Before government charity, voluntary mutual aid organizations (and churches) helped people. Their history shows that as a society becomes more rich, people can voluntarily help each other out, regardless of gender, class, or race. A modern equivalent would be very different, with actuarial science, larger pools, better communication, and generally more wealth with which to give aid.
More Americans belonged to fraternal societies than any other kind of voluntary association, with the possible exception of churches. A conservative estimate would be that one of three adult males was a member in 1920, including a large segment of the working class… Fraternalism was considerably more than a white male phenomenon. Its influence extended to such disparate groups as blacks, immigrants, and women… Societies accomplished important goals that still elude politicians… They successfully created vast social and mutual aid networks among the poor that are now almost entirely absent in many atomistic inner cities. Societies dedicated themselves to the advancement of mutualism, self-reliance, and good moral character. These values reflected a fraternal consensus that cut across such seemingly intractable divisions as race, gender, and income. Societies favored nonpartisanship to achieve harmony and to widen the applicant pool. Many members of the UOTR fought back with political action when the city of Richmond introduced Jim Crow streetcars. They helped organize boycotts and offered meeting facilities for protesters.
The usual practice of these societies was to consider applications for aid on a case-by-case basis. The Scots’ Charitable Society, for instance, allocated funds for such diverse purposes as ship passage, prison bail, and an old-age pension… Actuarial science was in an embryonic stage. [In 1842,] the Independent Order of Odd Fellows (100F)… initiated the first major departure from the often haphazard grants of previous societies by using a clear schedule of guaranteed benefits. Each member when taken sick could claim a regular stipend per week to compensate for working days lost. The geographically extended structure of the Odd Fellows allowed mobile members to retain benefits. It also facilitated a kind of coinsurance to mitigate local crises such as natural disasters or epidemics. In 1855 members in Massachusetts contributed more than $800 to relieve lodges in Pittsburgh that had exhausted their funds because of a fire.
In 1800 the fraternal scene (with the possible exception of Freemasonry) was characterized by small and localized societies with meager budgets and haphazard schedules of benefits. By 1900 Americans had flocked to far-flung national organizations with multiple lodges and hefty death and sick benefits.
The provision of insurance was the most visible manifestation of fraternal mutual aid. By 1920 members of societies carried over $9 billion worth of life insurance… Two of the three largest companies in the field, Prudential and Metropolitan Life, had evolved from fraternalism. Lodges offered two basic varieties of protection: cash payments to compensate for income from working days lost and the care of a doctor. Some societies, such as the SBA and the MWA, founded tuberculosis sanitariums, specialist clinics, and hospitals. Many others established orphanages and homes for the elderly.
Bina West was instrumental in building up the lodges (or “hives”) during the 1890s by successfully pitching to women an attractive combination of low-cost life insurance coverage, a forum in which to socialize, and opportunities to cultivate organizational and business skills… it had become the largest fraternal order controlled exclusively by women, with memberships passing the 200,000 mark by 1920. The women in these organizations regarded themselves as members of fraternal rather than sororal societies. For them, fraternity, much like liberty and equality, was the common heritage of both men and women.
From Mutual Aid to the Welfare State: Fraternal Societies and Social Services, 1890-1967, David T. Beito, http://www.amazon.com/Mutual-Aid-Welfare-State-Fraternal/dp/0807848417.