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Popularizing Health Conservation 
 
 LEE K^RANKEL 
 Sixth Vice-President Metropolitan Life Insurance Company 
 
 New York 
 
 A Paper Read before the American Life Convention 
 St. Paul, Minn., August 19, 1913 
 
r 
 

 Popularizing Health Conservation. 
 
 In the invitation which Dr. Foxworthy extended to me to 
 prepare a paper to be read before your body on the subject of 
 Health Conservation, he suggested that, if possible, I show 
 the economy of such activity on the part of life insurance com- 
 panies. I take it that the day has passed when it is necessary 
 to demonstrate the desirability of such effort on the part either 
 of life insurance companies or other bodies. The various reports 
 on health conservation, governmental and otherwise, which have 
 been presented in the past few years show clearly that conscious 
 constructive efforts in the direction of human life extension have 
 brought about valuable results. It seems to be well assured that 
 it is possible to increase the length of human life through a better 
 knowledge of the causes which shorten life, particularly pre- 
 ventable diseases, and by the education of the public in correct 
 methods of living. 
 
 As I have said, the question of the desirability of propaganda 
 along human life extension lines leaves nothing further to be 
 said. Whether action of this kind, however, on the part of life 
 insurance companies is feasible is another question. I confess 
 at the outset that I have little statistical data which proves or 
 disproves this statement. My knowledge of the subject is 
 limited largely to the work that has been done by the Metropolitan 
 Life Insurance Company and the few other insurance companies 
 that have entered this field. I am in hopes, however, that the 
 other data which I can present to you to-day will indicate, if not 
 prove, the advantage which accrues both to insurance companies 
 and their policy-holders by concerted effort to educate the latter 
 in human welfare work. The subject should really be considered 
 from three viewpoints. First, the value of education in life 
 conservation for the policy-holders ; second, the value to the agents ; 
 and third, the value to the companies. I shall attempt to discuss 
 these serially. 
 
 l 
 
The Value of Health Conservation to Ordinary 
 
 Policy-holders. 
 
 In considering the subject from the standpoint of its value 
 to policy-holders, we must further differentiate between so-called 
 Ordinary policy-holders and Industrial policy-holders. It is 
 questionable to what extent the former need further instruction 
 on the part of the companies with which they are identified. As 
 a rule, the individual who is in a position to take an Ordinary 
 policy of $5,000 and upward is so circumstanced that he is in 
 touch with movements which make for progress along health 
 lines. He is apt to be a man of some education. He reads the 
 newspapers, subscribes to magazines, comes in touch with other 
 individuals who think, study and read, and frequently is identified 
 with organizations and societies which have an active interest 
 in humanitarian and welfare work. For the insurance company 
 to attempt to bring further instruction to men of this class would 
 in many instances be another illustration of "carrying coals to 
 Newcastle." 
 
 And yet it must be recognized that Ordinary policy-holders 
 to-day are made up of a somewhat different stratum of society 
 than was the case fifteen or twenty years ago. It is not uncommon, 
 in fact quite common, for the artisan and for many individuals 
 who earn their living in the trades to take policies from $1,000 
 and upward. Our own experience with individuals who take 
 insurance in amounts of $5,000 and upward indicates fairly well 
 that these individuals are in a superior mortality class from those 
 whose insurance policies vary from one to five thousand dollars. 
 I think it is an axiom among medical examiners that the indi- 
 vidual who carries a hundred-thousand-dollar policy is a worse 
 moral hazard and gives a more unfavorable experience than the 
 one who can carry only five thousand dollars of insurance. The 
 group taking policies for about $1,000 has not as large opportunity 
 to obtain useful instruction and information regarding the con- 
 ditions under which they live and the rules and regulations which 
 they should follow to enable them to extend their span of life. 
 I think it is fair to say that for these it may be well worth while 
 for an insurance company to undertake a campaign of instruction 
 either by the dissemination of health literature, by periodical 
 examination of policy-holders or in such manner as may suggest 
 itself to the particular company. 
 
