to the French citoyen was invented by any of the reforms—than they were with “freeing” productive forces. The state continued to be seen as a caretaker of the economy, with the latter now associated in the eyes of reformers with capitalist markets and forms of production. What was new in the Reform Era was that the central state now willingly placed restrictions on its activities vis-àvis the realm it governed.21 The Allgemeines Landrecht, for instance, operated on the principle of subsidiarity, leaving many local observances in place and privileging particular over general rights. Moreover, administrative reforms between 1807 and 1821 aimed at dismantling the feudal mastery of men over men. Reformers sought to replace this hierarchy with a statutory administration that (1) awarded subjects the widest possible range of economic freedoms, and (2) enticed propertied males to take part in administering government.22 “Selfadministration,” with the emphasis placed on the second term, was the watchword here.23 Prussia’s transition in the nineteenth century from police state to Rechtsstaat was marked, then, by a continued faith in the administratability of the social and economic order. At the same time, this faith was relatively tempered in Page 35 → its pretensions. By creating the position of the “official” along with the abstract idea of the “office,” the reforms carried on the process of divorcing the competence of the state from any one person.24 The state became a legal entity separate from both ruler and subject, an institution (Anstalt) standing “above individuals.”25 This proved to be of profound consequence for state action in the nineteenth and twentieth centuries. Medieval government had operated under a cosmology whereby law was found, not made. In contrast, jurisprudence and administration—legal positivism and worker safety provide two of the best examples of this—in the central Rechtsstaat made decision making a function of the coherence of laws and regulations, operating according to what Luhmann has called an “If/Then logic.”26 Thus, the political legitimacy of the modern state of law was increasingly derived, not from its harmony with some larger moral order, but rather from its very own

administrative procedure.27 Parallel with these developments in state administration, the “maintenance of public quiet” rose to preeminence as the “first and most sacred duty” of policing in Prussia over the course of the first half of the nineteenth century. Based on the premise that the state was a citadel under siege, police action was militarized and its objectives restricted to the pacification of the masses. By 1850, a separate sphere of state activity, still calling itself policing, had emerged that relied on the constantly threatened use of force.28 The mid-century Prussian state thus separated two categories of action that the police state had previously conflated: welfare and force (Macht).29 Combining this distinction with that between internal and external security, the central state had now come to circumscribe Page 36 → a new domain (domestic security), goal (welfare), and method (assurance) of public action separate from policing. The Instrumental State of Law While some regions in German-speaking central Europe became thoroughly industrialized as early as the 1830s, German states, on the whole, experienced their most intense periods of economic growth in the years 1850–73.30 At the same time, liberalism as an organized political movement may have fallen on hard times after the failed revolutions of 1848, but its influence in public affairs continued as its advocates adopted a more pragmatic approach and turned to economic life to pursue their interests.31 By 1880, entrepreneurs from industry and banking not only had established market-economy advocacy groups, but had begun to concentrate their enterprises in large cartels and amalgamations.32 The rise of an economy increasingly marked by capitalist and industrial practices presented the Rechtsstaat with a number of challenges. Up until the 1840s, the Rechtsstaat had been identified primarily with bureaucrats and government officials who understood it as a state of enlightened reason (Vernunftstaat), with law as its unifying principle. But the relative success of constitutionalism in the Germanies after 1850, combined with the presence of expanding market forces in the economy, encouraged many observers to divorce political and constitutional ends from the theory of the contemporary state. During the second half of the nineteenth century, the Rechtsstaat assumed a more formal, more instrumental character in contemporary political and legal theory.33 Civil law of the time elevated individual freedoms to the status of fundamental norms and assumed the legal system to be socially and politically neutral, its uses left to other public domains to determine.34 Moreover, demands for greater legal certainty in the wake of rapid social change provided the backdrop for the rise to prominence after 1866 of legal positivism, a philosophy of Page 37 → jurisprudence that took the natural sciences as its model in defining justice as the purely systemic coherence of laws.35 This drift toward instrumentalization was also reflected in the activities of state administration at this time.36 From 1818 until well into the 1870s, Prussian authorities actively promoted free trade inside and outside the kingdom’s borders. For the first time, however, the state recognized the existence of a “civil society” independent of itself.37 In 1848 officials established the first permanent ministries for private (i.e., nonstate) economic affairs. In addition, while post-feudal law found it impossible to make sense of legal subjects as anything but persons endowed with free will, German jurisprudence from the 1870s onward found ways to extend basic rights to depersonalized commercial enterprises.38 The Prussian/German state thus conceded a relative autonomy to agents and forces in the productive economy. By 1880, the Rechtsstaat had become a regulatory institution in its dealings with society and economy, concerned primarily with providing the formal conditions for economic competition and productivity.39 Page 38 → From “Society” to “Social Policy”: Social Germany, 1750–1880 While the bifurcation of state and society was characteristic of nineteenth-century German statecraft, this should not be taken to mean that the state introduced this distinction “from above.” The notion that state and society were no longer coterminous did not originate from any one institution or group of individuals. Those who recognized

the dichotomy were found outside (legal scholars, social scientists) as well as inside (officials, legislators) government circles, and all recognized that society itself—in the form of stunning social changes—constituted a challenge to traditional, corporative political philosophy. There was no ultimate source for this admittedly profound shift in the public perception of community: institutional rituals, intellectual debates, political activities, industrial developments, elite anxieties, laboring-class behaviors, and technological innovations all contributed to the growing sense that some thing called “society” existed and had a life of its own. Society Imagined The first German theorists to recognize a distinction between the state and civil society were the cameralists. Daring to “imagine that population growth would result not in poverty but increased production and trade,” cameralists of the seventeenth and eighteenth centuries attempted to replace the predominating ethic of abstention with one that identified “consumption as the motor driving prosperity and the tie binding society together.”40 Liberal political thought followed suit, making the distinction between state and society the centerpiece of its political cosmology.41 Indeed, by counterposing civil society and the state, liberalism helped fix the conceptual boundaries of nineteenth-century social thought. To consider or theorize society at this time meant conceding the existence of a domain of human relations that was at once (in some measure at least) natural, self-regulating, autonomous, and vital. As feminist scholars have pointed out, however, liberalism did not just oppose society with the state: it also distinguished both from and against what Page 39 → was deemed the domestic (women, family, household). Dividing human interaction into public and private matters, liberal theory relegated women and family to the private, intimate sphere, while it assumed men to properly inhabit and rule within both spheres.42 Most observers considered the values of equality, freedom, private property, reason, and merit inherently irrelevant to women.43 Moreover, in making a virtue of independence, self-reliance, and self-interest, liberalism portrayed the universal “individual” of society as a decidedly masculine rational actor whose will was potentially constrained by family on the one side and the state on the other.44 Thus, when women did appear as social agents, they were compelled to rely on the public language of liberalism: “to speak, in private, the language of sentiment, a language increasingly cloying as it lost part of the force of the Christian ethic of caring and responsibility and was shorn of its power to beard power; or, alternatively, to seek remedies to social ills and to define their entrance into the public world along the lines of a frequently censorious moralism.”45 The wide berth liberal theory gave the domestic had as much to do with its critique of the Old Regime as it did with its disdain for women. Aristocracy, feudal relations of dependence, and femininity played on a mutually reinforcing set of symbols since the eighteenth century.46 Substituting ascriptive rank with achievement, personal dependence with contract, and paternalistic authority with law, liberal mythology represented civil society as the outcome of a fraternal social contract. This contract created “a new, modern patriarchal order that is represented as divided into two spheres: civil society or the universal sphere of freedom, equality, individualism, reason, contract and impartial law—the realm of men or ‘individuals’; and the private world of particularity, natural subjection, ties of blood, emotion, love and sexual passion—the world of women, in which men also rule.”47 As the source of political sovereignty, society was conceived as a brotherhood in direct contrast to the despotic and domesticating coercions of feudal hierarchy and feminine desire. Page 40 → By roughly 1830, then, European liberals had established the conceptual contours of society, associating it with activity, independence, and male citizenship. As has been well chronicled, German liberals developed their own set of assumptions and priorities within this intellectual movement. Constitutional theorists in the second half of the eighteenth century recognized society as distinct, but continued to see it composed of corporate estates, not atomized individuals.48 Wilhelm von Humboldt, one of the Reform Era’s most influential voices, justified his belief in a minimal state by contending that the inherently dynamic, diverse, and creative energies of individuals could flourish only if society was largely left to govern itself.49 Finally, Hegel too made clear, yet subtle, distinctions between state, society, individual, and family, but treated the state as the sole unifying element of the

liberal community.50 As an intellectual movement, European and German liberalisms served as a catalyst for the growing public recognition of a societal or “social” side of community life distinct from the state and the household. This recognition was not confined, however, to those with liberal sensibilities. As David Lindenfeld has observed, “The recognition of society was a reformulation . . . of something the scientists of state had long since known: the limits of state control over the autonomous activities of individuals and groups.”51 Since around 1750, natural-law scholars in Germany began routinely using the adjective “social” in their works. Later, the term appeared in earlynineteenth-century German dictionaries, typically linked with the expressions sociabel, gesellig (gregarious), and einträchtig (harmonious). By 1850, having become intuitively coupled with the concept of society, “social” was commonly set apart from “political,” referring primarily to the interpersonal and material relations of human beings in a community.52 Not everyone in educated and politically influential circles, however, conceded the legitimacy of a state/society distinction. Prussian conservatism emerged in the late eighteenth and early nineteenth century as a direct rebuttal to liberal and radical democratic political ideas. Coming from the ranks of the Prussian nobility—an aristocracy, Robert Berdahl emphasizes, whose sense of identity was strongly tied to ownership and management of landed estates—early Conservatives rejected the principles of parliamentary representation, free-market capitalism, and social contract theory. Invoking the ethos of das Page 41 → ganze Haus, theorists such as Adam Müller and Carl Ludwig von Haller denounced as “artificial” liberal and capitalist tendencies to treat authority as a human creation and to differentiate between public and private authorities.53 Nonetheless, in framing their political agenda in terms of a rhetoric of reaction, Prussian Conservatives grudgingly granted recognition to the “social” changes around them. As Garber has argued, they did more than simply hearken back to the “good old days.” Early Conservatives developed diverse theories about the causes of and appropriate responses to revolution.54 During the 1830s and 1840s conservatives made social concerns a chief priority in their analyses of the degeneration of the society of orders.55 By 1848, Friedrich Julius Stahl, a leading Conservative political theorist, granted that “society and the state, the social and the political realms are distinguishable,” even while insisting they were “inseparable.”56 The Science of Social Crisis, 1820–80 To many observers in the first half of the nineteenth century, society did not only exist: it was changing. Indeed, as discussed above, it was commonly taken to be the very source of change. This was, as Robert Gildea concisely puts it, the century of “barricades and borders”: an age of enfranchisement, industrialization, migrations, social movements, nationalisms, and violent mass mobilizations.57 Like other Europeans, Prussians from all walks of life experienced the years 1815–70 as a time of fundamental change. Large-scale transfers of land-ownership, a remarkable growth in population (from 10.4 million in 1816 to 17.2 million in 1855), the emergence of capitalist agricultural practices, the exodus of peasants from the countryside, the decline of domestic industry, the growing prominence of wage labor, and the spread of unemployment, poverty, and hunger acted as both cause and effect in displacing the traditional, corporate Page 42 → bonds of German culture.58 The new experience of railway travel—frequently described by contemporaries as accompanied by a sense of overwhelming, fatiguing, and terrifying loss of control and orientation—might be taken as paradigmatic, or at least indicative, of a more generalized apprehension.59 By the last quarter of the nineteenth century, as Joachim Radkau suggests in his insightful history of the subject, Germans were living in an “age of nervousness.”60 Conservatives lamented the erosion of moral values (Entsittlichung) and the loss of customary bonds (Dekorporierung, Bindungslosigkeit), while progressive Liberals and the labor movement criticized the squalor in which increasing numbers of workers were being asked to work and live. Social change, in Prussia at least, was greeted by many as signaling a profound crisis, a problem. The problem, crystallized by midcentury as “the Social Question,” was set forth as a matter of finding a way to create social affinities and to reassert a viable social order in the wake of the demise of the Old Regime.61

Across the ideological spectrum there was general agreement that capitalism was the chief cause of Prussia’s social crisis. Moreover, Adam Smith enthusiasts, radicals, and conservatives alike pointed to the Prussian government’s liberal, reformist policies as being responsible for enabling and promoting social and economic change. Yet the very bedrock of the liberal political tradition, the legal system, claimed little if any jurisdiction over the social consequences of its reforms. Operating under a largely abstract idea of justice and a narrow, selflimiting sense of its province, German law and legal science in the second half of the nineteenth century did not offer policymakers an amenable tool for systematically engaging the Social Question.62 Officials, bureaucrats, academics, and entrepreneurs eventually found their inspiration for making sense of social change in a new secular endeavor: social science. Indeed social science itself only first became possible once a thing called “society” was presumed to have a life of its own. Taking mechanics as their model, early social scientists, at first mostly political economists and social Page 43 → statisticians, transplanted the governing principles of physics into the realm of social relations to arrive at those laws governing the motions of society. Compelling applications for the thermodynamic laws of the conservation of energy and entropy were found, as researchers attempted to break society down into its constituent elements and analyze them according to size, number, arrangement, and interactions.63 In Prussia, standing at the crossroads of social criticism, social reform, and state policy, social science emerged in the second third of the nineteenth century and became increasingly prominent inside and outside government circles in the years 1866–90.64 The initial stimulus came from bourgeois social reformers of the 1830s and 1840s. Perceiving the formation of an urban proletariat as a threat to the social and political order, they sought a response that simultaneously satisfied their enlightened motives and their pragmatic faith in institutional intervention. What they found particularly in social statistics and probability was a diagnostic tool that offered the possibility of identifying, as one advocate put it in 1846, the “causes, nature, and remedy of many of our German Fatherland’s wounds.”65 Rudimentary statistics and mathematical probability were certainly nothing new to European life. Absolutist states had routinely kept data on their populations and trade, and the mathematical theory of probability was appropriated by some Enlightenment thinkers to arrive at a legal hierarchy of proofs and a science of the moral order. But early modern figures were never systematically analyzed and collected, while eighteenth-century probabilists remained individualistic, psychological, and prescriptive in their approaches.66 The statistics and probability theories applied to social life in nineteenth-century Europe were of a profoundly different character. Advanced by individuals Page 44 → and groups from government, industry, and science, the new statistics was part of a self-consciously social science of social motion, acquiring its sense of mission from the perceived dynamism of postrevolutionary, industrial life. It was offered as an eminently empirical, quantitative method for discerning the laws of a changing society. Yet equally important were its political implications. Statisticians of the early nineteenth century saw their science as an attempt “to bring a measure of expertise to social questions, to replace the contradictory preconceptions of the interested parties by the certainty of careful empirical observation. They believed that the confusion of politics could be replaced by an orderly reign of facts.”67 Equally innovative were social statistics’ premises and methodology. Society was assumed to be an entity in constant flux and subject to contingencies, movements governed by natural laws. In the principles of mathematical probability, statisticians believed they had found a systematic method for discovering necessary truths in apparent chance. Studying at first crime and suicide, social science observed society in the aggregate, assigning numerical values to individual actions and then determining their regularities. These regularities, in turn, were believed to reveal the laws of human conduct. Such laws, however, were not considered valid for individuals: statistics made no claim to predict individual behavior. Rather, statistical laws were laws of probability and therefore taken to be valid only en masse.68 Social science not only made society its object, it simultaneously treated society as a subject. Shunning at once metaphysics’ reliance on transcendent truth and the emphasis on personal responsibility characteristic of liberalism and the moral sciences, social science attributed the causes of social phenomena to society itself. As the

founder of social statistics, Adolphe Quetelet, expressed it, “The laws presiding over the development of man and modifying his actions, are in general the result of his organization, of his education or knowledge, means or wealth, institutions, local influences, and an endless variety of other causes.”69 Social statistics thus made it possible for the first time to speak of and quantify the “social conditions” that generated social problems. This had major consequences for European discourse about the poor. Medieval and early modern Europeans understood the poor as a natural, immutable mass. Around the turn of the nineteenth century, however, British and French observers influenced by Page 45 → social scientific notions began referring to the poor as a class created by industrialization and commercial capitalism. In the following decades, analysts began to speak explicitly of “poverty” and “pauperism” as conditions independent of their bearers. It was at these conditions that nineteenth-century poor-relief reform was directed.70 German-speaking central Europe during the years 1850–80 proved particularly receptive to the social sciences, especially social statistics. A collection of academics, industrialists, economists, policymakers, philanthropists, jurists, and bureaucrats embraced it as a technology that could provide reliable information about contemporary social changes. In self-conscious opposition to the revolutionary doctrines of socialism, statistics was visualized as a scientific endeavor placed in the service of social reform and legislation. Outside the state, historical national economists critical of the Smithian “Manchester School” of economics, the reform-minded Verein für Sozialpolitik, and physicians promoting sanitary reform all marshaled statistical evidence to influence policy. At the same time, state bureaucracies increasingly came to rely on statistical information for preparing legislation and decrees. Already in 1805 the Prussian state had created a statistical bureau to monitor changes in population and the economy. As the Social Question grew in prominence between 1840 and 1870, however, governmentsponsored surveys and censuses widened their purview to include working and housing conditions, wages, prices, work hours, living standards, and insurance. In 1875 an ambitious national survey was carried out to assess the impact of the factory legislation first passed in 1872–73.71 By 1880, the German state itself had become a promoter of social science. Leading social statisticians, such as Ernst Engel and Georg von Mayr, entered government service to direct statistical bureaus. These bureaus were enlisted to investigate the possibilities of an institutional (i.e., nonrevolutionary) solution to the social questions of the time. During his tenure as director of the Royal Prussian Statistical Bureau (1860–82), Engel, for instance, assessed, among other things, the probability of explosion in steam boilers and steam engines (for insurance rates), the health of disabled war veterans, demographic changes, the living standards of the poor, life expectancy within the population, Page 46 → and insurance schemes.72 Just as it was outside, inside government circles social science was accepted as a tool for identifying and evaluating social problems. The Meaning of Social Policy Thus, the invention of a concept of society, the impact of marked social change, the rise of social science, and growing concerns over a host of “social questions” reciprocally defined and mutually reinforced one another. This cluster of ideas, anxieties, and events constituted a historically new domain of human action and interaction, what Jacques Donzelot and others have called the realm of “the Social.”73 Society, now distinguishable from the state and the household, became a source of great concern. In both its public and private aspects, it was recognized as the catalyst of profound changes to the conventional order of things, changes anticipated by most as threatening. The most prominent political movements of the time shared the view that the central state had a formative role to play in addressing social questions.74 In addition, as discussed earlier, Prussian and German authorities of the nineteenth century believed it to be the state’s mission to assure domestic security and to oversee economic relations. Together, the demands of organized political interests and the increasingly formalistic logic of the central state helped define the solution of social problems as one of institutional mediation. The question of what form state intervention in the “social” sphere should take was therefore posed as the question of how to administratively manage the reorganization of Page 47 → a society stripped of its traditional, corporate ties, while assuring social and economic vitality.75

This required a new kind of state administration, one operating under the premises of “the Social.” Social administration, by definition, adopted the techniques and principles of social science, since social science had provided the means to identify and characterize social problems in the first place. State intervention therefore also represented an attempt to depoliticize social problems by transforming them into technical questions.76 By the time the Social Question had become synonymous with the Worker Question in the 1870s, politicians, academics, bureaucrats, and entrepreneurs found a name for the state’s jurisdiction over social affairs: social policy (Sozialpolitik). As a reform effort that deliberately abandoned utopianism, social policy in Germany was conceived as the rational, systematic, and scientific attempt to institutionally manage, but not wholly transform, society in order to make it stable (social peace), yet productive (economic growth). It is here, at this discursive juncture, that the idea of a compulsory workers’ insurance appeared most compelling. Insurance Becomes Social Policy Social policy thus took over the place formerly occupied by policing. Assuring domestic security in the nineteenth century meant, however, working with a different set of assumptions and strategies: the social causes of misery had to be identified, social stability and economic dynamism balanced, social conflict moderated, political values and interests reconciled. The rise of a class of wage-dependent, propertyless, mostly urban workers—the social question by 1880—represented an enormous challenge for the field of social policy. Observers from all political sides agreed that the proletariat’s mobility, poverty, and nontraditional lifestyle cut it off from the rest of society, while at the same time made it susceptible to social-democratic agitation. Among social policy makers there was a consensus that police measures and poor relief were inadequate for dealing with this historically unique phenomenon. Page 48 → Insurance was by no means an obvious solution to the Worker Question even at midcentury. Into the nineteenth century, insurance schemes often had more to do with gambling than with income maintenance. In fact, many forms of insurance had been outlawed in Germany since the eighteenth century for this very reason. Still, between 1840 and 1880 new, innovative insurance projects grew in popularity among conservative nobles, the bourgeoisie, and workers. These schemes provided social-policy experts with ready-made models of sophisticated and accepted income-support systems. Yet this still does not account for why insurance seemed such an attractive option for dealing specifically with Germany’s social problems. The question posed at the beginning of this chapter—what made the marriage of statecraft and insurance possible?—can now be reformulated more narrowly. How did insurance become social policy? The answer lies not only in what insurance could do, but also in how it went about its work. Insurance fit neatly into the project of social policy due both to its apparent results (income maintenance, social harmony, loyalty to the state) and to its premises and methods (compulsory savings, the redistribution of risks, mutuality). Explaining how the notion of a “social” workers’ insurance arose in nineteenth-century Germany means accounting for insurance’s emergence as the leading technology of social policy. It was able to assume this role because it offered a means to address the Worker Question that accommodated both liberal and conservative, bourgeois and noble, secular and Christian visions of social life. Security, Insurance, and the Bourgeoisie The state’s interest in insurance dates back to seventeenth- and eighteenth-century German cameralism. Working under mercantilist assumptions, cameralists embraced various forms of insurance as ways of promoting and securing the realm’s wealth. To be sure, fire insurance and shipping insurance were already well-established in medieval commercial cities. But what made the German cameralists different was their interest in personal insurances, considering them as a replacement for charity. While fire, maritime, natural disaster, and livestock insurance schemes were designed for businesses and municipalities, projects intended to benefit individuals and their households existed in Germany since the sixteenth century. The most prominent of these were life insurances in the form of dowry funds (Aussteuer- und Brautkassen), burial funds (Sterbekassen), and widow and orphan

funds (Witwen- und Waisenkassen). Cameralists touted these early versions of life insurance and drafted scores of life insurance projects that they then recommended to state authorities for endorsement. Their enthusiasm sprung primarily from their belief that personal assurance funds served the goals of mercantilist and police measures. By facilitating marriage and by assuring that the widows and orphans of the early modern Page 49 → bourgeoisie would not find themselves suddenly destitute, these funds were presumed to promote moral conduct, social stability, and population growth.77 The cameralists were taking their cue from sixteenth- and seventeenth-century legal scholars of aleatory contracts. The latter had developed an extensive literature on risky ventures like insurance, emphasizing the importance of prudent judgment based on the particulars of a case. At this same time, however, mathematicians of probability began turning their attention to real-life problems of uncertainty in an effort to ascertain the natural laws that governed the fair price of risks. Whereas jurists and cameralists sought to downplay the inherent uncertainties in insurance practice, classical probabilists highlighted insurance’s similarities with gambling.78 Drawing a connection between insurance and gambling was no academic feat. Lorraine Daston has pointed out that, unlike today, early modern insurance schemes were not risk-aversive, but rather invited risk as an opportunity. Bottomry, annuities, tontines, and life insurance were, for the most part, speculative enterprises in which one did not plan for, but rather bet on, the future.79 In many parts of Germany, especially Catholic regions where some of these practices were equated with usury, personal and life insurance schemes were illegal. Until the end of the eighteenth century, then, insurance in Germany and Europe was caught up in the opposition and tension between security and speculation, investing and betting.80 Over the course of the late eighteenth and early nineteenth century insurance underwent a profound change: it parted ways with the world of gambling. This happened for two principal reasons. First, German sovereigns and officials assumed the state to be responsible for securing the conditions of general economic Page 50 → wellbeing. For them, however, the goal of security required equally secure and certain administrative procedures. Administrators, inimical to gambling’s flirtation with uncertainty, therefore established regulations intended to excise gaming elements from schemes like fire insurance and widow and orphan funds and to base insurance practices on rational, scientific methods.81 Second, respectable and enlightened bourgeois circles began expressing contempt toward the activity of gambling. Inherently unpredictable, gambling appeared to the bourgeoisie irrational, incontinent, self-destructive, and base. Thus, between roughly 1750 and 1850, those interested in offering personal insurance such as life insurance to this new wealthy class first needed to make insurance appear legitimate by dissociating it from gambling. The result was the rise of private life-insurance companies that stressed three new features: their reliance on statistics and probability, their purpose to provide financial security for one’s family in case of sudden death, and their mutualistic form of financing by which members insured one another and thereby based success of the company on the continuance, not the end, of life. Here then was an insurance that emphasized the bourgeois and domestic virtues of order, thrift, prudence, farsightedness, family life, frugality, orderliness, responsibility, contribution, labor, industriousness, and economy all at once.82 Social Security and Christian Social Policy Insurance’s conformity with bourgeois values made it attractive to any number of entrepreneurs, intellectuals, bureaucrats, and politicians. But the backing of bourgeois policymakers alone would not have been enough for insurance to Page 51 → emerge as Germany’s preeminent tool of social policy. Germany of the late nineteenth century remained a profoundly Christian society. Estimates are that of the 49.5 million Germans in 1890, 31 million were Protestant, while 17.7 million were Catholic.83 Christian sentiment pervaded nineteenth-century politics. Three of the leading political parties—the mostly Protestant Conservatives and Free Conservatives and the Catholic Center Party—were driven by explicitly religious presumptions, motivations, and aims. Moreover, Bismarck, along with his closest social-policy advisers, consistently held in public and in private that social reform was an exercise in “practical Christianity.” Social insurance only came about in Germany with the broadbased support of devoutly Protestant and Catholic intellectuals, political leaders, and bureaucrats.84

German policymakers’ enthusiasm for social insurance was therefore also a function of its apparent consistency with the creeds of socially engaged Christians of both faiths. What united this rather diverse group was a common disdain for revolution and unbridled economic liberalism. Revolution was vilified as inherently evil, an effort to destroy order and, thus, to act against God’s will.85 At the same time, the spread of capitalism and liberal reforms was consistently blamed for unhinging people from their ascribed corporative status, unleashing rampant materialism, and, in the process, promoting immorality and atheism. In response, Catholic and Protestant intellectuals and leaders offered a range of solutions aimed at reestablishing the preeminence of Christian values, restoring the society of orders, and assuring a material and spiritual security for the working class.86 Since the revolution of 1848–49, a discernible Catholic social movement had grown up in Germany devoted to the ideal of a “harmonious” and “organic” society of orders. The Social Question for these Catholics was not simply one of growing poverty. The social crisis constituted a mass moral degeneration fed by the atomism, egotism, and competitiveness of liberal society. In its place, Catholic social leaders pressed states to stabilize social conditions by institutionally reaffirming each individual’s “organic membership” (organische Gliederung) in his or her corporative rank.87 Page 52 → The Social Question provoked lively debate among Catholic social reformers over the exact shape reform should assume. One of the chief points of contention here was the extent of state intervention. Freiherr von Ketteler (bishop of Mainz), Franz Hitze (general secretary of the Association of Catholic Industrialists and the Friends of Workers “Arbeiterwohl”), and Joseph Edmund Jörg (editor, Historisch-Politische Blätter), for instance, represented one strand of Catholic social thinking generally averse to direct state action. Lauding self-help and self-administration, they believed granting capital and labor corporative status and privileges would naturally lead the two to cooperate in addressing one another’s grievances. At the other end of the spectrum, Franz Joseph Buß (University of Freiburg), the priest August Pieper, and Georg von Hertling (Center Party Reichstag deputy 1875–1912) proved more amenable to increased state regulation and supervision over social affairs, albeit within a corporative framework.88 By the end of the century, however, prominent bourgeois Catholics—among them Hitze, Pieper, Franz Brandt, Carl Trimborn, Heinrich Brauns, and Otto Müller—had successfully laid out the basic tenets of progressive Catholic social reform.89 While the theme of state intervention continued to divide the left and right wings of the Catholic social movement, local reformers and most Center Party members had reached a rough consensus. Social-policy measures needed to respect market forces and employer prerogative while also securing the human dignity of workers by deproletarianizing them and integrating them into society. This could only be done, it was widely held, by adhering strictly to the principle of subsidiarity. This meant privileging self-help and selfadministration schemes like insurance and granting local institutions the widest jurisdiction possible. Catholic social policy of the late nineteenth century in this way linked social solidarity, social security, and the “common good” in a neocorporative vision that promised a curb on economic competition, compromise between interests, and, ultimately, class harmony.90 For their part, German Protestants of the nineteenth century tended toward a more state-centered notion of social reform. Many church officials and theologians, it has been pointed out, preached simple acceptance of social fate, loath to even engage the Social Question. From midcentury on, however, a group of paternalistic industrialists, Conservative and Liberal political leaders, academics, Page 53 → and charity organizers articulated a distinctly Protestant vision of social policy that looked to the state as the guarantor of social peace and security.91 Similar to Catholic social thinking, these Protestant approaches to the Social Question were informed by a Christian conservatism resting on the guiding principles of the sanctity of the society of orders, the state’s organic link to that society (Ständestaat), and the responsibility of each social rank to look after the others.92 These assumptions directed Protestant social reformers to seek solutions to the prevailing social crisis in corporative revitalization and political paternalism. In the words of Johann Hinrich Wichern (1808–81), founder of the charity “Inner Mission,” the solution to the Social Question required a “moral rebirth of the people.” Such a moral rebirth could only come about, Wichern emphasized, through concrete efforts designed to help the destitute

help themselves. More specifically, this meant efforts to rehabilitate family life (the “germ” of Christian social life) and to secure work for the poor so they could acquire property and practice Christian responsibility.93 Wichern and others believed the state and employers had a moral duty to bridge the gulf between rich and poor. This prompted some in Protestant reformist circles to actually flirt with socialism. Social critic Rudolf Todt (1839–87), for example, blamed capitalism and liberalism for what he saw as the degeneration of society. He, in turn, attempted to theologically wed socialism and Protestantism. More influential in this regard was Adolf Stöcker (Reichstag deputy 1881–93, cofounder of the Evangelical–Social Congress in 1890), who founded the Christian-Social Workers’ Party in 1878. Though failing to gain popular support, the party was vocal in its support for tax reform, worker safety laws, collective bargaining, and compulsory insurance.94 By the time the Bismarckian and Wilhelmian states began crafting German social security in the 1880s, the “state socialism” plans of reformers like Stöcker had been widely dismissed as too populist. Nevertheless, there was significant and vocal grassroots support among Protestant church leaders, synods, conferences, associations, and theologians for a state response to the demands of workers, and the leading organs of the state churches (Landeskirchen) openly backed the government’s social security plans.95 Social Protestants remained divided, however, on how to go about legislatively addressing social problems. Social liberals feared any measures that appeared to bolster feudal and Catholic interests, Page 54 → while Christian Socials, the majority of the synods, Conservatives, and the Christian trade unions remained fixated on the threat of socialism.96 What emerged by 1880 were three broads visions of Protestant social reform within government circles. The notion of a “Social Kingdom” (soziales Königtum) was first proposed by the Conservative Josef Maria Radowitz (1830–53) and later touted by some of Bismarck’s closest advisers. Its most prominent advocate was Hermann Wagener, editor of the Conservative newspaper Kreuzzeitung and Bismarck’s adviser on social policy in the years 1862–73. As Wagener expressed it, the king had an obligation to be “protector of the weak, the king of beggars, the savior and patron of the popular masses.”97 Wagener therefore proposed an alliance between the monarchy and the proletariat in the form of a regulated welfare state (Sozialstaat) administered by self-governing industrial syndicates (Genossenschaften).98 Bismarck himself offered a revised version of this scheme that emphasized the state’s responsibility to find ways to assure economic productivity and social stability. This would best be achieved, he believed, if the central state were to collect taxes and insurance premiums and redistribute the funds as benefits. To Bismarck’s thinking, such a system would have three results: it would guarantee the material well-being of the “higher working classes” and, in turn, secure the loyalty of the masses and undermine social conflict.99 The Lutheran bureaucrat Theodor Lohmann articulated a third alternative that distanced itself from the statist and compensatory models of Bismarck, Wagener, and Stöcker. Lohmann thought successful social reform must emphasize prevention rather than compensation and concern itself with fostering an ethos of mutual responsibility between workers and employers. This could only be achieved, in his view, through a solidarist social order in which class conflicts were resolved by negotiations between autonomous corporate bodies and refereed by a nonpartisan state.100 Page 55 → These visions of social reform clashed and were debated in government circles, as Reich officials in the years 1878–83 considered ways of reforming Germany’s accident liability laws. Significant differences remained among and between social Catholics and Protestants, and the final product of accident insurance was ultimately a result of compromises on everyone’s part.101 But despite their disagreements, Christian social reformers were agreed that worker demands needed to be addressed in a constructive manner. All looked to solutions that offered hope of establishing organic bonds between employers and employees. It is for this reason that social Christianity in Germany during the last quarter of the nineteenth century endorsed insurance as an appropriate and effective tool of social policy.

Insurance: A Technology of Social Affinity Between 1840 and 1880 the popularity of insurance schemes extended beyond a liberal-minded bourgeoisie and leading Catholic and Protestant social reformers. Workers themselves also proved receptive to insurance during this time. Guided by existing self-help programs among guilds, German journeymen and factory workers acquired government permission to form sickness funds financed by the contributions of their members. Bourgeois observers and state officials, in turn, supported these funds, praising them for helping to develop what they believed to be a much needed sense of responsibility, thrift, order, hard work, and moderation among the working class. By 1872, a total of 776,563 laborers and journeymen were insured by 4,763 separate funds throughout Prussia.102 The Prussian government’s enthusiasm for workers’ insurance was further demonstrated in its reform of mining laws in 1854 and 1865. These laws established for the first time a comprehensive health, accident, and invalid insurance system for miners. In what was to be a model for the social insurance legislation of the 1880s, the new miners’ funds (Knappschaften) bore many new features. The system was completely self-administered. Membership was obligatory, and benefits were linked to contribution levels and were awarded in the form of treatment, medication, and pensions. These benefits, in contrast to poor relief, were considered a right and were not subject to means testing.103 Once Germany created the first general workers’ insurance of its kind in the years 1883–91, insurance had thus developed a completely new form. Social Page 56 → insurance was not only different from its historical predecessors; it also deviated considerably from the practice of contemporary commercial insurance. For the first time, insurance was compulsory, national, and permanent.104 Moreover, whereas formerly it was the preserve of middle-class households, insurance now was deliberately placed in the industrial setting of capital-labor antagonism. This was a far cry from the bourgeois life insurance that emphasized the work of culling a “select” and homogeneous membership.105 State-promoted workers’ insurance therefore represented an original technology, novel in both rationale and method. Three features in particular made it especially attractive for social-policy purposes:

1. It seemingly offered German policymakers and reformers a way to institutionalize collective responsibility for the plight of workers without the threat of politicizing them. Modern insurance treated the world as composed of various kinds of risks. Rooted in statistics and probability, however, insurance’s notion of risk had less to do with the threat of danger than with the hazards of chance and randomness. For insurance, risk is always a potential measured in terms of probability. Insurance’s logic of risk was and is therefore based on statistical principles of normativity (according to how one is situated in relation to the mass of others), not on juridical principles of justice (according to how culpable one is). Risks so defined are inherently social, which is why insurance only covers groups.106 By extension, the eventuality of potential hazard was (and continues to be) understood as an accident in the contractual legal sense. The very idea of “accident” was only made possible by the emergence of contract relations and contract law in the sixteenth century. According to this body of legal thought, an accident was defined as the consequences of an unintended failure to perform an agreed-upon act. Under contract law, legal proceedings in cases of breach of contract sought to identify not only the intent that grounded the contract, but the consequences that “naturally” flowed from breaching it. Nineteenth-century insurance relied on this understanding of the accident to make the question of indemnity a purely technical one. Insurance did not determine financial compensation on the basis of culpability, but rather by Page 57 → establishing whether an event met the conditions of those risks insured. Obligation and injury were not seen as motivated acts, but rather as accidents. From this way of thinking, an illness, debility, or death signified a breached contract, while occupations were looked on as environments that “exposed workers to discrete hazards which could set off a series of contiguously related events.”107 Workers’ insurance therefore incorporated an ideal of collective responsibility through distributively sharing the burden of industrial risks. By assuming this responsibility on the basis of statistical and contractual theory,

however, it also presumed to set itself apart from the litigiousness endemic to the juridical order. Pragmatic, enlightened bureaucrats, paternalistic industrialists, and Christian social reformers alike found in workers’ insurance the apparent means to efficiently, safely, and appropriately look after the economic security of laborers without (they believed) feeding their political ambitions. 2. It offered income security without the radical redistribution of wealth. Since workers’ insurance granted benefits in relative proportion to contributions, it reinforced the capitalist work ethic and posed no threat to radically redistribute wealth across class boundaries. Its aim was to promote income security, not social mobility. Appealing to industrialists and bureaucratic liberals, it followed nineteenth-century bourgeois conventions that equated savings and private property with economic independence and, in turn, financial security. Workers’ insurance therefore served as “a functional alternative for the providential aspects of private property.”108 At the same time, its emphasis on security instead of mobility made workers’ insurance particularly attractive to Christian conservatives who were seeking to establish the proletariat as a relatively stable corporate rank. 3. It seemingly offered a way of creating social affinity at the expense of the organized labor movement. By classifying members according to their relation to risks and wages, insurance also represented a way of organizing people. It linked participants not horizontally with one another, but individually and serially to the insurance order. It had the potential Page 58 → then to reconstitute social classes as populations defined by age, sex, professional danger, and so on. Placing the question of one’s exposure and relation to risks at center stage, an insurance could reorganize its members across class and trade boundaries.109

Furthermore, as compulsory yet self-administered, workers’ insurance operated between state and society. Relying neither on the arbitrary benevolence of employers nor on direct state intervention, it fit well with the Catholic insistence on subsidiarity. Since, however, the system was established, maintained, and supervised by the nationstate, the latter was in the best position to take credit for its success. In this way, insurance offered social Conservatives a way to tie workers to an abstract, anonymous bureaucratic order rather than to one another (as the trade unions would have it), and in the process opened up the possibility of making the state their principal object of loyalty. In sum, insurance presented a way to fulfill the two great goals of nineteenth-century German social policy: social harmony and productivity. It held out the hope of creating a social affinity between workers and employers by making them mutually responsible for guaranteeing laborers a minimum income in case of sickness, disability, or death. Personal security, the logic held, would invariably lead to a social security. At the same time, personal income security through insurance coverage presupposed industriousness, since workers’ insurance attached premiums and pensions to wage levels. Public Health, Medicine, and the State If insurance was designed to promote a measure of income security for workers, it did this only conditionally. Benefits were awarded in cases of sickness, disability, and decrepitude. German social insurance of the late nineteenth and early twentieth century was, as noted earlier, an insurance against occupational risks to health. It was a public health insurance. Why health? The state’s interest in public health in Germany dates back once again to principles and practices associated with the early modern police state. From the beginning, policing was deeply concerned with the health of the general population, seeing it as an important factor in increasing the wealth of the realm. By the late eighteenth century, administrators, cameralists, and police theorists had Page 59 → established a new subfield called “medical policing.” Authorities acknowledged three major areas for medical police intervention: assuring population growth, providing sufficient numbers of competent health professionals, and enacting ordinances necessary to maintain and promote the population’s health. By the mid-nineteenth century German states and cities had enacted regulations covering a wide area, including the certification of physicians and midwives, the control of epidemics,

the inspection of the food supply, the regulation of prostitution, and the supervision of hospitals.110 The poor, too, fell under the jurisdiction of medical police. Sickness and poverty were seen as intimately linked. On the one hand, sickness was perceived as a cause of poverty since it manifested itself in an acute or chronic inability to work; on the other, poverty was believed to have an adverse effect on the health of the population, since poor nutrition and bad living circumstances were understood to facilitate the spread of infection and disease. German poor-relief measures of the eighteenth and nineteenth century therefore classified paupers on the basis of medical criteria and put physicians in charge of administering assistance.111 By around 1850, however, the era of the police state was nearing its end and, along with it, medical policing. As large numbers of relatively mobile workers flooded the cities and factories, policing’s authoritarian and paternalistic techniques became increasingly untenable.112 At the same time, bourgeois physicians from progressive liberal circles were challenging the legitimacy of medical policing and its practitioners. Leaders in the medical reform movement, as it was called, posed this challenge in two ways. First, they sought to transfer the governance of professional matters between physicians from the state to the collegial associations of doctors themselves. More importantly for our purposes, Page 60 → reformers also sought to replace medical policing’s focus on the longevity and general welfare of the individual with an overriding concern for the extent of an individual’s productivity (Leistungsgröße). Liberal physicians like Rudolf Virchow (1821–1902) and Max Pettenkofer (1818–1901) condemned medical officers for what they held to be their narrowly legalistic views of health and disease. Virchow and Pettenkofer, in contrast, spoke of “public health care” instead of medical policing and pressed medicine to foster the conditions of health.113 By “conditions” reformist physicians specifically meant the social and economic conditions understood to have an important effect on health and disease.114 From this perspective, the problems of public health could only be attacked scientifically. Agreeing with Virchow that “medicine is a social science,” reformers called on medical professionals to scientifically investigate those factors linked to disease. As a result, vital statistics became one of the more privileged forms of evidence in this project.115 Reform medicine’s deference to social-scientific investigation and social prophylactics was soon translated into a more formal program of sanitary reform after 1848. For the next forty years, “hygiene” became the new medical panacea for numerous physicians concerned with the Social Question in Germany. As a moral, scientific, and administrative solution to the problems accompanying modernity, hygiene was conceived by its advocates as both an extension of and alternative to earlier police initiatives.116 By the last quarter of the nineteenth century, this approach to public-health administration had largely Page 61 → supplanted the idea of medical policing. Its agenda—calling for the creation and advancement of water and sewage treatment, baths, hospitals, schools, and good nutrition for children, the control of contagious disease in schools, the establishment of regulations to fight cholera, and the promotion of public education about health matters—increasingly determined the shape of publichealth administration in Germany.117 Hygiene represented, however, only one possibility for institutionally addressing matters of public health. Like policing before it, hygiene made “population” its chief unit of analysis and object of intervention. The work of public-health administration was therefore confined in two important ways: it was spatially targeted according to political geographies (states, cities, neighborhoods), and it methodologically relied on preventive techniques. Clinical medicine, as both a system of knowledge and a professional practice, provided an alternative model of public health care. To be sure, the histories of hygiene and medicine overlap. But medical practice, well into the nineteenth century, was above all else an “art,” fundamentally based on personalized and tacit, not quantified and abstract, knowledge.118 Its relatively mobile practitioners, its focus on individuals, its attention to the singularity of cases, and its tradition of offering treatment allowed doctors to intervene at various times and places in people’s lives to restore health, not simply to reduce the probability of disease within a given population. During the nineteenth century, medicine was the site of unprecedented conceptual and professional innovation. Much of this had to do with the emerging field of biology, which itself experienced a renaissance over the course

of the 1800s. Mirroring theoretical changes in contemporary political, social, geological, and historical thought, two general themes emerged to dominate biological discourse. First, biology developed a new appreciation for time. Proponents of evolution, for example, broke with classical anatomy’s static view of the relationship between the constituents of organisms by treating the organization of a living thing itself as something subject to transformation. Change was, for the first time, recognized as a natural state, thereby granting organisms their own history.119 Second, while evolutionary theory made the study of Page 62 → species-level change the focus of its scientific program, other subfields developed an interest in the individual organism and its constituent elements. Cellular biology was the most prominent example, breaking down living creatures into ever smaller, selfcontained units. Here, too, in the biology of individual organisms, researchers were mindful of a temporal dimension. Fields like physiology (viewing the organism as a machine that functioned in terms of physical and chemical processes) and embryology (concerning itself with the ontogenetic development of an organism) understood the organism as an entity in a constant state of flux.120 These innovations in biology effected changes in medicine. Over the course of the nineteenth century, medicine drew increasingly on the ideas and institutional apparatus of contemporary biological science. This was especially true in Germany. Until the 1850s clinical education for physicians was based in hospitals, where instructors demonstrated how to record symptoms, arrive at diagnoses, plan treatments, and conduct therapy. Under the influence of chemistry, physiology, histology, and bacteriology during the second half of the century, however, German educators began seeing medicine as a natural science. As a result, practical, bedside training was replaced by lectures and laboratory work at university-based clinical institutes.121 Despite this, there were limits to how far German medical practitioners would go in accepting the truths of experimental science. Loyal to the idea that only the tacit skill of the doctor could be relied on to make sense of a patient’s unique circumstances, German academics and clinicians proved quite resistant to what they perceived to be the overly reductive intrusions of physiological determinism.122 German medicine therefore retained a strong emphasis on individualizing care. At the same time, medicine shared in the public esteem of science. To an unprecedented degree, medical practitioners brought themselves and their knowledge to public attention, founding professional journals, gathering in international congresses, advising governments, and educating the general public Page 63 → about health.123 Especially within literate, bourgeois circles, physicians and medical knowledge were lauded as the embodiment of modern scientific progress.124 Such sentiment helped reinforce efforts on the part of physicians to fully professionalize their trade, thereby giving them greater autonomy and social status.125 Conceptual change also came to medicine during the nineteenth century. Most notably, the governing principles of traditional medicine were largely superseded within scholarly circles by a new way of thinking that defined health and sickness in terms of the body’s ability to function and to be normative. No longer understood as categorically different from one another, illness and good health were now subsumed by and fitted along an imagined spectrum between the normal and the pathological.126 This modern clinical approach to disease emphasized many of the same themes as the new biologies: function, adaptation, change over time, and the ability of the body to regulate itself. The terms and themes of nineteenth-century clinical medicine and biology were therefore not articulated in isolation from one another. Nor did they exist in isolation from social and political discourses of the time. Especially in Germany, biology had strong ties to liberalism and the Romantic movement.127 This was due in great part to the traditional and Romantic roots of German liberal thinking that led many to envision civil society as a social organism. The Rechtsstaat, from this perspective, was a civil juridical association that exercised limited sovereignty over the autonomous personalities of individuals and conferred responsibilities of self-government on local corporative bodies. This resonated with prevailing currents in medical thought. Under the growing influence of natural scientific method, medicine in the second half of the nineteenth century reconfigured the human body, reducing its totality to an interaction between constituent elements (e.g., organs, cells, or chemicals). By extension, illness demanded that the physician localize the play of symptoms and retrace the linear chain of causality behind it. Health—whether one was Page 64 → speaking of an individual or a body part—was synonymous with normative

function: to be healthy was to be able to be productive.128 Political and medical discourses thus shared a number of characteristics: an interest in the individual constituent elements of an entity, a reliance on a functionalistic view of life, an emphasis on history, adaptation, and self-regulation, metaphors of production, and a concern to localize problems. Linked in the public imagination with reform, holding out the promise of science, and consistent with the goals and methods of the state, clinical medicine appeared uniquely suited to the needs of nineteenth-century workers’ insurance. Recall that insurance paid out benefits on an individual basis: what an individual contributed to the general fund, how much he or she earned, and to what extent he or she was disabled determined compensation. Insurers therefore required a technology that would allow them to examine the peculiar circumstances of each and every individual in their charge. Clinical medicine provided social insurance with this very thing. It furnished a language and technique for talking about and investigating the individual’s pathology. Moreover, by offering the prospect of not just reporting illness, but restoring health, it equipped emerging social insurance with the tools by which it could promote the health of the most elemental productive unit in industrial culture: the individual worker. Clinical therapeutics gave social insurance a way to salvage individual labor power, and, in the process, promote productivity. A Regime of Trust: Social Insurance and the Problem of Modernity in Nineteenth-Century Germany As Alf Lüdtke has pointed out, statecraft in nineteenth-century Germany was conceived as “the art of healing,” an effort to therapeutically and preemptively manage social change in order to ensure the security of the state and the social order.129 Social insurance reflected this vision. Combining the principles and techniques of four contemporary technologies—bureaucratic administration, insurance, clinical medicine, and jurisprudence—it constituted an unprecedented attempt on the part of the state to actively, but indirectly, mend apparently frayed social ties. While it is true that legislators and policymakers embraced the institution as a kind of inoculation against worker agitation and revolution, the conservative ideology of nineteenth-century social insurance should not blind us to the novelty of its method. Social insurance was an integral part of a much larger revolution in modern rationality. Along with legal positivism, statistics and Page 65 → probability, sociology, technical standardization, and medical pathology, insurance helped establish the “norm” as a governing term of social assessment and interaction. No longer finding the standard of measurement in reference to some metaphysical ideal, abandoning the idea that the visible world was the translation of an invisible world of essences, normative thinking arrived at standards and assessed its objects in relation to themselves. Here was no sovereign, no absolute standard of perfection. The norm—whether one is speaking of a statistical average or of a manufacturing standard of specifications—made its objects comparable, and in the process made each the measure of every other. “Normalization forces each individual to imagine the ordering principle behind his activity not only with respect to some ideal of perfection that he might attain in isolation (such an ideal isolation has no meaning in a normative system), but with respect to a determined need that must be satisfied. Normalization is a means of organizing that solidarity which makes each individual the mirror and measure of his fellow.”130 Society so imagined, as Ewald points out, also acquired a peculiar political life, “concerned primarily with the establishment of a balance between the various claims of individuals and groups, a stable social state. The achievement of specific ends is less important than the maintenance and negotiation of this state, since in the normative society social good and stability are one and the same.”131 The most proficient state is therefore that which establishes a reliable venue for managing social uncertainties. The rise to prominence of normative rationality in medical, scientific, industrial, legal, and political settings should be seen as a response to the enormous changes that accompanied the dissolution of the society of orders. With the erosion of feudal bonds based on honor and personal dependence and the secularization of the idea of fortuna (fortune or fate), the modern world of popular sovereignty, revolutions, social movements, and industrialization presented itself to contemporary observers as one filled with dangers and threats.132 These specters now, however, were articulated in a peculiar idiom of risks, of greater or lesser chances of mishap.

Modernity therefore unleashed a host of insecurities imagined in the form of probability and risk. This, Anthony Giddens rightly contends, placed the question of trust at the forefront of modern public discourse. What forms of knowledge could be trusted? What constituted proof? Who could be trusted with authority? What groups could be entrusted with civil rights? Statecraft, political theory, and scientific practice since the seventeenth century made it their common project to answer such questions. The problem of trust in modern Europe was therefore Page 66 → understood as the need to reestablish a sense of social security, epistemological certainty, and political legitimacy all at once.133 It was in serving this aim that insurance appeared most compelling. Like other normative technologies of the nineteenth century, insurance offered itself as a technology or regime of trust.134 Its reliance on the apparent objectivity of numbers and the presumed expertise of medical diagnosis allied it with a particularly privileged set of values: precision, authority, impersonality, uniformity, certainty, integrity, practicality, masculinity.135 It is this insurance regime—a hybrid of natural scientific, medical, statistical, legal, and bureaucratic rationalities and values—that first established the contours of our contemporary notion of social security. 1. For one of the more recent variations on this theme, see Bismarcks Sozialstaat: Beiträge zur Geschichte der Sozialpolitik und zur sozialpolitischen Geschichtsschreibung, ed. Lothar Machtan (Frankfurt and New York: Campus, 1994). 2. A separate insurance program for white-collar workers was established in 1911. Unemployment insurance first became law in Germany in 1927. 3. Ritter, Social Welfare, 85–86. 4. Heinrich Volkmann, Die Arbeiterfrage im preußischen Abgeordentenhaus, 1848–1869 (Berlin: Duncker & Humblot, 1968), 74. See also Ute Frevert, Krankheit als politisches Problem, 1770–1880: Soziale Unterschichten in Preußen zwischen medizinischer Polizei und staatlicher Sozialversicherung (Göttingen: Vandenhoeck & Ruprecht, 1984). 5. On the Depression, see Hans Rosenberg, Grosse Depression und Bismarckzeit: Wirtschaftsablauf, Gesellschaft, und Politik in Mitteleuropa (Berlin: Walter de Gruyter, 1967). 6. James J. Sheehan, German Liberalism in the Nineteenth Century (Chicago and London: University of Chicago Press, 1978), 181. 7. On the effects of the law, see Vernon Lidtke, The Outlawed Party: Social Democracy in Germany, 1878–1890 (Princeton: Princeton University Press, 1966). 8. The following relies on what remain two of the best political histories of Bismarckian social insurance: Walter Vogel, Bismarcks Arbeiterversicherung: Ihre Entstehung im Kräftespiel der Zeit (Braunschweig: Georg Westermann, 1951) and Ritter, Social Welfare. On accident insurance, see Otto Quandt, Die Anfänge der Bismarckschen Sozialgesetzgebung und die Haltung der Parteien (Das Unfallversicherungsgesetz 1881–1884) (Berlin: Emil Ebering, 1938). Quandt’s book, though conspicuously peppered with deferential remarks to the Nazis, is nevertheless a useful older study and was reprinted in the series “Historische Studien” in 1965. 9. On this influential social conservatism, see Beck, Origins of the Authoritarian Welfare State. 10. Promemoria des Kommerzienrats Louis Baare für den preußischen Handelsminister Karl Hofmann, 30 April 1880, in Quellensammlung zur Geschichte der deutschen Sozialpolitik 1867–1914, I. Abteilung, 2. Band, ed. Florian Tennstedt and Heidi Winter with Heinz Domeinski (Stuttgart, Jena, and New York: Gustav Fischer, 1993), 161–70. 11. This point is emphasized by Breger, Haltung. 12. Given that Germany was first unified in 1871, I should make clear how I intend to use the terms “Germany” and “German” throughout this chapter. When referring to developments from 1871 onward, the terms are meant to indicate the German Reich. Before 1871, I will distinguish between Prussia/Prussian and Germany/German: the latter should be construed as referring to the German-speaking states and societies of central Europe. 13. Reinhold August Dorwart, The Prussian Welfare State before 1740 (Cambridge: Harvard University Press, 1971); Hans Maier, Die ältere deutsche Staats- und Verwaltungslehre (Munich: Beck, 1980); Marc

Raeff, The Well-Ordered Police State: Social and Institutional Change through Law in the Germanies and Russia, 1600–1800 (New Haven: Yale University Press, 1983). 14. Eckart Pankoke, “Von ‘guter Policey’ zu ‘socialer Politik’: ‘Wohlfahrt,’ ‘Glückseligkeit,’ und ‘Freiheit’ als Wertbindung aktiver Sozialstaatlichkeit,” in Soziale Sicherheit und soziale Disziplinierung: Beiträge zu einer historischen Theorie der Sozialpolitik, ed. Christoph Sachße and Florian Tennstedt (Frankfurt a.M.: Suhrkamp, 1986), 148–77. 15. Keith Tribe, Governing Economy: The Reformation of German Economic Discourse, 1750–1840 (New York: Cambridge University Press, 1988), 19–34. 16. Otto Brunner, “Das ‘Ganze Haus’ und die alteuropäische ‘Ökonomik,’” in Neue Wege der Verfassungsund Sozialgeschichte (Göttingen: Vandenhoeck & Ruprecht, 1968), 103–27. Mary Lindemann, Patriots and Paupers: Hamburg, 1712–1830 (New York: Oxford University Press, 1990) shows that municipalities also practiced this paternalistic form of government into the nineteenth century. 17. Tribe, Governing Economy, 28–32. 18. These trends were further reinforced in the sixteenth and seventeenth centuries by the teachings of Neostoicism. An increasingly popular intellectual movement in the age of civil and religious wars, it stressed the values of moderation, reason, dutifulness, obedience, and discipline. See Gerhard Oestreich, Neostoicism and the Early Modern State (Cambridge: Cambridge University Press, 1982). 19. Werner Conze, “Sicherheit, Schutz,” in Geschichtliche Grundbegriffe: Historisches Lexicon zur politisch-sozialen Sprache in Deutschland, vol. 5, ed. Otto Brunner, Werner Conze, and Reinhart Koselleck (Stuttgart: Klett-Cotta, 1984), 831–62. 20. Dieter Wyduckel, Ius Publicum: Grundlage und Entwicklung des Öffentlichen Rechts und der deutschen Staatrechtswissenschaft (Berlin: Duncker & Humblot, 1984). 21. For an important philosophical defense of this shift, see Wilhelm von Humboldt, The Limits of State Action (Indianapolis: Liberty Fund, 1993), written in 1791–92. 22. Reinhart Koselleck, Preußen zwischen Reform und Revolution: Allgemeines Landrecht, Verwaltung, und soziale Bewegung von 1791 bis 1848 (Munich and Stuttgart: dtv/Klett-Cotta, 1989), 23–51, 153–216. 23. It is worthy of note that “self-administration” was considered the German equivalent to the English notion of “self-government.” On self-administration, see Heinrich Heffter, Die deutsche Selbstverwaltung im 19. Jahrhundert: Geschichte der Ideen und Institutionen (Stuttgart: K. F. Koehler, 1969). 24. Kenneth H. F. Dyson, The State Tradition in Western Europe: A Study of an Idea and Institution (New York: Oxford University Press, 1980), 117–32. This had been going on since the seventeenth century. See Hans Rosenberg, Bureaucracy, Aristocracy, and Autocracy: The Prussian Experience, 1660–1815 (Cambridge: Harvard University Press, 1958). 25. Wyduckel, Ius Publicum, 228–31. 26. Niklas Luhmann, “Vom Polizeistaat zum Rechtsstaat,” in Zweckbegriff und Systemrationalität: Über die Funktion von Zwecken in sozialen Systemen (Tübingen: J. C. B. Mohr, 1968), 58–71. 27. In Luhmann’s view, this historically recent form of legitimation—in contrast to concepts of legitimacy that stressed natural law or consensus building—comes from the secure sense that (1) one has access to decision-making procedures, and (2) one has an equal opportunity to receive a satisfactory decision out of these procedures. See Luhmann, Legitimation durch Verfahren. 28. See Alf Lüdtke, Police and State in Prussia, 1815–1850 (Cambridge: Cambridge University Press, 1989). 29. This is a social fact ignored by many scholars of the German police and welfare states. Dorwart, for example, rather ahistorically confuses a number of very distinct features when he states in his preface, “A welfare state is based upon compulsion, on exercise of the police power to regulate the actions of the individual.” He reiterates this point later: “Fundamental to any welfare state is police power, the element of force or compulsion, the authority inherent in the office of government.” Dorwart, Prussian Welfare State, 13. 30. Knut Borchardt, “The Industrial Revolution in Germany, 1700–1914,” in The Fontana Economic History of Europe, vol. 4, part 1: The Emergence of Industrial Societies, ed. Carlo M. Cipolla (London: Collins/Fontana, 1973), 76–157. 31. Leonard Krieger, The German Idea of Freedom: History of a Political Tradition (Chicago and London: University of Chicago Press, 1957), 341–457. David Blackbourn in The Peculiarities of German History

has called this the “silent bourgeois revolution.” 32. Helmut Böhme, An Introduction to the Social and Economic History of Germany: Politics and Economic Change in the Nineteenth and Twentieth Centuries (New York: St. Martin’s, 1978), 61–72. 33. Fritz Loos and Hans-Ludwig Schreiber, “Recht, Gerechtigkeit,” in Geschichtliche Grundbegriffe, ed. Brunner, et al., vol. 5, 231–311. 34. Michael John, “The Peculiarities of the German State: Bourgeois Law and Society in the Imperial Era,” Past and Present 119 (1988): 105–31; Politics and the Law in Late Nineteenth-Century Germany: The Origins of the Civil Code (Oxford: Clarendon, 1989). 35. Gerhard Dilcher, “Der rechtswissenschaftliche Positivismus: Wissenschaftliche Methode, Sozialphilosophie, Gesellschaftspolitik,” Archiv für Rechts- und Sozialphilosophie, 61/4 (1975): 497–528; Werner Conze, “Staat und Gesellschaft in der frührevolutionären Epoche Deutschlands,” in Staat und Gesellschaft, ed. Ernst-Wolfgang Böckenförde (Darmstadt: Wissenschaftliche Buchgesellschaft, 1976), 37–76; Dietrich Tripp, Der Einfluß des naturwissenschaftlichen, philosophischen und historischen Positivismus auf die deutsche Rechtslehre im 19. Jahrhundert (Berlin: Duncker & Humblot, 1983); ErnstWolfgang Böckenförde, “The Origin and Development of the Concept of the Rechtsstaat,” in State, Society, and Liberty: Studies in Political Theory and Constitutional Law (New York and Oxford: Berg, 1991), 47–70. 36. This increasing preoccupation with “process” was by no means a strictly political and administrative development. Rather, the instrumentalization of the state was part of a broader, secularizing trend in nineteenth-century German culture that, on the one hand, undermined the idea of final and absolute ends and meaning, and, on the other, extolled the perfection of technique. For this argument, see Georg Simmel, “Tendencies in German Life and Thought Since 1870,” International Monthly 5 (1902): 93–111, 166–84. 37. See the essays in Werner Conze, ed., Staat und Gesellschaft im deutschen Vormärz 1815–1848 (Stuttgart: Ernst Klett, 1962). 38. Gerhard Dilcher and Rudi Lauda, “Das Unternehmen als Gegenstand und Anknüpfungspunkt rechtlicher Regelungen in Deutschland 1860–1920,” in Recht und Entwicklung der Großunternehmen im 19. und 20. Jahrhundert: Wirtschafts-, sozial-, und rechtshistorische Untersuchungen zur Industrialisierung in Deutschland, Frankreich, England und den USA, ed. Norbert Horn and Jürgen Kocka (Göttingen: Vandenhoeck & Ruprecht, 1979), 535–76. 39. The Prussian, and later the German, state’s promotion of railroad construction, its sponsoring of patent legislation, and its standardization of currency are all examples of these concerns in the years 1850–1900. Indeed, even before 1848, Prussian officials in the Gewerbedepartment, Mining Corps, Seehandlung, and military technology services actively promoted technological innovations in the public and private sectors, albeit for diverse ideological reasons. See Joachim Hirsch, Wissenschaft-technischer Fortschritt und politisches System (Frankfurt a.M.: Suhrkamp, 1970); Wolfgang Zorn, “Staatliche Wirtschafts- und Sozialpolitik und öffentliche Finanzen 1800–1970,” in Handbuch der deutschen Wirtschafts- und Sozialgeschichte, vol. 2, ed. Hermann Aubin and Wolfgang Zorn (Stuttgart: Ernst Klett, 1976), 148–97; Eric Dorn Brose, The Politics of Technological Change in Prussia: Out of the Shadow of Antiquity, 1809–1848 (Princeton: Princeton University Press, 1993). 40. Isabel V. Hull, Sexuality, State, and Civil Society in Germany, 1700–1815 (Ithaca and London: Cornell University Press, 1996), 159. 41. John Keane, “Despotism and Democracy: The Origins and Development of the Distinction Between Civil Society and the State 1750–1850,” in Civil Society and the State: New European Perspectives, ed. John Keane (London and New York: Verso, 1988), 35–71; Jean L. Cohen and Andrew Arato, Civil Society and Political Theory (Cambridge and London: MIT Press, 1992), 83–116. 42. Carole Pateman, “Feminist Critiques of the Public/Private Dichotomy,” in Public and Private in Social Life, ed. S. I. Benn and G. F. Gaus (London, Canberra, New York: Croom Helm/St. Martin’s, 1983), 281–303. 43. Susan Moller Okin, Women in Western Political Thought (Princeton: Princeton University Press, 1979), 99–194. 44. Anna Yeatman, “Despotism and Civil Society: The Limits of Patriarchal Citizenship,” in Women’s Views of the Political World of Men, ed. Judith Hicks Stiehm (Dobbs Ferry, N.Y.: Transnational, 1984), 151–76.

45. Jean Bethke Elshtain, Public Man, Private Woman: Women in Social and Political Thought (Princeton: Princeton University Press, 1981), 127. 46. Joan B. Landes, Women and the Public Sphere in the Age of the French Revolution (Ithaca and London: Cornell University Press, 1988), 39–65. 47. Carole Pateman, “The Fraternal Social Contract,” in Civil Society and the State, ed. Keane, 112–13; The Sexual Contract (Stanford: Stanford University Press, 1988). 48. Krieger, German Idea of Freedom, 71–80. 49. See Humboldt, Limits. 50. G. W. F. Hegel, Elements of the Philosophy of Right, ed. H. B. Nisbet (Cambridge: Cambridge University Press, 1991/1821), 282–85. 51. David F. Lindenfeld, The Practical Imagination: The German Sciences of State in the Nineteenth Century (Chicago and London: University of Chicago Press, 1997), 181. 52. On these developments, see L. H. Geck, Über das Eindringen des Wortes “sozial” in die deutsche Sprache (Göttingen: Otto Schwartz, 1963). 53. Robert M. Berdahl, The Politics of the Prussian Nobility: The Development of a Conservative Ideology, 1770–1848 (Princeton: Princeton University Press, 1988). 54. Jörn Garber, “Drei Theoriemodelle frühkonservativer Revolutionsabwehr: Altständischer Funktionalismus, spätabsolutistisches Vernunftfrecht, evolutionärer ‘Historismus,’” Jahrbuch des Instituts für Deutsche Geschichte 8 (1979): 65–101. 55. Hermann Beck, “Conservatives and the Social Question in Nineteenth-Century Prussia,” in Between Reform, Reaction, and Resistance: Studies in the History of German Conservatism from 1789 to 1945, ed. Larry Eugene Jones and James Retallack (Providence and Oxford: Berg, 1993), 61–94, and Origins of the Authoritarian Welfare State; Wolfgang Schwentker, “Victor Aimé and the Emergence of Social Conservatism,” in Between Reform, Reaction, and Resistance, ed. Jones and Retallack, 95–121. 56. Quoted in Berdahl, Politics of the Prussian Nobility, 364. 57. Robert Gildea, Barricades and Borders: Europe 1800–1914 (Oxford: Oxford University Press, 1987). 58. Werner Conze, “Vom Pöbel zum Proletariat,” Vierteljahresschrift für Sozial- und Wirtschaftsgeschichte 41 (1954): 333–64; Eda Sagarra, A Social History of Germany, 1648–1914 (New York: Holmes & Meier, 1977); Berdahl, Politics of the Prussian Nobility, 264–310. 59. Wolfgang Schivelbusch, The Railway Journey: The Industrialization of Time and Space in the Nineteenth Century (Berkeley and Los Angeles: University of California Press, 1977), 113–58. 60. Joachim Radkau, Das Zeitalter der Nervosität: Deutschland zwischen Bismarck und Hitler (Munich and Vienna: Carl Hanser, 1998). 61. On this theme, see the masterful work by Eckart Pankoke, Sociale Bewegung-Sociale Frage-Sociale Politik: Grundfragen der deutschen “Sozialwissenschaft” im 19. Jahrhundert (Stuttgart: Ernst Klett, 1970). 62. Gerhard Dilcher, “Das Gesellschaftsbild der Rechtswissenschaft und die soziale Frage,” in Das wilhelminische Bildungsbürgertum: Zur Sozialgeschichte seiner Ideen, ed. Klaus Vondung (Göttingen: Vandenhoeck & Ruprecht, 1976), 53–66. 63. Greg Myers, “Nineteenth-Century Popularizations of Thermodynamics and the Rhetoric of Social Prophecy,” Victorian Studies 29 (1985): 35–66; Theodore M. Porter, “Natural Science and Social Theory,” in Companion to the History of Modern Science, ed. R. C. Olby, G. N. Cantor, J. R. R. Christie, and M. J. S. Hodge (London and New York: Routledge, 1990), 1024–43. 64. Friedrich Jonas, Geschichte der Soziologie, vol. 1: Aufklärung, Liberalismus, Idealismus, Sozialismus, Übergang zur industriellen Gesellschaft (Opladen: Westdeutscher, 1980), 283–313; Lindenfeld, Practical Imagination, 205–63. 65. Jürgen Reulecke, “Pauperismus, ‘social learning,’ und die Anfänge der Sozialstatistik in Deutschland,” in Vom Elend der Handarbeit: Probleme historischer Unterschichtenforschung, ed. Hans Mommsen and Winfried Schulze (Stuttgart: Klett-Cotta, 1981), 364. See also Rüdiger vom Bruch, “Einführung,” in “Weder Kommunismus noch Kapitalismus”: Bürgerliche Sozialreform in Deutschland vom Vormärz bis zur Ära Adenauer, ed. Rüdiger vom Bruch (Munich: C. H. Beck, 1985), 7–19; Jürgen Reulecke, “Die Anfänge der organisierten Sozialreform in Deutschland,” in “Weder Kommunismus,” ed. Bruch, 21–59. 66. Lorraine J. Daston, “Rational Individual versus Laws of Society: From Probability to Statistics,” in The Probabilistic Revolution, vol. 1, Ideas in History, ed. Lorenz Krüger, Lorraine J. Daston, and Michael

Heidelberger (Cambridge: MIT Press, 1987), 295–304; Ian Hacking, The Taming of Chance (Cambridge: Cambridge University Press, 1990), 16–26. 67. Theodore M. Porter, The Rise of Statistical Thinking, 1820–1900 (Princeton: Princeton University Press, 1986), 27. 68. Ibid. and Gerd Gigerenzer, Zeno Swijtink, Theodore Porter, Lorraine Daston, John Beatty, and Lorenz Krüger, The Empire of Chance: How Probability Changed Science and Everyday Life (Cambridge: Cambridge University Press, 1989), 37–69. 69. Lambert Adolphe Jacques Quetelet, A Treatise on Man and the Development of His Faculties (Gainesville, Fla.: Scholar’s Facsimiles and Reprints, 1969), 7. 70. On these developments in the history of poverty, see Mitchell Dean, The Constitution of Poverty: Toward a Genealogy of Liberal Governance (London and New York: Routledge, 1991); Robert Jütte, Poverty and Deviance in Early Modern Europe (Cambridge: Cambridge University Press, 1994); Giovanna Procacci, “Governing Poverty: Sources of the Social Question in Nineteenth-Century France,” in Foucault and the Writing of History, ed. Goldstein, 206–19. 71. Anthony Oberschall, Empirical Social Research in Germany, 1848–1914 (Paris and The Hague: Mouton, 1965); Ulla G. Schäfer, Historische Nationalökonomie und Sozialstatistik als Gesellschaftswissenschaften (Cologne: Böhlau, 1971); Theodore M. Porter, “Lawless Society: Social Science and the Reinterpretation of Statistics in Germany, 1850–1880,” in The Probabilistic Revolution, vol. 1, ed. Krüger, et al., 351–75. 72. Ian Hacking, “Prussian Numbers 1860–1882,” in The Probabilistic Revolution, vol. 1, ed. Krüger, et al., 377–94. 73. Jacques Donzelot, The Policing of Families (New York: Pantheon, 1979). Donzelot defines “the social” more narrowly than I as “the set of means which allow social life to escape the material pressures and politico-moral uncertainties; the entire range of methods which make the members of a society relatively safe from the effect of economic fluctuations by providing a certain security” (xxvi). Steinmetz, more appropriately for the German case, locates the social realm “between” the economy and the state, neither coterminous with civil society nor the state nor the family. See Steinmetz, Regulating the Social, 55–69. 74. On the various programmatic responses of political parties and social movements to nineteenth-century social change, see Ralph H. Bowen, German Theories of the Corporative State with Special Reference to the Period 1870–1919 (New York and London: Whittlesey House/McGraw-Hill, 1947); Franz Josef Stegmann, Von der ständischen Sozialreform zur staatlichen Sozialpolitik: Der Beitrag der HistorischPolitischen Blätter zur Lösung der sozialen Frage (Munich and Vienna: Günter Olzog, 1965); Hedwig Wachenheim, Die deutsche Arbeiterbewegung 1844 bis 1914 (Cologne and Opladen: Westdeutscher Verlag, 1967); Helga Grebing, The History of the German Labour Movement: A Survey (London: Oswald Wolff, 1969), 36–58; Conze, “Staat und Gesellschaft”; Sheehan, German Liberalism. 75. Pankoke, Sociale Bewegung, 171. See also Christof Dipper, “Sozialreform: Geschichte eines umstrittenen Begriffs,” Archiv für Sozialgeschichte 32 (1992): 323–51. This argument originates with Lorenz von Stein. For informed introductions in English to Stein’s ideas, see Karl-Hermann Kästner, “From the Social Question to the Social State,” Economy and Society 19 (February 1981): 7–26; Ernst-Wolfgang Böckenförde, “Lorenz von Stein as Theorist of the Movement of State and Society Towards the Welfare State,” in State, Society, and Liberty, 115–45. 76. Eckart Pankoke, “Soziale Selbsverwaltung: Zur Problemgeschichte sozial-liberaler Gesellschaftspolitik, ” Archiv für Sozialgeschichte 12 (1972): 185–203; Hanjoachim Henning, “Aufbau der Sozialverwaltung,” in Deutsche Verwaltungsgeschichte, vol. 3, ed. Kurt A. Jeserich, Hans Pohl, Georg-Christoph von Unruh (Stuttgart: Deutsche Verlags-Anstalt, 1984), 275–310. 77. Wilhelm Hagena, Die Ansichten der deutschen Kameralisten des 18. Jahrhunderts über das Versicherungswesen (Norden: Johann Friedrich Schmidt, 1910); Hans Schmitt-Lermann, Der Versicherungsgedanke im deutschen Geistesleben des Barock und der Aufklärung (Munich: Kommunalschriften-Verlag J. Jehle, 1954); Gerald Schöpfer, Sozialer Schutz im 16.–18. Jahrhundert: Eine Beitrag zur Geschichte der Personenversicherung und der landwirtschaftlichen Versicherung (Graz: Leykam, 1976). 78. On early modern probabilists, see Lorraine Daston, Classical Probability in the Enlightenment (Princeton: Princeton University Press, 1988).

79. Bottomry was a practice by which an insurer lent a merchant what was required to cover the cost of a voyage. If the ship was lost, the debt was cancelled; otherwise, it was repaid with a bonus. With an annuity, a lump sum was exchanged for regular payments over a period of time, usually the lifetime of the annuitant or a third person. The annuitant was therefore betting he would live long enough to recoup his initial investment or even more. A tontine, named after its Italian inventor Lorenzo Tonti, was an agreement according to which members made an initial contribution to a common fund. This fund was eventually awarded to the last surviving member or several members after a specified date. Finally, life insurances proper were short-term wagers taken out on the life of a third person (often a celebrity) or on the outcome of an important event like a battle. 80. Daston, Classical Probability, 116–25, 141–68; Schmitt-Lermann, Versicherungsgedanke im deutschen Geistesleben, 62–94. 81. Schmitt-Lermann, Versicherungsgedanke im deutschen Geistesleben, 74–117. 82. Lorraine J. Daston, “The Domestication of Risk: Mathematical Probability and Insurance 1650–1830,” in The Probabilistic Revolution, vol. 1, ed. Lorenz Krüger, et al., 237–60. Masius, in what was the first comprehensive, academic handbook on the theory of German insurance, downright gushes when speaking of the domestic virtues of life insurance:

What father could look death calmly in the eye if he had to admit to himself that by his passing mother and daughter, son and sister were to be left in abject poverty—a fate only diverted by his busy hands! Now he can!

What mother could carry with her without worry the thought that her departure will also leave her children defenseless before hunger and misfortune! Now they can be safe!

Domesticity and thrift, frugality and orderliness—the sole pillars on which the blessings of the house rest, the sole weapons against all temptations of growing hedonism—spread their charitable influences. . . .

E.A. Masius, Lehre der Versicherung und statistische Nachweisung aller Versicherungs-Anstalten in Deutschland (Leipzig: Fest’sche Velagsbuchhandlung, 1846), 476. 83. Jews numbered 567,900. For these figures, see E. I. Kouri, Der deutsche Protestantismus und die soziale Frage 1870–1919 (Berlin and New York: Walter de Gruyter, 1984), 63. 84. This is a point emphasized by Hans Rothfels, Prinzipienfragen der Bismarckschen Sozialpolitik (Königsberg: Gräfe und Unzer, 1929). 85. Günter Brakelmann, Die soziale Frage des 19. Jahrhunderts (Witten/Ruhr: Luther, 1964), 111–12. 86. On these attitudes, see Karl Heinz Grenner, Wirtschaftsliberalismus und katholisches Denken: Ihre Begegnung und Auseinandersetzung im Deutschland des 19. Jahrhunderts (Cologne: J. P. Bachem, 1967); Johann Baptist Müller, Bedürfnis und Gesellschaft: Bedürfnis als Grundkategorie im Liberalismus, Konservatismus und Sozialismus (Stuttgart: Ernst Klett, 1971). 87. Stegmann, Von der ständischen Sozialreform, 34–45; Grenner, Wirtschaftsliberalismus und katholisches Denken, 296–339. 88. Walter Vogel, Bismarcks Arbeiterversicherung, 58–66; Stegmann, Von der ständischen Sozialreform; Brakelmann, Die soziale Frage des 19. Jahrhunderts, 195–226. 89. Wilfried Loth, “Die deutschen Sozialkatholiken in der Krise des Fin de Siecle,” in Soziale Reform im Kaiserreich: Protestantismus, Katholizismus, und Sozialpolitik, ed. Jochen-Christoph Kaiser and Wilfried Loth (Stuttgart, Berlin, Cologne: W. Kohlhammer, 1997), 128–41. 90. Thomas Nipperdey, Religion im Umbruch: Deutschland 1870–1918 (Munich: C. H. Beck, 1988),

51–62; Ewald Frie, “Katholische Wohlfahrtskultur im Wilhelminischen Reich: Der ‘Charitasverband für das katholische Deutschland,’ die Vinzenzvereine und der ‘kommunale Sozialliberalismus,’” in Soziale Reform, ed. Kaiser and Loth, 184–201. 91. See William O. Shanahan, German Protestants Face the Social Question: Volume I. The Conservative Phase, 1815–1871 (Notre Dame: University of Notre Dame Press, 1954). 92. Brakelmann, Die soziale Frage des 19. Jahrhunderts, 112–13. 93. Ibid., 122–38. 94. Ibid., 150–74; Kouri, Der deutsche Protestantismus, 92–98. 95. Klaus Erich Pollmann, “Sozial Frage, Sozialpolitik, und evangelische Kirche 1890–1914,” in Sozialer Protestantismus und Sozialstaat: Diakonie und Wohlfahrtspflege in Deutschland 1890 bis 1938, ed. JochenChristoph Kaiser and Martin Greschat (Stuttgart, Berlin, Cologne: W. Kohlhammer, 1996), 41–56. 96. Klaus Erich Pollmann, “Weltanschauungskampf an zwei Fronten: Der Sozialprotestantismus 1890–1914,” in Soziale Reform, ed. Kaiser and Loth, 78. 97. Hermann Beck, Origins of the Authoritarian Welfare State, 106. 98. Florian Tennstedt, “Politikfähige Anstösse zu Sozialreform und Sozialstaat: Der Irvingianer Hermann Wagener und der Lutheraner Theodor Lohmann als Ratgeber und Gegenspieler Bismarcks,” in Soziale Reform, ed. Kaiser and Loth, 21–24. 99. Florian Tennstedt and Heidi Winter, “‘Der Staat hat wenig Liebe—activ wie passiv’: Die Anfänge des Sozialstaats im Deutschen Reich von 1871,” Zeitschrift für Sozialreform 39 (1993): 379, 383. 100. Hans-Jörg von Berlepsch, “Konsensfähige Alternativen zu Bismarcks Modell sozialpolitischer Gestaltung,” in Bismarcks Sozialstaat, ed. Machtan, 65–66; Hans Otte, “Den Ideen Gestalt geben: Der Sozialpolitiker Theodor Lohmann im Centralausschuss für die Innere Mission,” in Soziale Reform, ed. Kaiser and Loth, 32–55; Tennstedt, “Politikfähige,” 26–31; Renate Zitt, Zwischen Innerer Mission und staatlicher Sozialpolitik: Der protestantische Sozialreformer Theodor Lohmann (1831–1905)/Eine Studie zum sozialen Protestantismus im 19. Jahrhundert (Heidelberg: Universitätsverlag C. Winter, 1997), 434–48. 101. Florian Tennstedt and Heidi Winter, “‘Jeder Tag hat seine eigenen Sorgen, und es ist nicht weise, die Sorgen der Zukunft auf die Gegenwart zu übernehmen,’” Zeitschrift für Sozialreform 41 (1995): 671–706. 102. Frevert, Krankheit, 177. 103. Martin H. Geyer, Die Reichsknappschaft: Versicherungsformen und Sozialpolitik im Bergbau 1900–1945 (Munich: C. H. Beck, 1987), 26. 104. Abram de Swaan, In Care of the State: Health Care, Education and Welfare in Europe and the USA in the Modern Era (New York: Oxford University Press, 1988), 149. 105. Theodore M. Porter, “Precision and Trust: Early Victorian Insurance and the Politics of Calculation,” in The Values of Precision, ed. M. Norton Wise (Princeton: Princeton University Press, 1995), 173–97. 106. François Ewald, “Insurance and Risk,” in The Foucault Effect, ed. Burchell, et al., 197–210, and Vorsorgestaat, 171–238. 107. Karl Figlio, “What Is an Accident?” in Social History, ed. Weindling, 198. See also Anson Rabinbach, “Social Knowledge, Social Risk, and the Politics of Industrial Accidents in Germany and France,” in States, Social Knowledge, and the Origins of Modern Social Policies, ed. Dietrich Rueschemeyer and Theda Skocpol (Princeton: Princeton University Press, 1996), 48–89; Roger Cooter and Bill Luckin, eds., Accidents in History: Injuries, Fatalities, and Social Relations (Amsterdam and Atlanta: Rodopi, 1997). 108. Abram de Swaan, “Jealousy as a Class Phenomenon: The Petty Bourgeoisie and Social Security,” in Abram de Swaan, The Management of Normality: Critical Essays in Health and Welfare (London and New York: Routledge, 1990), 179. 109. Daniel Defert, “‘Popular Life’ and Insurance Technology,” in The Foucault Effect, ed. Burchell, et al., 211–33. Steinmetz points out that, in contrast to the French, German social insurance did not recognize workers as formal risk categories, but rather incorporated them according to accepted “lay sociologies” of the time. This is why, he contends, the German system largely excluded unskilled laborers and created an entirely separate program for white-collar workers. This, however, is only partly true. As I will show, while it may have been legislatively conceived in the terms outlined by Steinmetz, German social insurance kept the question of risk exposure at the center of its everyday practice. 110. George Rosen, “The Fate of the Concept of Medical Police, 1780–1890,” Centaurus 5 (1957): 97–113;

Raeff, Well-Ordered Police State, 119–35. 111. Frevert, Krankheit, 84–115. See also Christoph Sachße and Florian Tennstedt, Geschichte der Armenfürsorge in Deutschland: Vom Spätmittelalter bis zum Ersten Weltkrieg, vol. 1 (Stuttgart: W. Kohlhammer, 1980); Alfons Labisch, “‘Hygiene ist Moral—Moral ist Hygiene’—Soziale Disziplinierung durch Ärzte und Medizin,” in Soziale Sicherheit, ed. Sachße and Tennstedt, 265–85; Jürgen Reulecke and Adelheid Gräfin zu Castell Rüdenhausen, eds., Stadt und Gesundheit: Zum Wandel von “Volksgesundheit” und kommunaler Gesundheitspolitik im 19. und frühen 20. Jahrhundert (Stuttgart: Franz Steiner, 1991); Conrad, Vom Greis zum Rentner, 150–206. 112. Local governments, however, did retain certain features of medical policing. The municipal medical office continued to be a center for controlling communicable diseases, organizing medical professions, providing limited care to the indigent, and supervising sanitation. Municipalities in nineteenth-century Germany also continued to employ medical officers (so-called Physici) whose job it was to serve as advisers to courts in legal matters, supervise and register health-care workers, and look after general public-health affairs. Alfons Labisch and Florian Tennstedt, Der Weg zum “Gesetz über die Vereinheitlichung des Gesundheitswesens” vom 3. Juli 1934: Entwicklungslinien und -momente des staatlichen und kommunalen Gesundheitswesens in Deutschland, vol. 1 (Düsseldorf: Akademie für öffentliches Gesundheitswesen in Düsseldorf, 1985), 14–16. 113. Ibid., 25. 114. See Gertrud Kroeger, The Concept of Social Medicine as Presented by Physicians and Other Writers in Germany, 1779–1932 (Chicago: Julius Rosenwald Fund, 1937). 115. George Rosen, “What Is Social Medicine? A Genetic Analysis of the Concept,” in George Rosen, From Medical Police to Social Medicine: Essays on the History of Health Care (New York: Science History Publications, 1974), 60–119. 116. In the words of one of its chief elaborators, Eduard Reich (1836–1919):

The concept of hygiene thus comprises far more than was formerly comprehended under dietetics and medical police. Hygiene deals with man as a whole, as an individual and as he manifests himself in the family and in society; it deals with man in all his conditions and relations. Consequently, hygiene comprises the entire physical and moral world, and collaborates with all the sciences whose subject is the study of man and his environment. . . . Hygiene, or the theory of health and welfare, is the philosophy, science and art of healthy living for the individual, the family, society and the state. Its stream derives from three tributaries: the first arises from practical philosophy, the second from medicine, and the third from social science. Moral hygiene is an application of practical philosophy, social hygiene an application of social science, and dietetic (as well as climatic) and police hygiene are applied medicine.

