Health Care Organization models like Blue Cross and Blue Shield and Health Maintenance Organizations (HMOs) are among the many health care providers in the U.S. Ownership of the health care system is "mainly in private hands," but federal, state, county and city governments also offer health care facilities (Health, 2009, p. 1). A history of health care organization models since the 1920s, when doctors knew enough about illness to begin treating the sick reliably, shows that changes in models over time stem from economics and politics more to do with anything related to hospitals, doctors or patients. In fact, many of the changes in health care organizations since 1920 have occurred because former models were profitable. As Jonathan Cohn (2007) asserts, from the "Blues" to "HMOs" these organizations became "victims of their own success" (p. 3). As they became successful, private organizations attempted to displace them with newer models of health care organization.
Studying the history of Blue Cross and HMOs demonstrates Cohn's (2007) argument that successful health care organization models led to new models of organizations. For example, Blue Cross offered individuals low premiums and charged all insured the same price for premiums, receiving tax breaks from the government that kept costs low. Serving as what Cohn (2007) refers to "quasi-philanthropic" organization models of health care, all that changed when private insured invaded the market in the 1940s (p. 2). These private insurers charged different premiums based on calculated risk, while many large companies offered their own health care insurance that insured mainly the young. In order to survive, the Blues had to change suit to match private insurers. Government legislators helped the rise of private or corporate insurers by offering them the same income-tax exemption for health care related costs as they had the Blues.
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