In the past a family’s chief cost of sickness was loss of the family head’s earning, not expenses for health care. Since there were no government programmes, sickness insurance provided by friendly societies, commercial insurers, and other institutions was important in partially replacing the wage earner’s lost income. The Independent Order of Odd Fellows (IOOF) was the largest social society in Canada and the United States and also the largest provider of sickness insurance. Using cliometric methods and records from six grand-lodge archives, this book rejects the conventional wisdom about friendly societies and sickness insurance, arguing that IOOF lodges were financially sound institutions, were more efficient that commerical insurers, and met a market demand headed by young men who lacked alternatives to market insurance, not older men who had an above-average risk of sickness disability.