This quote from Eduard Reich’s System der Hygiene (1870–71) is taken from Rosen, “Social Medicine,” 88–89. 117. See chapter 2 in Labisch and Tennstedt, Weg zum “Gesetz.” For an excellent social and political history of public health in one German city, see Richard J. Evans, Death in Hamburg: Society and Politics in the Cholera Years, 1830–1910 (Oxford: Clarendon, 1984). 118. W. F. Bynum, Science and the Practice of Medicine in the Nineteenth Century (Cambridge: Cambridge University Press, 1994), 1–24, 176–217. For a discussion of the complex relations between the theoretical, practical, and technological elements of eighteenth- and nineteeth-century German academic medicine, see Thomas H. Broman, The Transformation of German Academic Medicine, 1750–1820 (Cambridge and New York: Cambridge University Press, 1996), 194–202. 119. François Jacob, The Logic of Life: A History of Heredity (Princeton: Princeton University Press, 1973), 130–77. This translated into the medical notion that illnesses, too, had histories. See Johanna Bleker, “Die historische Pathologie, Nosologie und Epidemiologie im 19. Jahrhundert,” Medizinhistorisches Journal 19

(1984): 33–52. 120. See the masterful discussion of these developments by William Coleman, Biology in the Nineteenth Century: Problems of Form, Function, and Transformation (Cambridge: Cambridge University Press, 1971). 121. Johanna Bleker, “Medical Students—to the Bed-side or to the Laboratory? The Emergence of Laboratory-Training in German Medical Education 1870–1900,” Clio Medica 21 (1987–88): 35–46; Thomas Neville Bonner, Becoming a Physician: Medical Education in Britain, France, Germany, and the United States, 1750–1945 (New York and Oxford: Oxford University Press, 1995), 187–90, 231–41, 281. 122. William Coleman, “Experimental Physiology and Statistical Inference: The Therapeutic Trial in Nineteenth-Century Germany,” in The Probabilistic Revolution, vol. 2: Ideas in the Sciences, ed. Lorenz Krüger, Gerd Gigerenzer, and Mary S. Morgan (Cambridge, Mass., and London: MIT Press, 1982), 201–26. 123. Bynum, Science and the Practice of Medicine, 142–75. 124. This is clearly evident in nineteenth-century literary representations of medicine and doctors. See Lawrence Rothfield, Vital Signs: Medical Realism in Nineteenth-Century Fiction (Princeton: Princeton University Press, 1992). 125. On the professionalization of doctors in Germany, see Claudia Huerkamp, “Ärzte und Professionalisierung in Deutschland: Überlegungen zum Wandel des Artzberufs im 19. Jahrhundert,” Geschichte und Gesellschaft, 3 (1980): 349–82 and Der Aufstieg der Ärzte im 19. Jahrhundert. Vom gelehrten Stand zum professionellen Experten: das Beispiel Preußen (Göttingen: Vandenhoeck & Ruprecht, 1985). 126. Georges Canguilhem, The Normal and the Pathological (New York: Zone Books, 1991); Volker Hess, ed., Normierung der Gesundheit: Messende Verfahren der Medizin als kulturelle Praktik um 1900 (Husum: Matthiesen, 1998). 127. Gunter Mann, “Medizinisch-biologische Ideen und Modelle in der Gesellschaftslehre des 19. Jahrhunderts,” Medizinische Journal 4 (1969): 1–23. 128. Gerd Göckenjan, Kurieren und Staat machen: Gesundheit und Medizin in der bürgerlichen Welt (Frankfurt a.M.: Suhrkamp, 1985), 150, 174, 281, 311–14. 129. Lüdtke, Police and State in Prussia, 2–29. 130. François Ewald, “Norms, Discipline, and the Law,” Representations 30 (1990): 151. 131. Ibid., 158. 132. Anthony Giddens, The Consequences of Modernity (Stanford: Stanford University Press, 1990), 19–36. 133. On the centrality of trust in modern political and scientific theory and practice, see Steven Shapin and Simon Schaffer, Leviathan and the Air-Pump: Hobbes, Boyle, and the Experimental Life (Princeton: Princeton University Press, 1985); Stephen Toulmin, Cosmopolis: The Hidden Agenda of Modernity (Chicago: University of Chicago Press, 1990); Steven Shapin, A Social History of Truth: Civility and Science in Seventeenth-Century England (Chicago and London: University of Chicago Press, 1994). 134. This terminology and idea comes from Theodore M. Porter, Trust in Numbers: The Pursuit of Objectivity in Science and Public Life (Princeton: Princeton University Press, 1995). 135. See Kathryn M. Olesko, “The Meaning of Precision: The Exact Sensibility in Early NineteenthCentury Germany,” in The Values of Precision, ed. Wise, 103–34; and Porter, “Precision and Trust.”

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CHAPTER 3 Embodied Entitlement: The Policy, Practice, and Politics of Disability Compensation, 1884–1914 August Kranich, a sixty-one-year-old cottager, was injured while working on 14 March 1908. He suffered contusions of the right shoulder, the right arm, and the chest. Seeking compensation under the statutes of compulsory accident insurance, Kranich turned to his local provider, the Brandenburg Agricultural Accident Insurance Board, for an appropriate pension. The insurance provider determined that he was not wholly incapacitated in his ability to earn a living, the criterion for establishing the degree of debility. Instead, the insurance board awarded him a pension from 14 June 1908 set at 20 percent of that for full disability. Administrators reduced this amount to 10 percent in November 1909 after a district physician certified that Kranich’s condition had measurably improved. Kranich refused to accept this new judgment, and he appealed to the Potsdam Government District Court of Arbitration for Workers’ Insurance in Berlin, armed with an examination report from another physician who supported his claim. The court called on yet another medical expert to examine and observe the pensioner over a period of time. Judges then personally examined Kranich during the hearing on 30 December 1909. They concluded that the injured man was not appreciably impaired in his earning capacity by the consequences of the accident:

It is true the plaintiff alleges not to be able to lift his right arm, which he effortlessly brings to the horizontal, to the vertical. He does succeed in lifting the arm to the horizontal, however, by bending down, in other words, by similarly bending his upper body horizontally. This motion, however, corresponds to the vertical for an erect body posture. The cracking noise, which occurs whenever there is a strong rotating motion of the right arm in the shoulder joint, is of no significance, since an emaciation of the musculature Page 68 → of the right shoulder cannot be established. The right arm musculature is no flabbier than the left; the right arm even shows an excess of ½ cm. 1

Kranich appealed the lower court’s decision to the highest court in insurance matters, the Reich Insurance Office. In his statement to the insurance office senate, he attacked the medical reports offered into evidence by insurance providers. “The evidence of the Agricultural Accident Insurance Board regarding my earning capacity is the result of tricks of said medical reports in which the one doctor claims there are no more noises audible in the shoulder joint, thus improved . . . the second doctor claims, with strong rotating of the arm, a cracking noise in the shoulder joint is audible! What’s of no significance?” In addition, added the pensioner, the physical examination the court conducted was nothing short of a farce. “I had to put the one hand on the table, bend over, and then try to touch the floor with the other one, and this bent [-over position] is referred to in the judgment as the successful vertical lifting of the arm?”2 The case was finally heard before the Reich Insurance Office Senate on 27 October 1910. Court records indicate that judges there examined the arm. In its statement, the senate announced that there was no reason to overturn the decision of the lower court. Although one physician persisted in the belief that the appellant deserved a 20 percent pension, two other physicians heard no noise in the shoulder. Ten percent, it was thought, was quite appropriate for the injured man’s condition.3 One and a half months later Kranich wrote the Reich Insurance Office, protesting its decision. The problem, he insisted, was that one judge was standing too far away to hear the noise in his shoulder. “If he [had] approached me to a meter away from me, then he would have heard the cracking noise from this distance.” Instead, the judge failed to look at the facts of the case for himself, and “I have been rejected, with my pain-racked body burdened with the accident, and I do not know how I am supposed to arrange it, so that I am able to make ends meet with 8.35 marks for a quarter year.”4

Here then is a case from the annals of German social insurance, an example of a system and a process that became a familiar part of the social landscape surrounding work, production, health, disability, and loss in the late nineteenth and Page 69 → early twentieth century. In 1885, the first year of accident insurance, 194,601 enterprises were compelled to insure themselves in order to finance the accident-insurance system, covering 2,986,248 individual workers; in 1891, the first year of invalid insurance, thirty-one insurance institutions administered invalid insurance for almost 11.5 million workers. Less than ten years later, in 1900, accident insurance had come to involve over 5 million enterprises and provided coverage for some 18 million workers; invalid insurance, by comparison, showed only a moderate increase, insuring around 13 million.5 By 1913, the numbers had reached over 25 million and over 16 million, respectively.6 In this same year, accident insurance was compensating more than 1 million individuals, 140,000 of whom were new to the rolls; invalid insurance showed similar trends, compensating 1,099,783, of which 134,159 were new benefit recipients. As the number of persons insured by compulsory insurance rose, so too did the number of pensions awarded, as well as the number of contested pension decisions (see tables 3 and 4). Cases like those of August Kranich thus became a part of the everyday direct and indirect experiences of millions of employees, employers, union officials, Page 70 → physicians, lawyers, and insurance administrators. Indeed, in this one case we confront many of the scenarios, dogmas, actors, and political machinations that marked the most basic and defining act in emerging social insurance—awarding and receiving a benefit. Injuries, applications, examinations, compensations, dissatisfactions, hearings, judges, employers, workers, attorneys, doctors, witnesses, recriminations, counter-recriminations, court decisions, further dissatisfactions, more appeals, more applications, and so on: these were the features of nineteenth-century disability insurance.7 Wilhelmian social insurance was not simply a conduit for social-policy initiatives, but a fluctuating, vital process, daily contesting and bargaining, defining and refining not only social assistance, but also occupational hierarchies, work and its values, and the concepts of health and illness.

Such an image of Imperial German bureaucracy flies squarely in the face of that of conventional German historiography.8 In Kranich’s case, he was afforded numerous opportunities to pursue his claim and be heard, and though he ultimately failed, many did not. Like millions of others, Kranich did not nor was compelled to play the grateful supplicant foreseen by social Conservatives and feared by Social Democrats. Moreover, while physicians and medicine clearly played a formative role in assessing the cottager’s plight, Kranich himself was given the opportunity to recruit his own medical expert opinion. Even more importantly, decisions in this and most other cases were consistently made by accident-insurance assessors, jurists, and bureaucrats, men trained in actuarial Page 71 → science, law, and administration, who insisted on personally examining the claimant and the facts of his case. How then did German social-insurance administration understand, award meaning to, and deal with basic human afflictions? This is the first question I want to pose in trying to uncover the history of social-insurance practice. Beginning in the 1880s, an array of afflictions—among them broken bones, blindness, deafness, amputations, disfigurements, depressions, and paralyses—found their way into the public venue of social policy through German social insurance. Individuals afflicted with such ailments and their surviving dependents placed their predicaments before insurance bureaucracy, inviting assessment and judgment on their claims for support. What then took place was a routine series of encounters during which claimants, insurers, physicians, labor unions, and bureaucrats debated and determined the extent of an individual’s entitlement to a pension. From these negotiations and adjudications, officials eventually arrived at an operational and open-ended administrative nosology of disabilities designed to guide the determination of disablement. This ordering of afflictions was articulated in a modernist idiom of productivity, expressed in functionalistic terms, but self-consciously constructed to avoid bureaucracy’s penchant for anonymity and schematism. The irony, as we shall see, was that this very scheme to balance bureaucratic formalism with an appreciation for the singularity of the individual case ultimately led to social-insurance administration becoming one of the most divisive and unwieldy bureaucracies in German society. As noted in the previous chapter, it was hoped that insurance would domesticate social conflict. As a result, the standard operational procedures of claims assessment were designed to follow a legalistically, scientifically, and medically instrumental train of reasoning. In short, the processing of claims was, in theory at least, a purely empirical investigation of the presence or absence of certain conditions. In practice, however, individual claimants and insurance courts resisted such reductionism, persistently introducing questions of fairness, moral responsibility, generosity, and sympathy into claims assessment. Thus, disability insurance never did succeed in excluding or containing conflict. In fact, by recognizing a social obligation to compensate injury, social insurance educated millions of Wilhelmian workers in a sense of entitlement that only further politicized them. The Legal Parameters of Disability Like public health administrations and poor relief before them, compulsory accident and invalid insurances were public enterprises, legally sanctioned and bureaucratically administered. What is perhaps most striking about the original and all subsequent laws establishing compulsory accident insurance (1884) Page 72 → and invalid insurance (1889) is the number of fundamental questions that remained legally unaddressed.9 Both sets of laws were, to be sure, very specific about identifying such things as those individuals covered, contribution levels, the institutions assigned to administer the programs, and the process for appealing a compensation decision. On the very concrete matter of how exactly insurance administrators were to judge what constituted a compensable affliction, however, the law said very little. Nowhere did law define the term “illness.” Nowhere did it identify specific compensable disabilities nor any universally accepted diagnostic techniques. This left many of the most important questions in the hands of those involved in social insurance’s administration, and thus open to debate, bargaining, and judicial arbitration. In sum, it was left to social-insurance practice to work out much of social insurance’s form and substance. Legislation did establish parameters, though. In the first place, the original laws fixed the guiding principles of entitlement. Claims could be filed either by the disabled party or, in the event that an accident killed a worker, by his or her spouse. Compensation itself was determined on the basis of a claimant’s “incapacity” or “inability” (Unfähigkeit). The inability to work (Arbeitsunfähigkeit) was the criterion used in sickness insurance to determine

the existence of a compensable illness. An employee was considered unable to work if he or she was not able, or was able only at the risk of aggravating a condition, to carry out the activities of his or her present occupation. Accident insurance employed the concept of the inability to earn a living (Erwerbsunfähigkeit). This meant that afflictions were measured according to how they affected the ability “of the individual to economically exploit his capacity to work in general.”10 As pointed out earlier, the system was not based on the principle of fault. It mattered in no way whether the worker, a fellow worker, or the machinery was responsible for the accident. If the injury happened within the work setting, a worker was entitled to compensation. Whereas under sickness insurance cash benefits were a fixed percentage of income, the size of pensions awarded under accident insurance was determined on a graduated scale, measuring the percentage of total disablement. The “inability to earn a living” could therefore be total (100 percent) or partial (as low as 10 percent). Taking into account not only the person’s injuries, but also his or her health before the accident, his or her occupation, and the labor market in general, the earning capacity of the claimant was fixed in a percentage. This, in turn, was Page 73 → measured against a figure equaling two-thirds of the insured individual’s annual income, since it was a long-standing tenet of public assistance that being on welfare should never be as lucrative as working. Pensions normally were then disbursed in monthly installments. Invalidity (Invalidität), lastly, was the precondition for receiving pensions within invalid insurance. Under the original principle, an insured worker was to be recognized as invalid if he or she was no longer able to earn at least one-sixth of what a similarly situated person of good health, with similar education or training, in the same region of the country, could earn in the prevailing labor market. This formulation was legally altered twice: first in 1899 when invalidity was redefined as a deficit of one-third (as opposed to one-sixth) and then again in 1911 when the term “same region of the country” was replaced by “the entire [national] labor market.” Two types of invalids were further distinguished in this scheme. Invalidity was considered chronic (dauernd) if, according to “reasonable” human judgment, there was no prospect of the condition improving in the foreseeable future. Statistics show that the majority of these pensioners suffered from pulmonary or circulatory ailments, the greatest number being diagnosed with tuberculosis.11 All other invalidities were deemed temporary (vorübergehend), and a short-term “sickness pension” was awarded. Invalid pensions were then paid out according to the number of contributory weeks and the wage class of the insured worker. To make matters even more complicated, the three principles of incapacity were not mutually exclusive. It was therefore possible for an afflicted person to collect benefits from more than one insurance branch. This meant, for instance, that if an insured worker was in an occupational accident and disabled more than two-thirds in his or her capacity to earn a living, then the individual would be considered both an accident casualty and an invalid. An invalid pension, in such a case, was to be paid in full until the accident pension was granted. Outside of general principles of entitlement, laws also mandated a formal process for assessing and litigating claims. In accident insurance, for instance, a claim could be made only if it followed an accident registered with local police. Insurance providers, once receiving a claim, would then carry out a physical examination of the allegedly injured person. Under invalid insurance, physicians contracting with the local insurance office carried out the exam. Within accident insurance, however, salaried certifying physicians (Vertrauensärzte), paid by the insurers themselves, conducted the examinations. More complicated Page 74 → or more dubious cases were often passed on to local hospitals and clinics, so that an insured worker could be observed over a period of several weeks. All physicians involved in a claimant’s examination then would submit a report of findings (Gutachten) to the insurance board conducting the assessment. Finally, the insurance board made a judgment on the validity of the claim. Once having awarded a pension, however, both invalid and accident insurers had the right to monitor a pensioner for evidence of improvement in health. If detected, insurers were then allowed to reduce or even take away an individual’s pension accordingly. Since legislators fully expected differences of opinion to arise, claimants were awarded the right to appeal pension decisions, and a judicial system of arbitration was created, with local courts (composed of bureaucrats, physicians, and representatives of employers and the insured) serving as the first instance and the Reich Insurance Office (in

the form of a senate composed of bureaucrats and representatives of employers and the insured) in Berlin serving as the final instance of appeal.12 The decisions of the Reich Insurance Office in particular were important not only because the office heard tens of thousands of individual cases every year, but because it also identified certain of its judgments as “decisions of principle” (grundsätzliche Entscheidungen). These were cases that the Reich Insurance Office identified as raising questions and problems fundamental to insurance practice. Although the German legal system did not formally recognize the principle of legal precedent, those judgments deemed grundsätzlich in fact largely functioned as precedents. This was due to the fact that the Reich Insurance Office throughout its lifetime (1884–1945) had the singular distinction of both playing the chief executive role in state insurance and being the highest judicial authority in insurance matters. “Decisions of principle” were thereby enforced as both policy standards for insurance providers and as jurisprudential guidelines for lower and upper courts of appeal. The need for such guidelines and the huge number of pension decisions and appeals highlight a basic tension within Wilhelmian social insurance. From the inception of workers’ insurance, the Reich Insurance Office had instructed insurance administrators and judges to assess every case individually. Decisions were not to be made solely on the basis of medical opinion, nor fashioned to crudely mimic general standards of practice or precedent. Instead, the individual variables in each case were to be sincerely considered in an effort to avoid Page 75 → what President of the Reich Insurance Office Gaebel derogatorily referred to as “a mechanical handling of the compensation process.”13 Still, as insurance boards and courts quickly became inundated with claims, assessors and judges called for a more systematic and efficient way by which to evaluate caseloads. The Reich Insurance Office answered the call by circulating its “decisions of principle” via memoranda and publications. Using these decisions and considering local experience, insurance administrators established general and often unstated criteria and principles for evaluating claims (a development much criticized in labor circles). By the turn of the century, the Reich Insurance Office was publishing a compilation of accident pension rates. Derived from actual cases heard before the government office, it aimed at setting some general standards in compensation procedure. The manual was organized according to injured body part and listed individual cases that came before the senate, the occupation of the injured party, the type of injury, and the percentage of disability. By 1912, six updated editions had been published, and the list of cases had expanded to 1,113.14 The tension between treating an ailment as a member of a genus of ailments within the insured population or placing the ailment in the more or less unique context of an individual’s life history remained, however. In virtually every case that came before insurance authorities, interested parties explored and prodded the elasticity that this tension allowed. The result was an ongoing pattern of expanding and constricting administrative criteria as assessors, claimants, and judges awarded and contested pension decisions. Pensions and the Politics of Disability The Political Epistemology of Disability By now it should be clear that disability insurance operated according to a very different set of rules from previous forms of public assistance. Having paid contributions to the insurance (as was the case with guild funds) did not in and of itself entitle one to benefits. The question here was neither one of establishing liability (the old railway laws) nor of measuring need (poor relief). It now was a matter of determining the definition, presence, and extent of a debility. Assessing whether a worker was an invalid, for instance, required more than simply determining the truth or falsehood of the claimant’s complaint. To Page 76 → start with, the assessor or judge had to take into account the individual worker’s abilities, the opportunities and standard wages in the local job market, and the probability that the worker’s ailment was incurable. These implied a host of other questions to be answered, as one Stuttgart official posed them. To which trade does the worker belong? What do tradesmen in the area normally earn? What kinds of abilities does the claimant possess: natural acumen (natürliche Geschicklichkeit)? technical training?

strength of will? intelligence? Can he or she perform any other kind of work, and if so, to what degree? Which jobs can he or she perform without additional training? To what extent would the worker earn less money in this new job than in his or her former one? Can one reasonably expect any changes in the claimant’s condition? How long has he or she had the ailment?15 Posed in this natural- and social-scientific manner, the problems before disability insurance were not couched in a moral idiom of the redistribution of wealth. Rather, they were epistemological problems, placing in the foreground the sources, methods, veracity, and limits of knowledge. Who best to determine the answers to those questions posed by invalidism: physicians? insurance assessors? local employers? trade unions? economists? government officials? invalids themselves? On what basis: medicine? political economy? statistics? personal or professional experience? Whose knowledge was best equipped to make these judgments? In this way, disability insurance opened up an entirely new field of social conflict. Once again, invalid insurance illustrates the point. Despite the fact that representatives of the insured helped manage local invalid insurance boards, the evidence indicates that workers understood their relationship to the boards as adversarial.16 Rebuffed pension claimants regularly complained that the invalid insurance system was bureaucratically petty and generally unresponsive.17 Organized labor, too, singled out invalid insurance administration for criticism, claiming that boards regularly denied benefits to deserving invalids in order to save money.18 A 1903 manual on the collected judgments of the Reich Insurance Office and the Reich Civil Court on matters involving invalid insurance (a Page 77 → document well over five hundred pages long) further attests to the extent to which virtually every definition and every procedure could be and was contested at one time or another.19 Wilhelmian disability insurance, then, was a highly politicized affair. In 1901, workers appealed nearly one in every five accident-insurance board decisions and one in every ten invalid-insurance board decisions; by 1912 these figures had risen to around one in every three and one in every six, respectively (see table 3). This is noteworthy not simply because it indicates how contentious the pension process was. More importantly, these cases offer us a window into social-insurance policy-making in practice, since every decision potentially had an impact on future pension cases. To examine how the politics of disability were a constituent part of social-insurance policy (rather than a force outside policy-making), let us look at the case of accident insurance in some detail. For a number of reasons, accident-insurance administration was the most divisive of all social-insurance branches.20 Primarily, however, this was due to the fact that it institutionalized industrial conflict more directly than any other insurance. Employers, forming so-called Berufsgenossenschaften or cooperative boards along regional and trade lines (117 by 1913), paid for and administered accident insurance directly. Insured workers therefore had no representation on accident-insurance boards, and the labor movement viewed the boards as nothing more than extensions of employer businesses. Thus, employers and workers, already predisposed to distrust one another, persistently took their conflicts to court. In this manner, individual employers and employees, along with the legal advisers, physicians, expert witnesses, and judges they recruited to their causes, gave definition and shape to both disability and the policies that governed it. Accident Insurers Accidents, Labor Power, and Disabilities For accident-insurance boards, the concept of “the accident” set the ground rules for their activities and judgments. As pointed out earlier, accident insurance was intended to compensate a strictly limited set of disabilities, in particular those associated with the risks and circumstances of modern work.21 Accident Page 78 → insurance was obliged to compensate only those disabilities caused by a work-related accident. It was therefore the job of insurers to identify just what kind of accident or injury had occurred in any given case. Was the injury the consequence of an accident as part of the contractual relationship between employer and employee? In other words, did the injury occur within the contractual confines of the occupational setting? If the

answer was yes, then the insurer was responsible for compensation. If, on the other hand, the insurance board or court judged the illness or debility to have arisen out of the contractually unrelated private life of the individual, then the insurer was not accountable. This basic question of determining the public (and thereby compensable) or private (noncompensable) nature of a malady established the basic premise for the work of accident insurance. When evaluating pension applications, insurance boards performed a rational calculus in an effort to determine the public or private character of the facts of the case. In rejecting insurance claims, insurance boards raised numerous questions about the validity of pension applications based on this central distinction. Court records reveal the most common grounds cited for rejecting claims: denial that an accident had actually taken place,22 contention that incapacity existed before the accident,23 belief that there was no causal connection between the accident and the worker’s ailment,24 doubt that the abilities of the insured worker were impaired.25 Accident-insurance providers thus had a firm understanding of their general task within social insurance: it was primarily to examine pension requests and to discriminate between public and private disabilities. In assessing individual claims, insurance boards relied on prevailing German manufacturing and commercial notions about labor and enterprise. The costs of administering the program, solely an employer burden, were not considered lost capital. Rather, most employers (especially the large industrialists) accepted and even embraced this spending as an investment in “labor power” (Arbeitskraft).26 The concept of “labor power”—the idea that both organic and inorganic entities possessed an inherent energy or Kraft that could be quantified, measured, manipulated, and evaluated in terms of cost and yield—was an influential Page 79 → trope in nineteenth-century thought.27 Physics, in particular, provided ample justification for recognizing an inherent connection between Arbeit and Kraft. As Crosbie Smith has pointed out, “the concept of work remained the essential measure of energy until energy acquired a status independent of mechanics late in the nineteenth century.”28 More particularly, Germany’s business community in the nineteenth century accepted labor power as the basis of employer-employee relations. Richard Biernacki has convincingly demonstrated that “German owners and workers viewed employment as the timed appropriation of workers’ labor power and disposition over workers’ labor activity.”29 Employers understood work as a conversion of labor power into a product, measuring “efficiency” (Nutzeffekt) in terms of the potential versus actual execution of labor during a time period. Concerned with work as a process and measuring it in relation to an imagined potential, German managerial techniques tended to aim at disciplining worker conduct and attitudes in order to assure high-quality production rather than asking “bad” workers to compensate the company for defective products they made (as in Britain). Boosting a worker’s potential or actual labor power was therefore widely perceived as an essential part of increasing productivity and profits. The way in which boards distributed the costs of accident insurance among individual employer members was also tied to labor power. Rules first established in 1888 and 1889 gave each accident-insurance board the job of awarding every member business a “risk number” (Gefahrziffer). This was arrived at by comparing the number of on-site accidents per man hours with the average number of accidents in similar trades or the same branch of industry. In calculating this, however, accidents were also weighted according to their severity. Four degrees of severity were identified. The most serious were those accidents involving injuries leading to death, followed by those involving injuries leading to chronic, total disability (Erwerbsunfähigkeit), injuries leading to chronic, partial disability, and, finally, injuries leading to temporary disability. Accident-insurance boards then grouped employers into a number of “risk classes” (Gefahrenklassen) and assigned them higher or lower premiums accordingly.30 Page 80 → Thus, employer members had a keen interest in seeing that accident-insurance boards determined degrees of disability as strictly as possible. How accident-insurance boards perceived this work of processing claims was also a function of their institutional status. Self-administered as they were by employers, insurance boards operated as capitalist enterprises. While legislation mandated that each board had to invest not less than one-quarter of its assets in bonds of the Empire or

of the federal states, the insurer retained the right to invest the remaining percentage of assets in interest-bearing funds, mortgages, or in undertakings that benefited the persons subject to the insurance or promoted the personal credit of the members of the insurance board. To owners financing and administering the institution, then, accident insurance was a business. In practice, this translated first of all into a pugnacious defense of autonomy and control over insurance affairs. To this end, administrators sponsored the building of and helped to manage hospitals, convalescent homes, and workshops for those injured in accidents. They opposed the efforts of workers and unions to gain participatory rights in the pension-setting process, fought the establishment of government-set, standardized pension rates, protested the replacement of insurance board courts with territorial courts in 1900, and rejected what they perceived to be the increasing intervention of the state through local insurance offices after reforms in 1911.31 Organized labor and the state were not the only perceived sources of encroachment. Physicians too met frequent opposition. As both a key figure in the assessment of pension claims and a member of an independent professional body with specialized knowledge, the physician represented an uncertain and unaccountable voice in social insurance. To be sure, accident insurers partly remedied this situation through the routine employment of their own certifying physicians, a group as infamously sympathetic to employer interests as company doctors. Yet even this was not enough to ensure that employers and insurance boards enjoyed hegemony over insurance practice. Claimants still offered their own medical expert opinion in hearings, and courts regularly commissioned independent medical reports in cases of conflicting judgments. Accident-insurance providers therefore found their decision-making capacity restricted. Page 81 → Their strategy in dealing with this predicament was to engage physicians in jurisdictional disputes whenever discrepancies arose.32 In such cases, board officials would regularly contend that any incongruity between assessments stemmed from overeager doctors reaching beyond their legal sphere of competence. The degree of disability, it was argued, was a judgment that could only be rendered by insurance providers and courts.33 According to accident insurers, the law strictly instructed independent physicians to do no more than describe the symptoms and condition of claimants. Determinations as to the inability of individuals to earn a living were best left to those competent to assess it, i.e. the personnel of the accident-insurance boards. Thus, as insurers maintained in the courts, the calculation of disability was not simply a medical matter. It needed to be made by those most familiar with the kind of work an injured laborer did. In a case that came before the Reich Insurance Office in 1886, the North German Lumber-Accident Insurance Board stated this position succinctly:

The physician is far too removed from the industrial conditions to be able to judge the degree of impaired ability to earn a living resulting from this or any other injury. To him is reserved solely the job of delivering a judgment according to his science about the objective condition of the injured body parts, their capacity to move in the near future, as well as their remaining manifest strength [Kraftäußerung] in comparison to earlier conditions. To measure the influence of these conditions upon the ability to earn a living is solely a matter for an individual who is an expert [Fachmann] in this occupational activity.34

Exploiting the elasticity of insurance law in this manner, accident insurers sought to bind and narrow the parameters of the physician’s task within insurance practice, while at the same time privileging the judgments of their own personnel. Thus, similar to providers elsewhere in Europe, German accident insurers went about their job with a heightened attention to details of work, costs, and profits.35 Administrators had an explicitly commercial and fiscal perception of social insurance. Pension awards, in this light, were to be contested in a similar manner to wages. Compensation and administrative expenses were investments Page 82 → to be monitored for efficiency. As for

the injuries and maladies of employees, insurance boards concerned themselves solely with the effects they had on an individual’s labor power, measured as the ability to earn a living. In the 1904–5 case of a machinist, for instance, the Miner’s Provident Fund–Accident Insurance Board sought to take away the worker’s 10 percent pension, owing to the fact that he had come to earn fifty-two pfennigs more per shift after the accident than before. Without a loss in earnings, insurers argued, he could not be considered disabled.36 More frequently, however, accident-insurance administrators simply found the productive capacity of an injured laborer unaffected by the accident. Typical was the 1886–87 case of a railman from Hattingen whose left index finger was partially amputated after an accident in December 1885. The Rhine-Westphalian Smelting and Rolling Mill–Accident Insurance Board compensated him until 31 May 1886, after which the board considered him adapted to his condition and revoked his pension. In the view of the insurance board, “the appellant is a large, strong man who can find work as a normal wage earner at any plant, despite his injured left index finger, if only he tries.”37 Employers must have found it odd indeed for men and women who for decades had worked through episodes of illness and injury to now cease working on the grounds of back pains, hernias, and amputated index fingers. The outspoken North German Lumber-Accident Insurance Board expressed the anger and frustration of many employers when it reminded the Reich Insurance Office, “Not every mutilation brings about a reduced ability to earn a living for every worker. The precondition for the establishment of this reduction must be: the mutilation is or will be accompanied by such serious consequences for the productive capacity [Leistungsfähigkeit] of the injured person that the ability and proficiency of this person to perform the same or similar work appropriate to the social and economic position of the mutilated individual, failing dishonest intentions, has been diminished or destroyed.”38 The efficient use of labor power was the overriding concern of insurance boards. As such, it was necessary for accident insurers to monitor maladies and those afflicted with them in order to assure that no percentage of labor power was wasted. Every insurance board collected a multitude of statistics on accidents and their consequences: accident frequency; fatalities; the number of pension claimants, appellants, and recipients; remuneration totals; and types of disability, just to name a few. Of particular interest, especially to the Association of German Accident Insurance Boards, were the statistical surveys of individual insurance boards, designed to measure the impact pensions and insurance laws had Page 83 → on workers.39 Individual boards often used these data to judge specific claims and justify policies. The Miners’ Provident Fund–Accident Insurance Board, for example, used statistical evidence to base an 1890 decision. In this case, a hewer had lost his sight in one eye and was awarded a pension set at 30 percent. Statistics of the local section showed that 171 one-eyed miners worked within the region, of which 154 received the same wages as healthy workers in the same wage category. Of the seventeen disabled, only three were judged more than 20 percent disabled. In the view of the insurance board, this offered conclusive proof that workers blinded in one eye were not significantly impaired in their ability to earn a living in the mining industry.40 The Social Epistemology of Distrust Employer concerns for the fiscal integrity of accident insurance, control over administration, and the close monitoring of labor power translated into a distinctly empirical form of knowledge-gathering. Insurers developed an epistemology of disability that privileged the visible, the observable, and the scientifically verifiable. From their positivistic standpoint, the complaints of claimants or the testimony of fellow workers could not constitute verifiable evidence in claim assessment. Rather, the ailments of injured workers needed to be “objectively” confirmed, i.e., they needed to be “outwardly visible.”41 The “subjective, entirely unverifiable complaints . . . of pain,” as one insurance board termed them, required observable corroboration.42 The testimony of fellow workers on behalf of claimants could likewise be rejected, since it could only attest to what a claimant said about the existence of pain or the inability to carry out his or her job.43 The issue again was control over the process. To set the notion of proof within the confines of a strict empiricism made the ailment more public and more subject to the rationality of experts and authorities. How was an insurance provider to respond in court to the complaints of sufferers or to the affidavits of Page 84 → fellow workers? On these terms, the voice of the afflicted individual had seemingly more authenticity than that of officials. By

removing subjective reporting from the field of acceptable proofs, however, insurers hoped to ground the judgment of cases in a more public and collective language. With the focus now on that which was observable, the insurance board was on an equal footing with the ailing worker. Indeed, it offered insurers a distinct advantage: they could award the opinions of their personnel greater legitimacy than those of the insured due to their professional competence and experience in such matters. This explains why insurers were so vehement about the indispensability of the medical insurance exam and the strict supervision of claimants. Controlled examination offered them the opportunity to evaluate the nature of afflictions in a secure environment. Unlike in the court hearing or police interview, here the insurance administrator could define the setting and set the agenda. Clinicians might monitor behaviors, moods, and even the most offhand remarks.44 It is little wonder then that insurers raised loud objections once claimants began to regularly avail themselves of the right to refuse examination. Such a refusal on the part of pension applicants undercut the work of the administrators at the earliest stage in the evaluative process, the gathering of evidence. Insurance boards throughout the years 1884–1914 therefore consistently challenged the right of pension applicants to refuse medical examination and enjoined state authorities to authorize compulsory medical insurance exams.45 The epistemological assumptions of insurance boards had still another consequence for insurance practice. They necessarily called personal experience and expression into question, inherently delegitimizing the laments of the injured. Pain and suffering and their expression simply lay outside the boundaries of the heuristic of insurance boards. Thus, administrators routinely greeted the complaints of pension applicants and recipients with disbelief and distrust. This translated not only into a principled renunciation of self-diagnosis as evidence, but also a caseby-case disparaging of motivations. If it was true, as employers seemed to think, that self-interest and selfaggrandizement were the engines of society and the individual, then how could the testimony of claimants be believed? In a world where subjective testimony could not be trusted and motivations were inherently suspect, the figure of the “malingerer” haunted accident-insurance providers as the ever present specter challenging the efficacy and integrity of the system. The concept of malingering (Simulation)—the notion of an individual who by feigning illness is able to shirk certain social responsibilities—is Page 85 → an old one.46 Its history in social welfare dates back to the poor-relief measures of German cities in the fourteenth and fifteenth centuries according to which recipients were obligated to work and only the decrepit, blind, and crippled were awarded begging rights.47 Malingering found new life in the culture of industrialism. Concerns over the recognition and prevention of malingering were voiced throughout the nineteenth century in economic, medical, and legal circles. With the advent of compulsory health insurance and its accompanying entitlements, however, employers and insurance boards saw a compelling new stimulus for malingering. Although collecting no statistics on the subject, insurers saw it creeping into case after case: in the routine exaggeration of symptoms, in the deceitful reporting of accidents, in the frequent feigning of ailments, and in the rampant pursuit of higher pensions among insured workers. In an 1885–87 case, for example, a stoker was able to convince a lower court that his pension deserved to be raised from 20 percent to 40 percent. The outraged Textile–Accident Insurance Board appealed to the Reich Insurance Office, pointing out that in his petition the injured worker had contended (1) that he could no longer perform wage labor, (2) that his wife had died recently, and (3) that he had three small children and only twenty marks a month to live on. The facts of the case, the board insisted, proved that the stoker was lying. “As for being a widower, he has already eliminated this disadvantage by getting married again on 29 January of last year, and thereby improving his economic situation. As for the children, the eldest, Elise, born on 9 September 1872, works in Dreyfus-Lentz & Co. factory and earns 1.20 marks a day. The second, Moritz, born on 16 November 1874, will already be able to work next year, and the third, Melanie, born on 1 August 1875, is still in school.”48 The implication was that if the stoker could concoct fables about his level of distress, then he certainly could just as easily be faking symptoms. For accident-insurance boards, malingering represented an ever present threat to the viability of insurance. Their response to this threat was a concerted vigilance, reinforced by stiff penalties for infractions. The official organ of accident insurers repeatedly reminded personnel and the public of the frequency and consequences of malingering:

1904, a miner was convicted of fraud for feigning dizziness and headaches and sentenced to three months in prison;49 Page 86 → 1908, a mason was sentenced to six months in prison and three years’ loss of his civil rights for self-inflicted wounds in a pension case;50 1910, a locksmith, after collecting three thousand marks in pension entitlements, admitted to feigning blindness over a twelve-year period and was sentenced to six months in prison;51 1911, a bricklayer was convicted of fraud for deliberately deceiving authorities into believing that his injuries happened on the job.52 This distrust on the part of employers and their insurance boards extended beyond select individuals, however. Similar to their attitudes within the larger marketplace, they exhibited a blanket mistrust toward organized labor. Accident insurers understood the forces of Social Democracy and trade unionism as movements of irresponsible agitation. Why did so many workers contest pension decisions, asked the organ of accident insurers in 1910. The number of insured workers who directly filed appeals, it noted, constituted scarcely 10 percent of all appeals among the industrial insurance boards. On the other hand, “[o]f the remaining 90 percent, barely another 5 percent lie in the hands of lawyers, legal consultants, etc., so that 85 percent of all appeals and the like rest with the representation provided by the union secretariat.”53 Accident insurers also pointed to Social Democratic publications which, they argued, clearly demonstrated that Social Democracy and labor unions were engaged in campaigns of defamation and propaganda, convincing naturally content workers to be unsatisfied with pension awards. The labor movement had by these means come to exercise a “Social Democratic terrorism” over the insurance process. It had gotten so bad, contended one board in 1911, that worker representatives in the Reich Insurance Office had begun to leak sensitive material from individual cases to socialist newspapers.54 The understanding of accident-insurance providers, therefore, was marked by suspicion and vigilance. Understanding their task as one aimed at discriminating between legitimate and illegitimate claims, preoccupied with efficient production, and eager to control and direct accident-insurance practice, accident insurers saw the afflictions of insured workers as a shortfall in labor power. This deficiency in the productive and earning capacity of the individual could be quantified and measured. In short, it could be integrated into the knowledge and practices of industrial capitalism. Page 87 → Insured Workers Insured Workers and Injury With limited means and resources, the Wilhelmian wage earner was made especially vulnerable by injury and illness. The prolonged sickness or death of a household’s breadwinner typically meant doing without, running debts, pawning property, and risking social decline.55 Poor-relief statistics confirm this link between sickness and poverty among Germany’s proletariat. In 1885, “injury or illness” and “physical or mental handicap” together were by far the most frequent reasons (42.7 percent of all cases) for applying for poor relief.56 But if workers as a class were more prone to poverty by the specter of ill health, this is not to say that all workers shared a common experience of this susceptibility. Like the impoverishment it threatened, debility meant something different to different categories of workers. This is especially important to keep in mind when talking about socially insured laborers, a distinctive group within the Wilhelmian working class. To explain how they understood their injuries, it is important first to appreciate their status as workers. German accident insurance covered a large, but limited, group of employees. According to the original 1884 law, coverage was awarded primarily to those wage laborers (and civil servants who earned no more than two thousand marks a year) who worked in mines, saltworks, ore-treating and metal-working plants, quarries, pits, shipyards, construction sites, and any other facility that met the criteria for a “factory.”57 By 1911, coverage had been extended to workers in a host of other trades and industries, including the railway and postal services, chimney sweeping, butchering, transportation, packing, and logging. As diverse as this list seems at first glance, some generalizations can be made about that part of the working

population covered by accident insurance. First and foremost, it was an overwhelmingly male workforce that enjoyed coverage. The gendered division of the German labor market meant that women were segregated from most of these sites and manufactories. Instead, job opportunities for women in the nineteenth century were restricted mostly to the textile, clothing, food, paper, and tobacco industries, with 80 percent of the incomeearning Page 88 → female labor force in 1882 still working in the household economy.58 Even within these industries, a gendered segmentation of work kept most women from positions that were covered.59 Thus, while accident insurance covered around 12.9 million men by 1898, the number of women covered was a little over 3.8 million; that same year, 8.3 million men and 4.2 million women were covered by invalid insurance.60 These numbers do not tell the whole story, since a significant number of females receiving coverage did so solely as dependents. As Kathleen Canning has shown, the Wilhelmian welfare state considered worker safety measures and labor protection laws, not insurance, as the principal means for regulating female factory workers.61 Second, those covered under accident insurance were among the highest-skilled and highest-paid wage earners in German industry. Whereas jobs in the textile industry and food processing averaged at the low end of the pay scale, positions in mining, the iron and steel industry, salt works, and chemical manufacturing clustered at the highest end (on average, around 1,600 marks a year).62 And even while real income tended to grow for most all industrial workers after the depression of the 1870s, those in the centralized industrial enterprises typically subject to accident insurance generally enjoyed greater job security and a more marked increase in real wages over time than their counterparts.63 By the late nineteenth century, wage laborers of all kinds had become accustomed to raises as they grew older. The distribution of average earnings over an industrial worker’s life cycle in Wilhelmian Germany tended to assume the shape of a bell curve, with a peak at around age forty. After this, any increases in household income were typically the result of working children living at Page 89 → home.64 Thus, by 1900, “the majority of workers expected ever rising earnings, an income that grew with age.”65 Injury therefore represented to insured workers more than simply a loss in income. It meant the potential loss of a relatively privileged position within the hierarchy of wage labor. To younger and middle-aged male workers, this was compounded by the fact that persistent debility threatened to confound their lifelong expectations of rising income and of serving as breadwinners for their families. To be sure, these workers had certain resources to help them get by in the short run. Trade unions offered unemployment assistance to members, on average in 1913 around 1.43 marks a day for a length of fifty-six days.66 In addition, evidence indicates that even some of the poorest worker households were able to save significant amounts of money for emergencies.67 Both union benefits and personal savings, however, were of only limited use for those battling with long-term unemployment. Since accident insurance handled only those claims where symptoms still persisted six and a half months following the accident, even the most frugal laborers were bound to have exhausted most of their options by the time of their first insurance hearings.68 The economic consequences of serious injury were further compounded by the changes in lifestyle brought on by being laid up. Evidence from historians of medicine indicates that peasants and the urban working classes since at least the sixteenth century had their own “folk” sense of disability, expressed in their wishes and attempts to be rid of impairing chronic ailments. Sixteenth- and seventeenth-century German physicians reported that the chronically ill were a generally impatient lot, forcing doctors frequently to fight with them Page 90 → over remaining in bed during their convalescence. Injured patients in particular voiced their eagerness not only to get back to work, but to once again perform such mundane, yet obviously meaningful, acts as hearing properly, eating normally, and reading Scripture.69 Insurance records confirm that workers understood their injuries as a crisis for themselves and their entire household. Because of those affected, claimants—in marked contrast to accident-insurance boards—recognized no distinction between public and private maladies, occupational and household consequences. Marie Birk, a Berlin textile worker whose right hand and lower arm were amputated in 1886, made this clear to insurers, insisting that she receive a full pension since she had two children (ages three and one) to care for. “I probably do not need to point out,” she later wrote an appellate court, “what kind of attention, care, and costs such young

children demand, and how much effort and strength a mother with two healthy hands needs if she has to look after and support both herself and her children.”70 Suffering from afflictions whose effects could not be limited to the workplace, insured workers tended to situate their injuries within their personal life history rather than within employer and insurance categories. This proved to have important consequences for social-insurance administration and politics. Encountering the Bureaucracy Historians have commented on how paltry pensions for injured workers were. Accident-insurance benefits averaged 178 Reichsmarks annually for each recipient in 1886. In 1900, the average decreased to RM 145, but by 1914 it had once again risen to RM 178. As Gerhard Ritter has pointed out, this fell far below the minimum necessary for an average individual or family to survive on.71 Despite this, however, the insured tenaciously pursued their claims. Such resolve may reflect a more general determination on the part of workers to refashion their apparent social destinies.72 Certainly pension benefits were also the most lucrative form of support available, even if they were meager. But most importantly, worker tenacity also needs to be seen as the result of the popularity Page 91 → of social insurance. Theirs was a very different relationship to social bureaucracy than that of past or contemporary welfare beneficiaries, not simply permanent, but invested with a sense of institutionalized proprietorship.73 In this (albeit limited) sense, Bismarck’s ambitions for social insurance were realized. Accident insurance, at first glance, appears to have left little room for insured workers to consider the institution “theirs.” Their injuries and afflictions had to be articulated in bureaucratically appropriate ways. Administrators, as we have seen, adopted a skeptical institutional posture toward claims and those who made them. It was incumbent upon the injured themselves to prove the validity of their claims. This meant that workers routinely assumed the responsibility of communicating the reality and relevancy of their sufferings to insurance authorities.74 It is this very skill, which workers and the disabled learned and honed through the claims process, that provided them the means to appropriate social insurance for themselves. From the very beginning of accident insurance, insured workers freely used the elaborate appellate system to pursue their claims. Taking charge of their own cases, most gathered testimonials from witnesses to corroborate their versions of the accident and the consequences it was having on their health.75 Others hired lawyers or legal consultants to litigate their cases for them. Pension claimants often proved to be as unrelenting in their resolve as accident insurers. Coal miner Albert Honnaker of Heidhausen, for example, spent more than four years looking after his claim. On 9 July 1900 he broke his left pubic bone and suffered a contusion of his tailbone. In October he received an original pension award of 50 percent from the Miner’s Provident Fund–Accident Insurance Board, but this was later reduced in February 1901 to 33⅓ percent. On 6 November 1902 insurers replaced the pension with free hospital care. Released from the hospital in December 1902, his pension was then reinstated at 25 percent. The local court rejected Honnaker’s subsequent appeal, but the Reich Insurance Office reversed that court’s judgment on appeal and granted him a 33⅓ percent pension again. In March 1904 the insurance board revoked Honnaker’s remaining pension, contending that his condition had improved so much as to no longer warrant compensation. Once again Honnaker appealed the insurance board’s decision. In June, the local insurance court rejected this Page 92 → appeal, but, as it had two years earlier, the Reich Insurance Office reversed the court’s decision and awarded Honnaker a pension set at 20 percent.76 Such behavior, routinely exhibited by the insured, can be seen as an extension of what Alf Lüdtke has dubbed the “Eigensinn” of German laborers at this time, the ability and desire of the individual worker to daily distance himself from employers and workmates in order to create an everyday space “by and for himself” (bei-sichsein).77 Atomized by pension claim procedure, workers embraced it for just that reason as a privatized, intimate space for self-assertion and political action. The everyday life of Wilhelmian social insurance was therefore made up of thousands of highly personal conflicts driven by individual, self-centered workers. Applying for a pension, however, was a taxing process. As the case of the mason Josef Kühn illustrates, it

uprooted workers and interrupted routines. On 8 July 1896 a girder fell on the left foot of the twenty-eight-yearold mason. Suffering contusions, but no broken bones, he returned to work a few days afterward. Five days later, a respiratory ailment diagnosed as tuberculosis in 1893 reappeared. After Kühn was treated by the local sickness fund, he applied for an invalid pension in January 1897, but was rejected. The local invalid insurance institute was, however, willing to help pay for treatment, and Kühn was sent between February and April 1897 to two different clinics for therapy. In May, he resumed work and filed an accident pension claim. The next month, the district physician examined him, and upon his recommendation the accident-insurance board sent Kühn to still another clinic in July. Here he stayed until September 1897, when a certifying physician demanded that he be placed again in the care of the local invalid insurance institute. On 20 October his accident pension was reduced from 100 percent to 25 percent. The following month, he began trying his case before a local insurance court.78 Engulfment in bureaucratic procedure and suffering caused by chronic ailments compelled introspection and preoccupation with self and health. The injured regularly monitored their own conditions, closely following changes and often spending a great deal of time chronicling the trajectory of their afflictions. One wage laborer from Düsseldorf, for instance, spent the better part of a year documenting his own hernia. By the time of his hearing before the Reich Insurance Office in February 1887, he had visited three physicians, collected three Page 93 → medical reports, researched opinion on predispositions to hernias, checked out the sickness register of his former employer, and procured testimonials from two of his foremen and an engineer.79 Placed in a bureaucracy with a fetish for documentation, disabled workers began to objectify their ailments as claims. No doubt for some who had lost not only a job but a lifelong calling, litigation offered (to use Freud’s phrase) the “secondary gain” of a personally meaningful campaign for recognition. This intimate, introspective experience of the injury is what led the insured to introduce in their claims an element quite foreign to the rationality of accident insurance: the experience of pain, suffering, and need. Perhaps, too, this was something of a residue from the long history of poor relief, where it was required to prove need in order to receive benefits. Yet workers freely insinuated it here where insurance boards were, as a matter of policy, institutionally indifferent to such matters. “With continuous walking or standing, I am growing stronger, that is to say the right foot is, [but] the pains that go with it, which I usually have in [the foot], make using it unbearable,” insisted steel-worker Adolph Henckel.80 Some, like carpenter Wilhelm Keller, who lost part of his thumb, complained that his hand was so sensitive “that by the slightest touch, I feel sharp pains and therefore cannot handle anything.”81 Such pains (Schmerz), however, were frequently represented by a more catastrophic suffering (Leiden) brought on by debility. “In the beginning, I was paid ⅔ wage as compensation. On 7 June I was awarded a monthly pension of 10 marks that was raised, however, to 20 marks after appeal,” stoker Moritz Erhardt told the Reich Insurance Office in 1886. “What am I supposed to do with 20 marks a month since none of the factory owners want to give me work anymore, and with my ailment I cannot do any wage labor? In the meantime, my wife has also died, and I sit here with three small children, without work and pay, and I am supposed to live on 20 marks.”82 Time and again claimants argued their cases less on the merits of their physical disability than on the basis of some set of distressing circumstances that, in tandem with their injury, made their predicament especially dire. More often than not, they identified their disability as the beginning of a very slippery slope. Railman Ignatz Lang, for instance, complained after part of his left index finger was amputated, “I am mutilated for life; I can no longer do my job nor fetch the same wage as [I did] before the accident. . . . I was previously ordered to leave the hospital. For a long time I was without a job and the means Page 94 → to live. I could not find any work, and I had to earn my living by begging.”83 For many, the problem was compounded by family, as package carrier Friedrich Schüler reported to the Reich Insurance Office. “I would like to forgo any pension, [but] I wanted to only point out that I am not a malingerer, and also that my situation is very dire, especially since besides myself I have to look after my wife and 4 children ranging in age between 2 and 10 years old/and every one of them can lay claim to being the most needy/I cannot find a living that allows me to work at a job in my condition/besides, I am completely destitute/and thus, because of the judgment of the lower court, the most tragic future has come to pass.”84

These last two cases are especially illustrative. Lang and Schüler were not simply being melodramatic. Wilhelmian workers, particularly the highly skilled and well-paid workers covered under accident insurance, took enormous pride in the dexterity by which they carried out their labors and in their success at achieving material security for their families. These were tangible and powerful signs of honor and respectability within Germany’s turn-of-the-century working class.85 This “respectability” was an ambition that skilled workers of the time held dear and articulated in direct opposition to the lifestyles of the poor. What social insurance did “was to organize [this] desire to be different.”86 Thus, in pension claim procedure, workers such as Lang and Schüler were asking accident insurance to certify that they were in fact still respectable. This explains why workers were so sensitive to the charges of malingering that insurance boards regularly raised against them. Disbelief implied a loss of honor, a backsliding into the mass of paupers, beggars, and working poor; it was a second injury compounding the original. What is especially interesting is the effect that the language of malingering—raising questions about motivations, insinuating laziness and irresponsibility—had on the way in which claimants often couched their arguments. Even in cases where no insinuations of malingering had been made, many pension candidates in their statements before the courts emphasized their willingness to work. “I have never avoided or shied away from work,” one wage laborer assured the Reich Insurance Office in 1886.87 Likewise, many seemed to feel compelled to inform officials not only of their willingness to work, but of their general good health. “I have been a soldier Page 95 → and a locomotive stoker,” streetcar operator Johann Koslowski explained to judges, “and have not been found to have heart or eye problems; despite detailed medical examination, I have never been sick before the accident.”88 Sickness here, placed in the context of proving one’s dependability and trustworthiness, became the functional equivalent of indolence. Thus, it made perfect sense for claimants like Nikolaus Lamberty to attempt to bolster their case by emphasizing their past eschewal of public support: “I have worked a full two years at the Düsseldorf Iron and Wire Industry plant, and I have never skipped work, and I have only once asked for a sick slip, and that was because I burned my eye on some cinders.”89 Sensitivity to disbelief also helps explain the particular contempt in which workers held the certifying physicians of accident-insurance boards. Insured workers saw these doctors as little more than the “hired guns” of employers, intent only on finding a way to release insurers from their obligations. Commenting on the way the boards sent claimants to numerous physicians for examination and supervision, the janitor Friedrich Dittberner concluded in his own case, “As its [the board’s] behavior and petitions before the court prove, it would like to have me examined by new experts or—something entirely unintelligible—keep me ‘under observation’ as long as it takes until it finally stumbles on an expert who will declare me wholly unimpaired by the accident.”90 Many among the insured demanded to be examined by another physician in addition to the certifying physician, one unconnected to the insurance board, before a decision on their application was made.91 Scores of others refused altogether to be examined by insurance doctors.92 Some claimants went so far as to voice doubts about whether such physicians even had the ability to make qualified judgments. As one quarryman in discussing his internal injuries put it, “As long as he does not perform an operation, no doctor can see into the human body.”93 In case after case, pension claimants lashed out at these physicians, questioning in detail their opinions and findings. As the coachman Emil Kunze explained to the Reich Insurance Office, workers like himself seemed to know much more about what hard labor involved than the so-called experts: Page 96 →

The medical report of Herr District-Physicus rests literally on the following: “While it can be presumed, according to medical findings, that Kunze is unable to work over long periods of time either walking or standing, it can also, on the other hand, be assumed that he is able to work over short periods of time walking or standing, and that he is surely able to work seated (such as, for example, sitting on the box of his coach).” This last contention sounds all very nice, but taking the facts of the situation into consideration as to the daily chores that arise in a coachman’s trade—that is, carrying heavy pieces of luggage, even the heaviest, fully packed baskets and other such things, into the carriage, lifting up and taking down and transporting to and from the residences of passengers, up and down 2, 3, and 4 steps, the kind of work I have to carry out while enduring the strongest pains in my foot—about

all this has the Herr Expert not thought, although this is exactly where the crux of the matter lies.94 (italics Kunze’s)

Such attention to the details of medical reports was not unusual. The widow Anna Lindemann, for instance, successfully appealed her deceased husband’s case before the Reich Insurance Office in 1902, claiming a link between his respiratory ailment and an accident he had suffered some months earlier. In defending her view, she carefully dissected the medical report of the examining physician in the case, concluding that “the medical report of Dr. Renvers, upon which the previous court decision is based, does not appear to me to be convincing since, to my thinking, it contains entirely obvious contradictions.”95 Like Lindemann, most claimants relied on medical reports from other, carefully selected physicians to defend their claims. The result was a proliferation of medical reports and a frenzied competition between expert opinions. Before long, court cases had come to generate large numbers of medical exams and reports, all of which contributed to the overburdening of the claims process in the last decade before the First World War.96 Insured workers, then, were hardly the passive subjects originally envisioned by lawmakers. Yet, in an ironic twist, it was for just this reason that German workers and pensioners came to grant the system legitimacy. Providing them with a forum to individually and personally make their claims on the emerging welfare state, social insurance gave the insured a rare medium of political expression and action in Wilhelmian Germany. The fact that it was organized Page 97 → on the presumption of competing interests and that it offered little possibility for collective action seems only to have led individuals to invest it with even greater authority. But while this helped endow workers with a sense of proprietorship over social insurance, the organized labor movement predictably found the system alienating. The Organized Labor Movement Starting in the mid-1890s, labor unions and Social Democrats joined the fray and became more directly involved in social insurance. Representatives of organized labor were initially tepid in their attitude toward workers’ insurance. Between 1883 and 1884, leaders went around the country speaking to crowds of laborers, criticizing the sickness- and accident-insurance bills for their “class bias,” lack of humanity, undue restrictions, unnecessary complexity, and lack of central organization.97 Soon after the antisocialist law was abolished in 1890, however, the organized-labor movement began showing an increased interest in social hygiene, social insurance, and welfare. Sickness insurance funds, whose boards were elected by insured members, were soon dominated by party members, while Social Democratic functionaries over the next twenty years adopted a party program in which they called for restructuring and coordinating the nation’s entire health-care system.98 Both national and state parliaments served, at least in part, as soapboxes for publicly promoting this agenda. The parliamentary arena, however, had its legislative limitations when it came to social insurance, not least because much of the system’s administration was not legislatable, but rather lay chiefly in the hands of autonomous institutions. Thus, Social Democrats turned also to party periodicals like Vorwärts and Die Neue Zeit in order to press their cause and publicize their grievances against social-insurance practices before a wider audience. Party officials and intellectuals were especially active in this area after 1900. Die Neue Zeit, for instance, published numerous articles specifically aimed at revealing the seeming inequities in accident insurance. As might be expected, the employer-run accident-insurance boards bore the brunt of socialist attacks. H. Winter, for example, questioned their ability to distribute “justice.” In arguing the case, Winter used statistics of the Reich Insurance Office to show that while factory accidents were worse than ever in number and severity, Page 98 → pensions remained disproportionately low, with as many as 90 percent of the disabled workers in some industries receiving pensions assessed below 50 percent full disability.99 Fault was also placed on accident insurers for using what were seen as disingenuous tactics to cut costs at the expense of workers’ rights. Chief among these was the deliberate overestimation of the disabled’s ability to adapt to their afflictions.100 In addition to employers and their insurances, insurance courts were also regularly criticized by Social Democrats for demonstrating an inherent

bias in favor of insurers.101 As part of this new strategy to involve themselves more directly in social-policy matters, members of the organized-labor movement adopted a more hands-on approach by founding so-called worker secretariats (Arbeitersekretariate). Operating at the local (Bezirk) level and serving as an arm of the trade unions (freie Gewerkschaften), the worker secretariat’s main task was to provide free legal advice and services to workers on all matters relating to social insurance. Most, however, understood their charge more broadly, and systematically attempted to further the interests of union workers by, among other things, promoting the election of workers in insurance administration posts and collecting statistics on local factory accidents, health conditions, and insurance board decisions.102 By 1901, twenty-nine such worker secretariats had been created; by 1913, the number had reached 127.103 Worker secretariats proved to be the centerpieces in the labor movement’s efforts to influence and ultimately reform accident insurance. As one union publication expressed it in 1901, “The unavoidable duty of the unions is therefore to take a vital part in the activities of workers’ insurance, making sure that Page 99 → what can and must be made better is made better, and to ensure without fail that the privileges and rights awarded needy brothers and sisters by workers’ insurance are maintained and fully granted them without restriction.”104 Standing at the front lines in the campaign to realize these aims, local secretariats coordinated with one another to offer their services to workers at the shop level. Information centers were created with union lawyers offering expert advice on the nuances of workers’ compensation. Where workers were fearful of confronting employers or administrators, representatives offered themselves as middlemen in bringing complaints to the attention of authorities. When individuals wished to appeal an insurance board decision, secretariat personnel took care of the necessary and often confusing paperwork that was required.105 In their capacity as self-appointed representatives of insured workers, the worker secretariats thus acted as more than watchdogs. Personnel did keep a keen eye out for any patterns in the general processing of claims by insurance boards and courts. Indeed, the claim procedure was singled out by most secretariats as one of the more abusive aspects of the insurance system. Claims, it was argued, took too long to be handled, certifying physicians were biased, appropriate therapy was consistently denied deserving workers, the costs of appealing to the courts were too prohibitive, benefits to surviving dependents were awarded only grudgingly, and insurance boards conceived of their work in purely schematic business terms.106 Clearly cognizant of the fact, however, that the courts could be used as agents of change, the secretariats placed increasing emphasis on manipulating jurisprudence. The Central Worker Secretariat in Berlin mimicked accident insurers and began publishing its own handbooks on social-insurance jurisprudence. Citing various grundsätzliche decisions of the Reich Insurance Office—all naturally decided in favor of the insured—the guides were designed to serve as references for union representatives of the insured in their “struggle for pensions” (Kampf um die Rente).107 The more reform-minded, revisionist strategy adopted by Social Democracy after 1890 proved successful in effecting changes in social policy. By 1914, representatives of the organized labor movement could boast their greatest achievements in the areas of promoting accident and illness prevention and Page 100 → of pressing for the centralization of illness statistics.108 As Dietrich Milles has pointed out, however, trade-union campaigns to standardize and to better educate workers about safety measures hardly threatened employer interests.109 In addition, there is reason to question the extent of worker enthusiasm for such campaigns. The Berlin Worker Secretariat in 1904, for instance, expressed a befuddlement that crept into trade-union reports, publications, and speeches before the Great War. “Despite instruction and education about the importance of worker safety,” officials complained in their annual report, “an indifference prevails within worker circles such as one can hardly believe possible.”110 Such differences between union representatives and workers came to play a greater role during and after the First World War. Thus, though there was a seeming convergence of worker and organized-labor attitudes toward Wilhelmian social insurance, a creeping divergence was also present. Like individual laborers, Social Democracy and the trade unions by 1900 had developed a proprietary sense over the system. They too appropriated the goal of social security and endeavored to have a direct hand in administering social insurance. But whereas claimants tended to

see their ailments in highly personalized, life-historical terms, socialist and union officials approached the problem of worker disability from the larger perspective of the labor movement’s social mission. The issue that disability raised from their perspective was social justice. The proliferation of factory accidents, the relatively meager pensions, and the general reluctance on the part of insurance boards to dole out benefits were all understood as functions of a pervasive social inequity. The remedy rested in ensuring that workers’ rights were protected and that their voices were represented in the social-insurance system. Increasingly reformist in their strategies after the turn of the century and always concerned with politically organizing workers, the forces of Social Democracy sought to situate themselves as an essential link between the individual worker and his or her employer and the state. They, the personnel and institutions of the labor movement, would presumably mediate between social insurance and the worker. In adopting this role, they aimed not only at representing the interests of the individual Page 101 → worker, but even more importantly at promoting the welfare of the working classes in general. For Social Democracy and the trade unions, then—institutions whose very raison d’être in late-nineteenth-century Germany was to organize the individual voices of workers into a politically cohesive movement—the problems, remedies, and goals associated with their participation in social insurance were invariably socioeconomic and collective. Afflictions Adjudicated, Disability Defined As I have tried to demonstrate, accident insurance provided employers, insurers, workers, and the labor movement an arena for negotiating the meanings of injury and affliction. In numerous cases, however, insured workers and insurance boards proved unable or unwilling to resolve their disputes between themselves. In these instances, they turned to an arbitrator, the social-insurance court, which came to a decision binding on both parties. It seems more fitting then to speak of adjudication rather than of negotiation.111 The two modes of interaction, particularly as they relate to social-insurance jurisprudence, are not mutually exclusive. Adjudication, in contrast to negotiation, has been associated with a number of characteristics: disputants become petitioners or supplicants, relinquishing their ability to decide for themselves; disputants aim to persuade the adjudicator; decisions have an “all or nothing” or “black and white” quality about them; adjudication is involved in norm-using, rather than in norm-making. Yet as P. H. Gulliver has pointed out, adjudication and negotiation are often consecutively or simultaneously applied in the course of a single dispute.112 Differentiating the two within social insurance is especially difficult. Insurance courts certainly handed down authoritative decisions, and their official titles identified them as courts of arbitration. On the other hand, representatives of the interested parties sat on the courts as judges. German jurisprudence and the deliberate policy of the Reich Insurance Office called for individualizing appellate cases. In addition, court judgments rarely took a “yea or nay” form. More frequently, courts were asked to draw distinctions of degree on points unaddressed by written law, and their resolutions commonly had the qualities of Page 102 → compromise rather than fiat. Finally, the courts—and particularly the Reich Insurance Office as both chief executive and supreme court—were keenly concerned with trying to establish norms for the continuing relationship between employers and the labor force. As the perceived litigiousness of social insurance and the disappointing attempts at judicial reform demonstrated, insurance courts had to live with the consequences of their decisions. Widespread discontent only produced more appeals. More importantly, the disputants within social insurance, unlike those in criminal courts, were linked in persisting relationships involving work. Insurance courts necessarily understood the consequences of their decisions in a broader social and temporal framework. In short, they were interested not only in arbitrating individual disputes, but in establishing and managing a viable social order. The judgments of the social-insurance courts therefore reflected the influences of the knowledge, perceptions, and values of those parties involved in the everyday administration of the welfare state. How did the courts make sense of the vast array of injuries and plaintiffs that came before them? Instructed to view pension claims individually, jurists nonetheless needed to provide for generalization, consistency, and continuity, features crucial to the functioning of the bureaucracy. At stake were the very definition and social status of disability and the disabled themselves. The judgments of insurance courts, particularly those “decisions of principle” of the Reich Insurance Office, were of signal importance: they served both as judgments of “fact” (a decision about an

individual dispute) and as general judicial and policy standards (a decision intended to establish guiding principles of compensation). Disability and Its Relation to Work On 1 February 1887 the Reich Insurance Office Senate heard the details of the compensation dispute between Ignatz Lang and the Rhine-Westphalian Smelting and Rolling Mill Works–Accident Insurance Board. The accident insurer had revoked Lang’s accident pension on the grounds that his injury—two joints of his left index finger had been amputated—no longer interfered with his ability to find work, a view shared by the local court of arbitration. Lang emphasized the physical pain and poverty the injury had brought him in his appeal before the high court. After examining the man and soliciting medical advice, the senate overturned the lower court’s judgment and in so doing established a universal principle of assessment in cases of disability. We cannot agree, the court announced, “that the plaintiff as a common wage-laborer is not permanently impaired in his ability to earn a living by the loss of two joints on the index finger of his left hand [even] after the stump has healed. . . . When judging the compensation claim of someone injured in an occupational accident, one is to proceed from the assumption that as a rule any impairment of the integrity [Unversehrtheit] Page 103 → of those limbs which are commonly favored during work, [in this case] namely the hands, reduces the capacity to work and thereby the ability to earn a living.”113 The principle set out here was an important one for accident insurance. By insisting that some level of incapacity always accompanied the maiming of body extremities, disability was given a wider legal definition than employers and insurers had hoped. Disablement was now a relatively common experience, occurring virtually with the same frequency as injuries themselves. By underlining injuries to limbs, certain body parts—fingers, hands, arms, legs, and feet—were flagged as sharing a uniquely essential relationship to work. Disability could be located in individual body parts. This latter conclusion needed some qualification. Disability, the Reich Insurance Office indicated, was a relationship between the injury, the individual, and work. “In determining the ability to earn a living, the entire set of physical and mental abilities as well as the prospects for work that exist after the accident must be taken into account.”114 Thus, a given body part’s level of disability was situated in its capacity to perform the tasks associated with work. Yet this capacity was also affected by the talents and faculties of the individual. This formulation allowed for individualizing cases and accounted for the seeming paradoxes in compensation. It was now justifiable to argue that two people with an identical injury or illness were not disabled to the same degree. Nevertheless, the most fundamental relationship remained that of a body part to work, and its character was of an instrumental-functional nature. How an injured body part was able or unable to function in its application to work was therefore of primary importance in insurance assessment. Assuming the concept of labor power and following medical practice, the courts and the Reich Insurance Office looked to physiological signs to inform them about an individual’s disability. A hand might be examined to see if it could open and close or if it could grasp an object, a thumb prodded and manipulated for signals of pain, the musculature of an arm scrutinized for signs of development, scars checked for indications of healing.115 These signs were only meaningful, i.e., could only exist as signs, in that they were presumed to offer insight into Page 104 → the functioning of a given body part. The body was to be read for meaningful indications of its applicability to laboring activity. Injury was therefore related to work instrumentally through function. This criterion might serve to increase the percentage of debility.116 In other cases, this instrumental criterion justified reducing a disablement estimate. The painter Karl Wißman, for example, broke his spine in 1892, resulting in bladder and kidney problems and pains in the back and legs. The Hanover Building Construction–Accident Insurance Board reduced his pension to 65 percent in 1903 (though a court of arbitration later increased this figure to 75 percent). Wißman appealed the judgment, but the Reich Insurance Office upheld the lower court’s decision because he was still capable of doing “light work” in a seated position.117

Such reasoning also explains the judicial and compensatory practice of comparing and contrasting disabled body parts. In one case, for instance, the question was raised whether losing a hand was not the same as losing an arm. The Reich Insurance Office said not always, for “when setting a pension, loss of a hand is not to be equated under all circumstances with the loss of an arm, since the search for work in many cases will be easier with an artificial hand than for those with one arm.”118 Using similar logic, the court awarded a coachman with an injured left hand a pension of 30 percent. In this instance it pointed out that the injured hand was able to grab hold of the kinds of objects familiar to the daily work of the injured coachman. The court also added that since it was “the left hand and not the right hand” that was injured, the man’s disability was not as great.119 Right hands, as a matter of principle, were to be seen as more indispensable to work than left hands. Even among the parts of an individual human body, then, a hierarchical division of labor existed. Categories of Afflictions Disability, according to jurisprudence, involved a relationship between the injury, the individual, and work. A body part within this nexus represented a tool. Its owner’s level of ability could be measured in how productively and lucratively he or she could exploit its potential utility. This formulation in no way exhausted the variables contributing to a disability. Insurance jurisprudence was situated both within the framework of a set of rules (laws, regulations, Page 105 → precedents) and within society in general (its symbolic order, its discriminations and stratifications, its economic values). Human afflictions and individuals found themselves correspondingly classified and processed. All disabilities were not created equal because all ailments were not homologous and because all individuals were not situated similarly in society. The principles of compensation and disability were therefore the products of an interaction between the particular and two sets of categories of the general. The first set of categories distinguished between ailments. As it was for the accident-insurance boards, the distinction between public and private maladies was the most fundamental for insurance courts and the Reich Insurance Office. Was a symptom or an ailment the direct result of an occupational accident? This was the question that all assessors of insurance claims asked. It was also a question that repeatedly stood at center stage in the hearings of the Reich Insurance Office. Was there a causal link between the blood poisoning of a worker and the factory in which he worked?120 Was the hernia of a quarryman the result of an event at work or the manifestation of an antecedent predisposition?121 Could the onset of nervous symptoms two years after an accident be seen as a “natural development” arising from the original injury, or were the two unrelated?122 Such questions both assumed and created a distinction between ailments, and not just between the ailments of different individuals, but also between the different ailments of a given individual.123 Closely linked to this public/private dichotomy, a distinction between the sudden or progressive nature of the etiology of a disability also served to separate deserving from undeserving claims. The question here primarily was, did an accident take place? Were the disabling symptoms of a worker the result of a discrete, “extraordinary” (außerordentlich) event or the consequence of long-term exposure to certain chores or substances? In this contrast inhered the difference between a compensable accident and a noncompensable occupational illness. In the case of the farmer Karl Schöler, for instance, doctors identified tendovaginitis in the right arm. Schöler contended that what caused the ailment was the jolt he received from a scythe he used on 25 December 1896 as it hit a molehill. Both the lower court and the Reich Insurance Office, however, found Page 106 → it improbable that the impact of the jolt could have precipitated the inflammation in Schöler’s hand. In the words of the high court, as a general principle, “if bodily ailments (here, inflammation of the right hand) are not convincingly explained as an occupational accident (an accident of consequence), then they are to be viewed as an occupational illness (continuous over-exertion of the hand due to continuous work).”124 The occupational illness, however, did not become a recognized form of disability until 1925. To thus name an affliction was to deny its existence within the nosology of insured ailments. Not all categories of ailments were exclusive. While the courts classified ailments as physical or mental, neither designation implied a prima facie repudiation or acceptance. Indeed the Reich Insurance Office recognized a myriad of neurotic symptoms, from paralysis to heart palpitations, as early as 1889. Differentiating between the two was nevertheless important since it located the affliction and thereby helped to track down the causal agent. The distinction between physical and psychical afflictions often went hand in hand with discriminating between

external and internal injuries. The 1888–90 case of the seaman W. Dreyer illustrates well how the two sets of categories were often linked. Dreyer was the captain of a steamer destined for Hong Kong when the ship was hit by a typhoon in September 1888. During the chaos, he grew progressively weaker and died of heart failure. His widow claimed his death was the result of an occupational injury and demanded an accident pension. The Seaman’s–Accident Insurance Board denied the request, pointing to the fact that Dreyer had always suffered from a weak heart, and, in any case, a typhoon hardly represented an accident. A court of arbitration, however, disagreed with the accident-insurance board, noting that an accident could have two types of effect on the human body. “This effect brought about by the work-impeding [betriebswidrige] event can be a purely mechanical, external one or a more dynamic, internal one, ” judges pointed out. “In the case of the former, a direct injury to the external condition of the body takes place, a wound, a broken leg or arm; with the latter, however, a diversion of the effect occurs through the muscles, nerves or flow of blood to the internal organs, e.g. in the case of a fracture or a blow to the heart or brain, a haemorrhage in the lungs.”125 The Reich Insurance Office echoed this sentiment and asserted “that the direct, imminent danger and the sense of responsibility that he felt in the situation put Dreyer in a high state of agitation.” Dreyer’s widow was therefore awarded a pension, and yet another principle of compensation was fashioned. “Not only external injuries, but also pathological, internal processes of Page 107 → a psychical and/or physical nature are manifest accidents, if they are precipitated by a sudden, external event.”126 The reports of pain and suffering on the part of claimants also found a prominent place in the adjudicated order of disability. This recognition was couched, however, in different terms from those provided by the afflicted. Like any other ailment, pain and suffering were only meaningful insofar as they impinged upon the productivity of the individual. Thus, for instance, the Reich Insurance Office could award a 25 percent pension to a packer with an amputated left index finger because “the scar of the amputation incision . . . is painful when there is pressure on the thumb and middle finger or they are moved back and forth; [this] prevents the hand from closing and constitutes a considerable obstruction during work.”127 While this understanding of pain did not fully agree with that outlined by the disabled themselves, it was certainly more inclusive than the view taken by insurers. The Reich Insurance Office did not share the view of insurance providers that the subjective reports of claimants were necessarily suspect. Instead, the courts took such reports and placed them alongside the other signs and variables that relayed information on the capacity to be productive. They thereby integrated the phenomena of pain and suffering into the compensatory system, and in so doing transformed the representations of the disabled into a bureaucratically meaningful object. Categories of Individuals Individual pensioners and applicants represented, along with injury and work, the third element in the relationship that defined disability. Like their various afflictions, they too could be differentiated and classified and their claims assessed accordingly. Insurance jurisprudence identified a number of social variables as constituents of a disability. Chief among these was the kind of work an individual performed. Was the injured person a blue-collar or whitecollar worker? Did his or her work require any special skills? Did it rely on one body part over any other? The answers to such questions might help indicate the absence of a disability. More often than not, however, the nature of the work an individual performed helped indicate the presence and level of a disability. Berthold Gummich, the coachman of a horse-drawn carriage, for example, suffered multiple fractures of his lower left arm in an accident. The Streetcar–Accident Insurance Board denied his request for a 50 percent pension. Upon review, the local court of arbitration in Berlin overturned the insurance board’s decision and granted Gummich a pension set at 25 percent. “The different manipulations,” the court Page 108 → added, “which a coachman of a horse-drawn carriage must perform with the right arm forcefully and swiftly in quick succession—such as steering the horse, handling the brakes, etc.—Gummich finds impossible to carry out.”128 In arriving at such distinctions, the courts appear to have drawn on the same set of assumptions governing the

everyday social hierarchies of working-class Eigensinn. Certain occupations, the Reich Insurance Office explained, demanded more precise aptitudes and skills than others. Such conditions warranted different treatment in pension assessment. Disabilities involving fingers were considered particularly contingent upon the occupation of the individual. A head miller who also worked as a baker, for instance, challenged the pension award of his insurance board after he had lost part of his right index finger. The Reich Insurance Office agreed with the claimant’s higher figure of disability, noting that “for a head miller trained for more precise [feinere] work, the loss of a finger weighs heavier than for an ordinary worker.”129 In a similar case, the tailor Johannes Staib pricked his thumb with a needle, causing an inflammation that later had to be treated with an operation. As a consequence, Staib complained, the movement of his thumb was impaired. The local Clothing Industry–Accident Insurance Board did not share this view and rejected his application for a pension. Upon reviewing the case, the Reich Insurance Office granted that the injury would have been of little consequence for “an ordinary day-laborer involved in coarse [groben] labor.” This case was different, however, in that the work itself was different. “It is a different matter whether a day-laborer or a tailor is injured on the hands, [as the latter] is dependent to a much greater degree upon the dexterity and integrity of the fingers.”130 The issue of differentiating the disabilities of individuals according to their occupation was even more prominent in the development of standards for the compensation of eye injuries. From the very early stages of social insurance, judicial decisions acknowledged the hardships caused by the loss of eyesight, and principles of entitlement were established that recognized that any loss of vision would impair all workers to some degree.131 Despite this, the courts still considered there to be significant differences in how impaired vision affected workers in different occupations. The center of the Reich Insurance Office’s attention in this matter was the relatively large population of “oneeyed” workers, i.e., individuals left with only one fully functional eye. Their debilitation, it was remarked, was largely a Page 109 → function of the fact “that there are a large number of paying jobs in which carrying out the work . . . endangers the remaining eye to a significant degree and that consequently a one-eyed individual reasonably feels compelled to avoid work of this kind.”132 Nonetheless, it was the occupation of the worker that figured most prominently in the determination of this disability. In 1891 the Reich Insurance Office established a formal standard of differentiation between one-eyed laborers by introducing the concept of the “qualified worker.” Qualified workers were identified as laborers for whom good, binocular vision was essential to their work. This group included assembly-line workers, mechanics, watchmakers, glassmakers, wiredrawers, supervisors, machinists, blacksmiths, drivers, borers, and planers. In cases of vision loss in one eye, qualified workers as a rule were to be awarded pensions of 33⅓ percent, while “unqualified” workers were to be given pensions set at 25 percent. The distinction, while firmly adhered to by the courts, did not appear very clear or self-evident to everyone. Courts, even the Reich Insurance Office itself, contradicted themselves regularly by employing different definitions of qualified workers.133 Individual workers and union representatives voiced confusion and anger about the distinction, as the number of workers applying for pensions as “qualified” grew larger.134 This situation led the Reich Insurance Office in 1910 to abandon the concept and to adopt a new criterion that it hoped would individualize the assessment of one-eyed workers.135 Cases like these began to test the outer limits of accident-insurance jurisprudence. If the occupation of the individual constituted a major part of a disability, then the boundary between the ability to earn a living and “occupational invalidity” (Berufsinvalidität, the criterion for invalid insurance) was rather fluid. What exactly was the relation between the two kinds of disability criteria? The Reich Insurance Office took up this question in the case of the weaver Wilhelm Josten. In 1897 Josten had to have the nail joint of his right index finger removed because of the injuries he suffered in an accident. The Rhine-Westphalian Textile–Accident Insurance Board first awarded him a 10 Page 110 → percent pension, but revoked it after a follow-up examination in 1902. The weaver appealed the revocation, arguing before the Reich Insurance Office, “A weaver must be able with his right index finger to perform all the precise labors on the warp and weft, e.g. tying and taking up threads and similar chores. These labors demand a sure finger and a good feel, and the final employment contract depends substantially on the speed with which these labors can be performed.”136 The Reich Insurance Office, too, considered Josten capable

of earning a living at a level of 10 percent. In its opinion, the court noted the ambiguities that surrounded occupation-specific criteria for compensation.