 One fact, however, which has been well recognized by medical 
 
 2 
 
directors and examiners everywhere should be mentioned at this 
 point to illustrate why a health campaign may be desirable for 
 Ordinary policy-holders of all kinds, and irrespective of the amounts 
 of insurance which they carry. It is characteristic of human 
 nature that the possession of wealth, while it gives the holder 
 thereof opportunities for enjoyment, recreation, rest and leisure, 
 in many instances leads to excess. The individual who must 
 stint and save cannot indulge himself. His brother who is more 
 fortunately situated with respect to worldly wealth often puts 
 no bounds to gratifying his appetites. It is the general belief 
 among students of the subject that mortality from diseases of 
 the heart, arteriosclerosis, diabetes, Bright's disease and other 
 degenerative diseases is higher among those who are in a position 
 to live well and comfortably than among those to whom every 
 dollar counts. I think the particular value of medical re-exami- 
 nation of policy-holders will be demonstrated in this group who 
 hold large policies. There is a possibility that when the danger 
 signal has been shown to them through such re-examination they 
 may have the intelligence to adopt a simpler mode of living. 
 
 Welfare Work for Industrial Policy-holders, 
 
 With respect to the Industrial policy-holder, the matter 
 presents a somewhat different phase. As a rule, this group is 
 made up of the working men of the community, and includes not 
 only the male adults, but female adults and children of both sexes 
 as well. To a considerable extent the working population is 
 composed of recently arrived immigrants or of their descendants 
 in the first generation. The opportunities which these men and 
 women have had with respect to schooling have been limited. 
 Their knowledge of language, customs and traditions is equally 
 limited. They come frequently from countries in which living 
 conditions have been below standard. Their ideas of cleanliness 
 and health are vague and frequently incorrect. To what extent 
 this element is present in the population is shown by the fact 
 that much of the literature which the Metropolitan Life Insurance 
 Company distributes to its Industrial policy-holders must be 
 translated into ten different languages in order to be of service. 
 
 You will see from what I have said that there is a distinct 
 field of opportunity for Industrial insurance companies to educate 
 their policy-holders along health lines. Such education would 
 follow quite a number of directions. I need not recall to you 
 
 3 
 
gentlemen, who are probably conversant with the subject, the 
 fact that the Industrial mortality is considerably higher than that 
 of the American Experience Table. At some ages, in fact, it is 
 150 per cent, of the Ordinary mortality. Nor can we say that 
 this excessive mortality is due to the fact that medical inspection 
 only is made at the time the policy is issued. The experience 
 of certain European insurance companies who issue Industrial 
 policies with and without examination has demonstrated, odd 
 as it may seem, that individuals who insure without medical 
 examination or inspection, and whose policies come into full 
 benefit only after they are one or two years old, have a more 
 favorable mortality than policy-holders of the same group who 
 have passed a medical examination and as a result have immediately 
 had their policies in full benefit. This shows quite clearly that 
 there is a distinct selection against the company on the part of 
 individuals who are probably sub-standard lives but whose 
 condition is not revealed by the medical examinations which are 
 made. 
 
 The causes of the higher mortality in the Industrial group 
 must be looked for in their environment. I believe that such 
 excessive mortality is primarily traceable to occupation. Long 
 hours of work, hazardous industries, overstrain, combined with 
 insufficient recreation and amusement, unquestionably sap the 
 vitality of men and make them die earlier than they should. 
 The German statistics of accidents show these facts very clearly. 
 Generally speaking, it may be said that there are more accidents 
 occurring at the end of the week than at the beginning or during 
 the week. In other words, the effects of continuous labor and 
 the consequent and subsequent wear and tear, both on the muscular 
 and nervous system, develop a lassitude which makes for care- 
 lessness and resulting accidents. Other causes which may be 
 mentioned as producing higher mortality are housing conditions, 
 inadequate wages, insufficient nourishment, overcrowding both 
 in homes and in factories. All these combined make a determining 
 factor bringing about higher mortality in the Industrial group. 
 
 If we study the situation by age periods, this fact is even more 
 pronounced. The mortality which our Company experiences 
 in its Industrial department from tuberculosis (all forms) is 16.37 
 per cent, of all deaths. On the other hand, at the age period 
 20-24 the mortality is 43.61 per cent, of the total deaths. Similar 
 figures are brought out at the various ages by the study of 
 
 4 
 
other causes of death, particularly those directly traceable to 
 occupation. 
 
 Whether, therefore, the present mortality among policy- 
 holders is due to the individual's own recklessness and extravagant 
 methods of living, as is instanced by many Ordinary policy- 
 holders, or whether he is a creature of his environment, as is the 
 case with a large bulk of Industrial policy-holders, the fact remains 
 that both of them need enlightenment and instruction. I take 
 it to be the proper sphere of an insurance company to undertake 
 this education. Its immediate value for the life insurance com- 
 pany is reduction in mortality, which, in the last analysis, means 
 a reduction of premiums or an increased amount of insurance for 
 existing premiums. 
 
