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The Blues: A History of the Blue Cross and Blue Shield System. By Robert Cunningham III and Robert M. Cunningham, Jr. DeKalb: Northern Illinois University Press, 1997. xiii + 313 pp. Photographs, glossary, notes, bibliography, and index. $36.00. ISBN 0875802249.
The late Robert M. Cunningham, Jr., and his son Robert Cunningham III have written a lively and surprisingly readable narrative history of the Blue Cross and Blue Shield health insurance system; it emphasizes the strategies of national leaders in the context of repeated shifts in social attitudes and public policies regarding health care. Sponsored by the Blue Cross and Blue Shield Association and intended for readers outside the insurance industry, The Blues explains the basics of the health insurance business as it goes along. The authors are fortunate to have a series of candid oral-history interviews that earlier writers had conducted as far back as 1954 with leaders such as Justin F. Kimball, C. Rufus Rorem, and Walter McNerney.
During the early twentieth century, American society invested heavily in new and larger hospitals, new technology, and the training of specialist physicians. But occupancy rates fell in the 1920s, and still more in the 1930s, as many patients found it hard to pay for acute-care hospitalization. Commercial insurance companies, wary of the problem of adverse selection (the danger that people at...