The decisive factor, in accordance with the meaning of the Accident Insurance Law and the practice of the Reich Insurance Office, in judging the degree of ability to earn a living caused by an accident is not occupational invalidity, i.e. the impairment of this ability with regard to the present occupation, but the incurred impairment of the ability with regard to the total field of economic life and in light of mental and physical conditions. In addition, however, it is to be understood—and also has been consistently understood—that undue hardships are to be avoided, that appropriate consideration should be taken of education and present position of employment, and that therefore, without keeping this in mind, a change of profession . . . cannot be expected of an injured worker under all circumstances. . . . If it is also the case that the definitions of the concept of invalidity according to the law cannot be readily transferred to the area of accident insurance, then it is no less the case that the present occupation and the avoidance of undue hardships, common concerns of both accident and invalid insurance laws, must be kept in mind.137

To expect a worker trained in a certain trade to simply be able to earn a living in another trade—one perhaps having little in common with the former—would not, in the reasoning of the Reich Insurance Office, have been in keeping with the spirit of insurance law. Thus, to the kind of work an individual performed must also be added the education and training of the individual as a variable that affected the disability assessment. Insurance jurisprudence also identified the particular region and economic sector in which the individual lived and worked as a significant variable in determining disability. Different environments, it was thought, meant the disabled were often accustomed to different conditions and faced with very different challenges in exploiting their remaining labor power. This did not mean, Page 111 → as the Reich Insurance Office pointed out in 1887, that local circumstances were to be considered as somehow definitive in the evaluation of earning capacity.138 Relatively poor resources and employment opportunities in a region were not grounds enough to justify recognition of disability.139 What in fact the courts did have in mind were the differences that existed in the circumstances of rural, agricultural workers and urban, industrial workers. The countryside, they acknowledged, had admittedly disparate economies and values from those found in urban settings. Most acute were the differences in the labor markets that existed for agricultural workers and their industrial counterparts. Both sets of workers were to be assessed according to the same general standard. “In establishing the degree of disability caused by an accident for persons working in agriculture, the agricultural occupation of the individual and the agricultural labor market alone are not definitive, but above all the possibility of obtaining a job within the entire economic sphere, in other words, the total labor market of the German Empire.”140 The two sets of workers, however, did not have equal access to this general labor market. In the view of the Reich Insurance Office in particular, rural workers were at a distinct disadvantage within this wider market: “For the agricultural and forestry worker adheres more to the soil on which he was born than the industrial worker. It is therefore more difficult for him . . . to procure a job in other areas of economic life that corresponds to his physical and mental abilities. This greater proclivity to a sedentary lifestyle [Seßhaftigkeit] must be considered in measuring the remaining ability of an injured agricultural worker to earn a living.”141 In addition, certain employment possibilities were seen as more closed to disabled laborers in the agricultural sector than they were to those in industry. As the Reich Insurance Office pointed out in 1902, for example, there existed few wage-earning opportunities within the agricultural sector that would allow a worker to carry on his or her labor in a seated position. This necessarily compounded the disabling consequences of an injury for such a laborer.142 Compensatory principles of disability also cut along gender lines. From the very beginning of social insurance women were given the right to apply for pensions, and in 1887 the Reich Insurance Office recognized the right of

wives to legally represent themselves in judicial proceedings.143 Social insurance, Page 112 → however, did not acknowledge women’s productive work in the family, even when it was directly linked to the living earned by the husband, as a basis for the right to a pension. Indeed the Reich Insurance Office very early on—in the case of a woman who sought a higher pension in recognition of her impaired ability to carry out household chores—declined to see household work as productive labor. It made it clear that “full disability cannot be recognized because the injured woman justifies her allegation with the claim of having to care for her small children.”144 The distinction between male and female laborers involved more than simply the division of labor within the household. Insurance jurisprudence held there to be a category of “female occupations.”145 In order then to assess the disability of any female worker, it was necessary to understand to what degree she might be impaired in her ability to find work among these occupations. Marie Brinkop, for instance, was working as a textile worker when she had an accident that led to the removal of the nail joints on her right index and middle fingers. The local textile accident-insurance board contended she was no more disabled than 30–35 percent, defending its position by noting that in similar appellate cases the Reich Insurance Office had quoted this very figure. The high court, however, awarded Brinkop a 50 percent pension, owing to the fact that she was not particularly well-educated and that “female workers more than men are dependent on the utilization of their hands for work.”146 Brinkop’s disability obviously fit more neatly into accepted images of feminine work: relatively unskilled, physical labor associated with the household economy. Distinctions made on the basis of gender thus could, in some circumstances, work to the financial benefit of women. Viewed in more global terms, however, it must be recognized that traditionally “feminine” forms of labor were virtually excluded from consideration by socialinsurance administrators and courts.147 In attempting to establish the existence and degree of a disability, the insurance judicial system identified one last factor as significant in assessing claims: the age of the injured worker. As with so many of the categories employed by the courts, the distinction was conceived as a continuum (younger to older), but in practice functioned more as an opposition (young or old). In other words, the question was, in what way did the youth or the old age of an individual Page 113 → blunt or amplify the effects of his or her disability? Youth and old age were seen as offering a set of different challenges for the disabled. At issue here were the dissimilar ways in which the young and elderly were supposedly able to naturally acclimate and adapt to their debilitating conditions. The outlook for acclimation (gewöhnen, in insurance parlance, the process of becoming accustomed to a condition) and adaptation (anpassen, the more active process of adjusting to a condition) could signal the prognosis of a debility and thereby reveal another dimension in the ability to earn a living. As the court was prone to repeat, however, it was not to be assumed that youthfulness implied awarding comparatively lower pensions.148 The fact, for instance, that a disabled laborer was an adolescent who, as he matured, could be expected to earn as much as or even more than he presently did was not grounds in and of itself to justify lower assessments of disability.149 Some lower courts disagreed, seeing the growth potential of youths as a natural buffer.150 The Reich Insurance Office, however, rejected such deterministic notions. Natural growth and development were not to be mistaken for acclimation. A young worker with a crippled hand, for instance, might very well find that his or her capacity to earn a living improved over time. Such circumstances were due less to acclimation than to the inevitable strengthening of the body in the process of maturation.151 In the view of the judges, a young worker was simply “more easily and more quickly able to get over the effects of the accident than an older worker.”152 Judges did concede there were cases of still active and “vigorous” workers in their sixties and seventies. Such appearances, the Reich Insurance Office reminded insurance administrators, were deceptive, however.153 A poor employment prognosis, in contrast to younger workers, was to be assumed for the elderly. Serious injuries, as in the case of a sixty-year-old man who lost his left arm, necessarily affected the older worker more gravely than the younger. “Under certain circumstances considerable doubt can be entertained about whether in the case of a young, strong worker a 50 percent pension represents an appropriate compensation for the loss of an arm (regardless Page 114 → of whether it is the left). In any case, this pension figure is not sufficient when the injured worker . . . is already very old, and, as a consequence of both his old age and specific physical infirmity, he finds it difficult to still secure a job that does not require the unrestricted use of the arm.”154

The Secularization of Fate: Disability, Labor Power, and Social Citizenship The image of Wilhelmian bureaucracy that emerges from the records of social insurance is perhaps surprising. The claims procedure was a volatile, open-ended, and permeable one. Its emphasis on the singularity of cases, its invitation of conflict and negotiation, and its concern for judicious arbitration point less to its Weberian than to its Steinian features. Accident and invalid insurances not only provided a venue for the resolution of disagreements between employers, workers, and the state. In them, modern human sciences and technologies converged. Law, jurisprudence, bureaucratic administration, actuarial science, clinical medicine, social science, and statistics were asked to collaboratively settle debates over the values of health, suffering, work, and social obligation. Social conflict was thereby domesticated, housed within the largely technical confines of social administration. Contrary to the expectations of Bismarck, however, rather than pacifying workers and employers, the system emboldened them and provided them with a second order of issues over which to fight. The conflicts of Wilhelmian civil society were not successfully reduced to a social-insurance rationality. As litigants and judges invoked extra-institutional values and standards, litigation increased. In short, social conflict transformed the very social administration designed to tame it. Two distinctly modern notions resulted from this vital compensatory system: disability and entitlement. While earlier poor law had recognized the existence of “the lame,” “the crippled,” “the deformed,” and “the pauper,” it took social insurance to fully develop the idea of “disability,” a condition independent of its bearers. As Barbara Duden has pointed out, the premodern perception and experience of the human body was not framed in terms of possessive individualism.155 Well into the nineteenth century, being ill was widely perceived as a divine fate and understood in the sacred and profane categories of a Christian “illness theology.”156 This was even truer of those suffering from Page 115 → chronic illness. Since they were often not treated by physicians, they were inclined to accept their plights as reflections of God’s will.157 Accident and invalid insurances played the pivotal role in modernizing these perceptions of chronic affliction. The administration’s remarkable determination to individualize ailments—to the point of individualizing body parts on the same person—in relation to their effects on individual bodies prompted a particular way of making sense of chronic illnesses and injuries. The sufferer was now an institutionally isolated figure, interviewed, assessed, and compensated according to his or her unique circumstances. Both assessor and claimant were called on to attend to the minutest details of the latter’s body and health. In the process, both came to assume a decidedly modern, possessive image of human bodies and their ailments. In this way, social insurance forged the modern German ideal of social citizenship on the model of thermodynamics, one according to which belonging in the nation-state was mediated by the body’s ability to be productive. The rise of social insurance therefore represents an important chapter in the history of the secularization of the body, health, and illness. German social insurance gave birth to “disability” as the twentieth century would come to know it. Here was a notion that rested on modern, industrial categories, instrumentalizing the human body as a machine invested with labor power. Assuming the stratifications of contemporary divisions of labor, recognized social hierarchies of profession, education, gender, and age were superimposed on this conception. Thus, while all workers and their afflictions were uniformly evaluated in terms of labor power, distinctions nonetheless were drawn between them based on the productive potentials ascribed to each stratum. As ailments were being bureaucratically functionalized as disabilities, so too were they being increasingly secularized as public problems. Yet while the official concept of social citizenship hinged on a thermodynamic vision of work that linked entitlement to labor power, claimants and the trade unions voiced their demands in a moral idiom of suffering and justice. Where and how boundaries between disabilities and the disabled were to be drawn were the sources of endless conflict. Employers, insurance boards, physicians, organized labor, and individual workers clashed with one another, compelling the state to arbitrate. Yet it was the very combative nature of pension insurance that led workers, followed by the labor movement, to grant the system legitimacy. Every day, insurance boards and courts reinforced worker self-representations of respectability. Even in those cases where assessors turned down a claim, the insured were given the opportunity to further pursue the matter on their own behalf. They stood before authorities that treated their ailments Page 116 → as a claim, a suit. Workers obliged, immersing themselves in the

specifics of their own cases. Some acquired testimonials from fellow employees, others sought the aid of lawyers or worker secretariats, and most found physicians to certify their ailments. The claims process educated pensioners in the art of advocacy. Their injuries and complaints were translated into a bureaucratic idiom of monetary compensation. Thus, the disabled came to embody as well as to learn entitlement. Early German disability insurance succeeded, then, not because it provided workers with material security; such an accomplishment was beyond its intent. Rather, to borrow Michael Herzfeld’s apt term, it operated as a secular theodicy.158 The afflicted brought their injuries, pains, and sufferings before authorities, demanding recognition. If successful, their claim served as a justification for the perceived catastrophes that had befallen them. Bureaucratic recognition meant being formally consecrated as a respectable worker and citizen. What early social insurance secured was less a worker’s income than a worker’s self-esteem and faith in the existing order. 1. Bundesarchiv Koblenz (hereafter BAK), R89/21895, August Kranich v. Brandenburgische landwirtschaftliche-Berufsgenossenschaft (hereafter BG), Schiedsgericht für Arbeiterversicherung Regierungs-Bezirk Potsdam zu Berlin, 30 December 1909. 2. BAK, R89/21895, August Kranich to Reichsversicherungsamt (hereafter RVA), 21 January 1910. 3. BAK, R89/21895, August Kranich v. Brandenburgische landwirtschaftliche-BG, RVA Senate, 27 October 1910. 4. BAK, R89/21895, August Kranich to RVA, 13 December 1910. 5. Kaiserliches Statistisches Amt, Atlas und Statistik der Arbeiterversicherung des deutschen Reichs (Berlin: Carl Heymann, 1904), 14–15. Accident-insurance figures here exclude the workers covered by the state-run insurances, the Ausführungsbehörden. By 1900, there were 774,926 of these workers. 6. Kaiserliches Statistisches Amt, Statistisches Jahrbuch für das Deutsche Reich, 1915 (Berlin: Puttkammer und Mühlbrecht, 1915), 384. 7. I will use the term “disability insurance” throughout to refer to both accident and invalid insurances. 8. See references to this literature in chapter 2. 9. The original laws can be found in “Unfallversicherungsgesetz,” Reichs-Gesetzblatt, 6 July 1884, 69–112, and “Gesetz, betreffend die Invaliditäts- und Altersversicherung,” Reichs-Gesetzblatt, 22 June 1889, 97–144. Subsequent changes in the law had little effect on the matter of defining disabilities. On changes, see Ritter, Social Welfare, 83–130. 10. Kobler, “Arbeitsunfähigkeit-Erwerbsunfähigkeit-Invalidität,” Die Arbeiter-Versorgung, 33 (21 August 1916): 553. 11. Other common ailments were rheumatism, blindness, and, most especially among women, diseases affecting reproductive organs. See Oswald Keiner, Entwickelung der deutschen Invaliden-Versicherung: Eine volkswirtschaftlich-statistische Untersuchung (Munich: J. Schweitzer, 1904), 106–8. 12. Between 1884 and 1912, the lower courts changed their form twice. Up to 1900, accident-insurance courts of the lower instance were attached to individual insurance boards. They were replaced in 1900 by local Arbitration Courts for Workers’ Insurance that were removed from the administrative apparatus of the insurers. From 1912 onward, both accident and invalid insurance courts were replaced by local state insurance offices (Versicherungsämter) and superior insurance offices (Oberversicherungsämter), which divided responsibilities between them. 13. Niedersächsisches Hauptstaatsarchiv Hanover (hereafter NHStA), Hann. 121, Nr. 77, Gaebel to Vorstände sämtlicher der Aufsicht des Reichsversicherungsamtes unterstellten Berufsgenossenschaften und Invaliden-Versicherungsanstalten, 31 December 1901. 14. Zusammenstellung der Entschädigungssätze welche das Reichs-Versicherungsamt bei dauernden Unfallschäden gewährt hat (Groß-Lichterfelde: Verlag der Arbeiter-Versorgung, 1912). 15. Gustav Vogt, Die Vorteile der Invalidenversicherung und ihr Einfluß auf die deutsche Volkswirtschaft (Berlin-Grunewald: Verlag der Arbeiter-Versorgung, 1905), 42–43. 16. This point is emphasized by Florian Tennstedt, Berufsunfähigkeit im Sozialrecht (Frankfurt a.M.: Europäische Verlagsanstalt, 1972) and Stone, Disabled State. 17. See, for instance, BAK, R89/6605, Wilhelm Steffel to Königliches Justiz-Ministerium, 18 June 1910;

R89/6601, Maria Huße v. Landesversicherungsanstalt (hereafter LVA) Westfalen, Schiedsgericht für Arbeiterversicherung, 19 August 1910. 18. H. Mattutat, “Das Erlöschen der Rentenansprüche bei der Invaliden- und Unfallversicherung,” Die Neue Zeit 22 (1904): 716–21; “Die soziale Gesetzgebung und ihre Anwendung,” Berliner Tageblatt 14 December 1911; BAK, R89/4923, “Wer noch 33⅓ Pfennig täglich verdienen kann, ist noch erwerbsfähig,” Vorwärts 41 (18 February 1913). 19. Josef Keidel, Sämtliche Entscheidungen des Reichs-Versicherungsamtes und des Reichsgerichts auf dem Gebiete der Invalidenversicherung (Gießen: Emil Roth, 1903). 20. As a rule, of the two, accident pensions were considered more remunerative than invalid pensions and therefore were more in demand. Moreover, the very fact that accident insurance allowed for virtually any degree of incapacity by awarding partial pensions opened up much more to debate than invalid insurance. Since invalid insurance required a two-thirds disability, its clientele was also generally more self-selective. 21. Rabinbach, “Social Knowledge,” 62–63. See also my discussion in chapter 2. 22. BAK, R89/20045, Vorsitzender, Rheinisch-Westfälische Hütten- und Walzwerks-BG to RVA, 15 November 1886. 23. BAK, R89/20007, Vorstand, Knappschafts-BG to RVA, 16 June 1886. 24. BAK, R89/21484, Vorsitzender, Brauerei- und Mälzerei-BG to RVA, 31 March 1903. 25. BAK, R89/21932, Vorstand, Ostpreußische landwirtschaftliche BG to RVA, 6 October 1910. 26. Breger, Haltung, 212–16, and “Der Anteil der deutschen Großindustriellen an der Konzeptualisierung der Bismarckschen Sozialgesetzgebung,” in Bismarcks Sozialstaat, ed. Machtan, 42. 27. Rabinbach, Human Motor, 45–60. The science and study of work (Arbeitswissenschaft, Arbeitskunde) that emerged in Germany during the last third of the nineteenth century also contributed to this way of thinking, emphasizing the maximization of joy in work as an essential element in promoting efficiency and productivity. See Joan Campbell, Joy in Work, German Work: The National Debate, 1800–1945 (Princeton: Princeton University Press, 1989), 73–106. 28. Crosbie Smith, “Energy,” in Companion, ed. Olby, Cantor, Christie, and Hodge, 326. 29. Richard Biernacki, The Fabrication of Labor: Germany and Britain, 1640–1914 (Berkeley and Los Angeles: University of California Press, 1995), 12. 30. Konrad Hartmann, Das Gefahrtarifwesen und die Beitragsberechnung der Unfallversicherung des Deutschen Reiches (Berlin: Julius Springer, 1913). 31. Hauptverband der gewerblichen Berufsgenossenschaften, St. Augustin (hereafter HdgBG), Nr. 30, Bericht über den XVIII. ordentlichen Berufsgenossenschaftstag zu Eisenach am 24. Juni 1904; “Bericht über den XIX. ordentlichen Berufsgenossenschaftstag zu Lübeck am 14. Juni 1905,” Beilage zu der Berufsgenossenschaft 14 (1905): 4–6; HdgBG, Nr. 34, Verband der deutschen BGen to die Regierungen der Einzelstaaten, 20 June 1908; Geschäftsführender Ausschuß des Verbandes der deutschen Berufsgenossenschaften to die Mitglieder des Hohen Bundesrats, 10 June 1909; BAK, R89/6603, Rheinische Vereinigung berufsgenossenschaftlicher Verwaltungen, Geschäftsführender Zusammenkunft, 5 June 1913; H. Sybel, “Die festen Rentensätze,” Zentralblatt der Reichsversicherung, 22 (1916): 835–39. 32. On professional jurisdictions, see Andrew Abbott, The System of Professions: An Essay on the Division of Expert Labor (Chicago: University of Chicago Press, 1988). 33. BAK, R89/20501, Vorsitzender, Südwestdeutsche Holz-BG to RVA, 3 November 1890. 34. BAK, R89/20023, Vorsitzender, Norddeutsche Holz-BG to RVA, 7 October 1886. 35. Karl Figlio, “How Does Illness Mediate Social Relations? Workmen’s Compensation and Medico-Legal Practices, 1890–1940,” in The Problem of Medical Knowledge: Examining the Social Construction of Medicine, ed. Peter Wright and Andrew Treacher (Edinburgh: Edinburgh University Press, 1982), 174–224. 36. BAK, R89/21620, Vorstand, Knappschafts-BG to RVA, 28 September 1904. 37. BAK, R89/20051, Stellvertrender Vorsitzender, Rheinisch-Westfälische Hütten- und Walzwerks-BG to RVA, 19 November 1886. 38. BAK, R89/20023, Vorstizender, Norddeutsche Holz-BG to RVA, 7 October 1886. 39. Among other things, the hope was that such data would reveal the harmful effects of pensions on the laboring population, and thereby support the case for a one-time, monetary compensation (Kapitalabfindung) in place of pensions. Employers viewed the lump-sum settlement as a cheaper and more appropriate form of compensation than the pension. BAK, R89/1189, Geschäftsführender Ausschuß,

Verbands der deutschen Berufsgenossenschaften to Vorstände der in Berlin und Umgegend domizilirenden gewerblichen Berufsgenossenschaften, February 1893; Vorsitzender des Verbands der deutschen Berufsgenossenschaften to RVA, 8 November 1897. 40. BAK, R89/20493, Vorstand, Knappschafts-BG to RVA, 1 October 1890. 41. BAK, R89/21533, Vorstand, Straßen- und Kleinbahn-BG to RVA, 13 January 1904. 42. BAK, R89/20354, Vorsitzender, Ostdeutsche Binnenschiffahrts-BG to RVA, 18 September 1889. 43. BAK, R89/21491, Vorstand, Nordöstliche Baugewerks-BG to RVA, 18 May 1903. 44. BAK, R89/20790, Vorstand, Fuhrwerks-BG to RVA, 15 June 1893. 45. Their efforts were unsuccessful. BAK, R89/21743, Vorstand, Fuhrwerks-BG to RVA, 8 May 1907. 46. Edward L. Murphy, “Malingering,” in The History and Conquest of a Common Disease, ed. Walter R. Bett (Norman: University of Oklahoma Press, 1954), 286–309. 47. Otto Gerhard Oexle, “Armut, Armutsbegriff und Armenfürsorge im Mittelalter,” in Soziale Sicherheit, ed. Sachße and Tennstedt, 73–100. 48. BAK, R89/20240, Vorsitzender, Vorstand, Textil-BG von Elsaß-Lothringen to RVA, 11 February 1887. 49. “Zum Simulantenwesen,” Die Berufsgenossenschaft 7 (10 April 1904): 69. 50. “Bestrafung eines Simulanten,” Die Berufsgenossenschaft 4 (25 February 1908): 36–37. 51. “Empfindliche Bestrafung eines Simulanten,” Die Berufsgenossenschaft 12 (25 June 1910): 124. 52. “Strafrechtliche Verurteilung eines versicherten Steinsetzmeisters, der durch falsche Angaben eine Rente zu erschleichen versucht hat,” Die Berufsgenossenschaft 6 (27 March 1912): 82. 53. “Sozialdemokratischer Terrorismus,” Die Berufsgenossenschaft 11 (10 June 1910): 112–13. 54. BAK, R89/6605, Vorstand, Knappschafts-BG, Sektion I to RVA, 18 May 1911. 55. Alfred Kelly, ed., The German Worker: Working-Class Autobiographies from the Age of Industrialization (Berkeley and Los Angeles: University of California Press, 1987), 18, 188–203, 230–51. 56. “Death of the breadwinner” represented another 18.1 percent and decrepitude due to old age 12.4 percent of all cases. Gerhard A. Ritter and Klaus Tenfelde, Arbeiter im Deutschen Kaiserreich 1871–1914 (Bonn: J.H.W. Dietz Nachf., 1992), 672. 57. A “factory” was defined as any enterprise “that used steam boilers or elementary forces (wind, water, steam, gas, hot air, etc.) to power its machines.” Invalid insurance further extended its coverage to junior white-collar workers and domestic servants. 58. Angelika Willms, “Grundzüge der Entwicklung der Frauenarbeit von 1880 bis 1980,” in Strukturwandel der Frauenarbeit 1880–1980, ed. Walter Müller, Angelika Willms, and Johann Handl (Frankfurt a.M. and New York: Campus, 1983), 25–54; Reinhard Stockmann, “Gewerbliche Frauenarbeit in Deutschland 1875–1980,” Geschichte und Gesellschaft 11 (1985): 447–75. 59. Karin Zachmann, “Männer arbeiten, Frauen helfen: Geschlechtsspezifische Arbeitsteilung und Maschinisierung in der Textilindustrie des 19. Jahrhunderts,” in Geschlechterhierarchie und Arbeitsteilung: Zur Geschichte ungleicher Erwerbschancen von Männern und Frauen, ed. Karin Hausen (Göttingen: Vandenhoeck & Ruprecht, 1993), 71–96. 60. Kaiserliches Statistisches Amt, Statistisches Jahrbuch für das Deutsche Reich, 1900 (Berlin: Puttkammer & Mühlbrecht, 1900), 208. The numbers changed over time. In 1911, almost 15.4 million men and 9.2 million women were covered by accident insurance, 11 million men and 4.8 million women by invalid insurance. See Statistisches Jahrbuch für das Deutsche Reich, 1913 (Berlin: Puttkammer & Mühlbrecht, 1913), 372. 61. Canning, Languages, 116–30. 62. Hermann Schäfer, “Die Industriearbeiter: Lage und Lebenslauf im Bezugsfeld von Beruf und Betrieb,” in Sozialgeschichtliche Probleme in der Zeit der Hochindustrialisierung (1870–1914), ed. Hans Pohl (Paderborn: Ferdinand Schöningh, 1979), 160. 63. Jürgen Kocka, Arbeitsverhältnisse und Arbeiterexistenzen: Grundlagen der Klassenbildung im 19. Jahrhundert (Bonn: Dietz, 1990), 373–506. 64. Peter Borscheid, “Verdienst, Einkommen und Vermögen älterer städtischer Arbeiter während der Industrialisierung,” in Stadtwachstum, Industrialisierung, Sozialer Wandel: Beiträge zur Erforschung der Urbanisierung im 19. und 20. Jahrhundert, ed. Hans-Jürgen Teuteberg (Berlin: Duncker & Humblot, 1986), 255–76. 65. Hermann Schäfer, “Arbeitsverdienst im Lebenszyklus: Zur Einkommensmobilität von Arbeitern,”

Archiv für Sozialgeschichte 21 (1981): 237. 66. This, however, made up for only a third of a worker’s daily lost wages. Anselm Faust, “Funktion und soziale Bedeutung des gewerkschaftlichen Unterstützungswesens: Die Arbeitslosenunterstützung der Freien Gewerkschaften im Deutschen Kaiserreich,” in Vom Elend der Handarbeit: Probleme historischer Unterschichtenforschung, ed. Hans Mommsen and Winfried Schulze (Stuttgart: Klett-Cotta, 1981), 406. 67. Günther Schulz, “‘Der konnte freilich ganz anders sparen als ich’: Untersuchungen zum Sparverhalten industrieller Arbeiter im 19. Jahrhundert,” in Arbeiterexistenz im 19. Jahrhundert: Lebensstandard und Lebensgestaltung deutscher Arbeiter und Handwerker, ed. Werner Conze and Ulrich Engelhardt (Stuttgart: Klett-Cotta, 1981), 487–515. 68. A sample of Saxon workers shows that most working-class households with children outspent their earnings every year. Hubert Kiesewetter, “Zur Entwicklung sächsischer Sparkassen, zum Sparverhalten und zur Lebenshaltung sächsischer Arbeiter im 19. Jahrhundert (1819–1914),” in Arbeiterexistenz, ed. Conze and Engelhardt, 447–86. 69. Annemarie Kinzelbach, Gesundbleiben, Krankwerden, Armsein in der frühneuzeitlichen Gesellschaft: Gesunde und Kranke in den Reichsstädten Überlingen und Ulm, 1500–1700 (Stuttgart: Franz Steiner, 1995), 281–84. 70. BAK, R89/20049, Marie Birk to RVA, 29 December 1886. 71. Average annual invalid-insurance pensions were around RM 113 in 1891, RM 142 in 1900, and RM 201 in 1914. This amounted to about one-sixth of the average wage of those employed in industry, commerce, and transportation. See Ritter, Social Welfare, 87–88, 189, 191. 72. Mary Jo Maynes, Taking the Hard Road: Life Course in French and German Workers’ Autobiographies in the Era of Industrialization (Chapel Hill and London: University of North Carolina Press, 1995), 195. 73. On historical attitudes toward poor-relief institutions, see chapter 4. 74. The problem of describing to and receiving recognition from peers and authorities has been a persistent one in the history of pain and suffering. See Elaine Scarry, The Body in Pain: The Making and Unmaking of the World (New York and Oxford: Oxford University Press, 1985); Roy Porter, “Pain and Suffering,” in Companion Encyclopedia of the History of Medicine, vol. 2, ed. W.F. Bynum and Roy Porter (London and New York: Routledge, 1993), 1574–91. 75. See, for instance, BAK, R89/20079, Heinrich Fischer v. Steinbruchs-BG, 1887; R89/20208, Johann Philipp Anhäuser v. Norddeutsche Holz-BG, 1887. 76. BAK, R89/21599, Albert Honnaker v. Knappschafts-BG, 1904. 77. Alf Lüdtke, Eigen-Sinn: Fabrikalltag, Arbeitererfahrungen und Politik vom Kaiserreich bis in den Faschismus (Hamburg: Ergebnisse, 1993); “Polymorphous Synchrony: German Industrial Workers and the Politics of Everyday Life,” International Review of Social History, 38 (1993), supplement, 39–84. 78. BAK, R89/21173, Josef Kühn v. Südwestliche Baugewerks-BG, Schiedsgericht der Südwestlichen Baugewerks-BG, Sektion II zu Karlsruhe, 22 November 1897. 79. BAK, R89/20045, Nikolaus Lamberty v. Rheinisch-Westfälische Hütten- und Walzwerks-BG, 1887. 80. BAK, R89/20152, Adolph Henckel to RVA, 24 December 1887. 81. BAK, R89/21087, Wilhelm Keller to RVA, 17 November 1896. 82. BAK, R89/20240, Moritz Erhardt to RVA, 27 December 1886. 83. BAK, R89/20051, Ignatz Lang to RVA, 17 October 1886. 84. BAK, R89/21235, Friedrich Schüler to RVA, 23 July 1899. 85. Lüdtke, Eigen-Sinn, 136–51. 86. Heide Gerstenberger, “The Poor and the Respectable Worker: On the Introduction of Social Insurance in Germany,” Labour History, 48 (1985): 83. See also Susanne F. Eser, Verwaltet und verwahrt: Armenpolitik und Arme in Augsburg vom Ende der reichsstädtischen Zeit bis zum Ersten Weltkrieg (Sigmaringen: Jan Thorbecke, 1996), 207–22. 87. BAK, R89/20007, Statement of Johann Traugott Rau [29 July 1886]. 88. BAK, R89/21533, Johann Koslowski to RVA, 6 December 1903. 89. BAK, R89/20045, Nikolaus Lamberty to RVA, 19 December 1886. 90. BAK, R89/21491, Friedrich Dittberner to RVA, 7 June 1903. 91. BAK, R89/20937, Jakob Dannenberger v. Knappschafts-BG, 1895; R89/21855, Wilhelm Fechner v. Preußischer Eisenbahnfiskus, 1909; R89/21972, Heinrich Fleischer v. Brandenburgische

landwirtschaftliche BG, 1912. 92. BAK, R89/21445, Jochim Hinrich von Pein v. Schleswig-Holstein Landwirtschafts-BG, 1903; BAK, R89/21743, August Vogel v. Fuhrwerks-BG, 1909. 93. BAK, R89/20079, Heinrich Fischer to RVA, 16 March 1887. 94. BAK, R89/21101, Emil Kunze to RVA, 22 December 1896. 95. BAK, R89/21400, Anna Lindemann to RVA, 23 March 1902. 96. For example, in a case heard before the Reich Insurance Office in 1904, eleven separate medical reports, dating between February 1902 and December 1903, were introduced. BAK, R89/21568, Bericht und Gutachten in Unfallversicherungssache Pawlik v. Schlesische landwirtschaftliche-BG [1904]. 97. See various examples of this in Geheimes Staatsarchiv Kulturbesitz Merseburg (hereafter GStAKM): Rep. 77, tit. 343A, Nr. 152, Adh. 39, Bde., 1 and 2, 1883–86. 98. Alfons Labisch, “Die gesundheitspolitischen Vorstellungen der deutschen Sozialdemokratie von ihrer Gründung bis zur Parteispaltung (1863–1917),” Archiv für Sozialgeschichte 16 (1976): 325–70. 99. H. Winter, “Von der ‘Gerechtigkeit’ in der Festsetzung der Unfallrenten,” Die Neue Zeit 18 (1899–1900): 471–73. 100. This of course gave an insurance board the right to reduce a pension. “Gewöhnung an Unfallfolgen,” Die Neue Zeit 29 (1911): 204–6. 101. E. Gräf, “Das Glück der Unfall-Berufsgenossenschaften,” Die Neue Zeit 20 (1901–2): 408–9; H. Mattutat, “Rentendrückerei und Unfallrechtsprechung” Die Neue Zeit 31 (1913): 932–40. 102. Nordrhein-Westfälisches Hauptstaatsarchiv (hereafter NRWHStA), Polizei-Präsidium Aachen, Nr. 244, “Fünfter Kongreß der Gewerkschaften Deutschlands, 22.–27. Mai 1905; Th. Sust, Die Vertreter in der Arbeiter-Versicherung und deren Aufgaben (Hamburg: Verlag der Generalkommission der Gewerkschaften Deutschlands, 1901); Jahresbericht des Arbeiter-Sekretariats in Köln (Verlag des Kartells der freien Gewerkschaften Kölns und umgegend, 1905–8). Of the three branches of social insurance, accident insurance by far took up most of the worker secretariats’ time. In Cologne, for example, between 1905 and 1908, 9,466 of a total of 15,178 cases involved accident insurance. 103. Internationales Handwörterbuch des Gewerkschaftswesens (Berlin: Werk und Wirtschaft Verlagsaktiengesellschaft, 1931), 77. Staffs and budgets were relatively modest. In 1902, for instance, annual budgets of worker secretariats ranged between 19,465 marks (Halle) and 306 marks (Kiel). 104. Sust, Die Vertreter in der Arbeiter-Versicherung, 5. 105. Richard Soudek, Die deutschen Arbeitersekretariate (Leipzig: Jäh & Schunke, 1902); Florian Tennstedt, Vom Proleten zum Industriearbeiter: Arbeiterbewegung und Sozialpolitik in Deutschland 1800 bis 1914 (Cologne: Bund, 1983), 493–506. 106. August Müller, Arbeitersekretariate und Arbeiterversicherung in Deutschland (Munich: Birk, [1903]). 107. Hermann Müller, Die Rechtsprechung in Unfallrenten-Streitsachen (Berlin: Buchhandlung Vorwärts, 1909); Gewöhnung an Unfallfolgen und anderes zur Rechtsprechung in Unfallrentenstreitsachen ([Berlin]: Verlag der General-Kommission der Gewerkschaften Deutschlands, 1914). 108. Joachim S. Hohmann, Berufskrankheiten in der Unfallversicherung: Vorgeschichte und Entstehung der Ersten Berufskrankheitenverordnung vom 12. Mail 1925 (Cologne: Pahl-Rugenstein, 1984), 113–24. 109. Dietrich Milles, “Pathologie des Defekte oder Ökonomie der Arbeitsfähigkeit: Zur Dethematisierung arbeitsbedingter Erkrankungen in der Soziogenese der Arbeitsmedizin,” in Beiträge zur Geschichte der Arbeiterkrankheiten und der Arbeitsmedizin in Deutschland, ed. Dietrich Milles and Rainer Müller (Dortmund: Bundesanstalt für Arbeitsschutz, 1984), 123–79; “Industrial Hygiene: A State Obligation? Industrial Pathology as a Problem in German Social Policy,” in State, Social Policy, and Social Change, ed. Lee and Rosenhaft, 164–202. 110. 16. Jahres- und Kassenbericht der Berliner Gewerkschaftskommission, 1904, 137. On the experiential distance between workers and trade unions, see Lüdtke, Eigen-Sinn, 161–93. 111. For some general discussions about the concepts of negotiation and adjudication, see Simon Roberts, Order and Dispute: An Introduction to Legal Anthropology (New York: St. Martin’s, 1979), 140–41, and “The Study of Dispute: Anthropological Perspectives,” in Disputes and Settlements: Law and Human Relations in the West, ed. John Bossy (Cambridge: Cambridge University Press, 1983), 13–18; Anselm Strauss, Negotiations: Varieties, Contexts, Processes, and Social Order (San Francisco: Jossey-Bass, 1978). 112. P. H. Gulliver, Disputes and Negotiations: A Cross-Cultural Perspective (New York: Academic,

1979), 1–34. 113. BAK, R89/20051, Ignatz Lang v. Rheinisch-Westfälische Hütten- und Walzwerks-BG, RVA Senate, 1 February 1887. 114. BAK, R89/20168, L. Sieburg v. Nordwestliche Eisen- und Stahl-BG, RVA Senate, 11 June 1888. 115. BAK, R89/20223, August Rackow v. Ziegelei-BG, RVA Senate, 29 April 1887; R89/20683, Friedrich Baehr v. Speditions-, Speicherei- und Kellerei-BG, RVA Senate, 25 January 1893; R89/21079, Franz Milesino v. Steinbruchs-BG, Schiedsgericht für Section IV der Steinbruchs-BG, RVA Senate, 4 August 1896; R89/21975, Friedrich Heidemann v. Sektion IV der Knappschafts-BG zu Halle, Schiedsgericht für Arbeiterversicherung (Norddeutsche Knappschaftspensionskasse) zu Halle, 7 April 1911. 116. BAK, R89/20355, Eduard Hermann Wenzel v. Sächsisch-Thüringische Eisen- und Stahl-BG, RVA Senate, 21 April 1890. 117. BAK, R89/21631, Karl Wißman v. Hannoversche Baugewerks-BG, RVA Senate, 19 April 1905. 118. BAK, R89/21080, Karl Hoffmann v. Hessen-Nassauische Baugewerks-BG, RVA Senate, 20 January 1897. 119. BAK, R89/21535, August Dressel v. Fuhrwerks-BG, RVA Senate, 12 October 1904. 120. BAK, R89/20005, Louis Dressel v. Sächsische Baugewerks-BG, RVA Senate, 24 September 1886. 121. BAK, R89/20585, Claus Eggers v. Steinbruchs-BG, RVA Senate, 7 December 1891. 122. BAK, R89/21505, Karl Thies v. Königlicher Preußischer Eisenbahnfiskus (vertr. durch Königliche Eisenbahndirektion Berlin), RVA Senate, 28 June 1902. 123. BAK, R89/21855, Wilhelm Fechner v. Königlicher Preußischer Eisenbahnfiskus (vertr. durch Königliche Eisenbahndirektion Posen), RVA Senate, 20 December 1909. In this case, Fechner’s restricted mobility in the left arm was considered a compensable ailment, while his collapsed lung was not. 124. BAK, R89/21116, Karl Schöler v. Rheinische Landwirtschafts-BG, RVA Senate, 12 March 1898. 125. BAK, R89/20449, Witwe des W. Dreyer v. See-BG, Schiedsgericht der See-BG, Sektion II zu Bremen, 14 February 1890. 126. BAK, R89/20449, Hinterbliebene des Schiffers W. Dreyer v. See-BG, RVA Senate, 29 September 1890. 127. BAK, R89/20683, Friedrich Baehr v. Speditions-, Speicherei- und Kellerei-BG, RVA Senate, 25 January 1893. 128. BAK, R89/20303, Berthold Gummich v. Straßenbahn-BG, Schiedsgericht für Bezirk der StraßenbahnBG zu Berlin, 13 December 1888. 129. BAK, R89/20346, R. Martin v. Müllerei-BG, RVA Senate [1889]. 130. BAK, R89/20432, Johannes Staib v. Bekleidungs-Industrie-BG, RVA Senate, 16 June 1890. 131. BAK, R89/20493, Karl Seidler v. Knappschafts-BG, RVA Senate, 26 January 1891; R89/20494, Albert Heinrich v. Knappschafts-BG, RVA Senate, 26 January 1891. 132. BAK, R89/20138, Georg Wittmeyer v. Nordwestliche Eisen- und Stahl-BG, RVA Senate, 25 June 1888. 133. At one moment, it might refer to the education and training of the worker; at the next, the importance of the injured organ to an occupation. Some trades, such as locksmiths, turners, hewers, and quarrymen, found themselves designated as qualified workers in some cases and as unqualified in others. BAK, R89 /21869, Anlage zu Ziffer 2 des Protokolls der Abteilungssitzung vom 20. Juni 1910. 134. BAK, R89/21063, Wilhelm Wortmann to RVA [3 December 1896]; R89/21857, Carl Haider, ArbeiterSekretariat Munich to RVA, 24 April 1909. 135. BAK, R89/21869, Friedrich Harm v. Nordöstliche Eisen- und Stahl-BG, RVA Senate, 2 November 1910. The new, less formulaic principle enjoyed a longer life than its predecessor, only first revised in 1939. See BAK, R89/15118, RVA to Prof. Claus, Directory of University Eye Clinic in Halle, 24 February 1939. 136. BAK, R89/21439, Wilhelm Josten to RVA, 5 November 1902. 137. BAK, R89/21439, Wilhelm Josten v. Rheinisch-Westfälische Textil-BG, RVA Senate, 27 February 1903. 138. BAK, R89/20079, Heinrich Fischer v. Steinbruchs-BG, RVA Senate, 25 November 1887. 139. BAK, R89/20214, Carl Götte v. Zucker-BG, RVA Senate, 26 April 1887. 140. BAK, R89/21784, Fr. Czarnecki v. Westpreußische Landwirtschafts-BG, RVA Senate, 30 October 1908.

141. BAK, R89/20411, Anton Hubert Poppelreuter v. Rheinische landwirtschaftliche BG, RVA Senate, 27 June 1890. 142. BAK, R89/21371, Karl Iggeney v. Ostpreußische landwirtschaftliche BG, RVA Senate, 22 March 1902. 143. BAK, R89/20211, Protocol of the 234th Meeting of the RVA, 28 September 1887. 144. BAK, R89/20049, Marie Birk v. Norddeutsche Textil-BG, RVA Senate, 18 March 1887. 145. BAK, R89/20211, Louise Scheller v. Bekleidungsindustrie-BG, RVA Senate, 19 September 1887. 146. BAK, R89/20124, Marie Brinkop v. Norddeutsche Textil-BG, RVA Senate, 27 February 1888. 147. Kathleen Canning, “Social Policy, Body Politics: Recasting the Social Question in Germany, 1875–1900,” in Gender and Class in Modern Europe, ed. Laura L. Frader and Sonya O. Rose (Ithaca and London: Cornell University Press, 1996), 211–37, shows this was the case when it came to worker safety measures. 148. BAK, R89/21106, Minderjähriger Ludwig Cramme, vertr. durch seinen Vater Georg v. HessenNassauische landwirtschaftliche BG, RVA Senate, 14 January 1898. 149. BAK, R89/20024, Minderjähriger Robert Wagner v. Ziegelei-BG, RVA Senate, 13 December 1886. 150. BAK, R89/20407, Carl Becker v. Provinzialausschuß der Rheinprovinz als Vorstand der Rheinischen landwirtschaftlichen BG, Schiedsgericht für Sektion 60 der Rheinischen landwirtschaftlichen BG zu Wittlich, 12 September 1889. 151. BAK, R89/20572, Minderjähriger Theodor Sonnen v. Steinbruchs-BG, RVA Senate, 8 October 1891. 152. BAK, R89/21684, Minderjähriger Heinrich Rütten, vert. durch seinen Vater H. Rütten v. Seiden-BG, RVA Senate, 9 May 1906. 153. BAK, R89/21185, Johann Peter Repiater v. Rheinische landwirtschaftliche BG, RVA Senate, 28 September 1898. 154. BAK, R89/20569, Erben des Joseph Neubauer und Stadtgemeinde Augsburg v. PapierverarbeitungsBG, RVA Senate, 29 February 1892. 155. Barbara Duden, The Woman beneath the Skin: A Doctor’s Patients in Eighteenth-Century Germany (Cambridge, Mass., and London: Harvard University Press, 1991), 2–3. 156. Frevert, Krankheit, 55. 157. Francisca Loetz, Vom Kranken zum Patienten: ‘Medikalisierung’ und medizinische Vergesellschaftung am Beispiel Badens 1750–1850 (Stuttgart: Franz Steiner, 1993), 112–36. 158. Michael Herzfeld, The Social Production of Indifference: Exploring the Symbolic Roots of Western Bureaucracy (Chicago and London: University of Chicago Press, 1992), 5–10.

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CHAPTER 4 The Regenerative Welfare State: Therapy, Work, and the Birth of Rehabilitation, 1884–1914 Nineteenth-century Germany witnessed unprecedented innovation and growth in two fields of specialized work: medicine and social welfare. While it is generally acknowledged that physicians and social-welfare workers were often of one mind in advocating social reform, it nevertheless has been common for historians to speak primarily of the “medicalization,” “natural scientification,” or “hygienization” of modern German welfare and social policy.1 This terminology is misleading. It represents social welfare as permeable and changing in this encounter, but implies that medicine was a relatively closed and invariable entity. While some have discussed the changes that institutions such as social insurance had on physicians, such discussions typically limit themselves to questions of professional identity and interests.2 Page 118 → The previous chapter exposed some of the shortcomings of the notion that social policy underwent a medicalization. The notion of disability clearly was not the result of a ubiquitous medicalism. Rather, the influence of physicians and medical knowledge was mitigated by other social-service experts and disciplines and by lay beneficiaries. Doctors assumed a secondary role in processing claims. Invited by insurers, the insured, and the state to offer an opinion in individual cases, their judgments were neither final nor definitive. In a bureaucracy that gave the compensation process the form of a judicial hearing, disability emerged out of the multifarious confrontations and adjustments between modern technologies (economics, medicine, jurisprudence, policymaking, actuarial science, social science, statistics), their advocates, and their critics. In understanding the role of medicine in disability insurance, it is therefore essential to appreciate the fact that medicine was only one voice among many. Its practitioners were limited in their professional jurisdiction and compelled to apply and elaborate their knowledge in collaboration with others. In no small measure, the marriage of medicine and social policy in the late nineteenth century compelled the rethinking of both sciences. This is especially apparent in the history of the second great task of early German social insurance: the treatment and convalescence of the afflicted. Disability insurances in particular were not conceived of simply as pensiongranting institutions.3 Benefits were also awarded in the form of therapeutic services. In this setting, physicians came to play a primary role in social-insurance administration. The “therapy regimen” (Heilverfahren), as socialinsurance jargon termed it, initially consisted of little more than free medical treatment and supervision for the disabled and invalid. Within the first decade of accident and invalid insurances, however, the original therapeutic methods and aims had to be reconceived. Clinicians became convinced that conventional treatments offered little to reintegrate patients into specific trades. This led to the creation of new occupational therapies and clinics designed to return the disabled to work life. At the same time, insurance boards became increasingly convinced that monetary compensation was having a counter-therapeutic influence on worker health. This moved them to enhance social-insurance services by calling for the creation of job relocation agencies. As a result, the therapeutic regimen assumed three broad goals, corresponding to three stages in the healing process: treatment, rehabilitation, and reintroduction into the labor force. Rehabilitation in Germany must be understood then as an ideal and as a regimen that emerged out of an industrialized convergence of social-policy needs and clinical practices. Social insurance required the recuperation of labor power, the restoration of the earning and productive capacity of the individual Page 119 → worker. In carrying out this task, the Wilhelmian welfare state established itself as the first one of its kind: a regenerative state, one that claimed for itself the desire, aim, and ability to recover the seemingly lost labor power of disabled workers.

Treatment: Compulsion and the Politics of Surgery Treatment (Behandlung) represented the first and most fundamental element in what German disability insurances termed the therapy regimen. The Accident Insurance Law of 1884 stated that accident-insurance providers could, in place of a pension and in certain cases, offer a full and complete therapy regimen in a hospital at no cost to the insured. Invalid and old-age insurance legislation in 1889 similarly authorized invalid-insurance offices to provide therapeutic services for those invalids whose care was not among the responsibilities of sickness-insurance treatment programs. Although insurance officials often conceptually and linguistically made a distinction between “medical treatment” (ärztliche Behandlung) on the one hand and the broader therapy regimen on the other, insurance practitioners found it difficult to neatly separate treatment from the other facets of social-insurance operations. This was especially true of pension assessment. As we have already seen, treatment was not institutionally isolated from observation, supervision, and verification. Instead, it was inextricably bound up with confirming symptoms and testing the resolve of pension claimants.4 In addition, the kind of treatment an afflicted individual received was also considered to have a significant impact on his or her capacity to earn a living. Cases that eventually came before the Reich Insurance Office established principles that recognized, for example, that a truss reduced and a prosthesis increased the earning capacity of their wearers.5 Nowhere were the boundaries of treatment more in question, however, than in the ethical questions raised by remedies. Social insurance, by organizing the working population into mutualistic health communities, introduced a public health imperative. In this system, principled as it was on the maintenance and promotion of productivity, disability was an excusable, even understandable, absence from work, but one embedded in a contractual order of mutual obligations. Insurance both entitled the insured to certain benefits and imposed responsibilities on them. The debilitated certainly deserved, in principle at Page 120 → least, the monetary benefits for which they qualified. At the same time, they were expected to do everything in their power to rejoin the productive community. In other words, social insurance was rooted in the notion that all those who were ill or disabled had an obligation to try to get well. This is what motivated the attempts to ferret out malingerers. Insurers, certifying physicians, and the law demanded that insured workers express a considerable amount of sincerity in their efforts to recover. Otherwise, as the Reich Insurance Office established in an 1888 ruling, “The fact that the injured person is responsible for slowing down or rendering more difficult his recovery annuls the link between the occupational accident and its consequences.”6 Treatment, of course, was the most obvious and direct means of recovery. By hindering or obstructing treatment efforts, then, the injured became personally and legally responsible for breaking the only link between them and their benefits, the causal connection between the accident and the disability. To do this meant nothing less than forfeiting their rights to a pension. Like so many insurance principles, the obligation to undergo treatment prompted as many questions as it provided answers. To what extent could treatment be made compulsory? Were pension recipients obliged to subject themselves to experimental or less than tried-and-true cures? What of the consequences of the convalescence involved in most any hospital treatment? As one country widow from the Harz challenged her local accident insurer, did she not have a right to avoid a long hospital stay in order to tend to her household and farm?7 Disability treatment was therefore embroiled in debate over the parameters of obligatory medical care. One form of treatment in particular became the focal point of contention: the operation. Surgery, even in the late nineteenth century, was applied in a relatively limited number of cases. Since the Middle Ages, two groups of professionals administered surgical treatment. Generally, barber-surgeons and craft-surgeons (Wundärzte, Handwerkschirurgen) performed the more routine procedures of cautery, cupping, bloodletting, suturing, dressing wounds, fitting trusses, and setting broken bones. Academic surgeons (Chirurgen) were additionally sanctioned to carry out more invasive operations, including amputation.8 Historical evidence indicates that both surgeons and patients well into the nineteenth century chose the more invasive measures to treat injuries only as a Page 121 → last resort. Fear of pain and appreciation for the limits of

surgery were the main reasons for trepidation.9 Before antisepsis (the use of disinfectants during surgery to kill microorganisms) and asepsis (the chemical cleansing of the field of operation, including the operation site and surgical instruments, as well as the hands of the surgeon), surgery was routinely followed by infection. A great many horror stories were associated especially with compound fractures, in which postoperative infections resulted in amputation. One source estimates the mortality rate for amputations at this time at about 40 percent.10 Records from the Boston City Hospital in the United States between 1864 and 1869, for example, show that 66 percent of compound-fracture cases required amputation, and that in 49 percent of these cases the patient died.11 As both antisepsis and asepsis were gradually adopted by physicians in the years following publication of Joseph Lister’s work in 1867, surgeons were emboldened by the positive results they encountered. By the first decade of the twentieth century, surgeons were operating earlier, more often, and in a wider variety of cases than ever before, as orthopedic medicine emerged as an independent specialization.12 The optimism of surgeons was not, however, shared by the insured public. To their experience with the therapy regimen, the injured brought with them their reservations and fears about certifying physicians and insurance clinics. Disabled workers often found the treatment given to them by insurer-assigned physicians unhelpful or injurious. Laborer Jakob Bachmann, for instance, complained that after being successfully treated by his local physician, the Rhineland-Westphalia Textile–Accident Insurance Board in 1887 had sent two doctors to treat him. In both cases, he contended, his condition (headaches and dizziness) got worse. “After I began the cure with Dr. Schölling [the second physician assigned him], I demanded another treating physician,” Bachmann told the courts. “The board denied this [request], and I was forced against my Page 122 → will to remain under the care of this physician.”13 Injured workers continued to question the objectivity of insurer-provided doctors whose tasks included both certifying symptoms and providing treatment. Particularly in relation to operations, as one disabled laborer expressed it, it was “fully explicable” that the same physician who prescribed and who was supposed to conduct an operation would characterize the operation as “not dangerous” when called upon to provide a medical report.14 In other cases, the disabled and their advocates cited experience with an already unsuccessful therapy regimen as sufficient grounds for refusing to submit to a prescribed operation.15 The disabled voiced even greater concerns, however, about operations themselves. Disabled workers expressed pronounced anxieties about the prospect of undergoing an operation. No other form of treatment aroused such widespread and deep dread among the afflicted. Still associating surgery with its historically high rate of mortality, many were willing to go to great lengths to avoid subjecting themselves to what they regarded as a dangerous and tenuous remedy. One worker in 1902, for example, pointed out that he had read newspaper articles that stated that only in operating could a physician determine how involved an operation might be. Such uncertainty clearly alarmed him, as he sought to convince jurists that he had no problem in living with his ailment (a crushed right leg):

My right leg has been ill for 40 years, and has not yet been operated on. I am not now, at the age of 57, going to allow it to be operated on. I am entirely content with these pains that I have had up till now, and have not demanded anything more. Besides, I am not interested in having my wound scraped out without anaesthetic, since I cannot bear the pain.16

One injured worker was so fearful of the prospect of an operation on his genitals, the courts determined, that he died of a heart attack beforehand.17 Given such apprehension and reservations, the demands of disabled individuals are all the more explicable. Numerous workers insisted on guarantees before they would undergo a surgical process. Typical was an early case in which a miner maintained, “Ihave absolutely and categorically not refused [treatment], but I have explained I would subject myself to treatment in the hospital if I could be given written assurance that the injured arm would be brought back to its earlier, Page 123 → healthy condition by the new operation.”18 Reinhold Warthold from

Breslau shared the same view, telling the courts in 1892 that “since Herr Dr. Schütz cannot guarantee success, I have no interest in subjecting myself to experiments.”19 Thus, within the first several years after the institution of social insurance, it was not unusual for disabled laborers to insist that “any operative procedure can only be carried out with the consent of the injured person.”20 Accident-insurance boards, on their part, viewed the refusal to undergo an operation as a medical and legal obstruction. To them, surgery represented a quick and efficient way to recapture some of a worker’s lost labor power. The Streetcar–Accident Insurance Board, for instance, told the Reich Insurance Office in 1888 that the fears of one reluctant disabled worker were simply unfounded. Refusing to submit to a “minor operation,” according to the insurance board, thwarted efforts aimed at rehabilitation, necessitating that the pensioner bear the burden of his subsequent economic plight.21 The Sugar–Accident Insurance Board contended that rejection of an operation represented an interference with the insurer’s right to place a pensioner in a hospital’s custody.22 In addition, it was not uncommon for insurance providers to impugn the motivations of individuals who refused to be operated on, implying that their unwillingness to undergo an operation had more to do with malingering than anything else.23 With insurers and insured once again at cross-purposes, it fell to the judicial system to resolve matters. The position of the courts (up to 1916 at least) attests to their willingness to entertain the complaints of insured workers. Already in 1888, the Reich Insurance Office unequivocally recognized an inalienable right of the disabled to refuse consent in the case of operations.24 In so doing, the courts demonstrated a profound awareness of the limits of contemporary internal medicine and a strong attachment to principles of civil rights. The courts and the Reich Insurance Office identified a number of factors that led them to a right of consent. Chief among these was the apparent risk and uncertainty inherent in surgical processes. In a case involving a streetcar conductor with a broken ankle, both the upper and lower courts concurred in the judgment that he was under no compulsion to undergo an operation in which surgeons were to cut through a small bone in the foot and attempt to extend portions of the shin bone. In its opinion, the high court granted that an injured person was not allowed to obstruct the therapy regimen by refusing “harmless Page 124 → measures” like prescribed medicines or massages. “But such an invasive measure affecting the condition and integrity of the body, as is here expected of the claimant, he does not have to endure,” the senate forcefully explained. “Because of the type and gravity of the operation, the claimant does not have to submit himself to it.”25 Insurance records show that many lower courts later adopted the same reasoning in supporting the right of debilitated individuals to refuse an operation “whose success appears to be in no way certain.”26 By 1914, the Reich Insurance Office had come to recognize a right of consent not only in cases of uncertain results, but even in cases where positive results seemed assured. Expressing this sentiment in a case involving cataracts, the court remained skeptical in the face of repeated assurances from the medical community: “For a deterioration in the [eye’s] condition with the operation is still not entirely out of the question. The eye, such a sensitive organ, despite a perfectly successful operation, can become inflamed. In addition, glaucomatous conditions, detachments of the retina, lacerations of the eyeball can arise as side effects of the operation, all without any blame on the part of the one operating.”27 Courts also identified the pain and troubles that often attended an operation as something not entirely irrelevant to the question of compulsion. “It is not expected of the claimant to subject himself against his will to the pains and the longer hospital stay associated with the operation because the defendant [the insurance board] has the belief or hope that the earning capacity will thereby be fully restored.”28 Insurers, however, took this to mean that operations in which anesthetics were used were possible candidates for obligatory surgery. The Reich Insurance Office in response informed insurers that anesthetics in no way legitimated compulsory operations.29 What appears to have troubled jurists most about the notion of a compulsory operation was the sheer invasiveness of it. In decision after decision, courts used the same phrase in defining what they considered to be the central, disquieting attribute of an operation: an individual could not be compelled to submit to “invasive measures affecting the condition and integrity of the body” (Eingriffe in den Bestand und die Unversehrtheit des Körpers).

Such measures, in the words of one local court, were nothing short of “an encroachment on personal Page 125 → freedom.”30 Surprising language coming from officials in a Wilhelmian bureaucracy, yet the sentiments were reiterated and reinforced throughout the judicial system.31 After deliberations in 1892, the Reich Insurance Office seemed to set the matter at rest when it set out to explicitly delineate which therapeutic measures an injured person could refuse without jeopardizing his or her pension. As it understood the Accident Insurance Law, those injured were obliged to (1) get treatment in a hospital or clinic, (2) undergo medical treatment, e.g., massages or the application of electricity, and (3) submit to any measures that made treating a wound possible, e.g., laying open the injured part, cleaning the wound, and even cutting abscesses. Officials in the government, however, came to the conclusion that “any operation . . . unconditionally required the consent of the injured person.” In defending its position, the Insurance Office launched one of its most scathing attacks on the fiscal reasoning of the accident-insurance providers:

Awarding this consent, however, is his free right, one which neither laws nor the accident insurer nor anyone else can abridge. It is possible that this self-determination [Eigenwille] of an injured person hurts the business interests of the accident insurer; however, consideration of simple business interests may not induce us to encroach upon the free self-determination of a person in such a way that, as a result of an injured person’s refusal to allow himself to be subjected to an operation, his awarded pension is ordered suspended or reduced. For what exists here are two things that exclude any compromise with one another: on the one hand, the monetary interests of the accident insurer; on the other, the freedom to dispose of one’s life and health. . . . In addition, it should also be mentioned that usually the injured person himself . . . is most appropriately in the position to be able to determine whether he possesses the necessary strength and endurance to tolerate an operation.32

Page 126 → In the years following this decision, accident insurers pressed the Reich government to establish more restrictive guidelines. Their efforts achieved preliminary success when, in 1911, Section 606 of the Imperial Insurance Ordinance set down a more explicit code of conduct than existed in previous accident-insurance laws.33 Insurers soon began testing the limits of this newly formulated regulation, using it to justify revoking and reducing the pensions of injured workers who refused to undergo operations. In two court decisions from 1916, however, the Reich Insurance Office continued to insist that refusing to submit to an operation was “an inalienable, personal right.”34 Yet a decision of the Civil Imperial Court in 1913 seemed to open the way for accident-insurance boards and sympathetic officials to revise this thinking. In this case, the civil court had determined, on the basis of Sections 254 and 888 of the Civil Law Code, that an individual who rejected an operation as a treatment measure could be viewed as equally culpable in bringing about his or her condition. Under private, civil law, then, an injured person could justifiably lose his or her compensation without consent. World War I eventually provided opponents of consent with the justifications they needed to successfully call into question the Reich Insurance Office’s traditional position. As we will see in the next chapter, social policy makers during the war sought to all but eliminate litigation and to enhance the authority of administrators and personnel. At the same time, heavy casualties led to surgery becoming a more routine part of medical treatment in the field. With a growing administrative indifference to civil rights, surgery no longer considered to be an inherently lifethreatening procedure, and civil codes offering a compromise solution of sorts, the Reich Insurance Office Senate in April 1917 established a new precedent based on Section 606 of the Reich Insurance Ordinance, stating “that an injured person, even after a completed therapy regimen, may not forgo accepting a physically invasive measure which according to the prevailing state of medical knowledge is considered to be safe, is not associated with any appreciable pain, and leads one to expect with certainty a considerable improvement in the earning capacity of the

injured person.”35 In January 1918 officials in the Reich Insurance Office discussed and debated the decision, finally accepting it as the new guiding principle for disability insurance practice.36 Page 127 → “Protected from Want, but Instructed in Work”: The Invention of Occupational Rehabilitation Historical Alternatives in Therapeutic and Institutional Care Treatment occupied a relatively well-defined position in the division of therapeutic labor. Pension compensation, while not unaffected by therapeutic considerations, was treated as a diagnostic process. It was one that required the involvement of employers, employees, assessors, physicians, and jurists. Treatment, on the other hand, represented the first moment in the mostly clinical handling of disabled workers. It was seen as a medical matter, aimed at meeting the most immediate needs of the injured and debilitated: cleaning and closing wounds, stabilizing the condition, possibly involving surgery, and employing the services and techniques of medically trained personnel. For those involved in treatment, the problem posed by disability was an active pathology.37 Since the time of the Hippocratic physicians, therapeutics were generally a matter of allopathy and diet. Early modern physicians identified six daily regimens whose regulation was considered essential to good health: light and air, drinking and eating, movement and rest, sleeping and waking, bodily evacuations, and moods.38 Eighteenth-century practitioners retained these notions as well as a trio of therapeutic strategies passed down from Galen that consisted of bloodletting, drugs and antidotes, and purgatives. Such treatments were derived from a common medical view that understood the body as a system of intake and outgo built on a balance and equilibrium that needed to be preserved.39 Health, therefore, was a natural state, and it was the presumed supplementary role of therapy to aid the healing power of nature that was inherent in all organisms.40 Challenges to this standard repertoire of treatments came in the late eighteenth and early nineteenth century with the popularity of new forms and the revival of old ones, among them inoculation, electrotherapy, magnetism, hydrotherapies, diet and regimen, fresh-air cures, warm/cold treatments, gymnastics, and massage.41 Page 128 → Before the introduction of social insurance, peasants and the urban working classes found the means to pay for therapeutic services through a mostly informal network of self-help. Personal savings, relatives and friends, neighbors, sickness and burial fraternities, and guilds all routinely served as financial resources for the laboring ill. For those indigent, afflicted, and decrepit without friends, families, or workmates, municipal welfare was their last resort. Beginning in the seventeenth century, towns complemented their traditional “outdoor poor relief” with residential institutions. Offering shelter, strict supervision, and basic medical care, leper houses, almshouses, hospices for poor travelers and pilgrims, asylums, and homes for guild members and their dependents provided poor invalids with a bed and food.42 The early modern general hospital in Germany therefore was administered as a welfare institution and played the part of a repository for indigent sick residents who were chronically or terminally ill.43 While discipline was strictly based on the Christian values of poverty, chastity, and obedience, municipal hospitals and early insane asylums did seek to reintegrate some of their charges through a regimen of regular sleep, meals, prayer, Bible reading, and work.44 Throughout most of its history, Germany’s laboring classes loathed and sought to avoid the hospital. In part, this had to do with its association with death. Arthur Imhof’s now classic study of the records of the Charité Hospital in Berlin between 1731 and 1742, for instance, indicates that one in every four women and one in every three men admitted to the sick ward died. According to his findings, the eighteenth-century hospital served a middle-aged population Page 129 → (ages 20–40) which was predisposed to using the institution as a place to withdraw prior to death.45 Recent scholarship, however, has noted that elsewhere in Germany, particularly where mortality rates were not so unusually high, patients reserved most of their contempt for the impersonal treatment and humiliating discipline associated with the facilities.46 Even into the twentieth century, older generations of workers continued

to express their apprehension about and distaste for the hospital regime.47 The nineteenth century, however, transformed the structure, rationale, and methods of institutional care. Beginning in the first decades of the century, hospitals in Germany and elsewhere in Europe were reconfigured. State interest in ensuring a healthy military, the desire of physicians to have a continuous patient population for medical education and training, and local concerns over a growing pauper population were the main catalysts of change. As a result, hospitals began taking on the character of medical treatment facilities for the first time.48 Between 1820 and 1850, new treatment hospitals were founded in Hamburg, Freiburg, Hanover, Frankfurt, Nuremberg, Berlin, and Aachen.49 The proliferation of sickness-insurance funds during the second third of the nineteenth century prompted a second, more pronounced wave of hospital reconstruction. Following German unification, medical treatment came to dominate the hospital’s focus. The pavilion or barrack system was adopted in the building of new facilities in order to promote better monitoring conditions. Nursing became professionalized. Physicians themselves began to play a greater role in hospital administration. New medical specialties were incorporated.50 By the turn of the twentieth century, German hospitals remained administratively Page 130 → tied to municipal welfare, but their clients and mission had changed considerably. Patients now were mostly working migrants and those covered by workers’ sickness insurance with acute, rather than chronic, ailments. The result was a growing change of emphasis in hospital work, where medication and surgery replaced shelter and supervision as the centerpieces of the hospital’s activities and responsibilities.51 With the rise of the treatment and teaching hospital, stationary health care for the first time began to enjoy popular support. But as insured workers started looking on hospital care itself as an entitlement, health professionals discovered new institutional needs. German physicians, too, increasingly accepted hospitals as primarily medical treatment centers for curable, acute ailments. This, however, left little room for chronic and recuperating patients. By the 1870s, it was acknowledged that the existing health-care system lacked facilities for those convalescents who no longer needed acute medical treatment, yet were still unable to go back to work.52 The question of how to reintegrate the institutionalized ill and insane was not entirely new. Of course, for many patients the general hospital or the asylum was their permanent or final residence. Since early modern times, however, poorhouses, hospitals, and insane asylums in Germany distinguished between and institutionally segregated their residential populations according to the severity and nature of their conditions. In keeping with Protestant, humanist, and mercantilist notions of self-improvement, the able-bodied were put to work.53 Bourgeois and enlightened reformers at the end of the eighteenth century expanded on these practices by further categorizing inmates according to artisanal ideals of social utility and physical aptitude and by establishing work schools for wayward children.54 Over the next half century, German welfare and health-care facilities began to more deliberately place the question of resocialization at the forefront of treatment. This was nowhere more evident than in the institutional handling of the insane. Asylums architecturally separated “the quiet,” “the restless,” “the unclean,” Page 131 → “idiots,” and “the raving mad” from one another. Those deemed treatable received explicitly therapeutic care intended to instill proper habits and virtues in them so that they might eventually be released. The key to resocialization, it was thought, was the careful, pedagogical use of institutional hierarchy, discipline, work, diversion, and punishment.55 German municipal welfare adopted a similar approach beginning in the 1890s. Using medical and pedagogical criteria, poor-relief facilities created special branches for health, youth, housing, and unemployment care, designed to reintegrate beneficiaries on the basis of their particular susceptibility to poverty.56 Spas, Sanatoriums, and Medico-Mechanical Institutes Thus, by the time social insurance was established, German welfare and health professionals had developed an ideal of resocializing the ill, the disabled, the poor, and the insane. Institutional care was becoming just that: “care” (Fürsorge), in the form of a therapeutically justified, pedagogically applied, and work-centered

convalescence. For accident and invalid insurance boards, however, such developments did more to reveal the shortcomings in existing therapeutics and health care than to offer hope. Asylums were still predominantly human warehouses. The poorhouse continued to be administered independently by city governments, and in any event social insurance was intended to remove workers from such welfare institutions. Moreover, the kind of acute treatment offered in hospitals and clinics was intended solely to bring about the cessation of symptoms. Such medical interventions did next to nothing, for instance, for the amputee after the wound healed. The newly emerging medical and welfare facilities and therapies highlighted a need for a resocializing convalescence, but were largely inappropriate for the vast majority of the physically and mentally disabled workers covered under social insurance. For invalid-insurance offices, whose clients suffered from a range of chronic illnesses, the usefulness of hospital care was especially limited. Tuberculosis, lupus, gout, rheumatism, alcoholism, and any number of heart, lung, and circulatory problems were the most frequent maladies that invalid insurance had Page 132 → to treat on a routine basis. The existing institutions that appeared best-suited to look after individuals afflicted by such ailments were ones that had a history of serving the well-to-do with similar afflictions: the mineral baths, spas, and sanatoriums. Modern baths and spas were first founded in Germany around 1800 (although the idea of the healing powers of “the waters” had been around for centuries). Mineral sources as well as fresh air and sunlight were believed to possess genuine healing powers. So physicians sent selected patients, particularly those with chronic illnesses, to the baths in order that they might “take the cure.” Already by the early nineteenth century, the baths had gained their now familiar reputation as a playground for the elite. Time and money became prerequisites for admission. Residents conducted political and economic business with fellow residents during their stay. Places like BadenBaden became “hot spots,” as facilities were ornamented with elaborate gardens, elegant conversation chambers, and theaters. In the 1850s, casinos were introduced, and visitors from all across Europe came to the baths (BadenBaden alone accommodated around thirty thousand annually), bringing with them millions of German marks. By this time, however, the popular media began to poke fun at the enterprise, as the Berliner Montags-Post did in 1857, referring to those who drank from the springs as “milking cows” and branding the whole setup a “fraud.” Derision and satire took their toll, and in the late nineteenth century smaller spas and sanatoriums were established that aimed at providing therapy for those incurables unable to receive care elsewhere.57 As a result, Wilhelmian Germany experienced a veritable boom in the creation and expansion of sanatoriums for the mad, nervously ill, and tubercular.58 Invalid-insurance offices turned to this existing network of sanatoriums, convalescent homes, and mineral baths and spas. In addition, they also built their own sanatoriums designed specifically for their own client population (mostly for those with tuberculosis) and helped place willing incurables in invalid rest homes.59 Accident insurers responded to the inadequacy of general hospitals in similar fashion. Many administrators quickly came to believe that, in the aftermath of accident-insurance legislation, standard medical treatment for those injured Page 133 → in accidents required significant expansion. “It was apparent that many injured individuals whom we had registered upon discharge under the rubric ‘cured,’” as one influential physician recalled in 1901, “remained weeks and months afterward unable to return to work, primarily due to certain consequences of the accident that were not sufficiently enough considered by attending physicians.”60 In 1890 the Association of German Accident Insurance Boards was granted the right for individual and groups of accident insurers to construct and manage their own accident hospitals and convalescent homes.61 Here, those injured in an occupational accident could be examined, diagnosed, and undergo a comprehensive treatment program specifically designed for them. Even these institutions were not seen as sufficient in advancing the cause of therapy. Social insurance itself had created a new need. Based as it was on ensuring the maintenance of a productive population, social insurance shifted the goal of treatment from the restoration of health to the restoration of labor power. Such a system of values demanded more than medical treatment, but something narrower than a generic resocialization. It demanded occupational rehabilitation. To this end, the Miller’s–Accident Insurance Board as early as May 1888,

at the Second Annual Meeting of German Accident Insurance Boards, called for the creation of instructional centers for disabled workers. Such institutions, it proposed, should be funded by insurers and were to provide those injured in accidents with occupational training designed to increase their earning capacity.62 What in fact insurers had in mind was a group of institutions referred to at the time as medico-mechanical institutes (mediko-mechanische Institute). The first German medico-mechanical institute was founded in 1884 in Baden-Baden, with others following soon after in Hamburg (1886) and Berlin (1887).63 By 1893, medicomechanical institutes existed in cities and locales across Germany, including Dresden, Mannheim, Wiesbaden, Würzburg, Frankfurt a.M., Breslau, Leipzig, Wildbad, Stuttgart, Aachen, Karlsruhe, Pforzheim, Munich, Elberfeld, Bochum, Köningshütte, Hangenbieten, and Barmen. Simply put, the institute was a total institution designed to rehabilitate disabled workers. Its patrons were disabled workers who were awarded a therapy regimen as part of their insurance compensation. While some institutes and workshops admitted only Page 134 → certain kinds of afflicted individuals (e.g., workshops for the blind), most did not categorize the disabled by ailment in their admissions. As communities, they appeared—and accident insurers attempted to depict them this way—strikingly similar to their historical antecedent, the mineral bath or spa. For example, one medicomechanical institute in Alsace could boast of being situated along a wooded and verdant mountain slope, offering an abundance of sunlight, clean water, and fresh air. The facility itself accommodated seventy residents and included living rooms, bedrooms, a kitchen, bathrooms, a storeroom, a massage room, a workshop, an office for medical examinations, a library, and apartments for two assistant physicians, the superintendent and his wife, the resident masseur, and a machinist.64 Thus, disability insurance was the direct catalyst for the creation and expansion of a network of rehabilitation centers throughout Germany. Employer-run accident-insurance boards were among the most enthusiastic supporters of such facilities, embracing them as a way to get workers back on the job and off pensions. Legal impediments, however, hindered early efforts. In particular, compulsory health-insurance laws placed all afflictions that lasted up to thirteen weeks in the hands of sickness-insurance funds and thereby in the hands of hospitals and clinics. As a consequence, between the time of treatment and the time when accident insurers could commence a rehabilitative therapy regimen, weeks or months frequently went by. This problem was eventually rectified in January 1893 with an amendment to the Sickness Insurance Law that allowed accident-insurance boards to take over the health care of injured workers before the thirteenth week and thereby bridge the time between treatment and rehabilitation.65 Medico-mechanical institutes were widely seen as the pioneering facilities in this new regime of rehabilitation. Work in Therapy, Therapy in Work The sanatoriums and medico-mechanical institutes used by invalid and accident insurers differed in a fundamental way from their bourgeois counterparts. They were principled on the notion of rehabilitation. As already noted, the social problems associated with disability insurance demanded at once a much less clinical understanding of ill health and treatment and a much narrower vision of its consequences: measured more in employment terms than by reference to a probable illness history, while being centered solely on the degree to which Page 135 → an affliction affected an individual’s labor power. Insurers needed institutions that offered not simply the restoration of health, but the restoration of earning and productive capacity. This did not mean that the therapy regimen was obliged to provide the disabled with the means to return to their former occupations or trades. Rather, following legal definitions of disability, it meant instead that therapy should attempt to reclaim the generic productive potential of an individual worker. Therapy from this perspective needed to be fashioned so that it might help reunite the worker and his or her instruments of labor (i.e., his or her body parts) with the activity of work. The difference between private sanatoriums and those employed by social insurance therefore lay less in the real and imagined class differences between their patrons than in the aim and design of the therapy itself.66 By the time insurers were constructing their own and contracting with existing sanatoriums and medicomechanical institutes in the 1890s, bed rest and relaxation were already a constituent part of the therapy regimen for chronic patients at most facilities. Since the early part of the century, some physicians had also recommended physical exercise and activity, from walking to gymnastics, as important treatments that increased appetite and

improved circulation and respiration. Medico-mechanical institutes and sanatoriums adapted these notions to the needs of social insurance. They established a regimen, lasting roughly one to three months, consisting of two parts. The first part typically involved several weeks of rest and light physical exercise. In the case of tubercular invalids, breathing drills might be the extent of such exercises. All medico-mechanical institutes and some sanatoriums, however, relied on what was referred to as “mechanical treatment” in treating the disabled at this stage. As a therapeutic method, it aimed simply at removing the functional disturbances that a debility presented, i.e. those aspects of a malady that interfered with a body part’s ability to perform work. Mechanical treatment consisted of a regimen of massage, machine operation, active and passive movements of the extremities, the application of electricity and water, and steam baths. Largely influenced by Swedish-derived therapeutic gymnastics, mechanical treatment reasoned that continuous movement of body parts, coupled with massage and baths, improved the circulatory and nervous systems and curbed the stiffening of limbs. Figures 1–3 depict three different apparatuses used for passive exercise: one for bending at the waist, another for movement of the shoulder joint, and the last for the passive manipulation of finger joints. The innovation of these Page 136 → therapies lies in their approach to the human body. All three apparatuses clearly draw on the peculiar distinctions that the compensation process was making. Here, the disaggregated body parts that disability insurance flagged as essential tools of human labor (arms, legs, hands, joints) now get rehabilitated individually. The therapist assumes a less intrusive role than earlier hospital and asylum personnel, either totally absent or relegated to overseer. Instead, in an obvious parallel with mechanized industrial production, the patient’s body parts become part of the machine. In fact, they are literally moved by the apparatus. Machine, worker, and disabled body part form a rehabilitative circuit that at once standardizes therapy and self-reflexively recuperates lost human labor power for eventual use in the production process.