 The studies which the Metropolitan Life Insurance Company 
 has made from time to time of its Industrial mortality experience 
 have demonstrated a constant improvement. As a result, the 
 Company has twice, since 1907, increased the amount of benefits 
 to its Industrial policy-holders. Similarly, the large bonuses 
 which it has been distributing to its policy-holders annually for 
 a number of years have been possible partly through the more 
 favorable mortality in the Industrial group. This, I should say, 
 has been the result of the general improvement in health con- 
 ditions. Factory legislation, tenement house legislation, the 
 raising of standards of living have all aided. We are of the 
 impression that we are justified in supplementing these general 
 movements for the improvement of health conditions by the 
 campaign which we have had in effect now for some years, 
 directed, however, exclusively to our Industrial policy-holders. 
 
 Results Accomplished by the Metropolitan. 
 
 You will be desirous of knowing what results have been accom- 
 plished. As I have said at the outset, there is no statistical 
 data at hand to indicate whether there has been any financial 
 economy in the movement. I doubt, in fact, whether our mortality 
 statistics within the next ten years will show the results of such 
 a campaign. It is questionable whether they will ever be able 
 to show any marked change as a result of our activities. Mor- 
 tality, as you know, is affected by many conditions, over most 
 of which we have no control. Whereas mortality in certain 
 localities may show improvement, floods, epidemics and other 
 adverse influence may be at work in other localities to keep the 
 
 5 
 
general death rate about the same. It may be said here that at 
 no time has the Company expected its welfare work among 
 policy-holders to give a return measurable in dollars and cents. 
 It has assumed the financial burden in the belief that its relation 
 to its Industrial policy-holders was something more than a con- 
 tractual one. The Industrial insurance agent who visits his 
 policy-holders weekly is more than a canvasser. Insurance to 
 the average working man has been a matter of indifference, and 
 frequently of contempt or fear. The Industrial insurance agent, for 
 this reason, has possibly even more of a mission as an educator 
 in providence and forethought than falls to the lot of the Ordinary 
 agent. Similarly, we feel that as trustees of the hard-earned 
 savings of working men it is our business as an insurance company 
 not merely to pay death claims as they arise, but to attempt to 
 put off the payment period as long as possible. This latter 
 statement may sound mercenary; as a matter of fact it is just 
 the opposite. Few claims that have ever been paid to the families 
 of working men have ever compensated them for the loss of the 
 wage-earners and of their wages. If we can assist in prolonging 
 the period of efficiency for the average working man. so that 
 his family benefits thereby, we believe we are properly fulfilling 
 our function as an insurance company for the masses of the popu- 
 lation. 
 
 If we can, as I say, prove nothing at the present time with 
 respect to the economic value of welfare work, it is, however, 
 proven that such work is distinctly appreciated by policy-holders. 
 One of the objections to life insurance as prosecuted by life insur- 
 ance companies is due to its inherent limitations and inability to 
 bring policy-holder and company into closer contact. In this 
 respect, as compared with the large fraternal orders, it has signally 
 failed. To the average policy-holder the average insurance 
 company is looked upon generally with a rather distinct belief 
 in its solvency and ability to meet death claims, and at the same 
 time with an air of scepticism as to its motives and willingness 
 to give him a much-needed commodity at the lowest cost to him- 
 self. The officers of an insurance company ordinarily are unknown 
 to policy-holders excepting in the printed pages of annual reports. 
 Even the agent, the intermediary of the company (excepting in 
 Industrial insurance) , is known to the policy-holder mainly at the 
 time when the application is signed or the claim is paid. Most 
 frequently the agent represents to the policy-holder an individual 
 
 6 
 
whom he is glad to get rid of for fear that he may be induced, against 
 his desire or belief, to take out additional insurance. 
 
