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Trends in Health Programs for Workers in Industry

Ann Intern Med. 1963;58(1):181-188. doi:10.7326/0003-4819-58-1-181
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During the westward expansion of America's economic development, employers in lumbering, mining, railroading, or other activities which brought workers into isolated unsettled areas found it necessary to provide medical facilities. In some instances, the employer assumed the cost, in other instances he devised a method of payment by the recipients for the medical care. One such device was the "check-off" for the doctor and the hospital out of each pay envelope. Sawyer (1) stated that the Southern Pacific Railroad in 1868 organized the first major industrial prepayment program for medical care. During subsequent decades, fraternal organizations, lumber and mining companies,


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