Page 138 → This therapeutic ideal reaches its logical conclusion in figures 4-4 and 4-5. Mechanical treatment expanded on gymnastic therapies by also introducing the very tools and instruments of industrial and agricultural production into the treatment process itself. These tools were modified so that the difficulty and amount of physical movement could be regulated. By thus combining active and passive exercise with the actual means of production, proponents believed, a disabled worker could gradually refamiliarize himself or herself with the activity of labor. Such workers would supposedly be more engaged in the activities, owing to the fact that they were more familiar to them than gymnastics. In the end, they would become more confident by increasingly becoming more adept at using actual tools in productively familiar ways. As an additional advantage for insurance assessors, such activities presumably made the determination of a worker’s earning capacity upon discharge easier to calculate.67

The second part of many sanatorium and medico-mechanical institute regimes began with resident physicians examining the patient to determine whether he or she was fit to work. If so, the patient was then given work of one form or another to carry out on facility grounds. Patrons normally worked from two to five hours a day, depending on their health, and were supervised by medical personnel.68 This therapeutic plan—putting the disabled and invalid to work as part of their therapeutic regimen—came to be known as work or occupational therapy (Arbeitstherapie or Beschäftigungstherapie). As medico-mechanical institutes, workshops for the disabled, and sanatoriums began cropping up in the 1890s and 1900s, work and occupational therapies quickly gained adherents. By 1911, an article on occupational cures in sanatoriums could claim, for instance, that medical opinion was unanimous on the importance of such methods in cases of nervous illness (although it went on to admit that there was still disagreement over their use with respiratory patients).69 While physical labor of some kind was involved in almost every version of this program, there were some recognized differences in the nature and role of the work involved. A workshop, for example, aimed to do little more than teach disabled workers new manual skills within a workshop setting. Medico-mechanical institutes and sanatoriums, on the other hand, integrated the learning of new skills with clinical medicine, having trained physicians directing program operations.70 In addition, some therapeutic professionals distinguished between work therapy, which consisted of nothing more than systematic and regular muscular work, and occupational therapy, which involved performing Page 139 → Page 140 → Page 141 → Page 142 → the chores of a specific job.71 By far the most prominent and influential proponents of work and occupational therapy, however, were the medico-mechanical institutes and sanatoriums, and they tended to employ both.

In carrying out work and occupational therapy, the rehabilitative institutions that accident and invalid insurance boards employed cast their facilities as institutional economies managed by physicians. A resident, once declared to be fit, became a member of the sanatorium’s labor pool. In theory at least, the facility would take into account the character of its surroundings (e.g., open park lands versus land suitable for farming) to determine which economically applicable jobs it should create for its population. This needed to be done, according to one specialist, “since only an economically sensible and suitable occupation brings about the feeling of inner satisfaction.”72 Virtually all manual labor necessary for the running and maintenance of the sanatorium was then organized according to a well-defined division of labor into which medical personnel then fit patrons. This division of labor was also gendered, so that staff assigned men and women work “most appropriate to their inclination.”73 Sanatoriums and institutes set male residents to work primarily in three areas: garden work, field and agricultural labor, and handicrafts. Garden and agricultural work might involve a variety of chores, including the tending of gardens and parks, the gardening of vegetables, or the gathering of hay, firewood, and ice. Sanatorium workshops employed men in, among other things, cabinetmaking and repair for the facility, table making, carving, and bookbinding. Work assignments for women within the institutional setting mirrored the structure of contemporary, Wilhelmian divisions of labor. Female residents might, like their male counterparts, be assigned garden work, but were in any case given duties within the household economy.74 Women generally worked shorter hours than male residents and were most often given tasks involving cooking, washing, and cleaning. In the invalid-insurance institute sanatoriums in Cottbus and Glückhauf, for example, women worked at setting and clearing the dinner table and at cleaning rooms, floors, night tables, windows, and doors. At the Sanatorium for Women of the Invalid Insurance Institute of Brandenburg, house- and garden work were complemented with office work. Women factory Page 143 → workers at the sanatorium were reportedly so enamored with housework, Brandenburg officials bragged, that they had been converted to the “healthier, more wholesome” occupation of maidservant.75 The appearance of such disciplined, relatively self-sufficient institutional economies led some proponents of work and occupational therapy to envision the creation of quasi-utopian communities.76 As early as 1892, plans had been proposed to create worker colonies for those suffering from tuberculosis, designed to “call upon those ill individuals from public sanatoriums suited to it, to do light, strictly regulated and supervised work, particularly in agriculture.”77 The first well-developed plan, however, appeared in 1911, with the appearance of Dr. Otto Rigler’s (head physician, Ernst-Ludwig-Sanatorium in Darmstadt) article on “Land Colonies for Accident Casualties.” Rigler considered providing the disabled with work opportunities the best “medicine” against the rampant discontent and anxieties associated with the pension process. In his view, the applications of work and occupational therapy to date had not been ambitious enough. What was needed were land colonies—colonies of the disabled set up in isolated, wooded areas yet close to industrial centers—which would serve as self-sufficient productive communities for disabled workers. The community Rigler imagined would be based primarily on agriculture, although various crafts would also be practiced. Colonies were also to maintain small houses with gardens, special houses for singles and widows, a school, and a community office that administered affairs. While wages would be paid out so that colonists could pay for food, housing was to be provided at no cost. (“A certain kind of communism,” noted Rigler, “could not be avoided.”) “The main principle,” summed up Rigler, “that must prevail here always should be that the occupational accident casualty must be protected from want, but instructed in work.”78 Rigler’s ambitious program, while symptomatic of the enthusiasm that greeted work and occupational therapy, met with equivocal response from therapeutic specialists who harbored reservations about its effects on workers’ willingness to undergo a work-therapy regimen.79 Rigler’s utopian vision of a work community for the disabled did address one of the more disputed aspects of work and occupational therapy: the question of remuneration. Sanatorium officials and therapists were deeply divided Page 144 → over the question of whether and how the disabled and invalid who worked in these facilities should be paid. Many opposed compensation on principle. Some institutions, in contrast, paid their working patrons five to fifteen pfennigs an hour. It was reported in 1914, however, that hourly wages were still a relatively infrequent method of compensation among sanatoriums, awarded only to male residents in Ronsdorf, Wilhelmsheim, the Ernst-Ludwig-Heilstätte, Hellersen, and Waldhof-Elgerhausen. One convalescent home

determined pay according to a rough estimate of the amount of work done. Other institutions, particularly for craft work, allowed the working disabled to keep whatever they produced. This too had its drawbacks for residents. Given the nature of their work, it excluded the vast majority of women. In addition, because sanatoriums often made patients purchase the raw materials, they were fortunate to break even. Perhaps the most generous plan came from the Tuberculosis Sanatorium in Ambrock, which rewarded its working residents with a quarter liter of beer.80 Despite these differences of opinion, therapists and administrators on the eve of the First World War were buoyant about the possibilities offered by work and occupational therapy. In 1914, in invalid insurance alone, the therapy was being employed by twelve invalid insurance office–owned tuberculosis sanatoriums and was a part of the programs of fourteen private institutions with whom insurance providers contracted. Sanatorium physicians from England and Sweden reported similarly receptive conditions in their own countries. Specialists attributed such enthusiasm to both the medical and the social efficacy of work as therapy. Physiologically, “work as medicine” helped to stimulate the heart, bolster the nervous system, increase appetite, and strengthen muscles. More importantly, perhaps, routine physical labor was seen as having a profound psychological effect on the disabled. It removed boredom from the cure-life. It prevented normally hardworking laborers from becoming lazy after recuperation. The spirits of the afflicted were supposedly lifted, as “occupation also gives the ill person new confidence in his abilities [Kräften].”81 The result, as rehabilitation professionals saw it, was that such work made the transition from convalescence to trade work easier for the disabled and invalid, while at the same time giving physicians a better sense of the productive capacity of pensioners upon discharge. As members of a conference of sanatorium and certifying physicians organized by the Reich Insurance Office in 1901 expressed it, “One must always keep in mind: the most important occupation for a sick person in a sanatorium is to get well as soon as possible.”82 By combining the tools and methods of production with a therapy regimen, the therapeutic facilities of disability insurance invented the modern notion Page 145 → of rehabilitation. Their methods went beyond the pedagogically minded use of work as a vehicle for self-improvement that had been common in municipal hospitals, asylums, and poorhouses. Instead, therapy was devised with specific kinds of work in mind, while work itself took on the guise of therapy. Resocialization was replaced by an industrial regeneration of human labor power. Discontent inside and outside the Sanatorium: The Politics of Rehabilitation Contrary to some contemporary representations, all was not pastoral and serene at the sanatoriums and medicomechanical institutes. Dissatisfaction was a persistent nemesis for personnel trying to set up a rigorous work regimen for often hundreds of residents. Discontent, manifested in a variety of ways ranging from carelessly or sluggishly carrying out chores to outright refusal to participate, was perceived as a threat both to the patient’s health and to the management of the facility. The problem, specialists informed government officials, was a prevailing aversion to work (Arbeitsunlust) among pensioners.83 Numerous sanatoriums and institutes responded to this challenge by making work a compulsory part of their therapeutic program. As personnel at these institutions understood it, work was a “healing factor” (Heilfaktor) and, as such, had to be administered prescriptively by physicians. As a medical matter, it could not be left to the patient to decide its appropriateness. Staffs, however, were far from agreed on this point, and the Reich Insurance Office in a study conducted in 1911 revealed that among twenty-six invalid-insurance sanatoriums, ten made work compulsory, twelve had a completely voluntary system, and four made use of a combination of both.84 What lay behind the discontent among sanatorium and institute residents? How did therapeutic institutions and the insurance providers connected with them make sense of the resistance they encountered? Many sanatorium officials claimed they had little or no experience with patient unwillingness to work (although it was noted that whether or not an institution had a choice in admissions had an impact on patient unrest). What accounted for the differences in experience? In 1912, one sanatorium, upon request from the Reich Insurance Office, sought to explain what was going on.

The Bergmannswohl Accident and Nervous Patient Sanatorium was administered by the Miners’ Provident Fund–Accident Insurance Board and located in Schkeuditz.85 As a source of information about the political machinations Page 146 → within the institutional setting, the Bergmannswohl sanatorium offers a rare opportunity to see how a number of factors contributed to conflict. This is because the makeup of its residential population was strikingly diverse. Patrons included both the newly and longtime disabled and afflicted individuals from all three branches of health insurance and from different social backgrounds. Such diversity—in all likelihood more common to private than to insurer-owned institutions—highlighted the fact that conflict within social insurance was a function of interweaving relations of class, health, and institutional identities. To begin with, officials at the sanatorium traced one of the chief causes of patient discord to the inherently troublesome character of its afflicted population. “The majority of our ill are accident casualties,” they pointed out. “With them—and this is particularly true for those with nervous illnesses and for those whose accident dates back a long time—from the start, they unfortunately place their present hopes on a pension.” Such a lot, administrators reminded the Reich Insurance Office, was notoriously lazy, unaccustomed to any form of strain or cooperation, and unhappy with the pension system as a whole. Such patients, once inside the walls of a therapeutic facility, behaved no differently than they did during the pension compensation process. “They therefore approach a therapy regimen often with reluctance and distrust. They are in a belligerent mood [Kampfstimmung] and are discontented, and formally [förmlich] look for occasions to document their discontent.” The prognosis and length of the affliction also appeared to play a role in the manifest discord. Those residents newly disabled or whose accident happened only a short while before admission expressed what personnel considered to be genuine interest in getting healthy: “They submit themselves to the treatment. They go to the trouble of putting up with certain inconveniences.” Likewise, ill individuals sent by sickness funds and those assigned by invalid-insurance offices in order to prevent full-blown invalidity provided the Bergmannswohl with its best therapeutic experiences. Circumstances were quite different, however, with most chronic patients. Besides nervous and severely debilitated accident casualties, invalid pensioners also posed a serious institutional problem, owing to the fact that they “have been accustomed to the thought of never working again, but of just getting by with their pension.” These troubles were exacerbated by a distinct class dynamic. To begin with, those “well-to-do” in the sanatorium (examples cited were foremen, civil servants, and technicians) found it uncomfortable having to live in such close quarters with workers who made no secret of their political and social opinions. “In an integrated institution and with the most uniform treatment possible, it Page 147 → makes it difficult indeed to find the occasion to remove differences from the world,” officials could only admit to the Reich Insurance Office. In the Bergmannswohl sanatorium, however, administrators were at least partly pleased at the presence of more “esteemed elements” (hervorgehobene Elemente) in the facility. They proved to be important in “setting the general tone and serving as a model for others.” Personnel found the “better off” patrons surprisingly willing to carry on with “those of lesser means,” especially “when one can take into consideration their special wishes by providing them with a single room or the like.” The presence of such “esteemed” patrons in the sanatorium, however, also had its deleterious effects. The Bergmannswohl home had a compulsory work and occupational therapy program. Like their working-class counterparts, more well-to-do patients rejected the policy. Together, both groups appeared as a united front before sanatorium officials. Staff responded to this threat by seeking to appease those of a “better social standing.” To exempt them from work, however, was considered to be an unjustifiable alternative, since “this would neither be in the interest of their health, nor would it improve their position among the other patients.” Instead, personnel gave the more well-to-do their choice of occupation (subject to a doctor’s approval). It seems to have gone some way toward mollifying certain elements in the institution; however, general discontent remained. The Bergmannswohl sanatorium and other rehabilitative facilities believed that there was one force outside the walls of the institutions that was exerting the most profound influence on patient relations. How could one explain, for example, the fact that, according to administrators, urban workers consistently demonstrated an especially strong predilection for opposing work and occupational therapy regimens? As officials at the Bergmannswohl facility expressed it, “It has struck us that we relatively often run into particular opposition with

casualties from Berlin and the surrounding area, so that one almost gets the impression we are dealing here with peculiar, systematic influences whose source, to be sure, we are unable to uncover.” Officials in Schkeuditz were being coy. They were no more in the dark about such systematic influences than an official from the Association for Accident Casualties in Berlin was in 1906, when he reported to the Reich Insurance Office that the cause of the wide-scale aversion to work among pensioners “rests again largely in the agitation of Social Democracy, which seeks to nip any satisfaction in the bud.”86 Without a doubt, Social Democracy and trade unionism did have a direct hand in the unrest that confronted therapeutic professionals and insurers. Similar to their efforts to promote worker interests in the pension compensation process, labor unions and socialists from the 1890s on deliberately and concertedly Page 148 → waged a campaign against what were viewed as the unfair and abusive practices of sanatoriums and medicomechanical institutes. Labor leaders and the socialist press focused much of their attention on conditions within rehabilitative institutions. Substandard living conditions and inadequate care were the most common complaints. In 1895, for instance, Vorwärts launched a highly publicized offensive against the Orthopaedic Sanatorium of Dr. Müller in Berlin, an institution used regularly by insurance providers. Vorwärts charged the facility with ignoring and promoting unsanitary practices. According to the paper, buildings were dirty. Patients received clean underwear once every two weeks. Staff often forgot to provide residents with fresh linen and the opportunity to bathe. Rooms did not have cuspidors, forcing patrons to spit on the floor. Likewise, rooms were not equipped with urinals, and patients were forced to relieve themselves at night in metal buckets. Staffing was wholly inadequate: one woman, serving as cook, attendant, and maid, waited on twenty patients and the resident physician. As a result, patients themselves were forced to do much of the housework (e.g., making beds, heating the furnace, peeling potatoes).87 The complaints against Müller’s sanatorium almost immediately came to the attention of the Reich Insurance Office, and local police sent a city Physikus to inspect the facility one month later.88 One local accident insurer that regularly did business with the sanatorium vocally dismissed the complaints as unjustified: it insisted that during its own routine visits it had never once heard such grievances voiced and identified the source of the complaints as a known agitator.89 The results of the state’s investigation revealed that while there was room for improvements in the sanatorium, the accusations of the article were “essentially unfounded.”90 A year later, Vorwärts launched yet another attack against a Berlin clinic for forcing residents to wear street clothes, providing squalid meals, and having vermin-infested beds.91 In addition to the seeming wretched conditions within the sanatoriums and institutes, Social Democrats and worker secretariats set their sights on what they perceived as the systemic shortcomings in the disability insurance network of services. Both invalid-insurance-sponsored sanatoriums and the medico-mechanical institutes of accident insurance drew fire from organized labor. Invalid-insurance institutions were singled out for employing an overly Page 149 → bureaucratized system of hiring and for offering little means of support to those in their care. Between 1900 and 1910, the Berlin Worker Secretariat, for instance, assailed the local invalid-insurance office for what it called the rampant “bureaucratism” in its practices. As one example, it cited the stringent criteria certifying physicians applied in deciding whether to accept pensioners for sanatorium therapy.92 In addition, the Berlin Secretariat noted that in a whole series of cases that were rejected, “the applicant was sent a letter containing the meaningful words: ‘Since the requirements have not been met, admission in the sanatorium must be rejected.’ The applicant now runs from one place to another, and cannot get advice anywhere as to what these ominous words mean.”93 The Frankfurt Worker Secretariat in 1902 was especially uncompromising in its criticisms of the Invalid Insurance Office of Hessen-Nassau. While one of the richest invalid-insurance institutions in the country (with reserve funds of around 30 million marks by the turn of the century), the office in Hessen-Nassau provided only 167,000 marks (4 percent of its total budget) for therapy—in marked contrast, noted the secretariat, to Hanover (7.1 percent) and Baden (11.5 percent). In addition, the invalid insurer informed local sickness funds that it would no longer admit the mentally ill, hysterics, epileptics, and neurasthenics into its sanatoriums for rehabilitation.94

Other secretariats more commonly condemned local invalid-insurance boards for the meager financial support they gave to invalids and their dependents. One-half of the sick pay that most therapy recipients received, it was noted, went toward paying for sanatorium care, while the other half went to supporting family members (as a rule, amounting to six to eight marks a week). Secretariats in Altona, Hamburg, Halle, Hanover, and Frankfurt all reported that as a result of such low levels of compensation, many insured invalids avoided or terminated a cure in order to receive their sick pay in full.95 Labor circles reserved their most intense attacks, however, for accident-insurance providers and their medicomechanical institutes. As they did with invalid insurers, representatives of labor charged accident-insurance boards with providing inferior care and treatment. Oftentimes, one observer noted, injured workers were compelled to seek out an appropriate rehabilitation center themselves.96 What bothered worker secretariats the most, however, was the intimate professional relationship that sanatorium and institute physicians routinely had with insurance boards. “We have already in numerous cases pointed out,” noted the Munich Secretariat in 1902, “both in our reports and in our pamphlets Page 150 → and pleas before the courts, the kind of legal uncertainty that results for the injured by the fact that the owners and directors of medico-mechanical institutes report on the success of their own treatments in the form of medical reports, and that these reports are then being taken by accident insurers as the basis for pension assessment. . . . The proprietors and co-signatories of these institutions also, as a rule, serve as certifying physicians to their customers—the accident insurers—for the subsequent reduction of pensions.”97 Worker representatives thus took note of the fact that, as therapeutic specialists proudly proclaimed, pensioner participation in the therapy regimen offered physicians a way of reassessing the capacity of workers to earn a living. Since sanatorium and institute physicians were often employed by or served as certifying physicians for accident insurers, such a link between pension evaluation and therapy, however, institutionally placed the insured in a predicament: by taking part in a therapeutic regimen and showing signs of recovery, the disabled workers simultaneously and directly provided accident insurers with the evidence to justify reducing their pensions. Even private rehabilitation facilities, an article from Die Neue Zeit commented, were not immune to the influence of the accident-insurance providers: “The great majority of these institutes exist in private hands, and they have not been built for altruistic reasons, but for the purpose of making money. While they also serve the sickness funds and invalid-insurance offices for the treatment of the insured in a wide variety of ways, they are nevertheless for the most part dependent on the accident insurers.”98 By the turn of the century, labor circles had coined a term for the medico-mechanical institutes that stuck well into the 1920s: “pension pinchers” (Rentenquetschen). Reintroduction into the Work Force: Labor Exchanges If there was one thing representatives of capital and labor could agree on, it was that partially disabled workers needed to be quickly and smoothly reintegrated into the workforce. As we have seen, the character and needs of social insurance compelled a reconfiguration of medical treatment in the form of rehabilitation. At the end of the therapy regimen, then (in theory at least), the disabled or invalid worker was physically and psychologically prepared to take on the tasks of economically productive labor, the transition to work supposedly made easier. Already by 1890, however, insurance officials were confronted with a new set of challenges that they perceived as threatening to undermine any social benefit that might be reaped from the therapy regimen. This time, insurance providers and the insured shared the same problem. “It is unmistakable,” one Page 151 → injured worker informed the Reich Insurance Office in 1891 about the plight of him and others like him, “that [for] these unfortunate workers, while their will to work is still so strong, no one wants to hire an injured worker.”99 Accident insurers had the same experience. Employers were extremely reluctant to hire disabled workers (whether formerly in their employment or not) largely for fear that they would be less productive and more prone to accidents than healthy laborers.100 The Reich Insurance Office decried the development as detrimental both to the disabled and to insurers, insisting that “above all, the employer under whose service a worker suffered an accident also bears the moral responsibility to look after the continuing livelihood of those injured as much as possible.”101 Still, little could be done beyond reproaching management. In 1890, the Association of German Accident Insurance Boards discussed a tentative solution. It was proposed that accident-insurance boards establish labor exchanges (Arbeitsvermittlungen) for disabled workers, designed to

direct injured workers to job opportunities. Accident-insurance administrators appeared guardedly receptive. Suggestions were made that the institutions should operate solely on a local basis in the form of simple employment registry offices (Arbeitsnachweise) managed by individual boards and sections. Others expressed the wish to see such programs tied to larger industrial associations. In the end, it was agreed to give labor exchange a trial run in Berlin in order to see whether it worked.102 In the meantime, the governing committee of the association decided to take an officially neutral stand on the issue, and to allow individual accident boards to determine in what manner they wanted to accommodate disabled workers.103 The concept of labor exchanges was not novel. What was new was the idea of establishing a transregional network of bureaus attached specifically to accident-insurance providers. Wilhelmian Germany did not have and did not purport to have a systematically planned labor-market policy. The Reich and the federal states, unlike in the 1920s, had little reason at first to intervene in employment exchange and placement largely because of very low unemployment rates during the years 1890–1914 (averaging 2.6 percent) and the fact that private and municipal initiatives appeared to suffice.104 The latter had arisen in response Page 152 → to structural challenges in the labor market posed by the consequences of industrialization: the quantitative expansion and segmentation of the labor market, the growth of the urban population, the formation of large-scale industrial enterprises, the progressive division of labor and professional specialization, and the demise of certain trades and branches of industry.105 By 1890, labor exchanges existed in Germany in a variety of forms: private labor-exchange agents, trade guilds, charitable organizations, factory job registry offices, labor unions, and municipal labor-exchange offices all provided job search and placement services throughout Prussia and Bavaria.106 But while this patchwork of private, state, local, and regional labor-exchange services managed to help a significant number of employees, it was in no way systematic and had no competence in meeting the special needs of disabled workers.107 For these reasons, the Reich Insurance Office, in conjunction with insurance providers, between 1890 and 1893 developed and assessed strategies for creating accident-insurance labor exchanges. In a meeting between the officials of the Reich Insurance Office and representatives of accident insurance in May 1892, administrators discussed three possibilities: (1) organizing labor exchange as part of a local agreement between participating insurance boards and their sections and existing communal job-registry offices, and/or (2) using the Central Office for Labor Welfare Institutions to provide uniform regulation of labor-exchange affairs, or (3) conferring the entire operation on accident-insurance boards. In addition, the details of the Berlin experiment were ironed out: an invalid register would be prepared detailing information about each individual client’s sex, age, trade, annual income, and pension level. Negotiations were also to be carried out with the Berlin Central Job Registry Office in order to draw local invalids into the program, and after year’s end the results would be evaluated.108 Yet even while negotiations were being carried on, there was still little agreement about whether the insurance boards were a proper venue for labor exchange. In large measure, the lack of unanimity among insurance providers Page 153 → was a reflection of much broader disagreements between employers. While many industrialists were attracted to the notion of a labor-exchange network as a way of eliminating strikes, groups of other employers were either ambivalent or downright antagonistic to the idea. Heavy-industry employers were less receptive to the idea owing to the fact that they had their own individual systems established, replete with personnel offices and agents. Employers from the agricultural sector were even more put off. More than other branches of the economy, agriculture was especially hard hit by the exodus of labor to the cities after 1870, and employers were adamant in their opposition to creating any institutions that seemed to promote this migration. Employers in this sector therefore attempted to work around the idea of a coordinated labor-exchange network by acquiring foreign workers through the German Migrant Workers Agency and by trying to create their own local job-registry bureaus separate from all urban and central labor exchanges.109 The governing committee of the Association of German Accident Insurance Boards itself believed “that there were considerable difficulties that argued against the planned exchange insofar as, on the one hand, the workers themselves almost without exception are opposing the proposed institution because they fear it will mean a reduction in their pensions, and on the other, the secure supply of labor, a consequence of economic circumstances, makes the accommodation of invalid workers more difficult.”110 At the June 1893 annual meeting

of accident insurers in Stuttgart, members heard a report from a Berlin director who argued that labor exchange under the auspices of accident-insurance boards was neither financially nor practically feasible. High costs, the structural incommensurability between accident-insurance administration (organized according to trade) and proposed exchanges (organized geographically), and the inability of the insurers to act and appear nonpartisan were all cited as reasons for abandoning the plan. Further ammunition against creating a labor-exchange network among accident insurers came from the results of the 1892 survey of employment opportunities for the disabled in Berlin. Statistics indicated that of a total of 764 disabled workers who still had some ability to work, 80.6 percent found a job without the aid of accident-insurer labor exchanges. Comparing the incomes of those who found work after their injury with their previous salaries further revealed that the loss of income they suffered was only around 16 percent.111 Page 154 → The result: plans to establish a comprehensive network of labor-exchange and job-registry offices via accidentinsurance providers were abandoned. Proposals for creating such institutions continued to be proffered,112 but by the mid-1890s a tacit agreement had been reached that deciding on any programs was best left to individual employers and insurers. This did not mean, however, that employers and administrators put the issue aside. On the contrary, individual accident-insurance boards, invalid-insurance offices, and the Prussian state all became involved in promoting the rehiring of pensioners. Section I of the Northeastern Building Construction–Accident Insurance Board in Berlin, for instance, advertised its free job-placement services to local pensioners in 1895, with jobs available as administrators, janitors, security guards, servants, and drivers.113 The Butcher–Accident Insurance Board in 1899 announced its intentions to offer jobs to those qualified among its 1,400 pensioners as meat inspectors, work requiring little physical prowess.114 On its part, the Prussian Ministry of Public Works on 26 August 1891 and again on 6 July 1897 informed officials throughout the state of their obligation to ensure that state employees injured on the job be given work after their recuperation.115 Finally, invalid-insurance providers also became deeply involved in labor exchange in cooperation with local job-registry offices, welfare associations, and municipal governments. Offices in Berlin, Brandenburg, Hanover, and Westphalia, for example, worked closely with provincial job-registry associations in finding employment for invalid workers under their care. Tuberculosis sanatoriums in the Rhine province and the Rhenish Job Registry Association in Cologne operated an employment-exchange service under a written agreement. By 1914, virtually all invalid-insurance offices directed some kind of labor exchange.116 Rehabilitation and the Regenerative Welfare State The problems and qualified acceptance of accident-insurance labor exchanges reveal the extent to which medicine and social policy reciprocally influenced one another. The very idea of creating such a comprehensive employment service Page 155 → for the disabled arose out of concern to more effectively rehabilitate the injured and invalid. The successful opposition to such plans, on the other hand, was a reminder that clinical considerations were always informed by the needs and expectations of industrial capitalism. The rehabilitative ideal that German social insurance stumbled upon and developed was therefore an answer to a historically peculiar question.117 How was it possible to recuperate lost labor power? It implied a bold new approach to the art of healing, one that no longer relegated the healer to the centuries-old status of an assistant to nature. Instead, one could combat the second law of thermodynamics (entropy) by using surgery and mechanical treatments to recover the latent labor power of the disabled. Rehabilitation as both a value and a process was the product of an institutional merger of clinical medicine with social policy and the industrial labor market. The physician and medicine occupied a prominent place in this project. Surgery was used to repair damaged limbs and organs. The new forms of therapy (mechanical, work, and occupational) and the institutions that practiced them (sanatoriums, workshops, medico-mechanical institutes) assumed the pretensions of clinical care. Rehabilitative therapeutics were rationalized to a large degree in physiological terms (e.g., muscles grew stronger, heartbeats became more regular). Sanatoriums and medico-mechanical institutes either modeled themselves on the example of hospitals and spas or outright operated simultaneously as social-insurance rehabilitation centers and

private convalescent homes. Moreover, it was medical personnel who directed the rehabilitative services. In those sanatoriums that employed occupational therapy, physicians were the ones who assigned residents work within the institution’s artificially created economy. This last term, however, was equally important. The care provided by rehabilitation facilities was never allowed to remove itself from the larger social world of production that had given birth to it. Work within the sanatoriums and institutes was still supposed to be “economically useful,” labor remained divided, and men and women continued to be awarded separate chores along the same pattern as the market at large. Work was the centerpiece of rehabilitation, its ever present end. It is no coincidence that orthopedic medicine and public programs for crippled children, established at this same time, adopted the selfsame approach to their task.118 The promise of rehabilitation, as Udo Sierck has Page 156 → pointed out, was from the beginning a promise to make the “useless” useful, to “make a taxpayer out of the handout recipient.” But in yet another twist in the tangled relations between social policy and clinical medicine, work took on a medicinal purpose within the therapy regimen. It was not simply the goal of treatment, it was also its method. Manual labor became a panacea here in much the same way it had become in the scientific world.119 As a universal remedy, it received partial justification on medical grounds. Institutional physicians used work prescriptively. It is for this reason that manual work therapies were applied to all cases regardless of class. As the example of the Bergmannswohl sanatorium highlighted, institutional practices might indeed distinguish between classes, but these were always on the administrative side of operations (e.g., residents were given single rooms or given a choice of jobs). The “well-to-do” could not be excused, however, from taking part in physical labor since the activity was, like any other remedy, a cure. Medicine’s universalizing understanding of organic process and treatment therefore served to compel the therapeutics of social insurance to cut across the social distinction of class at different points in the process. At the same time, such rehabilitative reasoning provided the therapeutic justification for plans to establish labor exchanges. In social insurance’s approach to labor exchanges, the clinical understanding of disability reached its therapeutically logical conclusion. In fact, it was only because such services appeared clinically warranted that employers and accident-insurance providers even dared consider the idea of a centralized labor-exchange system, something many resisted (and would continue to resist) for years. None of this implies that the rehabilitative ideal dissolved frictions within social-insurance therapeutics. Social policy, economics, and clinical medicine were only uneasily commensurate with one another. Administrators, physicians, patients, employers, and organized labor all instrumentalized the three sciences, using their terms and values to articulate concerns, demands, and identities. In fact, in their conflicts over institutional hierarchies, regulations, and goals, those directly involved in rehabilitation pitted the values of public service, economic utility, and health against one another. Here the politics of rehabilitation mimicked the politics of disability compensation. The insured and organized labor argued that the disabled were entitled to treatment, unconditional convalescence, and a job afterward. Employers and administrators questioned the desire of the disabled to get well, sought to restrict benefits, and Page 157 → expressed reservations about the costs of a nationwide network of labor exchanges. These were the politics of social entitlement we encountered earlier. In an important way, however, the politics of rehabilitation signaled something quite new and quite different from the conflict over pensions. In rehabilitation, the German welfare state moved beyond being a simple compensatory state: the rehabilitative and labor-exchange programs of social insurance made the recovery of labor power their aim. This was an unprecedentedly ambitious pretension for the state to adopt, and one that was imaginable only from an industrial-clinical vision of social policy. With the emergence of rehabilitation under social insurance, the German welfare state became less a “therapeutic state” (Hong) than a regenerative state, one that purported to reclaim the apparently lost national resource of labor power. This regenerative aspect of the German welfare state, however, has gone largely unnoticed. Those few historians who have granted the ideal of regeneration a constituent role in modern social policy have focused exclusively on the ambitions of natalist and eugenic policies.120 Yet alongside their anxieties over the declining

fertility and genetic stock of the population, turn-of-the-century social policy makers and administrators were also deeply concerned about any potential threats to productivity and achievement. The physical-culture (Körperkultur) movement around this same time, which sought national regeneration through the promotion of exercise, sports, gymnastics, and physical education, was but one expression of this obsession with enhancing physical prowess and performance.121 Regeneration in the context of German social insurance, however, was more firmly rooted in the thermodynamic perception of work than in hereditary theories of pathology. Rehabilitation allowed social insurance to make good on its claim to maintain and augment labor power. This is what distinguished Wilhelmian social security from its European counterparts: not content to merely act as an indemnifying “providential state” (Ewald), the German welfare state embarked on a massive salvage operation of human labor as capital. This had enormous consequences for twentieth-century German social policy. For, as we will see, the justification of the welfare state as a regenerative force made critics of social welfare all the more sensitive to its degenerative influences. Page 158 → 1. See, for example, Frevert, Krankheit; Göckenjan, Kurieren und Staat machen; Reinhard Spree, Health and Social Class in Imperial Germany: A Social History of Mortality, Morbidity, and Inequality (Oxford, New York, and Hamburg: Berg, 1988); Paul Weindling, Health, Race and German Politics between National Unification and Nazism, 1870–1945 (Cambridge: Cambridge University Press, 1989); Alfons Labisch, Homo Hygienicus: Gesundheit und Medizin in der Neuzeit (Frankfurt a.M. and New York: Campus, 1992). By contrast, Dietrich Milles and Rainer Müller have been attentive to the reciprocal influences of medicine and industrial social policy. See Dietrich Milles und Rainer Müller, eds., Beiträge zur Geschichte der Arbeiterkrankheiten und der Arbeitsmedizin in Deutschland (Dortmund: Bundesanstalt für Arbeitsschutz, 1984). 2. See, for example, Tennstedt, “Sozialgeschichte”; Huerkamp, Aufstieg and her “The Making of the Modern Medical Profession, 1800–1914: Prussian Doctors in the Nineteenth Century,” in German Professions, 1800–1950, ed. Geoffrey Cocks and Konrad Jarausch (New York and Oxford: Oxford University Press, 1990), 66–84; Charles E. McClelland, The German Experience of Professionalization: Modern Learned Professions and Their Organizations from the Early Nineteenth Century to the Hitler Era (Cambridge: Cambridge University Press, 1991), 73–87, 135–43, 180–85. 3. Theodore M. Porter, “Precision and Trust,” 175. 4. See again BAK, R89/20790, Peter Nikolaus Söhl v. Fuhrwerks-BG, RVA Senate, 30 October 1893. 5. BAK, R89/20003, Josef Roßwag v. Südwestliche Baugewerks-BG, RVA Senate, 24 September 1886; R89 /20156, Friedrich Prange v. Privatbahn-BG, RVA Senate, 28 May 1888. 6. BAK, R89/20182, Peter Nitz v. Zucker-BG, RVA Senate, 24 September 1888. 7. BAK, R89/21676, Friedericke Schwarze to RVA, 11 September 1905. 8. Nancy G. Siraisi, Medieval and Early Renaissance Medicine: An Introduction to Knowledge and Practice (Chicago and London: University of Chicago Press, 1990), 153–86; Loetz, Vom Kranken zum Patienten, 94–95; Mary Lindemann, Health and Healing in Eighteenth-Century Germany (Baltimore and London: Johns Hopkins University Press, 1996), 150–85. 9. Robert Jütte has noted, however, that this apprehensiveness was despite a surprisingly good record for the surgical treatment of broken bones in early modern Europe (a 15 percent mortality rate in Zurich between 1674 and 1693). See Robert Jütte, Ärzte, Heiler und Patienten: Medizinischer Alltag in der frühen Neuzeit (Munich and Zurich: Artemis & Winkler, 1991), 134–35. 10. Paul Starr, The Social Transformation of American Medicine (New York: Basic Books, 1982), 156. 11. Morris J. Vogel, The Invention of the Modern Hospital: Boston 1870–1930 (Chicago and London: University of Chicago Press, 1980), 60–61. 12. Klaus-Dieter Thomann, Das behinderte Kind: “Krüppelfürsorge” und Orthopädie in Deutschland, 1886–1920 (Mainz and Stuttgart: Akademie der Wissenschaften und der Literatur/Gustav Fischer, 1995) and “Die Entwicklung der Chirurgie im 19. Jahrhundert und ihre Auswirkungen auf Organisation und Funktion des Krankenhauses,” in “Einen jedem Kranken in einem Hospitale sein eigenes Bett”: Zur Sozialgeschichte des Allgemeinen Krankenhauses in Deutschland im 19. Jahrhundert, ed. Alfons Labisch

and Reinhard Spree (Frankfurt and New York: Campus, 1996), 145–66. 13. BAK, R89/20111, Jakob Bachmann to RVA, 9 August 1887. 14. BAK, R89/20324, Julius Ohmann to RVA, 22 October 1889. 15. BAK, R89/20160, Dr. Leesen to RVA, 7 May 1888. 16. BAK, R89/21422, Karl Sellmann to RVA, 31 August 1902. 17. BAK, R89/20511, Surviving Dependents of Alexander Danielson v. BG der Gas- und Wasserwerke, RVA Senate, 10 July 1891. 18. BAK, R89/20143, W. Bothe to RVA, 12 December 1887. 19. BAK, R89/20795, Reinhold Warthold to RVA, 20 October 1892. 20. BAK, R89/20324, Julius Ohmann to RVA, 1 April 1889. 21. BAK, R89/20160, Straßenbahn-BG to RVA, 16 January 1888. 22. BAK, R89/20298, Zucker-BG to RVA, 15 January 1889. 23. BAK, R89/20436, Fuhrwerks-BG to RVA, 19 February 1890. 24. The original grundsätzliche decision was set down in BAK, R89/20134, W. Bothe v. Knappschafts-BG, RVA Senate, 14 May 1888. 25. BAK, R89/20160, Amandus Kannecht v. Straßenbahn-BG, RVA Senate, 11 June 1888. 26. BAK, R89/20298, Gottlieb Bähr v. Zucker-BG, Schiedsgericht III der Zucker-BG, 20 November 1888. 27. BAK, R89/22071, Hermann Feuring v. Maschinenbau- und Kleinindustrie-BG, RVA Senate, 23 June 1914. 28. BAK, R89/20160, F. A. Kannecht v. Straßenbahn-BG, Schiedsgericht für Bezirk II der Straßenbahn-BG in Hamburg, 10 December 1887. 29. BAK, R89/21422, Karl Sellmann v. Zucker-BG, RVA Senate, 28 November 1902. 30. BAK, R89/20436, Kaspar Böhler als gesetzlicher Vertreter seines minderjährigen Sohnes Albert v. Fuhrwerks-BG, Schiedsgericht des Section XXXII der Fuhrwerks-BG, 7 January 1890. 31. A lower court in Breslau, for example, reminded one accident-insurance board that although it might consider an operation to be “small” and “safe,” it often did not appear that way to those afflicted. “What seems to be a ‘small and safe operation’ from a surgical perspective, is not always so in the eyes of laymen, and the subjective significance of questionable operations for the injured party himself is to be placed in the foreground.” BAK, R89/20795, Reinhold Warthold v. Fuhrwerks-BG, Schiedsgericht der Sektion VIII der Fuhrwerks-BG zu Breslau, 4 July 1892. 32. BAK, R89/20795, Reinhold Warthold v. Fuhrwerks-BG, RVA Senate, 28 November 1892. 33. “If the injured person has not complied with a regulation that affects the medical treatment without any legal or other appropriate reasons therefore, and if his earning capacity will thereby be unfavorably influenced, then his compensation may be disallowed for the time being, either wholly or partly, after this has been pointed out to him.” The Workmen’s Insurance Code of Germany of July 19, 1911 (Washington: U.S. Bureau of Labor, 1911). 34. BAK, R89/22184, August Claudy v. Knappschafts-BG, RVA Senate, 25 October 1916. 35. BAK, R89/22223, Adalbert Konys v. Knappschafts-BG, RVA Senate, 1 February 1918. 36. See memo in BAK, R89/22223, entitled “Bergmann Adalbert Konys in Oberhausen gegen Knappschafts-BG,” ca. January 1918. 37. Saad Z. Nagi, “Some Conceptual Issues in Disability and Rehabilitation,” in Sociology and Rehabilitation, ed. Marvin B. Sussman (American Sociological Association, 1965), 100–113. 38. Jütte, Ärzte, 57–68. 39. Christa Habrich, “Characteristic Features of Eighteenth-Century Therapeutics in Germany,” Clio Medica 22 (1991): 39–49; Lindemann, Health, 263–64. 40. Guenter B. Risse, “Medicine in the Age of Enlightenment,” in Medicine in Society: Historical Essays, ed. Andrew Wear (Cambridge: Cambridge University Press, 1992), 149–95; Roy Porter, “The Eighteenth Century,” in The Western Medical Tradition: 800 BC to AD 1800, Lawrence I. Conrad, Michael Neve, Vivian Nutton, Roy Porter, and Andrew Wear (Cambridge: Cambridge University Press, 1995), 371–473. 41. Erwin H. Ackerknecht, Therapie: Von den Primitiven bis zum 20. Jahrhundert (Stuttgart: Ferdinand Enke, 1970); Charles E. Rosenberg, “The Therapeutic Revolution: Medicine, Meaning, and Social Change in Nineteenth-Century America,” in The Therapeutic Revolution: Essays in the Social History of American Medicine, ed. Morris J. Vogel and Charles E. Rosenberg (Philadelphia: University of Pennsylvania Press,

1979), 3–25. While many of these “new” therapies did question earlier methods and notions, it is equally the case that they all remained deeply influenced by traditional therapeutics. On continuities in the history of therapeutics, see Guenter B. Risse, “The History of Therapeutics,” Clio Medica 22 (1991): 3–11. 42. Martha Collins, “Medieval English Hospitals,” in The Hospital in History, ed. Lindsay Granshaw and Roy Porter (London and New York: Routledge, 1989), 21–39; John Henderson, “The Hospitals of LateMedieval and Renaissance Florence: A Preliminary Survey,” in Hospital in History, ed. Granshaw and Porter, 63–92; Guenter B. Risse, “Before the Clinic Was ‘Born’: Methodological Perspectives in Hospital History,” in Institutions of Confinement: Hospitals, Asylums, and Prisons in Western Europe and North America, 1500–1950, ed. Norbert Finzsch and Robert Jütte (Cambridge: Cambridge University Press, 1996), 75–96. 43. Robert Jütte, “Syphilis and Confinement: Hospitals in Early Modern Germany,” in Institutions of Confinement, ed. Finzsch and Jütte, 97–115. 44. Christina Vanja, “Madhouses, Children’s Wards, and Clinics: The Development of Insane Asylums in Germany,” in Institutions of Confinement, ed. Finzsch and Jütte, 117–32; Kinzelbach, Gesundbleiben, Krankwerden, Armsein in der frühneuzeitlichen Gesellschaft, 387. While historians have generally awarded a great deal of attention to the “social disciplining” functions of these institutions, new scholarship is beginning to raise questions about the accuracy of this emphasis. See Martin Dinges, “Frühneuzeitliche Armenfürsorge als Sozialdisziplinierung? Probleme mit einem Konzept,” Geschichte und Gesellschaft 17 (1991): 5–29. 45. Arthur E. Imhof, “The Hospital in the 18th Century: For Whom? The Charite Hospital in Berlin, the Navy Hospital in Copenhagen, the Kongsberg Hospital in Norway,” in The Medicine Show: Patients, Physicians, and the Perplexities of the Health Revolution in Modern Society, ed. Patricia Branca (New York: Science History Publications/USA, 1977), 141–63. 46. Loetz, Vom Kranken zum Patienten, 104, 245. 47. Barbara Elkeles, “Das Krankenhaus um die Wende vom 19. und 20. Jahrhundert aus der Sicht seiner Patienten,” Historia hospitalium 17 (1986–88): 89–105. 48. Eduard Seidler, “An Historical Survey of Children’s Hospitals,” in Hospital in History, ed. Granshaw and Porter, 181–97; Johanna Bleker, “To Benefit the Poor and Advance Medical Science: Hospitals and Hospital Care in Germany, 1820–1870,” in Medicine and Modernity: Public Health and Medical Care in Nineteenth- and Twentieth-Century Germany, ed. Manfred Berg and Geoffrey Cocks (Cambridge: Cambridge University Press, 1997), 17–33. 49. Dieter Jetter, Grundzüge der Krankenhausgeschichte (1800–1900) (Darmstadt: Wissenschaftliche Buchgesellschaft, 1977). 50. Heinz Goerke, “Großstadtmedizin und Kassenarzt,” in Medizin, Naturwissenschaft, Technik und das zweite Kaiserreich, ed. Gunter Mann and Rolf Winau (Göttingen: Vandenhoeck & Ruprecht, 1977), 102–18; Jetter, Grundzüge, 85–87, 117; Labisch and Spree, eds., “Einem jeden Kranken.” For more on the architecture of the new hospital, see John D. Thompson and Grace Goldin, The Hospital: A Social and Architectural History (New Haven and London: Yale University, 1975). 51. Göckenjan, Kurieren und Staat machen, 214–37, 302–4; Bleker, “To Benefit the Poor,” 28. 52. Barbara Elkeles, “Arbeiterautobiographien als Quelle der Krankenhausgeschichte,” Medizinhistorisches Journal 23 (1988): 342–58. 53. Christoph Sachße and Florian Tennstedt, Geschichte der Armenfürsorge in Deutschland, vol 1: Vom Spätmittelalter bis zum Ersten Weltkrieg (Stuttgart, Berlin, Cologne, and Mainz: W. Kohlhammer, 1980), 85–131; Kinzelbach, Gesundbleiben, Krankwerden, Armsein in der frühneuzeitlichen Gesellschaft, 325. 54. Ernst Köhler, Arme und Irre: Die liberale Fürsorgepolitik des Bürgertums (Berlin: Klaus Wagenbach, 1977), 92–107; Lisgret Militzer-Schwenger, Armenerziehung durch Arbeit: Eine Untersuchung am Beispiel des württembergischen Schwarzwaldkreises 1806–1914 (Tübingen: Tübinger Vereinigung für Volkskunde, 1979), 42–75; Klaus Doerner, Madmen and the Bourgeoisie: A Social History of Insanity and Psychiatry (Oxford: Basil Blackwell, 1981), 164–75. 55. Ernst Köhler, Arme und Irre, 127–28, 142; Dieter Jetter, Grundzüge der Geschichte des Irrenhauses (Darmstadt: Wissenschaftliche Buchgesellschaft, 1981), 44–74; Matthias M. Ester, “‘Ruhe—Ordnung—Fleiss’: Disziplin, Arbeit und Verhaltenstherapie in der Irrenanstalt des frühen 19. Jahrhunderts,” Archiv für Kulturgeschichte, 71 (1989): 349–76; Michael Kutzer, “Die Irrenheilanstalt in der

ersten Hälfte des 19. Jahrhunderts: Anmerkungen zu den therapeutischen Zielsetzungen,” in Vom Umgang mit Irren: Beiträge zur Geschichte psychiatrischer Therapeutik, ed. Johann Glatzel, Steffen Haas, and Heinz Schott (Regensburg: S. Roderer, 1990), 63–82. 56. Christoph Sachße and Florian Tennstedt, Geschichte der Armenfürsorge in Deutschland, vol 2: Fürsorge und Wohlfahrtspflege 1871–1929 (Stuttgart, Berlin, Cologne, and Mainz: W. Kohlhammer, 1988), 27–38. 57. Johannes Steudel, “Therapeutische und soziologische Funktion der Mineralbäder im 19. Jahrhundert,” in Der Arzt und der Kranke in der Gesellschaft des 19. Jahrhunderts, ed. Walter Artelt and Walter Rüegg (Stuttgart: Ferdinand Enke, 1967), 82–97. 58. Edward Shorter, “Private Clinics in Central Europe 1850–1933,” Social History of Medicine 3 (1990): 159–95; Radkau, Zeitalter, 107–21. 59. “Die Heilbehandlung in der Invalidenversicherung,” Die Berufsgenossenschaft, 19 (10 October 1911): 216; Wolfgang Seeliger, Die “Volksheilstätten-Bewegung” in Deutschland um 1900: Zur Ideengeschichte der Sanatoriumstherapie für Tuberkulose (Munich: Profil, 1988). 60. Prof. Dr. Ledderhose, “Festvortrag vom 27. 11. 1901 zur Einweihung des Straßburger Unfallkrankenhauses,” in Geschichte der gewerblichen Unfallversicherung, vol. 2, Ernst Wickenhagen (Munich and Vienna: Oldenbourg, 1980), 98. 61. “Probleme der Finanzierung von Unfallkrankenhäusern,” in Wickenhagen, Geschichte, vol. 2, 300–301. 62. BAK, R89/1189, RVA to Vorstand der Sektion I der Nordwestlichen Eisen- und Stahl-BG, 15 October 1906. 63. Medico-mechanical institutes first appeared in 1865 in Sweden. 64. See BAK, R89/1189, RVA to Vorstand der Sektion I der Nordwestlichen Eisen- und Stahl-BG, 15 October 1906. 65. BAK, R89/568, “Die Entwicklung der mediko-mechanischen Nachbehandlung,” Deutsches VerkehrsGewerbe, 8–9–10 (16 April–1 May–16 May 1893). 66. As I point out below, the patient population within a sanatorium or institute could and did cut across class boundaries. This was due to (1) the large number of white-collar workers covered by social insurance and (2) the common use insurers made of private institutions in placing the disabled in therapy facilities. 67. Dr. Hönig, “Über die Behandlung und Begutachtung der Unfallverletzten,” Die Berufsgenossenschaft 9 (10 May 1901): 92–96. 68. BAK, R89/6705, Ernst-Ludwig-Heilstätte to RVA President, 21 October 1912. 69. BAK, R89/6705, Franz, “Beschäftigung der Kranken in Heilstätten,” 31 July 1913. 70. BAK, R89/1189, Notiz, Kaufmann (RVA), 24 November 1906. 71. BAK, R89/6741, Comments of Dr. Billig, Konferenz der Vertrauens- und Heilstätten-ärzte der Landesversicherungsanstalt der Hansestädte, 1 June 1912. 72. BAK, R89/6705, “Über die Beschäftigung Lungenkranker in Heilstätten . . .” (ca. 1914). 73. Franz, “Beschäftigung.” 74. Indeed, one physician at the 1912 Conference of Sanatorium Physicians of the Hansa Cities informed his colleagues that at his facility in Glückhauf an experiment was made of using women to weed playing fields and paths. This had to be abandoned, he noted, because the work was done so carelessly. For simple pedagogical reasons, he added, light household work was best suited to women. BAK, R89/6741, “Konferenz,” 1 June 1912. 75. “Konferenz, 1 June 1912.” See also reports of Franz, “Beschäftigung”; “Über die Beschäftigung Lungenkranker.” 76. The notion of founding utopian breeding settlements also enjoyed some popularity in Germany in the last decades of the century. Advocates drew up guidelines for these settlements in accordance with the laws of racial and social hygiene in an effort to prevent degeneration. See Weindling, Health, 8–9. 77. BAK, R89/6705, Hofrat Dr. Wolff in Franz, “Beschäftigung.” 78. BAK, R89/1189, Dr. Otto Rigler, “Landkolonien für Unfallverletzte,” Separat-Abdruck aus der Umschau 42 (1911). 79. “Über die Beschäftigung Lungenkranker.” 80. Ibid.; “Konferenz, 1 June 1912”; Franz, “Beschäftigung.” 81. “Über die Beschäftigung Lungenkranker.”

82. Franz, “Beschäftigung.” 83. See, for example, BAK, R89/1189, Report of Fleischauer, 6 November 1906. 84. BAK, R89/6705, Franz, “Beschäftigung.” 85. The following description of policies and personnel (including quotations) at the Bergmannswohl sanatorium is taken from a lengthy report administrators sent to the Reich Insurance Office in 1912. See BAK, R89/6705, Bergmannswohl Unfall-Nervenheilanstalt der Knappschafts-BG to Regierungsrat Fritz (RVA), 8 October 1912. 86. BAK, R89/1189, Report of Fleischauer, 6 November 1906. 87. BAK, R89/568, “Die Rentenquetschen,” Vorwärts 58, 1. Beilage (9 March 1895); “Aus einer Heilanstalt für Unfallverletzte,” Vorwärts 64 (16 March 1895). 88. BAK, R89/568, Königlicher Polizei-Präsident zu Berlin to RVA, 13 April 1895. 89. BAK, R89/568, Vorstand, Norddeutsche Textil-BG to RVA, 29 April 1895. 90. BAK, R89/568, Dr. Bödiker (RVA) to Vorstände der Berufsgenossenschaften und berufgenossenschaftlichen Sektionen, deren Bereich Berlin umfaßt, 21 May 1895. 91. BAK, R89/568, “Die Segnungen der berufsgenossenschaftlichen Fürsorge für kranke Arbeiter,” Vorwärts 185 (9 August 1896). 92. 13. Jahres- und Kassenbericht der Berliner Gewerkschaftskommission (1901), 60. 93. 14. Jahres- und Kassenbericht der Berliner Gewerkschaftskommission (1902), 26. 94. Müller, Arbeitersekretariate, 171. 95. Ibid., 172. 96. Ibid., 148. 97. Ibid., 147. 98. H. Mattutat, “Rentendrückerei und Unfallrechtsprechung,” Die Neue Zeit 31 (12 September 1913): 935. 99. BAK, R89/1189, Unsigned letter to RVA, 21 November 1891. 100. For an example of a specific case, see BAK, R89/1189, Bochumer Verein für Bergbau und Gusßstahlfabrikation and Vorstand der Sektion VII der Rheinisch-Westfälischen Hütten- und WalzwerksBG to RVA, 3 June 1896. 101. BAK, R89/1189, RVA to Zentralstelle für Arbeiterwohlfahrts-Einrichtungen, January 1892 (no day given). 102. BAK, R89/1189, RVA to Vorstand des Verbandes der deutschen Berufsgenossenschaften, 4 June 1891. 103. BAK, R89/1189, Vorsitzender des Verbandes der deutschen Berufsgenossenschaften to RVA, 10 May 1892. 104. Hentschel, Geschichte der deutschen Sozialpolitik, 104. 105. Anselm Faust, “State and Unemployment in Germany 1890–1918 (Labour Exchanges, Job Creation and Unemployment Insurance),” in Emergence, ed. Mommsen, 150–63; “Arbeitsmarktpolitik in Deutschland: Die Entstehung der öffentlichen Arbeitsvermittlung 1890–1927,” in Historische Arbeitsmarktforschung: Entstehung, Entwicklung und Probleme der Vermarktung von Arbeitskraft, ed. Toni Pierenkemper and Richard Tilly (Göttingen: Vandenhoeck und Ruprecht, 1982), 253–73; Arbeitsmarktpolitik im deutschen Kaiserreich: Arbeitsvermittlung, Arbeitsbeschaffung und Arbeitslosenunterstützung, 1890–1918 (Stuttgart: Franz Steiner, 1986). 106. Faust, “Arbeitsmarktpolitik,” 257–58, 263; BAK, R89/1189, Auszug aus dem Bericht über den VII. ordentlichen Berufsgenossenschaftstag zu Stuttgart, 27 June 1893. 107. In 1904, exchanges mediated successfully in 1,093,470 cases; in 1912, in 3,594,502 cases. Faust, “Arbeitsmarktpolitik,” 264. 108. BAK, R89/1189, Notes of Dr. Zacher, 19 May 1892. 109. Faust, “Arbeitsmarktpolitik,” 261. 110. BAK, R89/1189, Vorsitzender des Verbandes der deutschen BGen to RVA, 10 May 1892. 111. BAK, R89/1189, Auszug aus dem Bericht über den VII. ordentlichen Berufsgenossenschaftstag zu Stuttgart, 27 June 1893; “Arbeitsnachweis durch die Berufsgenossenschaften,” Sozialpolitisches Zentralblatt 44 (31 July 1893); Untitled article, Allgemeine Zeitung, morning edition, 268 (27 September 1893). 112. See, for example, BAK, R89/1189, Dr. Max Immelmann, “Über die Errichtung von

Arbeitsnachweisstellen für solche Unfallverletzte, welche mit beschränkter Erwerbsfähigkeit aus dem Heilverfahren entlassen sind” (ca. 1896). 113. BAK, R89/1189, Notice of Nordöstlicher Baugewerks-BG, Sektion I, 6 February 1895. 114. BAK, R89/1189, Vorsitzender, Fleischerei-BG to RVA, 3 June 1899. 115. BAK, R89/1189, Rundererlaß aus Ministerial-Blatt für die gesammte innere Verwaltung in den königlich preußischen Staaten, 16 August 1897. 116. For example, East Prussia and Saxony-Anhalt had agreements with provincial associations, Silesia designed an index of all job-registry offices in the province, and the Tuberculosis Sanatorium in Cottbus helped place discharged residents in the employ of local hospitals. See “Über die Beschäftigung Lungenkranker.” 117. The term “rehabilitative ideal” comes from Francis A. Allen, The Decline of the Rehabilitative Ideal: Penal Policy and Social Policy (New Haven: Yale University Press, 1981). 118. See Udo Sierck, “Aus Almosenempfängern Steuerzahler machen,” in Kehrseite der Wohlfahrt: Die Hamburger Fürsorge auf ihrem Weg von der Weimarer Republik in den Nationalsozialismus, ed. Evelyn Glensk and Christiane Rothmaler (Hamburg: Ergebnisse, 1992), 221–40, and Arbeit ist die beste Medizin: Zur Geschichte der Rehabilitationspolitik (Hamburg: Konkret Literatur, 1992); Klaus-Dieter Thomann, Das behinderte Kind: “Krüppelfürsorge” und Orthopädie in Deutschland 1886–1920 (Stuttgart, Jena, New York: Gustav Fischer, 1995). Sierck and Thomann have shown how German programs for cripples and the handicapped (Krüppelfürsorge and Schwerbeschädigtenfürsorge) beginning in the late nineteenth century also relied on orthopedic surgery, work, job retraining, and labor exchanges to rehabilitate severely disabled children and adults. 119. Campbell, Joy in Work, 73–106, and Rabinbach, Human Motor, 189–95. 120. See William H. Schneider, Quality and Quantity: The Quest for Biological Regeneration in TwentiethCentury France (Cambridge and New York: Cambridge University Press, 1990) and Jürgen Reyer, Alte Eugenik und Wohlfahrtspflege: Entwertung und Funktionalisierung der Fürsorge vom Ende des 19. Jahrhunderts bis zur Gegenwart (Freiburg im Breisgau: Lambertus, 1991). 121. Christopher Derek Kenway, “Kraft und Schönheit: Regeneration and Racial Theory in the German Physical Culture Movement, 1895–1920” (Ph.D. diss., UCLA, 1996).

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CHAPTER 5 War, Revolution, and Care for the Disabled, 1914–21 As in so many other areas of German life, World War I was a watershed in the history of German social insurance. Conducting the first total war of its kind, the German state called on its citizens and leading institutions to concertedly redirect their labors toward the war effort. Disability insurance and those involved in its administration were willing and active participants in the mobilization for war. The challenges posed by total war—large numbers of casualties, shortages of trained medical personnel, the need for rapid and coordinated health services, and demands for treatment techniques designed to rehabilitate injured soldiers—required the assistance of civilian institutions to an unprecedented extent. Experienced as it was with many of these same challenges, the disability-insurance system came to occupy a prominent place in the processing and treatment of those injured during the war. The integration of social insurance into the war effort, however, also brought with it profound changes in the institutions and politics of disability insurance. Mass conscription and the mobilization of the economy persistently blurred the lines separating civilian and military matters. In turn, health-care providers were compelled to expand their conventional notions of treatment and service. Volunteering their facilities and knowhow, accident and invalid insurers found themselves intimately involved in areas (e.g., disabled veteran care) that had never before fallen under their jurisdiction. At the same time, the expansion of disability-insurance services into new domains forced insurers to cooperate with a variety of military, civilian, and charitable social-welfare agencies. Prussian and Reich government officials were instrumental in rationally reorganizing wartime health care into collaborative, transinstitutional projects. Such collaborative ventures, however, increasingly drew the ire of social-insurance administrators, many of whom hoped to preserve social insurance in its prewar configuration. Page 160 → Insurers were not the only ones forced by the war to rethink their status. Disabled pensioners too found that total war brought a new perspective to injury and chronic illness. In general, the war had a dual effect on the public response to disability: on the one hand, it thrust the problem of disability into the foreground of public awareness, yet on the other it led to official impatience with the conventional political machinations of insurance beneficiaries. With wartime regulations all but eliminating the ability of workers to appeal pension decisions, a new style of entitlement politics took shape during the last years of the war and the revolution of 1918–19. Collective protest replaced individual litigation as the prominent means by which disabled Germans laid claim to social entitlements. The First World War thus played a pivotal role in the birth of the first organized politicalaction groups for the disabled in Germany. Social Insurance and World War I Early Challenges to the Status Quo Even before August 1914, experts in Germany were contemplating the possible ramifications of war on the insurance establishment. On 12 and 13 December 1913 the German Association for Insurance Science held a special conference under the auspices of the Prussian State Assembly to discuss the topic “Insurance and War.” Mathematicians, legal scholars, physicians, and government officials exchanged views on a number of themes: the degree to which private insurance was financially prepared for war; to what extent life, transport, and fire insurances might be affected; and what trends could be expected in mortality rates. Social insurance, of course, also drew the attention of these insurance specialists. The task of predicting the effects that a war would have on social insurance fell to Walter Kaskel, a prominent legal scholar from Berlin. Kaskel began his analysis by emphasizing a point that would indeed prove to be of

central importance to the development of social insurance during the war. This was the fact that outside of a single reference, the recently enacted Reich Insurance Ordinance of 1911 made no mention whatsoever of war. “A number of legal precepts of social-insurance law will be indirectly or directly affected by a war,” he noted, “whereas on the other hand, a series of legal-insurance questions will crop up with the outbreak of a war that legislation will leave unanswered or at least without satisfactory answer.”1 To Kaskel’s thinking, the advent of war would have its greatest impact at the intersection of two great domains in social-insurance practice, the legal and the economic. Page 161 → The chief problem, he foresaw, would involve the contractual relations between insurers and the insured. For example, social insurances covered specific groups of employees. Would coverage be rescinded once a worker was drafted into military service? It appeared so. Since social insurance in only exceptional cases provided benefits for those living abroad, military personnel appeared to be doubly threatened by having their insurance coverage taken away. How would employees not actually in the military but performing labor with military aims, such as munitions production or the manufacturing of uniforms, be affected? They appeared to be less threatened with the withholding of insurance coverage since they would still be working within a formally civilian sector. In any event, however, the principles of compensation themselves, Kaskel believed, would not and could not change. In the area of accident insurance, for instance, the occurrence of a factory accident would remain the requirement for compensation, and pensions would continue to be paid out. The law, however, was unclear about how and to what extent services and prescriptions could be distributed to deserving recipients while they were active in the military. Outside of the question of compensation qualifications, insurance providers themselves were worried about what influence war might have on their assets. Before the war, the Reich regulated the kinds of investments that social insurers could make. Such investments were required to be secure and nonspeculative (mündelsicher). In practice, this translated into investments in government and local bonds, mortgages, special securities, bank deposits, and real estate. Returns on these investments were steady and moderate, averaging between 3.57 and 3.70 percent between 1910 and 1913.2 The size of these assets before the war was very large. In 1911, the assets of sickness insurance amounted to roughly 335 million marks, those of accident insurance 565 million, and invalid insurance 1.76 billion marks.3 It is thus no surprise that Kaskel appears to have felt obligated to reassure insurers that the Reich had no legal justification to simply confiscate their property in the event of war. It was more likely, he contended, that insurance providers would voluntarily place their assets at the disposal of the state, perhaps in the form of loans. Contributions to insurance funds, Kaskel noted with particular alarm, would be fundamentally shaken by the changes accompanying a war. Both invalid and accident insurances would find themselves faced with the same problem of diminishing premiums, while at the same time having to continue to dole out pensions and services. “Since the greatest share of the working, male population covered by insurance before the outbreak of war will now withdraw from Page 162 → insurance,” an extraordinary burden would be placed on the fiscal integrity of insurance bodies due to their heavy reliance on contributions from the insured for financing and for determining the limits of benefit levels. Invalid insurance, for its part, collected contributions according to a so-called capital coverage method (Kapitaldeckungsverfahren), calculated to cover all costs over a substantial period of time. This was coupled with a requirement that insured persons could only qualify for benefits after a given period of contributing to the invalid-insurance program (the so-called waiting period, normally one hundred contributory weeks). Accident insurance relied primarily on contributions from the members of the accident-insurance boards to finance benefits and cover costs. Its method, the cost-averaging method (Umlageverfahren), required (1) that the contributions of associated employers be proportionally distributed according to risk classifications, and (2) that the outlays have a return on their investment sufficient to cover any unexpected emergencies.4 Such a system of financing, relying as it did on the premium payments of those involved in the administration of insurance rather than on investments, was sure to be challenged, in Kaskel’s view, by the great upheavals in the civilian labor market and the higher incidence of mortality that would invariably accompany any war enlisting the services of significant numbers of young men. These findings led Kaskel to apprehensively conclude, “The result of this

examination is certainly not a gratifying one. In case of the outbreak of war the present regulation of insurance relations is partly unsatisfactory in regard to the admissibility of voluntary supplementary insurance within sickness insurance, partly incomplete in regard to the existence of activities in the service of the army that warrant insurance coverage, partly dubious in regard to the granting of benefits during the time in which the recipient stays in the field.”5 Once the war began, the early experiences of insurance administrators seem to have borne out Kaskel’s prognosis. In the first year of the war, sickness and invalid insurance appeared to many to be the most affected branches, with insurers in both systems finding it difficult to remain solvent. Invalid-insurance offices found themselves burdened with ever increasing financial obligations. Despite the fact that scores of invalids heeded the call to arms by providing much-needed labor in military and civilian war production, insurance boards were still compelled by law to award them their full pensions. These expenses were compounded by the growing costs of pensions for surviving dependents as insured men began dying in the field. The financial burdens did not stop there. Invalidinsurance offices further provided loans to municipal welfare associations, gave money to the German Red Cross, and from very early on invested heavily in war bonds. In an effort to cut administrative costs and free up Page 163 → personnel, insurance offices attempted to streamline the processing of pension claims by restricting final appeals to only those cases where the judgment of the first appellate court was “clearly wrong.”6 “Business as usual” proved to be equally impossible for accident insurers in the early stages of the war. As early as 10 August 1914 the Reich Insurance Office issued a decree that mandated a number of important changes for accident-insurance administration. Among other things, insurance boards were given the right to make decisions on pension claims without a hearing as long as the decision was to the advantage of both insurer and insured. Decisions to reduce or cancel a pension were not to be carried out until a waiting period of at least three months had passed. Lump-sum settlements were prohibited until further notice. Finally, prewar penalties for failure to meet accident-prevention standards were waived, and new, more lenient codes instituted.7 Accident-insurance officials reacted to these and other wartime changes by remaining steadfast in their conviction that the war was having no transformative effect on the system. “The concept of the accident is subject to no change by the war,” explained one insurance specialist in the spring of 1915.8 The war, he pointed out, did not represent a new “risk” since events of war (kriegerische Ereignisse) were recognized by neither private nor social insurances as potential causes of accident. This position of seeming indifference became increasingly untenable as the conflict continued. As Germany neared total mobilization of the country’s resources, it became more and more difficult to distinguish between civilian and military personnel and operations. The distinction was an important one for accident insurers, whose coverage extended only to civilian enterprises. The situation was further complicated by the fact that many men who were injured at the front returned to the home front for occupational therapy or for labor service in a factory. How was an insurance board therefore to treat a man who simultaneously appeared to fall under the jurisdiction of social insurance and the military’s own pension and health-care system? Administrative confusions like this led the Association of German Accident Insurance Boards in September 1916 finally to establish standards as to the insurance status of enlisted men. From then on, “detached” men (i.e., men under explicit military orders) were assumed to be under the jurisdiction of military care, while men “on leave” were understood to be covered by compulsory accident insurance. Thus, only those “men who are expressly assigned to an industrial factory for work-therapeutic Page 164 → reasons [arbeitstherapeutischen Zwecken]” were considered free from civilian accident insurance.9 Social-Insurance Institutions and Care for the War-Disabled10 The reappraisal and reformulation of standard insurance practices and codes constituted only one set of changes brought about by the Great War. Social-insurance administrations became much more deeply enmeshed in the German war effort as it quickly became evident that conducting the war was going to require an institutional network to provide health care for disabled soldiers. The first mention of such a system that I have found is a 20 November 1914 article from the Magdeburg newspaper Volksstimme entitled “A Necessary Action,” calling for

the creation of an organization whose task would be to look after the health and economic needs of disabled veterans.11 That same month, a conference was held to discuss coordinating care for “war cripples,” attended by military, state, and municipal authorities along with representatives from invalid insurance, the medical community, social-welfare associations, the Red Cross, academia, and labor exchanges.12 In December, the Prussian minister of the interior took note of the newspaper article and announced himself receptive to the suggestion that a form of public assistance supplementary to existing military programs be created in order to help disabled soldiers find work.13 Representatives of the Reich Insurance Office and the invalid-insurance office of Berlin also met and approved a proposal that the former should fashion an agreement with the Prussian War Ministry detailing the ways in which invalid insurers nationwide could take over the therapy regimen of those afflicted soldiers who were insured against invalidism. Such an arrangement, it was agreed, would focus primarily on those men for whom the “earliest possible appropriate treatment in a suitable sanatorium is prescribed.” This meant primarily those with respiratory or heart ailments, tuberculosis, or rheumatism. The costs would be assumed by the military.14 In January 1915 the head of the Red Cross in Prussia joined the chorus of those calling for the formation of new social-welfare organizations for war invalids. In treating the problem of integrating returning soldiers into civilian life, he argued, Page 165 →

granting military pensions and positions in the bureaucracy . . . will not alone suffice. . . . It is therefore, in our view, necessary to call upon the entire nation, namely for all employers to collaborate in the national task of creating adequate jobs, and for certain inhibitions in the thinking of employer and worker circles—whereby the former categorically refuse to employ disabled workers and the latter refuse to work with such persons—to be removed. If this does not happen, then there will most certainly emerge after the war a reign of pension hysterics such as was not rare to find among the partial invalids in peacetime; in addition, valuable manpower [Arbeitskräfte] would be permanently lost to the economy.15

As a preventive measure, the Red Cross warned against constructing a splintered system of assistance. Instead it proposed drawing together the efforts of charitable organizations, labor and employer representatives, and Reich, Prussian, and provincial authorities under the umbrella of regional state administrations aimed at promoting the employment of war invalids. Other organizations soon joined those speaking out in favor of such institutions, including the Association for the Care of Cripples and the Society for Social Reform. The first high-level discussions on the subject within the Prussian and Reich cabinets took place in January 1915. The Prussian minister of trade and industry was the first governmental authority to sketch out the framework of a comprehensive welfare program for those injured in the war. As it turned out, it became the model on which the entire system was based. In a letter to the Reich chancellor, the minister of war, and the minister of the interior, the trade and industry minister drafted a plan for the program’s structure. In order to provide the war-wounded with tangible assistance, he insisted, the relief measures had to have two goals: (1) the wounded must be given the most up-to-date orthopedic and surgical treatments available so that they could once again be able to work (arbeitstauglich); (2) disabled men who are no longer able to practice their usual trade must be accommodated by agencies equipped to retrain them for another suitable profession. In any event, follow-up medical treatment would be required. Such services, the minister proposed, could be provided by homes for the crippled and public and private clinics, as well as the convalescent homes and sanatoriums belonging to social-insurance providers, “who have amassed a wealth of valuable experience in the area of the rehabilitation of the disabled.” These activities would then be supplemented with the efforts of public labor exchanges to find jobs for invalid veterans. As to what shape war-disabled care should assume, he proposed that a board be created in each of the twelve

Prussian provinces. Members of these Page 166 → boards would come from among the ranks of local representatives within the public and private sectors. These would include representatives from chambers of trade, agriculture, and commerce, employer and employee associations, invalid-insurance offices, accident-insurance boards, the sickness funds, homes for the crippled, the Red Cross, and any other local organizations qualified to take part in the venture.16 By 28 January the Reich and Prussian governments were agreed that a system for the care of the war-disabled (Kriegsbeschädigtenfürsorge) was to be erected under the guidance of the state. Provincial Ober-Präsidenten and the General High Command were assigned the job of getting the various parties together to begin setting up local, provincial boards.17 Those involved in the early groundwork were instructed to follow three basic principles. First, the boards were to operate independently of military care administration. Second, services were to be organized uniformly (einheitlich). Owing to the uncommonly large number of independent organizations that asked to participate in the relief effort, organizers reasoned, services needed to be not simply collaborative, but coordinated to prevent gaps, overlaps, and splintering. At the same time, services were not to be administered through a central, national agency. Instead, emphasis was placed on decentralization in order to avoid overly schematic and bureaucratic procedure and to provide individually tailored treatment.18 As for the substance of the services offered, war-disabled boards were instructed to follow those precedents established by social-insurance administration over the previous thirty years. This meant distinguishing between therapeutic assistance (Heilverfahren) on the one hand and what was referred to as “civilian and social assistance” (bürgerlicher und sozialer Hilfe) on the other. In theory at least, the process worked something like this. Returning disabled soldiers reported to their appropriate board and were assigned a suitable therapy regimen. Prussian military officials declared the aim of this treatment to be “not only anatomical recovery, but also the most complete restoration of the use of sick or injured limbs as possible.” Following the therapy regimen, the services of a comprehensive civilian assistance program were presented to disabled veterans. At this stage, personnel from the war-disabled board—mostly educators and factory inspectors from the state industrial administration (gewerbliche Page 167 → Unterrichtsverwaltung and Gewerbeaufsichtsbeamten)—counseled recipients on occupational alternatives, put them in touch with job retraining programs, and helped them find jobs. Similar to accident-insurance rehabilitation programs, every effort was to be made to place the debilitated man in the trade he performed before the war.19 By May 1915 every province in Prussia had an operational program for the care of disabled soldiers. Since the form of administration was in great measure left up to individual war-disabled boards, the institutions often looked quite different from one another. Federal states, provinces, municipalities, and districts frequently operated according to divergent administrative traditions. Because local experience and practice were different, some boards were run along more hierarchical lines (as in East Prussia) while other provinces delegated responsibility and authority relatively widely (Hesse-Nassau). What is first of all most striking about these war-disabled boards was the unprecedented participation and cooperation of diverse authorities and groups who, in the not too distant past, had frequently found themselves at odds with one another. A list of the members of the steering committee for the Rhineland Board for the Care of the War-Disabled is illustrative. Besides the Landeshauptmann, it included representatives of the General High Command, provincial administration, invalid-insurance offices, the Association of Labor Exchanges, the Chamber of Agriculture, the Red Cross, the Order of St. John, the Association of Accident Insurance Boards, employers, employees, sanatoriums and convalescent homes, educational facilities, trade schools, industrial continuingeducation schools, and the Provincial Association of Women’s Unions for the Fatherland.20 By June 1917 the Rhineland War-Disabled Board was handling the cases of over nine hundred unemployed invalid veterans from a variety of occupational backgrounds.21 The work of the war-disabled boards consisted solely of providing social services for qualified soldiers. Military hospitals (Lazarette) provided straightforward medical treatment, while the granting of pensions and other forms of monetary settlement remained the province of the various social insurances and the military. Care for the wardisabled thus operated as an imagined third branch Page 168 → of public assistance for invalid men. Those

involved in its administration perceived it as a complement to the other two forms of assistance. At the same time, it was considered distinctive in that it operated both across and beyond the work of the other two by actually attempting to reintegrate disabled veterans into civilian life. This last point is worth emphasizing. War-disabled boards defined and carried out their initiatives in social reintegration in terms of the occupational lives of those they treated. The raison d’être of care for the war-disabled was thus to rehabilitate disabled soldiers so that they could be reintroduced into the workforce. In understanding their administration in this way, war-disabled boards were appropriating both the rationale and forms of occupational therapy practiced by invalid and accident insurance. In their concerns over pension hysteria (see chapter 7) and the aversion to work among disabled veterans, in their therapeutic aim at increasing the productive and income-earning capacity of the disabled, in their promotion of work as therapy, in their binding of health care with occupational training, and in their linking both with labor exchanges, administrators demonstrated the profound influence social insurance was having on wartime social policy. What tied care for the war-disabled to social insurance in this regard was more than an intellectual affinity on the part of administrators for the ideas of insurance providers. Invalid and accident insurance institutions played pivotal roles in the relief efforts of war-disabled boards. In this sense, it would be a mistake to understand social insurance merely as a part of those efforts. War-disabled boards relied on existing insurance personnel, techniques, and institutions to rehabilitate and reintegrate invalid veterans. Fully incorporated into the administration of care for disabled soldiers, invalid and accident insurance institutions were the administrative apparatus for the care of war-disabled. From very early on in the war, officials clearly recognized that disability insurance’s network of therapeutic services and establishments offered a ready-made infrastructure for the care of seriously injured and invalid war veterans. Their convalescent homes, spas, workshops, and experiences with retraining and resituating the disabled appeared to make them uniquely qualified for taking on the mass rehabilitation of returning soldiers.22 The accident-insurance boards helped in this effort by placing their personnel and associated institutions at the disposal of local war-disabled boards. Particularly popular was the idea of using the facilities and methods of workshops for the disabled and the medico-mechanical institutes. Since those injured in factory accidents, invalids, and the war-disabled, it was argued, shared the same general plight, the Page 169 → workshops and institutes of accident insurers were perfectly suited to the work of their rehabilitation.23 In 1916, after much discussion the previous year, the board of directors of the Association of German Accident Insurance Boards held a meeting to decide on the general parameters for assisting in the care for war invalids. Two resolutions were unanimously agreed upon: (1) the association recommended that any systematic attempts at therapy should include medically supervised physical exercise and work; and (2) an information office was to be created, serving as a central resource for those institutions involved in caring for those disabled in the war. A subcommittee was placed in charge of the latter, whose job consisted of collecting material detailing the occupational-assistance programs and specialists of those workshops for the disabled, schools for amputees, and sanatoriums affiliated with accident-insurance providers.24 The German military and the German Red Cross, both in charge of medical treatment in the field, responded to these initiatives by, among other things, funding the construction of new therapeutic facilities for disabled veterans under the direction of accident insurers. By fall 1917, their positive experience with collaboration had led members of the association to take part in talks, organized by the Reich Insurance Office, with representatives from the German Red Cross, invalid-insurance offices, and the larger sickness-insurance funds. They agreed to a set of general guidelines for cooperative work “in the area of treating incapacitated insured individuals with work [Beschäftigung] in sanatoriums and training workshops.” Administrators announced that the experiences of the war had unequivocally “confirmed the need for . . . the earliest possible reintroduction of the partially disabled [Erwerbsbeschränkter] into the work force and its favorable impact on the health of those injured in its entirety.” In practical terms, insurers agreed to help support the sanatoriums and workshops of the Red Cross designed to assist the war-disabled in exchange for rights to use these facilities after the war ended. Their support, in part, took the form of financial assistance (ranging from three hundred to six hundred marks from each insurer), but

educating and advising Red Cross staff on the application of work therapy also seems to have been an important task. A central advisory council was created for just this purpose, with members from the military, the Reich Insurance Office, the Reich Institute for White-Collar Workers, social-insurance providers, the Reich Board for the Care of the War-Disabled, provincial Page 170 → and municipal associations, trade organizations, employers associations, and various charitable organizations.25 Invalid-insurance offices found themselves even more intimately absorbed into the care for the war-disabled. As was the case with accident insurance, wartime administrators were particularly enamored with the strong work ethic so prominent in the therapeutic schemes of invalid insurance’s convalescent homes and spas.26 Already in August 1914, the representatives of the invalid-insurance offices announced their willingness to become directly involved in the management of wartime relief efforts. In the months following, individual offices and their personnel began insinuating themselves into the military health-care system on a local basis. In Kassel, for example, insurers sent orthopedic and surgical counselors along with businessmen and artisans to local military hospitals to speak with invalid soldiers about their prospects in civilian life. Military officials, representatives of the Red Cross, and the local invalid-insurance office in Hesse began collaborating as early as October 1914 in funding and administering care for war invalids. By spring 1915, Hesse could boast of a centralized and comprehensive system whereby all those requiring retraining were accommodated in one large military hospital in Offenbach. The Offenbach facility was indeed impressive, with over sixteen hundred beds, a training workshop (trades taught included locksmithing, printing, cabinetmaking, and lithography), and a staff including professors, architects, master craftsmen, and physicians. In addition, the municipal hospital opened its garden to the Offenbach facility’s patrons, while local entrepreneurs agreed to place their factories at the disposal of the war-disabled for retraining purposes.27 The Concerns of Insurers and the Call for Coordination The increasing involvement of invalid insurances in the care for the war-disabled, however, did not take place with the unanimous assent of insurance administrators. In April 1915, a general meeting of German invalidinsurance offices was called to decide on what kinds of participation could and should be expected from them by the government and other welfare providers. At the meeting, insurers agreed that, like accident insurers, they believed themselves to be best equipped to make available both a suitable therapy regimen and “social and economic care” (occupational counseling, job retraining, labor exchange) Page 171 → for disabled veterans. What upset many administrators, however, was that certain officials in the government along with a number of invalid insurers were demanding that they begin contributing even more to the general fund for wartime public assistance. This troubled them since, in their view, invalid insurance was already paying more than its fair share by way of war bonds and support for the war-disabled program. In addition, insurers also voiced complaints about relations with the military administration. Many remarked that military hospital staffs were inconsistent in their policies and largely uncommunicative when insurers visited. Apprehensions were also expressed that military officials might be trying to abandon their financial responsibilities as the primary caretakers of war invalids. After much debate, the assembly agreed to three general policy principles in assisting the program for the wardisabled. First, insurers agreed to participate in the care for the war-disabled by providing both medical and economic assistance. In order to prevent large numbers of severely disabled men from inundating invalidinsurance offices, however, insurers demanded that they be allowed to begin both medical and economic interventions before men were dismissed from service and that an agreement between them and the military administration be fashioned to settle jurisdictional questions. The terms of this agreement were then to be negotiated by the board of directors of the association of invalid insurers in conjunction with the War Ministry and local military administrations.28 Several months later, military and government officials and representatives of the Reich Insurance Office, labor unions, and each and every invalid-insurance office assembled in an unprecedented conference to discuss coordinating public-assistance efforts aimed at servicemen.29 Agreement was difficult to achieve. Union officials argued for greater say in relief administration and advocated a more central role for unemployment assistance. The

Reich Insurance Office requested that invalid insurers increase the level of their support of wartime welfare from a standard 3.5 to 5 percent of their total assets. Insurance administrators hotly debated the wisdom of the request, although most appear to have embraced the idea. Within the context of the development of German social insurance, what stands out about this conference was its participants and agenda. The interests assembled were all invited to take part in talks on two themes: the role of invalid insurance in welfare for soldiers and the participation (Mitwirkung) of the insured in the governing boards of the invalid-insurance offices. Insurers showed a great deal of resistance to the latter idea, but it was nonetheless conceded Page 172 → that the parties involved needed “to gain a greater influence and to secure a more inclusive role for lay elements.” While accord was not wholly reached between the antagonistic interests, proposals and plans for cooperative work were put forth by all parties. The representatives then went on to discuss a host of problems that previously had been largely peripheral to or altogether left out of invalid-insurance services. Sexually transmitted disease among the troops, unemployment, the plight of working women and families with absent fathers, the growing numbers of orphans, and the rapid appearance of scores of uninsured invalids on the home front all were subjects of discussion. These issues assumed a greater prominence during the war, and many recognized that they would not simply disappear when the war was over. As care for the war-disabled demonstrated, the requirements of total war blurred the institutional lines of the welfare state first set in the nineteenth century. It became increasingly difficult to distinguish between soldiers and civilians, between public and private caretakers, between medical and social services. Most important of all for social insurance, it was becoming ever cloudier just where insurance ended and custodial care (Versorgung) began. With the health and productive well-being of the German Volk at stake, the institutions of social insurance could find no way to deal with the challenges of the war and still retain their autonomy and identity except through an unprecedented level of cooperation. Collaborative public assistance was thus both an ideal and a perceived necessity of the First World War. This trend toward cooperative social service among government, insurance, and social-service institutions was a characteristic feature of the German welfare state in the years following World War I (see chapter 6). It is important to acknowledge that this shift, which began locally, quickly began to assume the status of official state policy over the course of the war. In fact, even before the war began, accident-insurance boards came to a contractual arrangement with sickness-insurance funds, laying out the circumstances under which the former would accept responsibility for accident casualties within the first thirteen weeks of their afflictions. This did not prevent conflicts from episodically arising between local insurers, however. Records indicate that under the financially trying conditions of war, accident and sickness insurers in cities such as Cologne, Remscheid, Berlin, and Magdeburg found themselves frequently at odds over the question of whose responsibility it was to look after the treatment of specific individuals.30 The Reich Insurance Office logically found itself embroiled in such disagreements given its role as the final arbiter in social-insurance affairs. As they had done earlier, officials attempted to mend fences between competing social-service Page 173 → providers. The war helped to reinforce their efforts. In January 1918 the Reich Insurance Office began circulating the idea of having invalid-insurance offices enter into formal agreements with sickness funds in order to resolve their long-standing jurisdictional questions. Individual insurance boards responded tepidly. Most claimed to see no need for any general, national agreement to be reached since appropriate arrangements had already been made for the most part at the local level. The Association of German Local Sickness Funds, however, proved to be more receptive to the idea, and with the backing of the Reich Insurance Office it drafted a seven-page document in the spring of 1918. Provisions covered such things as the transfer of care for invalids, measures designed to prevent sickness and disease, the payment of processing costs, the granting of therapeutic prescriptions such as false teeth and artificial limbs, and the construction, maintenance, and management of convalescent homes and sanatoriums.31 A formal agreement with invalid insurers, however, was not reached until after the war.