 Our welfare work among Industrial policy-holders is putting 
 a new phase to this relation between policy-holders and company. 
 We find them distinctly appreciative of the efforts which we are 
 making in their behalf. It is not uncommon for them to laud the 
 Company and to praise its activities. We believe that in the long 
 run we shall develop a group of policy-holders more satisfied to 
 be policy-holders than they ever were. We believe that continued 
 effort along welfare lines will make policy-holders realize more 
 thoroughly than they ever did that even corporations have souls. 
 It is our opinion, gained from our experience, that our policy- 
 holders may be educated along the lines we have planned for 
 them, and that they are willing as policy-holders to act concertedly 
 for their common good. We have mentioned in other places 
 the attempt which we made in 191 1 to secure a Federal department 
 of health. It was a comparatively simple matter to bring this 
 desire on our part to the notice of our Industrial policy-holders, 
 and to show them, through literature specially prepared for the 
 purpose , how desirable it was for their personal good to advocate 
 such a department. As a result, thousands of our policy-holders 
 communicated their wishes to their respective Congressmen, 
 and it is admitted that this campaign materially forwarded the 
 possibilities of national legislation directed toward the establish- 
 ment of either a Federal department or bureau of health. 
 
 Outings for Policy-holders. 
 
 During the present summer we have endeavored to extend 
 this sense of relationship between policy-holders and agents in a 
 rather novel manner. Circular letters were sent to our super- 
 intendents advising them that if they could arrange outings 
 for policy-holders the Company was prepared to contribute 
 a portion of the expense. We were led to this action by the 
 splendid results obtained by such an outing in the city of St. Louis 
 last year. In one district in that city the superintendent and his 
 agents gave a picnic at which it was estimated 40,000 policy-holders 
 were present. In fact, so great was the crowd that the street car 
 system of St. Louis on that day was at its wit's end to meet the 
 demands made upon it. Prizes of various kinds were offered; 
 policy-holders indulged in a variety of sports and were given free 
 admission to the various amusements in the amusement park 
 
in which the picnic was held. Ever since last summer the policy- 
 holders in this district have been making inquiries at the district 
 office to learn whether another picnic would be given to them 
 this year. Plans have just been completed to hold another picnic 
 in St. Louis on August 15th. 
 
 A number of picnics of this kind have been given by superin- 
 tendents in other cities this summer with most excellent results. 
 Not only have policy-holders participated in these outings, but 
 the motive which actuated the Company in giving them has won 
 the commendations of city officials, including mayors and health 
 officers, who have attended the same and made addresses. All 
 of which simply proves what I have attempted to demonstrate, 
 namely, that the social side of life insurance is one that may not 
 be ignored and one which will bear definite fruits. I think you 
 will agree with me that the policy-holders who have attended these 
 picnics feel a sense of obligation to the Company; that they 
 realize the efforts which the Company is putting forth in their 
 behalf; that the tendency to lapsation on their part is distinctly 
 minimized, and that the publicity that these policy-holders give 
 to this form of welfare work is distinctly beneficial both to them 
 and to the Company. 
 
 If I have dwelt on this phase of the subject somewhat at 
 length it is because I believe in its essential merit. When work 
 of this kind is attempted, the relation between the policy-holder 
 and the Company is no longer an abstract but a concrete one. 
 The fact that the policy-holder speaks of the Company as "my 
 Company" or as "our Company" shows the revulsion in feeling 
 which has taken place. The possibilities of work along these 
 lines are many. We have had under careful consideration for 
 some time the question of bringing policy-holders together at 
 periodical intervals and giving them lectures on health subjects 
 and on other subjects of vital interest to them. The only diffi- 
 culty in the way to date is the expense. Such a plan would 
 involve the employment of competent lecturers, the rent of halls 
 and other expense which, as we see it now, is not feasible. Purely 
 on experimental lines, we have at various times arranged meetings 
 at our district offices where mothers have been instructed by our 
 nurses regarding the care of their children. The success of this 
 experiment leads us to believe that it is well worthy of further 
 extension. 
 
The Health and Happiness League. 
 
 A little over a year ago, in our effort to get into closer personal 
 touch with children who are policy-holders in the Company, we 
 organized the Health and Happiness League. Children who 
 desired to join this League were required to sign a pledge in which 
 they promised to do certain definite things for the improvement 
 of their bodily health and to co-operate with the Company in its 
 welfare work. The members of this League receive a League 
 button and a membership certificate. Practically without effort 
 on our part, approximately one hundred thousand children are 
 enrolled as members of the League. We are now engaged in 
 devising plans to make the League a practical body of efficient 
 workers for the betterment and improvement of health conditions. 
 
