Health-insurance funds as they exist today in the Netherlands, as well as in Belgium and Germany, clearly date back to the age of the guilds, which played a key role in the economic, social and political life of towns and cities from the Middle Ages until the system was abolished at the end of the eighteenth and the beginning of the nineteenth century. The guilds operated as organisations that, with the permission of the local authority, members of a particular profession were obliged to join. The main aim of a guild was to promote the economic interests of its members with due regard for the common good. Initially, the guilds were purely associations of small urban entrepreneurs who united to protect their common interests. In many towns and cities, the craft guilds quickly evolved into regulatory trade organisations recognised by the local authority. They fulfilled several roles in the urban community (e.g. defence and administration). The guilds enjoyed a large degree of autonomy within the boundaries set by the local authority. They elected their own administrators and drew up their own rules and regulations, with which all members had to comply (e.g. admission to the profession, organisation of work). Around 1500, there were almost four hundred guilds in the area that is now the Netherlands. The number increased significantly during the Golden Age, reaching almost thirteen hundred by the end of the seventeenth century. Despite increasing political criticism, the guild system fl ourished until the end of the eighteenth century. The vitality and expansion of the guilds was sustained by increasing urbanisation and occupational differentiation. On the basis of national studies from 1796 and 1798, supplemented with information from local archives, Van Genabeek counted approximately 1,380 craft guilds in the Netherlands around 1800.

The origin of the Dutch health-insurance funds

It was only a small step from the protection of common interests within a guild to the solidary provision of mutual assistance in the event of death, accident and illness. Initially, financial assistance came straight from the guild coffers, but this situation gradually changed. From approximately 1630, guildsmen in many parts of the Netherlands began to set up separate mutual relief funds, so that the day-to-day business of the guilds was not threatened by the provision of relief