As the war neared its end in late August 1918, President of the Reich Insurance Office Kaufmann appeared before a national meeting of sickness-insurance funds in Koblenz and announced his interest in promoting even greater, more formalized collaboration between all three branches of health insurance. He began his speech by acknowledging the fact that even before the war the sickness funds, invalid-insurance offices, and accidentinsurance boards had shared the task of looking after the health of the German population. The war, however, had brought with it new challenges: “The loss of our best men on the battlefield, the damage to health through overexertions in the military and through poor nutrition at home, the necessity of enlisting women to work in trades that were not appropriate to their physical constitution, [and] the sinking birth rate forcefully demand now and in the long-term future the most careful attention to every citizen insofar as it is possible under these trying circumstances.” There was only one way, in Kaufmann’s view, for the nation to overcome these pressing social problems: “[Just] as we achieved commanding victories over our enemies through consciously bringing together all our strengths, carried by the secure knowledge of victory, so too in the field of social welfare complete success can only be realized in the collaboration and reciprocal support of the providers of the three great branches of social insurance.” Fully acknowledging that insurers in the course of the war had succeeded in promoting this kind of cooperative venture through numerous local contracts with one another, Kaufmann nonetheless believed that nothing short of “unified control” (einheitliche Kontrolle) over insurance affairs could adequately treat the ailments and social problems facing Germany. Thus, he proposed the formation of common or joint agencies (gemeinsamer Geschäftsstellen) for and by the Page 174 → three groups of insurance providers, whose task would be to represent insurers before government authorities, advise member providers about jurisdictional questions, and settle administrative conflicts between them.32 Despite every attempt to the contrary, then, accident and invalid insurance authorities were unable to isolate and protect social-insurance administration from the corporatist effects of the war. Their reserved, sometimes downright belligerent, reactions to government and military demands to expand their contributions to the war effort reflected a much broader concern of theirs. With every new involvement in veterans administration, unemployment assistance, and general welfare, social insurance drifted away from its founding principle of individualized, contractual assistance. In essence, what insurers feared was the eventual erasure of all boundaries between insurance, veteran, and welfare assistance. As we will see in the following chapter, these dilemmas and concerns carried over into the postwar period. But even before the war ended, these changes were having a marked impact on the political consciousness of disabled workers. The Working Disabled and Concerns over Pensions Operating the war-disabled program occupied a great deal of the time, energy, and personnel of insurance providers. While we must appreciate the fact that administrative distinctions between civilian and military invalids were becoming increasingly blurred, it needs to be equally acknowledged that those involved in social-insurance administration continued to perceive it primarily as a resource for civilian labor. A division of labor—tenuous as it was and reformulated constantly—continued to be recognized and enforced between the military and socialinsurance administrations during the entire course of the war. Thus, as the requirements of total war began exercising a greater and greater influence over habitual ways of doing business at home, social-insurance bureaucracy found itself increasingly called upon to renegotiate its prewar policies and practices. One area in which this was the case was the hiring and rehiring of the disabled. It is now generally accepted that the First World War provoked important changes in the division of both income-earning and household labor in Germany.33 Among other things, it is known that among German industrial enterprises Page 175 → with ten or more employees, adult men made up the bulk of the labor force before the war. In 1913, 5,410,000 adult males were occupied by such businesses, whereas males under the age of sixteen numbered only 384,000 and adult women 1,406,000. By 1918 the number of adult men in these same industries was 4,046,000 (a decline of 25 percent), while underage males numbered 421,000 (an increase of 10 percent) and adult women 2,139,000 (an increase of 52 percent).34 The chief catalyst for these changes was obviously the disproportionate number of adult men whose services were enlisted for the war (almost half of the entire male German population between ages fifteen and sixty had been conscripted by 1918). Women and young people were recruited for jobs in branches, such as the metal, machine, electrical, and chemical industries, long the exclusive domain of adult men. But as the

statistics indicate, men by no means disappeared from the civilian labor force during the war, for a number of reasons. Men in war industries were able to acquire exemptions or deferments, craftsmen were placed into industrial service, and older men, foreign workers, and prisoners of war all were used in the war effort. To these groups one must also add the disabled. As large numbers of able-bodied men were called up for military service in the first year of the war, government officials began turning to the over 2 million, mostly male, disabled receiving insurance benefits as another source of cheap labor on the home front. Most commonly, the disabled were employed to harvest crops. In June 1915, for instance, Regierungs-Präsident Baltz in Trier began a concerted campaign to recruit pensioners for the upcoming harvest.35 This was necessary, he later told the Reich Insurance Office, since most all the workers exempted from military service in the area were already working in the coal and armaments industries. Despite their inability to carry on the duties of their former trades, Baltz believed that disabled pensioners could play an important part in aiding the war effort by temporarily serving as farm workers.36 The idea faced problems, however. Employers had always shown a profound distrust of disabled and invalid workers. They feared that such individuals were more prone to accidents, were less productive than healthy workers, and possessed a disposition toward malingering. The war did not shake them of this sentiment. Even when union representatives and employers were sometimes Page 176 → able to agree locally on the principle of hiring disabled men, employers qualified their agreements by insisting on provisions that required hiring or rehiring the disabled only “where possible” and that allowed employers to pay them lower wages than existing collectively bargained levels.37 Pensioners, too, were uneasy, voicing the apprehension that their participation in any wage-paying labor activity would give insurers cause for either reducing or altogether voiding their pensions. Baltz was keenly cognizant of these biases on the part of employers and pensioners alike. Failing to respond to them, he clearly believed, would inevitably lead to the failure of any attempts to enlist the aid of the disabled. He therefore adopted a twofold strategy. First, he promised pensioners in a local newspaper, “I hereby assure you that from such short-term, temporary work in the service of the Fatherland no conclusions as to the individual’s capacity to work will be drawn, [and] that there is no reason to fear the reduction of pensions.”38 Baltz then, in his role as head of the invalid-insurance office in Westphalia, pressed the Reich Insurance Office to insist that both accident and invalid insurance providers respect this guarantee.39 Recommendations aside, the issue stood unresolved because accident insurers expressed little enthusiasm for honoring the Westphalian pledge. The issue came up again, however, in the summer of 1916. Then, the Hessian Ministry of the Interior, in seeking to acquire the help of invalid pensioners for the year’s harvest, asked the Reich Insurance Office to use its position to establish a general insurance policy promising that those pensioners involved would not have their pensions subject to reassessment.40 Officials in the Reich Insurance Office concurred with this view, and in August they wrote a memo to invalid and accident insurance providers (that was also sent to the press) informing them that “it is recommended that, as a matter of principle, participation in harvesting not be taken as grounds for rescinding pensions.”41 As proof of the correctness of its position, the insurance office began circulating copies of a letter sent directly to Chancellor Bethmann-Hollweg by a business owner and city Page 177 → councilman from Stettin who vouched for the productivity and integrity of disabled workers on the basis of his own personal experience.42 The Association of German Accident Insurance Boards dismissed the office’s attempt to establish a wartime principle of compensation as unnecessary and dangerous—unnecessary since insurers were already voluntarily taking the conditions of the war into consideration in individual cases, and dangerous since “it would mean a break with one of the most fundamental principles of accident insurance law: the principle that the size of the compensation is to correspond with the existing degree of injury.”43 Up until the winter of 1916 it was local institutions and officials that were most aggressive in the effort to get the disabled employed. In the Rhineland, for example, the provincial board for the care of the war-disabled made a concerted attempt to press local employers to change their policies in hiring. In a widely circulated and publicized “Call to Employers of the Rhine Province,” the board instructed them that the disabled did not constitute a homogeneous population: some had lost hands, some arms, others were blind, while still others suffered from

nervous ailments. These groups still offered employers different talents and abilities and could not be categorically disqualified from working simply because of the presence of some generic debility. As a general rule, the board strongly urged employers to organize their hiring practices in line with two principles: (1) “no healthy person may take a post that a qualified, severely disabled war veteran can perform,” and (2) “no disabled veteran may take a post that a qualified, more severely disabled individual can perform.” A hierarchy of disability was therefore established in the hiring of employees, with the healthy having the lowest priority and distinctions made among the disabled themselves. “In this sense,” as the call to employers explained, “an arm amputee is, as a rule, more severely disabled than a leg amputee. If the arm is completely gone or there is only a short stump, then the disability is more severe than if a longer stump is present to which a prosthesis can easily be attached.”44 Things changed, however, after the promulgation of the Auxiliary Service Law (Gesetz über den vaterländischen Hilfsdienst) of 5 December 1916. The law declared that every German male between the ages of seventeen and sixty who was not serving in the military was obligated to perform labor service on behalf of the country. This involved a massive redeployment of the labor force, transferring civilian workers from certain “nonessential” industries to industries central to the war effort. The law had clear implications for all German social Page 178 → insurance, but accident insurance proved to be most affected. Accident-insurance coverage for assigned workers was to be universally provided by the Reich government, and those workers injured in a factory accident were to be awarded compensation relative to a uniform pay scale that was calculated at twelve hundred marks a year for farm laborers and eighteen hundred marks for factory and skilled agricultural workers. The law also stated that in the case of the working disabled, their pensions remained unaffected by their participation in the new work program.45 In Prussia, the minister of the interior denounced individual employer attempts to use a person’s labor service as an excuse to change his insurance coverage, labeling such behavior “anti-social in the highest degree.” In order to prevent such “abuses,” he hit on the idea of using a little-known article in insurance law to award local poor-relief associations the duty and right to carry out “a careful examination” of individual cases where suspicions of abuse existed.46 By the end of 1917 there appears to have been a general compliance with the new rules, although the Reich Insurance Office continued to receive questions and complaints about isolated cases. Concern was particularly voiced about the fact that under the Auxiliary Service Law the same factory could have a number of disabled workers whose pensions were not reducible at the same time as other groups of workers (disabled and not) whose pensions were perceived as liable to reassessment. If such practices were allowed, argued one local official, “equally employed and paid workers within the same factory would be treated differently, producing discontent, which now must be avoided at any cost.” 47 The Reich Insurance Office therefore found it necessary to clarify for all employers and insurance authorities that the government was of the view that the provision for guaranteeing the pensions of the disabled pertained only to those individuals whose jobs came about “under the influence of the Auxiliary Service Law.”48 This did not mean that the issue was finally settled. The question of what to do about the pensions of the working disabled arose once again immediately after the war ended. Invalid-insurance providers and state insurance offices, for instance, expressed confusion about what stance they should take toward pensions since the Auxiliary Service Law was no longer in effect. Among them at least, there appears to have been a widespread fear of the consequences of massive pension reductions in the face of postwar social realities. As one insurance Page 179 → office in November 1918 expressed it, “[T]he present extraordinary inflation and difficulties in procuring food, in tandem with the uncertainty of present circumstances and the fear that present high wages will sink and that those pensioners still or once again able to make a living for themselves will lose their positions and become unemployed, will lead to a situation in which every reduction or revocation of even small pensions will most severely embitter those affected.”49 As it had throughout the war, the Reich Insurance Office agreed that circumstances should not be exploited in order to take away the pensions of disabled and invalid workers. It therefore instructed accident and invalid insurers to avoid diminishing or rescinding pensions except in extreme and clear-cut cases.50 Social Unrest in the Welfare State, 1916–21

The Emergence of Interest Groups for the Disabled World War I thus accentuated the fissures and conflicts that had been dividing the disabled and health-care providers since the 1880s. Two wartime developments, however, conspired to transform the disabled’s concerns, complaints, and identities. First, the restrictions placed on litigation during the war compelled the insured to find new avenues for expressing their dissatisfactions. As the wartime German welfare state increasingly abandoned the rule of law (sozialer Rechtsstaat) and turned to administrative regulation (sozialer Verwaltungsstaat) to manage affairs, it displaced the conflicts inherent in social insurance. Second, by upsetting conventional boundaries and hierarchies of work, the war created new possibilities of social solidarity. Established during the previous century, the categories and terms used to differentiate social groups and identities—male work/female work, civilian/military, working class/middle class/white collar, the disabled/the able-bodied—became increasingly difficult to employ within wartime social administration. As distinctions between compensatory entitlement and insurance, civilian and military care, and medical and social assistance grew fuzzier, the disabled, invalid, and war-injured found themselves faced with a common plight. To many of them, it became increasingly clear that neither political parties nor labor organizations nor for that matter any other existing associations understood what it meant to be chronically disabled, impoverished, and forced to live on a fixed, public income. Page 180 → Within the sphere of social welfare, two major groups took the lead in establishing themselves as organized political interests during and immediately after the First World War. Both veterans and war widows were largely dependent on the German welfare state for their livelihoods. Large numbers of them shared the experience of insufficient pensions, food shortages, and under- and unemployment. Frustrated by their daily dealings with public assistance and civilian life, veterans and war widows increasingly directed their resentment and anger toward the government, the latter especially in the form of demonstrations and riots. While some turned to Social Democracy to translate their sentiments into organized political action, from 1916 onward many opted to form alternative leagues and associations designed specifically to represent and promote the economic and political interests of their members.51 Those disabled and maimed in battle shared many of the experiences and views of their fellow veterans. But upon arriving home, disabled veterans found themselves confronting some unique problems. Passing through the administrative apparatus of wartime welfare, the war-disabled—just as they had on the front lines—lived in a world segregated from the rest of the population. They resided in hospitals, clinics, and rehabilitation centers. Once they left these institutions, they were only reluctantly accepted into the labor market. Their disabilities marked them as different and strange. Even those without extensive physical injuries, like shell-shock victims, found that they routinely evoked reactions of disgust and revulsion from those at home. The divide between such “war neurotics” and the rest of the population became so great by 1919 that one physician in the Prussian State Assembly called for creating permanent, separate settlements for war neurotics. “Esteemed colleagues,” he exclaimed, “it is high time that these neurotics, whom we see everywhere these days, disappear from our streets.”52 By spring 1916, some of these disabled veterans began showing signs of organizing themselves along lines that rejected both Social Democracy and veterans associations. In March, blinded patients at Dr. Silex’s School for the Blind in Berlin became the first to formally found an association for disabled veterans, the League of Blinded Soldiers (Bund erblindeter Krieger). By the spring of the following year, some involved in the care for the wardisabled began Page 181 → publicly calling for the formation of special organizations for the promotion of the “economic security” of similarly disabled veterans. Simultaneously, social-service administrators began reporting encounters with war invalids that seemed to signal the emergence of a new social identity. One Düsseldorf physician sympathetic to socialism and active in war-disabled care, for instance, warned his colleagues in the labor movement that war invalids when asked by administrators “What are you?” in interviews were “not answering ‘locksmith’ or ‘farm-hand,’ but rather are proudly answering ‘I am a disabled veteran.’”53 Within the next two years, a number of war-disabled organizations made their appearance. First, in April 1917, the German Economic Association of Disabled Veterans was formed with explicitly patriotic and anti-leftist aims. A

rival organization was then founded the following month with more pacifistic, Social Democratic views, the League of Disabled Soldiers and Veterans. By the fall of 1919, both groups changed their names and expanded their organizations. The former became the Central Association of Disabled German Veterans and Survivors (Zentralverband deutscher Kriegsbeschädigter und Kriegshinterbliebener, with 156,320 members in 1921), the latter the National Association of Disabled Soldiers and Veterans (Reichsbund der Kriegsbeschädigten und ehemaligen Kriegsteilnehmer, with 639,856 members in 1921). These groups were eventually joined by the International League of Victims of War and Work (Internationaler Bund der Opfer des Krieges und der Arbeit) and the Unity Association (Einheitsverband). Between them, these associations by 1921 had a total membership of over 1.1 million disabled and invalid veterans.54 By the time the war began, social insurance had come to serve the same function for civilian disableds and invalids as care for the war-disabled had for so-called crippled veterans. The invalid and disabled workers of German social insurance went through their own, similarly distinctive institutional rites of passage. In the process of pursuing claims and undergoing institutional treatment, insurance beneficiaries had staked their individual claims on the German state. But as reforms after 1900 progressively removed avenues of individualized advocacy from the insured, organized labor took on a more prominent role in the promotion of the disabled’s interests. This continued to be the case during and immediately after the war as well. Worker secretariats stayed active during the war years, albeit with some significant changes. The total number of clients diminished (683,890 in 1913 compared with 511,763 in 1917), the number of women using services increased markedly (540,316 men and 110,934 women in 1913; 252, 744 men and 224, 361 Page 182 → women in 1917), and financial difficulties restricted secretariat activities.55 Due to the success of Reich Insurance Office policies that aimed at eliminating the frequency of pension appeals during the war, worker secretariats were called on most commonly to handle cases involving military personnel, the families and wives of soldiers, and war widows.56 As the war drew to a close in 1918, the leadership of the German labor unions pressed state officials to finally institute those reforms in social insurance that it had been calling for since the turn of the century: uniform regulation of both worker and white-collar insurances; self-administration, worker representation, and parity in all social insurances; and equal distribution of social-insurance costs between employers, the insured, and the Reich government.57 Recall, however, that even before the war a rift between the disabled and organized labor was discernible. Trade union and Social Democratic platforms calling for increased worker representation and greater worker safety appear to have had only a limited effect in appeasing disabled workers who had become removed, oftentimes permanently, from the routine of work and employment. Taking their cue from the relatively well-coordinated war widow and disabled veteran movements, accident casualties and invalids by the end of the war began organizing themselves along similar lines. One of the earliest formal associations for disabled civilians was organized in December 1917 by the invalid Joseph Duda. Duda was a former masonry supervisor from the Ruhr who, due to a heart ailment, drew a monthly invalid pension of thirty-eight marks. After leaving the bricklaying trade, he became active in a variety of moneymaking schemes, including legal counseling, fortune-telling, and performing card tricks. Duda’s work as a legal adviser for social-insurance claimants was particularly infamous among local bureaucrats. They dismissed most of his claims and appeals for lack of substantive content and described his legal efforts as consisting primarily of reproaches against social-service institutions and personal attacks against leading officials. Despite his ailment, Duda was inducted into the military two separate times, from July to December 1915 and from April to September 1917. Although seeing no action, he continually referred to himself as a soldier (Kriegsteilnehmer) in letters that he began sending to the minister of the interior. His physical condition Page 183 → worsened during his time of service, so he received a military pension in addition to his invalid pension amounting to 16.60 marks a month.58 Duda first set out to organize a local association of pensioners in December 1917 in the town of Mülheim on the Ruhr. He succeeded in holding an organizational meeting in which an assembly of roughly one hundred resolved to found a local association for pensioners. A year later, the group met once again, now 150 strong. The assembly agreed to a set of grievances, which were then sent to the Westphalian government. Among other things, the

association demanded the appeals process be streamlined, pension benefits be raised for all dependents, criminals receive their revoked pensions upon release from prison, and demands for rehabilitation be recognized regardless of prognosis. In addition, it asked for the association to be given a seat and a vote in the Reich Insurance Office and all pension-granting administrations to be consolidated into one unified provincial pension institution.59 The document closes with a long tirade against capitalist interests, but it is impossible to ascertain whether these sentiments were shared by the entire group or simply imparted by Duda and his fellow writers. Either way, it is evident that by the end of the war some civilian pensioners were becoming more than simply radicalized. Whereas during the Wilhelmian period the disabled promoted their interests individually, only uniting in common political action through the mediating institutions of organized labor, social-insurance pensioners and invalids were now beginning to translate their shared predicaments and experiences into a distinct, collective political idiom. The organization of pensioners in Mülheim demonstrates that some of the disabled and invalid were learning to perceive themselves primarily in terms of their health and bureaucratic fate. The effects of this change in self-perception were felt as soon as the war ended. Unrest in the Sanatoriums, 1918-–21 In November 1918 Germany finally agreed to terms of surrender, the kaiser formally abdicated, and the creation of a German republic was proclaimed. During the winter of 1918–19, councils of sailors, soldiers, and workers sprang up in cities throughout Germany, demanding radical reform and challenging the authority of the parliamentary government. In January 1919, the Ebert government called on paramilitary Freikorps units to put down what it considered to be revolutionary forces. Order was eventually restored in Berlin, and elections Page 184 → were held for the Reichstag on 19 January. The council movement was eventually and conclusively brought to a close when the council republics of Bremen and Bavaria met their respective ends in February and May 1919.60 Though lasting only a matter of months, the revolution of 1918–19 had an important effect on German political culture. Radical politics, collective action, spontaneous demonstration, political violence, and the division of German socialism became an assumed, if not accepted, part of the political landscape. The revolution, combined with the effects of the war, brought large numbers of men and women in direct contact with the methods and goals of collective action and protest. Just as the war had done for veterans and widows, so too did the revolution open up new possibilities for political association and activity. The disabled and invalid were among those groups strongly influenced by these political developments. While growing numbers of pensioners began organizing themselves into formal interest groups, those social-insurance beneficiaries who lay in hospitals, sanatoriums, and clinics underwent a similar transformation. Throughout Germany, patients embarked on local, concerted campaigns against insurers and therapeutic facilities. Discontent with and within sanatoriums and medico-mechanical institutes, as we saw in the previous chapter, was certainly nothing new. By 1919, institutions were well acquainted with patients refusing to work and with organized labor publicly condemning residential conditions. But in the aftermath of the revolution, patient dissatisfaction started to be expressed in much less subtle, more direct ways. The Invalid Insurance Office in Berlin had firsthand experience of this. From August 1914 to November 1919, it provided therapeutic care for insured and military patients side by side. Lack of adequate funds, food, and coal led administrators to close several of their facilities. When a typhus epidemic broke out in a nearby town in August 1920, hospital beds normally reserved for respiratory patients were given to victims. Food rationing ensured that those under the office’s charge were provided for; however, officials admitted that the nutritional needs of patients were not being met. Patients residing in the Berlin office’s therapeutic facilities greeted these changes with a series of protests in 1919 and 1920. Demonstrations outside the insurer’s administrative building became so volatile they sometimes could only be put down by force. Within sanatorium walls, administrators found it increasingly difficult to work with socalled patient committees (Patientenausschüsse). These had been created in 1918 as a way of airing out

differences between sanatorium officials and residents. Administrators had hoped that the committees, composed solely of patients, would act as a pacifying and constructive link between Page 185 → both groups. This did not turn out to be the case, as it soon became evident that the committees saw themselves less a conduit than the advocates of residential patients before an adversarial administration. By the end of 1920, patients were demanding the expansion of residential committees to include two more members and the granting of unlimited rights of inspection to all committee members.61 Berlin was by no means the only nor the most explosive site of patient unrest. Insurance records chronicle a remarkable series of events that took place in 1919 in the town of Bad Lippspringe in Westphalia. The town was the site of a popular private spa to which a host of regional social-insurance providers, including the invalidinsurance offices of Hesse-Nassau, Brandenburg, and Westphalia, sent many of their ailing clients. During their stay, patients were housed in any one of a number of local boardinghouses affiliated with the spa. The revolutionary events of November 1918 had led to the election of a patient committee; it was never recognized by any state insurance office, however, and the committee dissolved after the original members were discharged. On 12 February 1919 a group composed of both male and female patients met to form a new patient committee.62 The following day, members of the governing board of the committee paid a visit to spa director Rayscher in order to speak with him about complaints being raised by residents of the facility. Rayscher, however, declined to meet with the group and refused to recognize the legitimacy of the committee. This prompted a second general meeting of patients at which a list of grievances was drafted and thereafter disseminated throughout the community. Boardinghouse owners then stepped into the fray by evicting committee members from their premises. The situation then took a new turn. Independent of developments in the spa, a local committee had been formed for new residents in the area with the intention of selecting a candidate for upcoming town-council elections. The patients’ organizers, in collaboration with local veterans, decided to become involved in the group in order to nominate individuals from their own ranks for candidacy. Hearing of the patients’ intentions, municipal officials in Lippspringe met with both the new residents and the patient committee on 18 February and reached an accord in which it was agreed that (1) the two groups would not put forward their own candidate for town-council elections, and (2) in return, Lippspringe officials and candidates promised to work for the creation of a spa Page 186 → commission headed by a town representative and composed of local residents and patients. Friction between spa administrators and the patients did not dissipate, however. Facility residents continued to press officials to remedy what they considered to be a long list of systematic and long-standing problems. Their complaints, detailed in a report given to the Reich Insurance Office in September 1919, bear great resemblance to those being raised against therapeutic institutions all across Germany since the turn of the century:

—Staff were negligent and abusive. Disruptive or noncompliant patients were being locked in their rooms, or even worse, thrown out on the street. Regular examinations did not take place. Indeed even when patients fell ill, nurses and physicians were so seldomly around that it fell to fellow patients to stay with the ill during the night and ensure that they were following medical prescriptions. In addition, facilities were so uncentralized that residents were continually being transported from place to place throughout the grounds. This led patients to feel that they were “being treated like ‘milking cows,’ or better put, like ‘goods’ in the worst sense of the term.” —Living conditions were unsanitary. Most rooms had no spittoons. Most linen remained unchanged and unwashed for four, six, eight, and even twelve weeks. After a patient was discharged, rooms were seldomly disinfected. In the majority of cases, boardinghouses had no lights and no heat and were often damp. —Food and drink were inadequate. Residents were never given whole milk, and what food they received was not enough and without taste. Boardinghouse owners offered additional food for those patients, but at exorbitant prices.63

Administrators and patients remained at a standstill. In the first week of March 1919, the patient committee succeeded in getting one boardinghouse closed and demanded that the federal government ensure that the house remain shut up until “healthy and orderly conditions” were restored. In addition, it called for the dismissal of director Rayscher on account of his supposed inhumane treatment of spa residents.64 The Reich Insurance Office responded by telling the patients that the boardinghouse would indeed remain closed until Page 187 → changes were made, but that the director, a disabled war veteran himself, was “a considerate and impartial man” and would remain at his post.65 Sometime after events in February, one of the patient organizers was discharged and the committee forced to formally dissolve on the orders of state authorities. Government and social-insurance officials, however, continued to monitor the situation and found it necessary to close yet another boardinghouse in Lippspringe in late spring.66 Patients continued to protest, however, and called for the uniform regulation of all boardinghouses in the area. By the summer of 1919, tensions were apparently running high between the citizens of Lippspringe and the spa administration on the one hand and the patients and the administration on the other. A new patient committee was formed, this time headed by two patients by the names of Bernstein and Bock. Bernstein, the president of the committee, was generally perceived by local residents and sanatorium staff to be a rabble-rouser. Under his leadership, patients offered up a new set of demands: free choice of doctor for all patients, the introduction of a supervisor in every spa residence to be selected by the patient committee, permission for patient assemblies, compulsory contributions from all insured patients for maintenance of the committee, and the lengthening of the evening walk. As the summer progressed, Bernstein held regular meetings in the woods and parks of Lippspringe and organized numerous demonstrations that routinely blocked traffic on the streets of the town. On the evening of 28 August, Bernstein and Bock held a meeting for patients at which representatives of the local transportation association were invited to speak. Violence apparently broke out after the representatives were cut off in the middle of their talk. In the melee, local residents attacked the assembly, beating up Bernstein right on the streets of Lippspringe, throwing a sailor into the water, and forcing Bock to immediately leave town. Calm was restored the following day, and Bernstein was told to leave the facility. Officials from the invalid-insurance offices of Hesse-Nassau and Westphalia examined the demands of the patients, but rejected them as inappropriate and definitively forbade the formation of any future patient committees.67 An outside inspection team was eventually sent to the town in November 1919 at the request of the invalid-insurance office in Westphalia and the worker secretariat and town council of Münster. They found that patients still harbored some grievances, but that on the whole spa and housing facilities were sanitary and proper and that the activities of the patient committee had had a more deleterious effect on the health of patients than the imagined poor conditions in Bad Lippspringe.68 Page 188 → The events in Lippspringe were not isolated. From 1919 to 1921, sanatorium administrations throughout Prussia confronted locally organized protests on the part of patients. Patients in the sanatorium Rhineland-Honnef, for example, all but took over the facility after worker and soldier councils were created on the premises in November 1918. Eventually the unrest was put down, but order was hardly restored. Patients were regularly late for therapy, demanded frequent leaves, complained about their treatment regimen, and took it upon themselves to leave when they wished. “The reason for this,” administrators surmised, “rests with a misconceived notion of freedom among [the patients], the idea that the restrictive regulations of the sanatorium are unworthy of a man and are a kind of persecution. This view is best expressed in the sometimes-heard phrase, ‘I am not in prison here.’”69 Sanatoriums in Brandenburg also experienced patient unrest in the winter of 1920–21. Patient demands here revolved primarily around increases in clothing subsidies and sanatorium allowances along with permission under certain circumstances to be excused from compulsory labor.70 These protests proved to be more organized than those in the Rhineland. Officials formally recognized a patient committee for the entire region and allowed it to conduct negotiations with the local invalid-insurance office. Sanatorium and insurance administrators reacted to the protests and demands of resident patients in a number of

ways. Some, as in Lippspringe, categorically rejected the formation of patient committees and denied the existence of shortcomings. Others, such as administrators in Brandenburg and Berlin, attempted to negotiate with their residents. Despite these differences, however, officials unanimously agreed on one thing. The politicization of patients was injurious to their health. As a director of the sanatorium in Friedrichsheim reminded the Reich Insurance Office in November 1919, “In the interest of the health of every individual it must again and again be emphasized that during the cure not only physical, but mental, rest is indispensable. It is already bad enough that the mental rest of the ill is frequently disturbed by misfortunes, anxieties, and troubles at home; this makes it all the more necessary to try to remove outside disruptions. That this is especially the case with regard to politics needs no further explanation.”71 Once again, social-insurance personnel and disabled workers were talking at cross-purposes to one another. Administrators and physicians in disability insurance’s network of treatment centers stuck to the view that the complaints of the disabled expressed little more than the influence of certain troublemakers Page 189 → emboldened by the revolution. Endowed as they were with a therapeutic vision of their work, they understood the changes brought about by the war and revolution in etiological, prognostic, and managerial terms. It comes as no surprise then that administrators in the Rhine province, for instance, in an effort to address the problem, recommended that boredom be removed as much as possible from the sanatorium environment, staff supervision be enhanced, physicians take a more active role in finding out from patients the troubles they might be having at home, and work therapy be employed more often than had been the case.72 Sanatorium officials thus tended to clinically reduce the political unrest of the disabled to the status of a therapeutically counterproductive distraction. As they had in the prewar claims and rehabilitation processes, however, insured and disabled workers refused to accept such administrative attempts to depoliticize social insurance and health care. The unrest in sanatoriums and clinics in the years 1916–21 was only the beginning of a widespread unrest that came to plague Weimar socialservice facilities.73 The importance of the war and the revolution in this development was that they created the conditions for a new political sensibility to emerge, for the disabled to see themselves politically as a group in and for themselves. At the same time, the corporatism of the wartime “civic truce” and the street politics of demonstrations and strikes provided the means for the disabled to express their differences with social-insurance administration in the form of collective action.74 In short, war and revolution gave birth to the organized, collective, and mass politics of social entitlement that came to dominate the Weimar years. 1. W. Kaskel, “Sozialversicherung und Krieg,” in Versicherung und Krieg: Vorträge gehalten bei den Mitglieder-Versammlung des Vereins im preußischen Abgeordnetenhaus am 12. und 13. Dezember 1913 (Berlin: Ernst Siegfried Mittler und Sohn, 1914), 119. 2. Gerald D. Feldman, “The Fate of the Social Insurance System in the German Inflation, 1914 to 1923,” in Die Anpassung an die Inflation/The Adaptation to Inflation, ed. Gerald D. Feldman, Carl-Ludwig Holtfrerich, Gerhard A. Ritter, and Peter-Christian Witt (Berlin and New York: Walter de Gruyter, 1986), 437. 3. Kaskel, “Sozialversicherung,” 129. 4. Feldman, “Fate,” 436–37. 5. Kaskel, “Sozialversicherung,” 129. 6. Ober-Regierungsrat Dr. jur. Hoffmann, “Kriegsfragen der Sozialversicherung,” Zeitschrift für die gesamte Versicherungs-Wissenschaft 15 (1915): 313–15. 7. Paul Lohmar, “Einiges über die Aufgaben der Berufsgenossenschaften im Kriege,” Die Berufsgenossenschaft 29 (30 September 1914): 189–91. 8. Justizrat Dr. Fuld, “Der Einfluß des Krieges auf die Unfallversicherung,” Zeitschrift für die gesamte Versicherungs-Wissenschaft 15 (1915): 378. 9. HdgBG, Nr. 43, Verband der Deutschen Berufsgenossenschaften to Vorstände der dem Verbande angeschlossenen Berufsgenossenschaften und deren Sektionen, 8 September 1916. 10. My discussion of the Kriegsbeschädigtenfürsorge will only treat developments in Prussia and its provinces. 11. GStAKM, 120 BB, VII 1, Nr. 3h, Bd. 1, “Eine notwendige Aktion,” Volksstimme 20 November 1914.

12. Thomann, Das behinderte Kind, 244–46. 13. GStAKM, 120 BB, VII 1, Nr. 3h, Bd. 1, Note of Minister of Interior, 1 December 1914. 14. BAK, R89/6714, Report of Ilges on Discussion of 20 November 1914, 2 December 1914. 15. GStAKM, 120 BB, VII 1, Nr. 3h, Bd. 1, Vorstizender, Central Comité-Preußischer Landesverein vom Roten Kreuz to Preußischem Minister für Handel und Gewerbe, 6 January 1915. 16. GStAKM, 120 BB, VII 1, Nr. 3h, Bd. 1, Preußischer Minister für Handel und Gewerbe to Reichskanzler, Kriegsminister, Minister des Innern, 7 January 1915. 17. GStAKM, 120 BB, VII 1, Nr. 3h, Bd. 1, Note of Minister für Handel und Gewerbe, 28 January 1915. 18. GStAKM, 120 BB, VII 1, Nr. 3h, Bd. 1, Minister des Innern to Minister für Handel und Gewerbe, 30 January 1915. Some of these principles were already laid out for the authorities in a 13 January lecture in the Reichstag given by the director of the Oscar-Helene-Home for the Treatment and Education of Infirm Children in Berlin-Zehlendorf. For this see Konrad Biesalski, Die ethische und wirtschaftliche Bedeutung der Krüppelfürsorge und ihre Organisation im Zusammenhang mit der gesamten Kriegshilfe (Leipzig and Hamburg: Leopold Voss, 1915). 19. GStAKM, 120 BB, VII, Nr. 3h, Bd. 1, Preußischer Minister für Handel und Gewerbe to Regierungspräsidenten und Polizeipräsidenten in Berlin, 6 March 1915; Reichskanzler Delbrück to sämtliche Bundesregierungen (ohne Preußen) und Herrn Statthalter in Elsaß-Lothringen, 22 March 1915. 20. NRWHStA, Regierung Düsseldorf, Sozialangelegenheiten, 33228, Protokoll über die Sitzung des Tätigkeitsausschußes für Kriegsbeschädigtenfürsorge am 7. Juli 1915. 21. NRWHStA, Reg. Düsseldorf, Sozialangelegenheiten, 33230, Tabelle der arbeitslosen Kriegsbeschädigten in der Rheinprovinz, (ca. May–June 1917). Eighty-three were farmers, 254 artisans, 136 skilled factory workers, 117 miners, 165 unskilled laborers, 33 Kopfarbeiter, and 139 were from other professions and trades. 22. Landesrat Dr. Schittmann, Die Sozialversicherung im Dienste der Heilbehandlung und der Berufsumschulung von Kriegsinvaliden (Berlin: Julius Sittenfeld, 1915). 23. Paul Lohmar, “Werkstätten für Erwerbsbeschränkten (Unfallverletzte, Invalide, Kriegsbeschädigte),” Ärztliche Sachverständige-Zeitung (1916): 97–104; Paul Ewald, “Kriegsbeschädigte, Unfallverletzte und Arbeit,” Ärztliche Sachverständige-Zeitung (1916): 230–33. 24. Paul Lohmar, “Nutzbarmachung der Kriegsjahren für die Unfallverletzten,” in 29. ordentlicher Berufsgenossenschaftstag zu Stuttgart, Verhandlungen am Samstag, dem 12 Oktober 1918, 31. 25. BAK, R89/6929, Dr. Speigelthal, “Die Erhaltung der für die Kriegsbeschädigten eingerichteten Heilund Anlernwerkstätten für die Invaliden der Arbeit” (23 November 1917). 26. Stadtrat H. von Frankenberg, “Sozialversicherung und Wehrkraft,” Zeitschrift für die gesamte Versicherungs-Wissenschaft 16 (1916): 363–75. 27. BAK, R89/6715, Verhandlungen der allgemeinen Versammlung der deutschen Landesversicherungsanstalten in Erfurt am 9. April 1915, 14–15, 27. 28. Ibid. 29. Protokoll der Konferenz der Vertreter der Versicherten bei den Landesversicherungsanstalten. Abgehalten am 2. August 1915 im Reichstagsgebäude zu Berlin (Berlin: Verlag der Generalkommission der Gewerkschaften Deutschlands, 1915). 30. See BAK, R89/13642 for the years 1916–17. 31. See BAK, R89/6709, February–ca. April 1918. 32. BAK, R89/6929, No name and no date given. (Vortrag vor ordentlicher Mitglieder-Versammlung des Gesamtverbandes deutscher Krankenkassen, 26–27 August 1918.) 33. Ursula von Gersdorff, Frauen im Kriegsdienst 1914–1945 (Stuttgart: Deutsche Verlags-Anstalt, 1969); Ute Daniel, Arbeiterfrauen in der Kriegsgeslleschaft: Beruf, Familie und Politik im Ersten Weltkrieg (Göttingen: Vandenhoeck & Ruprecht, 1989). Recent literature has been raising important questions about earlier contentions that these changes were especially “revolutionary” or “emancipatory.” On this, see Daniel, 256–75, and Françoise Thébaud, “The Great War and the Triumph of the Sexual Division of Labor, ” in A History of Women in the West, vol. 5: Toward a Cultural Identity in the Twentieth Century, ed. Françoise Thébaud (Cambridge, Mass., and London: Belknap, 1994), 21–75. 34. Jürgen Kocka, Facing Total War: German Society 1914–1918 (Cambridge: Harvard University Press, 1984), 17.

35. BAK, R89/4923, Regierungs-Präsident Baltz, “Aufruf an die Pensionäre und Rentenempfänger zur Teilnahme an der nationalen Arbeit,” 1 June 1915. 36. BAK, R89/4923, Vorsitzender Baltz, Königliches Oberversicherungsamt Trier to RVA, 27 July 1915. 37. GStAKM, 120 BB, VII 1, Nr. 3h, Bd. 2, Vertrag zwischen Reichsverband für das Steinsetz-, Pflastererund Straßenbaugewerbe—Sitz Leipzig—als Vertreter der Arbeitgeber und dem Verbande der Steinsetz-, Pflasterer und Berufsgenossen—Sitz Berlin—als Vertreter Arbeitnehmer über die Beschäftigung kriegsbeschädigter Berufsangehöriger, 28 June 1915; Abkommen betreffend die Weiterbeschäftigung der Kriegsteilnehmer im Braugewerbe zu Groß-Berlin, 8 October 1915. 38. Regierungs-Präsident Baltz, “Aufruf.” 39. This request was also published in the Norddeutsche Allgemeine Zeitung in August 1915. 40. BAK, R89/4923, Hessisches Ministerium des Innern to RVA, 25 July 1916. 41. BAK, R89/4923, RVA to Vorstände sämtlicher LVAen und Sonderanstalten, 2 August 1916; RVA to Vorstände der dem RVA unterstellten gewerblichen und landwirtschaftlichen BGen, 24 August 1916. 42. BAK, R89/4923, Rudolf Rieck to Reichskanzler Bethmann-Hollweg, 21 August 1916. 43. BAK, R89/4923, Verband der Deutschen BGen to RVA, 15 November 1916. 44. NRWHStA, Regierung Düsseldorf, Sozialangelegenheiten, 33230, Protokoll über die Sitzung des Tätigkeitsauschußes für Kriegsbeschädigtenfürsorge am 28. September 1916 im Rathause zu Cöln. 45. Fritz Stier-Somlo, “Vaterländischer Hilfsdienst und Sozialversicherung,” Zeitschrift für die gesamte Versicherungs-Wissenschaft 17 (1917): 262–86. 46. GStAKM, Rep. 77, tit. 923, Nr. 25, Beiakt. 2, Minister des Innern to sämtliche Herren Oberpräsidenten und die Herren Regierungspräsidenten, 21 February 1917. 47. BAK, R894923, Geheimrat Fritz to Dr. Rabeling, 20 November 1917. 48. BAK, R89/4923, RVA Memo. Kaufmann, 26 January 1918. 49. BAK, R89/4923, Oberversicherungsamt Groß-Berlin to RVA, 21 November 1918. 50. BAK, R89/4923, RVA to Vorstände der der Aufsicht des RVAs unterstellten LVAen und an den Vorstand der Seekasse, 27 November 1918; RVA to Vorstände sämtlicher dem RVA unterstellten gewerblichen und landwirtschaftlichen BGen, 28 November 1918. 51. On these groups, see Helene Hurwitz-Stranz, ed., Kriegerwitwen gestalten ihr Schicksal (Berlin: Carl Heymann, 1931); James Diehl, “The Organization of German Veterans, 1917–1919,” Archiv für Sozialgeschichte 2 (1971): 141–84; Robert Weldon Whalen, Bitter Wounds: German Victims of the Great War, 1914–1939 (Ithaca and London: Cornell University Press, 1984); Karin Hausen, “The German Nation’s Obligation to the Heroes’ Widows of World War I,” in Behind the Lines: Gender and the Two World Wars, ed. Margaret Higonnet, Jane Jenson, Sonya Michel, and Margaret Weitz (New Haven: Yale University Press, 1987), 126–40. 52. Bundesarchiv Postdam (hereafter BAP), RAM, Nr. 9338, Protokolle, Verfassungsgebende Preußische Landesversammlung, 30. Sitzung am 4. Juni 1919. 53. GStAKM, Rep. 191, Nr. 3649, Landesrat Dr. Horion, “Wirtschaftliche Vereinigungen von Kriegsbeschädigten,” Die Kriegsbeschädigtenfürsorge in der Rheinprovinz 23 (20 March 1917): 201–5. 54. On the formation of these groups, see Whalen, Bitter Wounds, 107–29. 55. BAP, RAM, Nr. 6523, Bl. 16–17, Generalkommission der Gewerkschaften Deutschlands to Reichsarbeitsamt, 2 November 1918. 56. BAP, RAM, NR. 6523, BL 8–10, Jahresbericht des Arbeiter-Sekretariats Darmstadt, 1916; Bl., JahresBericht des Arbeitersekretariats zu Lübeck, 1917. 57. GStAKM, 120 BB, VII 1, Nr. 1e, Sozialpolitische Arbeiterforderungen der deutschen Gewerkschaften: Ein Sozialpolitisches Arbeiterprogramm als Denkschrift der Generalkommission der Gewerkschaften Deutschlands überreicht an die gesetzgebeneden Körperschaften des Reiches und der Bundesstaaten (Berlin: Verlag der Generalkommission, 1918), 24–25. 58. GStAKM, 120 BB, VIII 8, Nr. 1, Bd. 1, Oberbürgermeister Engelhardt (Mülheim an der Ruhr) to Vorsitzenden des Oberversicherungsamts Düsseldorf, 13 February 1919. 59. GStAKM, 120 BB, VIII 8, Nr. 1, Bd. 1, Joseph Duda, Ernst Mehnert, Johann Priester to Regierung zu Düsseldorf, 22 December 1918. 60. F. L. Carsten, Revolution in Central Europe, 1918–1919 (Berkeley and Los Angeles: University of California Press, 1972); Ulrich Kluge, Die deutsche Revolution 1918/19: Staat, Politik und Gesellschaft

zwischen Weltkrieg und Kapp-Putsch (Frankfurt a.M.: Suhrkamp, 1985). 61. BAK, R89/6714, Verwaltungsbericht der Landesversicherungsanstalt Berlin, 1920, 9. 62. On events in February, see BAK, R89/6721, Protokoll über die am 12. Februar 1919 im Hause “Martha” stattgefundene Besprechung der Kurgäste zwecks Neuwahl des Kurgäste-Ausschusses; Protokoll über die am 24. Februar 1919 stattgefundene Versammlung der Kurgäste im Hotel Peters, Bad Lippspringe; and Tätigkeitsbericht des am 24 Februar 1919 gewählten endgültigen Ausschusses der Kurgäste in der Zeit vom 24.2.19 bis. . . . 63. BAK, R89/6721, copy of report from Willi Scheffler, “Die Zustände in Bad Lippspringe,” undated. 64. BAK, R89/6721, Heinrich Kegeler, Ausschuß der Kurgäste to Reichsamt des Innern, 14 March 1919. 65. BAK, R89/6721, RVA to Kegeler, 19 August 1919. 66. BAK, R896721, Report of Amtmann to LVA Westfalen, 20 May 1919; LVA Westfalen to RVA, 7 June 1919. 67. BAK, R89/6721, Report of Landesrat Krass, 5 September 1919. 68. BAK, R89/6721, Report of Landesrat Krass, 9 November 1919. 69. BAK, R89/6695, Chefarzt der Heilstätte “Rheinland” der LVA Rheinprovinz to Präsidenten des RVAs, 27 October 1919. 70. BAK, R89/6715, Gustav Konnecke im Auftrag der Krankenausschüsse der gesamten Heilstätten der LVA Brandenburg to RVA, 22 December 1920. 71. BAK, R89/6695, Direktion der Heilstätte Friedrichsheim to RVA, 5 November 1919. 72. BAK, R89/6705, Landesrat Appelius to Ärzte der Heilstätten der LVA Rheinprovinz, 27 January 1920; Chefarzt Dr. Rosenberg to Landesrat Appelius, 31 January 1920. 73. See Gräser, Der blockierte Wohlfahrtsstaat. 74. On the rise of corporatism during the Great War, see Gerald D. Feldman, Army, Industry and Labor in Germany, 1914–1918 (Providence and Oxford: Berg, 1992). Page 190 →

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CHAPTER 6 The Inflation of Social Entitlement, 1918–27: Sacrifice and the Politics of Victimization The politics of social welfare during the Weimar Republic have been among the most studied in the historiography of the German welfare state.1 Historians have generally seen Weimar social policy as the ultimately flawed attempt to grapple with intractable social problems in an ideologically fractious environment. Since Ludwig Preller’s study, historians of Weimar social welfare have identified three major “new social questions” that traced their origins back to prewar Germany, but came to dominate social-policy debate under the Weimar Republic.2 First was a public preoccupation with a marked decline in fertility. The trend began in the 1870s and became particularly pronounced in the years 1910–20.3 By way of response, Weimar Germany, like other European states at the time, embarked on ambitious, eugenically informed maternalist programs designed to curb abortions, limit the size of “undesirable” families, and promote fecundity among the upper classes.4 Linked to this demographic anxiety was a second major concern of Weimar social policy: youth. Widely perceived Page 192 → to be victims of the Great War as well as particularly susceptible to criminal and decadent influences, young people and children were singled out by local and national governments as objects of special measures designed to protect the weak and rehabilitate the wayward.5 But arguably most central to the fate of the Weimar Republic was the emergence of a “new poor” in interwar Germany. Millions of women, men, and young people were made destitute by a combination of war, inflation, currency stabilization, and mass unemployment, and they translated their discontent into a volatile animosity toward the Republic.6 The results of the recent inquiry into the “new social questions” that vexed interwar Germany provide us with an image of Weimar social-welfare politics that is strikingly different from the influential one sketched by Detlev Peukert in the 1980s. Peukert contended that progressive welfare reformers of the Weimar Republic, by attempting to therapeutically rationalize and normalize the sphere of working-class social reproduction, provided the essential legitimating precedents for the disciplinary social technologies of the Nazi state.7 The recent studies cited above, by contrast, have traced growing authoritarianism in Weimar social policy to a conservativeconfessional backlash against the therapeutic ethos of social-service work. This backlash was accompanied by a spirited defense of benefits and entitlements by consumers and reformers. The German welfare state, however, became overburdened by the growing demands made upon it. Reich authorities responded to each wave of economic crisis by foisting an ever greater financial burden onto municipal governments and mandating needsbased testing for an ever wider array of beneficiaries. Thus, a morally inflected fiscal conservatism and not an apolitical therapeutic technocracy, as the new consensus has it, served as the precursor to the Nazi racial state. This and the following chapter will provide a means to assess these competing images of Weimar social policy. In particular, this chapter evaluates the impact of the “new poverty” on German political culture by examining the politics over benefits to civilian disabled pensioners and their dependents. As will become evident, the politics of social entitlement during the Weimar Republic reinforce the view that Peukert’s thesis is overstated: a therapeutic ethos had already developed and was fully politicized by 1919; working-class pensioners were hardly socially disciplined into passivity; and fiscal austerity and conservative Page 193 → policy-making virtually reduced all forms of social assistance (compensatory, insurance, and poor relief) to a needs-based welfare. But Peukert was not completely off the mark. Chapter 7 will go on to show that the conservative and liberal backlash of the late 1920s and early 1930s was inspired and informed by the very therapeutic idiom implicit in the social-insurance system. The regenerative ideal first established and institutionalized by Wilhelmian social insurance acquired a new, spiritual significance under the Weimar welfare state, one that proved especially compelling to conservative and liberal critics of social policy. Before delving into the great debate over the fate of social security during the Weimar Republic, it is vital to first understand the changes that the politics of social entitlement underwent in the years between the end of the First

World War and the creation of unemployment insurance in 1927. Numbering around 2.8 million in 1920 and 4 million by 1924, “social pensioners” (Sozialrentner)—as chronically ill, disabled, and elderly pensioners and their surviving dependents came to be called by the 1920s—were a prominent group among the “new poor.” Karl Christian Führer and David Crew, however, are among the few scholars to trace the fate of these pensioners between 1918 and 1933.8 Their studies reveal that elderly, disabled, and female pensioners were among the hardest hit by the inflation. Initiatives on the part of the federal government and the municipalities to assist these individuals were largely ineffective, however, since special relief programs were so restrictively administered that only a third of pensioners received benefits. Pensioners responded to increasing impoverishment by both individually and collectively mobilizing and confronting local welfare authorities. David Crew’s impressive history remains the only major study to target the politics of social pensioners in particular. Crew sees the politics of social entitlement among Weimar pensioners as bifurcated into spheres of “traditional” and “informal” politics. On the one hand, he argues, pensioner organizations pressured authorities on the basis of “traditional” models borrowed from the labor movement, associational life, and bourgeois political parties. At the same time, individual pensioners engaged in what Crew calls “informal politics” or “micropolitics” with authorities in an effort to “reconstruct the personal ‘honor’ and dignity” they felt they were losing in the system.9 While Crew’s formulation helps to map out the possibilities of interest-group politics in the Weimar welfare state, I would insist that the distinction between Page 194 → a “traditional” organizational politics and an “informal” individual politics does not entirely capture the simultaneously conventional and innovative nature of the two spheres of political activity. Both disabled individuals and the chief political association for the disabled can be characterized as traditional in three ways: in their reliance on a political sensibility of entitlement that dated back to Wilhelmian Germany, in this sensibility’s link to the bureaucratic fate of consumers, and in the way consumers treated the national state as ultimate arbiter. Not to be overlooked, however, is the fact that disabled pensioners after World War I also broke with established convention by organizing their own political-action groups (distinct from veteran and worker associations) and contributing to a peculiarly postwar political discourse of victimization. Thus, the politics over social pensions heralded an innovation in the politics and administration of the German welfare state. As we have seen, social pensioners had already formed nascent organized political groups during the war. By 1920, disabled pensioners had built on their mutual sense of entitlement to embark on campaigns against insurers and treatment facilities. Having translated their individual plights into common political cause, the early organizers of the disabled provided their constituencies with a new means to perceive and to articulate their grievances. Once demobilization, inflation, and hyperinflation began to erode any semblance of social security, social pensioners could turn to the language of collective mobilization to argue their causes. As a result, the economic crises that followed the Great War not only fed a growing sense of mass victimization among social pensioners; they also prompted a restructuring of Germany’s pension and health-care systems. Repercussions of the Inflation: The Emergence of a Politics of Victimization, 1919–22 The Growth of the Welfare State and Its Discontents Noting what appears to have been an almost unbroken pattern of expansion in the compass of social services since the late nineteenth century, social scientists and historians have recognized the 1920s as a time of especially acute growth in German public assistance. Government expenditures after the First World War showed a particularly marked increase in three areas: public housing, public health, and social insurance. Together, these three spheres constituted the primary sites of Weimar social interventionism.10 Analysts have found it more difficult, however, to agree on the historical significance of these interventions, with discussion largely centered on the question of whether, and to what extent, the social programs of the Reich and municipalities overburdened Page 195 → the social-welfare state and thus contributed to the demise of the Weimar political order.11 This literature and the questions it has raised intersect with the concerns of another group of historians. Interest in

the German inflation of 1914–24 has helped to identify some of the more general consequences of the increasing depreciation of the mark for Germany’s social classes during and after World War I.12 Among other things, studies have shown that salaried employees, civil servants, and the new middle class in general went through a “proletarianization” after 1914.13 In addition, evidence indicates that while real wages had increased for most wage earners by 1920, the average working-class household could still not cover expenses. Especially susceptible to this overall trend toward impoverishment were unskilled workers, disabled veterans and their dependents, unmarried women and widows, single mothers, and those with limited employment possibilities.14 A number of other historians have expanded the study of the inflation by noting the effects of the stabilization measures of 1923–24 on German political culture. Those like Thomas Childers, who are particularly interested in the growth of smaller, single-interest, and regional parties in national elections up to 1928, emphasize that “stabilization, not inflation, constituted the most salient economic issue for the various components of the middleclass electorate.”15 Page 196 → In this regard, it has been pointed out that the people most hurt by the inflation and subsequent stabilization were those with savings, those on fixed incomes, and those in the business of extending credit.16 Thus, when creditor and saver political-action groups began to form after 1922, elderly and disabled pensioners joined investors and creditors to form the core of the movement. While these smaller interests did not necessarily unite under the banner of one political party, they did share a similar political attitude that translated into an animosity toward leftists, big business, and the state, and a concomitant sympathy for the interests of farmers and shopkeepers, a corporatist economic order, and an authoritarian, nationalist state.17 The inflation and subsequent stabilization of the German currency can be seen, then, as one of the chief sources of the widespread discontent with the welfare state that developed and grew during the 1920s. That this discontent emerged at the same time that public assistance was expanding in scope and size itself requires explanation, however. The example of social pensioners provides an instructive case for making sense of this paradoxical convergence of developments. Sacrifice and the Politics of Victimization The massification of social-entitlement politics that had begun during the war was reinforced in the years 1914–29 by profound changes to two of the principal symbolic means by which Germans related to one another and to the state: the German currency and the discourse of citizenship. In the former case, the depreciation of the mark had a profound effect on social-insurance administration. Accident and invalid insurances financed themselves through the fixed contributions of members and returns on capital investments. Pension benefits, in turn, were awarded on a graduated scale, measured in relation both to the wages earned at the time of disability and to the amount of contributions paid. A rapidly inflating currency predictably wreaked havoc with such a system. Costs began to outrun previously paid contributions. Savings and investments increasingly lost their value. Meanwhile, the number of beneficiaries grew as a result of the increased number of accidents and widespread health problems that had accompanied the war. As for benefit levels, they reflected less the cost of living than a formulaic relation of former wages and premium payments. Page 197 → The result was a financial disaster that reverberated throughout the entire network of social-insurance administration. By 1923, it was apparent to insurers that neither contributions nor benefits were able to keep up with the rate of inflation. In the end, government officials resolved to leave the administration of necessary austerity measures in the hands of insurance providers at the local level who, for their part, turned to a policy of retrenchment in order to save the social-insurance system.18 The consequences of these measures were perceived and weighed by social pensioners through, among other things, the available political rhetoric of citizenship. The discourse of national belonging in Germany, however, had undergone something of a transformation. The postwar Republic found itself quickly confronted by demands for recompense from veterans, war widows, and orphans, nationally recognized as Germany’s “war victims” (Kriegsopfer). To be sure, their use of suffering as a vehicle for collective self-identification, expression, and

political demands was not without precedent. Such uses can be traced back to changes in social sensibilities brought about by the French Revolution, nationalist movements, and Romanticism that had given birth to a competing market of the self-professed disenfranchised in the nineteenth century: those denied their liberties, rights, freedoms, work, privileges, autonomy, traditions, languages, homelands, and so on.19 The First World War added another dimension to this status by revalorizing the representation of the citizen’s relationship to the nation-state with a mythic ethos of sacrifice (Opfer) for the sake of the nation.20 German men and women were enlisted in what was venerated as a holy undertaking. They were to relinquish that which was dear to them and offer it on the “altar of the Fatherland.”21 Here was a direct invocation of the Christian concept of self-sacrifice that accepted pain, suffering, violence, loss, and renunciation as Christ-like fulfillment.22 It meant nothing less than being sanctified.23 This equation of national Page 198 → service “for the Fatherland” with sacred obligation was eventually monumentalized in the 1920s and 1930s by war memorials throughout Germany that represented Kriegstod as Opfertod.24 The political prominence of the idiom of victimization after the war must therefore be seen as a direct historical consequence of the German state’s wartime invocation of national sacrifice. It is equally important to note, however, that linking victimhood with sacrifice was no arbitrary act. The term Opfer means both “sacrifice” and “victim” (in addition to “casualty”). This mutual implication derives from the structure of ritual sacrifice itself, one that requires a victim in order to assure the sacrificer a measure of redemption. In this way, ritual sacrifice not only implies a victim, but also represents a sacred contract between the one offering the sacrifice and the divinity. The divinity too has obligations.25 Sacrifice, victimhood, and entitlement were therefore historically, linguistically, and ritually linked with one another. Invoking sacrifice necessarily meant invoking the idioms of victimization and entitlement as well. The triad of sacrifice-victim-casualty provided a powerful heuristic by which Germans after the war could understand and politically explain military defeat, the subsequent civil unrest, and the virtual universalization of loss, sickness, and impoverishment during the postwar period.26 Throughout the 1920s many were led to question whether the sacrifices they had made had been evenly distributed, and whether they had been worth it in the first place. First, war widows, veterans, orphans, and workers, followed by civil servants, the young, the elderly, savers, creditors—an array of individuals and organizations cast themselves as innocent victims of war, revolution, and economic disarray. Page 199 → The task of repairing the damage done fell most consistently to the national state, since it had been in the name of the Reich that Germans had been called on to make their sacrifices in the first place. Inflation was therefore not the only reason why the job of Reich officials was, for all practical purposes, intractable. Their problems were further compounded by the incommensurability of the cacophonous demands being made on them. Unable to fulfill everyone’s wishes, the government could only partly grant the requests of self-styled victims, who in turn believed themselves to be even further victimized by the state as well as by other groups of victims. Victim status thus represented symbolic capital in the Weimar welfare state. Its returns were expected to rise proportionally with the level of expressed misery of one’s plight, with the extent of one’s contribution to the community, and, if necessary, at the expense of others. The pensioners of social insurance in the 1920s were educated by and simultaneously had a hand in fashioning this world where widespread suffering operated as both a centripetal and centrifugal social force. One of the most telling signs of this development among the disabled and invalid was the increasingly prevalent use of new labels which they began assigning to themselves. During the Wilhelmian period, a disabled worker generally tended to refer to him- or herself as a simple “claimant” or an “invalid.” Organized labor typically introduced a class element into its labels, often calling such individuals “worker invalids” (Arbeiterinvaliden). As disabled and pensioner action groups began forming in the 1910s, they used terms such as “pensioners” and “patients” to identify themselves. After the war, however, a new vocabulary appeared in articles, petitions, posters, and correspondence. At some point around 1920, some disabled individuals and organizations began referring to themselves as “work invalids”

(Arbeitsinvaliden), “victims of work” (Arbeitsopfer), and “fellow sufferers” (Leidensgenossen). The change in terminology reflected a change in self-perception. These terms were obviously intended as a play on the familiar theme of the war victim. They were, however, a variation on the theme. The new terminology aimed at distancing disabled and invalid pensioners from those whom they believed unable to understand their predicament and therefore unqualified to represent their interests, among the latter being the general, healthy population, war veteran and war-disabled groups, private capital pensioners, and organized labor. As will become clear, then, disabled pensioners during the early years of the Weimar Republic played a pivotal role in producing and reproducing a politics built around suffering, sacrifice, and victimization.27 Page 200 → The Plight of Disabled Pensioners and the Founding of the Central Association of German Invalids and Widows The new labels projected the growing political self-consciousness among disabled pensioners.28 These terms, however, were invested with a thoroughly embodied meaning. The circumstances of most social pensioners during the early 1920s were dire indeed. In 1920 Berlin, for example, an average male invalid pensioner with a family received around 45–60 marks a month from his insurance. Even if this income were supplemented by unemployment-relief support (approximately 43 marks), it did not come even close to covering the cost of rationed food alone, which, depending on the number of children, could range anywhere from 380 to 900 marks a month.29 The Invalid Insurance Office in Berlin complained of this very situation in a letter to the Reich Ministry of Labor in September 1920. “Despite raising pensions,” officials remarked, “the present pension installment is so small that it still does not in the least suffice to cover even the most modest necessities of life of the pensioner” (italics theirs). Berlin administrators reported that resentment among invalid pensioners had become especially pronounced since large numbers of them had worked during the war to supplement their incomes and had recently lost their jobs as part of demobilization efforts. It had gotten so bad, Reich officials were warned, that, during a meeting of the Berlin office’s board of directors, “a gathering of several thousand people formed in front of our administration building, sending a delegation of eleven people to announce their requests for a compromise on the above mentioned incongruities. The board of directors is unanimous in the conviction . . . that consideration of the requests cannot be denied.”30 Disabled and invalid pensioners throughout Germany let government officials and insurers alike know of their plight and outrage. Individuals persistently and directly wrote government ministries apparently in the belief that most had no knowledge of how bad things had gotten. Franz Wagner from Silesia, for example, wrote the Reich Ministry of Labor insisting that it take immediate action on behalf of him and his fellow “work invalids.” “Here prompt help is necessary, this year’s misery is especially big, blame for that lies with the government Page 201 → for raising food prices over 300 percent for potatoes, etc.,” Wagner wrote in his rambling, but pointed, style. “It appears as though the old ‘work invalids’ are being betrayed and sold out by God and men; for all the civil servants there is a salary allowance of 1,000 marks, to say nothing at all of the enormous salary raises, and the old invalids who earned a starving wage for their 50–60 years and more of productive work for the fatherland, one leaves them to their fate.”31 The seventy-five-year-old former miner Robert Nagel echoed these sentiments in a letter he wrote the Prussian minister for public welfare in which he detailed how impossible it had become for him and his seventy-one-year-old wife to get by on 184 marks a month. “It is deplorable after you have sacrificed [geopfert] your youth and health for society, and you still have to go hungry and starve during your final declining days.”32 A growing number of interest groups and associations reinforced the efforts of disabled individuals to get the attention and support of authorities and administrators. The Private Capital and Insurance Pensioner Association of the Saarland, for instance, posed the question of assistance for social pensioners to the Reichstag by rhetorically asking, “Should there then really be no help for the pensioners, widows, and orphans who have sacrificed their life, limbs, and health for the good and the defense of the state and industry?”33 In Zwickau in October 1920, the board of directors of a group calling itself “Invalidenheil” delivered a list of demands to local accident, invalid,

municipal, and district administrations as well as to the Reich government. Among other things, its reported membership of twelve thousand work invalids, old-age pensioners, accident casualties, widows, and orphans demanded that pensions be indexed to existing wage levels, the system of certifying physicians be phased out, all welfare, insurance, and public assistance boards include representatives of the invalid, municipal welfare provide financial assistance to pension recipients, and government ensure the delivery of cheap food and fuel for all pensioners.34 Records indicate that invalid and pensioner associations such as the one in Zwickau existed in almost every region of the country by 1920. The Ruhr especially was a hotbed of agitation. Here, disabled, invalid, and elderly pensioners organized a political-action group in 1919, the Association for the Economic Union of German Accident-, Miners’ Fund-, Old Age-, and Reich-Invalids and Their Dependents, known more commonly and succinctly as the Civil Pension Recipients Association (Zivil-Rentenempfänger-Verband). Its local chapter in Page 202 → Bochum was strongly active in reminding the government and interested citizens of the plight of local pensioners. “The bitterness in accident invalid circles is deep,” noted local director Robert Heupts in a newspaper article in 1919. “Why are we not awarded the same right as the war invalids? What is right for the one must be just for the other.”35 On behalf of his constituency, Heupts was unrelenting in his campaign to prove that “the disabled war veterans do not suffer as frightfully as accident casualties” and that “the antisocial spirit” that dominates social insurance would first have to disappear “in order for true Christian charity to be shown those who are suffering.”36 In the summer of 1920, however, the Civil Pension Recipients Association along with disabled and pensioner groups from Frankfurt, Bremen, and Essen dissolved as independent bodies. From this point on, these groups joined to form what was to be the largest organization of disabled pensioners in Germany throughout the Weimar Republic. The Central Association of German Invalids and Widows (Zentralverband der Invaliden und Witwen Deutschlands) was founded in Essen in July 1920.37 It is apparent from its rules on membership qualifications that the association envisioned itself as a magnet for all pensioners with health problems and their dependents. Those invited to join were work and lifelong invalids from every branch of social insurance and their dependents, with the latter group including widows, children, parents, and siblings. At the time of its founding, the association claimed a national membership of around sixty thousand and by December had created some three hundred local chapters. The group set out its general aims in Article 2 of its governing statutes.38 Advocating equal rights for women, but remaining religiously and party-politically neutral, the association sought the “protection before the law and the administration of the common interests of invalids and their dependents in their economic and social affairs.” It announced that its goals were to be reached Page 203 → through publishing a newspaper, tracking relevant health and economic statistics, influencing legislation and administration through correspondence, advising economic organizations on the special needs of members, and promoting good relations with work invalids and their dependents in other countries. In addition, the organization was to provide for members free occupational counseling and legal advice, assistance in preparing applications for pension and welfare benefits, and legal representation before insurance courts. Finally, members declared their interest in cooperating with existing worker, white-collar, and civil-servant organizations in achieving the association’s goals. In statements to the membership in the months following the July 1920 meeting, Central Association organizers and leaders explained the rationale behind creating a national union for civil invalids and their families. “Educated by the knowledge that we are nothing as long as we are splintered, and that only through one large organization—to which also belong the invalids with incurable diseases, etc. as well as family members and, in particular, widows—will it be possible for us to realize our goals and demands, we must take up the fight,” remarked the governing board in an attempt to rouse local chapters. This was the first and admittedly most important aim of the Central Association: to organize “fellow sufferers” (Leidensgenossen) so that “no institution and no government will dare ignore the misery of those suffering and weak without their participation and without regard for their interests.”39 In this, the group was self-consciously modeling itself after the war-invalid groups that had recently had a hand in

getting the Reichstag to pass a comprehensive national pension law for disabled veterans (the April 1920 Reichsversorgungsgesetz).40 Still, while they certainly felt an affinity for those soldiers debilitated in the war, civil pensioners found it unnerving that veterans were receiving benefits that were largely withheld from them. Spokesmen for the Central Association therefore demanded that the segregated treatment of the two groups come to an end, and national invalid offices be created for the care of all invalids, both civilian and military. Like the disabled war veterans, disabled civil pensioners also expressed little trust in outsiders. Government, welfare, and social-insurance administrators were among the most immediate targets of this distrust. But while David Crew has stressed that the Central Association was a traditional “working-class organization, firmly situated in the Social Democratic political orbit,” it should not be overlooked that the organization was breaking new political ground.41 Page 204 → What is especially striking is the profound sense of an unbridgeable gulf in society between the able-bodied and the disabled that organizers articulated in their instructions to members. “[W]e have to represent everywhere the principle that only an invalid can be the representative of invalids,” stated the official organ of the Central Association in November 1920. “We know from thousands of examples that the healthy individual [der Gesunde] cannot place himself in the position and frame of mind of an invalid, that decisions involving the interests of invalids lie fully in the hands of the healthy, and that this domination conceals dangers for us against which we must work through organization and education.”42 The Central Association was therefore the first mass lobbying group born solely of the German welfare state. Put another way, it was an association that had more in common with the political culture of the twentieth than the nineteenth century, founded as it was to look after the interests of individuals whose chief link with one another was a common physical and bureaucratic plight. Guided by its peculiar sense of mission, the organization and its members began a concerted campaign to extract concessions from Reich, municipal, welfare, and social-insurance administrations. Social-Pensioner Relief, 1918–24 Initial Improvisations: Allowances and Municipal Welfare, Winter 1918–Summer 1921 Under these pressing and politically volatile conditions, social-insurance and government officials began improvising a set of responses to the havoc that the inflation, compounded by the effects of the war and revolution, was wreaking on the lives of the disabled and invalid pensioners. Already in December 1917, the chancellor’s office had been made aware of the “urgency of suitable relief measures [Fürsorgemaßnahmen] for fixed-income pensioners.”43 Officials were successful in pressing the Bundesrat to pass a decree on 17 January 1918 that awarded a monthly supplemental allowance of eight marks to all accident casualties with at least twothirds of a full pension. Responsibility for assuming the costs of these allowances fell to accident-insurance boards themselves. During the course of 1918, however, it became apparent that the high cost of living and the depreciation of the currency were making the allowances inconsequential. Page 205 → This led some in the Reich government immediately after the war to propose an increase in the supplement. Doubts were raised about social insurers’ ability to foot the bill again, and it was suggested that municipal governments and associations also contribute to the program.44 Nevertheless, the plan to raise allowances was put on hold until November 1919, when a government decree once again awarded the same group of accident pensioners an allowance of twenty marks a month, financed for the most part by a transfer of funds from still unpaid war bonds. Assistance for social pensioners in the years immediately following the war chiefly came, then, from sources outside the Reich government. In practice, the burden fell on the shoulders of cities and towns. Following precedents that had been established in the nineteenth century, German municipalities during and immediately after the First World War became centerpieces for national welfare initiatives.45 As part of this welfare, municipalities by 1920 were offering public assistance in a variety of forms to social pensioners. Local governments were first introduced to these individuals through community poor relief, after high prices and currency depreciation qualified large numbers of them for welfare assistance. Both officials (who feared being overrun by petitioners for local poor relief) and social pensioners (who found the meager support and strict regulations of poor relief distasteful) were unhappy with simply adding social pensioners to the rolls of local

welfare. Local civil invalid groups called on city councils to target aid specifically at social pensioners and at others who were physically limited in their ability to work.46 At the same time, federal, state, and insurance officials were also pressing local communities to consider playing a more prominent role in relief efforts. Page 206 → Inundated by requests and demands from all sides, municipal governments did in fact become active in providing support and social services for their social-pensioner populations. The town of Offenbach am Main, for instance, instituted a five pfennig streetcar ticket for those determined to be at least 50 percent disabled, gave away wood to needy pensioners, and awarded five thousand marks to the local chapter of the Central Association of German Invalids and Widows for building an office. The city of Essen gave its pensioners a one-time allowance from its welfare treasury. In Munich, officials transferred the care of disabled pensioners from poor relief to war welfare administration. In Hamburg, a special law was passed that automatically adjusted civil invalid pensions to match increases in unemployment support. The city of Nuremberg, finally, went further than most in segregating pensioner relief from standard welfare programs by creating a separate department in the local welfare office—referred to as “Middle Class Assistance” (Mittelstandshilfe)—solely for those residents needing aid outside of poor relief. With 75 percent of its workload taken up by the disabled and invalid, Middle Class Assistance provided those it supported with a one-time allowance and money toward rehabilitation (approximately 150–300 marks).47 Local governments, however, were not at all willing to be the sole providers of welfare relief for social pensioners. Municipal officials insisted that the federal government and social-insurance providers assume the lion’s share of costs and administration.48 In this, municipalities were as adamant as every other public institution. Throughout 1920, administrators took part in a frenzy of finger-pointing, as insurers, invalid and pensioner groups, and Reich, state, and local governments all demanded that one or several of the others take on more responsibility for the welfare of social pensioners. There was little agreement on anything but one point: everyone, except for its own officials, believed that the Reich needed to play a more active role in social-pensioner relief. Representatives of the constitutional national assembly, ministers of finance and industry from federal states, individual disabled petitioners, officials from the Central Association of German Invalids and Widows, and leaders of the Association of German Accident Insurance Boards all insisted that the federal government begin placing its resources at the disposal of disabled pensioners. Reich authorities responded by passing yet another decree on 5 May 1920 according to which war bonds would be used again to finance another series of Page 207 → pension allowances. This time, invalid as well as accident insurance pensioners were awarded an allowance whose size was now to be measured in proportion to the size of the pension and extended to all those with pensions set at 50 percent disability or more. In addition, discussions started being held within government circles on the possibility of abandoning the policy of administering socialpensioner relief by decree and, instead, introducing a new law designed to govern permanently in such matters. Already by the summer of 1921, it was clear that social insurance was changing in important ways. The nature of the demands being made on it had begun to assume a more comprehensive form. “From a true social state we expect true social action,” is how one accident pensioner expressed the prevailing sentiment among invalids at this time. In a correspondence with the Reichstag, he articulated many of the complaints and demands that his “fellow sufferers” were routinely raising by this time: the government was more responsive to the needs of “well-to-do classes” than to those of the disabled; invalids had no business being beggars after having sacrificed life and limb for the common good; the disabled deserved to be included in social-policy decision-making; civil servants, war invalids, old-age pensioners, and accident invalids should no longer be given separate administrative treatment; jobs should be provided for needy pensioners at the expense of civil servants and their families.49 Social pensioners were becoming some of the most vocal proponents of a move away from insurance and toward universal, compensatory entitlement on the model of veterans’ benefits. Accident insurers were among the first to recognize that administrative responses to demands were altering fundamental social-insurance principles. “Accident insurance has been arranged by the Reich Insurance

