BCBS Blue Cross and Blue Shield is a national association that manages about 70 independent health care plans. The association owns the rights to the Blue Cross and Blue Shield name, trademarks, and licenses them to members. These association members either directly or indirectly provide insurance benefits to over 100 million people (Blue Cross Blue Shield Association, 2012). In American there are 68 million people directly enrolled Blue Cross and Blue Shield insurance plans. There are an additional 34 million people served by Blue Cross and Blue Shield by means of the association's function as contractors for Medicare (FundingUniverse.com). Thus, the "Blues" (as Blue Cross and Blue Shield are commonly collectively referred to) represent the largest health care providers in the United States and also have subsidiaries in the UK, Canada, and Jamaica.

The Blues provide its subscribers with an array of different types of plans. All of the Blues insurance plans are managed separately by the prospective providers; however each plan must satisfy the overall standards that are listed by the association. Nearly 90% of the Blues subscribers are members of group insurance plans and the rest (a little over 10%) are enrolled in individual plans. About 16 million subscribers obtain their health care by way of Preferred Provider Organizations (PPOs) that allow the person to their choice of a physician or hospital, but also offer a more attractive benefit package if the person chooses a physician or hospital from those that are "preferred" by their plan (in the plan's network of providers). Another 5.5 million Blues subscribers in 42 states partake of Health Maintenance Organizations (HMOs; FundingUniverse.com).

In 1929 Dr. Justin Ford Kimball, at the time the vice-president of Baylor University's health care department, is credited with being the originator of Blue Cross [6wikki]. Kimball observed that there were a large number of unpaid university hospital bills credited to a large group of local school teachers. This vexed him and he decided to organize a plan for teachers where they would be covered for a three-week...

This first plan was very attractive to prepaying as little as 50 cents a month or about six dollars per year. The first group health plan was immediately in place as nearly 1,250 teachers enrolled once the plan was made available (Blue Cross Blue Shield Association, 2012).
This plan was so popular that it was extended to people from other vocations in the Dallas, Texas area and then Illinois and Iowa developed similar plans. However, these nascent programs followed the example of the original program in Dallas by offering their benefits at only one particular hospital. This was awkward for many and in the early part of the 1930s certain plans, especially in New York and California, began to spring up that allowed the subscribers more of a choice regarding hospitals that would accept their coverage. The name and symbol for Blue Cross was developed in 1934 and by the next year, 1935, 11 states had Blue Cross plans. That same year the American Hospital Association (AHA) adopted the symbol for Blue Cross as an emblem for plans that met certain qualifications and also created the Committee on Hospital Services to watch over the rising number of new Blue Cross programs that were being developed on a nationwide basis. By the year 1938, there were 38 different Blue Cross plans in the United States that accounted for 1.4 million subscribers compared to a nationwide enrollment of only about 100,000 people in other private insurance companies (FundingUniverse.com). In 1960 AHA authority was taken over by the Blue Cross Association and Blue Cross' affiliation with the AHA was dissolved in 1972 (Blue Cross Blue Shield Association, 2012).

The Blue Shield concept was developed separately. Lumber and mining companies in the Pacific Northwest had started to develop programs to pay physicians a monthly fee in exchange for providing their employees with health care services in the early part of the 20th Century with the first of the plans appearing in 1917 in Tacoma, Washington. These plans served…