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Drawing on extensive company archives, this first complete history of the Blue Cross and Blue Shield system tells the story of America's largest and oldest health care insurer, from its beginnings in the 1930s to the turbulent 1990s. Often regarded as uniquely American because of its grass-roots organization, the Blue Cross and Blue Shield system is a network of independent, locally operated insurance companies whose growth has fluctuated with broader economic, social, and political changes and with the national search for cost-effective health care.

Several states are virtually bankrupt, including California and New York, with others fast approaching that status. In Tragedies of Our Own Making, West Virginia Supreme Court Justice Richard Neely distills the insights of a lifetime spent dealing with our nation's worst social problems. "Twenty years as a judge", he writes, "has convinced me that state government fiscal crises, deteriorating schools, declining living standards among the old blue-collar class, and our rising crime rate are all strangely interrelated". His overriding conclusion? Problems including colossal Medicaid costs, savagery in the streets, and the falling relative wage rate of half our workforce all relate to a disintegrating family structure. All public agencies - welfare, the courts, public health, education - "are crumbling under the burden of acting as a surrogate family". In presenting a brilliant fiscal analysis of social insurance predicated on personal responsibility, Neely argues that "we are going broke because we are allowing excessive losses to be triggered through carelessness. Millions of children are being born to school-age girls and to parents who will needlessly divorce, making those children uncared for and insecure. Illegitimacy and divorce are to social insurance what leaving a pot of oil on a burning stove is to fire insurance". Neely paints a vivid picture of the "actuarial limits" of our ability to rescue people from the consequences of their own actions. He offers a two-part solution to the core problems of divorce and illegitimacy. First, Neely calls for a massive, government-financed media campaign aimed at educating the public on the financial and psychological costs of divorce toadults and children. He also presents a comprehensive and politically acceptable approach to improved birth control.

Blue Cross and Blue Shield Association - The Blue Cross and Blue Shield Association is the national trade organization that links 40 independent regional health insurance companies in the United States (including Puerto Rico) and Canada. Based in Chicago, Illinois, it was formed in the 1982 merger of the Blue Cross Association and the National Association of Blue Shield Plans.

Anthem (insurance) - Anthem was an insurance company which began in the 1980s as a spin-off of the group insurance operations of American General Insurance. From its move to a publicly-traded company in 2001 until its final merger in 2004, it merged the Blue Cross Blue Shield organizations of several states to achieve economy of scale, converting them in the process from non-profit to for-profit status.

California Insurance Equality Act - The California Insurance Equality Act (AB 2208) is a state law that requires California insurance providers and managed care plans (HMOs) to provide coverage for registered domestic partners that is equal to spousal coverage. The law complements California’s Domestic Partnership Rights and Responsibilities Act of 2003 (AB 205), which grants registered domestic partners most of the same rights and responsibilities under California law as belong to married couples.

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