Ordinance,” the Association of German Agricultural–Accident Insurance Boards reminded the Labor Ministry, “according to the so-called insurance principle [Versicherungsprinzip], i.e., only the average yearly income that an injured person at the time of the accident received is insured. A categorical shift from the insurance principle to the so-called compensatory principle [Versorgungsprinzip] we must reject.” Representatives of the organization cited two main reasons for objecting to the gradual introduction of such universalist measures into socialinsurance matters: insinuating compensatory entitlement into social insurance required nothing short of a comprehensive, legal reform of the system, and the economy and insurers were in no condition to finance such measures. The larger Association of German Accident Insurance Boards shared this view, but both groups conceded that welfare relief for social pensioners was necessary. They therefore pressed the Labor Ministry to emphasize the provisional nature of welfare relief for social pensioners and to establish needs qualifications and needs-based Page 208 → testing (“Bedürfnisprinzip und Bedürfnisprüfung” ) in the administration of any future public assistance.50 Insurers remained steadfast in their insistence that no matter what, the insurance principle of contribution-based, individually assessed aid was to be the basis for all social-policy initiatives aimed at assisting impoverished invalids. Growing Reich Involvement: Emergency Measures, Summer 1921–Spring 1922 Between July 1921 and January 1922, the rate of inflation rose another 250 percent, the most it had since 1919, sending the mark to its lowest level ever.51 Meanwhile, there continued to be no letup in the public outpouring of demands on the Reich government. The Ministry of Labor bore the brunt of the assault. The Union of German Farming Associations asked that allowances be extended to those with pensions below 50 percent disability.52 The Rhine-Westphalian chapter of the Economic Association of Accident Casualties, Invalids, and Dependents attempted to impress upon the government and citizens alike the vital need for bread and potatoes among the disabled population and their families. Members also urged the government to reform social insurance and to index pensions in line with the rate of inflation. “Pensions for all social pensioners must be set so that they are left with the possibility of enjoying a humane and dignified life,” they demanded in August 1921. “If this were done according to one’s salary and the kind of practical, productive work one did, then the difference between civil servant pensions and social pensions would not be so irresponsibly great. We must try to ensure in cases of invalidism that there is a certain evenhandedness at work, whether it’s a laborer, white-collar worker, or state or municipal civil servant.”53 In Hamburg in September 1921, accident and invalid pensioners joined with poorrelief recipients to protest higher bread prices, low pensions and allowances, and what they perceived to be the lack of consideration shown them by the Reich government.54 Page 209 → With the currency still declining in value and insurers unable to support any further increase in allowances, Reich minister of labor Heinrich Brauns (Center Party) sent a memorandum to then chancellor and Reich minister of finance Joseph Wirth (Center Party) detailing his plan for responding to the growing needs of social pensioners. Whereas a prewar social pensioner might have had to spend one-third or one-fourth of his or her pension on bread, he pointed out, by the fall of 1921 the same individual had to spend the entire pension plus allowances for the same amount of bread. “In daily correspondences I receive from associations and pensioners, the distress of the latter is described in the darkest colors and urgent help is demanded,” Brauns reported. Yet, he added, the Reichstag appeared totally unable to agree on any assistance measures. In the labor minister’s view, it was left to the Reich administration to take the initiative. Brauns therefore proposed that for a brief period of time (perhaps two years, he suggested) the Reich target 3 billion marks annually toward efforts to support those approximately 2 million social pensioners assessed to be most needy. Social pensioners at least two-thirds incapacitated in their ability to earn a living were to receive an allowance of whatever sum was necessary to ensure that the individual had a yearly income of 2,500 marks. Reich financing of the program (90 percent) was to be supplemented by an additional contribution from municipalities (10 percent).55 Over the next several months, government officials and interested groups debated the labor minister’s proposed “emergency measures” (Notstandsmaß-nahmen). Chancellor and Finance Minister Wirth felt obviously uneasy with the plan. “One has to be clear about the fact that there exists neither a legal nor a moral responsibility for the

Reich to raise all the funds, and that it remains primarily a matter for insurance providers to keep pensions at the necessary level,” he emphasized in a letter to Brauns. Wirth therefore proposed that federal, state, and local governments share the burden of financing the initiative, leaving its administration to existing municipal welfare offices.56 Brauns adopted this approach to the problem and began fashioning a draft for a decree on emergency measures in which a minimum yearly income would be guaranteed for indigent social pensioners, to be funded equally by the three levels of government.57 Criticism of the plan came from a number of directions. The Prussian minister for public welfare, for example, complained that state and municipalities Page 210 → were already overburdened with welfare costs, and that at best cities and towns could front one-sixth of the costs.58 The Association of German Cities rejected even this. Its board of directors refused to recognize that municipalities had any responsibilities when it came to financing what was, in its view, a social-insurance program. All funding, it insisted, should first come from insurers themselves and then, if needed, from the Reich.59 The newly created National Economic Council, the Association of German Agricultural Accident Insurance Boards, and, of course, the Central Association of German Invalids and Widows also joined the federal states and municipalities in offering their own schemes for distributing costs and for deciding on who qualified for benefits.60 The Reich government finally decided the matter on 7 December 1921. A decree established minimum yearly income levels at 18,000 marks for invalids, 15,000 marks for widows, and 7,000 marks for orphans. A social pensioner earning anything below these levels was awarded an allowance for the difference. The municipalities were assigned the task of determining which individuals qualified for the allowance and of distributing the payments. The Reich then reimbursed local authorities 80 percent of the funds expended. The decree did little to satisfy anyone. The inflation rate continued to gallop (another 250 percent between January 1922 and July 1922), and as it did, Reich and state government offices were inundated with letters from impoverished invalids and social pensioners demanding that their pensions and allowances be raised.61 The Central Association of German Invalids and Widows stepped up its campaign to convince Reich administrators and lawmakers that only a “comprehensive Reich relief effort” could mitigate the catastrophic effects of the inflation. It invited government officials and parliamentary leaders in February 1922 to a formal discussion on the subject of “Relief Measures for Germany’s Needy Invalids and Their Families.” Here again, the Central Association took the opportunity to remind officials, “We are convinced that a new Page 211 → way of providing social assistance can only be found in consultation with the representatives of those who are suffering and weak themselves.”62 Matters were made worse by the fact that a number of municipalities were finding it barely possible to contribute their share to the general fund for emergency measures.63 By the spring of 1922, government officials found themselves overwhelmed by the mounting number of demands being made on them. Reich minister of finance Hermes described the predicament shared by many in the Reich government in a confidential letter he wrote to Labor Minister Brauns in March. In it, he pressed the latter to emphasize more explicitly the “financial distress of the Reich” in his dealings with Reichstag deputies. On the one hand, he admitted, there was the need to “avert the financial collapse of the Reich”; on the other, a genuine desire to aid the most needy in German society. It was impossible to impose further burdens on the Reich budget, yet “preparatory negotiations [over new welfare measures] have taken such a concrete form that a total rejection also appears no longer possible to me.”64 The only choice apparently left to such officials was to manipulate rhetoric in the hope of discouraging any further escalation of demands. Hyperinflation: The Growing Importance of Social Services, Summer 1922–January 1924 As the hyperinflation began taking its course in the latter half of 1922, it was apparent that the simple manipulation of rhetoric could do little to allay the expressed frustration and desperation of millions of social pensioners. Neither could monetary allowances keep up with runaway inflation rates. Reich officials during this last phase of the inflation continued to try to raise allowances to match the depreciation of the mark. In the inflation’s last eighteen months, no fewer than thirty-seven decrees were handed down to regulate contributions and allowances in accident insurance alone. By the end of 1923, however, the system of raising allowances to

meet the rate of inflation had become untenable, as new levels needed to be established at first every two weeks and then every day. In a world where currency mattered less and less, promises of more money from the government seemed emptier and emptier. Glancing at the letters and petitions sent by individual social pensioners and invalid groups during these Page 212 → months, two things are most striking. First, these documents express an ever more pronounced anger directed at the federal state. “Hunger hurts! We were born human, and we should not have to die of hunger in the civilized state [Kulturstaat] of Germany,” was the blunt reminder for the Reichstag from one invalid group in Saxony.65 Disabled activists time and again confronted Reich officials with what they saw as the contradiction between Germany’s self-proclaimed identity as a “social” or “cultural” state and the existing social reality. In the eyes of many social pensioners, the state was largely in the hands of a corps of elite individuals uninterested in the plight of the rest of the population.66 Thus, invalids and their interest groups expressed their disappointment in, and frustration with, the federal state in two ways: by vocally criticizing Reich officials and procedures and by denouncing civil servants as a class. Alongside this increasing contempt for the Reich government and its employees, a second theme can be discerned in the correspondence and publications of disabled pensioners during this time: a demand for a more comprehensive, more inclusive conception of social policy. “[A] general national welfare law must be created for all individuals,” wrote one group to the Reich Ministry of Labor in the summer of 1922.67 The Central Association of German Invalids and Widows emphasized in its correspondence the duty of “every part of the population together” to contribute to the assistance of “the suffering and weak of Germany.”68 Demands like these became increasingly commonplace in invalid petitions and discussions. To be sure, social-pensioner groups continued throughout these last months of the inflation to insist on further increases in allowances and subsidies.69 These latter kinds of requests, however, no longer occupied center stage. As money became worthless, the focus shifted to goods and services. The “organization of medical treatment, the supply of prosthetic and orthopaedic aids, the creation of a welfare office for answering the questions of the disabled” were the points of emphasis at the first national convention of the Central Association of German Page 213 → Invalids and Widows in June 1922.70 These concerns eventually led the organization to initiate negotiations directly with manufacturers themselves as a way of acquiring, for example, affordable shoes and boots for the winter.71 But good intentions alone, in the view of many pensioners, would not bring about an end to their misery. Nothing short of the complete reform of social insurance could achieve that. “The chief aim of social insurance is to grant benefits that can be directed at social need,” the regional section of the Central Association in Saxony told the Labor Ministry in November 1922. “Unfortunately this has not been the case up to now. The financial basis of insurance providers forbids paying out higher pensions since benefits are set according to contributions. It would be more logical if it were reversed.”72 The Saxon group therefore proposed “once and for all breaking with the principle of reserve financing” in order to ensure a minimum living standard. By March 1923, the same group had developed this idea into a general plan for the radical reform of social insurance that entailed “one large, uniform institution for social welfare, for all branches of existing insurance and welfare ranging from white-collar insurance to the poor relief inherited from the Middle Ages.”73 Thus, by winter 1922–23, invalid and social pensioner groups were either explicitly or implicitly asking for a thoroughgoing reconstruction of social insurance. Administrators at all levels, however, seemed little receptive to the notion. Caught up in the immediacy and gravity of the prevailing circumstances, most acted just as pensioners did: they promoted and defended their most pressing interests. Ministers in the Prussian cabinet rejected early attempts by the Reich in 1922 to involve their government in the funding of social-pensioner relief.74 Accidentinsurance boards continued to insist on the necessity of needs qualifications and needs-based testing for any and all public-assistance programs for insured workers.75 In addition, they opposed the idea of tying pension Page 214 → levels to anything other than former wages and contributions (e.g., to existing wage levels or the rate of inflation) since, in their view, such changes represented a violation of insurance principles and opened the way for unions to introduce the question of pension levels into labor negotiations. As for municipalities, they confessed to

being fiscally exhausted by February 1923, and indeed reports were being received during the spring that cities and towns were routinely no longer paying out allowances.76 Even within the Reich government itself, the general welfare and relief effort was fragmenting. In a memorandum in June 1923, the minister for food and agriculture informed the labor minister that food producers were losing their patience with subsidies, and that relief efforts for the needy should be directed not at regulating prices, but rather at adjusting wages, salaries, pensions, and allowances.77 The pull of fragmentation was met by those on the front lines of social-pensioner relief with calls for the reform and unification of health-care administration. By the spring and summer of 1923, the municipalities and local welfare offices assured Reich officials that the existing system of insurance relief was incapable of addressing the problems that war and inflation had created. In April, the German Union for Public and Private Welfare recommended to the Labor Ministry “the standardization [Vereinheitlichung] of war-victim assistance (welfare for social and private capital pensioners, the war-disabled, and surviving dependents) through the municipalities (and municipal associations).”78 Only the complete financial, legal, and administrative coordination and standardization of all social assistance for these individuals, to its membership’s thinking, could respond to the comprehensive nature of their needs. In the same vein, the board of directors of the German Association of Cities echoed these sentiments in its appeal to the Labor Ministry in June to promote “an organic combination and standardization” (organische Zusammenfassung und Vereinheitlichung) of war-victim assistance.79 Page 215 → In July 1923, Labor Minister Brauns offered his assessment of the problems associated with social-insurance reform and pensioner relief in particular reference to accident insurance. “A distinction between the pension and the allowance is no longer appropriate today,” he told state governments. Ordinarily the pension was the chief benefit and the allowance a simple supplement designed to serve as a counterweight to the effects of inflation. Runaway inflation, however, had rearranged the terms. Compounding the problem was the fact that both benefits were proving inadequate in addressing the problems facing large numbers of pension recipients. Pensions reflected wages and contributions, not cost of living; allowances, determined in relation to a national minimum income and the extent of one’s disability, failed to take into consideration the inherent differences of family status and local inflation. Thus, many were being given allowances who did not need them, while others were receiving far less than they required. To resolve this dilemma, Brauns suggested doing away with all distinctions between pensions and allowances and between those deserving allowances and those not. Instead, all pensions should be calculated, he argued, according to an average yearly income. This calculation was to differentiate, however, the economic and personal circumstances of the individual pensioner. Thus, following social-insurance principles, different average yearly incomes would be assigned unskilled as opposed to skilled laborers, blue- versus white-collar workers, male versus female employees, and younger versus older individuals. In addition, benefit levels would be gauged in reference to local economic circumstances and the familial status of the pensioner. Throughout, Brauns insisted that one thing needed to be kept in mind: “The primary focus is treatment, rehabilitation, and adaptation, rather than a one-sided emphasis on monetary pensions.” This was the key in his view. “The goal for future development is a stronger emphasis on goods and services [Sachleistungen], an expanded therapeutic and occupational welfare program for the injured through the most comprehensive system possible of medical treatment, rehabilitation as well as reintroduction into economic life, in addition to an expanded welfare program through provision of goods and services for surviving dependents. Monetary benefits that cannot be done away with must recede more in their general significance.”80 The labor minister’s plan, like all the other reform schemes, was pushed to the side. Deliberate and concerted reform was something that was persistently postponed during the Weimar era. Yet it would be wrong on our part simply to dismiss such talk of comprehensive reform of social insurance as no more than idle chatter. The schemes of Brauns and others point to the fact that Page 216 → administrators and social pensioners alike were understanding their situations and their tasks in different terms. This spilled over into administrative practice. By

August and September 1923, the Labor Ministry began placing the emphasis of its relief efforts less on allowances and more on making fuel and food affordable and accessible to those in need.81 A trend toward providing comprehensive social services was already being woven into the fabric of insurance administration. In October 1923 the currency collapsed. Inflation reached its most absurd proportions. In just twelve days, the price of one hundred German pounds of coal (approximately sixty to seventy-five briquettes) rose in Saxony from 32 million to 500 million marks, a pound of butter from 10 million to 1 billion marks, and ten pounds of potatoes from 2 million to 200 million marks.82 Administrators readily admitted that it had now become impossible to index allowances to inflation.83 Clearly, with a worthless currency social insurance could not be expected to resolve its problems. As it was for so many other social institutions, social insurance finally broke out of the vicious cycles created by hyperinflation after the Rentenmark was introduced in November 1923. Over the next two months, pensions were reassessed in terms of the new currency. Retrenchment measures in December and January placed new restrictions on benefits: strictly uniform contribution and compensation rates were established, some small pensions were altogether eliminated, voluntary supplemental benefits were curtailed, and the Reich emergency-relief program was discontinued. While the task of providing any future allowances now fell to the federal states and municipalities, the Reich did agree to pay certain subsidies for invalid pensioners.84 Subsequent government contributions to the invalid insurance program rose from RM 24.6 million in 1927 to RM 171 million by 1929. Despite the increase, invalid pensions remained modest (on monthly average, RM 47–48 for men and RM 29–30 for women in 1931), so that a large share of beneficiaries found it necessary to continue to work and seek other forms of assistance.85 Page 217 → The Development of Welfare Consortia, 1918–27 Retrenchment and Calls for Reform In the immediate months following the stabilization measures, policymakers throughout Germany sought to convince the Reich government and social insurers that the time had come for retrenchment to be replaced by reform. The recently created Provisional National Economic Council (Vorläufiger Reichswirtschaftsrat), for instance, was one of many bodies to propose a thorough “reorganization” of social insurance.86 The Chamber of Commerce in Chemnitz agreed, suggesting that local sickness-insurance funds be turned over to municipal governments and that existing accident-insurance boards be replaced by geographically organized accident societies.87 In the Reichstag, one subcommittee proposed that the government combine the invalid and old-age insurance system with the more centralized war veterans assistance administration.88 Yet another plan that circulated within government and insurance circles called for dissolving all social-insurance bodies except for invalid-insurance offices. The latter would then serve as the sole providers of all social insurance in Germany.89 As vocal as anyone else were the representative associations of social pensioners and the disabled. Not surprisingly, these groups were especially concerned with the cutbacks in benefits that had been instituted as part of the new austerity policy. Invalids and social pensioners, one local chapter explained to the Reichstag in February, “expect that the Reich government will not implement [the retrenchment measures] and that pensions and benefits will continue to be paid out at their present levels, so that thousands of people who have become invalid and old after working hard their whole lives will not have to go hungry while there are still fully stocked barns and shops. The Reich government is certainly in the position to find the means to prevent this.”90 These views were echoed by numerous other political-action groups for the disabled. The notion that the government in fact did have the resources to continue social-pensioner relief was based largely on the prevailing sentiment among Page 218 → social pensioners that officials were helping only those groups “close to their hearts.”91 Correspondence between social-pensioner organizations and authorities attests to the fact that civil invalids and their families in the aftermath of stabilization continued to believe that public assistance and

attention were being unequally distributed among the needy. “The gold standard pension rates for the war-disabled and their families,” complained one group, “[and] the unequal pension contributions between invalid and salaried employee insurances are an arresting example of the injustice of the present organizational disconnectedness [Zerfahrenheit].”92 A group in Stettin passed a similar judgment on invalid insurance. “This insurance, which has raised its contribution levels, has, however, lowered its pension levels,” its board argued. “How differently has salaried employee insurance handled things: it has lowered contribution, but raised pension, levels. Why this inequality? Are invalids from the ranks of labor worse than invalids from salaried employee circles?”93 Sentiments like these led many social-pensioner groups to press the government for a “unification of all social insurance, veteran assistance, and welfare.”94 Only a comprehensive reform of the entire public-assistance system, many contended, would be able to treat the problems now facing impoverished invalids. As the Saxon Invalid Pensioner Association prodded parliament in January 1924, “The time is now. Social pensioners therefore call on the Reichstag and government: ‘Get to work, help us now, so that this barbarous [kulturwidrige] situation is done away with and that the much needed unity of the people is promoted.’”95 All these plans, however, met with pronounced opposition from social-insurance administrators and interests. The National Association of German Agricultural and Forestry Employers vehemently opposed suggestions that agricultural accident-insurance boards be centralized and subsumed under the jurisdiction of other institutions.96 A host of industrial employer groups, including accident insurers themselves, mobilized quickly to inundate the Reich Labor Ministry with letters and petitions expressing their complete lack of support Page 219 → for any attempts to incorporate accident-insurance boards into a centralized administrative order. In their view, such proposals smacked of “nationalization” (Verstaatlichung) and represented a clear violation of the right to selfadministration.97 Efforts aimed at “unifying” social insurances also were rejected by a group of sickness insurers who insisted that “an effectual reform of social insurance will not be achieved through merger, i.e., making everything equal, but rather through an arrangement that takes into consideration the peculiarities and different needs of individual occupation groups.”98 Accident-insurance personnel echoed the same views. Any such reforms, they warned, would result “in an increase of accidents and thereby in harm coming to the labor force.” “Retrenchment [Abbau],” they lamented, “is fast becoming ruinous exploitation [Raubbau] for the German people.”99 The Ministry of Labor and the Promotion of Welfare Consortia Conditions therefore were not conducive to implementing radical reform after stabilization. Yet, as we have seen, war, demobilization, and inflation had already prompted a great deal of collaboration between social-insurance providers and other public-assistance agencies. Despite the protests of antireformers, a de facto integration of German social services had already taken place by 1924. As early as 1913, officials in the Reich Insurance Office were mediating conflicts between social insurers and between insurers and other agencies.100 Out of this came the first set of formal agreements between accidentinsurance boards and sickness funds regulating matters such as compensation and treatment.101 Involvement in the coordination of services and personnel for war-disabled care during the war acted as a further impetus for accident and invalid insurers to consider the advantages of establishing regional associations of insurance providers.102 In the first years after the war, accident-insurance boards and invalid-insurance offices throughout Germany began forming regional associations of social-insurance providers. Accident-insurance boards in the Rhineland, Berlin, and Brandenburg were among the first to do so in 1919, exchanging information Page 220 → on accident prevention, therapy, rehabilitation, and job-placement services.103 The aim of such cooperative ventures was to “promote a close alliance of all insurance providers, pursue a standardization and consolidation of social tasks according to the Reich Insurance Ordinance, and realize in practice ideas which some are proposing to achieve through changes in the law.”104 Over the next three years, accident-insurance boards, invalid-insurance offices, and sickness-insurance funds across Germany helped found similar institutions in Berlin, Silesia, Westphalia, and the Rhine province. The Berlin partnership was a particularly ambitious one, coordinating a wide range of health

insurance matters, including the training of health workers, rehabilitation services, the joint purchasing, building, and management of hospitals and sanatoriums, and the creation of self-administered courts of arbitration.105 As the practice spread, these collaborative organizations grew in scope, enlisting other public-assistance agencies. Administrators in Hesse-Nassau, Saxony, Saxony-Anhalt, Hanover, and Schleswig-Holstein were among the first to create comprehensive welfare consortia (Arbeitsgemeinschaften). The membership of these consortia reads like a catalogue of Weimar social and health services. The Consortium of Social Insurance and Welfare for HesseNassau, for instance, included representatives from regional and state government, state insurance offices, the local invalid-insurance office, the provincial association of sickness funds, regional associations of both industrial and agricultural accident-insurance boards, the provincial college of physicians, the public health office, welfare offices and agencies, the local headquarters for war-disabled care, the district association for tuberculosis treatment, and an area association of convalescent homes.106 What had developed out of necessity and improvisation was quickly embraced by prominent party functionaries, reformers, and government officials. A constellation of socialist, progressive liberal, and Catholic policymakers supported closer ties between social services.107 Both of the first two Weimar ministers of labor—Gustav Adolph Bauer (Social Democratic Party, February–June 1919) and Alexander Schlicke (Social Democratic Party, June 1919–June Page 221 → 1920)—actively encouraged the proliferation of welfare consortia.108 Then, in the spring of 1922, the Reichstag formally authorized the government to “bring about, through the creation and promotion of local administrative unions of insurers and providers of public and private welfare, a greater systematization and uniformity [Planmäßigkeit und Einheitlichkeit] of those measures aimed at preventive treatment by insurance providers, particularly by invalid insurance offices.”109 By 1924, Reich officials were following a deliberate strategy based on two principles: social insurance was to be simplified and standardized, and it had to possess “a collaborative, local foundation.”110 The chief proponent of this policy was Labor Minister Heinrich Brauns of the Catholic Center Party, who served in this position from June 1920 to June 1928. His own perspective owed much to the tradition of social reform prevalent in German Catholic political and social thinking. Since the early part of the nineteenth century, the social theory of German Catholicism possessed both a distaste for industrial capitalism and a strong pastoral element that emphasized the church’s and society’s duty to look after the well-being of the less fortunate. Bemoaning the rise of what was considered to be an overly atomized society, Catholic thinkers since the midcentury continued to look to the model of feudal, corporate society and to Christian values for a social reformist solution to social problems. During the 1920s, German Catholic social reform took three directions, one in the form of a romantic-conservative rejection of modernity and another a Christian Socialist–styled planned economy. Brauns and other leading figures in the Center Party, however, embraced a third alternative, solidarism. Assuming the notion that society was an organism for which state authorities had the responsibility of ensuring the order and harmony of the whole, solidarist thinkers like Heinrich Pesch (1854–1926) believed that social justice had to be premised on the reciprocal dependence of individuals in society. This meant that public welfare needed to be understood as a right of every citizen and social group. The coherence of the society was to be guaranteed through a corporatist social order (berufsständische Ordnung) that linked individuals to one another through their professional status. The aim, therefore, was to transcend the conflicts between individualism and collectivism and between capitalism Page 222 → and socialism by placing responsibility for directing the political and social order with what Theodor Brauer (1880–1942) called the “versatile and elastic corporate bodies of self-administration and self-management.”111 Brauns’ thinking was indebted to this tradition. A priest by vocation, he never abandoned the belief that government activities had to have an essentially religious and moral foundation. “The state is not simply an instrument of the economy. It has broader and higher tasks,” he emphasized in 1922.112 Brauns, however, was no integralist. He took society to be an organism and considered it to be the Center Party’s role to play the part of a “party of the middle” between radicalism and reaction. The state’s task was to appreciate the organic nature of society. A new social order could not be achieved, from Brauns’ way of thinking, through laws and statutes alone. Instead, through social policy, the state was to promote the full integration of the working class into “the social

organism” through its support for cooperation between employers and workers.113 These ideas informed Brauns’ activities and goals in his eight years as labor minister. During his tenure, officials in the Reich Ministry of Labor pressed anyone and everyone involved in social-insurance administration to standardize public assistance, collaborate at the local level, and reject any radical reforms. Indeed, in 1922, he and his officials began negotiating with social-insurance providers, welfare agencies, and physicians groups to map out an ambitious, nationwide “Planned Economy for Preventive Health Care” (“Planwirtschaft für vorbeugende Heilfürsorge”) modeled on the example of welfare consortia. Arriving at a formal policy in December 1922, Brauns spent the next two years enlisting the support of health-care providers and social services throughout Germany. By the end of 1924, the Labor Ministry could boast that all men, women, and children receiving a social pension now categorically had access to comprehensive health care.114 In 1925, the Labor Ministry’s director of social-insurance affairs explained the ministry’s position on socialinsurance reform in a speech before Page 223 → the convention of the Society for Social Reform. It is worth quoting at some length, for it expressed not only the motivations of Brauns’ administration, also it offered an ad hoc justification for the policies and developments of the previous six years:

German social insurance has its shortcomings. It is mixed and diverse in its branches, its providers, its benefits, and its collection of revenue. These differences and qualities are in part a result of historical development, in part, however, also a function of technical reasons. The defects of German social insurance are in large measure the natural complement to its virtues. Despite strong opposition, social insurance work demonstrated its enormous strength as a political force [despite being] in conflict with the large parties in the Reichstag and dominated by political objectives. Informed, order-loving civil servants, who placed great value on a well-functioning administrative mechanism, contributed to its implementation. To speak metaphorically: German social insurance has emerged out of the association with the genius of bureaucracy, if one may refer to German civil servants in such a way. The solution is not merger [Verschmelzung], but association [Verbindung], the creation of consortia and local administrative unions. The new laws, decrees, and enactments promote and deliberately aim to realize collaborative principles in every insurance branch, particularly in the area of social hygiene. . . . Perhaps an objection could be raised against German social insurance. Has it brought about or eliminated social peace? Social unrest is greater than ever. Tensions are higher and class conflicts deeper. One can admit the increase of social unrest, but one cannot attribute it to social insurance. The work of social insurance is restricted, its potential for influence limited. It certainly has eliminated or alleviated a vast number of sicknesses, afflictions, and sufferings. It has entirely or partly protected the income of workers and salaried employees against the vicissitudes of life. It is an economic means toward social ends. Preventive and palliative measures, along with appropriate monetary compensation, are necessary to protect and preserve the labor power and health of the insured population. Secondly, it is also necessary that we award the worker professional respect [Standesehre]. He has professional honor and we owe it tribute. Thirdly, the moral renewal of laborers and salaried employees is also necessary, [promoted] not simply by them alone, but by us all.115

As critics from all points on the political spectrum began labeling social insurance an untenable, unmanageable, and even downright dangerous bureaucracy Page 224 → by the last third of the 1920s—this will be discussed in detail in the following chapter—the Reich Labor Ministry remained one of the system’s staunchest advocates. Spurred by the ministry, collaborative ventures went on apace. The Berlin Consortium of Social Insurance Providers began expanding its work to include the education of young people and workers on sickness and accident prevention.116 The Provisional National Economic Council formed a Working Committee for the Reform of Social Insurance Laws that brought together representatives and specialists from employer, employee, and physician circles.117 In 1926, the Labor Ministry announced new guidelines for “the cooperation of sickness, invalid, and salaried employee insurances in the area of health care for insured individuals with tuberculosis and

venereal disease.”118 Insurance administrators typically proved unsympathetic to the idea of creating such universally binding guidelines.119 Nevertheless, the threat alone of legally enforced codes had the effect of pressing many social insurers and consortia to quickly adopt their own independent accords with one another in order to avoid further government intervention. A nationwide agreement between the Association of German Accident Insurance Boards and the various associations of sickness-insurance funds on 31 December 1926 over compensation and health-care provisions, the so-called Sickness Fund Agreement, was most certainly a product of the Labor Ministry’s call for collaborative social service.120 Suffering, Sacrifice, and the Improvised Welfare State The decade of inflation witnessed a series of profound changes in the administration of German social insurance: the increasing intervention of the Reich and municipalities, the financial collapse of social insurance, the declining significance of monetary compensation, and the emergence of welfare consortia. These were often pragmatic, rapid responses to a seemingly endless chain of social and fiscal problems. The economic and health consequences of a total war unconditionally lost and financed by debt compelled unprecedented numbers Page 225 → of individuals to enter the ranks of the impoverished and the disabled. For social pensioners especially, who had become accustomed to the respectability and the measured security that social insurance had afforded them, their losses were unwarranted and unjust. The mutation of social entitlement that occurred at this same time offered the discontented new possibilities for political action. Social pensioners in the 1920s sought, as they had before, bureaucratic recognition of their plight in the conventional form of compensation, the pension. This time, however, their sense of entitlement was informed by mass, corporatist politics.121 Now the invalid and their families were organized and represented by associations on a scale only hinted at by the improvisational groups of the war and revolution. The disabled of social insurance, along with their surviving dependents, bypassed both organized labor and the organizations of the war-disabled to create their own formal associations. In light of earlier developments, it is clear that these organizations came out of affinities and conditions established and promoted over the previous thirty years. The common set of afflictions and bureaucratic fates that befell disabled individuals in social insurance since 1884 had done much to distance them from the general population. The political activism of the war and especially the revolution began to give a more self-consciously political edge and agenda to this sentiment of segregation. Finally, as other welfare-state beneficiaries began forming interest groups in the early 1920s, the disabled too began distinguishing themselves from others as a category. The “civil invalid” was born. This new independent identity was informed and infused by a rhetoric of heroic self-sacrifice. The wartime German state had used the symbolism and imagery of sacrifice to mobilize the masses. Invoking such an overdetermined trope, however, had substantial implications for relations between the state and its citizens. As a rite, sacrifice is a means of influencing forces. As Beattie has observed, it is about power and powers. In it, causal efficacy is imputed to symbolic expression. It is “a form of art, a drama, which is believed by its performers (when they reflect on the matter) to work.”122 In the case of wartime Germany, it offered the prospect of drawing the citizen closer to the beatified nation and, in turn, drawing the nation closer to the citizen. If the many reports of enthusiastic recruits and selfless fraternity on the front teach us anything, it Page 226 → is the extent to which the war was for some an opportunity not just to serve the Fatherland, but to embody it.123 The privations brought about by war, demobilization, hyperinflation, and stabilization ultimately brought the discourses of social entitlement and national sacrifice to bear on one other. Both had become potent forms of communication between the state and its citizens. Both articulated that relationship as an inviolable compact. Now, entitlement and sacrifice reinforced one another, placing questions of trust, responsibility, and reciprocity at the forefront of political debate. By the 1920s, then, the insured had succeeded in reorienting social citizenship away from its links to labor power toward a more explicitly moral rhetoric of suffering and theodicy. But something went terribly wrong. The myth of national sacrifice, like most forms of sacrifice, promised restoration, redress, and regeneration through violence and bloodshed.124 These were promises, however, that the German state appeared unable to keep to its workers, veterans, war widows, and pensioners. The popular contempt

in which so many held the Weimar Republic can be explained by this: a seemingly unresponsive welfare state implied that the sacrifices had in fact not “worked,” that the prevailing order of things was unreliable. The socialsecurity contract between state and citizen that was forged by Wilhelmian Germany appeared to be broken by Weimar Germany. The German welfare state therefore failed its beneficiaries, as it had once succeeded, as a secular theodicy. Moreover, inflation and hyperinflation were doubly frustrating for the disabled and their families because they made the medium of money obsolete as a form of communication between social pensioners and the state. As currency, and along with it compensation, took on an ever more surreal character, suffering replaced it as a more stable medium of social relations. This suffering found expression through the idiom of victimhood, one that lay unassumingly implied in the discourse of sacrifice. The language of victimization made it possible for individuals to judge themselves and be judged by one another with reference to the kinds and degrees of distress that marked their lives. It is in this sense that one can say that Germany of the 1920s was overrun with victims: wave upon wave of individuals who represented themselves as having sacrificed Page 227 → their health or their husband or their limbs or their income for a state, which, they now believed, wanted to abandon them. The fact that the Weimar welfare state had only limited resources at its disposal added another element to this environment: competition. Nineteenth-century social insurance, by institutionalizing compensation and making it compulsory, had transformed compensation into an individual right. Now, however, it was necessary to prove that one’s needs were more pressing, one’s predicament more dire, one’s sacrifice far greater than anyone else’s. Disabled pensioners understood this well. Civil servants, they said, had already received salary allowances. Disabled war veterans, they pointed out, were already awarded their comprehensive welfare program. In this milieu of corporatist competition for limited supplies of public benefits, the politics of social entitlement in the Weimar Republic assumed more solidaristic features than under the Wilhelmian regime. Thus, the competition between victims for the attention of the welfare state had a dual effect on social relations. On the one hand, it brought together in association millions of individuals who had hitherto been separated from one another by bureaucratic process: war veterans, pensioners, and the disabled, to name just a few, discovered their respective common plights and interests. On the other hand, the competitiveness that marked the inflation years led to just this very fragmentation, as these newly realized interest groups further demarcated themselves from one another by focusing their and the government’s attention on those needs most pressing to them. As a strategy for negotiating with officials, this modus operandi was successful in differentiating a particular group’s demands from others’. It also had the effect, however, of assigning groups the task of looking after the interests of their constituents alone, thereby promoting a hypercorporatist political order where every group competed with every other for benefits. Echoing the conventional wisdom on the subject, historian Gerald Feldman has referred to these circumstances—most obvious during the hyperinflation—as “Hobbesian,” concluding that the inflation was one of the reasons that “Germans defaulted not only on democracy but also on civilization itself.”125 This, I believe, is a misreading. The politics of victimization were thoroughly inflected by a deeply moral discourse of sacrifice, entitlement, and redemption. The growing bitterness toward the German welfare state that so Page 228 → characterized Weimar political culture was an expression of many things: frustration with the inability to communicate with the state in familiar terms, the sense that the implicit social contract with the state had been broken, and, therefore, the fear (and for some, outright conviction) that all sacrifices had been in vain. These resentments converged as a profound loss of faith. The intense competition between welfare-state beneficiaries should not be construed as the indiscriminate renunciation of social order, but as part of a general remaking of that order on the theodician terms of suffering and obligation. In this regard, it is noteworthy that what most social pensioners advocated was not a particularist and targeted public assistance, but rather a universal and comprehensive social welfare. The mass politics of victimization in Weimar Germany, therefore, were not an indication of an anarchic civil war between narcissistic interests, but rather were part of a broader national quest to find moral meaning in loved ones lost, sufferings borne, and promises unkept.126 It would be wrong to portray the state as a passive object in these developments. The Reich began intervening in

social-insurance affairs from the very beginning of the war by regulating benefits, mobilizing insurance facilities, and serving as mediator and arbiter in insurance affairs. Certainly, municipal authorities, too, brought some of their resources to bear on the problems facing indigent invalids after the war, but cities and towns never assumed the central management role that the Berlin government had acquired. With hindsight, one might call inappropriate the expectation of social pensioners after the war that the Reich would and should intervene to bring some measure of stability to the social-insurance system, but it did not require a leap of imagination. During the inflation, the Reich (and more specifically the Labor Ministry) became a hub to and from which the demands of accident casualties, invalids, widows, and every other kind of social pensioner were channeled. It assumed this role less because individuals believed the Reich to be responsible for the depreciation of the currency or due to some vague notion of the modern state’s obligation to its citizens; rather, it was largely because social pensioners were accustomed to depend on the federal government to help negotiate insurance matters. The Reich Insurance Office had done this very thing before 1918, and it now fell to the Reich Ministry of Labor to take over the same role. To this extent, political-action groups of the disabled were simply following bureaucratic precedent. Circumstances were new, however. The politics of social insurance were far less individualized in 1920 than they were at the turn of the century. Individual hearings and settlements were now replaced by negotiations at the national, regional, and local levels between the representatives of organized interests. Page 229 → But with competition acute between these interests, satisfactory compromise or arbitration was hardly possible. Moreover, the impact of an increasingly worthless currency made the most basic principles and practices of insurance obsolete. What relation did a premium or former wage have to a depreciated mark? What could be said for a pension that had little if any value in the market? Reich and other authorities improvised. Their responses to the inflation—allowances, subsidies, handouts, services—were stopgap reactions to what appeared to be a very concrete set of needs. Since money could do little to relieve the rampant hunger and poverty among social pensioners, the direct provision of goods and services appeared the most logical response. This, then, is how the three distinct forms of German social entitlement—contribution-based insurance (Versicherung), state-financed compensation (Versorgung), and means-tested welfare (Fürsorge)—were syncretized. In the face of mass poverty and universal suffering, the boundaries between entitlements that had been created decades earlier started to erode. The case of allowances is instructive here. First, pensions assumed a lesser value. Then, allowances were added to bring benefit levels up. Finally, the vicious cycle set in: inflation rose, the real value of pensions declined, allowances were raised, inflation rose, and so on. By the end, not pensions but allowances were what were keeping people alive (and barely, at that). As money became a less and less efficacious medium, however, goods and services retained, even increased, their value. Thus, it took welfare and compensatory assistance to salvage currency-based social insurance: municipal relief efforts and Reich allowances targeted the most needy, while social insurance and welfare consortia established a de facto network of comprehensive services. This merger of entitlements was an uneasy one at best. It signaled the extent to which no one form of assistance appeared worthy of the public trust. Instead, Weimar policymakers and citizens manipulated and invoked each form of entitlement to keep the others in check. The national pension law for disabled veterans offered a model of social justice that looked to citizenship as the sole criterion for entitlement, with the state as universal caretaker. Insurance, on the other hand, was argued to balance fairness with individual contribution and thereby promote personal responsibility. Needs-based welfare, finally, held out the promise of curbing the inflationary spiral of social claims imputed to the other two principles. This development reached its climax in the creation and subsequent fate of unemployment insurance. Wilhelmian lawmakers had considered accepting unemployment as a risk to be covered by workers’ insurance, but could never agree on how to redistribute the risk, finance the system, and select providers.127 Most unemployed had to turn to municipal poor relief and labor exchanges Page 230 → for assistance. Prompting mass layoffs in some industries and pronounced labor shortages in others, the mobilization of the German economy during World War I created even greater problems for traditional poor relief and the labor exchanges. As a response to pressure from trade unions and growing concerns about the postwar labor market, the government promulgated a “Decree on Welfare for the Unemployed” on 13 November 1918. While this regulation made some changes in public

assistance, the system remained locally administered, operating more in line with welfare than insurance principles.128 For the next eight and a half years, unemployment assistance was administered as a relief program.129 Even when a “provisional” unemployment-insurance program mandating premium payments was set up after currency stabilization in 1924, it nonetheless required passing a means test in order to receive benefits.130 Problems in administering this hybrid insurance-relief program, the Reich government’s interest in relieving itself of the costs associated with the program, and the rise of mass, chronic unemployment led officials to draft a proposal for unemployment-insurance legislation in 1925. Backed by the Reich Ministry of Labor, the “Labor Exchange and Unemployment Insurance Law” was eventually passed by a broad majority of 355 to 47 Reichstag representatives on 7 July 1927.131 Benefits were now contingent on having contributed to the fund and on proving oneself “able to work, willing to work, and involuntarily without work.” The law constituted an important departure from nineteenth-century social insurance in that, among other things, the new insurance was to cover a non-health-related risk.132 From 1929 onward, however, this more expansive understanding of social security was combined with a more restrictive understanding of its administration. Beset by fiscal problems, officials in the 1930s once again turned to means testing coupled with compulsory labor service in order to cut costs and reduce supposed abuses.133 Page 231 → The creation of unemployment insurance thus represents a Janus-faced portal in the history of German social insurance. By incorporating an entirely new class of risks, the new program testified to the heuristic power of insurance rationality. At the same time, unemployment persistently defied easy actuarial domestication. By insinuating means-testing features into its operation, unemployment insurance was also a reminder of the diffuse lack of faith in traditional social security that the postwar welfare state had helped generate. Such dissonant elements only made it easier to question just what social insurance had become. Page 232 → 1. An earlier version of this chapter appeared as “The Politics of Victimization: Social Pensioners and the German Social State in the Inflation of 1914–1924,” Central European History 26 (1993): 375–403. I wish to thank the journal for permission to reprint some of that material here. 2. Ludwig Preller, Sozialpolitik in der Weimarer Republik (Kronberg and Düsseldorf: Athenäum/Droste, 1978). 3. John Knodel, The Decline of Fertility in Germany, 1871–1939 (Princeton: Princeton University Press, 1974), 38–87. 4. On these policies and themes, see James Woycke, Birth Control in Germany, 1871–1933 (London and New York: Routledge, 1988); Lynn Hollen Lees, “Safety in Numbers: Social Welfare Legislation and Fertility Decline in Western Europe,” in The European Experience of Declining Fertility, 1850–1970: The Quiet Revolution, ed. John R. Gillis, Louise A. Tilly, and David Levine (Cambridge, Mass., and Oxford: Blackwell, 1992), 310–25; Usborne, Politics of the Body; Grossmann, Reforming Sex; Annette Timm, “The Politics of Fertility: Population Politics and Health Care in Berlin, 1919–1972” (Ph.D. diss., University of Chicago, 1999). 5. On child and juvenile care in the Weimar Republic, see the works of Harvey, Gräser, and Dickinson. 6. On the politics of the “new poverty,” see Thomas Childers, The Nazi Voter: The Social Foundations of Fascism in Germany, 1919–1933 (Chapel Hill and London: University of North Carolina Press, 1983); Gerald D. Feldman, The Great Disorder: Politics, Economics, and Society in the German Inflation, 1914–1924 (Oxford: Oxford University Press, 1993); Crew, Germans; Hong, Welfare; and Davis, Home. 7. His argument is laid out in Detlev Peukert, Grenzen der Sozialdisziplinierung: Aufstieg und Krise der deutschen Jugendfürsorge von 1878 bis 1932 (Cologne: Bund-Verlag, 1986). 8. Karl Christian Führer, “Für das Wirtschaftsleben ‘mehr oder weniger wertlose Personen.’ Zur Lage von Invaliden- und Kleinrentern in den Inflationsjahren 1918–1924,” Archiv für Sozialgeschichte, 30 (1990): 145–80; Crew, Germans, 89–115.

9. David Crew, “‘Wohlfahrtsbrot ist bitteres Brot.’ The Elderly, the Disabled and the Local Welfare Authorities in the Weimar Republic 1924–1933,” Archiv für Sozialgeschichte 30 (1990): 244–45. 10. Abelshauser, “Die Weimarer Republik.” 11. See, for example, Jürgen von Kruedener, “Die Überforderung der Weimarer Republik als Sozialstaat,” Geschichte und Gesellschaft 11 (1985): 358–76. The debate has been partly carried on within the wider debate over Knut Borchardt’s Wachstum, Krisen, Handlungsspielräume der Wirtschaftspolitik, translated as Perspectives on Modern German Economic History and Policy (New York: Cambridge University Press, 1991). 12. This research was sparked by the so-called Inflation Project of Gerald Feldman, Carl-Ludwig Holtfrerich, Gerhard Ritter, and Peter-Christian Witt. Gerald D. Feldman’s The Great Disorder impressively and comprehensively synthesizes this research. 13. Andreas Kunz, “Verteilungskampf oder Interessenkonsensus? Einkommensentwicklung und Sozialverhalten von Arbeitnehmergruppen in der Inflationszeit 1914 bis 1924,” in The German Inflation Reconsidered: A Preliminary Balance/Die deutsche Inflation: Eine Zwischenbilanz, ed. Gerald D. Feldman, Carl-Ludwig Holtfrerich, Gerhard A. Ritter, Peter-Christian Witt (Berlin and New York: Walter de Gruyter, 1982), 347–84; Kocka, Facing Total War; Gunther Mai, “‘Wenn der Mensch Hunger hat, hört alles auf.’ Wirtschaftliche und soziale Ausgangsbedingungen der Weimarer Republik (1914–1924),” in Die Weimarer Republik, ed. Abelshauser, 33–62. 14. Merith Niehuss, “Lebensweise und Familie in der Inflationszeit,” in Die Anpassung an die Inflation/The Adaptation to Inflation, ed. Gerald D. Feldman, Carl-Ludwig Holtfrerich, Gerhard A. Ritter, and PeterChristian Witt (Berlin and New York: Walter de Gruyter, 1986), 237–77. 15. Thomas Childers, “Inflation, Stabilization, and Political Realignment in Germany 1924 to 1928,” in German Inflation, ed. Feldman, et al., 418. See, too, his book The Nazi Voter. Of a similar view is Larry Eugene Jones, “In the Shadow of Stabilization: German Liberalism and the Legitimacy Crisis of the Weimar Party System, 1924–1930,” in Die Nachwirkungen der Inflation auf die deutsche Gechichte 1924–1933, ed. Gerald D. Feldman (Munich: Oldenbourg, 1985), 21–41, and German Liberalism and the Dissolution of the Weimar Party System, 1918–1933 (Chapel Hill: University of North Carolina Press, 1988). 16. Michael L. Hughes, “Economic Interest, Social Attitudes and Creditor Ideology: Popular Responses to Inflation,” in German Inflation Reconsidered, ed. Feldman, et al., 385–408, and Paying for the German Inflation (Chapel Hill and London: University of North Carolina Press, 1988). 17. Thomas Childers, “Interest and Ideology: Anti-System Politics in the Era of Stabilization, 1924–1928,” in Nachwirkungen, ed. Feldman, 1–19. 18. See Feldman, “Fate of Social Insurance,” for an overview. 19. Joseph A. Amato, Victims and Values: A History and a Theory of Suffering (New York: Praeger, 1990). 20. Whalen, Bitter Wounds; George L. Mosse, Fallen Soldiers: Reshaping the Memory of the World Wars (New York and Oxford: Oxford University Press, 1990). 21. Kathrin Hoffmann-Curtius, “Altäre des Vaterlandes: Kultstätten nationaler Gemeinschaft in Deutschland seit der Französischen Revolution,” Anzeiger des Germanischen Nationalmuseums (1989): 283–308; “Opfermodelle am Altar des Vaterlandes seit der Französischen Revolution,” in Schrift der Flammen: Opfermythen und Weiblichkeitsentwürfe im 20. Jahrhundert, ed. Gudrun Kohn-Waechter (Berlin: Orlando Frauenverlag, 1991), 57–92. 22. Hildegard Cancik-Lindemaier, “Opfersprache: Religionswissenschaftliche und religionsgeschichtliche Bemerkungen,” in Schrift der Flammen, ed. Kohn-Waechter, 38–56. 23. The Latin term sacrificium means “to make holy or sacred.” As Cancik-Lindemaier has pointed out, French, Italian, and English all retain the Latin distinction between sacrificium and victima. The German term Opfer, however, does not, thereby allowing for a great deal more permeability between its meanings. 24. Michael Jeismann and Rolf Westheider, “Wofür stirbt der Bürger? Nationaler Totenkult und Staatsbürgertum in Deutschland und Frankreich seit der Französischen Revolution,” in Der politische Totenkult: Kreigerdenkmäler in der Moderne, ed. Reinhart Koselleck and Michael Jeismann (Munich: Wilhelm Fink, 1994), 23–50. 25. Hubert and Mauss emphasize this reciprocal, contractual character of the relationship between sacrificer and the sacred:

[A]bnegation and submission are not without their selfish aspect. The [sacrificer] gives up something of himself, but he does not give himself. Prudently, he sets himself aside. This is because if he gives, it is partly in order to receive. Thus sacrifice shows itself in a dual light; it is a useful act and it is an obligation. Disinterestedness is mingled with self-interest. That is why it has so frequently been conceived of as a form of contract. Fundamentally there is perhaps no sacrifice that has not some contractual element. The two parties present exchange their services and each gets his due. For the gods too have need of the profane.

Henri Hubert and Marcel Mauss, Sacrifice: Its Nature and Functions (Chicago: University of Chicago Press, 1964), 100. 26. This, as Jay Winter effectively shows, was part of a more general European reaction to the war marked by sacred and apocalyptic appeals to traditional rituals, myths, and imagery. See Jay Winter, Sites of Memory, Sites of Mourning: The Great War in European Cultural History (Cambridge: Cambridge University Press, 1995). 27. On the importance of these politics in modern German history, see Greg Eghigian and Matthew Berg, eds., Sacrifice and National Belonging in Twentieth-Century Germany (College Station: Texas A&M University Press, forthcoming). 28. There is evidence that widows played a significant part in this movement. Social-pensioner politicalaction groups, however, were predominantly led by the disabled, with their programs centered chiefly on the latter’s concerns. While widows were admitted to most organizations, their inclusion as members was generally an extension of their late husbands’ insurance coverage. In this, social-pensioner organizations reproduced the gendered structure of social insurance by understanding women and children primarily as dependents. Future research on the role of widows in Weimar political culture, however, may tell a different story. 29. Niehuss, “Lebensweise,” 249. 30. BAP, Reichsarbeitsministerium (hereafter RAM), no. 4532, Landesversicherungsanstalt Berlin to RAM, 17 September 1920. 31. BAP, RAM, no. 4532, Franz Wagner to RAM, 7 October 1920. 32. BAP, RAM, no. 4547, Bl. 125–26, Robert Nagel to Preussischen Minister für Volkswohlfahrt, 1 September 1921. 33. BAP, RAM, no. 4533, Bl. 39–40, Pensionär- und Rentenempfänger-Verband Saarland to Reichstag, 20 July 1920. 34. BAP, RAM, no. 4532, Bundes-Vorstand des Invaliden-Bundes “Invalidenheil” der Arbeitsinvaliden Zwickau i. S. to Reichsregierung, 16 October 1920. 35. BAK, R89/11426, Robert Heupts, “Für eine Reform der Unfallgesetzgebung,” Volkszeitung, 28 April 1919. 36. BAK, R89/11426, Robert Heupts to RVA, 30 August 1920; Robert Heupts to RAM, 15 May 1921. The Civil Pension Recipients Association of Bochum remained a vigilant and active force in social-service politics right up until the occupation of the Ruhr in January 1923, consistently calling for the complete reform of social insurance and routinely petitioning insurance providers and the federal government on behalf of disabled individuals who were dissatisfied with their pension awards. For specifics, see BAK, R89 /11426. 37. A police report from 1920 states that the organization was founded in 1918, but I have been unable to find any evidence to confirm this. What is more likely the case, as it was reported by the Central Association itself, local pensioner groups began meeting directly after the war to discuss the possibility of forming a national organization. These talks, however, did not develop any further until 1920. 38. GStAKM, Rep. 191, no. 4032, Satzungen des Zentralverbandes der Invaliden und Witwen Deutschlands, beschlossen auf der Reichskonferenz in Essen am 24.–26. Juli 1920. 39. GStAKM, Rep. 191, no. 4032, Hauptvorstand, Zentralverband der Invaliden und Witwen Deutschlands,

Rundschreiben an die Ortsgruppen-Vorstände, August 1920. 40. Michael Geyer, “Ein Vorbote des Wohlfahrtstaates: Die Kriegsopferversorgung in Frankreich, Deutschland und Großbritannien nach dem Ersten Weltkrieg,” Geschichte und Gesellschaft 9 (1983): 230–77. 41. Crew, Germans, 102. 42. GStAKM, Rep. 191, no. 4032, Deutsche Invaliden-Zeitung: Organ des Zentralverbandes der Invaliden und Witwen Deutschlands, November 1920. 43. GStAKM, 120 BB, VIII 8, no. 1, vol. 1, Reichskanzler to sämtliche Bundesregierungen in Preussen, die Herren Minister für Handel und Gewerbe und für Landwirtschaft, Domänen und Forsten, und den Herrn Statthalter in Elsass-Lothringen, 28 December 1917. 44. GStAKM, 120 BB, VIII 8, no. 1, vol. 1, Staatssekretär des Reichsarbeitsamt to sämtliche Regierungen, 26 November 1918. 45. Jürgen Reulecke, “Auswirkungen der Inflation auf die städtischen Finanzen,” in Nachwirkungen, ed. Feldman, 97–116; Norbert Ranft, “Erwerbslosenfürsorge, Ruhrkampf und Kommunen: Die Trendwende in der Sozialpolitik im Jahre 1923,” in Anpassung, ed. Feldman, et al., 163–201; Dieter Langewiesche, “‘Staat’ und ‘Kommune’: Zum Wandel der Staatsaufgaben in Deutschland im 19. Jahrhundert,” Historische Zeitschrift 248 (1989): 621–35. Municipalities assumed major responsibilities for administering, among other things, Kriegswohlfahrtspflege, compulsory measures of the war economy, and demobilization regulations. 46. Among other things, disabled groups requested that local government officials provide additional allowances for pensioners, add invalid representatives to welfare boards, double the pocket money given to poorhouse residents, create a separate department for the disabled in municipal labor exchanges, and subsidize clothes and shoes, and, in the winter, potatoes, bread, milk, and fuel. BAP, RAM, no. 4532, Invalidenbund “Invalidenheil,” Ortsgruppe Reichenbach to Stadtrat of Reichenbach, 1 April 1920; Zentralverband der Arbeitsinvaliden Deutschlands, Gau Sachsen, Ortsgruppe Gross-Dresden to Stadtverordneten-Kollegium, 24 April 1920; Zentralverband der Arbeitsinvaliden Deutschlands, Gauleitung Sachsen to (Stadtrat Bautzen), 13 July 1920; GStAKM, Rep. 191, no. 4032, Zentralverband der Invaliden und Witwen Deutschlands, Entwurf einer Eingabe für Ortsgruppen to städtische Behörden, ca. August–November 1920. 47. BAP, RAM, no. 9132, Bl. 5–9, Deutscher Verein für öffentliche und private Fürsorge. Fachausschuss für städtisches Fürsorgewesen to Ministerialrat Dr. Karstedt, 19 October 1920; GStAKM, 120 BB, VIII 8, no. 1, vol. 2, Deutscher Verein für Armenpflege und Wohltätigkeit, Sitzung des Hauptausschusses, 28 October 1920. 48. BAP, RAM, no. 4532, Mayors of cities of Reichenbach, Mylau, and Netzschkau to Reichsministerium der Finanzen, 11 May 1920; Magistrat der Stadt Bernburg to Staatsrat für Anhalt, 19 June 1920. 49. BAP, RAM, no. 4533, Bl. 36–7, Franz Josef Kohl to Reichstag, 6 July 1920. 50. BAP, RAM, no. 4535, Verband der deutschen landwirtschaftlichen Berufsgenossenschaften to RAM, 9 June 1921; Verband der Deutschen Berufsgenossenschaften to RAM, 11 June 1921. 51. Figures come from Gordon A. Craig, Germany, 1866–1945 (New York: Oxford University Press, 1978), 450. 52. BAP, RAM, no. 4534, Vorstand, Vereinigung der deutschen Bauernvereine to RAM, 10 August 1921. 53. BAP, RAM, no. 4547, Bl. 251–54, “Mehr Hilfe den Sozialrentnern!” Der Ratgeber für soziale Praxis: Zeitschrift für Invaliden, Unfallbeschädigte und deren Hinterbliebenen 1 (1 August 1921). 54. BAP, RAM, no. 9132, Bl. 56, “Protestversammlung der Arbeiter-Invaliden,” Hamburger Echo 415 (6 September 1921). 55. BAP, RAM, no. 4547, Bl. 20–7, RAM, Brauns to Reichskanzler, Reichsminister der Finanzen Wirth, 15 September 1921. 56. BAP, RAM, no. 4547, Bl. 79–81, Reichsfinanzminister Wirth to Reichsarbeitsminister Brauns, 29 September 1921. 57. GStAKM, Rep. 151, IC, no. 12019, Reichsarbeitsminister Brauns to Staatssekretär in der Reichskanzlei, 8 October 1921. The sums were 2,500 marks for invalids, 2,000 marks for widows, and 1,000 marks for orphans. 58. GStAKM, Rep. 151, IC, no. 12019, Preussischer Minister für Volkswohlfahrt to Ministerpräsidenten, 22

October 1921. 59. GStAKM, Rep. 151, IC, no. 12019, Vorstand, Deutscher Städtetag to Reichsrat and Reichswirtschaftsrat, 31 October 1921. 60. GStAKM, Rep. 151, IC, no. 12019, Vorläufiger Reichswirtschaftsrat, “Antrag zu dem Entwurf eines Gesetzes über Notstandsmassnahmen zur Unterstützung von Empfängern von Renten aus der Invalidenversicherung,” 2 November 1921; GStAKM, 120 BB, VIII 8, no. 1, vol. 2, Verband der deutschen landwirtschaftlichen Berufsgenossenschaften to Staatsminister Dr. von Trott zu Solz, Mitglied des Reichsrats, 15 November 1921; Verband der deutschen landwirtschaftlichen Berufsgenossenschaften to Reichsarbeitsminister, 29 November 1921; BAP, RAM, no. 9132, Bl. 62–4, Zentralverband der Invaliden und Witwen Deutschlands to Sozialpolitischen Ausschuß des Reichstags, ca. 26 November 1921. 61. GStAKM, Rep. 191, IC, no. 12019, signed “Viele tausend Invaliden und Altersrentner” to (Prussian) Finanzministerium, 5 January 1922. See also the scores of letters from individual accident pensioners over the course of 1922 in BAP, RAM, no. 4536. 62. BAP, RAM, no. 9132, Bl. 72, Zentralverband der Invaliden und Witwen Deutschlands to RAM, 20 February 1922. 63. GStAKM, Rep. 191, IC, no. 12019, Reichsstädtebund to Preussischen Finanzministerium, 10 April 1922. 64. BAP, RAM, no. 4549, Bl. 478–79, Reichsminister der Finanzen Hermes to Reichsarbeitsminister Brauns, 16 March 1922. 65. BAP, RAM, no. 4549, Bl. 130, Vorsitzender, Sächsische Invalidenrentner-Vereinigung (Chemnitz) to Reichstag, 1 June 1922. 66. BAP, RAM, no. 4549, Bl. 137, Steuerfreie Sächsische Invaliden-Vereinigung Gross-Dresden und Umgegend to Reichsregierung, ca. June 1922. 67. BAP, RAM, no. 4549, Bl. 132, Sächsische Invalidenrenter-Vereinigung (Chemnitz) to RAM, 24 August 1922. 68. BAP, RAM, no. 9132, Bl. 78, J. Lüneburg, Zentralverband der Invaliden und Witwen Deutschlands to Reichsverband der Deutschen Industrie, 9 August 1922. 69. BAP, RAM, Nr. 4548, Bl. 120, Verband der Arbeitsinvaliden (Düsseldorf) to RAM, 10 July 1922; Nr. 4549, Bl. 121, Zentralverband der Invaliden und Witwen Deutschlands to Reichsernährungsminister, 20 November 1922; no. 4550, Bl. 311, Arbeiter-Sekretariat Rosenheim and Zentralverband der Invaliden und Witwen Deutschlands, Ortsgruppe Kolbermoor to Reichstag, 5 March 1923. 70. BAP, RAM, no. 9132, Bl. 75–6, “Unser erster Verbandstag,” Deutsche Invalidenzeitung 7 (July 1922). 71. BAP, RAM, no. 9132, Bl. 95–7, Niederschrift über die Verhandlungen betr. Anfkauf von Schuhwaren seitens des Zentralverbandes der Invaliden und Witwen Deutschlands in Berlin, 5 December 1922. 72. BAP, RAM, no. 4533, Bl. 164–65, Zentralverband der Invaliden und Witwen Deutschlands, Gau Sachsen to RAM, 28 November 1922. 73. BAP, RAM, no. 4550, Bl. 312, Zentralverband der Invaliden und Witwen Deutschlands, Gau Sachsen to Reichstag, 19 March 1923. 74. GStAKM, Rep. 191, IC, Nr. 12019, Bericht über Besprechung im Ministerium für Volkswohlfahrt am 27. April 1922. It was all to no avail; by the end of the year, Prussia too was contributing to the effort. 75. BAP, RAM, no. 4536/1, Verband der deutschen landwirtschaftlichen Berufsgenossenschaften to RAM, 8? September 1922; Verband der deutschen Berufsgenossenschaften to RAM, 20 September 1922; GStAKM, 120 BB, VIII 8, no. 1, vol. 2, Entschliessung des 33. ordentlichen Berufsgenossenschaftstages des Verbandes der Deutschen Berufsgenossenschaften in Bonn am 13./14. September 1922. For 1923, see BAP, RAM, nos. 4537, 4537/1, 4538. 76. GStAKM, Rep. 191, IC, no. 12019, Verband der Deutschen Landkreise to Reichstag and Fraktionen des Reichstags, 6 February 1923; BAP, RAM, no. 4549, Bl. 389, RAM to Regierungen der Länder (Sozialministerien), 6 March 1923; no. 4550, Bl. 678, Zentralverband der Invaliden und Witwen Deutschlands to Preussischen Minister für Volkswohlfahrt, 27 June 1923. 77. BAP, RAM, no. 4550, Bl. 239, Reichsminister für Ernährung und Landwirtschaft to RAM, 19 June 1923. 78. BAP, RAM, no. 4550, Bl. 98, Deutscher Verein für öffentliche und private Fürsorge to RAM, 21 April 1923.

79. BAP, RAM, no. 4550, Bl. 475–77, Vorstand, Deutscher Städtetag to RAM, 25 June 1923. Such a system, the board insisted, would not require centralizing administration. On the contrary, municipalities could be assigned the task of administering welfare at the local level, while it would be left up to the national level to agree on general standards and aims. 80. GStAKM, 120 BB, VIII 8, no. 1, vol. 2, Reichsarbeitsminister Brauns to Regierungen der Länder, 3 July 1923. 81. BAP, RAM, no. 4552, Bl. 218–19, RAM to Sozialministerien der Länder, 29 August 1923; no. 4550, Bl. 547–48, RAM to Reichsminister der Finanzen, 3 September 1923; no. 4552, Bl. 282, Bürgermeister, Rat der Stadt Leipzig (Fürsorgeamt) to Sächsisches Arbeitsministerium, 29 September 1923. 82. BAP, RAM, no. 4550, Bl. 686, Vorsitzender, Sächsische Invalidenrentnervereinigung Chemnitz to Reichstag, 11 October 1923. 83. BAP, RAM, no. 4551, Bl. 14, Hessisches Ministerium für Arbeit und Wirtschaft to RAM, 25 October 1923. 84. BAP, RAM, no. 4590, Bl. 23–24, RAM to Reichsminister der Finanzen, 10 December 1923. 85. Martin H. Geyer, “Soziale Rechte im Sozialstaat: Wiederaufbau, Krise und konservative Stabilisierung der deutschen Rentenversicherung 1924–1937,” in Arbeiter im 20. Jahrhundert, ed. Klaus Tenfelde (Stuttgart: Klett-Cotta, 1991), 407–11. 86. BAP, RAM, Nr. 4590, Bl. 90, Vorläufiger Reichswirtschaftsrat to RAM, 4 February 1924. 87. BAP, RAM, Nr. 4590, Bl. 116–31, Handelskammer zu Chemnitz to RAM, 8 February 1924. 88. BAP, RAM, Nr. 4590, Bl. 91, President of the Reichstag Löbe to Reichsminister der Finanzen, 14 February 1924. This proposal was specifically rejected by the Labor Ministry as untenable. Nr. 4590, Bl. 135, RAM to gesamte Presse, 29 March 1924. 89. BAP, RAM, Nr. 4590, Bl. 176–85, Regierungsobersekretär Kucharski, “Zusammelegung, Vereinfachung und Verbilligung der Sozialversicherung,” 18 July 1924. 90. BAP, RAM, Nr. 4552, Bl. 409, Zentralverband der Invaliden und Witwen Deutschlands, Ortsgruppe Bremen to Sozialpolitischen Ausschuß des Reichstags, 8 February 1924. 91. BAP, RAM, Nr. 4552, Bl. 60–62, Preußischer Minister für Volkswohlfahrt to RAM, 6 January 1924. 92. BAP, RAM, Nr. 4552, Bl. 402, Zentralverband der Invaliden und Witwen Deutschlands, Ortsgruppe Kulmbach to [Reichstag], 27 January 1924. 93. BAP, RAM, Nr. 4552, Bl. 405, Zentralverband der Invaliden und Witwen Deutschlands, Ortsgruppe Stettin to Reichstag, 6 February 1924. 94. BAP, RAM, Nr. 4552, Bl. 412–13, Zentralverband der Invaliden und Witwen Deutschlands, Ortsgruppe Lockwitz to Reichstag, 10 February 1924; see also Ortsgruppe Hildesheim to Reichstag, 3 February 1924. 95. BAP, RAM, Nr. 4552, Bl. 401, Sächsische Invalidenrentner-Vereinigung, Chemnitz to Reichstag, 23 January 1924. 96. BAP, RAM, Nr. 4592, Bl. 100–101, Reichsverband der deutschen land- und forstwirtschaftlichen Arbeitervereinigungen to RAM, 17 January 1924. 97. See the various letters of employer associations in BAP, RAM, Nrs. 4592 and 4593. 98. BAP, RAM, Nr. 4590, Bl. 84–89, Deutschnationale Krankenkasse to RAM, 25 February 1924. 99. BAP, RAM, Nr. 4592, Bl. 106–12, Verband der Beamten und Angestellten der Reichsunfallversicherung to RAM, 24 January 1924. 100. This typically involved asking for and collecting suggestions and advice, arranging meetings, and brokering agreements between insurers and welfare providers. See BAK, R89/6709. 101. BAK, R89/13641, Rheinische Vereinigung berufsgenossenschaftlicher Verwaltungen to angeschlossenen Verwaltungen, 25 November 1913. 102. BAK, R89/6944, Hermann Klammer, “Ist eine freie Vereinigung aller Versicherungsträger in Westfalen angezeigt?” 10 February 1918. 103. BAP, RAM, Nr. 4542, Vereinigung berufsgenossenschaftlicher Verwaltungen für Groß-Berlin und Provinz Brandenburg to RAM, 15 December 1919. 104. BAP, RAM, Nr. 4542, Dr. Hans Boywidi to RAM, 22 January 1920. 105. BAK, R89/6934, Satzung der Arbeitsgemeinschaft von Reichsversicherungsträgern Groß-Berlins, 20 March 1920. 106. BAK, R89/6945, Niederschrift über die Verhandlungen der 1. ordentlichen Mitgliederversammlung

der Arbeitsgemeinschaft der Sozialversicherung und Wohlfahrtspflege für Hessen-Nassau am 15. Juli 1920 zu Wiesbaden. 107. As Hong points out, however, they did this for very different reasons: socialists hoped to fashion a universalist welfare state, while progessives sought a standardized social security state and Christian charities a welfare system firmly grounded in the principle of subsidiarity. Hong, Welfare, 44–75. 108. BAK, R89/11421, Arbeitsgemeinschaft für Neuordnung der Sozialversicherung to RVA, 29 April 1921; BAP, RAM, Nr. 4542, RAM to Regierungen der Länder, 12 April 1920; BAP, RAM, Nr. 4542, Dr. Pölligkeit, “Ziele und Wege für ein ergänzendes Zusammenwirken der Träger der Sozialversicherung mit der öffentlichen und privaten Wohlfahrtspflege.” Gemeinsamer Ausschuß für Neuregelung der gesetzlichen Wohlfahrtspflege, 1 November 1921. 109. BAP, RAM, Nr. 4545, Bl. 1, Mündlicher Bericht des Ausschußes für den Haushalt . . . für Rechnungsjahr 1922, 8 April 1922. 110. BAP, RAM, Nr. 4590, Bl. 29–31, Reichsarbeitsminister Brauns to Staatssekretär Dr. Lewald, 29 January 1924. 111. Franz Josef Stegmann, “Geschichte der sozialen Ideen im deutschen Katholizismus,” in Geschichte der sozialen Ideen in Deutschland, Wilfried Gottschalch, Friedrich Karrenberg, and Franz Josef Stegmann (Munich and Vienna: Günter Olzog, 1969), 325–482. On the internal sources of this interest in cohesion within the Center Party, see Eberhard Pies, “Sozialpolitik und Zentrum 1924–1928: Zu den Bedingungen sozialpolitischer Theorie und Praxis der Deutschen Zentrumspartei in der Weimarer Republik,” in Industrielles, ed. Mommsen, et al., 259–70. 112. Heinrich Brauns, Katholische Sozialpolitik im 20. Jahrhundert: Ausgewählte Aufsätze und Reden (Mainz: Matthias-Grünewald, 1976), 87. 113. Hubert Mockenhaupt, Weg und Wirken des geistlichen Sozialpolitikers Heinrich Brauns (Paderborn: Ferdinand Schöningh, 1977). 114. BAP, RAM, Nr. 4545, Bl. 29–49, Stellungnahme des Abt. IX RAM zu Reichstagsentschließung vom 19. Mai 1922 und Leitsätze, 13 December 1922; RAM, Nr. 4545, Bl. 58–76, Neiderschrift über die Sitzung vom 13. Januar 1923 im Reichsarbeitsministerium; RAM, Nr. 4552, Bl. 206, RAM to Abteilung II, 13 March 1924; RAM, Nr. 4552, Bl. 430–32, Memorandum from Abteilung II, RAM, “Die Fürsorgepflichtverordnung,” 4 December 1924. 115. BAP, RAM, Nr. 4604, Bl. 67–72, Speech of Ministerial Director Grieser, “Zur Reform der Sozialversicherung,” Kölner Tagung der Gesellschaft für soziale Reform, ca. early 1925. 116. See the consortium’s annual reports between 1925 and 1929 in BAK, R89/6934. 117. GStAKM, Rep. 120 BB, VIII 8, Nr. 2, Bd. 1, Vorläufiger Reichswirtschaftsrat, Sitzung des Arbeitsausschußes für die Reform der sozialen Versicherungsgesetze am 22. April 1927; Bd. 2, Vorläufiger Reichswirtschaftsrat, Bericht des Arbeitsausschußes für die Reform der sozialen Versicherungsgesetze, 10 March 1928. 118. BAK, R89/6697, Richtlinien über das Zusammenwirken der Träger der Kranken-, Invaliden- und Angestelltenversicherung auf dem Gebiet der Gesundheitsfürsorge für tuberkulöse und geschlechtskranke Versicherte, ca. 1926. 119. See, for example, BAK, R89/6947, Stenographischer Bericht über die Mitgliederversammlung der Arbeitsgemeinschaft von Reichsversicherungsträgern der Rheinprovinz, 26 June 1926. 120. BAK, R89/13646, Krankenkassen-Abkommen, 31 December 1926. 121. On the corporatist trends in German political culture at this time, see Charles S. Maier, Recasting Bourgeois Europe: Stabilization in France, Germany, and Italy in the Decade after World War I (Princeton: Princeton University Press, 1975); Werner Abelshauser, “The First Post-Liberal Nation: Stages in the Development of Modern Corporatism in Germany,” European History Quarterly 14 (1984): 285–318. 122. J.H.M. Beattie, “On Understanding Sacrifice,” in Sacrifice, ed. M.F.C. Bourdillon and Meyer Fortes (London: Academic, 1980), 33. 123. In this regard, see the canonical works of Eric J. Leed, No Man’s Land: Combat and Identity in World War I (Cambridge and New York: Cambridge University Press, 1979); Robert Wohl, The Generation of 1914 (Cambridge: Harvard University Press, 1979); Jeffrey Herf, Reactionary Modernism: Technology, Culture, and Politics in Weimar and the Third Reich (Cambridge and New York: Cambridge University Press, 1984); Modris Eksteins, Rites of Spring: The Great War and the Birth of the Modern Age (New York:

Anchor, 1989). 124. Victor W. Turner, The Drums of Affliction: A Study of Religious Processes among the Ndembu of Zambia (Ithaca: Cornell University Press, 1981), 270–77; Michael Geyer, “The Stigma of Violence, Nationalism, and War in Twentieth-Century Germany,” German Studies Review, special issue (Winter 1992): 75–110. 125. Feldman, Great Disorder, 858. Feldman’s use of the term “civilization” here appears to be playing on the oppositions culture/nature and order/anarchy. Any number of criticisms can be and have been waged against uncritically equating “civilization” with the achievements of “culture” and “order,” while casting off National Socialism as the barbaric interloper. See, for example, Zygmunt Bauman, Modernity and the Holocaust (Ithaca: Cornell University Press, 1989). In any event, I see no evidence in Weimar politics of a turn away from the symbol-, value-, or order-making that Feldman’s contention seems to imply. 126. In this, I agree with Richard Bessel in emphasizing that the social crises of the Weimar Republic were widely perceived in moral terms. See Richard Bessel, Germany after the First World War (New York and Oxford: Oxford University Press, 1993). 127. Faust, Arbeitsmarktpolitik, 131–92. 128. Ibid., 245–65 and Karl Christian Führer, Arbeitslosigkeit und die Entstehung der Arbeitslosenversicherung in Deutschland 1902–1927 (Berlin: Colloquium, 1990), 119–43. 129. Richard J. Evans, “Introduction: The Experience of Unemployment in the Weimar Republic,” in The German Unemployed: Experiences and Consequences of Mass Unemployment from the Weimar Republic to the Third Reich, ed. Richard J. Evans and Dick Geary (New York: St. Martin’s, 1987), 1–22; Merith Niehuss, “From Welfare Provision to Social Insurance: The Unemployed in Augsburg, 1918–1927,” in German Unemployed, ed. Evans and Geary, 44–72. 130. Naoki Fukuzawa, Staatliche Arbeitslosenunterstützung in der Weimarer Republik und die Entstehung der Arbeitslosenversicherung (Frankfurt: Peter Lange, 1995), 171–208. 131. Only significant numbers of Communist, Nazi, and German National delegates voted against the bill. Ibid., 233–77; Peter Lewek, Arbeitslosigkiet und Arbeitslosenversicherung in der Weimarer Republik, 1918–1927 (Stuttgart: Franz Steiner, 1992), 199–255, 328–67. 132. Anselm Faust, “Von der Fürsorge zur Arbeitsmarktpolitk: Die Errichtung der Arbeitslosenversicherung,” in Die Weimarer Republik, ed. Abelshauser, 260–79. 133. B. Weisbrod, “The Crisis of German Unemployment Insurance in 1928–1929 and Its Political Repercussions,” in Emergence, ed. Mommsen, 188–204; Peter D. Stachura, “Introduction: The Development of Unemployment in Modern German History,” in Unemployment and the Great Depression in Weimar Germany, ed. Peter D. Stachura (New York: St. Martin’s, 1986), 1–28; Heidrun Homburg, “From Unemployment Insurance to Compulsory Labour: The Transformation of the Benefit System in Germany, 1927–1933,” in German Unemployed, ed. Evans and Geary, 73–107.