 It is difficult to determine the economic value to the insurance 
 company of welfare work such as has been indicated above; it is 
 even more difficult to determine the value of an educational 
 campaign carried on through the distribution of pamphlets, 
 leaflets, etc. There is no means of checking up such a campaign, 
 or at least none the cost of which would not be prohibitive. A 
 considerable part of our welfare campaign has consisted of the 
 distribution to our Industrial policy-holders of pamphlets on 
 tuberculosis, the care of the child, teeth, tonsils and adenoids, and 
 a more recent one on the health of the worker. We have now 
 in preparation a pamphlet on first aid in the home, and a series 
 of leaflets on preventable diseases such as smallpox, diphtheria, 
 scarlet fever, etc. It is important, in connection with literature 
 of this kind, that it should be written in a fashion that the average 
 working man will read and understand. Unless it is put in an 
 attractive form he will probably consign it, unread, to his waste- 
 basket or garbage-pail. 
 
 Health Literature. 
 
 We have every reason to believe, however, that the literature 
 which we distribute is read and that it has a distinct effect. Very 
 recently a committee of midwives, with their counsel, requested 
 an interview. This was granted to them. It appeared that they 
 took exception to a statement contained in our pamphlet "The 
 Child" in which the prospective mother was advised to have a 
 doctor or to go to the hospital in preference to a midwife. The 
 committee contended that this statement was ruining their busi- 
 ness, since whenever they entered the homes of our policy-holders 
 
they were shown a copy of the booklet "The Child," and their 
 attention directed to the statement respecting midwives. 
 We feel that when policy-holders are sufficiently acquainted 
 with the contents of our booklets to take an attitude of the 
 kind described, such literature has a very distinct value. Other 
 instances of the same kind could readily be cited. I need only 
 mention the case of a mother who wrote to us that she had dis- 
 charged her midwife because the latter had not carried out the 
 instructions in our booklet with respect to the care of a baby's 
 eyes. A father writes us that, prior to the receipt of our booklet 
 "Teeth, Tonsils and Adenoids," it had never entered his mind 
 to have his boy examined. When he did, he discovered that the 
 boy had adenoids, which thereupon were removed. At various 
 county fairs throughout the United States and Canada where 
 the Company has exhibited its welfare work and distributed its 
 literature, we have had the superintendents carefully watch to 
 ascertain whether such literature was found lying around the fair 
 grounds. It has been very gratifying to us to be informed 
 that almost invariably the literature which we distributed was 
 taken away by the visitors to these fairs. In fact, as a result of 
 this distribution we have constant inquiries from the neighbors 
 of individuals who have received our pamphlets requesting to be 
 furnished with copies. 
 
 The Visiting Nurse Service. 
 
 The most important phase of our welfare work among policy- 
 holders has been our visiting nurse service. Here, too, again, 
 I must admit that we have no statistics which indicate whether 
 this service, given voluntarily to policy-holders, has been instru- 
 mental in materially reducing the mortality. On the other hand, 
 we have instance after instance of individuals who have written 
 to us of their belief that their lives have been saved by the service 
 of the nurse; and nurses have reported instances of the saving 
 of life. In our opinion, the value of this particular service, 
 which to-day has been extended to practically all of our Industrial 
 policy-holders, lies primarily in the realization on the part of the 
 policy-holder that we are attempting to render him a service. 
 He grasps the salient fact in the suggestion which we make to 
 him in concrete form through the instrumentality of the nurse 
 or in the literature which we hand to him through our agents, 
 that our efforts are directed primarily for his benefit and his 
 
 10 
 
improvement. In this way we secure his co-operation. In this 
 way a bond of friendship is established between the Company and 
 its policy-holders — a bond which we hope will be lasting and per- 
 manent, if any effort on our part can make it so. 
 
 Value of Conservation Campaign to Agents. 
 
 Here, too, I can speak only from our own experience. This, 
 I may say, has been not only distinctly favorable, but highly 
 illuminating. We believe it no exaggeration to say that the 
 co-operation which our agents have given us in our human life 
 extension campaign has put them on a distinctly higher and better 
 plane. The conscientious insurance agent's work is not exclusively 
 to increase business. This is particularly true of the Industrial 
 insurance agent who, in addition to his duties as canvasser, is 
 required to act as collector of small weekly premiums. His work 
 brings him constantly in contact with the working population. 
 The work is hard and difficult, frequently trying and exasperating. 
 The difficulties which the Industrial agent encounters are in many 
 respects similar to those of all insurance agents. At one moment 
 they reach the heights of delirious expectation, only to be cast 
 down the next moment into the depth of disillusionment. Since 
 the work of the Ordinary agent is on a commission basis, his 
 income is an uncertain factor, and for this reason the pecuniary 
 side of this work looms up in his horizon. 
 
