Steerage

Steerage refers to the lowest decks of a ship. This area of the ship was once used to accommodate passengers traveling on the cheapest class of ticket, and offered only the most basic amenities, typically with limited toilet use, no privacy, and poor food. The name "steerage" came from the fact that the control strings of the rudder ran on this level of the ship.

One American observer in 1905 wrote of steerage in the following terms:

...the 900 steerage passengers crowded into the hold of so elegant and roomy a steamer as the Kaiser Wilhelm II, of the North German Lloyd line, are positively packed like cattle, making a walk on deck when the weather is good, absolutely impossible, while to breathe clean air below in rough weather, when the hatches are down is an equal impossibility. The stenches become unbearable, and many of the emigrants have to be driven down; for they prefer the bitterness and danger of the storm to the pestilential air below. The division between the sexes is not carefully looked after, and the young women who are quartered among the married passengers have neither the privacy to which they are entitled nor are they much more protected than if they were living promiscuously.

The food, which is miserable, is dealt out of huge kettles into the dinner pails provided by the steamship company. When it is distributed, the stronger push and crowd, so that meals are anything but orderly procedures. On the whole, the steerage of the modern ship ought to be condemned as unfit for the transportation of human beings...Take for example, the second cabin which costs about twice as much as the steerage and sometimes not twice so much; yet the second cabin passenger on the Kaiser Wilhelm II has six times as much deck room, much better located and well protected against inclement weather. Two to four sleep in one cabin, which is well and comfortably furnished; while in the steerage from 200 to 400 sleep in one compartment on bunks, one above the other, with little light and no comforts. In the second cabin the food is excellent, is partaken of in a luxuriantly appointed dining-room, is well cooked and well served; while in the steerage the unsavory rations are not served, but doled out, with less courtesy than one would find in a charity soup kitchen.

The steerage ought to be and could be abolished by law...On many ships, even drinking water is grudgingly given, and on the steamer Staatendam, four years ago, we had literally to steal water for the steerage from the second cabin, and that of course at night. On many journeys, particularly on the SS Fürst Bismarck, of the Hamburg American Line, five years ago, the bread was absolutely uneatable, and was thrown into the water by the irate emigrants.

In providing better accommodations, the English steamship companies have always led; and while the discipline on board of ship is always stricter than on other lines, the care bestowed upon the emigrants is correspondingly greater.

"Steerage" in the health industry
"Steerage" is also a term sometimes used in relation to preferred provider agreements between service providers (such as hospitals or physician groups) and employers (or more generally, payors of health benefits). The service provider will agree to offer a discount on services in exchange for the employer/payor's promise that it will encourage its employees/members (patients) to use the provider's services. This encouragement is sometimes referred to as "direction" or "steerage" and is usually in the form of financial incentives like lower copayments or deductibles for the patients. Patients are told that they will receive a discounted rate if they use the preferred provider.