Blue Cross

“To attract subscribers to the Blue Cross plans, the publicity had to accomplish two tasks: one, to make certain that the hospital, more precisely, the voluntary hospital, was defined by the public as the appropriate setting for the treatment of acute illness; the other, to persuade individuals that a group health insurance policy was a sound personal investment” (Rothman, 24). . . . By underscoring the unexpected character of health care needs and by emphasizing the notion that illness could strike anyone at any time, Blue Cross set out to create a level of anxiety great enough to attract subscribers without immobilizing or terrorizing them. Blue Cross messages also stressed how expensive hospital stays were, in a shrewd effort to force potential subscribers to calculate whether they would be able to afford the requisite services” (26). . . . Through the 1950s, New York Blue Cross rarely used a black model in its advertisements, in another effort to make certain that no one confused its members with those who went to public hospitals” (29). . . . But Blue Cross was never ready to open its membership ranks widely. In these years, the plans generally limited their enrollments to the employed . . . . its public presentation obfuscated the critical division between the employed and the indigent, posing the question of health care delivery as though the voluntary sector could satisfy all needs, and omitting consideration of those at the bottom of the economic ladder. Blue Cross did not take as its responsibility exposing the limitations of public hospitals or the number of citizens, young and old, who were unable to join a voluntary health program. . . These considerations might be thought to lie outside its purview, except for the fact that Blue Cross framed its mission as a test case for democracy. But it was a test case of a biased sort, casting the debate on health care exclusively in terms of how to serve middle-class Americans, with scant attention to the fate of others” (33, 34).