 I believe that our agents, as a result of their interest and activity 
 in our welfare campaign, have unconsciously been made to realize 
 the dignified character of the work in which they are engaged, 
 even more so than formerly. They have awakened to the fact 
 that their labors are fundamentally altruistic. Life insurance 
 is a profession, the advocates of which, aside from the fact that 
 they earn their living therein, are educators in self-abnegation 
 and self-sacrifice. The teachings of the doctrine of thrift, of 
 provision for protection against important contingencies of life, 
 are educational activities which make the work of the agent vie 
 with that of the school teacher or the college professor. This in 
 itself gives dignity to the work our insurance agents undertake. 
 The activities we have assigned to them in our welfare campaign 
 have added materially to the consciousness of our agents of the 
 important part they play in the development of communal and 
 civic activities for the betterment of their fellow citizens. Since 
 we have undertaken this work, many of our agents and superin- 
 
 11 
 
tendents have of their own initiative brought schemes for the 
 improvement of existing conditions to the notice of officials in 
 the cities in which they live. Only recently one of our agents 
 wrote to us for full information regarding the establishment of 
 free dispensaries. There was none in his city and he had interested 
 the mayor and other officials in organizing one. 
 
 We find that as a result of this work the relationship of agent 
 to policy-holder is more that of a friend and adviser than one 
 of cold formal business. The fact that it is the agent who dis- 
 tributes health literature and explains the contents to his clientele 
 gives him at once a standing in the household which we believe 
 could not readily be gained by any other means. Incidentally, 
 the conscientious agent, in order to fully carry out the ideas which 
 prompt the Company to institute welfare work, must of necessity 
 come in contact with representative individuals of his community 
 engaged in similar social enterprises. We recently sent out a 
 circular to our superintendents inviting them to advise us of the 
 social and civic activities with which they were connected. The 
 returns have been quite surprising and gratifying. Many of our 
 superintendents are members of boards of trades and chambers 
 of commerce in their respective cities; a number of them are 
 identified with charitable and philanthropic institutions. Others 
 are officers of or are on committees of civic bodies. 
 
 Let me give you an illustration of the value of this work to 
 the agent and to the superintendent. In the early spring we 
 sent circulars to all our superintendents calling their attention 
 to the house-cleaning campaign which had been instituted and 
 organized by the health department of the city of New York. 
 We suggested the desirability of a similar campaign in their own 
 cities, and advised them to take the matter up either with the 
 mayor or with the health officers. We have still to hear of an 
 instance in which interviews were refused to our representative, 
 or where the city officials were not heartily in sympathy with the 
 attempt of the superintendent, under our instructions, to establish 
 ideal conditions of cleanliness through a city-cleaning campaign. 
 In a number of instances superintendents, at the request of their 
 city officials, wrote to the Home Office for a description of the plan 
 in use in New York, and for copies of the literature which we had 
 distributed to our policy-holders asking them to co-operate with 
 the health officials of the city to insure an efficient and effective 
 house-cleaning campaign. 
 
 12 
 
A Better Agency Force. 
 
 You will note that throughout this paper I have endeavored 
 to give you practical illustrations of the results which we have 
 thus far accomplished. The conclusions which I have drawn are 
 based upon the actual results obtained; the illustrations which 
 have been given could be multiplied and multiplied. Summed up, 
 we have no doubt that as a result of our campaign we have a better 
 agency force than formerly. This does not necessarily mean 
 better men. Our standard for agents has been high for years. 
 It does mean, however, that we have a field force to-day equipped 
 to handle life insurance as a social proposition rather than as a 
 purely sordid business enterprise. The responsibility which the men 
 feel toward the Company has grown and been accentuated. The 
 work which they are able to do through our welfare campaign 
 gives them a distinct status and standing in their communities. 
 In what is distinctly a social era they are able to play their part 
 as men and insurance agents. The educational value to the 
 agents through a health conservation campaign means loyalty 
 and pride in the Company, not to speak of the possibilities of 
 increasing and bettering business. One illustration I can cite with 
 respect to the latter. We are in daily receipt of applications 
 from non-policy-holders throughout the United States and Canada 
 asking for copies of our publications. These are always forwarded 
 by us through the superintendent or agent. It is surprising to 
 note the large number of instances in which the literature has been 
 instrumental in obtaining new friends and policy-holders for the 
 Company. Lastly, and probably of greatest importance with 
 respect to the agent, is the realization on his part that he can 
 make work of this kind his life work. He realizes the undesira- 
 bility of constant change in occupation. The finaling of agents' 
 accounts is becoming less and less, and we have with us to-day 
 a body of men whose interests are the Company's interests, and 
 the Company's interests only. For such a result alone, if it ac- 
 complished nothing else, a welfare campaign would have proved 
 its economic value. 
 