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CHAPTER 7 The Rise of the Degenerative Welfare State: A Genealogy of the Backlash against Weimar Social Policy, 1889–1933 In the wake of the unemployment insurance law, criticism of German social policy rose to a crescendo. Between 1927 and 1933, government officials, policy analysts, and social-service professionals engaged in an acrimonious public debate over the shortcomings and future of the welfare state. Historians of German social welfare have awarded this debate a prominent place in the history of Weimar politics. Generally discussed as a product of both “the struggle between worldviews” (Weltanschauungskampf) and the growing support for eugenics during the Weimar Republic, the concerted backlash against the German welfare state is commonly treated only as a precursor to Nazi authoritarianism and racism. This perspective, however, assumes too narrow a context. Criticisms of German social insurance in particular did not first emerge in the second half of the 1920s, but rather were present since the very founding of the system. Moreover, while eugenicists did criticize the German welfare state even before the Weimar Republic, such attacks never merited serious consideration by the social-insurance community. Why then did such criticisms only first find a receptive mass audience in the late 1920s and early 1930s? What did earlier criticisms have to do with later ones? It is my interest in this chapter to stake out a terrain for historical investigation that has only rarely received attention in and of itself: the history of social-policy retrenchment and backlash. The rash of faultfinding with Weimar social insurance, I argue, relied on the very same idiom that policymakers and social pensioners had used to promote and defend the system. Social insurance and the entitlement politics to which it gave birth not only gave voice and form to the expansion and inflation of entitlements, but Page 234 → also to the ridicule and dismantling of those entitlements. Attacks on German social policy were therefore as much a constituent element of the welfare state as they were a response to it. The backlash against Weimar social security can be traced back to a late-nineteenth-century, but continuing, debate over the causes and consequences of a bizarre phenomenon: the so-called pension neurosis or pension hysteria (Rentenneurose, Rentenhysterie).1 In 1889 the Reich Insurance Office recognized the existence of the traumatic neurosis as a compensable illness. Thirty-seven years later, the same institution introduced a principle of entitlement that all but eliminated bureaucratic recognition of the illness. The “traumatic neurotic”—or “pension neurotic,” as one suffering from such an illness was called in policy and medical parlance—could manifest a number of symptoms, including hysterical paralysis, shakes, dizziness, hypochondria, fatigue, sleeplessness, disturbances in movement, disturbances in mood, and heart palpitations. Claiming their afflictions were the result of occupational accidents, such neurotics sought compensation from accident-insurance boards in the form of pensions. Representing by most critics’ estimates no more than 1 to 2 percent of all accident pension claims, they hardly constituted a numerical or financial threat to the system. Nevertheless, in the years between 1889 and 1926 the debate over the pension neurosis preoccupied social insurance and the interests within it. What was it about this illness that led to such intense disagreement? The debate over pension neurosis focused in one place the fears, expectations, and politics that have been discussed in previous chapters. In the phenomenon of “pension hysteria”—a term used by contemporaries to refer both to the neurosis and to the purported mass demand for pensions among the working population—the troubles and frustrations of disability compensation and rehabilitation converged: distrust of certifying physicians and rehabilitation services, concerns about worker politicization and fraud, anxieties over lost labor power. Debates over sickness insurance, disability insurance, care for the war-disabled, and welfare all collided. Within thirty years, the pension neurosis phenomenon transformed itself from one in a catalogue of problems plaguing socialinsurance administration into the very emblem of all the ills, paradoxes, and conflicts inherent in modern German social security. In the final years of the Weimar Republic, conservative, liberal, and eugenic detractors of social policy presented the figure of the neurotic male worker as evidence of the degenerative, emasculating character of

the welfare state. While differing in particulars, opponents shared a common notion of remedy: greater deterrence Page 235 → and discipline in administration and greater heroic self-sacrifice on the part of citizens. The ambition of Weimar critics of social welfare was to make the German welfare state regenerative. This, of course, was one of the original aims of the social-security system, and one which the National Socialists too later came to appropriate and redefine. The Traumatic Neurosis in Early Social Insurance As a clinically defined object, “neurosis” in the second half of the nineteenth century was a relatively permeable diagnosis. Indeed, it comprised a host of other, equally porous, diagnoses, all of which potentially bled into one another, making them often interchangeable to those individuals who employed them. Most clinicians since the 1840s had accepted neurosis as a so-called functional nervous disease, “a disruption of nervous function in which an anatomical lesion was lacking.”2 The definition proved to be generous in its inclusiveness, as it could embrace not only the symptoms of hysteria (fits, paralyses, various aches and pains), dissociation (somnambulistic and catatonic states), neurasthenia (chronic fatigue, headaches, insomnia, loss of sensation, recurrent indigestion), and hypochondria, but those of delirium tremors, epilepsy, chorea, goiter, and tetanus as well.3 While any number of physicians and laypeople were inclined to associate certain of these maladies with women and girls (hysteria) and others with men (neurasthenia), clinicians nonetheless tended to assign the above diagnoses both to females and males.4 Neurosis in its hysteric, neurasthenic, and hypochondriacal forms was not new to the institutional world of insurance when it made its appearance in social insurance in the mid-1880s. In the last third of the nineteenth century, a group of diagnoses sharing a common etiology found their way into European and American medical parlance. The chief cause of the affliction was believed to be some kind of physical and emotional shock. Most commonly called “railway spine” or “traumatic neurosis” (traumatische Neurose), these medical concepts were developed between the mid-1860s and the late 1880s, during the same period as the first railway-accident laws were being promulgated in England and Germany. Under these laws, physical injuries due to railway accidents were deemed compensable. Soon after their implementation, however, a Page 236 → growing number of liability claims were made against the railway companies in which various nervous ailments were cited as resulting from accidents. Basing their views on this experience with accident casualty claims, physicians linked these nervous ailments to the traumatic shock that accompanied industrial accidents.5 By the time Hermann Oppenheim published his classic essays on the subject in 1888 and 1889, the notion of compensable traumatic neuroses enjoyed solid support within the medical community. This support was nevertheless tempered, and numerous renowned experts from 1879 onward expressed their skepticism about the genuine existence of the traumatic neurosis, seeing the phenomenon more as a case of malingering than a medical ailment.6 Upon confronting their first cases of traumatic neurosis, accident insurers adopted a highly skeptical posture. “We are fully aware of the consequences of a phenomenon which, since the introduction of worker insurance laws, is showing up in more and more numerous cases, and unmistakably exerts its influence to the detriment of industry,” noted the organ of the accident-insurance administrations in 1893.7 As a principle, insurance boards viewed such nervous conditions as little more than a wave of mass malingering. These traumatic neuroses—by 1900, being pegged by critics “pension neuroses”—were thus conceived by insurance providers as intimately linked to what was seen as a prevailing aversion to work (Arbeitsscheu) among laborers. As such, insurers vigorously fought their recognition as compensable afflictions. Nevertheless it was not possible for accident-insurance administrators to simply adopt a blanket policy of rejection for all pension neurosis claims. Precedents had been set since the railway laws of 1871, and the Reich Insurance Office in 1889 recognized the existence of traumatic neuroses as deserving of accident-insurance compensation.8 Instead, insurance boards were forced to take on each case individually. This translated into an overall environment in which pensions were granted rarely and then only grudgingly, while insurance appellate courts were continually plagued with pension neurosis claims. An overview of the court records of the Reich Insurance Office dealing with pension neuroses in the years 1889–1911 shows that most were cases in which the insurance board rejected the claim of the insured on the grounds of a probable case of feigned symptoms, Page 237 →

exaggeration, or outright malingering.9 The interest of insurance providers in limiting the number and costs of pension neurosis claims was demonstrated in a number of other ways as well. They regularly made use, for example, of their right to diminish or completely revoke pensions in many such cases, frequently citing an improvement in condition.10 Insurance boards also fought to limit the size of pensions for neurotics, consistently opposing the appeals of insured workers for full instead of partial pensions.11 In justifying such lower pensions, the Silesian Textile–Accident Insurance Board, for example, in one case quoted an Imperial Court report stating “that by providing a pension that is not so high, a healthy [heilsamer] pressure is exerted on the claimant to find and accept gainful employment, which, from our experience, constitutes the best remedy for those injured through accident with nervous disturbances”—a common sentiment among accident insurers.12 Lastly, the insurance boards fought attempts by claimants to acquire higher pensions on account of the worsening of their nervous conditions. Here insurers either denied the existence of a deterioration or rejected a causal link between the new symptom and the original accident.13 In thus employing the same procedural strategies they commonly used on all other forms of disability, the accident-insurance administrators sought to restrict bureaucratic recognition of the pension neurosis and thereby nullify what they could only view as a threat to work values. For their part, self-proclaimed traumatic neurotics proved as unwilling to accept the decisions of insurance boards and certifying physicians as their physically debilitated counterparts. Many employed the services of lawyers, with varying degrees of success. Challenged with the reports of medical officers, they arranged for their own medical reports or demanded reports from local physicians whom they already knew.14 Awarded partial pensions, they demanded full pensions.15 Confronted with pension reductions, claimants argued Page 238 → that the prognosis for their nervous ailment was worse than insurance-board physicians contended.16 Likewise they did not hesitate to take providers to court months or even years after the initial decision in order to acquire a higher pension in recognition of their deteriorated condition.17 The Debate over the “Rentenkampfneurose” Having already discussed the general litigiousness of accident insurance, the views and actions of insurance boards and pension neurosis claimants should strike a familiar chord. The politics of pension neurosis claims in this regard differed little from those accompanying the other disability and invalidity claims. Around the time of the Reich Insurance Ordinance (1908–11), however, the debate surrounding traumatic neuroses took a decidedly different turn. By 1911, insurance courts were and were perceived to be overburdened. Individual chambers alone were leaving hundreds of cases undecided each year. Despite being unable to keep pace with the workload, judges were pressured by superiors to take on even more cases. Individual jurists rejected such proposals as preposterous. As one Düsseldorf judge put it to his superior:

The belief of Herr Regierungs-Präsident in the decree of 12 February of this year—that with a five-hour work day a presiding judge can settle 60 cases a week—is something that I consider to be impossible in practice. If only for the reason that of the given 30 weekly hours of work, at least 10 hours go to holding the hearings themselves and to evidentiary appointments [Beweistermine], so that for the 60 cases per week, only 20:60 hours or 20 minutes would remain, having to suffice for the entire settlement of the individual case. I consider it out of the question that such a presiding judge can familiarize himself even to a limited extent with the contents of the records.18

In this environment of intense litigiousness, overworked courts, and complex, esoteric laws, the pension-hearing process began to take on downright Kafkaesque qualities. The pension neurosis case of the coachman L. H. Jürgens Page 239 → provides a paradigmatic example. In 1893 Jürgens appealed a decision of the Arbitration Court for Workers’ Insurance for Section VI of the Brewery and Malt Works–Accident Insurance Board. In so doing, he submitted a medical report that confirmed he was totally incapable of earning a living as a result of a traumatic neurosis. The Reich Insurance Office, for its part, sent him to the New General Hospital in Hamburg for observation and examination between 24 August and 26 September 1893. Here Dr. Fränkel examined him and

filed a report with insurance-office judges on 27 September. He then enlisted the aid of Dr. Schede, who in turn submitted a medical report of his own. The two of them recommended that Jürgens be cared for through poor relief. In the meantime, however, the Reich Insurance Office had received a report from Dr. Reinhard on 25 September stating that none of the medical consequences of the accident were verifiable. The office then sent Jürgens to still another clinic for further observation between 23 December 1893 and 30 January 1894. Here Drs. Krüger, Oehrens, Rülans, Wahncan, and Erman all monitored and examined the claimant. They reported that Jürgens was “physically and psychologically healthy” and that his sickness was simply feigned. Jürgens now introduced evidence calling Dr. Erman’s report into question. Owing to this new information, the Reich Insurance Office once again decided to send Jürgens to a clinic for observation, the General Poor Relief Institute in Hamburg. This, however, was finally prohibited by Drs. Schede and Rautenberg on 20 May 1894 due to the fact, they said, that Jürgens’ condition made him “unable to travel.” 19 With experiences such as this it is perhaps not surprising that many claimants, and especially those with nervous ailments, found the hearing process as traumatic as the accident itself. It was out of this state of affairs that a second, even more controversial pension neurosis made its appearance in social insurance, the “Rentenkampfneurose” (literally, the “pension struggle neurosis”). By 1900 courts were hearing cases in which claimants argued that the process of attempting to acquire a pension itself had brought about nervous ailments. Disappointed expectations, accusations of malingering, several years of preoccupation with defending one’s claim, numerous court appearances, and equally numerous medical examinations: all, pension claimants argued, brought about nervous ailments or further worsened existing ones. In 1902 the Reich Insurance Office agreed to hear the Rentenkampfneurose case of August Wohlfarth from Gräfinau in order to establish a definitive judicial position on this new phenomenon. On 7 August 1897 Wohlfarth suffered an accident at work for which the Potters–Accident Insurance Board awarded him a pension of 20 percent. Examinations in 1898, however, convinced the insurance board that Wohlfarth had become fully capable of earning a living, and that any lingering symptoms were now solely attributable to malingering. It Page 240 → therefore revoked his pension on 10 May 1899. Now complaining of weakness in the leg, headaches, dizziness, shakes, and heart palpitations, the injured man appealed the decision of his insurance board on 26 July 1899, only to have his claim rejected by a Rudolstadt court. Wohlfarth then went to the Thuringian Invalid Insurance Office for aid and received an annual sickness pension of 168 marks. The invalid insurer, in turn, believing the ailments were due to the 7 August 1897 accident, raised a claim against the Potters–Accident Insurance Board in May 1900 and demanded that it provide compensation. After accident insurers once again rejected Wohlfarth’s claim, the invalid-insurance institute appealed the decision in the courts on 21 March 1901. In February 1902 an appellate court finally decided that Wohlfarth’s symptoms were attributable both to the 7 August 1897 accident and to the deleterious effects of his efforts to gain a pension, and it therefore awarded him a pension set at 40 percent. Nevertheless, Wohlfarth remained unsatisfied and appealed to the Reich Insurance Office Senate in March 1902 for a pension of at least 75 percent. By this time he had seen no fewer than twelve doctors over the five years of his attempt to acquire a pension. Three days before his hearing was to take place, Wohlfarth wrote court officials on his own behalf:

Since I am not in the condition to travel to Berlin and to attend this hearing at my own expense, so may God’s will be done—as it will/I am unable to work and am frail since 7 August/Still, up till now I have not yet been able to get a careful medical examination/A little abandoned. . . . There are many who receive the pension and who are not nearly so ruined as I, and that is something no professor and also no doctor wants to find/It is inconceivable to me/If I were able to do my work it would never occur to me to want this pension/And so let happen what will happen.20

In the 20 October 1902 hearing before the Reich Insurance Office Senate, accident insurers argued that

Wohlfarth’s symptoms were not directly attributable to the original accident, and, at any rate, were largely exaggerated. The court finally settled the case in a grundsätzlicher decision stating that although Wohlfarth’s symptoms were clearly indicative of a nervous ailment, an insured individual’s attempt to acquire a pension in and of itself could not be recognized by social insurance as the causal agent of an illness. In the words of the high court, the accident itself must be the “fundamental moment in the formation of the nervous affliction.”21 The 1902 decision of the Reich Insurance Office succeeded in all but eliminating bureaucratic recognition of the Rentenkampfneurose. Since judicial decisions Page 241 → under German law, however, were not legally binding on future cases, Rentenkampfneurose claims continued to appear now and then in the courts. They were consistently rejected.22 The Rentenkampfneurose phenomenon, however, had an even greater impact outside the courtroom. In the years 1908–14, employers, insurance-board personnel, certifying physicians, and critics of the welfare state in general began to see in this curiosity of the social-insurance system the embodiment of the failings of German social policy. Specialist journals were inundated with articles from doctors who now identified socialinsurance legislation itself as the agent provocateur of nervous illnesses. Many professional observers, like Walther Ewald, still identified the greediness of insured workers as the main culprit. Such selfishness, he contended, was attributable to a system that placed a premium not on recovery, but on gaining a pension.23 In the words of one physician, “There would finally be a radical means available, without [necessitating] a change in legislation, were there to be a turn to a change in jurisprudence; namely, to recognize the ‘traumatic neurosis’ as something not brought about by the accident itself, to completely not recognize it as a compensable consequence of an accident, and to reject the pension claims of all such cases.” The result, he added, would be that “in the foreseeable future the ‘traumatic neurosis’ would again disappear from our population with few exceptions.”24 A more popular alternative among critics was lump-sum compensation (Kapitalabfindung). International statistics had indicated that incidents of pension neurosis were more numerous in countries with pension compensation for nervous conditions resulting from accident than in countries where the insured received a one-time cash settlement as compensation. Officials in Germany thus looked to the lump-sum systems of nations like England, Denmark, and Hungary as models for restructuring compensation for pension neurotics.25 The view now began to take hold that since long, protracted processes in an effort to obtain pensions promoted the spread of the pension neurosis phenomenon, only a system involving the swift and smooth resolution of claims could serve as a deterrent. Debate over pension neurosis grew even more intense in the policy-fixated climate of the years following the promulgation of the Reich Insurance Ordinance Page 242 → of 1911. In 1912 Ludwig Bernhard, professor of Staatswissenschaft in Berlin, used the pension neurosis to wage a comprehensive and scathing attack on German social policy. Bernhard was a prominent member of the circle of friends surrounding industrialist, right-wing politician, and founder of the Pan-German League Alfred Hugenberg.26 Challenging state regulation in the private sector, he criticized what he called the mass “pension addiction” that the pension-insurance system itself had created. Pension neuroses and the general greed of workers could be imputed to a faulty system that did not check, but institutionally promoted, malingering and the exaggeration of symptoms. In Bernhard’s view, the routines of German social insurance—from the widely circulated medical reports to the well-publicized court hearings to the labor movement’s publications and counseling efforts—taught workers one lesson: “to be as sick as possible.” The result was a system that institutionalized greed, bred dependency, and increased the average healing period for illnesses. Bernhard concluded his polemic by proposing five reforms: (1) simplify the appeal process, (2) compel sickness funds and accident-insurance boards to judge the status of claims more quickly, (3) abolish the cost-free processing of appeals, (4) reform the practice of awarding small, partial pensions, and (5) replace accidentinsurance pensions, where possible, with a lump-sum payment.27 Bernhard’s book provoked a wave of responses.28 The heightened publicity that now attended the pension neurosis question further fueled the political conflict between insured workers and insurance providers. For the accident-insurance boards, the question was no longer whether a small group of pension recipients was malingering, but whether the pension neurosis phenomenon revealed systemic failures in German social-policy administration.29 In Page 243 → March 1913, at the Extraordinary Assembly of the Westphalian Union of

Accident Insurance Administrations in Dortmund, accident-insurance officials exchanged with one another their views, experiences, and ideas for reform on the topic “Pension Addiction and Pension Hysteria: Proliferation, Causes, and Resistance.” The overwhelming view was that the continued appearance of pension neuroses was attributable to the same sources that insurance boards had concluded were contributing to the simultaneous increase in exaggeration and malingering among workers. Administrators and certifying physicians identified a series of systemic shortcomings in insurance administration as the causes behind all three manifestations:

—“the ease with which the insured, due to the gratis nature of the process itself, can pursue dubious claims” —the impression given to the insured by the courts that pensions were nothing more than “Schmerzengeld” (literally, “money for pain”) —the counseling given to workers by lawyers and labor unions —the influence of the party-political press —the growing distrust between physicians and patients —the sluggishness with which cases were dealt —the leading questions asked by police in the investigation of accidents that all but invited the injured to raise pension claims

Together, officials contended, these routine, but pernicious, aspects of social-insurance practice promoted values of greed and pension addiction and placed a “premium on whining.” The goals of social insurance—reestablishment of the ability to earn a living and reintroduction into the labor market—were thereby being undermined. By way of solution, accident insurers fixed on three general proposals. The first was the nationwide replacement of pension compensation in cases of pension neurosis with some version of a compulsory lump-sum settlement system. A second position argued that judicial circles, and particularly the Reich Insurance Office, should promote greater standardization. Officials adhering to this view proposed that the courts act more swiftly in deciding cases, continue to reject pension neuroses, discontinue awarding small pensions, restrict the access of workers to medical reports, and support compulsory operations in certain cases. In addition, proponents advised that the Superior Insurance Offices and the Reich Insurance Office enforce stricter guidelines for awarding pensions in general. A final set of proposals centered on solutions that were to be implemented by insurance providers and certifying physicians themselves. Under this category were proposals for better training of physicians, more follow-up examinations and better supervision of pensioners, well-publicized punishment in Page 244 → cases of malingering, and the swift commencement of the therapy regimen by accident-insurance boards. Furthermore, officials enjoined both the sickness funds and their fellow accident insurers to prevent workers from “calling in sick” and to make introduction into the workforce the focus of all treatment. In sum, accident-insurance providers began working toward a strict limitation of bureaucratic recognition of the pension neurosis through a judicial and self-administered process of centralization and standardization.30 Labor representatives of the insured quickly refuted the arguments of Bernhard and insurers. They insisted that the nervous ailments resulting from accidents were genuine illnesses, and that, in any case, the social-insurance system worked more to the advantage of employers than of workers. As one article in Vorwärts claimed, views of nonpartisan physicians showed that the infamous listlessness of stricken workers was not due to malingering, but to hysteria or neurasthenia.31 Aversion to work and avarice, values that employers claimed predominated among

the insured, as one physician sympathetic to the cause put it, “are at least as prevalent, if not more prevalent, among the middle and even higher classes than among the working population.”32 In an article in Die Neue Zeit from 1913, Mattutat compiled statistics on appeal applications and compensation payments. He found that since 1901 the number of applications brought before the Reich Insurance Office by accident-insurance providers showed a 14.4 percent increase (representing in 1913 93.7 percent of all applications), while those of insured workers decreased by 13.9 percent (6.2 percent of all applications). “This squares poorly with the often-talkedabout pension addiction and pension avarice of the insured,” concluded Mattutat.33 War and Neurosis World War I carried the traumatic neurosis into new venues: the military hospital, the military benefits system, and the provincially organized war-disabled care program. Estimates are that German military hospitals alone encountered around 613,000 cases of “nervous illness” between 1914 and 1918.34 Meanwhile, among socialinsurance groups, debate on the matter remained relatively unchanged. Representatives of the insured continued to demand a greater role Page 245 → in the compensation process, while accident insurers (led by the vocal director of the Rhine Association Paul Lohmar) continued their campaign to convince government officials of the appropriateness of a one-time cash settlement system of compensation.35 With the changed priorities accompanying total war, then, neuroses and hysterias within care for the war-disabled attracted the attention that formerly had been awarded the pension neuroses. Nevertheless, even though the focus was now being placed on soldiers in the field instead of workers in the factory, diagnosis, treatment, and prevention of the nervously ill injured in war were articulated in the same terms as those of the accident casualty. Concerns about malingering, aversion to work, pension addiction, and greed established the parameters for discussions over awarding pensions and healing war neurotics. Since the early days of war-disabled care in 1915, specialists echoed the now-familiar refrains of insurance providers and employers. “This welfare [for the war-injured] should not simply consist of the awarding of pensions; its higher goal is to make as many of those as possible whose health has been impaired capable of working and earning a living again, ” explained one publication.36 Prussian government officials warned Ober-Präsidenten and committees for the war-disabled of the dangers of “pension psychosis” among the injured, “that is, the fear of the man injured in war that if he himself tries to find a way to earn something, he would hurt his pension.” The appearance of such “pension psychoses,” the reports claimed, could be expected to play “an inhibiting role” in health-care efforts.37 Particularly susceptible to such notions, it was agreed, were wounded soldiers with nervous ailments. Such cases needed to be handled with wariness, “in order not to arouse avaricious thoughts, and with them, pension neuroses.”38 The solution, like the problem, was borrowed from social-insurance debate: eliminate the rewards from the formula and place the focus upon reintroduction Page 246 → into the war economy. Thus, “above all, it should be arranged as much as possible that neurotics be lodged in areas that are not located too close to their hometowns.”39 In addition, increasing importance was placed on training and retraining.40 In 1916 the pension solution to the pension neurosis question received yet another blow, this time from the German Association for Psychiatry. Citing numerous cases of war neurosis in which symptoms disappeared immediately after discharge from service, the association at its wartime convention refused to recognize war neurosis as an independent mental illness. Instead, it unanimously agreed to three resolutions: eliminate compensation for those persons judged to be under 20 percent incapable of earning a living, set pensions at their lowest possible level for those with wartime neuroses or psychoses in order to compel them to work, and, more preferably, replace pensions with a lump-sum payment in the case of war neurotics.41 The war neurosis question thus had taken up where the pension neurosis question had left off. Occupied with the question of preventing institutionalized greed and aversion to work, a growing number of health-care officials began to identify the pension system itself as the major catalyst in the proliferation of nervous ailments. Insurance State or Custodial State? The Postwar Debate over Reforming Social Security As discussed in previous chapters, the war had introduced a tension within social-insurance administration

between two general forms of public assistance. On the one hand was the conventional insurance principle of aid, based on the idea that one only received benefits relative to one’s contributions to a general fund. On the other hand, welfare and compensatory entitlements made the comprehensive provision of services the responsibility of the state. These forms were uncomfortably syncretized with one another over the course of the inflation years. As the conventional boundaries separating entitlement principles were blurred, however, social-service professionals began assessing the consequences of these changes. Discussion during the years immediately after the war took the form of a debate over the reform of German social security. Opinions ran between two poles. At one end stood social pensioners and a number of Social Democratic politicians and social-service professionals. They proposed a nationalized welfare Page 247 → system that would offer free services and be financed through taxes.42 This option was typically referred to as the “custodial state welfare” alternative (Staatsversorgung or staatliche Fürsorge). Seeking to change the social foundations of the health-care system, promoters of this alternative believed that the liberal and capitalist foundations of social insurance needed to be undermined. The premium/benefits system of health insurance, in their view, was incompatible with the goal of eliminating social inequality in health care. Instead, a more comprehensive and completely universal form of public assistance was called for in order to equitably redistribute incomes, goods, and services. The national government was considered to be the most appropriate center for achieving these aims. In this regard, both the majority Social Democrats and the Independent Social Democrats publicly called for the creation of a Reich Health Ministry and for the socialization of medicine as early as 1918.43 Their efforts, however, were unsuccessful on both counts, being met by opposition from two directions: from physicians who saw socialization as a profound threat to their status, autonomy, and livelihood, and from government officials who argued that nationalization of health care was unfeasible in a federal republic such as Germany.44 At the other end of the spectrum were advocates of the existing premium/benefits insurance system. Insurance in this context represented the progressive liberal alternative, defended by party members of the bourgeois middle, government officials, and of course the social-insurance establishment. As Young-Sun Hong has pointed out, progressives advocated a preventive and therapeutic approach to social welfare in order to “foster a sense of rational self-discipline among the needy, promote a spirit of self-help, and thus assist these persons in regaining their economic and moral autonomy.”45 Guided by liberal principles, this camp invariably opposed the creation of any custodial state welfare system, voicing particular reservations about the imagined effects that such a system would have both on the individual and on health care in general. Leading this progressive cause were two prominent figures: Paul Kaufmann and Paul Moldenhauer. Kaufmann was a lawyer and a career bureaucrat, who served as the influential president of the Reich Insurance Office in the years 1906–23. Moldenhauer was a trained insurance scholar who was an active member of the German People’s Party (DVP), sat in the Reichstag from 1920 Page 248 → to 1930, and eventually became head of the Reich Finance Ministry in December 1929. The two men raised a number of concerns about the state welfare plan, beginning with the costs. The process alone of singling out those persons needing care, argued Kaufmann, would involve costs so staggering they would “devour the provisions for accident victims.”46 The lessons of the postwar period, Moldenhauer remarked in the middle of the inflation, showed all too clearly “how dangerous it is when house is kept using state coffers filled only with paper.”47 A second reservation they voiced about the state welfare solution was the dangers they believed to be associated with bureaucratization. State welfare, Kaufmann contended, necessarily meant centralization and bureaucratization. The self-administered corporate bodies of social insurance would have to be eliminated under such an ambitious reform. The administration of regulations would lose any vitality (lebendige Kraft), becoming simply a process of implementing the letter of the law. Bureaucrats would gain wider powers over the system. The necessities of austerity that always accompany state financing would play a more profound role in policymaking.48 The resulting bureaucracy, in other words, would necessarily be too schematic. Top-heavy, centralized, and huge, Moldenhauer warned, it would not be able to individualize services nearly as well as the existing insurance system did.49 Finally, both men believed that custodial state welfare would undermine the positive values promoted by

traditional social insurance. The insurance system, Kaufmann insisted, promoted the virtues of self-help, selfresponsibility, and the responsibility of individuals to look after their families.50 These values would be displaced by the introduction of a universal welfare state. “Custodial state welfare,” Moldenhauer agreed, strives to create “people without risk” [risikolose Menschen]; in other words, “people for whom the state takes over all concerns for the future and, along with it, the driving force for creativity and progress.”51 No longer having a sense of contributing to the system, individuals would view accepting services as an embarrassment. The point was clear: replacement of a self-administered and self-financed health-care and public-assistance system with a bureaucratized, removed, and tax-funded institution would mean the replacement of self-reliance and pride with dependence and shame. Page 249 → In between calls for state welfare and justifications of traditional social insurance were a variety of proposals for reform that mixed and matched ideas and language from the two alternatives. Some of these focused on the unification of all branches of compulsory insurance. Others sought the creation of new offices, while still others promoted the idea of creating new interest groups in order to effect change in government policies. Countless proposals were published in the medical periodical Ärztliche Sachverständige-Zeitung, for example, calling for the formation of new, reformed, or special institutions to accompany changes in social insurance and war veteran assistance.52 Health professionals in particular clamored for greater coordination in health care. The German Association for Public Health Care (Deutscher Verein für öffentliche Gesundheitspflege), for instance, in 1919 invited “representatives of the state medical administration and municipalities, social insurance providers, medical community and hygiene science leaders, representatives from hygiene associations of all types, from the unions as well as the political parties and charitable societies” to come together to form a German Health Parliament. The goal of this assembly, according to the association, would be to take positions on legislative and administrative measures pertaining to health care and then itself “work out legislative proposals and lay them before the [various] governments and parliaments.”53 Still another group of reformers within the social-insurance system proposed further expansion of the system. Believing, as one standing member of the Reich Insurance Office argued, that insurance providers had become “significant patrons of public health care,” some argued that social insurance had outgrown its narrow confines. Pointing to the precedents of the First World War as the “seed” of reform, numerous reformers (Ledderhose, Kaskel, Schulz, Wörner, Schöttler, and Kuffler, among others) called for a still greater emphasis on custodial principles within social insurance. Ledderhose suggested the creation of a sickness-insurance pension. Kaskel demanded the unification of all groups of insured persons and the simplification of all forms of insurance. In addition, he called for expanding the obligations of insurance based on war-disabled care. Wörner recommended that insurers rely more on providing services and goods than on awarding monetary benefits. Kuffler, finally, identified what he considered basic principles for the improvement of the system: equal care for all types of physical impairment, rejection of the concept of compensation through pensions, and expansion of treatment through work.54 Page 250 → The debate over social security reform between 1919 and 1924 was the direct result of the changes effected by war and inflation. The mobilization of the social services, the blurring of distinctions between forms of public assistance, and the fiscal crisis of social administration prompted a general reassessment of the welfare state. The debate, however, was over more than simply technical, administrative matters. As seen in previous chapters, questions about social security were invariably moral and political ones as well. Entitlement politics waere a politics of national belonging, where the extension of social rights was made contingent upon exhibiting individual responsibility, hard work, and self-reliance. In debating the form that social security should assume, administrators, government officials, assessors, and physicians were also debating the very principles and virtues they believed should govern the new republic.

The Pathology of the Welfare State: The Pension Neurosis Question, 1919–26 It was in this environment that those involved in social insurance wrestled with the question of the pension neurosis after the war. Since publication of Bernhard’s book, the pension neurosis had become synonymous with what some were calling the “seamy side” (Schattenseite) of social insurance. In the eyes of insurers, certifying physicians, and many government officials, the pension neurosis had come to represent the failings of the therapy regimen, the promotion of dependency and avarice, and the overpoliticization of health matters. By embracing the lump-sum payment “as the most effective method of treatment” in 1916, psychiatrists helped legitimate skepticism about the existence of the illness. Government inquiries during the war indicating that the overwhelming majority of war neurotics quickly found jobs after discharge only lent further credence to the psychiatrists’ conclusions. Revolution in the winter of 1918–19 reinforced the growing cynicism by promoting even greater mistrust than existed before between workers and physicians, as councils directly called into question the objectivity of doctors as well as the hierarchical relationship between patient and doctor.55 As early as 1919, then, social policy makers within the central government began paying serious attention to the lump-sum proposal of accident insurers. The Reich Labor Ministry in October and November 1919 sent questionnaires to all sanitary offices (Sanitätsämter) and medical officers, inquiring after their experiences with neurotic patients and Page 251 → their general opinion toward the one-time cash settlement idea. Results indicated that there was neither enough support in the public at large nor in the medical community for a compulsory lump-sum system to be established, but that there was support from the medical community for a onetime payment to replace pensions under 25 percent.56 The Reich Insurance Office conducted its own survey of expert advice on the issue. Its study indicated that medical specialists continued to affirm that “with the one-time payment, a therapeutic purpose is served” because it would eliminate the “struggle for the pension,” and thereby the anxiety and avaricious thoughts that accompanied it.57 Government interest in the lump-sum solution continued to be expressed as late as 1924, when the Reich Labor Ministry asked the Association of German Accident Insurance Providers to sketch out a plan for implementing the system for accident insurance. Nevertheless, even with the overwhelming support of insurance providers and psychiatrists, the solution was never instituted. It is still unclear why this was the case.58 In all likelihood, however, divisions over social-insurance reform made the lump-sum solution untenable. In order to be carried out, it would have required not simply an administrative reform but a legislated one. As the legislative record of the early 1920s indicates, however, the Reichstag was hardly the forum for instituting radical change in social insurance. The administrative arena offered a more amenable environment. In any case, insurance authorities looked elsewhere for the solution. The Reich Insurance Office in particular was under pressure to respond to the changing consensus on pension neurosis. This pressure grew even more intense in 1920, after the Reich Supervisory Office for Private Insurance allowed private insurance companies to include a clause in their insurance contracts stating that “[in those cases of] psychic and nervous disturbance involving an accident where the capacity to work is impaired, a compensation is only awarded if and insofar as this disturbance is attributed to an accident-caused organic illness of the nervous system or to a newly developed epilepsy in connection with the accident.”59 The intent of the private insurance companies was clear. Eliminate bureaucratic recognition of the illness, and along with it the illness itself, by basing entitlement on an organic etiological link with the accident. Accident insurers now seized the opportunity to urge the Reich Insurance Office and the Labor Ministry to eliminate compensation for accident neuroses. “In our [earlier] petition . . . we had proposed a special provision for the one-time Page 252 → payment in combating the traumatic neurosis,” wrote the Association of Agricultural–Accident Insurance Boards to the minister of labor in December 1924. “After reexamination, we must now prefer the provision from the regulations of private accident insurance, since they more effectively combat the harmful pension ideas in traumatic neurosis cases from the start by completely disallowing a compensation claim from even arising.”60

In 1925 the Reich Insurance Office began to carefully study the feasibility of instituting such a policy for accident insurance. To this end, it once again turned to the medical community, more particularly to university clinicians and medical officers. Over a period of eighteen months, Reich insurance officials collected medical reports from ongoing cases, attended conferences, invited lecturers, and requested opinions from noted physicians. In its survey, it encountered the general sentiment that, as one report noted, “without the existence of liability laws of any kind, accident or other avaricious pension neuroses would entirely not exist.” This convinced officials that they could finally justify a change in their stance on the pension neurosis on “objective,” medical grounds.61 In June 1926, Dr. Ewald Stier, a longtime critic of the pension neurosis, provided the Reich Insurance Office with ten “Medical Theses on the Question of the Accident Neurosis.” Describing the pension neuroses as “psychologically understandable wish reactions,” Stier recommended the policy implemented by private insurances, adding that the policy would “represent a humane and social measure.”62 Using Stier’s guidelines, the Reich Insurance Office then prepared to use upcoming appeals to establish a new policy and juridical principle. Officials settled on several cases and judged them together in 1926. One of these cases was that of Elfriede Morsbach and her factory sickness fund against the Foodstuffs-Industry–Accident Insurance Board. The facts of the case were typical of pension neurosis claims. Injured on 14 May 1924, Morsbach exhibited nervous symptoms that she claimed made her unable to work. After receiving benefits from her sickness fund, both she and the fund throughout 1924 and 1925 petitioned the accident-insurance board to provide her with proper treatment. It consistently rejected the petitions. After the Superior Insurance Office in Düsseldorf in June 1925 also denied Morsbach’s appeal, she appealed to the Reich Insurance Office, emphasizing that “up to now I have made no claim on a pension and have constantly expressed the most ardent wish to be rehabilitated in order to again resume my job at the firm of Hiller Brothers, Page 253 → which has become dear to me.”63 The records in the case indicate that court members were little interested in the particulars, but rather were impressed that the “matter in question appears . . . particularly suited” for the purposes of establishing a new Grundsatz.64 The report on the findings of the court largely occupied itself with a detailed discussion of contemporary medical views regarding pension neurosis. Citing a change in the “prevailing” medical opinion on the subject, the court pronounced the following new principle of compensation:

If the inability of an insured person to earn a living is solely grounded in his thought of being sick, or in more or less conscious wishes, or if the insured person after an accident has resigned himself to the thought of being sick, or if the predominating wishes of his mental life focus on an accident compensation, or if harmful ideas have been reinforced through the unfavorable influences of the compensation process, then a preceding accident is not a fundamental cause of the inability to earn a living.65

In justifying the principle of compensation, the judges pointed out that medical experience had decisively shown that the compensation process was a major cause and promoter of pension neuroses, since “as a result of the numerous observations, negotiations, memoranda, judgments, etc. that accompany compensation, the thought of compensation and, along with it, the idea of one’s own incapacity to work, is always conjured up and reinforced in the [mind of] the applicant.” The new medical consensus, the Reich Insurance Office continued, thus called into question the causal link between accidents and the illness. The court, however, was quick to point out that the decision represented a “judgment of debate from the field of medical science” rather than a decision over legal meaning. In practice, this meant that other courts were not legally bound by the decision. “An agreement of the Senate in medical questions can therefore only be established through the powers of persuasion of medical theory, not through procedural, legal prescriptions.” In other words, the decision was to be interpreted as an expression of medical, not legal, wisdom.66 Even with these qualifications, however, all interested parties within social insurance recognized the 1926 decision as both a medical and an administrative turning point. Soon after the decision, members of the Reich

Insurance Office began actively recruiting supporters by attending countless conferences Page 254 → and publishing a series of books and articles about the impact of the new principle.67 Insurance providers and the courts, although not legally bound by the decision, overwhelmingly relied on the new principle in assessing cases before them. In the years following the decision, representatives of the insured—including unions, sympathetic physicians, and the Reich Association of German War Invalids and Surviving Dependents—attacked what one critic called the “extermination campaign against pension neuroses.”68 Despite the opposition of organized labor, pensioners, and the disabled, the 1926 decision stood as, if not a solution, a resolution to the pension neurosis question.69 When seen in the light of health-care debates of the early twenties, this resolution represented not one but three measures designed simultaneously to treat pension neuroses and to reform social (particularly accident) insurance.70 First, it was a prophylactic measure. Its restrictions inevitably created a smaller circle of insured persons who were eligible to take part in the pension process. Since the process itself was seen to promote nervous ailments, separating as many individuals as possible from the process was therefore a means to combat the phenomenon. In addition, by removing workers from a system that baited them with a pension, it was thought that disreputable values would no longer be promoted. Second, the decision was believed to be a therapeutic measure, in that it recognized that the system itself contributed to poor prognosis, slower recuperation rates, and counterproductive thinking. Recalling the concerns of accident insurers and sanatorium administrators over patient politicization as well as arguments for the lumpsum settlement, the court thus decided that work, not benefits, was the most suitable form of treatment for illness. By not compensating pension neurotics, they were compelled to resume work and thereby also forced to carry out their own treatment. Page 255 → Last, the decision was an attempt to depoliticize accident insurance. As Paul Starr and Ellen Immergut have argued, depoliticization has taken two forms in modern health care: the passage of a set of problems from the public realm to the private realm or passage from the political to the technical.71 The Reich Insurance Office chose the latter alternative. It had been careful to emphasize that its decision was based on a survey of current medical opinion that it had conducted. By an appeal to medical science, it hoped to place the pension neurosis question on the “objective” grounds of medicine and thereby remove it from the political arena of workeremployer relations. Since workers, however, hardly viewed physicians as nonpartisan experts, the political debate over the issue did not fully disappear, as the literature after 1926 demonstrates. Social-insurance administration’s response to the phenomenon of the pension neurosis was thus to apply the very same terms and methods it applied to the illness to itself. Neurosis and welfare-state bureaucracy implicated one another. Since it was a form of traumatic neurosis, the cause of the pension neurosis had to be found in a shock, one which increasingly became identified as the pension process itself. At the same time, insurance administration, designed to attribute maladies to accidents, sought to retrace the linear causal chain that accounted for the illness, only to find that its investigation ultimately led back to itself. Very few voiced any opposition to this conclusion. While there was disagreement over whether one should be compensated for Rentenkampfneurose, there was a widespread consensus that social-insurance bureaucracy was responsible for proliferating and exacerbating nervous ailments. Thus, the German welfare state, by extension of its own workings, became identified as both pathological and pathogenic. Weimar Social Security under Attack In the last third of the 1920s, this acceptance of the German welfare state as a pathologically contagious force in society converged with the widespread disenchantment and moral outrage of social pensioners. Social policy became a lightning rod for criticism, an object of and forum for disagreement over the proper constitution of the German polity. The welfare state now inherited the unenviable task of justifying the wartime losses and the new republic, at the very same time that it was being recognized as a degenerate and dangerous institution.

Debate at the policy level was couched as a conflict between competing worldviews of state and society: between those social-service providers and Page 256 → consumers who defended (or, like some socialists, who wished to extend) the traditional ameliorative welfare state and an array of critics on the Right who wished to, in one form or another, privatize social fate and remoralize state action. At issue was whether the progressive vision of social security embodied by social insurance had finally outlived its usefulness. Trade unions and socialists generally supported the current system, but there were calls for reform among their ranks. Many shared the views of reformer Hans Maier that the ultimate aim of the welfare state should be to create a “risk-free existence” for all citizens and that this could only be fully realized in a socialist society.72 Thus, some on the Left after 1926 continued to press for the replacement of traditional social insurance with a unified, comprehensive custodial welfare system.73 The most serious challenge to conventional social security, however, came from three distinct camps. Liberal and Christian-conservative politicians, intellectuals, and social-service professionals were outspoken in their opposition to both the status quo and left-wing reform proposals. Conservative and confessional welfare organizations and reformers rallied around a moralizing Kulturstaat vision of the welfare state that focused on promoting family, marriage, spirituality, and labor all at once. Liberal critics, by contrast, embraced a free-market conception that looked to deinstitutionalize German social welfare in order to undermine “mechanistic” and “bureaucratic” impulses.74 By the early 1930s, both sets of criticisms were proving attractive to local welfare administrators, who were having to make do on austerity budgets.75 Finally, proponents of eugenics and race hygiene soundly criticized the Weimar welfare state for failing to work toward explicitly eugenic ends. Drawing increasing support within the social-service community from the mid-twenties on, eugenics advocates attacked social-welfare programs as misspent investments on “those of lesser value” (“Minderwertige”). They therefore urged the state to cut back on programs for the congenitally ill, use housing and family policy to promote the reproduction of those deemed healthy and worthy, and legalize voluntary sterilization of “those of lesser value.”76 Page 257 → Recent studies have shown that this backlash took the form of a growing repudiation of the therapeutic ethos that had come to dominate social services. At the same time, it was thoroughly inflected by concerns over the prophylactic protection of sexuality, youth, and family life.77 Promiscuity, increased incidence of divorce, rising abortion rates, falling birth rates, higher numbers of married women at work, and a marked decline in family size alarmed observers and moved policymakers to look for answers.78 Women and children were singled out as the objects of these new social-policy concerns, at once understood as the sources of social decay and anarchy and yet to be protected as populations at risk.79 From the mid-1920s, child-welfare services were simultaneously reconfessionalized and deinstitutionalized, abandoning those therapeutic programs designed to resocialize children for a greater emphasis on identifying those children with inherited mental abnormalities.80 Teens and “wayward” young people were likewise subject to new policies and laws. The rehabilitative treatment programs of local youth centers drew heavy criticism, while juvenile courts adopted a more punitive approach to delinquency and reformatories set themselves the task of identifying “at risk” and “incurable youths” for “protective supervision.”81 These policies were reinforced by a 1926 censorship law sponsored by conservative and religious groups to protect young people from the pornographic influences of “trash and filth.”82 Women were widely assumed to be the pivotal figures in contemporary juvenile delinquency, since it was believed that working women’s neglect of Page 258 → their families was fostering such antisocial behavior. While conservatives attacked birth-control clinics for contributing to the “weakness” of the German nation, Weimar policymakers embarked in a pronatalist direction. This took the form of steering the decline in birth rates through measures designed to protect motherhood (Mutterschutz).83 By contrast targeting an overwhelmingly male, older, and working population, social insurance was nevertheless not immune from the backlash that assailed the Weimar welfare state. Liberal, conservative, and eugenic critics invoked the pension neurosis time and again as evidence of the ineffective, pathological, and “antisocial” (unsozial) nature of the German social-security system. Particularly following the stabilization of the currency in 1924, administrators and policymakers were unrelentingly challenged to justify the system.

Supporters did just that, offering philosophically expansive, morally valorized defenses of insurance and its social mission. At a 1924 meeting of the German Association for Insurance Science, for instance, one leading scholar argued before an enthusiastic audience that insurance constituted the pragmatic alternative to the irrational universalism of communism and religion for achieving community solidarity.84 For many in the field, it was insurance’s ability to technologically manage happenstance and uncertainty that made it such a valuable asset. It presumably offered the individual a feeling of security, investing him or her with a sense of entitlement and thereby a moral interest in the prevailing order, thus promoting the social good.85 In making this possible, as insurance advocate Arthur Liebert expressed it, insurance was the very linchpin of civilization. For in contrast to primitives who, Liebert argued, lived in fear and offered sacrifices to appease angry gods, modern civilizations were defined by their ability to bring order and “lawfulness” (Gesetzlichkeit) to the inherent chaos and vicissitudes of nature.86 This was insurance’s, and especially social insurance’s, supposed achievement. It provided, in the words of coeditor of the progressive Soziale Praxis Frieda Wunderlich, an economically and scientifically sound altruism, where “the fortunate help the unfortunate.”87 Moreover, Page 259 → the “fixed structure of insurance institutions,” according to one legal scholar in 1933, necessarily promoted social responsibility by making every individual “subject to the discipline of the group community.”88 Such justifications did not convince critics, who appear to have found an even more receptive audience after Germany introduced unemployment insurance in 1927. Among the most prominent detractors of German social security was Gustav Hartz, a völkisch-minded intellectual active in national revolutionary socialist circles. Beginning in 1928, Hartz published a number of books in which he condemned the “errant ways of German social policy” for eroding the organic bonds between individual and community. To his thinking, social insurance had begun with the laudable goals of promoting personal autonomy, civic peace, and social security. But by replacing individual property with a legal claim to entitlement, social insurance had had the moral effect of replacing responsibility, honesty, and loyalty with whining, dishonesty, and ingratitude.89 The postwar German state, Hartz lamented, had allowed itself to be turned into one big poorhouse in which citizens played the role of pleading supplicants. Such a way of life was, in his view, unmanly and corrupting. “The state is not the shaper of all individual fates and should not be a scapegoat for those who are unsatisfied with their fate,” he emphasized in 1932.90 For Hartz, an espoused National Socialist by this time, only a system that emphasized self-help, family savings, and lump-sum settlements could end the rampant abuses within social insurance. Along similar lines, Erwin Liek, a physician with conservative political ties, also wrote extensively on the failings of German social security. Liek first made a name for himself in 1927 with the publication of The Physician and His Mission, in which he made the case that social insurance, indeed all social welfare, was responsible for promoting the physical and mental weakness of German men and the moral degeneration of the population at large.91 Echoing sentiments that had been expressed for some time in the debate over pension neurosis, Liek blamed social insurance and its health-care facilities for legitimating the “pension craze,” providing virtually no incentives for patients to get well, and thereby serving as “institutions of higher education for malingering.” Social insurance, he added, had turned being sick into a profession, the result being “longer and more incomplete recoveries, moral ruin, [and] the breeding Page 260 → of hypochondriacs.”92 Thus, the social-insurance system itself, Liek held, constituted an injury, “an injury [Schaden] to the soul,” by undermining the desire to work, save, and overcome defect.93 Others joined Hartz and Liek in attacking the principles and institutions of German social security. Above all else, critics were united in the conviction that social insurance had become an essentially perverse and perverting institution in modern German society. Time and again opponents contrasted the original pretensions of social insurance, frequently citing Bismarck or Kaiser Wilhelm, with its “unintended consequences.”94 Rather than promoting loyalty to the state, public health, and high productivity, they claimed, the system had nurtured a host of unhealthy and immoral habits—greed, malingering, deceit, exaggeration, laziness, dependence, illness, hypochondria, sexual and moral depravity—while enfeebling the virtues of strength, self-help, responsibility, courage, joy in labor, and selflessness. A corrupt institution, where purportedly administrators worked in palatial facilities and physicians indulged the hysterical complaints of workers, was having a corrupting influence on society in general.95 The masses of discontented pensioners, according to this line of thinking, were indeed victims, but victims of an altruism gone wrong.

Social policy was not merely being disparaged here in the utilitarian terms of means and ends. Rather, these were criticisms articulated in a moral rhetoric of sacredness and profanity, mimicking the language of social pensioners and questioning the very metaphysical assumptions of social security. Perhaps no other figure demonstrated this more clearly than the conservative philosopher Ernst Horneffer. Horneffer was a classical philologist, who was renowned for publishing Nietzsche’s Nachlass as well as the monthly Die Tat. He entered the debate over the German welfare state with his 1923 psychological analysis of capital-labor relations entitled The Great Wound. In it, Horneffer pointed to the war as partly responsible for turning German society on its head: “And our side—this nervous jumpiness, this disorganization and undiscipline right up to the highest levels, the lack of leadership and the opposition to appointed leaders, this confused tangle of emotions, the arrogance and the sullenness, and then after Page 261 → the collapse, the search for the ‘guilty ones,’ reconciliation, and the vilification of the leaders. . . .”96 To his thinking, however, the war did not so much cause as make manifest such neurotic features of the German people. The underlying cause of Germany’s wartime and postwar nervous breakdown, he believed, was its social order, one that atrophied spiritual life by eliminating the incentives and spurs provided by competition, fate, misfortune, and poverty.97 Horneffer later elaborated on these ideas when he directed his attention to German social policy in 1929. As the title of a much-cited work of his expressed it, social insurance had become an “abomination [Frevel] against the people.”98 It had destroyed the ethic of hard work (“the father of all virtues”) and given license to abuse of public institutions, anxiety, cowardice, and parasitism (Schmarotzertum). Laying blame also on the “sentimental bourgeoisie” who had passed social legislation, Horneffer lamented the consequent “shameful effeminacy [Verweichlichung] of our time” and the “contemptible spiritual hedonists, the aesthetes,” to which it gave rise.99 The newly created unemployment insurance, according to Horneffer, best demonstrated to what extent the concern for social security had come to pervert the natural order of things. Risk, danger, poverty, and hunger, he argued, were “the indispensable driving forces of human life,” making it “tragic, painful, hard.” By trying to avoid and overcome such sufferings, “one was simply attempting to wipe out this heroic character of existence, out of a mawkish softness [in süßlicher Weichheit] to make life pleasant, safe, and secure for everyone.”100 For critics like Horneffer, it was time for state policy to reheroicize life and undermine the forces of demoralization and emasculation. This would be done by dismantling those welfare-state institutions that had come to mediate social relations. At the top of that list was the social-security system. What was required, as Gustav Hartz put it in 1930, was a “social community instead of a social insurance.” Social security needed to be personalized by once again privatizing fate, making individuals and households responsible for securing their survival in cases of mishap.101 Such sentiments rang especially true for liberals, who typically believed the best solution was less reliance on the state and greater commitment to self-help. Bloated bureaucracy and inadequate public assistance led some to suggest Page 262 → a return to “the old bourgeois ideal” of savings. The idea in this case was to replace social insurance with a compulsory system of personal savings. This would be done in the expectation that it would help promote the eventual “bourgeoisification of the worker.”102 Others, however, found such plans too timid. Some therefore urged the creation of a completely voluntary system of insurance.103 One reform proposal went so far as to suggest adopting the private-insurance system of the United States.104 Eugenic critics of German social security shared, at least in part, the liberal enthusiasm for deregulation. Advocates of eugenics such as Erwin Liek favored deinstitutionalizing social security as a way of shifting the burden of weathering adversity away from the state and on to individuals. This, he believed, would result in stronger, healthier, and more responsible families and citizens.105 Similar sentiments were voiced by a group calling itself the German Renewal Community in Leipzig. It denounced the social-insurance system for its “moral bankruptcy.” In one of its leaflets from 1928, the group complained that “the will to be healthy is being undermined, [and] sickness is becoming an occupation.” While the “veterans of work” and the “fit” worked diligently without ever taking a sick day, “those of lesser value”—the lazy, the criminal, the congenitally sick, the mentally impaired—were increasing their numbers. “No wonder,” explained German Renewal. “The entire state and public interest looks after the unfit and impaired. . . . We believe, however, Germany should not become one big house for invalids and an Eldorado for elements unwilling to work.” The group therefore proposed that social

insurance be totally eliminated and that forced sterilization of the inferior be carried out.106 For many advocates of race hygiene and eugenics, then, dismantling the welfare state held out the promise of both improving society and elevating the moral status of most Germans. But such critics of German social security differed from liberals in believing the state still had a central regulatory role to play in social policy. As Bavarian statistician and race demographer Friedrich Burgdörfer argued in a series of publications in the twenties and thirties, government could not stand idly by as the aging of the population bankrupted invalid Page 263 → insurance and families of good stock found it increasingly difficult to have children. Burgdörfer therefore proposed, among other things, the creation of a parents’ insurance, whose benefits would be extended, not to individuals, but to families.107 The head of the Church-Social League (Kirchlich-Sozialer Bund), a German National (DNVP) parliamentarian, also wished to see social policy diverted from a “one-sided individualism.” Understanding Germany’s social problems to be both racial and spiritual, he and his organization called for reform of workers’ insurance, worker safety regulations, public housing, and health care for women and children, “all in order to strengthen the German race.”108 The rise to prominence of such arguments raises important questions about the place of eugenics and race hygiene in pre-Nazi German social policy. Some, such as Peter Weingart and Sheila Weiss, have stressed the continuities in the development of German eugenics, seeing National Socialist race policy as the culmination of technocratic impulses in eugenic science and politics.109 Hong, on the other hand, has more recently argued that the discourse of eugenic welfare reformers was historically novel, rejecting “both the individualist, humanist premises which underlay the ideal of social citizenship shared by Progressives and Christian conservatives and the preventive, therapeutic programs which had been created to secure the realization of this ideal.”110 Hong’s points are welltaken, for as recent comparative histories of eugenics demonstrate, eugenics has not operated under one unifying logic nor served only one monolithic set of goals.111 That said, it is equally important to acknowledge that liberal, conservative, eugenic, and even socialist critics of the Weimar welfare state had arrived at a consensus of sorts. Social insurance had become a bane that would have to be removed, or at least transformed, in order to revitalize and redeem a demoralized German society. Even if they planned to go about it somewhat differently, critics of all stripes generally saw reform of social insurance as a process of cleaning up a corrupt and corrupting system. Seen in this light, the rise in popularity of eugenics during the late twenties was as much an effect of as it was an Page 264 → influence on the debate over the welfare state.112 As Jürgen Reyer has pointed out, eugenics was a relative latecomer to social policy. Having arrived, however, its assessment of the viability of social programs in terms of community costs versus individual benefits resonated with the concerns of policymakers juggling austerity budgets. It provided a consistent and seemingly inexpensive way to determine those of “lesser value” on whom social welfare was misspent.113 At the same time, it reinforced the conservative and liberal idea that life was indeed a heroic struggle for survival that the state would now referee. In eugenics, social and fiscal problems were presumed to find their common solution in the promise of a spiritualizing “human economics” (Menschenökonomie). The backlash against the Weimar welfare state provided policymakers with arresting images and a language by which to perceive, articulate, and manage the social and economic crises that erupted after the depression. Once again, the foundations of German social insurance were threatened, this time by unemployment (from 3 million unemployed in winter 1929–30 to over 6 million in winter 1931–32), reduced wages, and foreign debt. High unemployment and lower wages in particular created a vicious cycle of increased demand for social benefits coupled with less revenue to finance such benefits. By 1931, accident insurance was running an annual deficit of RM 65 million, invalid insurance a deficit of 185.5 million.114 From the summer of 1930, the governments of Heinrich Brüning and Franz von Papen used the power of emergency decree to begin the process of “social dismantling” (Sozialabbau). A wave of successive decrees in 1931 and 1932 introduced austerity measures that in consequence, if not in intent, increasingly privatized hardship. In unemployment insurance, contribution rates were raised, support levels reduced, married women and young workers summarily removed from eligibility, and applicants compelled to prove their “neediness.” Accident insurance first froze, then lowered, benefits, revoked the pensions of the 132,000 partially disabled (20

percent disability and below), and restricted eligibility requirements for widows and children. Invalid insurance felt the pinch even more, as pensions were slashed, along with funds normally allocated for treatment (from RM 97.7 million to RM 38.6 million in 1932).115 Page 265 → The cuts in social-insurance benefits and services met with familiar refrains. Social Democrats and other supporters of the welfare state spoke of the millions of “needy victims” (Notopfer) on whose shoulders the burden of austerity now fell, while advocates of custodial state welfare insisted that only a unification of public assistance could save the state and its citizens.116 But while opposition to the measures appears to have gone some way toward tempering the pretensions of retrenchment enthusiasts, it did not divert the Brüning government’s deflationary policies. The social dismantling measures largely had their desired effects. Results in invalid insurance were the most striking. While the total number of invalid pensioners rose from 1.99 million to 2.28 million between 1930 and 1932, the amount spent on those pensions actually decreased from RM 953 million to 921 million. At the same time, spending on invalid-insurance benefits and services in general fell by around RM 200 million. The Reich government was also able to boast of cutting the amount it was contributing to invalid insurance to RM 374 million, the lowest it had been since 1928.117 Cuts in treatment services also had a marked impact. Most notably, invalid-insurance sanatoriums and rehabilitation centers drastically reduced their care for those with neuroses and other nervous illnesses. Spending some RM 9.7 million on 26,843 nervous patients in 1930, the same therapeutic facilities treated only 8,053 nervous patients in 1932, a decrease of 70 percent at a savings of almost RM 7 million.118 Retrenchment thus successfully transformed the campaign against pension neurosis into a massive deinstitutionalization of those with nervous ailments.119 Like other periods of government retrenchment in this century, the 1931–32 social dismantling project developed its own vocabulary. The talk was of “protecting the domestic peace,” “waste” (Schlacken) in insurance administration, public “abuses of social insurance,” the “retiring” (Ruhen) of pensions, and Page 266 → “securing benefits” by a thorough “restoration” (Sanierung) of social insurance.120 These were more than deliberately misleading euphemisms. The term Abbau (meaning dismantling or dissolution), for instance, came from neurology, where Constantin von Monakow had used it to refer to the cascading effects of shocks and traumas on the nervous system.121 The language of retrenchment, playing as it did on the themes of trauma, neurosis, corruption, danger, social insecurity, and rehabilitation, revealed to what extent policy had come to appropriate the terms of its critics (who themselves had originally appropriated the social-insurance idiom). A talk given by the physician B. Martin before officials of the Reich Insurance Office and Reich Disabled Veterans Court in February 1932 highlights the extent to which austerity led Weimar policymakers to entertain more radical measures. Medical progress over the previous two decades in the use of anesthetics, Martin claimed, justified revisiting the question of compulsory surgical operations. With the mortality rate for surgery with the use of ether at 1 in every 20,000–25,000, advances in postoperative pharmacology, and postwar improvements in prosthetic technology, Martin urged that the time had come for both social insurance and war-disabled care to allow surgeons to operate in a wider range of cases.122 Martin’s plea for broadening the parameters of compulsory operations was more than a resuscitation of a thirty-year-old debate. Delivered as it was at the height of austerity, it was indicative of a mentality that dwelled in policy-making circles during the transition from the Weimar Republic to the Third Reich. Here was the promise of an easy, available, technological solution to seemingly intractable fiscal dilemmas and social problems. Progressives, conservatives, and eugenics advocates alike could find hope in it. What Martin’s proposal obscured behind its mundane appeal to common sense, however, was that such a promise could only be fulfilled by granting the welfare state greater prerogative to use force. The Degenerative Welfare State

At first glance, it is perhaps ironic that the German welfare state drew its most vicious attacks at the very same moment when it was expanding in size and scope. But the inflation of social demands and the rising tide of disenchantment with social policy were intimately bound up with one another, and not as a function of some kind of political-economic stimulus-response where increased Page 267 → spending presumably provoked fiscal anxiety. As the government’s handling of pension neurosis shows, there was something more in the criticisms waged against social programs than the now-familiar liberal calls for laissez-faire or administrative accountability. The discomfort with the welfare state’s role in promoting neurosis was articulated in a singularly hybrid set of terms that played on the registers of medicine, economics, bureaucracy, and morality all at once. The welfare state became recognized by both administrators and beneficiaries alike as having exercised a malignant influence on society and public morale. It was not only inept, it was pathological; it was not merely ineffective, it was pathogenic. Growing claims and widespread disillusion were therefore treated as clinically verifiable symptoms of what was taken to be a contagiously degenerate institution. The fact that pathology, political economy, and the state found themselves linked with one another in Germany specifically through neurosis should command our attention here. As both Janet Oppenheim and Joachim Radkau have observed, nineteenth- and early-twentieth-century clinicians and laypeople understood nervous ailments in terms of an economy of energy. Like labor power, every person was supposed to be endowed with a reserve of nervous energy. This energy served as a form of vital capital that needed to be properly distributed and invested in productive enterprises: too little, too much, or wasted stimulation, in turn, meant depleting this reserve of energy and thus potentially precipitating a nervous breakdown.123 Thus, fin de siècle society was already well-versed in drawing analogies between neurology, political economics, and government. Social insurance’s use of the term “hysteria” to globally refer both to a medically recognized set of symptoms and a reproachable set of attitudes and behavior also hints at a more tangled connection with that diagnosis. The link with clinical hysteria, however, is at first glance a perplexing one. Long held to be a female malady, scholars have often interpreted hysteria as the manifestation and embodiment of culturally inscribed feminine roles, attributes, and attendant conflicts, an affliction arising out of that private sphere of social life relegated to bourgeois women. What then is to be made of the predominantly male pension-neurotic population in Germany at this time? A clue may be found in the contemporaneous understanding of male hysteria. Jan Goldstein, Ursula Link-Heer, Mark Micale, and Joachim Radkau have all shown that bourgeois literary and medical circles in nineteenthcentury Europe recognized the existence of a male hysteria.124 Goldstein and Link-Heer Page 268 → in particular argue that parallel to the widely held view that female hysteria was a malfunction of the female organs of reproductivity, male hysteria tended to be seen as a corresponding malfunction of the faculties of male creativity and productivity. In addition, psychiatric professionals like Charcot ascribed different symptomatology to men and women and associated male hysteria primarily with the working class, the unemployed, and the racially foreign. Thus, the prevailing clinical picture of hysteria relied on and reinforced a set of bourgeois oppositions: men linked with the productive, the public, and the workplace and women with the reproductive, the private, and the household. German social insurance fed into these selfsame oppositions. Its traditional exclusion of most women from independent membership and its overriding emphasis on industrial production made it, as we have seen, a primarily male institution and domain. It was designed above all else to assist male breadwinners when afflictions interfered with their ability to work. Social insurance therefore shared all the elements necessary for the emergence of male hysteria and neurosis: their presence here at this time was not surprising to contemporary observers. It was, however, deeply disturbing. It is necessary then to account for the disproportionately (given the relatively few cases) intense negative reactions that pension hysteria attracted. A product itself of German industrial society, social insurance embraced conventionally masculine ideals—independence, self-sufficiency, hard work, discipline, fortitude in the face of adversity, strength—all in a concerted effort to promote and maintain the health of the nation. These were reinforced by a broader, turn-of-the-century political rhetoric that employed a sexual language of bellicosity and identified biological pathologies as the causes and symptoms of national decline.125

World War I, however, both nurtured and upset common gender distinctions and assumptions. The war turned out to be a period of significant inversion in the experiences of men and women. The fighting itself was a masculine enterprise, while wives and mothers were expected to care for the home front. Yet, as the example of shell-shock victims showed, the experience of battle could “feminize” conscripts by taking away their sense of control and confining Page 269 → them in ways akin to Victorian women.126 Late Wilhelmian society made the discrepancy even more glaring by mobilizing a new unsentimental and hardened image of masculinity that emphasized strength of will.127 At the same time, many women spent the war assuming traditionally male responsibilities and entering previously forbidden places in industrial production (e.g., heavy industry).128 The increased participation of women in social work, combined with the millions of unemployed men who entered the social-welfare system after 1927, only exacerbated these tensions and instabilities.129 In the process came confusion, anxiety, and belligerence. With the emergence of a more public, autonomous woman upsetting standards of authority, many men expressed a virulent rage against things deemed feminine, interior, private, and emotional.130 The result was a discourse of belonging during the Weimar Republic that more explicitly employed metaphors of blood, body, and sexuality.131 The presence of pension neurosis in social insurance, conjuring the image of the hysterical female, thus represented the insinuation of impure, feminizing elements into a self-consciously masculine administrative world made highly sensitive to the intrusion of recent social changes. The list of reproachable symptoms and habits purportedly instilled by a corrupting social-security system reads like a litany of modernist stereotypes of feminine, hysterical excess: overexcitability, self-indulgence, dependency, petulance, laziness, anxiety, deceit, cowardice, sentimentality, hypochondria, illness, weakness. These were, to borrow Mary Douglas’s apt definition of dirt or pollution, “matter out of place.”132 The Reich Insurance Office’s decision on pension neurosis in 1926 attempted to halt this course. Despite this, from 1927 to 1930 the number of those with nervous and neurotic ailments being treated in invalid-insurance facilities more Page 270 → than doubled (from 12,893 to 26,843). Men consistently made up around 61 percent of these patients.133 The critics of German social security therefore were not invented by eugenics nor fascism nor even the First World War. They had existed for quite some time. It was only against the backdrop of total war, economic catastrophe, and the disruption of conventions that their concerns inspired broader, cultural criticism of the polity. As Girard has observed, a social crisis in which established hierarchies and differences erode or disappear is commonly experienced as a moral crisis of the first order, an eclipse of culture itself.134 This is what happened in Weimar Germany. The ensuing backlash against social security from liberal, conservative, and eugenic circles attempted to appropriate popular resentment, but only to redirect and reshape it in the form of a call for moral regeneration. The remedy offered by the Right was a reassertion of traditionally masculine distinctions, newly valorized by the discourse of sacrifice and by the experience of mass destruction and suffering. Those demanding the privatization of social insurance wished to reexpose the “soft” German people to the inherent risks of existence. Life once again would be invested with heroism through self-sacrifice. The introduction of needs-based benefits in social insurance could be and was justified for the very reason that it would redirect social insurance toward its original regenerative ends. The backlash against the Weimar welfare state was therefore the product of three converging social philosophies of reaction made possible and palpable by a popular resentment articulated in the language of heroic sacrifice and victimization. 1. An earlier version of the material on pension neurosis has appeared in “Die Bürokratie und das Entstehen von Krankheit: Die Politik und die ‘Rentenneurosen’ 1890–1926,” in Stadt und Gesundheit: Zum Wandel von ‘Volksgesundheit’ und kommunaler Gesundheitspolitik im 19. und frühen 20. Jahrhundert, ed. Jürgen Reulecke and Adelheid Gräfin zu Castell Rüdenhausen (Stuttgart: Franz Steiner, 1991), 203–23. 2. Edward Shorter, From Paralysis to Fatigue: A History of Psychosomatic Illness in the Modern Era (New York: Free Press, 1992), 215. 3. George Frederick Drinka, The Birth of Neurosis: Myth, Malady, and the Victorians (New York: Simon & Schuster, 1984), 40. 4. Hannah S. Decker, Freud, Dora, and Vienna 1900 (New York: Free Press, 1991); Joachim Radkau, “Industrialisierung des Bewußtseins und moderne Nervosität: Zur Mythologie und Wirklichkeit der

Neurasthenie im Deutschen Kaiserreich,” in Gesundheitsrisiken, ed. Milles, 363–85. 5. Schivelbusch, Railway Journey, 129–49. 6. Esther Fischer-Homberger, Die traumatische Neurose: Vom somatischen zum sozialen Leiden (Bern, Stuttgart, and Vienna: Hans Huber, 1975), 29–73; Gabriele Moser, “Der Arzt im Kampf gegen ‘Begehrlichkeit und Rentensucht’ im deutschen Kaiserreich und in der Weimarer Republik,” Jahrbuch für kritische Medizin, 16, AS-Sonderband 193 (1991): 161–83. 7. BAK, R89/342, “Traumatische Neurose und Simulation,” Die Berufsgenossenschaft 16 (1893). 8. BAK, R89 (Rep. 322)/290, Röhl v Privatbahn-BG, RVA Senate, 17 June 1889. 9. BAK, R89/342, Kehr v. Knappschafts-BG, RVA Senate, 29 March 1889; Landmann v. Knappschafts-BG, 17 June 1889; Lauterbach v. Süddeutsche Eisen- und Stahl-BG, 12 June 1892; Jürgens v Brauerei- und Mälzerei-BG, 26 June 1894; R89/343, Eichert v. Straßen- und Kleinbahn-BG, 4 January 1908. 10. BAK, R89/342, Kehr v. Knappschafts-BG, BA, R89/15112, Müller v. Sächsische-Thüringische Eisenund Stahl-BG, RVA Senate, 20 January 1909. 11. BAK, R89/342, Sebastiani v. Straßenbahn-BG, RVA Senate, 21 October 1889; R89/343, Thies v. Königlich Preußische Eisenbahnfiskus, RVA Senate, 28 June 1902. 12. BAK, R89/343, Leuchtenberger v. Schlesische-Textil-BG, RVA Senate, 7 March 1902. 13. BAK, R89/342, Skiba v. Knappschafts-BG, RVA Senate, 7 February 1890; Müller v. Brandenburgischelandwirtschaftliche-BG, RVA Senate, 1 April 1892; R89/343, Kubsch v. Nordöstliche Baugewerks-BG, RVA Senate, 18 March 1903. 14. For examples see Kehr v. Knappschafts-BG, 29 March 1889; Skiba v. Knappschafts-BG, 17 February 1890; Leuchtenberger v. Schlesische-Textil-BG, 7 March 1902. 15. BAK, R89/342, Landmann v. Knappschafts-BG, 17 June 1889; Sebastiani v. Straßenbahn-BG, 21 October 1889; RVA to State Secretary of the Interior, 26 March 1890; Leuchtenberger v. Schlesische-TextilBG, 7 March 1902; Thies v. Königlich Preußischer Eisenbahnfiskus, 28 June 1902. 16. Kehr v. Knappschafts-BG, 29 March 1889; Müller v. Sächsisch-Thüringische Eisen-und Stahl-BG, 20 January 1909. 17. For example, Lauterbach v. Süddeutsche Eisen- und Stahl-BG, 12 June 1892. 18. NRWHStA, Reg. Düsseldorf-Präsidialbüro, Nr. 955, Zedlitz to Regierungsrat Dr. von Gottschall, 23 February 1910. Zedlitz’s chamber alone, for example, heard 2,250 cases in 1909. Among all chambers in the Düsseldorf area, 6,799 cases were heard in 1909, with 577 remaining undecided at year’s end. 19. BAK, R89/342, Jürgens v. Brauerei- und Mälzerei-BG, RVA Senate, 26 June 1894. 20. BAK, R89 (Rep. 322), Nr. 1404, Wohlfarth to RVA, 17 October 1902. 21. For all records in the case, see BAK, R89 (Rep. 322, Nr. 1404, Wohlfarth and Thüringische Landesversicherungsanstalt v. Töpferei-BG, RVA Senate, 20 October 1902. 22. BAK, R89/343, Kress v. BG der chemischen Industrie, RVA Senate, 23 March 1903; “Unfallneurose,” Die Berufsgenossenschaft (1915): 202–5; “Rentenhysterie ist nicht entschädigungspflichtig,” Die Berufsgenossenschaft (1916): 77–78. 23. Walther Ewald, Die traumatischen Neurosen und die Unfallgesetzgebung (Berlin and Vienna, 1908). 24. Heinrich Sachs quoted by Kurt Mendel, “Über Querulantenwahnsinn und ‘Neurasthenia querulatoria’ bei Unfallverletzten,” Separate publication from Neurologischem Centralblatt (1909): 3–4. 25. Blind, “Internationale Erfahrungen in der Arbeiterfürsorge und deutsche Reichsversicherungsordnung,” Ärztliche Sachverständige-Zeitung (1910): 65–69. 26. Dankwart Guratzsch, Macht durch Organisation: Die Grundlegung des Hugenbergschen Presseimperiums (Düsseldorf: Bertelsmann, 1974), 41–47. 27. Ludwig Bernhard, Unerwünschte Folgen der deutschen Sozialpolitik (Berlin: J. Springer, 1912). 28. Alexander Elster, “Rentenhysterie und Schadenersatz,” Concordia 19 (1912): 146–47; “Licht und Schatten bei der deutschen Arbeiterversicherung,” Die Arbeiter-Versorgung 29 (1912): 665–66; R. von Edberg’s review of Kaufmann’s “Licht und Schatten bei der deutschen Arbeiterversicherung,” Concordia 19 (1912): 488; Lange, “Der Kampf um die Rente,” Die Arbeiter-Versorgung 29 (1912): 833–37; Wuermeling, “Zum Kampf um die Rente,” Concordia 20 (1913): 1–5; Altenrath’s review of Bernhard in ibid., 18–19; Hugo Stursberg, Unerwünschte Folgen deutscher Sozialpolitik? (Bonn, 1913); Franz Hitze, Bernard Wuermeling, and Christian Faßbender, Zur Würdigung der deutschen Arbeiter-Sozialpolitik: Kritik der Bernhardschen Schrift “Unerwünschte Folgen der deutschen Sozialpolitik” (M. Glodbach: Volks-

Verein, 1913); “Rentensucht und Rentenhysterie,” Ärztliche Sachverständige-Zeitung (1913): 184; [Review], Ärztliche Sachverständige-Zeitung (1913): 368–70. 29. “Über den Einfluß von Rechtsansprüchen auf Neurose,” Hochbau: Amtsblatt der Bayerischen Baugewerks-BG 5 (1913): 423–24; Rumpf, “Über nervöse Erkrankungen nach Eisenbahnunfällen,” Sonderabdruck von Zeitschrift für Bahn- und Bahnkassenärzte (1913); “Unfallversicherung und Zeitkrankheiten,” Südwestdeutsche Wirtschaftszeitung 18 (1913): 169–70. 30. BAK, R89/15113, Bericht über die außerordentliche Vertreterversammlung der Westfälischen Vereinigung berufsgenossenschaftlicher Verwaltungen, 18 March 1913. 31. In BAK, R89/15112, “Hysterie als Unfallfolge,” Vorwärts 236 (1912). 32. BAK, R89/15112, Dr. Paul Franck to RVA, 2 September 1912. 33. H. Mattutat, “Rentendrückerei und Unfallrechtsprechung,” Die Neue Zeit 31 (1913): 933. 34. Franz Lemmens, “Zur Entwicklung der Militärpsychologie in Deutschland zwischen 1870 und 1918,” in “Medizin für den Staat—Medizin für den Krieg”: Aspekte zwischen 1914 und 1945, ed. Rolf Winau and Heinz Müller-Dietz (Husum: Matthiesen, 1994), 41. 35. See, for example, Protokoll der Konferenz der Vertreter der Versicherten bei den Landesversicherungsanstalten (Berlin, 1915); Paul Lohmar, “Schattenseiten der Reichs-Unfallversicherung, ” Die Berufsgenossenschaft (1916): 93–95, 105–7, 117–18; HdgBG, Nr. 43, “Übersicht über die der Geschäftsstelle des Verbandes übermittelten Abänderungsanträge von grundsätzlicher Bedeutung,” 12 February 1916. 36. NRWHStA, Reg. Düsseldorf-Sozialangelegenheiten, Nr. 33228, Landesrat Appelius, “Streben nach Rente nicht das höchste Ziel des Kriegsverletzten,” in Kulturarbeit im Lazarett (Düsseldorf, 1915). 37. NRWHStA, Reg. Düsseldorf-Sozialangelegenheiten, Nr. 33228, Dr. Horion to Tätigkeitauschuss für Kriegsbeschädigtenfürsorge in der Rheinprovinz, 14 April 1915; Nr. 33229, Minister der Innern (Prussia) to sämtliche Herren Oberpräsidenten und den Herrn Regierungspräsidenten in Sigmaringen, 8 September 1915; Nr. 33230, “Niederschrift über die Sitzung des Tätigkeitsausschusses für Kriegsbeschädigenfürsorge am 5. Oktober 1917 in Cöln.” 38. NRWHStA, Reg. Düsseldorf-Sozialangelegenheiten, Nr. 33229, Sitzung der Tätigkeitsauschusses für Kriegsbeschädigtenfürsorge der Rheinprovinz, 20 December 1915; Nr. 33230, Landeshauptmann der Rheinprovinz to sämtliche Ortsausschüsse für Kriegsbeschädigtenfürsorge in der Rheinprovinz, 20 November 1917. 39. Erwin Loewy-Hattendorf, Krieg, Revolution und Unfallneurosen (Berlin, 1920), 12. 40. Paul Lerner, “Rationalizing the Therapeutic Arsenal: German Neuropsychiatry in World War I,” in Medicine and Modernity, ed. Berg and Cocks, 121–48. 41. F. Stern, “Bericht über die Kriegstagung des Deutschen Vereins für Psychiatrie in München am 21., 22., und 23. September 1916,” Ärztliche Sachverständige-Zeitung (1916): 236–39, 249–52. 42. On the politics of Social Democratic welfare reform in the first years of the Republic, see Hong, Welfare, 44–54. 43. Dr. Christian, “Ein Reichsministerium für Volksgesundheit und Bevölkerungspolitik,” Concordia 26 (1 May 1919): 71–73; Kurt Nemitz, “Die Bemühungen zur Schaffung eines Reichsgesundheitsministerium in der ersten Phase der Weimarer Republik, 1918–1922,” Medizinische Journal 16 (1981): 424–45. 44. Bernhard Möllers, Gesundheitswesen und Wohlfahrtspflege im Deutschen Reich (Berlin and Vienna: Urban und Schwarzenberg, 1923), 62. 45. Hong, Welfare, 60. 46. Paul Kaufmann, “Sozialversicherung oder Staatsbürgerversorgung?” Zeitschrift für die gesamte Versicherungs-Wissenschaft 24 (1924): 12. 47. Paul Moldenhauer, “Versicherungsprinzip oder Versorgungsprinzip in der deutschen Sozialversicherung,” Zeitschrift für die gesamte Versicherungs-Wissenschaft 22 (1922): 180. 48. Kaufmann, “Sozialversicherung oder Staatsbürgerversorgung?” 10–13. 49. Moldenhauer, “Versicherungsprinzip oder Versorgungsprinzip,” 180–81. 50. Kaufmann, “Sozialversicherung oder Staatsbürgerversorgung?” 8. 51. Moldenhauer, “Versicherungsprinzip oder Versorgungsprinzip,” 180. 52. See review under “Soziale Fürsorge,” Ärztliche Sachverständige-Zeitung (15 December 1920): 39–42. 53. H. Albrecht, “Ein Gesundheitsparlement?” Concordia 26 (1 August 1919): 122–23. The second

quotation is Albrecht’s words, not the association’s. 54. Erwin Franck, “Soziale Medizin,” Ärztliche Sachverständige-Zeitung (15 December 1920): 39–42; Gerhard Wörner, “Sachleistung oder Geldleistung als Leistungsprinzip der Sozialversicherung,” Zeitschrift für die gesamte Versicherungs-Wissenschaft 23 (1923): 291–301; W. Schöttler, “Fürsorgeprinzip und Versicherungsprinzip,” Die Neue Zeit 41 (25 April 1923): 55–58. 55. F. Leppmann, “Rückblick und Ausblick. Neujahr 1919,” Ärztliche Sachverständige-Zeitung (1919): 10; Loewy-Hattendorf, Krieg, Revolution und Unfallneurosen, 17. 56. Loewy-Hattendorf, Krieg, Revolution und Unfallneurosen, 19. 57. BAK, R89/15113 (Loewy-Hattendorf), “Die Kapitalabfindung bei Unfallneurosen,” 25 November 1920. 58. I have been unable to find any documents that touch on this directly. 59. BAK, R89/15114, Verband der deutschen landwirtschaftlichen Berufsgenossenschaften to Reichsarbeitsminister, 10 December 1924. 60. Ibid. Also herein, see Verband der deutschen Berufsgenossenschaften to Reichsarbeitsminister, 24 November 1924. 61. See BAK, R89/15114 for details of this survey. 62. BAK, R89/15114, Dr. Ewald Stier, “Ärztliche Leitsätze zur Frage der Unfallneurose,” 3 June 1926. 63. BAK, R89 (Rep. 322), Nr. 2373, Karl Morsbach für die kranke Elfried Morsbach to RVA, 22 July 1925; and Betriebskrankenkasse der Firma Gebrüder Hillers Grafräth to RVA, 17 July 1925. 64. BAK, R89 (Rep. 322), Nr. 2373, Notes of Dr. Knoll, undated. 65. BAK, R89 (Rep. 322), Nr. 2373, Morsbach and Betriebskrankenkasse Firma Geb. Hillers v. Nahrungsmittel-Industrie-BG, RVA Senate, 24 September 1926. 66. Ibid. 67. See BAK, R89/15114, between the years 1926 and 1930. 68. See, for example, “Nerven!” Der Reichsverband 7 (1926): 83; Levy-Suhl, “Der Ausrottungskampf gegen die Rentenneurosen und seine Konsequenzen,” Sonderabdruck Deutsche Medizinische Wochenschrift (1926); “Ärztliche Wissenschaft und Reichsversicherungsamt auf gefährlichem Wegen,” Der Bergknappe 32 (1927); A. Hoche, “Unzulässige Auslegung in der Unfallversicherungsgesetzes,” Sonderabdruck Deutsche Medzinische Wochenschrift (1928); Ernst Beyer, “Zum Streit um die Geltung die von Unfallneurosen,” Ärztliche Sachverständige-Zeitung (1928), 310–14. All can be found in BAK, R89/15114. 69. It was recognized as valid in 1939 by Nazi officials, accepted by the Federal Republic in 1957, and only first underwent modification by the Federal Social Court in 1962. See BAK, R89/15115, Leipziger VereinBarmenia to RVA, 13 October 1939; Klaus Linneweh, Die Beurteilungsproblematik neurotischer Störungen im System der sozialen Sicherheit (Diss. sozialwiss. Doktorgrades: Georg-August-Universität zu Göttingen, 1970). 70. These were the selfsame technocratic ambitions that drove the pronounced growth of occupational medicine and work science during the Weimar Republic. See Gertraud Schottdorf, Arbeits- und Leistungsmedizin in der Weimarer Republik (Husum: Matthiesen, 1995). 71. Paul Starr and Ellen Immergut, “Health Care and the Boundaries of Politics,” in Changing Boundaries of the Political, ed. Charles S. Maier (Cambridge: Cambridge University Press, 1987), 221–54. 72. Hong, Welfare, 217. 73. BAP, RAM, Nr. 4604, Bl. 242, Fritz Croner, “Die Nationalisierung der Sozialversicherung,” Leipziger Volkszeitung? September 1928; RAM, Nr. 4604, Bl. 249–52, Die Beschlüsse des 13. Kongresses der Gewerkschaften Deutschlands [ca. October 1928]. 74. Hong, Welfare, 216–26. 75. David Crew, “The Ambiguities of Modernity: Welfare and the German State from Wilhelm to Hitler,” in Society, ed. Eley, 319–44; Young-Sun Hong, “World War I and the German Welfare State: Gender, Religion, and the Paradoxes of Modernity,” in Society, ed. Eley, 345–69. 76. Bock, Zwangssterilisation, 21–58; Jürgen Reyer, Alte Eugenik und Wohlfahrtspflege: Entwertung und Funktionalisierung der Fürsorge vom Ende des 19. Jahrhunderts bis zur Gegenwart (Freiburg im Breisgau: Lambertus, 1991), 57–59, 81–162; Hong, Welfare, 239–71. On some of the differences dividing eugenicists and race hygienists, see Robert N. Proctor, Racial Hygiene: Medicine under the Nazis (Cambridge, Mass., and London: Harvard University Press, 1988), 20–45, and Hans-Walter Schmuhl, Rassenhygiene, Nationalsozialismus, Euthanasie: Von der Verhütung zur Vernichtung “lebensunwerten Lebens,”

1890–1945 (Göttingen: Vandenhoeck & Ruprecht, 1992), 90–105. 77. See the special issue of Central European History 30 (1997) on “Women and the Welfare State in the Weimar Republic.” 78. Renate Bridenthal, Atina Grossmann, and Marion Kaplan, eds., When Biology Became Destiny: Women in Weimar and Nazi Germany (New York: Monthly Review, 1984); Ute Frevert, Women in German History: From Bourgeois Emancipation to Sexual Liberation (Oxford and Washington: Berg, 1988), 185–204. 79. In this regard, German developments followed international trends of maternalist social policy that intervened to protect and look after the “needs” of mothers and children. See Gisela Bock and Pat Thane, eds., Maternity and Gender Policies: Women and the Rise of the European Welfare States, 1880s–1950s (London and New York: Routledge, 1991); Koven and Michel, eds., Mothers of a New World; Susan Pedersen, Family, Dependence, and the Origins of the Welfare State: Britain and France, 1914–1945 (Cambridge: Cambridge University Press, 1993). 80. Dickinson, Politics of German Child Welfare, 169–203. 81. Harvey, Youth and the Welfare State, 186–263; Gräser, Der blockierte Wohlfahrtsstaat, 148–73. 82. Detlev Peukert, “Der Schund- und Schmutzpolitik als Sozialpolitik der Seele,” in “Das war ein Vorspiel nur . . .” Bücherverbrennung in Deutschland 1933: Voraussetzungen und Folgen, ed. Hermann Haarmann (Berlin and Vienna: Medusa, 1983), 51–64; Margaret F. Stieg, “The 1926 German Law to Protect Youth against Trash and Dirt: Moral Protectionism in a Democracy,” Central European History 23 (1990): 22–56; Klaus Peterson, “The Harmful Publications (Young Persons) Act of 1926: Literary Censorship and the Politics of Morality in the Weimar Republic,” German Studies Review 15 (1992): 505–23. 83. Usborne, Politics of the Body, 31–68; Grossmann, Reforming, 46–77. 84. Hanns Dorn, “Die Zukunft des Versicherungsgedankens,” in Festversammlung am 2. Oktober 1924. Veröffentlichungen des Deutschen Vereins für Versicherungs-Wissenschaft, vol. 34, 51–62. 85. Hans Weissenbach, Über das Wesen und den Wert der Versicherung (Stuttgart: W. Kohlhammer, 1926). 86. Arthur Liebert, “Das Problem der Versicherung im Lichte der Philosophie,” Zeitschrift für die gesamte Versicherungs-Wissenschaft 24 (1924): 73–83. 87. Frieda Wunderlich, Der Kampf um die Sozialversicherung (Berlin: Deutscher Verband der Sozialbeamtinnen, 1930), 24. 88. W. Rohrbeck, “Die Universalität des Versicherungsgedankens und die Grenzen des Versicherungsschutzes,” Wirtschaft und Recht der Versicherung 65 (1933): 102. 89. Gustav Hartz, Irrwege der deutschen Sozialpolitik und der Weg zur sozialen Freiheit (Berlin: August Scherl, 1928), 14–18. 90. Gustav Hartz, Die national-soziale Revolution: Die Lösung der Arbeiterfrage (Munich: J. F. Lehmann, 1932), 128. 91. Erwin Liek, Der Arzt und seine Sendung (Munich: J. F. Lehmann, 1927). 92. Erwin Liek, Die Schäden der sozialen Versicherungen und Wege zur Besserung (Munich: J. F. Lehmann, 1928), 41. 93. Erwin Liek, Soziale Versicherungen und Volksgesundheit (Langensalza: Hermann Beyer und Söhne, 1929), 33–54. 94. On the invocation of Bismarck in Weimar debates over social insurance, see Martin H. Geyer, “Bismarcks Erbe—welches Erbe?” 280–309, and Lothar Machtan, “Hans Rothfels und die sozialpolitische Geschichtsschreibung in der Weimarer Republik,” 310–84, both in Bismarcks Sozialstaat, ed. Machtan. 95. See, for instance, Hans Stappert, Krankenscheingefällig? (Munich: Verlag der Ärztlichen Rundschau Otto Gmelin, 1928); Vereinigung der Deutschen Arbeitgeberverbände, Die Reform der Sozialversicherung—eine Schicksalsfrage des deutschen Volkes (Berlin: Vereinigung der Deutschen Arbeitgeberverbände, 1930). 96. Ernst Horneffer, Der große Wunde: Psychologische Betrachtungen zum Verhältnis von Kapital und Arbeit (Munich and Berlin: 1923), 63. 97. Ibid., 82–83. 98. Ernst Horneffer, Frevel am Volk: Gedanken zur deutschen Sozialpolitik (Leipzig: R. Voigtländer, 1929). The term “Frevel” implies a sacrilege, crime, or outrage of some kind. 99. Ibid., 17–18.

