Health insurance becomes mandatory – the establishment of TK

Werner von Siemens designed and built the world’s first electric tram in 1881. Carl Benz founded the "Benz & Co., Rheinische Gasmotorenfabrik" gas engine factory in 1883. Between 1847 and 1887, Alfred Krupp established a steel group of international significance. While industry and commerce had been thriving since the beginning of the 19th century, the new stratum of workers and employees lived in social hardship. Engineers, technicians and similar workers increasingly ended up in a position of financial and social distress. Neither pension insurance nor adequate accident or health insurance were available.

On 15 June 1883, Emperor Wilhelm I, through the German Chancellor, Prince Bismarck, proclaimed the "Gesetz betreffend die Krankenversicherung der Arbeiter" ["Law on the Health Insurance of Workers"]". For the first time in Europe, compulsory insurance is introduced which focuses on the well-being of workers. The law guarantees free medical treatment and sick pay benefits. Employees and employers each have to pay half of the insurance contributions. The law has a clear political objective: to thwart the socialist workers’ movement.

The establishment of TK

The "Deutsche Technikerverband" ["German Federation of Engineers and Technicians"] establishes its own health insurance fund, which is organised according to the principle of self-governance. Until the "Eingeschriebene Hilfskasse für Architekten, Ingenieure und Techniker Deutschlands" ["Registered Assistance Fund for German Architects, Engineers and Technicians"] was founded, the members of these professions were forced to belong to "a fund intended more for journeymen and day labourers".

During the early years, the primary objective of the Berlin-based assistance fund was to build a secure economic foundation. That was essential to ensure that the fund could effectively support its members, especially in difficult phases of their lives.

The first headquarters of the "Hilfskasse für Architekten, Ingenieure und Techniker" fund was located on Markgrafenstrasse in the Berlin-Mitte district. A short time later, the fund moved to a building on Grosse Präsidentenstrasse in the same district. In January 1888, many parliament members from Berlin as well as representatives of the local governments from Dresden, Frankfurt/Main, Grabow, Leipzig and Magdeburg attended the general meeting of the fund, which was held in Berlin.

Approved alternative health insurance fund or rather private health insurance?

The year 1927 was to be the decisive turning point in the history of today’s Techniker Krankenkasse. However, the initial situation was anything but promising. After missing the registration period to be approved as an alternative health insurance fund in 1913, the "Krankenversicherungsverein auf Gegenseitigkeit für Ingenieure, Architekten und Techniker Deutschlands" ["Mutual Health Insurance Association for Engineers, Architects and Technicians in Germany"] could only operate as a subsidy fund. Contrary to statutory health insurance funds, the association was not allowed to accept members who were subject to compulsory insurance. Over the years, the association thus lost three quarters of its members. In 1913, there were almost 4000 members, but by 1927, only 908 members remained - a historic low. In addition, the monopoly of the existing health insurance funds seemed insurmountable. Attempts to change the legal regulations failed.

Political unrest, strikes and economic crisis are consequences of the First World War. For those in the technical professions, this means: "There is an alarmingly high and persistent unemployment rate particularly among older employees - between 35 and 40 years old - and once again engineers and technicians are included in this category." On 27 May 1919, the "Bund der technischen Angestellten und Beamten" ["Union of Technical Employees and Civil Servants"], called "BUTAB" for short, was established. A strong trade union, BUTAB becomes an impactful advocate for the interests of engineers and technicians.

"Berufskrankenkasse deutscher Techniker, Ersatzkasse" ["Occupational Health Insurance Fund of German Technicians, Approved Alternative Health Insurance Fund"]
At that time, professional associations with more than 10,000 members had the option to have their mutual insurance association converted into an "approved alternative health insurance fund" by the end of the year. The BUTAB federation of trade unions made an offer in this regard to the Technicians' Health Insurance Association. On 17 October, the "Berufskrankenkasse deutscher Techniker, Ersatzkasse" ["Occupational Health Insurance Fund of German Technicians, Approved Alternative Health Insurance Fund"] is established.

1927: Many new members

In its 1926/27 annual report, BUTAB states that "In the few months since it was established, the development of our occupational health insurance fund has been very positive. On 31 December 1927, 5,404 persons in the fund were already insured against illness." Many former and new members spontaneously decide to join the newly founded fund because it is extremely service-oriented, efficient and offers excellent benefits: exemption from paying contributions during a longer period of illness, suspension of membership in the event of unemployment ...

1933: Self-governance system is revoked

In the period between 1933 and 1945, TK was subject to the same regulations that applied to all insurance funds at the time: they were subordinated to the interests of the National Socialists, the system of self-governance was revoked, and the executive and managerial positions were filled by NS functionaries who generally had no knowledge about the business of managing insurance funds.

The bombings during World War II hit the health insurance fund hard: four branch offices were bombed out in October and November 1943 alone. On 22 and 23 November 1943, the head office located at Alte Jakobstrasse 81/82 in Berlin was also devastated by a bomb attack. The "Berufskrankenkasse der Techniker" ["Occupational Health Insurance Fund for Technical Employees"] - as TK was called at the time - had just acquired the building in 1939, and only a little more than four years later it lay in ruins. In March 1945, a new air raid finally razed everything to the ground.

The office buildings and most of the business documents were destroyed. Only a portion of the membership register could be excavated. It was moved to the town Deutsch Krone (today Walcz), but was lost during the escape from the advancing Red Army. At the end of the war, the health insurance fund was left with nothing.

The call for universal insurance quickly fades away again

In war-torn Germany, it seemed that the die had been cast: Soviet occupiers, Western Allies and many German experts deemed it appropriate to abolish the traditional "estate-based" system of social insurance in Germany. The dissolution of all occupational and company health insurance funds, standardisation of benefits and contributions, centralisation of the management of health insurance funds - the formula for rebuilding the healthcare system, which had been completely shattered by the war and its aftermath, was as simple as it was radical. For the second time since 1933, the existence of the "Berufskrankenkasse der Techniker" occupational health insurance fund was at stake.

When the Federal Republic of Germany was founded in 1949, however, the universal insurance project failed because the democratic majority of Germans were in favour of keeping insurance funds aligned with professional organisations. The Grundgesetz [German Basic Law] and the Sozialversicherungs-Anpassungsgesetz [Law on the Adjustment of Social Insurance] enacted in May and June 1949 reinstated the legal security of the occupational health insurance funds. In particular, the members’ identification with their profession and the good networking and cooperation between trade unions and health insurance funds for salaried employees saved the "Berufskrankenkasse der Techniker" occupational health insurance fund from being submerged into universal insurance.

TK und Institut für Firmen- und Wirtschaftsgeschichte, Hamburg