 I can only take a word here to speak of the welfare campaign 
 which we are carrying on for our employees, including our field 
 staff. This has been developed in varying directions, and to-day 
 has a wide application. We hope within the next few months to 
 open our sanatorium for tuberculous employees at Mount Mc- 
 Gregor, New York. This is the first attempt on the part of an 
 
 13 
 
insurance company to make institutional provision for the care 
 of its agents afflicted with tuberculosis. 
 
 Vai.uk to the Company. 
 
 Finally, the value of welfare work or conservation work, which- 
 ever one may call it, to the insurance companies remains to be 
 considered. It would seem as if this did not require any further 
 elaboration in view of what has been said of the value of such 
 work to the policy-holders and to agents. After all, an insurance 
 company is something of an intangible thing. Primarily, it is 
 the policy-holders who are the company. It is their funds which 
 are accumulated; it is for their benefit and protection that the 
 company exists. Nevertheless, there is a company viewpoint 
 which may not be ignored; and when I speak of company in this 
 sense, I speak of the officers who direct it. Welfare work from 
 the standpoint of the officers spells reputation. By this I do not 
 mean notoriety. Each and all of us, whatever our employment, 
 desire to have a certain satisfaction from the work in which we 
 are engaged — to receive a certain return for our labors. To some, 
 the purely financial reward is sufficient; to others, the recognition 
 on the part of their fellow men of the motives which inspire their 
 work is all-compelling and all-sufficient. No insurance company's 
 officials can long maintain its standing to whom its reputation 
 is not as the breath in their nostrils. Life insurance companies 
 may have their assets; the surplus may be large, the reserve fund 
 ample to protect policy-holders. These, after all, are not matters 
 of congratulation so much as they are requirements of law. If 
 they did not exist the officers would be held accountable. It is 
 the things which the company does over and above its legal 
 requirements which place it in a category to receive consideration 
 from thoughtful men and women. Any attempt on the part of 
 an insurance company to show the community its highly laudable 
 desire to consider policy-holders not as so many units who pay 
 premiums, but as men and women whose physical welfare should 
 be its concern, will give to the company a reputation for honest 
 and fair dealing to which it would be justly entitled. 
 
 In the past it has been the tendency of the public, the press and 
 legislatures to deprecate the work done by insurance companies 
 rather than to extol it. Even to-day it is not uncommon for a news- 
 paper, in commenting upon the good work which an insurance com- 
 pany may have done, to omit the name of the company for fear 
 
 14 
 
that undue advertising and publicity maybe given to the company. 
 On the other hand, it is equally not uncommon, and at the same 
 time regrettable, that many newspapers do not hesitate to give the 
 widest publicity to an insurance company if in the opinion of its 
 editors it has been guilty of the least infraction of the law or has 
 not done everything that the policy-holder might expect. From the 
 purely utilitarian standpoint, welfare work among policy-holders 
 has a distinct public value. When I speak of publicity, I refer to 
 it in its highest sense. Charitable and philanthropic organizations, 
 welfare movements of all kinds, do not hesitate to-day to advertise 
 their activities in every possible way. Only a few days ago at 
 a seashore hotel, fans were distributed at all the tables on which 
 the summer work of one of our large New York charities was 
 given in detail. Our newspapers from day to day show similar 
 advertisement of other welfare and charitable movements. Prob- 
 ably all of us frequently receive letters requesting our support 
 and contributions for agencies of all kinds engaged in social uplift. 
 Their success in securing support depends upon their ability to 
 present to the public the results which they have obtained. Their 
 standing in the community is based altogether upon the success 
 with which they conduct their work. 
 