100. Ibid., 41–42. 101. Gustav Hartz, Eigentum oder Rente? Eine Auseinandersetzung mit meinen Kritikern über das Thema: Sozialversicherung oder Sozialsparkasse? (Berlin: August Scherl, 1930), 21–39. 102. BAP, RAM, Nr. 4604, Bl. 180, “Eigentum statt Sozialrente! Die Gewerkschaften dagegen,” Deutsche Bergwerks-Zeitung 30 September 1928. 103. BAP, RAM, Nr. 4604, Bl. 125, “Für die Zwangs-Sozialversicherung: Grieser gegen Erkelenz—Wirtschaft und Sozialversicherung bedingen einander,” Schleswig-Holsteinische Volkszeitung, 21 October 1927. 104. BAP, RAM, Nr. 4604, Bl. 259, Dr. Fritz Horst, “Reform der Sozialversicherung: Wo bleibt das privatwirtschaftliche Versicherungsgewerbe?” Deutsche Bergwerks-Zeitung 12 June 1929. 105. See section 6 “Ärzte und soziale Versicherung,” in Liek, Arzt. 106. BAP, RAM, Nr. 4604, Bl. 175, “Versicherungswesen und Volksverfall!” Deutsche Erneuerungsgemeinde Leipzig, October 1928. 107. Friedrich Burgdörfer, Der Geburtenrückgang und seine Bekämpfung: Die Lebensfrage des deutschen Volkes (Berlin: Richard Schoetz, 1929), 178–90. See also his Volk ohne Jugend: Geburtenschwund und Überalterung des deutschen Volkskörpers (Berlin-Grunewald: Kurt Vowinckel, 1932). 108. BAP, RAM, Nr. 4604, Bl. 256, “‘Einer trage des anderen Last,’” Soziale Praxis 11 April 1929. 109. Sheila Faith Weiss, Race Hygiene and National Efficiency: The Eugenics of Wilhelm Schallmayer (Berkeley and Los Angeles: University of California Press, 1987); Peter Weingart, Jürgen Kroll, and Kurt Bayertz, Rasse, Blut und Gene: Geschichte der Eugenik und Rassenhygiene in Deutschland (Frankfurt a.M.: Suhrkamp, 1988). 110. Hong, Welfare, 241. 111. See the review essay by Frank Dikötter, “Race Culture: Recent Perspectives on the History of Eugenics,” American Historical Review 103 (1998): 467–78. 112. It is for this reason that I believe Weindling overstates the case when he speaks of the “biologization of welfare” during the Weimar Republic. See Paul Weindling, “Eugenics and the Welfare State during the Weimar Republic,” in State, Social Policy, and Social Change, ed. Lee and Rosenhaft, 134–63. 113. Reyer, Alte Eugenik und Wohlfahrtspflege, 59. 114. Preller, Sozialpolitik in der Weimarer Republik, 462. 115. Tennstedt, “Sozialgeschichte,” 435–36, 465–67; Preller, Sozialpolitik in der Weimarer Republik, 391–495; Ernst Wickenhagen, Geschichte der gewerblichen Unfallversicherung, vol. 1 (Munich and Vienna: Oldenbourg, 1980), 222–23; Wilfried Berg, “Arbeits- und Sozialverwaltung einschließlich Sozialversicherung und Reichsversorgung,” in Deutsche Verwaltungsgeschichte, vol. 4, ed. Kurt A. Jeserich, Hans Pohl, and Georg-Christoph Unruh (Stuttgart: Deutsche Verlags-Anstalt, 1985), 236–37. 116. “Sozialversicherung und Reichshaushalt,” Amtliche Nachrichten für Reichsversicherung 4 (1930): 224–31; Heinze, “Zum Streit über die Lastenverteilung in der Invalidenversicherung,” Amtliche Nachrichten für Reichsversicherung 7 (1931): 362–68; Preller, 430. 117. “Geschäftsbericht des Reichsversicherungsamts für das Jahr 1929,” Amtliche Nachrichten für Reichsversicherung 3 (1930): 125–60; “Geschäftsbericht des Reichsversicherungsamts für das Jahr 1931,” Amtliche Nachrichten für Reichsversicherung 3 (1932): 125–60; “Geschäftsbericht des Reichsversicherungsamts für das Jahr 1932,” Amtliche Nachrichten für Reichsversicherung 3 (1933): 121–60. 118. Reichsversicherungsamt, Gesundheitsfürsorge in der Invalidenversicherung 1932, Beilage zu den Amtlichen Nachrichten für Reichsversicherung 10 (1933): 43. 119. Deinstitutionalization appears to have been an aim in German psychiatric care since at least 1925, which was when the average length of time people spent in asylums began shortening. Michael Burleigh, Death and Deliverance: “Euthanasia” in Germany 1900–1945 (Cambridge and New York: Cambridge University Press, 1994), 30. 120. Martin H. Geyer, Reichsknappschaft, 256–89. 121. Anne Harrington, Reenchanted Science: Holism in German Culture from Wilhelm II to Hitler (Princeton: Princeton University Press, 1996), 82. 122. B. Martin, “Die Verpflichtung zur Duldung von Operationen in der Reichsversicherung und Reichsversorgung und die Fortschritte der Chirurgie,” Amtliche Nachrichten für Reichsversicherung 3

(1932): 128–32. 123. Janet Oppenheim, Shattered Nerves: Doctors, Patients, and Depression in Victorian England (New York and Oxford: Oxford University Press, 1991), 79–109; Radkau, Zeitalter, 190–200, 232–46. 124. Ursula Link-Heer, “‘Männliche Hysterie’: Eine Diskursanalyse,” in Weiblichkeit in geschichtlicher Perspektive, ed. Ursula A. J. Becher and Jörn Rüsen (Frankfurt a.M.: Suhrkamp, 1988), 364–96; Jan Goldstein, “The Use of Male Hysteria: Medical and Literary Discourses in Nineteenth-Century France,” Representations 34 (1991): 134–65; Mark S. Micale, “Hysteria Male/Hysteria Female: Reflections on Comparative Gender Construction in Nineteenth-Century France and Britain,” in Science and Sensibility: Gender and Scientific Enquiry, 1780–1945, ed. Marina Benjamin (Cambridge, Mass.: Basil Blackwell, 1991), 200–239; Radkau, Zeitalter, 121–44. 125. See Isabel V. Hull, The Entourage of Kaiser Wilhelm II, 1888–1918 (Cambridge: Cambridge University Press, 1982); Robert A. Nye, Crime, Madness, and Politics in Modern France: The Medical Concept of National Decline (Princeton: Princeton University Press, 1984); George L. Mosse, Nationalism and Sexuality: Middle-Class Morality and Sexual Norms in Modern Europe (Madison: University of Wisconsin Press, 1985); Daniel Pick, Faces of Degeneration: A European Disorder, c. 1848–1918, (Cambridge: Cambridge University Press, 1989). 126. Elaine Showalter, The Female Malady: Women, Madness, and English Culture, 1830–1980 (New York: Pantheon, 1985), 167–94. 127. Radkau, Zeitalter, 357–428. 128. Susanne Rouette, “Nach dem Krieg: Zurück zur ‘normalen’ Hierarchie der Geschlechter,” in Geschlechtshierarchie und Arbeitsteilung: Zur Geschichte ungleicher Erwerbschancen von Männern und Frauen, ed. Karin Hausen (Göttingen: Vandenhoeck & Ruprecht, 1993), 167–90. 129. Crew, Germans, 70, 116, 152–65; Hong, Welfare, 163. 130. See Klaus Theweleit, Male Fantasies, 2 vols. (Minneapolis: University of Minnesota Press, 1987–89). 131. On these themes, see Maria Tatar, Lustmord: Sexual Murder in Weimar Germany (Princeton: Princeton University Press, 1995); Uli Linke, “Gendered Difference, Violent Imagination: Blood, Race, Nation,” American Anthropologist 3 (1997): 559–73. 132. Mary Douglas, Purity and Danger: An Analysis of the Concepts of Pollution and Taboo (London and New York: Routledge, 1966). On the modern segregation of conventionally male and female spheres of social life, see Karin Hausen, “Die Polarisierung der ‘Geschlechtscharaktere’—Eine Spiegelung der Dissoziation von Erwerbs- und Familienleben,” in Sozialgeschichte der Familie in der Neuzeit Europas, ed. Werner Conze (Stuttgart: Ernst Klett, 1976), 363–93. 133. Reichsversicherungsamt, Gesundheitsfürsorge in der Invalidenversicherung 1929, Beilage zu den Amtlichen Nachrichten für Reichsversicherung 6 (1930): 90–91; Gesundheitsfürsorge in der Invalidenversicherung 1932, Beilage zu den Amtlichen Nachrichten für Reichsversicherung 10 (1933): 43. This massive growth mirrored general trends in psychiatric residential care. Between 1924 and 1929, the number of psychiatric patients in Germany rose from around 185,000 to over 300,000. Burleigh, Death, 29. 134. René Girard, Violence and the Sacred (Baltimore and London: Johns Hopkins University Press, 1977); The Scapegoat (Baltimore: Johns Hopkins University Press, 1986).

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CHAPTER 8 Conclusion: Social Security and the Politics of Entitlement in Twentieth-Century Germany So, in the practical life of our mature cultures our pursuits take on the character of chains, the coils of which cannot be grasped in a single vision. . . . The long strands of means and ends, which transform life into a technical problem, make it completely impossible to remain clearly aware at every instant of the terminus of each strand. On one hand it is impossible to keep track of the entire sequence, and on the other, each step before the last one requires the whole concentration of one’s spiritual energies. Thus, our consciousness is bound up with the means, whereas the final goals which import sense and meaning into the intermediate steps are pushed toward our inner horizon and finally beyond it. Technology, which is the sum total of the means of a civilized existence, becomes the essential object of struggle and evaluation. Thus, people are eventually surrounded everywhere by a crisscrossing jungle of enterprises and institutions in which the final and definitely valuable goals are missing altogether. Only in this state of culture does the need for a final goal and meaning for life appear. Life, as long as it consists in short means-ends relations, each of which is sufficient and comforting in itself, knows nothing of the restless questioning which is a product of reflection about a being that is captured in a network of means, detours, and improvisations. Georg Simmel, Schopenhauer and Nietzsche By 1933 the basic contours of modern German social insurance had been defined. The policies, politics, structures, criticisms, and justifications that developed since the social legislation of the early 1880s established an enduring Page 272 → language and policy framework. They provided the terms by which German social security in the twentieth century has been construed and crafted. Despite such continuity, however, the German welfare state in this century has undergone more than a simple linear expansion. By way of conclusion, I wish to assess the historical significance of German social insurance by outlining some of the connections between nineteenth- and twentieth-century developments in social security and its politics. Since the end of the Weimar Republic, Germans have lived under fascist, occupation, communist, and divided, then unified, democratic rule. Throughout, the guiding principles of social security have played a persistently, indeed an increasingly, prominent role in the constitution of German polities. The ethos of social security and the politics of entitlement have proven remarkably adaptive, informing the aspirations of otherwise dissimilar publics and guiding the policies of ideologically opposed regimes. How are we to account for this? What consequences has this had for contemporary Germany? Perhaps it is best to begin by first asking where the episode of National Socialism fits into this history. National Socialism and Securing the “Volksgemeinschaft” Much has been made of the continuities between the policies of the Brüning, Papen, and Schleicher governments and those of the National Socialists in their first years in power. Nazi opinions about social insurance expressed before 1933, to be sure, were hardly original. Their attacks on sickness-insurance funds for promoting socialism as well as their support for a more corporately organized (ständisch) social-insurance system aped what had been said by right-wing critics for some time. Once in power, Nazi leaders up to 1936 followed what Harold James has described as “a rather unadventurous and conservative” economic and fiscal policy that followed “the lines laid down by previous governments’ responses to the world Depression.”1 Things were no different when it came to social insurance during these years. Until 1938, the Nazi government built on the retrenchment measures of 1931 and 1932 by further increasing premiums, extending waiting periods, cutting pensions, and adopting a restrictive compensation policy in cases of occupational accident.2 Page 273 →

National Socialist policy, however, deviated from the agenda set by earlier critics and policymakers in a fundamental way. Moved by the organizing principle of struggle, Nazi policy was envisioned in martial terms, as the defense of the racially pure and inherently productive Volksgemeinschaft (“national community”).3 A scientifically justified racism provided new norms for social behavior and, thereby, for regulation.4 Biological chauvinism, most markedly after 1937–38, thus came to inform and inspire every aspect of public policy in the Third Reich.5 Eugenics provided the salient heuristic that contributed a measure of consistency between competing party and state, central and local decision makers.6 Social policy necessarily had two aspects, then. There was a negative eugenics, the task of which was to identify, select, segregate, and ultimately destroy those people and habits believed to threaten the strength and integrity of the Volksgemeinschaft. The forced sterilization of those supposed to be “hereditarily ill” and police raids on the homeless began as early as mid-1933.7 As Wolfgang Ayaß has shown, before 1938, the campaign against “asocials,” those deemed “incapable of being part of the community” (gemeinschaftsunfähig), was largely an uncoordinated affair. Driven and directed by local welfare and government authorities, measures restricted the benefits and movements of vagabonds, beggars, welfare recipients, and the congenitally disabled. Once the war began, these regulations were extended to juvenile delinquents, prostitutes, and Sinti and Roma (“gypsies”); “asocials” were sent to concentration camps; and around eighty special workeducation camps were set up for so-called work slouches (Arbeitsbummelanten).8 Such policies dovetailed with a more centrally orchestrated Page 274 → set of “euthanasia” programs that killed around 200,000 mentally ill, disabled, chronically ill, and racially undesirable men, women, and children.9 The counterpart to these aspects of Nazi social policy was a positive eugenics that sought to nurture and enhance the productive and reproductive capacities of the community. Here, a highly gendered division of labor placed different sets of expectations on the private and public spheres within the Volksgemeinschaft. Women were publicly recognized and officially rewarded for their services as mothers and nurturers of men.10 As recent studies have reminded us, however, such traditional feminine ideals still allowed large numbers of women to play prominent roles as social workers, health-care professionals, and industrial laborers.11 At the same time, public works and employment programs beginning in 1935 reinterpreted the question of male unemployment in military terms as a matter of “labor deployment” (Arbeitseinsatz).12 First rearmament, then war itself, ultimately led to pressuring workers to accelerate their output, rationalizing the production process, and increasing reliance on foreign slave labor.13 The assumption underlying all Nazi social and economic policy was that the Volksgemeinschaft was not only a community of race, but a community of competitive achievement (Leistungsgemeinschaft). In factories, work service Page 275 → crews, army units, and concentration camps, the measure of conduct and human value remained strikingly consistent: performance, work, output.14 The entire social-insurance establishment was likewise drawn into the service of these imperatives. Concerns over labor shortages since 1936, coupled with the demands of total war from 1941 onward, led policymakers to adopt a familiar strategy to promote labor power. First, those factors inhibiting production were to be “prophylactically” identified and excised. In keeping with this aim, the Labor Ministry restricted access to sickness-insurance benefits in May 1941 by replacing the longstanding criterion of “ability to work” (Arbeitsfähigkeit) with the notion of “work deployment ability” (Arbeitseinsatzfähigkeit). In addition, certifying physicians were enlisted to select and institutionally segregate workable insurance claimants, pensioners, and patients from those unable to work. Factory physicians (Betriebsärzte) assumed similar tasks, playing a key role in the identification of “asocials” at the shop level. Second, social-insurance institutions and personnel were to “therapeutically” reintegrate the disabled into the productive economy. Old sanatoriums were retooled and new sanatoriums were built, using traditional work therapies to rehabilitate and retrain the invalid, the chronically ill, tuberculars, the war-wounded, and the elderly.15 In sum, National Socialism purged the social-insurance system of undesirable personnel, insinuated state authority into social self-administration, and coordinated the institution’s mission to racially and eugenically justified ends. Upon coming to power, the Nazi leadership adopted the thinking of Weimar social-policy critics that the German welfare state had become degenerate and corrupting. Yet despite promising a regenerative reform of German social policy, the regime never abandoned or dismantled conventional social insurance. This was not for lack of

trying on the part of some decision makers, however. As in other areas of public policy, National Socialist opinion about social security was divided. Historical research to date has identified at least four different, often competing, schools of thought among the Nazi leadership about the uses and future of traditional social insurance. Robert Ley’s German Labor Front, along with its Work Science Institute, doggedly advocated the creation of a comprehensive, unified social-security system to replace the existing branches of social insurance. Ley and his associates (“productivists”) placed great emphasis on the need to improve economic performance and sought to center any Page 276 → future social-security system in the workplace.16 Ley frequently clashed with Leonardo Conti, originally with the Headquarters for Public Health of the Nazi Party, later named Reich health leader in April 1939. Conti and his officials (“race hygienists”) believed, too, that a comprehensive reform of health care was necessary. Their plans, however, were family-centered, driven by racial hygiene desires to promote Aryan fecundity.17 A third school of thought was implemented in the Generalgouvernement of occupied Poland after 1939. Here local administrators (“colonialists”) established a unified state insurance system that restricted benefits on the basis of racial criteria.18 Finally, the Reich Ministry of Labor and its chief Franz Seldte (“traditionalists”) were the consistent defenders of the social-insurance system in its historical form. Originally wedded to the retrenchment policies of 1931 and 1932, the Labor Ministry from 1941 on became the chief advocate for improving social-insurance benefits despite cuts in administrative personnel.19 In the end, the Reich Labor Ministry carried the day. Social insurance retained most of the features it had developed during its first fifty years. Without question, the divisive nature of the Third Reich’s departmental polyocracy had much to do with this continuity.20 Personnel politics made consensus on reform impossible, thus leaving the status quo as the path of least resistance. Perhaps too, however, Nazi social security reflected to what extent entitlement in its historical form had become a fixture in German political culture. More research needs to be done on this subject, but there is compelling evidence that the Volksgemeinschaft was no mere epiphenomenal fabrication of Page 277 → the party.21 Instead, it was a social fact, operating as a kind of surrogate civil society by which individuals could articulate demands on authorities and whose opinions policymakers tracked.22 Those involved in shaping Nazi social policy showed signs of genuine concern over the welfare and mood of deserving comrades (Volksgenossen).23 The Labor Front’s ambitious plans after 1939 to revamp social security, for instance, included “care-free old age” for “the victims of war,” the elimination of class distinctions in benefits packages, and a special honorarium (Ehrensold) for the wardisabled, “victims of work” (Opfer der Arbeit), and anyone else “who has suffered an injury in the course of deploying his person in service or on the job.”24 Even during the last stages of the war, many top officials went on record in favor of increasing pensions in order to prove to German workers that wartime retrenchment measures were not going to be at their expense.25 This is not to say—as Götz Aly and Susanne Heim, and those associated with the Hamburg Institute for Social Research and its project on “National Socialist Health and Social Policy” have contended—that National Socialist policies were merely a consequence of mundane socioeconomic concerns and planning.26 For one thing, as social insurance demonstrates, attempts to neatly distinguish the influences of Nazi social and economic policies from those of its racial policies are inherently flawed. Social security during the Third Reich remained “social” by always being racial, by directly serving positive or negative eugenic functions.27 Page 278 → But perhaps what Aly and Heim’s image of an emerging “expertocracy” most importantly overlooks is that the Third Reich’s social policy was also forged and inflected by the unscientific popular discontent and victimization politics of the twenties and early thirties. According to the foundational myth of the Nazi party, members of the Volksgemeinschaft were long-suffering, taken advantage of by parasitic forces, and in recent times compelled to make enormous sacrifices while receiving little gratitude in return. The narrative of unrewarded sacrifice and indulged whining was particularly prominent in the Third Reich’s mythology of the Frontgemeinschaft (the community of soldiers at the front). Nazi leaders came to power in 1933 explicitly promising to make sure “the

sacrifices [of afflicted veterans] were not in vain.” Memorials and ceremonies commemorated the fallen heroes of the party and nation.28 Such martial rites and values were carried over into social policy, where Hitler himself referred to injured workers as “victims of work” who had “fallen on the fields of labor.”29 But the fighting man remained front and center. At the Nuremberg Party rally of 1933, the director of the National Socialist Disabled Veterans Relief organization made it clear that the new regime was not going to treat wounded veterans the same as “the unemployed, invalids, and other welfare recipients.” Rather, veterans were to be granted the greater honor (and by extension, the larger pension) that was due them. Moreover, laws passed in 1938 and 1939 awarded greater benefits to active-duty soldiers injured in combat than to those injured either in peacetime or in rear-echelon duty.30 These efforts were reinforced after the outbreak of war in 1939 by a change in administrative language. From 1940 on, German military and health administrations replaced the term “Kriegsbeschädigter” (a World War I term used to refer to those injured in combat and implying notions of “damage” and “ruination”) with the term “Kriegsversehrter” (a term whose etymology linked it to pain, wound, and combat).31 Thus Nazi military disability policy abandoned conventional principles of compensation (based on earning ability) and reoriented them toward militarized values of courage, heroism, and sacrifice. Page 279 → Social Security and the Social Entitlement State Continuities in the History of Entitlement Politics Social security in the Third Reich therefore represented neither a culmination of nor a radical departure from the developments of the previous fifty years. Rather, it was a variation on a theme. Its apocalyptic, chauvinistic, and exterminationist elements certainly met with the approval of a sufficient number of utopian policymakers and professionals to enable the orchestration of the “Final Solution.” At the same time, however, the banal elements of programs like social insurance provided the mass of Germans with a familiar space of private concern into which they could flee from the public sphere.32 This haven of “normality” proved to be a powerful source of legitimation for the Hitler state during and even after its reign.33 Thus, while the Nazi welfare state was an integral part of genocidal politics, it should not be reduced to a generic racism. All social and economic measures did presume racist categories and had racist implications, but National Socialism did not consist of one tacitly accepted, homogeneous racism. Decision makers were motivated by and policies were organized according to different, frequently conflicting, ideas of how to ensure the well-being of the Aryan polity. The same sciences and technologies that had informed social-insurance practice—bureaucratic administration, statistics, political economy, clinical medicine, actuarial science—necessarily played an important mediating role in policy formulation and debates, offering a historically legitimate set of terms by which to communicate the methods and purposes of violence and genocide.34 But perhaps the most important line of continuity connecting the National Socialist with the Wilhelmian, Weimar, and contemporary German welfare states is more obvious than this. As Martin Geyer has outlined, Nazi social policy makers were driven by a progressive dream of a socially secure and economically prosperous consumer society.35 Social security and economic progress were believed to be inherently bound up with one another. The regime’s policy of steering supply-side production instead of facilitating demand-side Page 280 → redistribution and emphasizing Vorsorge over Fürsorge had long been the strategy of the German state and remained so after World War II. Social security’s values of individual benefit, solidaristic support, safety, and stability served during the Third Reich as a shelter for some, a source of inspiration for others. It is this attachment to the normality of social security that links the years 1933–45 to the economic miracle of the 1950s as much as to the social legislation of the 1880s.36 Ironically, this rather apolitical conformist current in German history can trace its sources in part to the emergence of the highly politicized sense of entitlement to which social insurance gave birth. In important ways, the

insurance solution to the nineteenth-century Worker Question succeeded beyond the expectations of Bismarckian lawmakers. Social insurance institutionalized compensation in two ways. By making it compulsory, it simultaneously transformed compensation into a legal right. By also making benefits contingent on whether a body or body part was ill or injured, it clinically naturalized compensation, lending it an aura of natural scientific inevitability. Every eligible worker could lay claim to benefits and services on these grounds: they were and felt entitled. Turn-of-the-century social insurance thus played a leading role in making a general attitude of claim, demand, and entitlement the primary link between the German state and those it governed.37 The success of Bismarckian social insurance, however, was double-edged. While the state gained the loyalty of millions of insured workers, it also assumed a huge and growing responsibility. Entitlement bred its own inflationary style of politics. Individual workers were the driving force behind the highly dispersed politics of entitlement that dominated Wilhelmian social insurance. Here the claims and treatment process largely atomized the insured. Insurance beneficiaries, however, invested the bureaucratic process with a moral theodicean significance, prompting an explosion of litigation. World War I, corporatist politics, and the economic crises of the 1920s and early 1930s eventually transformed these individual grievances into organized interests. With avenues of individual protest cut off, pensioners discovered common cause and voiced their discontent through the rhetoric of sacrifice and victimization. The state, in turn, met (or attempted to meet) their demands in like fashion, categorically targeting at first those deemed most needy, then later those deemed most deserving. These efforts, however, proved incapable of retaining the traditional and highly popular distinction between insurance and welfare. By 1933, then, social pensioners were déclassé, collapsed into the mass of poor and unemployed. Page 281 → The widespread flight into the private sphere under National Socialism was, from this perspective, a way for many to heroically personalize, and thus seemingly elevate, their social fate. The Ethos of Social Security In stark contrast to the picture of French social insurance painted by neo-Foucauldians such as Ewald, Defert, and Donzelot, the German system was characterized by open conflict. This was intended. In fact, it was the German solution to the Social Question. Institutionalize social conflict. Use administration to mediate between the two great interests of industrial society. Replace social revolution with social reform by maintaining economic productivity and integrating workers into society by ensuring some minimum existence. This served to institutionalize some of the most basic tensions in modern capitalist society. Social conflict, however, was hardly tamed by this experiment in therapeutic social administration. It seeped out in unexpected ways and, in the process, transformed the very bureaucracy designed to domesticate it. Above all else, what generated the desire and design for this attempt at managing industrial social conflict was the German state’s concern over security. Ensuring the security of the realm had been a long-standing obligation of the state in central Europe, one premised on there being an inherent link between the fate of the polity, economic prosperity, and the welfare of subjects. Prussian and German statecraft in the nineteenth century continued to assume these connections. Now, however, a more autonomous civil society and its problems required new managerial skills. Social policy served this function: a rational, scientific process that, like its predecessor the police state, incorporated public policy, economics, medicine, and statistics. At the intersection of these techniques stood nineteenth-century insurance. For reformers, state officials, liberals, and conservatives it represented a talisman for the Worker Question: essentially conservative ambitions could be wedded with modern innovations in technology. As a heuristic, insurance provided a powerful new way to understand social problems in a language of risks and insecurities. At the same time, it offered itself as a solution by secularizing misfortune, placing it in the hands of employers, employees, and professionals. The resulting pacification of social tensions, it was hoped, would mean the restoration of trust, security, and certainty. Insurance made security social. It also made it a commodity. Firmly rooted in industrial society, social insurance took property rights as its model.38 Social security for workers was Page 282 → equated with income security, which thereby made it a question of recognizing those risks to one’s ability to work for a living. Sickness and disability became reified in

economic terms, where showing “concern” was measured by awarding and receiving more or less money, more or fewer services. This, in turn, perpetuated a sense of civic selfhood that could only be expressed in the form of fulfillments and disappointments, validation and resentment.39 This has had two consequences for twentiethcentury health care: a technical acceleration of medical analysis and treatment coupled with a growth in the demand for health. The politics of entitlement were bred by this mutually reinforcing supply of and demand for social-security refinement.40 Thus, the very rationality of social security has contributed to the proliferation of entitlements. Since risks are always both actual and potential, the job of controlling and eliminating them is never finished. Indeed, greater planning has only revealed new sources of uncertainty.41 As Luhmann has observed, the welfare state’s inclusiveness is derived from this inherently expansive feature of its work: “Consequently, this involved not only the securing and continuous improvement of the minimal standards of social well-being for everyone, but also specific problems of the most diverse kind that can become serious for anyone who gets into these difficult situations. Therefore, improvement proceeds not only in the direction of raising minimal standards, but also in the direction of the discovery of ever new problems—safer docking facilities for Sunday sailors, hot-air hand dryers in public restrooms, etc.—as public goals.”42 Trends in contemporary social insurance have moved in the same direction. The introduction of new technologies, the identification of growing numbers of environmental hazards, the ever increasing life expectancy of men and women, and the ongoing displacement of physical by mental and service labor have only prompted the recognition of new risks and, in turn, new spheres of activity for social insurance.43 Page 283 → In bringing its technology of risk assessment to the enterprise of statecraft, insurance merged with administrative regulation, public law, and clinical medicine. This convergence of bureaucratic, actuarial, judicial, and medical technologies gave birth to a new, therapeutic style of government. The norms governing society were to be managed by the application of technologies weighed and measured less for their moral or metaphysical justification than for their utility.44 Moreover, social problems became increasingly pathologized. “Cases” were understood in metaphors of dysfunction, and plans of “treatment” were constructed. The clinical triad of diagnosis, treatment, and prophylaxis was translated into the bureaucratese of administrative assessment, rehabilitation, and sickness and injury prevention. By the early part of this century, the heuristic of therapeutic risk management had become so compelling that it was self-reflexive. Even the welfare state itself could be recognized as a pathological entity with the potential to create the very problems it attempted to address. The pursuit of social security, first outlined in the nineteenth century, became a self-justifying political and social principle in the twentieth.45 The catastrophic effects of the Great War were largely translated into the idiom of danger and uncertainty. More needed to be done, Germans from all walks of life demanded, in order to reestablish a stable order and a secure existence. The National Socialists devised one form of this security, a nationalist, racist, and totalitarian fantasy that reunited violence and domination with welfare. After the Second World War, Germans once again found themselves picking up the pieces, expelled from the East, widowed and orphaned, their infrastructure destroyed. West Germans of the late 1940s and 1950s reasserted their claims on security by retreating into their families, reestablishing traditional social insurance, and electing the political party that ran under the slogan “No Experiments.”46 To this day, postwar public policy in the Federal Republic has remained driven by the memory of traumatic historical experiences and the consequent desire for security, predictability, and stability.47 Social insurance thus gave birth to a system of values and technologies that has exercised a seemingly irresistible hold over twentieth-century political Page 284 → culture. “The common good” and “the general welfare,” once keywords of the early modern welfare state, now have an arcane ring to them. Rather, the twentieth-century welfare state has been more concerned with securing, preserving, and sustaining a standard of living. Particularly among those publics who developed “post-materialist” concerns after World War II, social security has been almost universally accepted as the very raison d’être of the welfare state.48

The Keynesian welfare state, the model for many Western European nations from 1945 to the mid-1970s, represents one important moment in this development. The idea of “managed capitalism” emphasized the need for the state “to intervene within the market to generate an enhanced level of ‘effective demand,’ promoting both the propensity to consume and to invest, so as to ensure sufficient economic activity to utilize all available labor and thus to secure equilibrium at full employment.”49 It therefore linked economic and social progress in a circular mechanism that was itself considered governable by well-timed, carefully considered regulation.50 The Federal Republic was not altogether receptive to Keynesianism, however. With the exception of the years 1966–74, the government rejected demand stimulus in favor of a traditional supply-side approach to economics. This decision was primarily a function of Germany’s system of organized capitalism and corporatist cooperation, both of which made a Keynesian reunion of politics and economics largely unnecessary. Thus, while West Germany’s “social market economy” was deliberately contrasted with key tenets of the Keynesian welfare state, the former did not represent a departure from the accepted wisdom that the economy required steering.51 Both the Keynesian welfare state and the social-market-economy projects shared one other important feature: both projects hinged on economic growth. Growth was needed as an incentive for investment, a stimulus for economic activity, and a resource for increased expenditure.52 In sum, its promotion was taken as a prerequisite for prosperity and social security. The centrality of growth meant that it increasingly took on the character of an entitlement itself. The West German pension reforms of 1957 are a good example of this. These reforms, among other things, made pensions “dynamic” by awarding pensioners Page 285 → a right to increases in benefits if productivity and prevailing wage hikes warranted them. They therefore guaranteed “non-productive” members of society a share in the yield of economic growth.53 By 1964, Social Democrats were defining the task of the welfare state as “constantly securing the standard of living, the growing standard of living.”54 Government responsibility for full employment, price stability, economic growth, and balanced trade was formally acknowledged three years later by the Stability and Growth Law of 1967. By the time of the economic recession of the 1970s, the German state had become responsible for securing both social progress and rising affluence.55 Lest we think these developments peculiar to West Germany and other postwar capitalist states, it should be noted that the nation of “actually existing socialism” showed a similar concern for social security.56 After an initial period of dismissing social policy as nonsensical, the German Democratic Republic from 1957 established a comprehensive social-security network (including social insurance) that aimed at fulfilling the “fundamental needs” of its citizens and eliminating or reducing “dysfunctional” differences in standards of living. Like its western counterpart, the East German state considered social progress (“distributive justice”) and economic progress (“the development of productive forces”) compatible and interrelated. Similarly too, the promotion of growth was taken to be an essential prerequisite for achieving both ends.57 While the stimulation of productivity remained the centerpiece of social policy in the German Democratic Republic throughout its history, parallels with capitalist developments continued during the regime’s final two decades. Under increasing pressure to provide consumer goods, policymakers in the 1970s began to talk of placing greater emphasis on the quality of life and the nonessential needs of the population.58 Eventually riddled by deficit in the 1980s, the East Page 286 → German government adopted its own policy of cost-cutting (“intensification”), calling on producers to achieve more results with existing resources.59 Social security, then, cannot be identified with any one form of government, economy, or political ideology. Over the course of the twentieth century, it became a self-sustaining ethos that has unremarkably informed public life: unremarkably because so much of the decision making that goes on in its name has been of an exceedingly technical nature and kept safely removed from public debate.60 This has proven to be a boon for the human sciences.61 As policy became less remedial, increasingly targeted, and more prophylactic in its approach, the need for secure knowledge grew.62 Policy analysts, economists, sociologists, and medical professionals, having helped shape the idea and content of social policy since the nineteenth century, have therefore played an ever more indispensable role in formulating German social-security policy since 1945.63 This was no truer than in the GDR, where an elaborate system of planning and management technologies was required to centrally direct the economy.64 This is not to imply that contemporary social security has managed to fulfill the dreams of early-twentieth-century

technocrats. East German planning failed miserably to command its economy, as the persistent modifications and reversals in five-year plans demonstrated. The Keynesian welfare state and the Page 287 → social market economy, for their part, never aspired to this utopia, and in any event remained restricted in their actions by the force of law.65 Rather, what the imperative for a social security did was to reinject an element of faith into politics and government. Technology and the human sciences are the object of this faith, which at once seeks safety and certainty. The impetus in a world understood to be composed of risks, as Beck points out, lies in projecting dangers of the future: “We have become active today in order to prevent, alleviate or take precautions against the problems and crises of tomorrow and the day after tomorrow—or not to do so.”66 By targeting high-risk groups, calculating the probability of imminent catastrophe or danger, and prophylactically controlling workspaces, contemporary social work, psychiatry, environmentalism, engineering, and ergonomics have all contributed to social security’s penchant for risk aversion and prevention. Time, and specifically the future, thus took on a new significance after the postwar recovery. As policy and politics became increasingly preoccupied with avoiding any number of uninviting fates, the ethos of social security compressed past, present, and future.67 This is most apparent in the so-called generational contract (Generationen-Vertrag): a social contract for the twentieth century, where the young and still industrious pay for the care of the elderly, while securing their own retirement through savings and raising the next generation of taxpayers. Like so many other refinements in social security, this one too has opened up new possibilities of moral and political discourse, allowing opponents of any new set of risks “to bring the topos of ‘future generations’ into play.”68 As this history of German disability insurance has shown, social security and its politics of entitlement have the potential both to promote political solidarities and to nurture a self-centered, atomized citizenry. Ours is a decidedly insecure age. The restructuring of the global economy, the end of the cold war, the reform of welfare states, and the growing prominence of international organizations in world affairs make it difficult to situate oneself in, as Simmel put it a century ago, the “criss-crossing jungle of enterprises and institutions in which the final and definitely valuable goals are missing altogether.” More than ever, the contemporary individual is “captured in a network of means, detours, and improvisations” that provides few stable guideposts to morally justified Page 288 → ends. The result, as Enzensberger has observed, has been a pervasive loneliness, a vague sense of frustration, indiscriminate violence.69 Social insecurity has bred a new Innerlichkeit (inwardness), but one that frequently elides ethical reflection. If there is reason for concern, it lies in the shortsightedness of a world in which entitlement has become an end in itself. 1. Harold James, “Innovation and Conservatism in Economic Recovery: The Alleged ‘Nazi Recovery’ of the 1930s,” in Capitalism in Crisis: International Responses to the Great Depression, ed. W. R. Garside (London and New York: St. Martin’s, 1993), 90; The German Slump: Politics and Economics, 1924–1936 (New York: Oxford University Press, 1986), 343–418. 2. Karl Teppe, “Zur Sozialpolitik des Dritten Reiches am Beispiel der Sozialversicherung,” Archiv für Sozialgeschichte 17 (1977): 206, 209–22, 229–31. Teppe points out that whereas 76.7 percent of all reported accidents led to compensation in 1932, by 1938 only 32.8 percent were compensated—this despite a 142.6 percent increase in the rate of occupational accidents during the same period. 3. Timothy W. Mason, Social Policy in the Third Reich: The Working Class and the “National Community” (Providence and Oxford: Berg, 1993), 6–7. 4. Detlev J. K. Peukert, Inside Nazi Germany: Conformity, Opposition, and Racism in Everyday Life (New Haven and London: Yale University Press, 1987), 215. 5. See Michael Burleigh and Wolfgang Wippermann, The Racial State: Germany 1933–1945 (Cambridge and New York: Cambridge University Press, 1991). As Christoph Sachße and Florian Tennstedt have noted, Nazi social welfare did not remain static. In particular, they have argued that Nazi social policy can be divided into two periods, a prewar authoritarian phase and a “völkisch” second phase. See their Geschichte der Armenfürsorge in Deutschland, vol. 3: Der Wohlfahrtsstaat im Nationalsozialismus (Stuttgart, Berlin,

Cologne, and Mainz: W. Kohlhammer, 1992). 6. This point is convincingly made by Henry Friedlander, The Origins of Nazi Genocide: From Euthanasia to the Final Solution (Chapel Hill and London: University of North Carolina Press, 1995). See also Peter Weingart, “Eugenik—Eine angewandte Wissenschaft: Utopien der Menschenzüchtung zwischen Wissenschaftsentwicklung und Politik,” in Wissenschaft im Dritten Reich, ed. Peter Lundgreen (Frankfurt a.M.: Suhrkamp, 1985), 314–49. 7. On the forced sterilization program, see Bock, Zwangssterilisation, and “Antinatalism, Maternity, and Paternity in National Socialist Racism,” in Maternity and Gender Policies, ed. Bock and Thane, 233–55. 8. Wolfgang Ayaß, “Asoziale” im Nationalsozialismus (Stuttgart: Klett-Cotta, 1995). Along similar lines, see Christiane Rothmaler, “‘. . . um sie nachher in der offenen Fürsorge gefügig und arbeitswillig zu machen’: Der fürsorgerechtliche Arbeitszwang in der Weimarer Republik und im Nationalsozialismus,” in Kehrseite der Wohlfahrt, ed. Glensk and Rothmaler, 241–66. 9. Most noteworthy among the recent literature on this aspect of Nazi genocide are Karl Heinz Roth and Götz Aly, “Das ‘Gesetz über die Sterbehilfe bei unheilbar Kranken’: Protokolle der Diskussion über die Legalisierung der nationalsozialistischen Anstaltsmorde in den Jahren 1938–1941,” in Erfassung zur Vernichtung: Von der Sozialhygiene zum “Gesetz über Sterbehilfe,” ed. Karl Heinz Roth (Berlin: Verlagsgesellschaft Gesundheit, 1984), 101–79; Schmuhl, Rassenhygiene, Nationalsozialismus, Euthanasie; Burleigh, Death; Friedlander, Origins of Nazi Genocide. 10. See Claudia Koonz, Mothers in the Fatherland: Women, the Family, and Nazi Politics (New York: St. Martin’s, 1986); Irmgard Weyrather, Muttertag und Mutterkreuz: Der Kult um die “deutsche Mutter” im Nationalsozialismus (Frankfurt a.M.: Fischer Taschenbuch, 1993). 11. Carola Sachse, Industrial Housewives: Women’s Social Work in the Factories of Nazi Germany (New York and London: Institute for Research in History, 1987); Angelika Ebbinghaus, Opfer und Täterinnen: Frauenbiographien des Nationalsozialismus (Frankfurt a.M.: Fischer, 1996). 12. Birgit Wulff, Arbeitslosigkeit und Arbeitsbeschaffungsmaßnahmen in Hamburg 1933–1939: Eine Untersuchung zur nationalsozialistischen Wirtschafts- und Sozialpolitik (Frankfurt a.M.: Peter Lang, 1987); Volker Herrmann, Vom Arbeitsmarkt zum Arbeitseinsatz: Zur Geschichte der Reichsanstalt für Arbeitsvermittlung und Arbeitslosenversicherung 1929–1939 (Frankfurt a.M.: Peter Lang, 1993). 13. See Rüdiger Hachtmann, Industriearbeit im “Dritten Reich”: Untersuchungen zu den Lohn- und Arbeitsbedingungen in Deutschland, 1933–1945 (Göttingen: Vandenhoeck & Ruprecht, 1989); Tilla Siegel and Thomas von Freyberg, Industrielle Rationalisierung unter dem Nationalsozialismus (Frankfurt and New York: Campus, 1991); Mason, Social Policy; Ulrich Herbert, Hitler’s Foreign Workers: Enforced Foreign Labor in Germany under the Third Reich (Cambridge: Cambridge University Press, 1997). 14. This was not done, I want to emphasize, to the exclusion of racial criteria. For instance, racial hierarchies obviously held different consequences for death-camp inmates from those for German factory workers. 15. See Karl-Heinz Karbe, “Das nationalsozialistische Betriebsarztsystem während des zweiten Weltkrieges—ein Instrument arbeitsmedizinischer Praxis?” in “Medizin für den Staat,” ed. Winau and Müller-Dietz, 66–81; Martin Höfler-Waag, Die Arbeits- und Leistungsmedizin im Nationalsozialismus von 1939–1945 (Husum: Matthiesen, 1994). 16. Teppe, “Zur Sozialpolitik des Dritten Reiches,” 237–48; Marie-Luise Recker, Nationalsozialistische Sozialpolitik im Zweiten Weltkrieg (Munich: Oldenbourg, 1985), 82–126; Campbell, Joy in Work, 337–75. The terms “productivist,” “race hygienist,” “colonial,” and “traditional” are my own. 17. Michael Kater, “Dr. Leonardo Conti and His Nemesis: The Failure of Centralized Medicine in the Third Reich,” Central European History 18 (1985): 299–325; Recker, Nationalsozialistische Sozialpolitik im Zweiten Weltkrieg, 121–26; Höfler-Waag, Arbeits- und Leistungsmedizin, 17–35. 18. Petra Kirchberger, “Die Stellung der Juden in der deutschen Rentenversicherung,” in Sozialpolitik und Judenvernichtung: Gibt es eine Ökonomie der Endlösung? Beiträge zur nationalsozialistischen Gesundheits- und Sozialpolitik, vol. 5 (Berlin: Rotbuch, 1983), 111–32. Christopher Browning has shown that there were still more factions (“productionists” and “attritionists”) within the Generalgouvernement’s administration. Christopher Browning, “Vernichtung und Arbeit: Zur Fraktionierung der planenden deutschen Intelligenz im besetzten Polen,” in “Vernichtungspolitik”: Eine Debatte über den Zusammenhang von Sozialpolitik und Genozid im nationalsozialistischen Deutschland, ed. Wolfgang

Schneider (Hamburg: Junius, 1991), 37–51. 19. Teppe, “Zur Sozialpolitik des Dritten Reiches”; Recker, Nationalsozialistische Sozialpolitik im Zweiten Weltkrieg, 111, 206–17, 275–85. 20. The notion of a Nazi departmental polyocracy is from Martin Broszat, The Hitler State: The Foundation and Development of the Internal Structure of the Third Reich (London and New York: Longman, 1981). 21. This point is made by Peter Fritzsche, Germans into Nazis (Cambridge, Mass., and London: Harvard University Press, 1998), 209–10. 22. Two noteworthy works in this regard are Eckhard Hansen, Wohlfahrtspolitik im NS-Staat: Motivationen, Konflikte, und Machtstrukturen im “Sozialismus der Tat” des Dritten Reiches (Augsburg: Maro, 1991); and John Connelly, “The Uses of Volksgemeinschaft: Letters to the NSDAP Kreileitung Eisenach, 1939–1940,” Journal of Modern History 68 (1996): 899–930. Hansen, in particular, shows that central party planners were often frustrated by the zealousness and militancy of local functionaries in the National Socialist Volkswohlfahrt. 23. Geoffrey Cocks, Psychotherapy in the Third Reich: The Göring Institute (New Brunswick and London: Transaction, 1997), 219–50. 24. Recker, Nationalsozialistische Sozialpolitik im Zweiten Weltkrieg, 104. 25. Ibid., 283–84. 26. See Susanne Heim and Götz Aly, “Die Ökonomie der ‘Endlösung’: Menschenvernichtung und wirtschaftliche Neuordnung,” in Sozialpolitik und Judenvernichtung, 11–90, and “Sozialplanung und Völkermord: Thesen zur Herrschaftsrationalität der nationalsozialistischen Vernichtungspolitik,” in “Vernichtungspolitik,” ed. Schneider, 11–23; Götz Aly and Susanne Heim, Vordenker der Vernichtung: Auschwitz und die deutsche Pläne für eine neue europäische Ordnung (Frankfurt a.M.: Fischer, 1993); Götz Aly, Peter Chroust, and Christian Pross, Cleansing the Fatherland: Nazi Medicine and Racial Hygiene (Baltimore and London: Johns Hopkins University Press, 1994). 27. Ulrich Herbert has made this point effectively about the Nazi use of foreign labor. Ulrich Herbert, “Arbeit und Vernichtung: Ökonomisches Interesse und Primat der ‘Weltanschauung’ im Nationalsozialismus,” in Ist der Nationalsozialismus Geschichte? Zur Historisierung und Historikerstreit, ed. Dan Diner (Frankfurt a.M.: Fischer Taschenbuch, 1987), 198–236. 28. Jay W. Baird, To Die for Germany: Heroes in the Nazi Pantheon (Bloomington and Indianapolis: Indiana University Press, 1990); Sabine Behrenbeck, Der Kult um die toten Helden: Nationalsozialistische Mythen, Riten, und Symbole (Vierow bei Greifswald: S-H, 1996). 29. Walter Schuhmann and Ludwig Brucker, Sozialpolitik im neuen Staat (Berlin-Charlottenburg: Willy Rink and Berhard Krause, 1934), 345. 30. James M. Diehl, The Thanks of the Fatherland: German Veterans after the Second World War (Chapel Hill and London: University of North Carolina Press, 1993), 31–53. 31. This information is from Geoffrey Cocks, “Pain and Well-Being in and beyond Nazi Germany,” in Pain, Prosperity and the Past: Reconsidering Twentieth-Century German History, ed. Paul Betts and Greg Eghigian (Stanford: Stanford University Press, forthcoming). 32. Hans Dieter Schäfer, Das gespaltene Bewußtsein: Über deutsche Kultur und Lebenswirklichkeit, 1933–1945 (Munich and Vienna: Carl Hanser, 1981), 114–62. 33. Ian Kershaw, The “Hitler Myth”: Image and Reality in the Third Reich (Oxford and New York: Oxford University Press, 1987), 253–69. 34. Ludger Weß, “Wissenschaft und Massenmord: Einige Schlußfolgerungen aus der konzeptionellen Beteiligung der deutschen Intelligenz an der nationalsozialistischen Vernichtungspolitik,” in “Vernichtungspolitik,” ed. Schneider, 103–18. 35. Martin Geyer, “Soziale Sicherheit und wirtschaftlicher Fortschritt: Überlegungen zum Verhältnis von Arbeitsideologie und Sozialpolitik im ‘Dritten Reich,’” Geschichte und Gesellschaft 15 (1989): 382–406. 36. On the importance of modern consumerism in Nazi Germany, see Peter Reichel, Der schöne Schein des Dritten Reiches: Faszination und Gewalt des Faschismus (Frankfurt a.M.: Fischer, 1993). 37. Habermas, Structural Transformation, 211. 38. Hans Braun, Soziale Sicherung: System und Funktion (Stuttgart: W. Kohlhammer, 1972), 23–24; de Swaan, In Care, 152–86. 39. Niklas Luhmann, “Anspruchsinflation im Krankheitssystem: Eine Stellungnahme aus

gesellschaftstheoretischer Sicht,” in Die Anspruchsspirale: Schicksal oder Systemdefekt? ed. Philipp Herder-Dorneich and Alexander Schuller (Stuttgart, Berlin, Cologne, Mainz: Kohlhammer, 1983), 28–49. 40. Michel Foucault, “Social Security,” in Politics, Philosophy, Culture: Interviews and Writings 1977–1984, ed. Lawrence D. Kritzman (New York and London: Routledge, 1988), 169. See also the essays in Die Anspruchsspirale, ed. Herder-Dorneich and Schuller. 41. Hans Braun, Soziale Sicherung, 15; Soziales Handeln und soziale Sicherheit: Alltagstechniken und gesellschaftliche Strategien (Frankfurt a.M. and New York: Campus, 1978), 17–18. 42. Niklas Luhmann, Political Theory in the Welfare State (Berlin and New York: Walter de Gruyter, 1990), 35–36. 43. See Wirtschafts- und Sozialwissenschaftliches Institut des Deutschen Gewerkschaftsbundes, Sozialpolitik und Selbstverwaltung: Zur Demokratisierung des Sozialstaates (Cologne: Bund, 1977). 44. See Philip Rieff’s thoughts on the therapeutic in The Triumph of the Therapeutic: Uses of Faith after Freud (New York and Evanston: Harper and Row, 1968). 45. See Franz-Xaver Kaufmann’s impressive study Sicherheit als soziologisches und sozialpolitisches Problem (Stuttgart: Ferdinand Enke, 1973). 46. Hans Braun, “Das Streben nach ‘Sicherheit’ in den 50er Jahren: Soziale und politische Ursachen und Erscheinungsweisen,” Archiv für Sozialgeschichte 18 (1978): 279–306; Hans Günter Hockerts, Sozialpolitische Entscheidungen im Nachkriegsdeutschland: Alliierte und deutsche Sozialversicherungspolitik, 1945–1957 (Stuttgart: Klett-Cotta, 1980). 47. Manfred G. Schmidt, “Learning from Catastrophes: West Germany’s Public Policy,” in The Comparative History of Public Policy, ed. Francis G. Castles (New York: Oxford University Press, 1989), 56–99. 48. Ronald Inglehart, Culture Shift in Advanced Industrial Society (Princeton: Princeton University Press, 1990); Claus Offe, “Challenging the Boundaries of Institutional Politics: Social Movements since the 1960s, ” in Changing Boundaries, ed. Maier, 63–105. 49. Christopher Pierson, Beyond the Welfare State? The New Political Economy of the Welfare State (Cambridge: Polity, 1991), 27. 50. Jacques Donzelot, “The Promotion of the Social,” Economy and Society 17 (1988): 395–427. 51. Christopher S. Allen, “The Underdevelopment of Keynesianism in the Federal Republic of Germany,” in The Political Power of Economic Ideas: Keynesianism across Nations, ed. Peter A. Hall (Princeton: Princeton University Press, 1989), 263–89. 52. Christopher Pierson, Beyond, 131. 53. Gaston V. Rimlinger, “The Economics of Postwar German Social Policy,” Industrial Relations 6 (1967): 184–204; Hans Günter Hockerts, “German Post-War Social Policies Against the Background of the Beveridge Plan: Some Observations Preparatory to a Comparative Analysis,” in Emergence, ed. Mommsen, 315–39. 54. Helga Michalsky, “The Politics of Social Policy,” in Policy and Politics in the Federal Republic of Germany, ed. Klaus von Beyme and Manfred G. Schmidt (Hants: Gower, 1985), 64. 55. Ernst-Wolfgang Böckenförde, “The Significance of the Distinction between State and Society in the Democratic Welfare State of Today,” in State, Society and Liberty, 146–74. 56. Heinz Vortmann, “Die soziale Sicherheit in der DDR,” in Deutschland-Handbuch: Eine doppelte Bilanz, 1949–1989, ed. Werner Weidenfeld and Hartmut Zimmerman (Munich and Vienna: Carl Hanser, 1989), 326–41. 57. Wolf-Rainer Leenen, Zur Frage der Wachstumsorientierung der marxistisch-leninistischen Sozialpolitik in der DDR (Berlin: Duncker & Humblot, 1977). 58. Akademie der Wissenschaften der DDR, Probleme der sozialistischen Lebensweise: Ökonomische und soziale Probleme der weiteren Ausprägung der sozialistischen Lebensweise (Berlin [East]: Akademie, 1977); Dietrich Staritz, Geschichte der DDR, 1949–1985 (Frankfurt a.M.: Suhrkamp, 1985), 203–9. 59. Doris Cornelsen, “The GDR in the Eighties,” in GDR and Eastern Europe—A Handbook, ed. German Institute for Economic Research (Hants: Aveburg, 1989), 10–17. 60. Peter J. Katzenstein, Policy and Politics in West Germany: The Growth of a Semisovereign State (Philadelphia: Temple University Press, 1987). In this regard, Luhmann is correct to note the short attention span of democratic political debate in managing forms of risk in society. “Politics works in episodes, in

short stories each finishing with a collectively binding decision, a symbolic gesture of conclusion. The political system is thus free to turn to new topics or to await feedback from old ones. . . . In most cases, [risks] are handed over to the legal system, and are very often passed on by the legal system to the economic system.” Niklas Luhmann, Risk: A Sociological Theory (New York: Aldine de Gruyter, 1993), 165. 61. This is especially true of the social sciences. See Stephen Brooks and Alain Gagnon, eds., Social Scientists, Policy, and the State (New York: Praeger, 1990); Peter Wagner, Carol Hirschon Weiss, Björn Wittrock, and Hellmut Wollmann, eds., Social Sciences and Modern States: National Experiences and Theoretical Crossroads (Cambridge and New York: Cambridge University Press, 1991). 62. Thomas Blanke, “Der Präventionsstaat in der Risikogesellschaft,” in Die neue Sicherheit: Vom Notstand zur sozialen Kontrolle, ed. Roland Appel, Dieter Hummel, and Wolfgang Hippe (Cologne: Kölner Volksblatt, 1988), 191–202. 63. Jürgen Krüger, Wissenschaftliche Beratung und sozialpolitische Praxis: Die Relevanz wissenschaftlicher Politikberatung für die Reformversuche um die Gesetzliche Krankversicherung (Stuttgart: Ferdinand Enke, 1975); Stuart Blume, Joske Bunders, Loet Leydesdorff, and Richard Whitley, eds., The Social Direction of the Public Sciences: Sociology of the Sciences Yearbook, vol. 11, 1987 (Dordrecht: D. Reidel, 1987). 64. Gert Leptin and Manfred Melzer, Economic Reform in East Germany (Oxford: Oxford University Press, 1978). 65. Hans-Jürgen Puhle, “Vom Wohlfahrtsausschuß zum Wohlfahrtsstaat: Entwicklungstendenzen staatlicher Aufgabenstellung und Verwaltungsprobleme im Zeichen von Industrialisierung und Demokratisierung,” in Vom Wohlfahrtsausschuß, ed. Ritter, 29–68; Claus Offe, Contradictions of the Welfare State (Cambridge: MIT Press, 1984), 108–9. 66. Ulrich Beck, Risk Society: Towards a New Modernity (London: Sage, 1992), 34. 67. On time and space compression, see David Harvey, The Condition of Postmodernity: An Enquiry into the Origins of Cultural Change (Oxford and Cambridge, Mass.: Basil Blackwell, 1989), 284–307. 68. Luhmann, Risk, xi. 69. Hans Magnus Enzensberger, Civil Wars: From L.A. to Bosnia (New York: New Press, 1994).

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Select Bibliography Archival Materials Bundesarchiv, Koblenz (BAK) Reichsversicherungsamt Bundesarchiv Potsdam (BAP) Reichsarbeitsministerium Reichskanzlei Reichsministerium des Innern Vorläufiger Reichswirtschaftsrat Geheimes Staatsarchiv Kulturbesitz Merseburg (GStAKM) Ministerium für Handel und Gewerbe Ministerium für Landwirtschaft Ministerium für Volkswohlfahrt Hauptverband der gewerblichen Berufsgenossenschaften, St. Augustin (HdgBG) Niedersächsisches Hauptstaatsarchiv, Hanover (NHStA) Knappschafts-Oberversicherungsamt Clausthal Landkreis Zellerfeld Oberpräsident der Provinz Hanover Regierung Hildesheim Staatskommissar für die Landesversicherungsanstalt Nordrhein-Westfälisches Hauptstaatsarchiv, Düsseldorf (NRWHStA) Oberversicherunsamt Essen Polizeidirektion Aachen Regierung Aachen, Präsidialbüro Regierung Düsseldorf, Präsidialbüro Regierung Düsseldorf, Sozialangelegenheiten NOTE: Since compilation of this bibliography, many archival records have been relocated. Most noteworthy, the records of the Reichsversicherungsamt and the Reichsarbeitsministerium have been moved to the Bundesarchiv in Berlin-Lichterfelde, while those records formerly held in Merseburg are now housed in the Geheimes Staatsarchiv

Preussischer Kulturbesitz in Berlin. Page 290 → Newspapers and Journals Amtliche Nachrichten für Reichsversicherung Die Arbeiter-Versorgung Ärztliche Sachverständige-Zeitung Die Berufsgenossenschaft Concordia Die Neue Zeit Vorwärts Zeitschrift für die gesamte Versicherungs-Wissenschaft Zentralblatt der Reichsversicherung Contemporary Printed Materials Arbeiter-Sekretariat Berlin. Jahres- und Kassenbericht der Berliner Gewerkschaftskommission. 1901–1922/24. Arbeiter-Sekretariat Köln. Jahresbericht des Arbeiter-Sekretariats in Köln. Verlag des Kartells der freien Gewerkschaften Kölns und umgegend, 1905–1908. Bernhard, Ludwig. Unerwünschte Folgen der deutschen Sozialpolitik. Berlin: J. Springer, 1912. Brauns, Heinrich. Katholische Sozialpolitik im 20. Jahrhundert: Ausgewählte Aufsätze und Reden. Veröffentlichungen der Kommission für Zeitgeschichte, vol. 19. Mainz: Matthias-Grünewald, 1976. Burgdörfer, Friedrich. Der Geburtenrückgang und seine Bekämpfung: Die Lebensfrage des deutschen Volkes. Berlin: Richard Schoetz, 1929. ———. Volk ohne Jugend: Geburtenschwund und Überalterung des deutschen Volkskörpers. Berlin-Grunewald: Kurt Vowinckel, 1932. Dorn, Hanns. “Die Zukunft des Versicherungsgedankens.” In Festversammlung am 2. Oktober 1924. Veröffentlichungen des Deutschen Vereins für Versicherungs- Wissenschaft, vol. 34, 51–62. Ewald, Walther. Die traumatischen Neurosen und die Unfallgesetzgebung. Berlin and Vienna, 1908. Franck, Erwin. “Soziale Medizin.” Ärztliche Sachverständige-Zeitung (15 December 1920): 39–42. Frankenberg, Stadtrat H. von. “Sozialversicherung und Wehrkraft.” Zeitschrift für die gesamte VersicherungsWissenschaft 16 (1916): 363–75. Fuld, Justizrat Dr. “Der Einfluß des Krieges auf die Unfallversicherung.” Zeitschrift für die gesamte Versicherungs-Wissenschaft 15 (1915): 371–83. Generalkommission der Gewerkschaften Deutschlands. Gewöhnung an Unfallfolgen und anderes zur Rechtsprechung in Unfallrentenstreitsachen. [Berlin]: Verlag der General-Kommission der Gewerkschaften

Deutschlands, 1914. Germany. Reichs-Gesetzblatt. 1884–1929. ———. Zusammenstellung der Entschädigungssätze welche das Reichs-Versicherungsamt Page 291 → bei dauernden Unfallschäden gewährt hat. Groß-Lichterfelde: Verlag der Arbeiter-Versorgung, 1912. Gräf. “Das Glück der Unfall-Berufsgenossenschaften.” Die Neue Zeit 20 (1901–1902): 408–9. Hartmann, Konrad. Das Gefahrtarifwesen und die Beitragsberechnung der Unfallversicherung des Deutschen Reiches. Berlin: Julius Springer, 1913. Hartz, Gustav. Eigentum oder Rente? Eine Auseinandersetzung mit meinen Kritikern über das Thema: Sozialversicherung oder Sozialsparkasse? Berlin: August Scherl, 1930. ———. Irrwege der deutschen Sozialpolitik und der Weg zur sozialen Freiheit. Berlin: August Scherl, 1928. ———. Die national-soziale Revolution: Die Lösung der Arbeiterfrage. Munich: J. F. Lehmann, 1932. Heinze. “Zum Streit über die Lastenverteilung in der Invalidenversicherung.” Amtliche Nachrichten für Reichsversicherung 7 (1931): 362–68. Hitze, Frank, Bernard Wuermeling, and Christian Faßbender. Zur Würdigung der deutschen ArbeiterSozialpolitik: Kritik der Bernhardschen Schrift “Unerwüschte Folgen der deutschen Sozialpolitik.” M. Glodbach: Volks-Verein, 1913. Hoffmann, Ober-Regierungsrat Dr. jur. “Kriegsfragen der Sozialversicherung.” Zeitschrift für die gesamte Versicherungs-Wissenschaft 15 (1915): 313–15. Hönig, Dr. “Über die Behandlung und Begutachtung der Unfallverletzten.” Die Berufsgenossenschaft 9 (10 May 1901): 92–96. Horneffer, Ernst. Frevel am Volk: Gedanken zur deutschen Sozialpolitik. Leipzig: R. Voigtländer, 1929. ———. Der große Wunde: Psychologische Betrachtungen zum Verhältnis von Kapital und Arbeit. Munich and Berlin: 1923. Hüttenarbeiter-Schicksal. Der Entschädigungsanspruch von drei Hüttenarbeiterfamilien infolge tödlicher Gasvergiftung ihrer Ernährer vor dem Gericht. Duisberg: Christlicher Metallarbeiterverband Deutschland, ca. 1922. Internationales Handwörterbuch des Gewerkschaftswesens. Berlin: Werk und Wirtschaft Verlagsaktiengesellschaft, 1931. Kaiserliches Statistisches Amt. Atlas und Statistik der Arbeiterversicherung des deutschen Reichs. Berlin: Carl Heymanns Verlag, 1904. ———. Statistisches Jahrbuch für das Deutsche Reich. Berlin: Puttkammer und Mühlbrecht. Kaskel, W. “Sozialversicherung und Krieg.” Versicherung und Krieg: Vorträge gehalten bei den MitgliederVersammlung des Vereins im preußischen Abgeordnetenhaus am 12. und 13. Dezember 1913. Berlin: Ernst Siegfried Mittler und Sohn, 1914. Kaufmann, Paul. “Sozialversicherung oder Staatsbürgerversorgung?” Zeitschrift für die gesamte VersicherungsWissenschaft 24 (1924): 1–14. Keidel, Josef. Sämtliche Entscheidungen des Reichs-Versicherungsamtes und des Reichsgerichts auf dem Gebiete der Invalidenversicherung. Gießen: Emil Roth, 1903. Page 292 →

Keiner, Oswald. Entwickelung der deutschen Invaliden-Versicherung: Eine volkswirtschaftlich-statistische Untersuchung. Munich: J. Schweitzer, 1904. Kleeis, Friedrich. Die Geschichte der sozialen Versicherung in Deutschland. Berlin- Lichterfelde: Verlag der “Arbeiter-Versorgung,” 1928. Liebert, Arthur. “Das Problem der Versicherung im Lichte der Philosophie.” Zeitschrift für die gesamte Versicherungs-Wissenschaft 24 (1924): 73–83. Liek, Erwin. Der Arzt und seine Sendung. Munich: J. F. Lehmann, 1927. ———. Die Schäden der sozialen Versicherungen und Wege zur Besserung. Munich: J. F. Lehmann, 1928. ———. Soziale Versicherungen und Volksgesundheit. Langensalza: Hermann Beyer und Söhne, 1929. Loewy-Hattendorf, Dr. Erwin. Krieg, Revolution und Unfallneurosen. Berlin: Richard Schoetz, 1920. Lohmar, Paul. “Einiges über die Aufgaben der Berufsgenossenschaften im Kriege.” Die Berufsgenossenschaft 29 (30 September 1914): 189–91. ———. “Werkstätten für Erwerbsbeschränkten (Unfallverletzte, Invalide, Kriegsbeschädigte).” Ärztliche Sachverständige-Zeitung (1916): 97–104. Martin, B. “Die Verpflichtung zur Duldung von Operationen in der Reichsversicherung und Reichsversorgung und die Fortschritte der Chirurgie.” Amtliche Nachrichten für Reichsversicherung 3 (1932): 128–32. Masius, E. A. Lehre der Versicherung und statistische Nachweisung aller Versicherungs-Anstalten in Deutschland. Leipzig: Fest’sche Velagsbuchhandlung, 1846. Mattutat, H. “Das Erlöschen der Rentenansprüche bei der Invaliden- und Unfallversicherung.” Die Neue Zeit 22 (1904): 716–21. ———. “Rentendrückerei und Unfallrechtsprechung.” Die Neue Zeit 31 (1913): 932–40. Moldenhauer, Paul. “Versicherungsprinzip oder Versorgungsprinzip in der deutschen Sozialversicherung.” Zeitschrift für die gesamte Versicherungs-Wissenschaft 22 (1922): 177–81. Molkenbuhr, H. “Rente oder Almosen?” Die Neue Zeit 27 (1909): 500–505. Müller, August. Arbeitersekretariate und Arbeiterversicherung in Deutschland. Munich: Birk, [1903]. Müller, Hermann. Die Rechtsprechung in Unfallrenten-Streitsachen. Berlin: Buchhandlung Vorwärts, 1909. Rohrbeck, W. “Die Universalität des Versicherungsgedankens und die Grenzen des Versicherungsschutzes.” Wirtschaft und Recht der Versicherung 65 (1933): 81–104. Schittmann, Landesrat Dr. Die Sozialversicherung im Dienste der Heilbehandlung und der Berufsumschulung von Kriegsinvaliden. Berlin: Julius Sittenfeld, 1915. Schöttler, W. “Fürsorgeprinzip und Versicherungsprinzip.” Die Neue Zeit 41 (25 April 1923): 55–58. Schuhmann, Walter and Ludwig Brucker. Sozialpolitik im neuen Staat. Berlin- Charlottenburg: Willy Rink and Berhard Krause, 1934. Soudek, Richard. Die deutschen Arbeitersekretariate. Leipzig: Jäh & Schunke, 1902. Page 293 →

“Sozialversicherung und Reichshaushalt.” Amtliche Nachrichten für Reichsversicherung 4 (1930): 224–31. Stappert, Hans. Krankenscheingefällig? Munich: Verlag der Ärztlichen Rundschau Otto Gmelin, 1928. Stein, Lorenz von. The History of the Social Movement in France, 1789–1850. Totowa, N.J.: Bedminster, 1964. ———. System der Staatswissenschaft, vol. 1. Stuttgart and Tübingen: J. G. Cotta, 1852. ———. Die Verwaltungslehre, vol. 2. Die Lehre von der Innern Verwaltung. Stuttgart: J. G. Cotta, 1866. Stier-Somlo, Fritz. “Vaterländischer Hilfsdienst und Sozialversicherung.” Zeitschrift für die gesamte Versicherungs-Wissenschaft 17 (1917): 262–86. Stursberg, Hugo. Unerwünschte Folgen deutscher Sozialpolitik? Bonn, 1913. Sust, Th. Die Vertreter in der Arbeiter-Versicherung und deren Aufgaben. Hamburg: Verlag der Generalkommission der Gewerkschaften Deutshlands, 1901. Sybel, H. “Die festen Rentensätze.” Zentralblatt der Reichsversicherung 22 (1916): 835–39. Vereinigung der Deutschen Arbeitgeberverbände. Die Reform der Sozialversicherung—eine Schicksalsfrage des deutschen Volkes. Berlin: Vereinigung der Deutschen Arbeitgeberverbände, 1930. Vogt, Gustav. Die Vorteile der Invalidenversicherung und ihr Einfluß auf die deutsche Volkswirtschaft. BerlinGrunewald: Verlag der Arbeiter-Versorgung, 1905. Weissenbach, Hans. Über das Wesen und den Wert der Versicherung. Stuttgart: W. Kohlhammer, 1926. Winter. “Von der ‘Gerechtigkeit’ in der Festsetzung der Unfallrenten.” Die Neue Zeit 18 (1899–1900): 471–73. Workmen’s Insurance Code of Germany of July 19, 1911. Washington: U.S. Bureau of Labor, 1911. Wörner, Gerhard. “Sachleistung oder Geldleistung als Leistungsprinzip der Sozialversicherung.” Zeitschrift für die gesamte Versicherungs-Wissenschaft 23 (1923): 291–301. Wunderlich, Frieda. Der Kampf um die Sozialversicherung. Berlin: Deutscher Verband der Sozialbeamtinnen, 1930. Page 294 →

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Index accident, 56, 77–78, 105 accident insurance: coverage, 87; cutbacks, 264; financing, 162; impact of World War I, 163, 178; statistics, 27, 69–70; therapy and, 132–33. See also accident insurance boards; Erwerbsunfähigkeit; workers accident insurance boards (Berufsgenossenschaften): assets, 161; attitudes toward labor exchanges, 151–54; attitudes toward operations, 123, 126; attitudes toward pension neurosis, 236–37, 243, 252; composition, 77; concept of disability, 77–86; social pensioner relief and, 207–8, 213–14, 218–19; World War I and, 163–64, 168–69, 177 administration, 8–9, 18, 20, 34, 37, 46, 281, 283 Aly, Götz, 277–78 Arbeitsunfähigkeit, 72 asylums, 128, 130–31 Beck, Ulrich, 287 Bernhard, Ludwig, 242 Bismarck, Otto von, 14–15, 26–27, 29–30, 54, 260 body, 19–20, 103–4, 136–41 Bourdieu, Pierre, 13n.46 Brauns, Heinrich, 52, 209, 215, 221–23 Burgdörfer, Friedrich, 262–63 cameralism, 48 Catholic social thought, 30, 51–52, 221–22 Central Association of German Invalids and Widows, 202–4, 206, 210, 212 certifying physicians (Vertrauensärzte), 73, 80–81, 95–96, 150 conservatism: criticisms of welfare state, 192–93, 256; social legislation in nineteenth century, 26–31; social thought, 40–42, 54 Conti, Leonardo, 276 courts of arbitration: composition, 74; defining disabilities, 101–114; litigiousness, 77; workload, 238–39 Crew, David, 193 disability: Berufsinvalidität, 109–110; categories of, 102–114; concept of, 114–16, 282; injury and, 78, 87–97; legal definitions, 71–73; social science of, 18–19. See also Arbeitsunfähigkeit; disabled; Erwerbsunfähigkeit; Invalidität

disabled: pensions during World War I, 174–79; political action groups, 179–89; terms for, 199. See also social pensioners Donzelot, Jacques, 46 Eigensinn, 92, 108 entitlement: as learned sensibility, 115–16, 198; changes in, 225–27, 229; continuities in history of, 279–81; periodization, 20–21; politics of, 282, 287–88 Erwerbsunfähigkeit, 72 eugenics: 256–57, 263–64; and National Socialism, 273–74; and race hygiene, 262–63 expenditure, social, 1–2, 4–5, 15–16, 194 Federal Republic of Germany (West Germany), 1, 283–85, 287 Foucault, Michel, 9–12, 281 Fürsorge, 131, 229, 247 gender: accident insurance and, 87–88; disability and, 111–12; social thought and, 38–40; therapy and, 142–43; Weimar welfare state and, 258, 267–70 German Democratic Republic (East Germany), 4, 6–7, 285–86 grundsätzliche Entscheidungen, 74 Page 296 → Hartz, Gustav, 259, 261 Horneffer, Ernst, 260–61 hospitals, 128–31 human sciences, 10, 286–87 hygiene, 60–61 illness, 63–64 individualization: in clinical medicine, 62–63; in social insurance, 74; in welfare state, 6 inflation, 195–96 injury. See disability invalid insurance: concept of disability, 75–76; cutbacks, 264–65; financing, 162; impact of World War I on, 162–63, 169–70; statistics, 28, 69–70; therapy and, 131–32. See also Invalidität insurance: historical notions of, 33, 48–50; values associated with, 50. See also accident insurance; invalid insurance; sickness insurance; social insurance Invalidität, 73 Kapitalabfindung, 241, 245–46, 251, 259

Kaufmann, Paul, 173, 247–48 Keynesianism, 284, 286 labor exchanges, 150–54 labor movement. See Social Democracy labor power, 78–79, 157, 275 Ley, Robert, 275 liberalism: criticisms of welfare state, 256, 262; social legislation in nineteenth century, 26–31; social thought, 38–40, 42 Liek, Erwin, 259–60, 262 Lohmann, Theodor, 54 Luhmann, Niklas, 9, 11–12, 282, 286n.60 malingering, 84–86, 94–95, 120, 123, 236–37, 239, 244, 260 mechanical treatment, 135–43 medicalization, 117–19 medicine: clinical, 61–64; physician in social insurance, 142, 155; reform in nineteenth century, 59–61; role in social insurance, 118–19 medico-mechanical institutes, 133–45 Moldenhauer, Paul, 247–48 municipal welfare: early modern history, 31–33; Weimar, 193, 205–206, 210, 214 National Socialism, 272–81, 283 neurosis, 106, 235–36, 261, 265. See also pension neurosis Oppenheim, Hermann, 236 pain (suffering), 84, 93–94, 107, 115, 121, 124, 197, 199, 226, 229, 270, 278 pensions: claims process, 67–70, 73–74; size of, 90 pension neurosis (pension hysteria): politics of, 236–46, 250–55; Rentenkampfneurose, 238–41; significance of, 267–70; symptoms, 234; trauma and, 235–36, 255; World War I and, 244–46 Peukert, Detlev, 192 police: in early modern Germany, 31–33; medical, 58–59 poverty: care of the poor, 128; historical conception of, 44–45; “new poverty,” 192–93; relation to sickness, 59 Protestant social thought, 52–55 Prussia: social change, 41–42; social insurance policy, 164–67, 213; social policy in nineteenth century, 26–30;

statistics, 43 Rechtsstaat, 33–36 Red Cross, 164–65, 169–70 rehabilitation: methods of, 133–45; politics of, 145–50; welfare state and, 154–57 Reich Insurance Office (Reichsversicherungsamt): archival records, 22; coordination of social welfare, 171–74, 219; policy toward pension neurosis, 236–37, 251–55; role in administration, 74–75, 102; World War I and, 163–64, 179 Reich Ministry of Labor, 216, 219–24, 228, 276 Reichstag: role in social legislation in nineteenth century, 30; Weimar, 209, 221 retrenchment, 1, 4–5. See also Sozialabbau reunification, 4, 6 revolution of 1918–19, 183–84 Rigler, Otto, 143 risk: criticisms of social insurance and, 248, 270; early insurance and, 49; groups at-, 257; social insurance conception of, 56–58, 65, 79–80, 281–83, 287 Page 297 → sacrifice, 196–99, 197n.23, 225–26, 270, 278, 280 sanatoriums, 132, 138, 142–45, 183–89 security, 31–38 Seldte, Franz, 276 self-help, 89, 128, 259 sickness insurance, 48, 55 Simmel, Georg, 11–12, 271 social citizenship, 115–16 Social Democracy: anti-socialist sentiment, 27–28, 57, 86; attitudes toward pension neurosis, 244; attitudes toward social insurance, 97–101, 147–50, 265; worker secretariats, 98–101, 148–50, 181–82 social insurance: benefits, 70; Bismarckian legislation, 26–31; coverage, 26; historiography of, 25–31; modernity and, 64–66; reform of, 214, 217–19, 246–50; relation to other forms of public assistance, 172, 207, 215, 229–30; values associated with, 57–58, 65, 71, 119, 156, 226–28, 237, 243–44, 248–49, 258–61, 268, 283–84. See also social security; welfare state social market economy, 284, 287 social pensioners: definition, 193; political mobilization, 200–202; relief measures, 204–216. See also Central Association of German Invalids and Widows; disabled

social policy, 46–47 Social Question: 42, 45, 47, 281; Christian social thought and, 50–55; health and, 60–61; “new social questions,” 191–92; Worker Question, 28, 47, 280 social science: relation to medicine, 60; relation to nineteenth-century social policy, 41–46 social security: continuities in history of, 279–81; criticisms of, 255–66; definition of, 5; ethos of, 281–88; public attitudes toward, 5–7 social statistics. See social science society, 38–41, 46 Sozialabbau, 264–66, 272 spas, 132 state, German, 12–17, 20, 31–38 Stein, Lorenz von, 7–8, 11–12 Stier, Ewald, 252 subsidiarity, 52, 58 suffering. See pain surgery, 119–26, 266 therapy: cutbacks, 265; history of, 127–34; politics of, 119–57; relation to work, 134–45, 156–57 trust, 65–66, 83–86 unemployment insurance, 229–31, 261 Versorgung, 172, 207, 229, 247 victimization, 194, 196–99, 226–28, 278, 280 war-disabled care (Kriegsbeschädigtenfürsorge), 164–74, 177 Weber, Max, 8–9, 11–12 welfare: definition, 5; historical conception of, 31–38 welfare consortia, 219–24 welfare state: contemporary developments, 1–3, 5–7; criticisms of, 4; historiography of, 12–17; rationality of, 7–12; terminology, 12n.43; Weimar, 191–94, 199, 226–27, 280; Wilhelmian, 16, 70, 96–97, 114–16, 280 Wichern, Johann Hinrich, 53 Worker Question. See Social Question workers: attitudes toward disability insurance, 87–97; attitudes toward labor movement, 100, 182 World War I, 160–64, 177–78. See also war-disabled care Wunderlich, Frieda, 258