 Since the life insurance companies to-day, in a certain sense, 
 are great social institutions, it is only fitting that they too shall 
 keep the public advised and acquainted with the attempts which 
 are being made to improve the conditions of their policy-holders. 
 It is significant to note that where this is done and where it is 
 realized that this form of care for policy-holders is inspired by 
 proper motives, the legitimate newspaper press of the country 
 is prepared to give due credit. The life insurance companies of 
 to-day are engaged in an honest business ; the competition between 
 them is based on a gentleman's agreement. All are interested 
 to the best of their ability in inculcating the principles of insurance 
 among their constituents so that they may guard themselves 
 against the hazards of life. The insurance companies equally 
 with other social associations are entitled to the proper recog- 
 nition of their services to the community by the press, the public 
 and the legislatures. 
 
 The Need of the Future. 
 
 If it were necessary to cite another utilitarian reason for 
 welfare work by insurance companies, the marked changes in 
 
 15 
 
insurance thought in the past few years could be referred to. 
 Insurance companies must watch closely the signs of the times. 
 Even in the United States to-day one hears the advocates of State 
 insurance and sees laws enacted authorizing such experiments. 
 In Italy, life insurance has been taken entirely out of the hands 
 of private corporations and been made a state monopoly. The 
 threadbare discussion as to the need of an agency force constantly 
 comes to the front. We constantly hear the opinion of tyros voiced 
 that under state insurance a Utopian scheme can be developed 
 in which the agent would no longer be necessary. It would seem 
 that the results in England, in Belgium, in Wisconsin, and most 
 recently the failure of the large insurance society in Diisseldorf, 
 Germany, which attempted to do business largely without agents, 
 would have given sufficient testimony as to the impracticability 
 of such ventures. Nevertheless, the private insurance company 
 is at the bar. Whether we are to have a continuance of private 
 voluntary insurance or the introduction of compulsory insurance 
 will, to my mind, depend entirely upon the way in which the 
 private insurance companies conduct themselves and realize 
 their responsibility and obligations to their policy-holders. 
 
 The question may well be asked whether the smaller insurance 
 companies with comparatively limited financial resources can 
 undertake life extension work of the character indicated in this 
 paper. I am of the impression that they can. It may be that 
 their activities would necessarily be limited in proportion to their 
 financial ability. If it is of interest to this meeting, I may say 
 that I understand plans are on foot in the East to effect an 
 organization which will enable all insurance companies to 
 participate in this work of health conservation without the neces- 
 sity of special machinery for each company. It is planned to 
 organize an independent central organization; a business corpora- 
 tion, as I understand it, whose purpose is to do for all companies, 
 through a centralized system, what is at present being done by 
 a number of individual companies. I am not at liberty at present 
 to go into particulars. The project is not one that has been 
 initiated by an insurance company. It is only because its pro- 
 moters have consulted me that I happen to know about it. 
 
 Whether such a centralized body, independent of all insurance 
 companies, will be the medium through which the smaller com- 
 panies can undertake welfare work or not I am not prepared to 
 say. I mention the fact here simply to show that the question 
 
 16 
 
of human life extension is in the foreground, and that evidently- 
 reputable business men consider the subject of sufficient impor- 
 tance to attempt to organize a health conservation movement on 
 a purely business basis. 
 
 I have detained you here overlong and doubtless wearied you. 
 I am in hopes, however, that when you have left this meeting 
 and are refreshed you will on second sober thought realize the 
 value of the arguments which I have presented. No insurance 
 company to-day can afford to ignore the possibilities that lie 
 in welfare work for policy-holders. I have cited distinct utili- 
 tarian and good business reasons why it is advisable for insurance 
 companies to enter this field. The greatest reason, however, 
 and one which overshadows all the others, is the responsibility 
 which insurance managers owe to their policy-holders. The 
 funds which insurance companies hold belong in the last analysis 
 to their policy-holders. The latter have invested these in the 
 main in a spirit of unselfishness and frequently of self-sacrifice. 
 They are using the machinery of the company to make provision 
 for themselves and their families against life's risks and accidents. 
 The modern attitude of an insurance company toward the policy- 
 holders is primarily one of stewardship. It is incumbent upon 
 every company to live up to this sense of stewardship; to hold 
 such as a sacred trust, and to do everything that lies in its power 
 to improve and better the living conditions of its policy-holders. 
 
 17 
 
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